Summary of "The REAL Reason You Have Back Pain (we were lied to)"

Key Wellness Strategies, Self-Care Techniques, and Productivity Tips for Low Back Pain

Understanding the Problem

Low back pain is often misunderstood. Traditional physical therapy (PT) protocols focus on initial rehabilitation but miss critical long-term recovery and strengthening.

The low back can be described as S.H.I.T.:

Sensitive
Hidden imbalance
Incredibly weak
Tight

Many people, even with expert care, remain stuck in a cycle of reinjury because the spinal muscles themselves are not progressively strengthened.

Core Concepts and Training Methodologies

Core as a Barrel

The core includes:

Front muscles (six-pack abs)
Obliques
Transverse abdominis (deep core)
Diaphragm (ceiling)
Pelvic floor (floor)
Spinal muscles (spinal erectors, quadratus lumborum, multifidus, etc.) — often neglected in rehab

Traditional PT focuses on front and lateral core muscles but neglects the spinal muscles that attach directly to the spine, which are crucial for long-term back health.

Key Strategies for Managing and Improving Low Back Pain

1. Sensitivity (Desensitization)

Pain and muscle spasm are nervous system responses to vulnerability. Use graded exposure to build tolerance:

Back extension holds on a Roman chair or similar machine
Start with 3 sets of 10 reps or 30-second holds
Progress slowly from easier positions (higher pad placement) to harder (lower pad)
Goal: 2-minute holds without pain or spasm

Incorporate Trap 3 Raises for mid to upper back strength with very light weights, gradually increasing reps and sets.

Frequency: Train 2 times per week, progressing over 3–6 months.

2. Hidden Imbalance (Mobility & Posture)

Low back injury often causes compensatory imbalances such as hip hike, uneven pelvis, or SI joint pain.

Address hip and pelvic mobility with simple, effective exercises:

Split Squat Hold: Hold bottom position for 1 minute per side, focusing on hip mobility and glute activation.
Squat Hold: Hold deep squat position with heels elevated if needed to avoid lumbar rounding (butt wink) for 1 minute, 2 sets.

These exercises help restore symmetry and reduce compensatory strain on the back.

Frequency: Practice 2 times per week.

3. Incredibly Weak Low Back (Strengthening)

Most people don’t know how strong their low back is because it’s rarely tested or trained.

Test and build low back endurance with bodyweight back extensions:

Perform reps until muscle fatigue (aim for 30 slow, controlled reps as a goal)
Start with partial reps or assisted holds if needed
Progress to full range of motion with spinal flexion and extension

Achieving a “low back pump” (muscle fatigue and blood flow) is a positive sign of strengthening.

Strengthening these muscles protects the spine and reduces injury risk.

Recommended timeline: Minimum 6 months, progressing gradually.

4. Tightness (Symptom, Not the Cause)

Tightness is a protective muscle response to pain and lack of trust in the spine.

Avoid just stretching tight muscles repeatedly without strengthening.

Use a “squeeze then stretch” approach:

Strengthen tight muscles in their shortest range (e.g., outer glutes/internal rotators) to build blood flow and trust
Follow with gentle stretching to improve mobility

Example: Outer hip drop set — short-range isometric holds followed by stretching.

Avoid over-reliance on passive relief methods like deep stretching, twisting, or popping joints without muscle support.

Additional Tips and Philosophies

Avoidance and fear of movement prolong back pain; gradual exposure and strengthening build trust in the body.
Back pain recovery is a long-term journey (1–2 years or more), not a quick fix.
Focus on building evidence in your body that it can handle load and movement safely.
Resist “Band-Aid” solutions like painkillers, injections, or passive therapies without active strengthening.
Consistency and patience are key: even 5 seconds of back extension hold daily is progress.
Community support (e.g., lowbackability.com) can provide guidance and motivation.

Summary of Recommended Exercises and Protocol

Back Extension Holds: Start with 30 seconds, progress to 2 minutes, 3 sets, 2x/week
Trap 3 Raises: Light weights, 2 sets of 15 reps, 2x/week
Split Squat Hold: 1 minute per side, 2x/week
Squat Hold: 2 sets of 1 minute, heels elevated as needed, 2x/week
Bodyweight Back Extensions: Build up to 30 slow reps, gradually increasing range and reps
Outer Hip Drop Set: Strengthen short-range contraction, then stretch

Presenters / Sources

Brandon: Creator and presenter; formerly injured back sufferer, exercise science student, physical therapy tech
Jordan: Assistant/backstage support
Mention of experts like Stu McGill (physical therapy protocols referenced)

This summary distills the core advice from the video: low back pain is complex, often misunderstood, and requires a multi-faceted, long-term approach focusing on desensitization, mobility correction, direct spinal muscle strengthening, and rethinking the role of tightness.