🚀 The Book in 3 Sentences

1. Most low back pain is caused by poor posture and prolonged periods of sitting.
2. Chronic low back pain can be self-managed through a series of exercises designed to correct a bulging or herniated disc caused by over-stretching of back ligaments.
3. A treatment plan can be designed based on your current pain level - and once the pain subsides you should regularly do maintenance exercises, along with conscious posture, to prevent future pain.

🎨 Impressions

This book changed how I approach the management of my chronic back pain of 4+ years. Within the first day of performing these exercises I started to feel pain relief.

I started to connect the dots from decades of poor posture from riding in buses/flying and general bad habits from office work - I saw that the cause of my back issues was from not being conscious about my posture and misattributing my pain to weight-lifting.

I went from being passive (i.e., just waiting for my next episode and resigning that only bed rest will cure it) to an active participant in managing my pain.

While I'm still early within the treatment plan, the early results are positive and I plan to adopt a more preventative approach to my posture and making lifestyle changes to stay pain free.

👤 Who Should Read It?

If you’re suffering from constant and recurring pain in your buttocks and down your leg (typically only on one side) caused by lower back pain (bulging or herniated disc), this is required reading. If nothing else, you'll learn more about why the causes of your pain and gather effective posture strategies.

If you haven't yet seen a physical therapist or doctor, and don't know for sure that your pain is caused by disc issues, go to your doctor first - then read this.

☘️ How the Book Changed Me

How my life / behavior / thoughts / ideas have changed as a result of reading the book.

• Pain Reduction: Reduced my back pain over the course of one day - as a result of the exercises in this book
• Mindset Shift: I changed how I view the pain and saw that I could take an active role in recovery - and speed it up to get back to the activities I enjoy faster
• Taking my Posture More Seriously: My idea of having proper posture has shifted from "eh, it's good to not sit for a long time" to "you need to maintain proper posture, no excuses"

✍️ My Top 3 Quotes

• N/A - this book is more of a "how-to" manual.

📒 Summary, Highlights, + Notes

Introduction

• McKenzie came across the method and exercises described in the book by chance - one of his patients were inadvertently propped up on a table and experienced much relief in his back pain
• The key was that the patient's pain "centralized" or moved up from his leg and more into his lower back - a good sign. If the pain can be centralized, there is a good chance the methods in the book can help you.

1. About the Problem

• Most people experience some type of back pain in their life - the problem is that when the initial pain goes away, people forget they had the pain and bad habits come back
• The main point of the book is that the management of back pain is the patient's responsibility - self-management of back pain is the most effective long-term strategy
• If it is your first time experiencing back pain, you should consult your doctor

2. The Low Back or Lumbar Spine

• Discs are special cartilages that separate the vertebrae in your lower back and are linked by a series of joints and soft tissues that form the lumbar spine
• In the lower part of the spine, there is a network of nerves on each side that form the left and right sciatic nerves - which travel down your legs to your feet. When these nerves are irritated (like from a disc disruption), you feel pain down your legs (often referred to as sciatica).
• When you are standing upright (in a good posture), lumbar lordosis (or the hollow in the low back) is naturally present. Lordosis is what you want in your back all the time, whether you are sitting or standing (good posture)
• When you lose lordosis, typically by slouching or from poor sitting posture, it causes over-stretching of your lower back ligaments and other surrounding soft tissues.
• After a lot of over-stretching, your discs bulge and become distorted - which creates painful pressure on the sciatic nerve.
• Once soft tissues are damaged, pain will be felt until healing is complete and function is restored.
• Pain is typically felt first in the lower back, then it moves down one side through your buttock and leg (sometimes reaching your foot)

The checklist and questions at the end of this chapter almost exactly described the pain I was feeling (worst in the morning, gets better during the day) and when I felt relief (walking, more active, better lying face down [after a while]) - pretty astonishing how accurate this was, and made me believe he knew what he was talking about.

3. Common Causes of Low Back Pain

• The most common cause of low back pain is postural stress - brought on by sitting for a long time in a poor position (the worst and most common culprit), prolonged bending in bad working position, heavy lifting, or standing (in a poor position, slouched).
• If you avoid prolonged over-stretching (poor posture), pain will not occur - you can correct your poor posture yourself

‍