McGill's Big 3

IonRod

Level 5 Valued Member
The discussion over what is bad and good form is quite interesting. Where is the line between good and bad form? How much flexion is unsafe? How do we know this?

My favorite example is not Konstantinovs deadlifts, but a simple exercise that is loved by weightlifters and by many SFGs as I observed - the Jefferson Curl. Which one is more dangerous, deadlift or Jefferson? Which one causes higher injury rates? Where is that line of safety that turns a dangerous deadlift into a safe Jefferson Curl? I will make a bold statement that such line does not exist. You cannot lift as much weight with a JC as you can with a competition style DL. The mechanics of the JC are just not beneficial to lifting large weight. So we simply don't load the JC the same way we do the DL and we call that lift safe. Not because the spine is not flexed - it's even moving under flexion (gasp)! But because we trust that the lifter loads it properly and incrementally. This is why I believe that when we talk about unsafe position, we really only mean unsafe load.

The only thing that is dangerous about a flexed spine in the deadlift is if it never happened before. Then the muscles that have not gone through the usual adaptation process would suddenly experience a load they did not carry before. That creates a dangerous overload. But if this flexed position was loaded incrementally, muscle adaptations occured and it does not prevent the lifter from increasing their performance, then who are we to say it is "bad form"?
 

Anna C

Level 9 Valued Member
Elite Certified Instructor
Finally, there is a biomechanical reason to suspect that poor form could transfer an enormous moment force onto a muscle mass that is not prepared to accept it
Then the muscles that have not gone through the usual adaptation process would suddenly experience a load they did not carry before. That creates a dangerous overload.
I think you're both saying a similar thing here, and it's a really interesting point. It further specifies how "poor form" might cause injury. Unloaded or lightly loaded poor form in any circumstance --- probably no issue. Less than optimum form trained and progressed upward with heavier loads --- probably no issue. But but a sudden deviation from the form that one has trained, during a heavily loaded movement --- issue. This could be from mis-grooving a lift or some unexpected input to the scenario. It could also occur from bad programming or mis-management of session fatigue. Certain muscle groups don't do their job, and the same sort of thing occurs as the force is transferred to an undesirable or unprepared part of the body. In that case, would it be a "form" problem? Seems to me it could be seen that way...
 

Steve Freides

Staff
Senior Certified Instructor
Elite Certified Instructor
The only thing that is dangerous about a flexed spine in the deadlift is if it never happened before.
I strongly disagree, to the point that I consider this advice to be irresponsible. A flexed lumbar in the deadlift may allow a lifter to move up to a certain weight before resulting in injury once a heavy enough weight is used.

Let us please not give medical advice here in any form, nor state with certainty that we know what does and does not present a risk for spinal injury. I don't mean to sound overly harsh but this thread is filled with overly broad generalizations.

This is why I believe that when we talk about unsafe position, we really only mean unsafe load.
This is an example of what I mean. There are many trainees at various points in their development for whom certain positions can be described as unsafe and for a wide variety of reasons. Some people can put their back out getting up from the sofa but we don't characterize getting up from the sofa as either an unsafe position or an unsafe load. Load is not the only relevant variable and neither is position.

There are more things at issue here than just those being discussed so far in this thread. I am going to ask that we treat Dr. McGill with respect, understand that his recommendations have worked for many people and that he is, without a doubt, and expert and a very valuable resources. The best sources of deadlift instruction as far as StrongFirst is concerned are our courses and certifications. In-person feedback from an experienced lifter and teacher - that is what everyone wishing to deadlift should seek out.

It's not a problem to relate one's personal experiences here, including those that seem to go against Dr. McGill's recommendations, but let's refrain from over-generalizing our individual approaches.

If you want to learn how to safely and effectively perform a Jefferson curl, attend StrongFirst Resilient. If you want to learn how to deadlift safely and effectively, attend our course or our cert or work with one of our certified instructors in person.

-S-
 

Al Ciampa

Level 8 Valued Member
Certified Instructor
I strongly disagree, to the point that I consider this advice to be irresponsible. A flexed lumbar in the deadlift may allow a lifter to move up to a certain weight before resulting in injury once a heavy enough weight is used.

Let us please not give medical advice here in any form, nor state with certainty that we know what does and does not present a risk for spinal injury. I don't mean to sound overly harsh but this thread is filled with overly broad generalizations.


This is an example of what I mean. There are many trainees at various points in their development for whom certain positions can be described as unsafe and for a wide variety of reasons. Some people can put their back out getting up from the sofa but we don't characterize getting up from the sofa as either an unsafe position or an unsafe load. Load is not the only relevant variable and neither is position.

There are more things at issue here than just those being discussed so far in this thread. I am going to ask that we treat Dr. McGill with respect, understand that his recommendations have worked for many people and that he is, without a doubt, and expert and a very valuable resources. The best sources of deadlift instruction as far as StrongFirst is concerned are our courses and certifications. In-person feedback from an experienced lifter and teacher - that is what everyone wishing to deadlift should seek out.

It's not a problem to relate one's personal experiences here, including those that seem to go against Dr. McGill's recommendations, but let's refrain from over-generalizing our individual approaches.

If you want to learn how to safely and effectively perform a Jefferson curl, attend StrongFirst Resilient. If you want to learn how to deadlift safely and effectively, attend our course or our cert or work with one of our certified instructors in person.

-S-
I might make the point that Steve and I (and a few others) have come back from downright debilitating back conditions.

I don’t discount anything discussed here, but I also agree with Steve.
 

IonRod

Level 5 Valued Member
Let us please not give medical advice here in any form, nor state with certainty that we know what does and does not present a risk for spinal injury. I don't mean to sound overly harsh but this thread is filled with overly broad generalizations.
My sentiment was exactly this - nobody actually knows what causes injury during training. Pain symptomatics are extremely complex and involve much more than just biomechanics.
I also agree with the examples of people who throw their back out from moving on a sofa or sneezing sometimes. Nobody tries to coach a proper form for sneezing and I hope nobody actually believes that the flexion from the sneeze is an explanation for the injury. However, if that same person threw their back out during a deadlift set, there would be immediate desire by many people to point at something wrong in their setup or lift and proclaim: "See, this is bad form and it produced injury"
I strongly disagree, to the point that I consider this advice to be irresponsible. A flexed lumbar in the deadlift may allow a lifter to move up to a certain weight before resulting in injury once a heavy enough weight is used.
And the same applies to a neutral spine as evidenced by cases when experienced lifters would tweak their backs even though they were not flexing the spine.
This is why I was arguing against phrases like "bad form" in the context of injury. Especially considering how it may adversely affect the lifter's expectation and perception of pain. This is not the same as advocating to not care about form at all. Form is very important as it establishes consistancy and effeciency in training as well as produces desired adaptations.
 

Steve Freides

Staff
Senior Certified Instructor
Elite Certified Instructor
@IonRod, Robin McKenzie, in "Treat Your Own Back," discusses the injury mechanism from getting up from the sofa. It's an excellent resource for anyone with back issues and for trainers. McKenzie was a physical therapist from New Zealand.

-S-
 

dc

Level 6 Valued Member
20yrs ago I herniated my l4 & l5 discs, the l5 actually ruptured. I also fractured the vertebrae in between. I just want to take the time to thank the StrongFirst forum & especially Steve for introducing me to McGills & McKenzie’s work. Truly changed my life & the lives of other people with devastating back injuries that I know personally who I can proudly say I inspire to do & be better.
Thank you
 

rickyw

Level 7 Valued Member
Interesting discussion here. Clearly we all interpret pain differently, but the absence of pain is not a guarantee that tissue damage is not occurring. Nor, (as has been pointed out in cases of allodynia especially) does the perception of pain necessarily mean that tissue damage is occurring.

Bill Been shared the story of the man who almost stuck a nail into his foot, but didn't. I've read of a similar but different case where a Korean man went to see the doctor with a "headache" (which he had for 4 years), and they pulled a sizable nail out of his head. This illustrates in a drastic way how differently people perceive pain.

I've been through many hours of pain science literature for continuing education. It is interesting for sure. I use it a lot to downplay the changes seen on MRI/imaging when those symptoms do not correlate with clinical examination. I try and make my examination very thorough and work to place my finger on what is causing a person's pain. There are many reasons for pain: hypomobility, postures, poor movement patterns, weakness, etc. Especially with the low back, it takes evaluation of the hip joints, the pelvic girdle, the lumbar spine, and the thoracic spine, at the very least, and the exam may need to go further depending. These exams take time.

To simplify pain by saying it is just central sensitization, or it's in the patient's head, does a disservice to the patient. It's also a great way for clinicians to rationalize away their inability to help a patient. That is the danger of the biopsychosocial model. But, there are people whose pain is more than just mechanical. I often send them for a thorough work up by an internist to look for possible systemic factors that contribute. Poor mental health can be associated with pain in my experience, but how much is mental health influenced by overall systemic and endocrinal health? I think it is, quite a bit. Lifestyle and stress levels are also factors. Melzack's neuromatrix illustrates the many factors that influence pain.

There is a reason we have nociceptive fibers: they communicate danger/damage to tissue. To say that "so and so can deadlift with a rounded spine and is okay so form doesn't matter for the rest of us" is as Steve Friedes said, an over generalization. There is a reason I see (and thousands of other clinicians as well) patients who have hurt their backs with flexion based activities. It is because in the majority of us it tends to eventually damage tissue.

In regards to McGill's Big 3 causing pain. I often wonder if people are doing them right. There are little nuances to them that are important.

Stuart McGill is all about finding the pain trigger, eliminating it, and replacing it with pain free movement. As has been pointed out, this does involve cooling off a sensitized nervous system by avoiding pain triggers. It's truly a simple thing in a way. He approaches it very much from a mechanical angle because he has been able to show mechanically what damage is occurring in the low back and how that correlates with their pain clinically. When people criticize Dr. McGill, I often wonder how much of his work they are truly familiar with? It's hard to argue against his exceptional results.

I'm on a runaway train here. Great discussion.
 
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