The method you learn is one that I've learned personally from the world's leading expert in spine biomechanics, Dr. Stuart McGill.

你所學到的方法是我從世界頂尖脊柱生物力學專家斯圖爾特-麥吉爾博士那裡親自學到的。

Now before we get into the corrective exercises, we first need to understand how you got here in the first place.

現在，在開始糾正練習之前，我們首先要了解你是如何走到這一步的。

Your spine is biologically and architecturally different than any other joint in your entire body, and therefore functions and operates under a different set of rules.

脊柱在生物學和建築學上與全身任何其他關節都不同，是以其功能和運作規則也不同。

For example, your hip and shoulders are ball and socket joints, designed to create a lot of movement and power.

例如，您的髖關節和肩關節是球窩關節，設計用於產生大量運動和力量。

Your spine is not comprised of ball and socket joints, but instead 33 individual bones stacked on top of each other, each separated by a disc.

您的脊柱不是由球窩關節組成，而是由 33 塊骨頭疊加而成，每塊骨頭之間由椎間盤隔開。

The disc has an outer section, called the annulus, which is composed of multiple fibrous rings similar to the layers of an onion that are connected and function like a strong fabric.

椎間盤的外層稱為椎環，由多個纖維環組成，就像洋蔥的表層，這些纖維環相互連接，就像一塊堅固的織物。

Inside the annulus is a gel-like nucleus, which is pressurized to a high degree as you move and perform daily tasks.

瓣環內部是一個凝膠狀的瓣核，在您移動和執行日常任務時，瓣核會受到很大的壓力。

Your discs allow the spine to act as a very flexible rod, giving us the ability to bend over and tie our shoes, twist to swing a golf club, and perform the latest dance craze.

您的椎間盤讓脊柱像一根非常靈活的杆子，讓我們能夠彎腰繫鞋帶、扭腰揮舞高爾夫球杆以及表演最新的舞蹈熱潮。

They also act like shock absorbers when carrying or moving loads.

在承載或移動負載時，它們還能起到減震器的作用。

Now our spine is at its strongest and most resilient to injury when it assumes its natural curvature when we lift weights with good posture, called neutral.

現在，當我們以良好的姿勢舉重時，我們的脊柱會呈現出自然的弧度，也就是所謂的中立態，這時的脊柱是最強壯的，也是最容易受傷的。

Research has consistently demonstrated a neutral spine spreads load evenly across the spinal structures, preventing excessive stress concentrations on any one part of the spine.

研究一致表明，中性脊柱能將負荷均勻地分散到脊柱結構中，防止脊柱的任何一個部位過度受力。

Now to keep our extremely flexible spine from buckling when lifting, all of the muscles that surround the spine work together like a guy wire system to a radio tower to create stiffness and stability.

現在，為了使我們極其靈活的脊柱在舉重時不發生彎曲，脊柱周圍的所有肌肉就像無線電塔的吊線系統一樣共同作用，以產生剛度和穩定性。

So while a good looking set of abs may look great in the mirror, the primary purpose of your core muscles is to actually help you better control and stop excessive spine motion.

是以，雖然從鏡子裡看一組漂亮的腹肌可能很不錯，但核心肌肉的主要作用實際上是幫助你更好地控制和阻止過度的脊柱運動。

Here's an example.

這裡有一個例子。

This person is lifting by moving about his hips while his back remains in a relative neutral position.

這個人通過移動臀部進行抬舉，而背部則保持相對中立的姿勢。

This hip-centric motion, called a hinge, decreases injury risk when lifting loads.

這種以髖關節為中心的運動被稱為 "鉸鏈"，可以降低舉重時受傷的風險。

However, if he flexed his back while lifting, the spinal disc is bent, creating large posterior stresses on the inner nucleus.

但是，如果他在舉重時屈曲背部，椎間盤就會彎曲，從而對內核產生較大的後應力。

If this poor lifting technique is repeated enough, the combination of compressive load and spine movement creates shearing loads on the disc that will eventually cause the ring-like layers of the annulus to loosen, a process called delamination.

如果這種拙劣的移位技術反覆出現，壓縮負荷和脊柱運動的結合就會對椎間盤產生剪切負荷，最終導致椎間盤環狀層鬆動，這一過程被稱為分層。

Similar to how the fibers of your shirt would unravel and open up a bit if stressed back and forth enough, this creates a pathway for the pressurized nucleus to now push through.

這就好比衣服的纖維如果受到足夠大的壓力，就會鬆開並張開一些，這就為加壓的原子核創造了一條通道。

And this is how a disc bulge is eventually formed.

椎間盤突出就是這樣最終形成的。

Now this is just one of the many types of back pain that I see amongst my patients as a doctor of physical therapy, and rest assured, the exercises I show you later in this video can very likely help you too, but only if you don't skip this crucial step.

現在，這只是我作為物理治療醫生在病人中看到的眾多背痛類型之一，請放心，我在本視頻稍後向你展示的練習也很可能對你有所幫助，但前提是你不能跳過這一關鍵步驟。

You see, the truth is that most people would see dramatic improvements in their back pain recovery if they realized it was the way in which they were moving during their day that was actually causing their symptoms.

事實上，如果大多數人意識到是自己日常的運動方式導致了背痛症狀，那麼他們的背痛恢復情況就會大為改觀。

Today, I'm going to take you through five different tests and screens to help you find the movements that are triggering your symptoms.

今天，我將帶您進行五種不同的測試和篩查，幫助您找到引發症狀的運動。

Based on what we find, I'll then offer you some different ideas for ways in which you can move throughout your day without pain.

根據我們的發現，我將為您提供一些不同的方法，讓您在一天的活動中都不會感到疼痛。

To start, if your pain is worse when sitting slouched and pulling up on the underside of a chair, or with bending movements and lifts like picking up objects from the ground, or especially deadlifting, your pain can be categorized as a flexion intolerance, often due to a disc bulge or herniation.

首先，如果你在懶散地坐著和拉椅子底部時疼痛加劇，或者在做彎腰動作和舉起地上的物品等動作時疼痛加劇，尤其是在舉重時，那麼你的疼痛可以歸類為屈曲不耐受，通常是由於椎間盤突出或椎間盤突出症引起的。

If this sounds familiar, you need to learn how to avoid spine flexion when sitting by using some support for your low back and with bending tasks by hinging about your hips.

如果這聽起來很熟悉，那麼你就需要學習如何在坐著時避免脊柱彎曲，方法是在腰部使用一些支撐物，以及在彎腰時通過臀部彎曲來避免脊柱彎曲。

The most simple way to learn how to hinge is with the short stop squat.

學習如何鉸鏈的最簡單方法是短停深蹲。

Push your hands into your thigh and simultaneously push your butt back as you slide your hands down to the top of your knees.

雙手推向大腿，同時臀部向後用力，雙手向下滑動至膝蓋上方。

The act of pressing your hands into your thigh creates sufficient core stiffness to help eliminate excessive spine bending, allowing you to move about your hips as you bend forward.

將手按在大腿上的動作可以產生足夠的核心硬度，幫助消除脊柱過度彎曲，讓你在向前彎腰時可以活動臀部。

Use this with everyday tasks like unloading your dishwasher, and you'll notice that your pain starts to eventually wind down.

在卸洗碗機等日常工作中使用這個方法，你會發現疼痛感最終會逐漸減輕。

If you need to pick up something heavier from the ground, use this short stop squat, and then drop your hips straight down, grab the object, stick in your core, and stand straight up.

如果你需要從地上撿起較重的東西，可以採用這種短距離停止下蹲的方法，然後臀部直直地向下，抓住物體，堅持你的核心，然後直直地站起來。

The same goes for reversing a heavy object back to the ground.

將重物倒回地面也是同樣的道理。

Hinge at the hips, and then squat.

臀部鉸鏈，然後下蹲。

If you're going to pick up a very light object off the ground, think about moving like a golfer picking up their ball, by taking one leg back and hinging forward on one leg.

如果你要從地上拾起一個很輕的物體，可以考慮像高爾夫球手撿球一樣，一條腿向後，一條腿向前。

You can also try kneeling.

您還可以嘗試跪姿。

Both options will help concentrate movement about your hips while minimizing triggering spine flexion.

這兩種方法都有助於將運動集中在臀部，同時儘量減少引發脊柱彎曲。

Now some with a flexion intolerance find benefit from lying on their stomach to relieve pain.

現在，一些患有屈曲不耐受症的人發現平躺能緩解疼痛。

If laying like this for 3 minutes reduces your symptoms when you stand back up, I'd recommend performing this a few times a day when you need some relief.

如果像這樣躺 3 分鐘能減輕你站起來時的症狀，我建議你每天在需要緩解症狀時多做幾次。

If however you find lying on your stomach, arching backwards, or creating an anterior pelvic tilt causes pain, you may be dealing with an extension intolerance due to a facet joint irritation or spondylolisthesis, an injury where one vertebrae begins to slip forward on another.

然而，如果你發現平躺、向後拱起或骨盆前傾會導致疼痛，那麼你可能是由於面關節受刺激或脊椎滑脫（一種椎骨開始在另一椎骨上向前滑動的損傷）導致的伸展不耐受。

Extension intolerances are common for gymnasts, cricket bowlers, and those in the gym who overarch their low backs when performing certain lifts.

體操運動員、板球保齡球運動員以及在健身房做某些舉重動作時腰部過高的人都會出現伸展不耐受的情況。

In this situation, learning to maintain a braced neutral spine with the cue ribs down will help you avoid this pain trigger.

在這種情況下，學會在肋骨下垂的情況下保持脊柱支撐中立，就能幫助你避免這種疼痛的誘因。

Next, let's see how you respond to dynamic loading such as running, jumping, or even the olympic lifts.

接下來，讓我們看看你對動態負荷的反應，如跑步、跳躍，甚至奧林匹克舉重。

Raise up onto your toes, and then drop quickly onto your heels.

抬起腳尖，然後迅速落到腳跟上。

You may feel a shockwave of load shoot up your body.

你可能會感到一股衝擊波湧上你的身體。

Notice this created pain.

請注意，這造成了痛苦。

When you drop onto your heels quickly like that, you create spine compression.

當你像這樣快速落到腳跟上時，就會造成脊柱壓縮。

But when someone has pain with this test, sometimes it's because their vertebrae will slide a bit, unevenly loading the disc and the facet joints on one side of the body.

但如果有人在做這項測試時感到疼痛，有時是因為他們的椎骨會滑動一下，使身體一側的椎間盤和椎面關節受力不均。

If this sounds like you, brace your core like this.

如果這聽起來像你的聲音，請像這樣支撐你的核心。

Stick your fingers into the sides of your stomach, then activate your abs in a way that pushes your fingers away.

將手指伸入腹部兩側，然後激活腹肌，將手指推開。

Then keep this stiffness engaged as you perform the test again.

然後在再次進行測試時保持這種硬度。

If your pain decreased, you just proved to yourself that enhanced core stability will help you minimize spine instability and help you reduce your symptoms moving forward.

如果你的疼痛減輕了，你就證明了增強核心穩定性將幫助你最大限度地減少脊柱的不穩定性，並幫助你減輕今後的症狀。

If your pain was however worse with bracing, you're likely dealing with a compressive injury to the thin layer of material that separates the disc and vertebral bones called the end plate.

如果在使用支撐架後疼痛加劇，則很可能是椎間盤和椎骨之間的薄層材料（稱為終板）受到了擠壓損傷。

We see this sometimes with powerlifters who don't allow adequate rest between sessions to allow for appropriate adaptations.

我們有時會在力量舉運動員身上看到這種情況，他們在兩次訓練之間沒有足夠的休息時間來進行適當的適應訓練。

If this is you, it would be a good idea to take a big step back from lifting at this time to allow your body to heal.

如果你是這樣的人，最好在這個時候從舉重運動中退出一大步，讓你的身體得到康復。

Next, try holding a light weight out in front of you at arm's length while you take a few deep breaths in and out.

接下來，試著將一個輕的重物放在面前，與手臂等長，同時深呼吸幾次。

If this sparks pain, try that abdominal bracing strategy again and see if that changes your symptoms.

如果這引發了疼痛，請再次嘗試腹部支撐策略，看看是否能改變症狀。

If your pain is reduced, you again proved that enhancing core stability will be helpful for controlling your pain and you need to think about that bracing strategy in the same way when you do simple tasks during your day like picking up a cooler from the ground.

如果你的疼痛減輕了，那麼你再次證明，增強核心穩定性將有助於控制你的疼痛，當你在一天中做一些簡單的工作時，比如從地上撿起一個冷藏箱，你需要以同樣的方式考慮這種支撐策略。

If however your pain is still present, your injury is very load intolerant and you need to consider postponing your lifting workouts at this moment and having someone else help you with daily lifting tasks until your back can further heal.

但是，如果你的疼痛仍然存在，說明你的傷勢非常不耐受負荷，此時你需要考慮延後提舉鍛鍊，並讓其他人幫助你完成日常提舉任務，直到你的背部進一步痊癒。

Last, if your pain is present when sneezing or rolling over in bed, you may be dealing with an instability.

最後，如果打噴嚏或在床上翻身時出現疼痛，則可能是身體不穩定。

In this case, bracing strategies such as pushing into a countertop before sneezing or making sure that you're rolling your entire body as one unit when turning over in bed will be key for preventing painful micro movements.

在這種情況下，採取一些支撐策略，比如在打噴嚏前推一下臺面，或者在床上翻身時確保整個身體滾動成一個整體，將是防止微小運動造成疼痛的關鍵。

It would also be wise to avoid chiropractic manipulation in this case as you already have too much motion at certain joints.

在這種情況下，避免脊椎按摩也是明智之舉，因為你的某些關節已經活動過多了。

Now I can't stress how important it is to perform these types of tests when you have back pain or any type of injury.

現在，我再三強調，當你背部疼痛或受到任何類型的傷害時，進行這類測試是多麼重要。

That's why I wrote my book Rebuilding Milo.

這就是我撰寫《重建米洛》一書的原因。

It contains all of these tests and more to help you fix your back pain along with other common injuries.

它包含所有這些測試和更多內容，幫助您解決背痛和其他常見損傷。

So when this video is done, go head on over to Amazon.com and pick up a copy of my book Rebuilding Milo.

視頻播放完畢後，請前往亞馬遜網站購買我的新書《重建米洛》。

But for now, let's continue.

但現在，讓我們繼續。

Some of you may find your symptoms fall into more than one category.

有些人可能會發現自己的症狀不止一種。

That's not abnormal.

這並不反常。

In these situations, it's key to try to maintain a neutral spinal posture throughout your day and move about your hips to help your symptoms wind down.

在這種情況下，關鍵是要在一天中儘量保持中立的脊柱姿勢，並活動一下臀部，以幫助症狀緩解。

Our next step to fixing back pain is to enhance spine stability with the McGillVic 3 routine.

我們治療背痛的下一步是通過 McGillVic 3 程序來增強脊柱的穩定性。

The modified curl up is the first exercise.

第一個練習是改良式捲髮。

Start by lying on your back with one knee bent and one leg relaxed on the ground.

首先仰臥，單膝彎曲，一條腿放鬆放在地上。

Have one hand under your back to support the spine.

一隻手放在背部下方，支撐脊柱。

Take your other hand and push your fingers into your side.

拿起你的另一隻手，將手指推向你的側面。

You're going to first pre-brace your core by engaging your abs in a way that push your fingers to the side.

首先，你要預先支撐你的核心，用腹肌的方式將手指推向一側。

Then you will lift your head, neck, and shoulders as one unit a bit off the ground and enter to.

然後，將頭、頸、肩作為一個整體抬起，離開地面一點，然後進入。

Your focus of rotation will be your upper back.

旋轉的重點是上背部。

So don't just flex your neck.

所以，不要只是彎曲你的脖子。

As you perform this movement, you should not feel your lower back flatten out into your hand.

在做這個動作時，你不應該感覺到下背部平伸向你的手。

So think of your hands as pressure sensors and keep your low back in its neutral position with the slight arch.

是以，要把雙手當作壓力傳感器，保持腰背處於中立位置，微微弓起。

Hold this position for 10 seconds while you take small sips of air in and out before relaxing back down.

保持這個姿勢 10 秒鐘，同時小口吸氣和呼氣，然後再放鬆下來。

This will be followed by the side plank to address the sides of your core.

然後是側平舉，以鍛鍊核心部位的兩側。

The most simple version is to lay on your side with your knees bent in front of you.

最簡單的方法是側臥，膝蓋彎曲放在身前。

Move into a side plank by squatting your hips up.

臀部下蹲，做側平舉。

Maintain a neutral spine the entire time.

全程保持脊柱中立。

As you hold this position for 10 seconds, keep your core tight and you should feel your downside abs and even your downside glutes a little, helping you keep your pelvis level.

當你保持這個姿勢 10 秒鐘時，保持核心收緊，你應該會感覺到下腹部的腹肌，甚至下腹部的臀肌也會稍稍收緊，幫助你保持骨盆水準。

After 10 seconds, squat your hips back down to the ground to limit bending your spine.

10 秒鐘後，臀部蹲回地面，以限制脊柱彎曲。

A progression would be going to the full side plank and you could even lift your top leg if you really want to work your core and lateral glutes.

如果你真的想鍛鍊核心肌群和側臀肌，你甚至可以抬起上肢。

The last of the McGill Big 3 routine is the bird dog.

麥吉爾三巨頭的最後一個套路是 "鳥狗"。

Start on your hands and knees with your back in a pain-free position.

開始時雙手抱膝，背部保持無痛姿勢。

Free brace your core slightly before then lifting your opposite arm and leg off the ground an inch.

在將對側手臂和腿抬離地面一英寸之前，先輕微支撐你的核心。

Without any spine movement, extend the arm and opposite leg.

脊柱不動，伸展手臂和對側腿部。

Make sure to keep your back leg close to the ground as lifting the leg too high could cause you to move your lower spine.

確保後腿緊貼地面，因為腿抬得過高可能會導致下脊柱移動。

Making a fist with your extended hand can also help engage your body optimally as well.

伸手握拳也有助於身體的最佳參與。

A helpful cue is to think about pushing the floor away with your plant arm to help stabilize the torso.

一個有用的提示是考慮用你的植臂推開地板，以幫助穩定軀幹。

Take small breaths in and out for about 10 seconds while keeping the core braced before sweeping your legs back to the start position.

在保持核心支撐的同時，小口吸氣和呼氣，持續約 10 秒鐘，然後將雙腿掃回起始位置。

Then relax and repeat.

然後放鬆並重復。

If this is too difficult, try performing the bird dog off a bench or a chair.

如果太難，可以嘗試在長凳或椅子上做鳥狗動作。

If this is too easy, you could progress by drawing squares with your outstretched arm for the 10 seconds.

如果覺得太簡單，可以在 10 秒鐘內伸出手臂畫方格。

As far as programming, Dr. Stuart McGill recommends starting off with 5-6 reps of each exercise for 10 second holds.

至於訓練計劃的制定，斯圖爾特-麥吉爾博士建議，開始時每個練習做 5-6 次，每次保持 10 秒鐘。

If you would like a greater challenge, don't increase the time of the hold but add in more reps in a descending rep scheme pyramid like this.

如果您想挑戰更高難度，不要增加保持時間，而是像這樣以遞減的金字塔式增加次數。

For most of my patients, I recommend performing the McGill Big 3 every single day, especially before physical activity to enhance spine stability endurance.

對於我的大多數病人，我建議他們每天都做麥吉爾三大法，尤其是在體育活動之前，以增強脊柱的穩定性和耐力。

Another core stability exercise I find very helpful for many dealing with back pain is an offset walk.

我發現另一種對許多背痛患者非常有幫助的核心穩定運動是偏移步行。

To perform, hang a lightweight, such as a 10-pound plate off of a PVC pipe or broomstick.

表演時，在 PVC 管或掃帚上掛一個輕物，如 10 磅重的盤子。

Stay as upright as possible while you take a few steps back and forward.

儘量保持直立，同時前後邁出幾步。

I often start my patients out with 3-4 rounds before switching sides.

我經常先讓病人做 3-4 個回合，然後再換邊。

Research shows that many who develop low back pain often have a decreased ability to sense spinal joint position and movement.

研究表明，許多腰痛患者往往對脊柱關節位置和運動的感知能力下降。

Basically, they can't tell if they're in a good or a bad position.

基本上，他們分不清自己的處境是好是壞。

The bouncing weight creates an unstable environment, which activates small muscles deep next to our spine that sense the smallest positional changes of the vertebral bones, meaning this can enhance your body's awareness of position and movement, also known as proprioception.

彈跳的重量會產生一種不穩定的環境，從而激活我們脊柱旁邊深層的小肌肉，這些肌肉能感知椎骨最細微的位置變化，也就是說，這可以增強身體對位置和運動的感知，也就是本體感覺。

According to Dr. Andrew Locke, who I learned this exercise from, this exercise helps build a suit of armor from the inside out.

我向安德魯-洛克博士（Dr. Andrew Locke）學習了這一練習，根據他的說法，這一練習有助於由內而外地打造一套盔甲。

The next step to our rehab program will be for those who have sciatic-like symptoms.

我們康復計劃的下一步將針對那些有類似坐骨神經症狀的人。

If you have pain that radiates into your glutes or even down your legs, try this.

如果疼痛會放射到臀部甚至腿部，不妨試試這個方法。

The test to see if the sciatic nerve is at fault starts by sitting over the edge of a Start with your pain-free side.

測試坐骨神經是否有問題的方法是，先用無痛的一側坐在起點邊緣。

Flex your ankle and pull your toes back towards your body before then bending your head forward.

彎曲腳踝，將腳趾向身體後方拉，然後將頭向前彎曲。

Now do the same thing on your painful side.

現在在你疼痛的一側做同樣的動作。

If this recreates your radiating symptoms, you would likely benefit from nerve glides.

如果您的放射症狀再次出現，您可能會從神經滑行術中受益。

Sit tall with your hands behind you for support.

坐高，雙手放在身後支撐。

Flex your neck down while at the same time bending your knee and pointing your toes down.

向下彎曲脖子，同時屈膝，腳尖朝下。

Then do the reverse.

然後再反過來。

Extend the neck, take your leg out, and pull your toes back.

伸長脖子，邁開腿，腳尖向後撤。

This cycle should be nice and slow, taking about 5 seconds and should not cause any symptoms.

這個循環應該很慢很慢，大約需要 5 秒鐘，而且不會引起任何症狀。

Start with just 10 reps.

開始時只做 10 次。

And if this does not create any more symptoms, you can start doing this on a daily basis, but just not right after waking up in the morning.

如果這樣做不會產生更多症狀，你就可以開始每天這樣做，但不要在早上起床後馬上做。

The next step in our complete back pain rehabilitation plan is to assess your hips and restore mobility and glute activation.

腰痛全面康復計劃的下一步是評估您的髖部，恢復活動能力和臀部功能。

Stiff hips, especially on one side, will lead to uneven forces placed on your low back.

臀部僵硬，尤其是一側，會導致腰部受力不均。

But before jumping right into doing mobility exercises, I'm first going to show you two tests you can easily perform to see if you have problems in these areas.

不過，在開始做移動練習之前，我首先要告訴你兩個測試方法，你可以很容易地進行測試，看看自己是否在這些方面存在問題。

If you test positive in any of these areas, I'll then give you a home exercise program focusing on mobilizing those tight areas and restoring balance to your body to take load off your low back.

如果您在上述任何一個部位的測試結果呈陽性，我就會為您提供一個家庭鍛鍊計劃，重點是活動這些緊繃部位，恢復身體平衡，減輕腰背部的負擔。

The first is the Faber test, which assesses both external rotation and extension.

第一種是法布爾測試，它同時評估外旋和外展。

Lay on your back and place one foot on top of your opposite side knee.

仰臥，將一隻腳放在對側膝蓋上。

Then let your leg relax and drop as far to the ground as possible.

然後讓你的腿放鬆，儘可能地落在地面上。

Make sure to keep your pelvis level, as rotating your hips will throw off the results of the test.

確保骨盆保持水準，因為轉動臀部會影響測試結果。

If you have less range of motion on one side, that would indicate a positive test.

如果一側的活動範圍較小，則表明測試結果呈陽性。

For test number two, we're going to look at hip internal rotation.

第二項測試是髖關節內旋。

This test is best done with a friend, so you can relax if the friend assesses how much you can rotate.

這項測試最好與朋友一起進行，這樣，如果朋友評估了你的旋轉能力，你就可以放鬆下來。

However, if you're by yourself, sit over the edge of a table or bed and rotate one foot out to the side as far as possible without your pelvis moving or your torso shifting to the side.

不過，如果你是一個人，可以坐在桌子或床的邊緣，在骨盆不移動或軀幹不向一側移動的情況下，儘可能將一隻腳向一側旋轉。

If you have less range of motion on one side, that would indicate a positive test.