Research digest — not medical advice. Full disclaimer · How we rate evidence
McGill Big 3
Stabilise the spine
Do NOT start this protocol if:
Loading an injured tissue without assessment can make things significantly worse. If any of these apply, see a physiotherapist or physician before starting.
- •Radicular pain (pain, numbness, or tingling radiating down a leg) — consult a physiotherapist or physician first. This may indicate disc involvement or nerve compression.
- •Red-flag symptoms: loss of bladder or bowel control, saddle anaesthesia, or progressive lower-limb weakness — seek emergency care immediately
- •Acute back injury within the last 72 hours — rest and ice first, load later
- •Known vertebral fracture, severe osteoporosis, or recent spinal surgery without clearance
When to see a physiotherapist
See a physiotherapist if you experience: pain that radiates down a limb, numbness or tingling, swelling that does not resolve within 72 hours of rest, or symptoms that worsen over 1–2 weeks of consistent protocol.
Overview
Core endurance protocol based on Dr. Stuart McGill's research. These are not ab exercises — the goal is spinal stiffness and endurance in the deep stabilisers. Pain-free movement comes from a stable spine, not a strong one. Best for non-specific mechanical low-back pain.
Equipment Needed
- •Floor mat (or carpeted floor)
Phases
Daily Spine Hygiene
Forever (lifelong maintenance)These three exercises build endurance in the deep spinal stabilisers without flexing or extending the spine under load. Do them daily, ideally in the morning once the discs have rehydrated overnight — McGill specifically recommends avoiding spinal flexion in the first hour after waking.
Goals
- →Pain-free movement in daily activities
- →Endurance (not strength) in the deep stabilisers
- →Long-term spinal resilience to recurrent pain flares
| Exercise | Sets | Reps | Hold | Frequency |
|---|---|---|---|---|
Modified Curl-Up Lie on your back. One knee bent, the other straight. Place your hands palms-down under the natural curve of your low back. Lift your head, shoulders, and upper chest slightly off the floor — just until the shoulder blades clear. Hold. Do not flatten your back into the floor. | 3×6-4-2 | Descending pyramid: 6, then 4, then 2 | 10 seconds per rep | Daily |
Side Plank On your side, on knees (easier) or feet (harder). Support on the elbow directly under the shoulder. Lift the hips to create a straight line from head to knee or foot. Keep the spine neutral — do not let the hips sag or pike. | 3×6-4-2 | Descending pyramid: 6, then 4, then 2 (each side) | 10 seconds per rep | Daily |
Bird Dog On all fours. Extend the opposite arm and opposite leg at the same time, until both are parallel to the floor. The goal is NOT moving the spine at all — a glass of water balanced on your low back should not spill. Return, switch sides. | 3×6-4-2 | Descending pyramid: 6, then 4, then 2 (each side) | 10 seconds per rep | Daily |
Sources
- •Core training: evidence translating to better performance and injury prevention — McGill SM (2010)
- •Low back disorders: evidence-based prevention and rehabilitation (3rd ed.) — McGill SM (2015)
- •Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with chronic non-specific low back pain — Bagheri R, Takamjani IE, Dadgoo M, et al. (2018)
Last updated: 2026-04-10
Sidebar
Medical Disclaimer
This is a research summary, not medical advice. Body Signals is an independent research digest — it summarises published research for informational purposes and is not a healthcare provider. Stop immediately if pain increases, radiates, or persists beyond the session. Seek a physiotherapist for acute injuries, swelling, numbness, tingling, or symptoms that worsen over 1–2 weeks of consistent protocol. Movement-based rehab should gradually reduce pain, not cause it. In an emergency, call 911.
Need hands-on guidance?
A physiotherapist can tailor this programme to your injury severity, mobility level, and recovery goals.
Find a physiotherapist near you