Interview: Dr. Stuart McGill


Insights Interview: Sailing, Chainsaws, and Tissue Tolerance

AC:
Dr. Stuart McGill a name that will inevitably live on forever as being one of the most influential researchers of spinal biomechanics and its applications.  Dr. McGill has shaped my understanding of the lumbar spine in a way the scholastic system (at that time) couldn’t. Moreover, he helped me of ongoing lumbar pain though simple instruction and habit changing (avoiding repeated flexion during the treating of my patients). Really there aren’t enough words to say regarding this man and the impact he has made and will continue to make on humanity. Thanks Dr. McGill for your excellence in both work ethic and on a personal level. Your hospitality to my questions is much appreciated.
AC:
Spinal biomechanics isn’t something the typical college matriculate would say they want to study. Dr. McGill please explain how you became so interested in spinal biomechanics.
SM:
A series of chance events. I was starting my PhD in Systems Engineering and
met a professor who was just starting spine research and I switched to his lab. His name was Bob Norman. He was a mentor to me in many components of life.

AC:
When I was watching your first DVD I noticed you had a boat. It looks like a pretty nice boat. Is that one of your hobbies?
SM:
I love to sail and that sequence was on a trip where we chartered a boat in the
Virgin islands. I built a small wooden boat last winter and currently have a canoe under construction.

AC:
Moving into academia now, your research has sparked more controversy in health and fitness than personally anyone else I have read (and I read a lot). Extremes will always exist but what do you think people are missing when you come under fire regarding topics such as lumbar flexion during movement and exercise?
SM:
Several principles but here are a couple.
Tissues have a finite number of cycles of load, and particularly bending under load, until they break.
Bone, muscle adapt but discs accumulate fatigue loading. So it is important to use the number of bends wisely. Further, with so many people spending so much time sitting, bending the discs uses up even more capacity. There is usually little need to train more bending. Also posture – posture determines a tissues ability to survive load and usually flexion reduces disc strength. Choice of exercise is also so important to spare the spine – optimal choice allows a greater volume of training pain-free. Removing the cause of the offending motion/posture/load as well is a major key.


AC:
Considering this, how do you deal with people who criticize your work?
SM:
Most of it I have to ignore as they rarely have a full understanding. They may
pick on one facet of our work not realizing that we have done work on spine tissues, back pain patients, athletes and use virtually all imaging and diagnostic techniques. We have several hundred scientific publications. For example this past weekend I was at a conference and one delegate stated that our work on TvA used surface electrodes and was not valid (only intramuscular electrodes are valid). I suppose he had read only one of our papers. I had to point out that had he read our complete work I was one of the first people in the world to have intramuscular electrodes implanted into my TvA and many other deep spine muscles too. This was published years ago. But having stated that sometimes their criticism is correct.

AC:
When you work on patients clinically do you ever have those patients who just don’t follow through with treatment or fail to improve? If you do, how do you personally deal with that?
SM:
First I don’t see the average painful back – only those who have failed to get
better after seeing several other clinicians. So these are the difficult patients and that is our specialty. So, Yes I have patients who fail. We then try a different approach to see if we can get some improvement. But if they have better and worse days we rarely fail to find out the mechanisms that cause this and
from there we help to create more pain-free days. Then we try to modify the progression to keep building more success. As well, people have to pay out of their pockets to see me – that motivates them I think. Yet there are still those who don’t follow through which is their choice. And any clinical failure bothers me. And then there is the category of those who may have substantial pathology and I fail. They may have had several surgeries and they have little tissue left that is able to bear load or they may have been hit by a bus.

AC:
I have to ask this one. When was the last time you hurt your back?
SM:
I fell on ice this past winter and really cracked my pelvis – it took a while to get
over that one.

AC:
Where do you see the future of spinal biomechanics? Whats exciting you at the moment?
SM:
Several avenues: developing more provocative tests to detect the painful tissues
and learn more ways to remove the offending mechanism and pain. Learning the mechanisms that great athletes employ to enhance performance and perfecting more physical based treatments.

AC:
In your book there was a picture of you working with the wonderful Dr. Vladimir Janda. Which leads me to ask, who has influenced you?
SM:
Virtually all of the great experts: Janda, Sahrmann, Skaggs, Erhard, Kirkaldy-Willis, Farfan, Bogduk, to name just a few together with some of the great training pioneers: Siff, Santana, Kazmaier, and many other great coaches.

AC:
Lastly and probably the most personal. Whats something not many people know regarding your life?
SM:
I try to do heavy physical labour every day – my favorite tools are a chain saw and a heavy splitting maul. It is good therapy.

============================================
Dr. Stuart M. McGill is a professor of spine biomechanics at the University of Waterloo (Waterloo, ON, Canada). His advice is often sought by governments, corporations, legal experts and elite athletes and teams from around the world. Difficult back cases are regularly referred to him for consultation. Dr. McGill’s research at the Spine Biomechanics Laboratory has three objectives: to understand how the low back functions; to understand how it becomes injured; and, knowing this, formulate and investigate hypotheses related to prevention of injury and optimal rehabilitation of the injured back, and ultimate performance of the athletic back.

They have two separate laboratory approaches – one which examines intact humans which utilizes a rather unique approach that monitors spine motion and body segment position, muscle activation, ligament involvement and modelling tissue loading in each individual subject; and a second approach where they examine the mechanical behaviour of low back tissues and spine specimens. His graduate students have been involved in several issues such as investigating the load tolerance of the spine under various types of load, assessment of spine stability, examination of devices such as abdominal belts, examination of various injury mechanisms and determining the safest methods of achieving performance in the back, to name a few.
This work has been recognized with many awards including the R. Tait McKenzie Award 2005, the CSB Career Award 2004, the Stow visiting lectureship from the Ohio State University College of Medicine 2002, the Steven Rose Lectureship from the Washington University School of Medicine 2001, to name a few.

http://www.backfitpro.com/

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About doctoranthony
As a spinal rehabilitation specialist with over 7 years clinical experience in the areas of - Spinal Manipulative Therapy, Active & Passive Spinal Rehabilitation, Functional Movement and Orthopedic Assessment, Strength and Conditioning Coaching, Fitness Programming, Business Development, Cognitive Behavioral Therapy, Motivational Interviewing and Consultancy - you can feel safe knowing that I understand the worry and concern surrounding spinal pain. This is why self-efficacy lies at the heart of my practice. For more info: nz.linkedin.com/in/anthonyclose

3 Responses to Interview: Dr. Stuart McGill

  1. Pingback: Good Reads for the Week « Bret's Blog

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