According to the Global Burden of Disease Study 2021, back pain (BP) is a global health concern that affected 619 million people in 2020, and it is estimated to increase to a staggering 843 million cases by 2050 due to population expansion and aging (1). BP is not only a prevalent issue but also the single leading cause of disability worldwide, making back pain rehabilitation crucial for a significant portion of the population (2). BP can strike at any age, and most individuals will experience it at least once in their lifetime, with prevalence increasing with age and being more common in women (3).
People often exhibit intelligence and foresight when it comes to planning for their financial future, personal growth, and relationships. Unfortunately, there is a tendency to overlook or neglect similar strategic planning when it comes to their health. It's rare that we prioritize our health and create strategies for a more robust, resilient body that moves well, which, in turn, profoundly influences all internal systems. The pervasive influence of social media fitness influencers has added confusion, often promoting impractical solutions and ineffective rehabilitation strategies for back pain. In this article, we'll explore the realm of back pain rehabilitation and examine two well known approaches—Stuart McGill's "Back Mechanic" methods and Functional Patterns. Additionally, we'll explain some crucial factors that may be contributing to the degenerative aspects of back pain.
Back Pain Rehab and the Stuart McGill Approach
Stuart McGill, a renowned Canadian expert in spine biomechanics and back pain rehabilitation. McGill's work focuses on understanding spinal mechanics, with a specific emphasis on back pain, injury prevention, and rehabilitation. He is best known for his "Big 3" exercises for spinal stabilization, which include the curl-up, side plank, and bird dog exercise. These exercises aim to improve core strength and stability, with the goal of reducing back pain and enhancing overall function. His work has been widely adopted in the rehabilitation community. However, the effectiveness of these exercises in addressing the growing problem of back pain remains a topic of debate. A valid question arises: if these methods are as effective as they are often touted to be, why do back pain cases continue to rise, as evidenced by the projected increase to 843 million cases by 2050?
Rethinking Back Pain Rehab
In contrast, Functional Patterns, a movement system developed by Naudi Aguilar, offers a different perspective on back pain rehabilitation. It introduces the "Functional Patterns First Four" principles, encompassing standing, walking, running, and throwing. This system is designed to enhance these fundamental human movement patterns and posture, ultimately reducing the risk of injury and enhancing overall functionality. One commonality shared among all humans is the enduring pressure we bear while navigating this planet, from the crown of our heads to the soles of our feet. This is called longitudinal compression caused by gravity. People with back pain have a strained relationship with gravity which is where the root cause lies. Rather than focusing solely on alleviating pain through isolated exercises, Functional Patterns emphasizes decompression techniques that precisely integrate muscle chains in a way that enhances the function of the targeted muscle chain, resulting in an immediate carryover to more efficient movement. As one progresses through this type of training stimulus, the spine becomes more decompressed and stable while moving. The muscles of the back work in coordination with the rest of the body, suspending the spine within the muscle tissues. This allows the spine to bend, flex, extend, and rotate at the intended segments, avoiding the damaging effects of compression and shearing. This suspension and decompression while in motion results in a lifelong, robust, and resilient back free of pain.
Results speak for themselves. People from around the world are already experiencing the long-term benefits, as evident on the Functional Patterns web pages and FP Practitioners social media pages. Daily, you can witness practitioners worldwide achieving remarkable results and assisting individuals in reclaiming their lives. While Stuart McGill's approach focuses on the curl-up side plank, and bird dog exercise, Functional Patterns emphasizes a first principle’s approach, cutting through the uncertainties and focusing on what truly delivers results. A brief Google search will direct you to the evidence supporting this assertion.
Another important aspect of the ongoing dialogue about back pain rehabilitation is the evaluation of specific exercise regimens, such as Stuart McGill's "Big 3" exercises – the curl-up, side plank, and bird dog. Critics argue that the "Big 3" may not be universally effective for everyone. Some individuals find these exercises challenging or uncomfortable, raising concerns about their accessibility and adaptability across diverse populations. Moreover, the debate extends to the long-term effectiveness of these exercises in addressing the underlying factors of back pain, such as the adverse impact of gravity on posture, issues related to overstretching, structural imbalances, sedentary lifestyle, and obesity.
While acknowledging the contributions of established approaches, it's essential to remain open to ongoing discourse and evolving methodologies in the pursuit of effective back pain rehabilitation. The Functional Patterns 10-week online course represents the avenue which offers individuals an opportunity to explore alternative perspectives and strategies for achieving life lasting relief from back pain.
Transforming Spinal Degeneration into Spinal Regeneration through Natural Laws
An important question to consider when attempting to solve the riddle of back pain and its resolution is whether our body is conducive to the healing process. Our bodies undergo a natural process throughout the day, engaging in day-to-day activities and during sleep. The autonomic nervous system comprises two branches: the sympathetic and parasympathetic. The sympathetic branch governs the production of stress (catabolic) hormones in response to situations involving fight-or-flight or high stress. Contrarily, the parasympathetic branch oversees the production of regenerative (anabolic) hormones during periods of rest, digestion, and sleep.
When helping injured clients, practitioners often notice a substantial imbalance between the sympathetic and parasympathetic branches. In numerous instances, a client's environment tends to be more sympathetic dominant. It's important to understand that maintaining a constant state of stress, worry, or perpetual need for stimulation or distraction can hinder the parasympathetic branch, preventing the release of crucial hormones necessary for tissue repair. This obstruction ultimately impedes the recovery process from back pain.
The key to a lasting solution is initiating the journey toward cultivating a more parasympathetic-driven environment. While making these adjustments might require some time, the eventual benefits will far outweigh any initial discomfort experienced during the adaptation process. Let's take a look at Bruno's transformative journey of body regeneration. Low back pain had been a constant companion since adolescence, leading him to believe it was a normal part of life at 32 (left). Through Functional Patterns , he successfully banished both lower back pain and the lingering discomfort from a poorly recovered knee surgery. At 41 (right), he credits biomechanical corrections as pivotal, wiping away pain and unlocking the potential to discover the true capabilities of his body.
If this resonates with you, the Functional Patterns 10-week online course offers an ideal learning path that emphasizes "tuning into the boring" while following along through key MFR (myofascial Release) exercises during the initial phase. "Tune into the boring" is a concept introduced by Naudi Aguilar, signifying the ability to embrace stillness and boredom, allowing both your body and mind to settle. As you establish a more profound connection with your body, you'll gain insights into releasing constant tension in muscles that often remain sore, promoting relaxation. This initial phase lays the foundation for the second phase that follows, which concentrates on strengthening key postural muscles, including those in the deep abdomen and back. The third phase concentrates on strengthening major muscles of the torso, including the obliques, latissimus dorsi, and gluteal muscles, in a manner that improves standing, walking, and running. In simple terms, if your goal is to be able to walk, move, and effortlessly get off the floor as you age, the 10-week course is your golden ticket to start the journey of building a better relationship with gravity and live a pain free life.
Back pain stands as a pressing global health concern affecting millions, with projections estimating a significant rise in cases by 2050. Acknowledging its prevalence and impact on global disability, the exploration of effective rehabilitation becomes paramount. While Stuart McGill's "Big 3" exercises—curl-up, side plank, and bird dog—have been widely adopted by the back pain rehabilitation community, the persistent rise in back pain cases prompts critical evaluation and discussions about their universality. Functional Patterns, championing a first principles approach, presents a paradigm shift. Beyond debates, individuals globally are experiencing long-term benefits, showcased through transformative results. This perspective challenges uncertainties, prioritizing what truly delivers tangible outcomes.
Functional Patterns 10-week online course emerges as a dynamic avenue offering alternative perspectives and strategies for achieving lasting relief from back pain. It promotes the understanding of key factors contributing to spinal degeneration and the transformative potential of spinal regeneration through adherence to natural laws. The pivotal role of the autonomic nervous system in back pain recovery is highlighted, emphasizing the need to cultivate a more parasympathetic-driven environment. In essence, this article paints a path toward spinal regeneration, offering hope for a future free from the constraints of back pain, in harmony with the natural laws governing our bodies.
- GBD 2021 Low Back Pain Collaborators. Global, regional, and national burden of low back pain, 1990-2020, its attributable risk factors, and projections to 2050: a systematic analysis of the Global Burden of Disease Study 2021. Lancet Rheumatol 2023. https://pubmed.ncbi.nlm.nih.gov/37273833/
- GBD 2019: Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. https://vizhub.healthdata.org/gbd-results/.
- Global Health Group Data Exchange http://ghdx.healthdata.org/gbd-results-tool accessed Nov 15, 2020).