In this captivating Part 2 episode of the Func Med Nation podcast, host Dr. Steve Noseworthy engages in an in-depth conversation with Dr. Stuart McGill, a professor emeritus from the University of Waterloo and a world-renowned expert in spine function and rehabilitation. Together, they explore Dr. McGill's vast career spanning over three decades, during which he has contributed significantly to understanding lumbar function and back pain.
Dr. McGill shares his professional journey and personal philosophy on health and fitness, highlighted by inspiring anecdotes involving professional athletes and ordinary individuals who have transformed their lives under his guidance. The dialogue transitions from traditional discussions about biomechanics to broader life lessons, touching upon critical misconceptions and the importance of personalized health approaches.
Tune in for a unique episode that looks beyond conventional views on back pain, as Dr. McGill provides insights into optimizing health, understanding one’s body, and striving for holistic well-being. This is an episode rich with knowledge, humor, and yes, a few words about Dr. McGill's famous mustache.
See Dr. McGill on the Web.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
Hey everyone, welcome to the Funkbed Nation podcast.
I'm your host, dr Steve Noser.
The views and opinions ofguests on this podcast are their
own and may differ from my own,but as always, I try to be
respectful of other people'sopinions, even when we might
disagree.
My guest today is Dr StuartMcGill.
Dr McGill is a professoremeritus at the University of
(00:27):
Waterloo in Ontario, canada, anda world-renowned lecturer and
expert in spine function, injuryprevention and rehabilitation.
Dr McGill has written more than200 scientific publications on
the topics of lumbar function,low back injury mechanisms and
the investigation of tissueloading during rehabilitation
(00:48):
programs.
He's received several awardsfor his work, including the
Volvo Bioengineering Award forlow back pain research from
Sweden, and is a recipient ofthe Order of Canada, the second
highest merit award in thenation.
Dr McGill has been an invitedlecturer at many universities,
has delivered more than 200addresses and 70 keynotes to
(01:11):
societies around the world.
He has written four books andcontributed 32 chapters to
others.
He's sat on the editorialboards of many journals in the
physical medicine and rehabspace and recently has appeared
as a guest on other podcastswith Andrew Huberman, peter
Attia and Mark Bell.
As a consultant, he hasprovided expertise on assessment
(01:33):
and reduction of the risk oflow back injury to government
agencies, corporations,professional athletes and sports
teams of all varieties.
Most recently, he accompaniedTeam Canada to the Paris
Olympics.
When Dr McGill agreed to join mefor a conversation, I was
determined to not simplyrecreate other interviews he had
done by asking him about thecauses of low back pain.
(01:55):
Rather, we delved into hiscareer, his personal and
professional philosophies onhealth and fitness, and he
shared several inspiring storiesabout both professional
athletes and regular people thathe has worked with and how he
derives deep satisfaction fromhelping people change their
lives.
And yes, I felt compelled toask him about his iconic
(02:18):
mustache.
Let's get to the interview.
This is a question I've askedyou before and I think it bears
repeating.
You are very well known forcertain things.
The example I gave you beforewas people hear I'm a
(02:40):
chiropractor.
They think they have me figuredout.
They pigeonhole me intowhatever their impression is of
a chiropractor, and my knowledgeand expertise goes well beyond
that.
And to me, in talking to you,it's quite clear that your
expertise goes beyondbiomechanics and simple low back
(03:03):
pain.
Biomechanics and simple lowback pain.
So I'd like you if you wouldjust comment on what is the main
difference between the commonpersona that people think of you
, like when they hear the nameStu McGill, or they listen to
you talk.
What's the difference betweenthat impression or that image of
(03:25):
you and your impression ofyourself?
Maybe that's an unfair way toask it, um, but nevertheless
there's the question.
Speaker 2 (03:38):
Wow, um, yeah, well, I, I, I don't know what
impression I have of myself.
I think the variation thatyou're describing of some people
who hear my name and have animpression is that they're
(04:00):
internet educated or socialmedia educated, versus having
spent time with me either hereat BackFit Pro or just at a
conference.
When I was a professor, I usedto find the most valuable
experience of going to aconference was going and have
(04:23):
dinner with a group of studentsor with other professors.
That's when the real work andunderstanding of individual
viewpoints is acquired and honed.
So would it help to summarizewhat I did at the university and
it may, if anyone's interested,stimulate them to look at what
(04:53):
was performed and maybe why.
I have some of the opinionsthat I have that extend beyond
biomechanics.
Speaker 1 (05:01):
Yeah, I think that would be very helpful.
And I'd like to also if we canboth remember, to come back to
this for you to you know, maybepoint out a couple of things,
that a couple of things aboutyourself that most people
wouldn't come to know if allthey knew was you on the
internet, like watching,watching a podcast interview, or
(05:23):
watching there's videos of youout there.
You know doing an assessmentwith certain people, or you know
showing someone how to do aproper pull up, or, for example.
So you know, start with that,like what did you actually do at
the university?
And then maybe lead into here'sa couple of things that people
don't know about me and mybackground, and it can be
(05:43):
anything.
It could be professional, itcould be personal.
Speaker 2 (05:46):
Okay, I started at the university, as I said, as a
professor in 1986.
And I just had one question andthis would bother people a
little bit, because normally anew professor has to have a
hypothesis.
You write that into a grant,you submit that grant and this
(06:07):
is the hypothesis that I'm goingto test and I want money for.
Well, I was never like that.
My question was how does thespine work?
It's not a hypothesis, it'sjust a question how does the
spine work?
So over the years a fewcolleagues would have fun with
me and they say oh, mcgill,you're such a spine slut, you
(06:29):
will do anything with anybody atany time, as long as you can
learn something more about thespine.
So if I would work with asurgeon and attend surgery or
work with a team, study theinjury patterns, I would be
invited to the team's trainingcamp and I would meet with the
medics and we'd be sitting up inthe stands there and we would
(06:51):
have the idea we're watching allthese players, we were
discussing them and I'd say,good, get out a piece of paper
and let's write down ourhypotheses being who will be
hurt and where by the end of theseason, put it in the envelope
and that's going in your deskand that doesn't come out till
the end of the season, and let'ssee how good we really are if
(07:13):
we think we can predict injuryby watching them move.
So you know, just fun thingslike this.
How does the spine work?
How does the spine work?
Anyway, the first laboratorythat we started in 86 was
equipped to measure internalloads in the living person.
(07:33):
So we would film themthree-dimensionally moving.
And then the big step was thevirtual spine.
So the computer technology wasjust at the point where we could
take CT scans or MRI scans,which are serial slices, stack
them and then recreate thatindividual's spine, their
(07:58):
musculature, the ligaments, thediscs etc.
That was called the virtualspine.
The instrumentation measuredthe spine curve, the external
mechanics of load on their handsand, working through link
segment dynamics, figuring outthe external mechanics, the
loads on the spine, and thenusing electromyography of
(08:18):
electrodes around the body,figuring out muscle force,
stiffness, stability etc,allowed us to measure the stress
concentrations on the actualtissues.
Interestingly enough, in mostpeople the stress concentrations
was where the pain was comingfrom, not in all but in most,
(08:39):
which was fundamental.
Then I realized I didn't knowthe injury processes.
So we took cadavers and wewould apply the loads to the
spines and the various tissuesof the cadaver.
So we learned very preciselywhat are the pathways to disc
herniation?
How do you fracture an implant?
What really causesspondylolisthesis?
(09:03):
And, as it turns out, it's alittle bit of anatomy with the
set angle, plus the cycles ofload, plus the brittleness of
the bone, etc.
Then I realized, boy, all ofthese people are coming into the
experimental research clinicand I'm reading the radiology
reports, but there's no linkback to the mechanical causation
(09:25):
pathway.
So we developed a radiologysuite, I acquired some money and
we got x-ray machines, micro CT, ultrasound for living people,
et cetera.
Then the dean asked me well,okay, hotshot not using those
words, but that's what he meantwhy don't you start seeing
(09:49):
patients and test your scienceto see how good it is?
So I started the experimentalresearch clinic, but remember, I
didn't have the constraints oftraditional medical training or
funding models, training orfunding models.
The patients would come in andI set aside two hours to assess
(10:10):
them and give them my opinion asto what is going on, and then
that will inform what theyshould and shouldn't do.
You know, steve, after thefirst year I changed that to
three hours.
Well, this was unheard of.
My medical colleagues said whatare you going to do with people
for three hours?
Who's going to pay for that?
Anyway, the other uniquefeature of that was we followed
up with every single patient weever saw in the history of that
(10:33):
clinic.
We know exactly our efficacyscore for the different
categories, you know.
Is it discogenic pain?
Is it neural arch pain?
Categories you know.
Is it discogenic pain?
Is it neural arch pain?
Is it pain exaggerated becauseof the fear that they have of
losing their job and now havingfive mouths to feed at home?
(10:57):
You know all of the subsubcategories.
The next pillar that we usedand I developed being a spine
slut, remember was we.
I realized as I saw patients,clusters were forming.
I was paying attention, and sowhy was it?
Gymnasts had quite a commonpresentation as they were coming
(11:21):
in.
Crossfitters had just started.
Why are they coming in with?
Again?
It was almost always discogenicpain.
And then in my work indifferent sports I would see how
come this baseball team haszero stress fractures?
The next baseball team has fourspine stress fractures.
(11:45):
It wasn't the game, it was thestrength coach who was causing
the stress fractures in theirback not realizing the mechanism
and that biological capacityhas a finite bound and you just
can't keep bending the pars,which is the bone that was
stress fracturing in their back,back and forth over and over
(12:06):
and over again, becauseeventually it will crack and if
you keep going it will fracture.
So that came from our study of,from studying clusters.
We won an award.
Actually we had the longestlongitudinal study of the
Toronto Police Force, the ETF,and you know the things that we
(12:29):
learned.
You know where is the mostdangerous place in terms of
musculoskeletal injury for anelite SWAT team, police officer
and people will think, oh well,it's rappelling down a building
or you know a hostage situation.
No, it's the weight room and,interestingly enough, the ones
(12:52):
who push themselves to have thehighest level of fitness had the
highest injury rate.
Speaker 1 (12:58):
So you know to almost expect that right, because
you're, I mean by nature.
Speaker 2 (13:03):
You're pushing the band yeah.
Yeah, you and I would, but notsome of the strength coaches.
Speaker 1 (13:08):
They always think, oh being stronger is always better
, strong is always better itisn't.
Speaker 2 (13:13):
There is an optimum for enhancing resilience as a
police officer, as there is forevery single athlete.
Speaker 1 (13:22):
Oh, I would love to drill down on this idea of what
is optimal strength.
Do you have a sense of that?
Of course, do share.
Speaker 2 (13:37):
Right now.
I am perceiving that because ofthe internet, there's a lot of
people who are jumping on thebandwagon get stronger, get
stronger, get stronger.
Do Olympic lifts and that kindof thing.
I'm old enough that I've seenquite a number of true Olympic
(14:00):
lifters and I've followed themthrough until they're.
I've got one guy who's in his80s.
Do you think he's the mostcapable, 80 year old right now?
Speaker 1 (14:11):
I imagine that kind of training takes a toll.
Speaker 2 (14:15):
Well, that particular one is on a walker.
His shoulders are shot, hisknees are shot, his hips are
shot.
Now, I'm not saying that I maynot be there myself, but you
know, optimal strength is onethat suits your body frame.
First of all, there are somepeople, through the right choice
(14:37):
of their parents, they cancarry a lot more strength and
they're going to be fine.
There are others who will nevercarry that strength without
paying the price to their joints.
There are some who move welland can utilize that strength,
and there are others who aresomeone put a V12 engine into a
(15:00):
jalopy and it tore up the restof the frame, so we're starting
a little bit with genetics there.
What are the demands of theirlife?
Is the strength sustainable?
And I will say this and again,people will disagree, but that's
fine.
The stronger the person is, theless of their life they will
(15:25):
carry that.
Now I'm talking about extremes.
People who come here as backpain patients and I'll say
what's your goal?
And they say I want my nextdeadlift record.
And they're 33 years old,they've got an implant fracture,
a disc bulge, maybe more sorehips, torn labrum, and they're
saying I want my next.
And I'll say who's paying you amillion dollars for the next
(15:48):
world record Not world record,sorry your next personal best
which is done in your basementand they look at me and I'll say
let me ask you something.
And say they're a 56-year-oldand I'll say how old are your
kids?
Oh, I got a 30-year-old.
And I'll say how old are yourkids?
Oh, I got a 30-year-old son.
And whatnot?
Yeah, do they have kids?
(16:09):
He says yeah, we just had ourfirst grandchild.
I said, how about this?
Would it grab you if you couldbe the best rocking 80-year-old
on this planet playing with yourgrandson, taking him fishing,
etc.
And they stop and think andthey really pause and they say,
(16:29):
well, I've never really thoughtabout it that way before and I
said, well, on your current path, if you want your next personal
best, the chance of you beingthat very capable, sufficiently
strong 80-year-old diminishesand that rocks them a little bit
(16:52):
.
And then, if I can get them tobuy in a lifespan longevity kind
of a goal, we have a muchbetter chance of improving their
health.
That's sustainable.
That is not maximum strength, itis sufficient strength.
But I've given you that it is acontext.
(17:14):
Given their frame, their injuryhistory, how successful are we
to adapt some base robustnessnow, given their injury history,
to get them through to that?
So I can't give you, unless wehave a person with us, great,
we'll assess them and we willestablish what sufficient
(17:36):
strength means for them.
But of course there are somegeneralizations.
If the person has and I knowwhere you're headed with this
you want generalizations and,darn, you're going to force Stu
to give them to you.
But what our research showed usover the years, there are some
baseline things that most people, if they can do this, they're
(18:01):
sufficiently strong and I goback to when I was working in
the NHL.
They're sufficiently strong.
And I go back to, you know,when I was working in the NHL
National Hockey League, I thinkover the course of three or four
seasons we had five sportsman'shernias with different teams,
do you know, and that's a torninternal oblique or external
(18:22):
oblique abdominal wall muscle.
Internal oblique or externaloblique abdominal wall muscle.
When we met, we would go backthen and look at their fitness
scores.
Every single one of them, notone of them could hold a side
plank for a minute.
Now you're asking me, what isan NHL player doing who is at
(18:45):
that level of physical abilityand they can't hold a side plank
?
They're terribly out of whack,out of balance in their physical
training.
Anyone who could hold a sideplank for a minute we never did.
Now, this is anecdotal, there'sonly five cases, but it's a
(19:05):
minute we never did.
Now, this is anecdotal, there'sonly five cases, but it's a
hypothesis.
So my colleague at theuniversity, jack Callahan, he
would take back pained peopleand normal people and then just
measure their side plank.
Those who had longer sideplanks could stand longer
without back pain.
In other words, the people whoare getting back pain Now.
Again, is that causation or isit correlation?
(19:26):
I think it's probably a littlebit of both, but anyway I know,
steve, you're asking me forgeneralizations.
Most people should be able tohold the side plank for a minute
and that should be symmetricbetween sides, within 5%,
because if they're asymmetricthat increases their risk of
future back pain as well.
Now we get into the discussion.
(19:48):
Have I ever measured aprofessional golfer who is
symmetric right and left on theside plank?
And the answer is no, I neverhave.
But every single pro golfer whocomes to see me has a back pain
.
History playing a highlyasymmetric sport.
Playing a highly asymmetricsport.
And, by the way, if I had aprofessional baseball pitcher,
(20:14):
would I demand and expect andhave the goal of symmetry?
Absolutely not.
They're an asymmetric, elasticathlete.
So do you see how the nuance ofall of this just continues and
continues.
But you want somegeneralization.
So it would be.
Now maybe your shoulder is soreand that is the reason why you
can't hold a side plank.
It's not a spine or a coreendurance issue.
So we might have to do a sidelaying lateral leg hover as a
(20:41):
surrogate for the measure of.
Is it as good as a side plank.
No, it's not, it's a surrogate.
Anyway, does that?
Speaker 1 (20:49):
help.
Yeah, no, that's helpful and itleads my brain down a couple of
different avenues.
Yesterday the very first thingyou said in this part of the
conversation was a lot of it hasto do with genetics and say,
body style, um, I showed my dada video of the guy recently
(21:10):
breaking the world deadliftrecord, you know, thousand plus
pounds, and I made a comment tohim.
My wife was there and I made acomment like these guys are all
built the same way, like, if youlook at a high level power
lifters, strong men, there's aphenotype that lends them to
that type of capacity.
(21:30):
Obviously, training becomesvery important.
And you can go to the otherextreme and you look at, like
Kenyan runners, you're not goingto expect them to deadlift
tremendous amounts of weight,and so I totally understand that
body habitus.
There you know your, yourphenotypic expression, how, how
thick are your joints and yourbones, and maybe we can make
(21:53):
some correlations with ligamentand tendon strength, strength as
a result of that.
So I totally understand,totally get that.
So what I want as a professionalis I want and maybe we'll never
get there, but I want a set ofbasic guidelines, like one of my
great interests, because of thetypes of people that I work
(22:14):
with, who are, as I mentionedbefore, tend to be the sickest
of the sick, not with disease,but with dis-ease and
dysfunction, and many of themhave lost what I call exercise
tolerance.
They've either had to greatlyreduce their physical activity
to match their performance andrecovery capabilities, some have
(22:38):
given up on exercise altogether, because at least they perceive
that anything they do isproblematic for them, because at
least they perceive thatanything they do is problematic
for them.
And so I, as a clinician, I'malways asking myself, number one
, when is the right time to getthis person into an activity or
an exercise program?
And I do make a distinctionbetween those two things,
(22:59):
activity versus exercise.
And how do I blend that with myunderstanding of their, and how
(23:22):
do I blend that with myunderstanding of their what I
call their metabolic tippingpoint, and that's their ability
to basically perform and recover, as perhaps dictated by their
inflammatory state, their energymetabolism systems and a couple
of other things that we couldthrow in there as well.
And so the question is alwayswhere's the starting point and
how quickly can we progress them?
Because, as you said one of ourprior conversations, like you
know, there's there's aninfinite ability.
No, I'm sorry, there's alimited ability to perform and
recover, and when someone'sinjured, that goes down.
And I see the same thing from ametabolic standpoint, to the
(23:45):
point where people are sometabolically compromised and
deranged that even walking ablock is challenging for them or
doing their household chores ischallenging for them.
And so I'm always trying todevelop for myself and then to
share with colleagues how do weget someone into an exercise and
activity program for thebenefit of their whole body
(24:07):
health?
And I shared with you beforethat, when I started thinking
this way, one of the very firstthings that I adopted was the
McGill Big Three, just as almostwhat I call a low-load
preparatory phase of training,where I might have somebody
spend six weeks every other daydoing the McGill Big Three and
doing some shoulder girdlestabilization exercises and
(24:31):
watching how they can performand recover and handle.
That tells me a lot about howquickly I can progress them into
, say, gravity-dependentexercises and then full-body
exercises, whether it's assimple as an air squat or a
thruster with nothing in theirhands, for example.
And so I know I keep harping onthis like what are the basics,
(24:53):
what are the baselines?
Because for me in my world.
If I can find that lowestcommon denominator and then
progress people from there tosome semblance of sufficient
strength, sufficient mobility,sufficient flexibility and so on
, then I'm doing the best that Ican clinically to help these
people live a good life 10, 15,20 years down the road, from
(25:15):
wherever it is that we'restarting from.
I don't know if that helps youclarify what my thought process
is, or I don't even know ifthere's a question in there, stu
.
Speaker 2 (25:26):
Well, I can riff on the topics that you brought up,
and that was a great essay thatyou just wrote, by the way.
Well, you know you started outtalking about phenotypes and I
just have so many friends inthis whole area, chances are, I
know the person that you'retalking about, who set the
(25:47):
deadlift record.
But you know, I've learned somuch from someone like Ed Cohn
and if anyone's in thepowerlifting world they will
know the name Ed Cohn.
And Ed is just built to lift,but you know incredible strength
of mind and personality and allthe rest of it.
(26:09):
And he's absolutely verydifferent from a Kenyan runner.
One of my good friends is ShaneBenzie, who wrote the book Lost
Art of Running, and he hasspent years living in Kenya
working with coaching andstudying the Kenyan runners.
And you're absolutely right,these are not Ed Cohn, these are
(26:32):
elastic, tuned, elastic athletewith beautiful upright postures
, tuning the elastics to storeand recover energy, to enhance
efficiency.
You know nothing to do withEd's athleticism and a totally
different definition ofsufficient strength, but both
are world-class at what they do.
(26:56):
But I'm going to go back to apatient who I saw yesterday Just
a lovely fellow, and he came tome and he said I used to be
over 600 pounds and he came andhe was 300 pounds and not a tall
man, but what a lovelypersonality.
And you know I tried tounderstand what the pathway was
(27:19):
leading him to becoming 600pounds and he, you know, had a
challenge with the pandemic and,okay, I can understand what
happened and allowed him tobecome a prisoner of his room
and he could lay in bed and walkto his computer and go to the
toilet and then he became aprisoner of that room.
(27:41):
But he became.
He became started to work withone of my grand old friends who
used to be on our Olympic team,a fantastic strength power
athlete, but he now hasdebilitating back pain and I
think what you were talkingabout with some of your people.
(28:01):
They are an extremely low leveland they're extremely fearful
and they've given up on exercisebecause it's always hurt.
So I'm trying to give abackground now for the challenge
that I had yesterday.
And here is this fellow.
He's lost 300 pounds, half hisbody weight.
He's lost 300 pounds, half hisbody weight, but he's still 300
(28:24):
pounds through caloric deficit.
He can't go any lower.
His metabolism is so slow.
He's got to do some physicalactivity to change and reset the
caloric expenditure side of theequation.
So can he walk.
Yes, so can he walk, yes, well,we did some walking training.
(29:10):
Again, from my experience ofthe Kenyan runners, can we use
some elastics now and some bodypositioning, soing this?
You said they can only walk fora block Great Walk to the end
of the room and back and do itevery 15 minutes.
So the lower level that theperson is starting from the
principle of graded exposure istry and have a shorter interval,
smaller dose, more often, andthen, as they start to gain a
(29:35):
little bit of capacity, the dosebecomes larger, but so does the
time between the exposures.
And in the extreme you canbecome Ed Cohn, and even though
he was by far the bestdeadlifter in the world, he
really only trained once, maybetwice a week, but he spent that
(29:57):
much time between the exposuresbecause of the intensity of them
.
So that is a little bit of ascientific principle in this
idea of graded exposure.
Speaker 1 (30:11):
Do you know?
It's hard to jump in here, butyou know Marty Gabala at
McMaster.
Speaker 2 (30:15):
I know Marty well.
Speaker 1 (30:17):
Yeah, so I interviewed Marty last year.
We have a mutual friend, a guyI went to chiropractic school
with, and he was the one I don'tthink he coined the phrase, but
he was the one.
I don't think he coined thephrase, but he was the one that
introduced me to the idea ofexercise snacking.
Speaker 2 (30:32):
Well, Marty really is considered the father of HIIT
high intensity interval training.
Speaker 1 (30:37):
Yeah, yeah, yeah.
In fact, to this day, myinterviews with him are some of
the best, the most downloadedand listened to episodes in my
uh, in my funk meditationpodcast.
Speaker 2 (30:48):
Yeah, yeah, no, marty's fabulous.
Speaker 1 (30:50):
Yeah, he certainly is .
Uh sorry, and I know Iinterrupted your train of
thought.
I just wanted to bring his nameinto it.
Um, back to you.
Speaker 2 (30:59):
Well, and then you mentioned bird dogs and I was
thinking yesterday, okay, birddogs, and I was thinking
yesterday, okay, first of all,my client needed permission to
do physical things.
He was petrified that, with hisbody and its current condition,
that he might create an injuryand more pain, because he came
(31:22):
to me with back pain.
But it really was spine hygieneor movement competency showing
him how to squat.
So that same style of shortstopsquat that we talked moments
ago with that elderly woman atthe medical school.
I showed him and yeah, but weexpanded it with him.
(31:44):
We did the shortstop squat andthen I said now reach across
your body and touch my hand overhere.
And he reached out.
Oh yeah, that causes pain.
And I said, why did it causepain?
He said I don't know.
And I had to remind him yetagain that your pain is caused
when your spine gets out ofposition.
How do we keep position?
You're going to reach across,but turn your hips, put a
(32:06):
pointer on your rib cage, apointer on your pelvis and those
stay together.
It doesn't cause pain, does it?
No, it doesn't.
Why hasn't anyone shown me thatbefore?
So I got him to do a shortstopsquat reach across, turn the
hips, push his hips back alittle bit further, pull his
hips through, square up andrelax.
(32:26):
Let all of the control go, Justrelax and hover.
He says, yeah, that didn'tcause pain.
This was monumental in changinghis opinion of movement being
something to fear versusmovement being liberating and
now allowing me to accomplishthat.
So that was the first stepgiving him permission to move,
but also showing him a techniquenot to trigger his specific
(32:53):
pain mechanism.
Then we got down and we didbird dogs.
It was a challenge getting downand then to do a bird dog,
because his shoulders were alsoan issue.
Okay, well, there's bird dogs,and then there's bird dogs.
And here's where the expertisecame in.
I showed him how to do a birddog and his arms were way out in
(33:13):
front of him.
He said oh, my shoulders aresore.
I said get your handsunderneath your shoulders, your
knees underneath your hips andlift your tail.
Okay, did a bird dog Well, thathurts my shoulder that he's
supporting 300 pounds with.
I said, good, grab the groundwith your hands and try and pull
(33:35):
your hands to your knees.
Now you, with your training,knows what I just did with his
back.
We turned on the lower trapstrapezius, not trapezius, lower
trapezius, serratus anterior,and a little bit of lats, and
all of a sudden I tricked himinto a shoulder stability
(33:57):
pattern.
So now his shoulder didn't hurtand I said now push the earth
away.
And now do the bird dog, tryingto pull the stance heel of your
hand towards your knee, tookhis pain away.
So you know that was importantbecause it now gave him another
(34:17):
tool to really integrate thisgoal of he's got to have some
caloric utilization now becausehe's maxed out.
He's so calorie deficit.
His reset is now 300 pounds.
He wants to get to 200.
But anyway, it was such a wonder.
(34:38):
I called him, as I always dothe next day.
So this what's today?
Thursday, I saw him Tuesday.
So I called him yesterday andhe says yeah, you know, on the
verge of tears, I haven't hadany pain.
I gave him a lumbar to put inhis low back.
So the person who drove himhere, he is almost five hours
(34:59):
through the snow and I said,yeah, I didn't have any pain in
my drive home, so it's justfiguring out his mechanism and
giving him permission to moveand then showing him a few tools
so that he realizes wow, thisdoesn't hurt me, I'm safe and
(35:19):
it's what I need now to meet mygoal, which him?
He still needs to lose anotherhundred pounds, but that is the
scientific reality.
He needs caloric exposure now.
Speaker 1 (35:32):
Maybe in the beginning, what you did was you
removed both a physical as wellas a perceptual block to making
that next step right.
Speaker 2 (35:44):
You asked me earlier where's the misperception of me?
People say, oh, mcgill'sbiomechanical never considers
the psychosocial, fullbiopsychosocial rubric of pain
and anyone who comes here says,wow, that's the most
(36:04):
biopsychosocial assessment andintervention I've ever seen.
So again there are people onthe internet who they haven't
contributed to the science.
Speaker 1 (36:30):
Again social media they want to gain exposure by
right you know, misrepresentingother people.
I suppose I would imagine thatwhen, in you know, I I
approached this interview withyou with the express intent of
not doing just another stewmcgill interview where all we
did was talk about back pain,because I knew it's been
refreshing and fun.
(36:56):
Yeah, well, I knew that therewas more to you and more to your
expertise, and that's reallywhat I wanted to bring out, as
you were talking about thisgentleman and I'm sure it's more
multidimensional than this butbeing confined to his room and
being that large, he had such ahigh mechanical load on his
spine.
But being confined to such asmall space and unable to really
(37:17):
move all that much, he wouldhave fallen into such states of
disuse, atrophy, such states ofdisuse, atrophy, um, and it made
me think about you know this,and I'll, I'll, I'll bring this
out particularly like I'm inanother month, I'll be flying to
California to teach a weekendseminar on, uh, we call it brain
(37:39):
chemistry, but it's a, it'sabout a lot more than that, um,
and and I usually start theentire weekend seminar by
bringing docs through, kind oflike, the different
developmental stages, frominfancy to adulthood, so to
speak.
And just if you'll bear with mehere for a second, and I think
anybody who either has childrenor have spent time around
(38:03):
infants will recognize this, youknow, babies come out of the
womb and they're completelyspastic, they're all over the
place, they can't control theireyes, they can't control their
head, they're just movingspontaneously.
And as the brain begins todevelop, the first thing it
learns to control is theeyeballs.
That's like literally the firstmotor system that begins to
(38:25):
mature, is the eyeballs.
That's like literally the firstmotor system that begins to
mature.
And because the ocular motorsystem is linked to the
vestibular system and to theintrinsic spinal muscles, the
next thing that develops is somesemblance of cervical stability
.
And those get yoked together tothe point where, just even
after four or five weeks of life, a baby can see something
(38:46):
across the room and turn theireyes and their head to look at
an object of interest.
And then, as they continue todevelop beyond that, that
stabilization of the spinalstructure, which at this point
doesn't have any curvature toany great extent, and I should
say it's a big C curve, itdoesn't have a cervical or a
lumbar lordosis.
(39:06):
And as these core systemsdevelop, we get the cervical
lordosis.
Stabilization progressescaudally and now we get
stabilization of the pelvis.
This gets combined with theability to turn over, sit up,
then they can stand, then theycan walk, then they can run, and
(39:29):
from a neurological standpoint,this creates the platform from
which all higher cognitivefunctions develop.
There's a reason why mostchildren don't start talking
until a certain age.
The motor system has to developbefore we can acquire language.
In most cases, right, there wasalways outliers and that may be
(39:52):
actually a sign of a problem.
But and maybe this is the biasof a chiropractor talking I look
at the spine and spinalintegrity in many ways as being
foundational to health andwellness.
I think it's a critical part andit's not just because it's what
(40:13):
allows us to move and exploreour environment and to do things
you know, say, with the graceand beauty of a ballerina or an
elite gymnast a ballerina or anelite gymnast.
The influence of the spine andcapacity of that to neurological
(40:34):
health is scientificallyundeniable.
And even if we go into maybethe clouded history of
chiropractic and its origins,back before chiropractic became
known as a back pain modality,people in the early 1900s went
to chiropractors because theirguts didn't work, you know, they
(40:55):
had indigestion or they weren'tsleeping.
I mean, chiropractic in itsorigins was a true healthcare
discipline and then we gotpigeonholed into back pain and
neck pain, which is fine, itstill serves a purpose.
But I love talking to peoplelike you because you see things
(41:15):
differently.
Your experience is different interms of meeting people where
they are and treating them asindividuals and working to
remove barriers to allow them tohave basic functionality.
I look at that and go.
If I can get someone to gothrough that process and open
(41:40):
their mind to the possibility ofdoing new and different things,
I know that I'm going to have agreat result with them.
It doesn't mean they're goingto be a hundred percent and I
can't guarantee when that'sgoing to happen, but I look at
motion and movement as a keycomponent of health, wellness
(42:05):
and fitness for so manydifferent reasons.
But the spine is integral and Ithink we can track that all the
way back to how neurologicalsystems are designed.
And I could just keep going on,but I'll probably get lost in
my own thought process.
But what's your response tothose things that I just shared,
from my perspective?
Speaker 2 (42:26):
Well, again, I'm so enjoying this.
I was jotting down a few thingsas you triggered them and as
you spoke, so I'm just going togo back to the client that I
spoke of a couple of days ago,who was, and continues to be,
trapped in his body.
So, yes, he still has a goal oflosing weight.
(42:47):
But why?
What is the real root of all ofthat?
And it came out working withhim.
He says I just want tosocialize, I want to go out and
meet people, and he's juststarting to now.
And you know your heart, I'mtrying not to cry now as I not
now, but when I was with him andjust to you know, receive what
(43:12):
he was giving me and, as I said,he was had the most lovely
personality, good looking guy.
I can hardly wait for him toget out.
And you know, again I mentionedthis started with the pandemic
and you realize, for some peoplethat was such a challenge.
(43:35):
I loved it.
I hate to gloat.
You know my daughter was livingin Australia.
She came home.
My son, who's lived in the UShis whole adult life since he
was 18.
He came home.
My son, who's lived in the U?
S his whole adult life, uh,since he was 18, he came home.
I lived with my adult kids forhalf a year.
It was the most beautiful thingfor me.
And yet here was my patientyesterday who lost his twenties.
(43:57):
He said to me and uh, you know,so this is a huge thing that,
yes, losing the weight, theperson who has really developed
this idea of DNS dynamicneuromuscular stabilization,
(44:34):
which is really based onontological development, and
he's really opened my eyes tothe progression of the gaining
of ability and how sometimes anadult with pain, it's wise to
take them back to.
Some of those people refer tothem as primitive or child
(45:17):
development principles andreestablish those manipulation,
et cetera.
And I can give an example thereof we had a national level
gymnast come into the clinic forback pain.
Well, remember now we justdon't assess them.
We put on full instrumentationand measure them while they're
(45:40):
doing things.
And it was a bit curious.
They said you know, I also havea pain.
And they appointed laterally totheir oblique wall and they say
it's just nagging right thereand we put our electrodes right
over it and then we tried to getthem to relax and that muscle
(46:03):
wouldn't relax.
In other words, the motor unitsand neuromuscular compartments
in the abdominal obliques isn'tone.
In other words, the externaloblique is not a muscle.
The external oblique has manyneuromuscular compartments
within the area where they saidis always sore, it never relaxed
(46:28):
.
It was a local area of a spasmin their muscle.
Well then we had a chiropractormanipulate them Within 300
milliseconds.
Now this is going to inform ashort loop reflex Within 300
milliseconds.
That spasm was about a half.
So it was.
(46:49):
You know this controversy.
Does spinal manipulation affectneurology, distal in the body?
That's a huge question.
Well, there was a prettypowerful piece of evidence that
wasn't near the spine, that wasout in the abdominal wall, and
yet that neurology and whateverwas the source of that spasm, a
(47:11):
short loop reflex was stimulatedand changed immediately.
So where the spindles stretchedand, uh, created a control
delete, shall we say true tothat pattern?
That that would be myhypothesis and that's all it is.
Maybe I'm wrong, but anyway,the implications of that, of
(47:34):
distal influence, is huge.
And then you got on to talkingabout the dexterity of these
engrams.
To talking about the dexterityof these engrams and just to go
back to myself.
I don't want to.
I'm only using this as anexample.
But again, at my age, and I haveto face the fact that I'm not
(47:58):
going to become more physical,I'm only going to become less.
And every day when I getdressed, to become less.
And every day when I getdressed, I typically would stand
on my left leg, put my rightleg into my underwear first and
in my left.
Just a habit, it's what I do.
Well, now I reverse it.
I put my left sock on first, Itry and do everything in reverse
(48:20):
and then I will stand.
Do you know the stork in karate?
Yes, and I'll just stand in thestork.
Can I hold it, lock it anddon't fall.
Then I go in and brush my teeth.
I'm right-handed, veryright-handed.
I'm going to brush my teethwith my left hand.
Man, I have to really work mybrain to brush my teeth
(48:41):
left-handed.
So I play these games, justliving life, challenging myself
in balance, neurologicaldexterity, et cetera.
So I don't know if that helpsor no it does.
Speaker 1 (48:57):
And to that last point, like from a neurological
standpoint particularly, youknow, you see this a lot that
people get older and they getconcerned about their cognitive
capacity and so they becomeexperts in crossword puzzle or
Sudoku and they do the samething over and over and over
again.
And you know, one of the thingsthat we teach practitioners in
(49:20):
our brain seminars is that, well, I guess it's no different than
in physical training.
Like if I hired a personaltrainer who was good at their
job, they would put me through abattery of tests, find out
where I'm weak and train mewhere I am weak.
They wouldn't have me just keepdoing the things that I'm
already good and strong at,because my interest is general
(49:43):
physical capacity andpreparedness.
Like I don't want to be an EdCohen, I'm certainly not a
Kenyan runner.
I want baseline capacity acrossmultiple domains that we might
include in the word fitness.
And it's the same thing withthe brain.
If all you do is Sudoku puzzles, you get really good at these
number puzzles, but you mightlose some language capacity.
(50:06):
And so from a brain standpoint,it's important to do things
that you're not good at, likebrushing your teeth with your
offhand or getting dressed in adifferent order.
Like you said, left leg firstinstead of right leg first.
These things are helpful andany one thing like that might
not be all that great.
So any one thing like thatmight not be all that great, but
if you do a bunch of thosethings then they sum up over
(50:27):
time to put yourself in aposition where your brain is
better off somewhere in thefuture to do that.
The other thing that I wanted topoint out when we were talking
earlier that came to my mindabout neurological development
when we're kids we move throughlife three-dimensionally we hop,
(50:48):
we skip, we jump, we tumble, wetwist, we turn, we roll and
then we become adults and webasically sit up and down and we
move predominantly straightforward to some degree the
capacity to generate andtolerate rotational movements or
you know, you were talkingabout the gentleman and
(51:09):
obviously he would have otherchallenges but sometimes just
the ability to get down on thefloor and get back up again.
You know which we could train,for example, with some version
of a Turkish get-up, which Ithink is a fabulous exercise.
But I quite often think abouthow much we lose because of the
connection between movement andneurological and cognitive
(51:30):
health.
How much do we lose when westop doing the things that we
used to do all the time andnaturally, when we were children
?
And if you were to look at allthe athletes that you work with,
do you see any correlations?
Like you've talked about,golfers who swing in one
direction all the time, pitchersthat throw in one direction all
(51:50):
the time.
They practice theseasymmetrical movement patterns.
But then we have gymnasts, forexample, that do flip and twist
and turn and it seems, just byme watching their routines, that
they tend to do it to the rightand to the left.
Do you see, from yourobservation, do you see any
(52:12):
patterns that emerge?
And I don't want to constrainyour thoughts just to like
injuries, but any comment Ithink you have would be useful.
But do you see any differencebetween sport practitioners
where multidimensional andangular movement and the impact
(52:34):
on their body is different thansomeone who's just a repetitive
single motion sport practitioner?
Speaker 2 (52:41):
Sure, I think I know where you're coming from with
that question.
And do they end up in adifferent place when they're 70
years old?
Is that the question?
That's part of it.
Yeah, I don't know, except tosay that if they were an impact
(53:02):
or a collision athlete, they arein a very different place.
Also, if they were a high levelgymnast, I don't see many of
them at our age where they're asphysical as we are.
But of course it's a biasedselection in that they're coming
(53:24):
to me with back pain.
Chances are.
You know I had an NFLlinebacker here not too long ago
.
He was in his 30s and he had twoknee replacements and two hip
replacements In his 30s.
Yeah well, late 30s Couldn'tget off the floor.
(53:49):
You know I've had another veryhousehold name, shall we say,
from the NFL and he said oh, drMcGill, if I'd known it was
going to hurt this bad, I neverwould have done it.
And you know the the accoladesthat he has received in his life
(54:09):
and he would have given allthat up not to have the pain
that he that he has now.
But again, these are are one of.
There are some very, verysuccessful uh athletes.
I gave a lecture actually uh,to the NFL probably five years
ago, just before the pandemic,on returning the NFL player to
(54:33):
civilian life and the challengebecause we know that every year
you play in the NFL and I forgetwhether this has been updated
or not, but it was somethinglike every year you play is two
years taken off your lifestatistically.
Speaker 1 (54:51):
And is that playing above a certain level is like
collegiate or it's onlyprofessional?
Speaker 2 (54:56):
So every year, that you played in the NFL.
It took a certain amount oftime, a substantial amount of
time statistically from yourallocated years for your age
group.
Speaker 1 (55:09):
Aside from these impact type activities, are
there any other physicalactivities that you see that are
inconsistent with goals oflongevity and quality of life?
Speaker 2 (55:23):
Well, look at every high level sport and athlete.
Do any of them outlive the restof them?
Speaker 1 (55:31):
So you're saying pretty much anything to the
extreme.
Speaker 2 (55:34):
Right, it's a toll on your body.
And there are some people whotrain like Olympic athletes and
they're a computer operator notrealizing that if they don't go
quite as hard now, they willhave most likely a longer health
(55:55):
span.
Some of them are just way tooextreme for a variety of reasons
.
But anyway, that's myobservation now of watching
these people for over 40 years,like you, and you recognize
patterns.
(56:16):
When I go to a medical meeting,which occasionally I will go to
as an invited speaker now, andyou know, all the speakers sit
at a table and what, what do wetalk about at lunch and dinner?
Well, I remember the last timethe, the dermatologist, who came
in and gave a an overview ofdermatology and what they
(56:39):
learned over 40 years.
He says, well, I love publichot tubs, they keep me in
business.
And then, you know, know, theorthopedic, the there might be a
spine surgeon or a hip surgeon,and you know he can predict
who's sitting in his uh, waitingroom.
There's a pattern there thatthey've they've noticed people
(57:00):
who do certain things increasetheir risk of becoming a patient
for that particular yeah.
So you know, we all know thesekinds of things and I don't know
if that no, no, it's, I meanit's it's.
Speaker 1 (57:17):
I think it speaks to the idea, like I'll go back to
what I was saying before Like if, if you asked, let's say you
take 15, 20 people off thestreet and ask them you know
what are the best examples offitness?
You're going to get a varietyof answers that all fall to the
extremes, right the Kenyanrunner, the extreme BO2 max, the
(57:39):
extreme strength athlete?
Um, I would argue that neitherof those two extremes represent
true fitness.
I think fitness ismultidimensional, in the sense
that it probably encompassesstrength, speed, power,
endurance, agility, mobility,cardiorespiratory capacity.
Speaker 2 (58:05):
Just before you get too far ahead of me.
Steve, can I interrupt and askyou something?
Speaker 1 (58:09):
Yeah.
Speaker 2 (58:10):
This is a really interesting conversation that
I've had with a lot of differentcoaches, and health would link
to being the best athlete.
Speaker 1 (58:34):
And you're not talking about skill, you're
talking about I might be, youmight be.
Speaker 2 (58:39):
I might be, but that was a simple question what and
who is the best athlete?
What and who is the bestathlete?
So, to start my line of logicon that and how I've answered
that question in the past if youtake a long distance runner,
they have a unidimensionalathleticism.
(59:00):
If you are a swimmer and youare a world record swimmer and
I've worked with a number ofworld record swimmers they are
unidimensional athletes.
Are they the best basketballplayer?
No, and one of the examplesthat I would use there is the
sport of being a triathlete,obviously dominated by endurance
(59:22):
, and when you're on a bike,it's endurance power, and when
you're on a bike, it's endurancepower is the person who wins
the first leg of the event,which is the swim.
So their athleticism, in otherwords, a great swimmer, will
beat all of the triathleteswimmers.
(59:45):
However, to be a swimmer, youneed to be a fish.
It is a great advantage to haveloose joints.
Big feet act like flippers.
With a loose ankle joint,that's the kiss of death.
To run, where you need to havethe elasticity to store and
recover elastic energy andbasically be a kangaroo or a
bunny rabbit in terms of themost matched athleticism.
(01:00:10):
Because if you look at the bestrunner, they won't be able to
swim.
You know, again I'm talkinggeneralizations.
Of course there are thosetriathletes touched by the hand
of God who really have theability to do all of these
things.
So those kinds of sports, to me, are not the best athletes.
(01:00:32):
Those are the unidimensionalathletes and they're really good
at one thing.
I've asked this of docs who arein the Olympic program for their
country, so they're exposed toa lot of different sports and
then when they're, the Olympicsonly occur once every four years
(01:00:54):
, so they're doing things thatare usually associated with very
high level sports teams andthat kind of thing.
If you look at a basketballplayer, a basketball player has
to have pretty much of it all.
They are agile, they can changedirection quickly, they have
beautiful hand-eye coordination,they have game savviness and
(01:01:16):
sense strategy, a certain amountof endurance, a certain amount
of strength, a certain amount ofspeed.
From an all-around perspective,that's pretty good.
Some of the NFL footballplayers before they get too
banged up, I was placed in thehead of an NHL hockey player who
(01:01:39):
skating is interesting.
It's not running, it's notground-based, yeah, um, anyway,
there's a, there's a thought forsome of the best athletes,
shall we say.
Speaker 1 (01:01:58):
Who's your, what's your favorite type of athlete to
work with, and that can eitherbe sport-based or maybe both.
Comment sport-based commentmindset.
Speaker 2 (01:02:16):
Well, this will surprise you.
I'm not a sports fan.
In other words, I would neverchoose to watch sport, never.
That's my life, and the onlytime I watch sport on TV is if
one of my clients or patients ison the screen and I think it
was three years ago.
(01:02:40):
In the Super Bowl which is thebest players in the NFL I had
one guy.
In the World Series, I had apatient.
And then in the NHL Stanley Cup, I had a patient All in one
year.
All in one year.
Yeah, it was interesting.
(01:03:01):
Do I have a favorite?
And the answer is no.
My favorites are the ones whereI get the internal satisfaction
of changing their life.
So either I was able to getthem out of pain and they were
satisfied that they'd done theirbest and now they're ready to
retire, or wow, I'm here inBackFit Pro HQ.
(01:03:25):
There's several posters aroundthe walls here.
Thank you for adding a fewyears to my career, thank you
for adding a couple more records.
So those are ones that I feltsatisfied with.
Shall we say and I'm not sayingI can help everybody, because I
(01:03:47):
can't, but anyway that I don'thave a favorite sport.
I will say this I'm a littlebit mesmerized by anyone who's
really good at what they do.
If this person is the bestspine surgeon, I want to hang
(01:04:12):
out with them.
I want to see how they think.
I want to know their habits, Iwant to know their skills.
I have some people who live inthe small town of Gravenhurst
here who are fabulous at whatthey do.
They might be a musician, theymight be a nature artist, they
might be a canoeist.
(01:04:32):
I'm going to seek them out.
Yeah, so I love mastery, and itgoes way beyond sport.
I remember here's a funny storythat it's rather oblique and you
(01:04:53):
might enjoy it, though when Iwas a PhD student I was going to
quit, and the reason I wasgoing to quit was I was
terrified of public speaking.
It was so difficult for me togo to a medical conference or a
biomechanics science meeting andtell them what I'd been working
on, and even though I was theexpert at what I had done, it
(01:05:15):
was so difficult for me and Iwas going to quit.
And I remember 1983, theUniversity of Waterloo hosted
the World's BiomechanicsConference and there was a very
famous spine surgeon there namedHarry Farfan.
And I went to lunch with DrFarfan and he said oh, that was
(01:05:38):
a good speech you gave.
And he asked me a few questionsabout my work and he said so,
where are you headed next?
And I said Professor Farfan orDr Farfan?
I'm struggling.
I don't know if I'm going tocontinue with this, and this
will surprise a lot of people,because I made my life living
speaking and he said well, I'lltell you what he says.
(01:06:02):
That was a good talk you gavetoday.
Just keep doing it and if youever screw it up, they'll never
ask you back again and yourproblem is solved, problem
solved.
And that was what I needed tohear at that time and I fought
through it.
But I'll tell you.
Even today, when people ask meto come and give a talk and it
(01:06:23):
doesn't matter if it's in frontof 10 graduate students or
10,000 people at the nationalsafety convention my knees are
shaking.
Speaker 1 (01:06:35):
I, you know it's funny you say that that because
I in the last 15 years I've I'vetaught thousands of doctors of
all persuasions.
But thousands of doctors of allpersuasions, you know I would
(01:06:59):
do roughly depending on the year.
Before COVID I was doingprobably 15 to 18 three-day
weekend seminars a year.
And even now, even after 15years of teaching, the first 10
minutes I'm nervous.
And then you know, just kind ofget into the flow and you
forget what you're doing and nowyou're just talking to a bunch
of colleagues and then the restof the weekend is fun, but those
first 10 minutes for me alwaysnerve wracking.
Speaker 2 (01:07:17):
Same.
Speaker 1 (01:07:18):
Yeah, well, I'm glad, glad to hear that I'm not, uh,
I'm not alone.
Speaker 2 (01:07:23):
Well, listen, I never goes away.
Speaker 1 (01:07:26):
No, it doesn't.
I know that you have some snowshoveling to do, so I do.
I have one question I wouldlike to end on, and you can
choose to answer this or not.
You got to tell me about themustache.
The mustache, it's so iconic,it's even part of your brand.
Speaker 2 (01:07:43):
Well, it is, and the story behind that was I was
always I had a mustache since ora beard, actually from high
school.
That's probably the only thingI was good at in high school,
but in any case.
And then my daughter, who wouldhave been a very young girl,
(01:08:06):
maybe four or five years of age,and I'd always had a beard
usually a full beard in thewinter and then just a mustache
in the summer and she said Dad,I've never seen you without a
mustache.
Why don't you shave it off?
See what you look like?
I thought for maybe 30milliseconds, so I went and
(01:08:27):
shaved it off and I was kind ofsurprised.
There's a couple of photos.
They're rare.
And I went to work the next dayand I walked by my colleagues
who I've worked with for years.
They just walked by, no onerecognized me, and then a couple
would say, oh my God, andanyway, in those days the
(01:08:49):
internet was just starting andI'd be flying to different
places.
Like you, I was somewhere inthe world every month for 25
years and usually a graduatestudent or someone would be
assigned to pick me up at theairport.
And what was the instruction?
Because there was no internet,they didn't know what I looked
like.
They were just a senior studentand usually the instruction was
(01:09:13):
look for the mustache, you'llknow it when you see it.
But people were so upset thatwhen I showed up without a
mustache they said, well, that'snot a student, miguel, that's
not what we paid for.
So I realized, darn, I'm kindof stuck with this and that my
wife hates it, does she really?
(01:09:34):
Oh, yeah, she.
She hates facial hair andwhatnot, but I don't know it's,
it is what it is.
By now, I guess.
Speaker 1 (01:09:45):
I, you know, I've, I've grown, I've grown a full
beard a couple of times in mylife and I always ask my wife
what do you like better, shavedor not shaved, or goatee or
whatever?
And her answers are sononcommittal that it drives me
bananas, it drives me nuts.
So anyways, like I said, yourmustache is so iconic.
(01:10:06):
I know there's got to be morestories about the mustache, uh,
but maybe we'll save that forfor a different time.
Speaker 2 (01:10:14):
I would love do you want to hear one that that just
came to mind, since you saidthat I was coming into a Dublin
airport in Ireland and, uh, youknow how they swab different
things as you're coming in andthe woman who did it just said
(01:10:35):
just a moment.
And two burly guys came and onecame under each arm and took me
back to this room and they said, sir, why do you have, is there
anything you want to tell us?
And I said no.
And they said, okay, why do youhave explosives on your hands?
(01:10:56):
And I said no idea.
And do you know then that theywent through my mustache and
were Really, yes, yeah, gettingmolecules of TNT?
And then they heard my accentand they said, oh, you're
Canadian.
And I said yes, and they said,have you been around firearms?
(01:11:17):
And I said yes, I cleaned myguns two weeks ago, two weeks
ago, and there was residue offmy guns and gun oil I guess, and
it was still in the pores of myhands and I washed my hands a
lot because I washed my handsbetween every single patient.
(01:11:37):
But there you go.
I had gunpowder residue andthey picked up a molecule that's
how good those machines are.
Yeah.
Speaker 1 (01:11:46):
Well, I'm going to I'm going to have to grow some
facial here and go test out thattheory.
Speaker 2 (01:11:53):
Yeah, careful what you touch, that's right.
Speaker 1 (01:11:58):
Well, stu, this is.
This has been a hoot.
I really appreciate it.
I know you're a busy man andyour time is valuable, so thanks
for taking time to talk to meand and to talk to our community
.
Um, I would like to proposethat maybe we do this once a
year.
Speaker 2 (01:12:14):
Well, let's, let's see how it goes.
Maybe next time I can come outto the rock.
Speaker 1 (01:12:19):
There you go.
Yes, we'll come out and I'll,and I'll, I'll share my uh, my
favorite fish and chips placeand a brew pub.
Speaker 2 (01:12:26):
No, to hell with that .
Let's go out and catch one.
Oh there you go.
We'll have it on the back porcheven better.
Speaker 1 (01:12:35):
That sounds awesome, stu McGill.
Thank you, sir, I appreciateyour time.
Speaker 2 (01:12:39):
Dr Noseworthy, thank you so much.
I've enjoyed every second.
Hey everyone, welcome to the Funkbed Nation podcast.
I'm your host, dr Steve Noser.
The views and opinions ofguests on this podcast are their
own and may differ from my own,but as always, I try to be
respectful of other people'sopinions, even when we might
disagree.
My guest today is Dr StuartMcGill.
Dr McGill is a professoremeritus at the University of
(00:27):
Waterloo in Ontario, canada, anda world-renowned lecturer and
expert in spine function, injuryprevention and rehabilitation.
Dr McGill has written more than200 scientific publications on
the topics of lumbar function,low back injury mechanisms and
the investigation of tissueloading during rehabilitation
(00:48):
programs.
He's received several awardsfor his work, including the
Volvo Bioengineering Award forlow back pain research from
Sweden, and is a recipient ofthe Order of Canada, the second
highest merit award in thenation.
Dr McGill has been an invitedlecturer at many universities,
has delivered more than 200addresses and 70 keynotes to
(01:11):
societies around the world.
He has written four books andcontributed 32 chapters to
others.
He's sat on the editorialboards of many journals in the
physical medicine and rehabspace and recently has appeared
as a guest on other podcastswith Andrew Huberman, peter
Attia and Mark Bell.
As a consultant, he hasprovided expertise on assessment
(01:33):
and reduction of the risk oflow back injury to government
agencies, corporations,professional athletes and sports
teams of all varieties.
Most recently, he accompaniedTeam Canada to the Paris
Olympics.
When Dr McGill agreed to join mefor a conversation, I was
determined to not simplyrecreate other interviews he had
done by asking him about thecauses of low back pain.
(01:55):
Rather, we delved into hiscareer, his personal and
professional philosophies onhealth and fitness, and he
shared several inspiring storiesabout both professional
athletes and regular people thathe has worked with and how he
derives deep satisfaction fromhelping people change their
lives.
And yes, I felt compelled toask him about his iconic
(02:18):
mustache.
Let's get to the interview.
This is a question I've askedyou before and I think it bears
repeating.
You are very well known forcertain things.
The example I gave you beforewas people hear I'm a
(02:40):
chiropractor.
They think they have me figuredout.
They pigeonhole me intowhatever their impression is of
a chiropractor, and my knowledgeand expertise goes well beyond
that.
And to me, in talking to you,it's quite clear that your
expertise goes beyondbiomechanics and simple low back
(03:03):
pain.
Biomechanics and simple lowback pain.
So I'd like you if you wouldjust comment on what is the main
difference between the commonpersona that people think of you
, like when they hear the nameStu McGill, or they listen to
you talk.
What's the difference betweenthat impression or that image of
(03:25):
you and your impression ofyourself?
Maybe that's an unfair way toask it, um, but nevertheless
there's the question.
Speaker 2 (03:38):
Wow, um, yeah, well, I, I, I don't know what
impression I have of myself.
I think the variation thatyou're describing of some people
who hear my name and have animpression is that they're
(04:00):
internet educated or socialmedia educated, versus having
spent time with me either hereat BackFit Pro or just at a
conference.
When I was a professor, I usedto find the most valuable
experience of going to aconference was going and have
(04:23):
dinner with a group of studentsor with other professors.
That's when the real work andunderstanding of individual
viewpoints is acquired and honed.
So would it help to summarizewhat I did at the university and
it may, if anyone's interested,stimulate them to look at what
(04:53):
was performed and maybe why.
I have some of the opinionsthat I have that extend beyond
biomechanics.
Speaker 1 (05:01):
Yeah, I think that would be very helpful.
And I'd like to also if we canboth remember, to come back to
this for you to you know, maybepoint out a couple of things,
that a couple of things aboutyourself that most people
wouldn't come to know if allthey knew was you on the
internet, like watching,watching a podcast interview, or
(05:23):
watching there's videos of youout there.
You know doing an assessmentwith certain people, or you know
showing someone how to do aproper pull up, or, for example.
So you know, start with that,like what did you actually do at
the university?
And then maybe lead into here'sa couple of things that people
don't know about me and mybackground, and it can be
(05:43):
anything.
It could be professional, itcould be personal.
Speaker 2 (05:46):
Okay, I started at the university, as I said, as a
professor in 1986.
And I just had one question andthis would bother people a
little bit, because normally anew professor has to have a
hypothesis.
You write that into a grant,you submit that grant and this
(06:07):
is the hypothesis that I'm goingto test and I want money for.
Well, I was never like that.
My question was how does thespine work?
It's not a hypothesis, it'sjust a question how does the
spine work?
So over the years a fewcolleagues would have fun with
me and they say oh, mcgill,you're such a spine slut, you
(06:29):
will do anything with anybody atany time, as long as you can
learn something more about thespine.
So if I would work with asurgeon and attend surgery or
work with a team, study theinjury patterns, I would be
invited to the team's trainingcamp and I would meet with the
medics and we'd be sitting up inthe stands there and we would
(06:51):
have the idea we're watching allthese players, we were
discussing them and I'd say,good, get out a piece of paper
and let's write down ourhypotheses being who will be
hurt and where by the end of theseason, put it in the envelope
and that's going in your deskand that doesn't come out till
the end of the season, and let'ssee how good we really are if
(07:13):
we think we can predict injuryby watching them move.
So you know, just fun thingslike this.
How does the spine work?
How does the spine work?
Anyway, the first laboratorythat we started in 86 was
equipped to measure internalloads in the living person.
(07:33):
So we would film themthree-dimensionally moving.
And then the big step was thevirtual spine.
So the computer technology wasjust at the point where we could
take CT scans or MRI scans,which are serial slices, stack
them and then recreate thatindividual's spine, their
(07:58):
musculature, the ligaments, thediscs etc.
That was called the virtualspine.
The instrumentation measuredthe spine curve, the external
mechanics of load on their handsand, working through link
segment dynamics, figuring outthe external mechanics, the
loads on the spine, and thenusing electromyography of
(08:18):
electrodes around the body,figuring out muscle force,
stiffness, stability etc,allowed us to measure the stress
concentrations on the actualtissues.
Interestingly enough, in mostpeople the stress concentrations
was where the pain was comingfrom, not in all but in most,
(08:39):
which was fundamental.
Then I realized I didn't knowthe injury processes.
So we took cadavers and wewould apply the loads to the
spines and the various tissuesof the cadaver.
So we learned very preciselywhat are the pathways to disc
herniation?
How do you fracture an implant?
What really causesspondylolisthesis?
(09:03):
And, as it turns out, it's alittle bit of anatomy with the
set angle, plus the cycles ofload, plus the brittleness of
the bone, etc.
Then I realized, boy, all ofthese people are coming into the
experimental research clinicand I'm reading the radiology
reports, but there's no linkback to the mechanical causation
(09:25):
pathway.
So we developed a radiologysuite, I acquired some money and
we got x-ray machines, micro CT, ultrasound for living people,
et cetera.
Then the dean asked me well,okay, hotshot not using those
words, but that's what he meantwhy don't you start seeing
(09:49):
patients and test your scienceto see how good it is?
So I started the experimentalresearch clinic, but remember, I
didn't have the constraints oftraditional medical training or
funding models, training orfunding models.
The patients would come in andI set aside two hours to assess
(10:10):
them and give them my opinion asto what is going on, and then
that will inform what theyshould and shouldn't do.
You know, steve, after thefirst year I changed that to
three hours.
Well, this was unheard of.
My medical colleagues said whatare you going to do with people
for three hours?
Who's going to pay for that?
Anyway, the other uniquefeature of that was we followed
up with every single patient weever saw in the history of that
(10:33):
clinic.
We know exactly our efficacyscore for the different
categories, you know.
Is it discogenic pain?
Is it neural arch pain?
Categories you know.
Is it discogenic pain?
Is it neural arch pain?
Is it pain exaggerated becauseof the fear that they have of
losing their job and now havingfive mouths to feed at home?
(10:57):
You know all of the subsubcategories.
The next pillar that we usedand I developed being a spine
slut, remember was we.
I realized as I saw patients,clusters were forming.
I was paying attention, and sowhy was it?
Gymnasts had quite a commonpresentation as they were coming
(11:21):
in.
Crossfitters had just started.
Why are they coming in with?
Again?
It was almost always discogenicpain.
And then in my work indifferent sports I would see how
come this baseball team haszero stress fractures?
The next baseball team has fourspine stress fractures.
(11:45):
It wasn't the game, it was thestrength coach who was causing
the stress fractures in theirback not realizing the mechanism
and that biological capacityhas a finite bound and you just
can't keep bending the pars,which is the bone that was
stress fracturing in their back,back and forth over and over
(12:06):
and over again, becauseeventually it will crack and if
you keep going it will fracture.
So that came from our study of,from studying clusters.
We won an award.
Actually we had the longestlongitudinal study of the
Toronto Police Force, the ETF,and you know the things that we
(12:29):
learned.
You know where is the mostdangerous place in terms of
musculoskeletal injury for anelite SWAT team, police officer
and people will think, oh well,it's rappelling down a building
or you know a hostage situation.
No, it's the weight room and,interestingly enough, the ones
(12:52):
who push themselves to have thehighest level of fitness had the
highest injury rate.
Speaker 1 (12:58):
So you know to almost expect that right, because
you're, I mean by nature.
Speaker 2 (13:03):
You're pushing the band yeah.
Yeah, you and I would, but notsome of the strength coaches.
Speaker 1 (13:08):
They always think, oh being stronger is always better
, strong is always better itisn't.
Speaker 2 (13:13):
There is an optimum for enhancing resilience as a
police officer, as there is forevery single athlete.
Speaker 1 (13:22):
Oh, I would love to drill down on this idea of what
is optimal strength.
Do you have a sense of that?
Of course, do share.
Speaker 2 (13:37):
Right now.
I am perceiving that because ofthe internet, there's a lot of
people who are jumping on thebandwagon get stronger, get
stronger, get stronger.
Do Olympic lifts and that kindof thing.
I'm old enough that I've seenquite a number of true Olympic
(14:00):
lifters and I've followed themthrough until they're.
I've got one guy who's in his80s.
Do you think he's the mostcapable, 80 year old right now?
Speaker 1 (14:11):
I imagine that kind of training takes a toll.
Speaker 2 (14:15):
Well, that particular one is on a walker.
His shoulders are shot, hisknees are shot, his hips are
shot.
Now, I'm not saying that I maynot be there myself, but you
know, optimal strength is onethat suits your body frame.
First of all, there are somepeople, through the right choice
(14:37):
of their parents, they cancarry a lot more strength and
they're going to be fine.
There are others who will nevercarry that strength without
paying the price to their joints.
There are some who move welland can utilize that strength,
and there are others who aresomeone put a V12 engine into a
(15:00):
jalopy and it tore up the restof the frame, so we're starting
a little bit with genetics there.
What are the demands of theirlife?
Is the strength sustainable?
And I will say this and again,people will disagree, but that's
fine.
The stronger the person is, theless of their life they will
(15:25):
carry that.
Now I'm talking about extremes.
People who come here as backpain patients and I'll say
what's your goal?
And they say I want my nextdeadlift record.
And they're 33 years old,they've got an implant fracture,
a disc bulge, maybe more sorehips, torn labrum, and they're
saying I want my next.
And I'll say who's paying you amillion dollars for the next
(15:48):
world record Not world record,sorry your next personal best
which is done in your basementand they look at me and I'll say
let me ask you something.
And say they're a 56-year-oldand I'll say how old are your
kids?
Oh, I got a 30-year-old.
And I'll say how old are yourkids?
Oh, I got a 30-year-old son.
And whatnot?
Yeah, do they have kids?
(16:09):
He says yeah, we just had ourfirst grandchild.
I said, how about this?
Would it grab you if you couldbe the best rocking 80-year-old
on this planet playing with yourgrandson, taking him fishing,
etc.
And they stop and think andthey really pause and they say,
(16:29):
well, I've never really thoughtabout it that way before and I
said, well, on your current path, if you want your next personal
best, the chance of you beingthat very capable, sufficiently
strong 80-year-old diminishesand that rocks them a little bit
(16:52):
.
And then, if I can get them tobuy in a lifespan longevity kind
of a goal, we have a muchbetter chance of improving their
health.
That's sustainable.
That is not maximum strength, itis sufficient strength.
But I've given you that it is acontext.
(17:14):
Given their frame, their injuryhistory, how successful are we
to adapt some base robustnessnow, given their injury history,
to get them through to that?
So I can't give you, unless wehave a person with us, great,
we'll assess them and we willestablish what sufficient
(17:36):
strength means for them.
But of course there are somegeneralizations.
If the person has and I knowwhere you're headed with this
you want generalizations and,darn, you're going to force Stu
to give them to you.
But what our research showed usover the years, there are some
baseline things that most people, if they can do this, they're
(18:01):
sufficiently strong and I goback to when I was working in
the NHL.
They're sufficiently strong.
And I go back to, you know,when I was working in the NHL
National Hockey League, I thinkover the course of three or four
seasons we had five sportsman'shernias with different teams,
do you know, and that's a torninternal oblique or external
(18:22):
oblique abdominal wall muscle.
Internal oblique or externaloblique abdominal wall muscle.
When we met, we would go backthen and look at their fitness
scores.
Every single one of them, notone of them could hold a side
plank for a minute.
Now you're asking me, what isan NHL player doing who is at
(18:45):
that level of physical abilityand they can't hold a side plank
?
They're terribly out of whack,out of balance in their physical
training.
Anyone who could hold a sideplank for a minute we never did.
Now, this is anecdotal, there'sonly five cases, but it's a
(19:05):
minute we never did.
Now, this is anecdotal, there'sonly five cases, but it's a
hypothesis.
So my colleague at theuniversity, jack Callahan, he
would take back pained peopleand normal people and then just
measure their side plank.
Those who had longer sideplanks could stand longer
without back pain.
In other words, the people whoare getting back pain Now.
Again, is that causation or isit correlation?
(19:26):
I think it's probably a littlebit of both, but anyway I know,
steve, you're asking me forgeneralizations.
Most people should be able tohold the side plank for a minute
and that should be symmetricbetween sides, within 5%,
because if they're asymmetricthat increases their risk of
future back pain as well.
Now we get into the discussion.
(19:48):
Have I ever measured aprofessional golfer who is
symmetric right and left on theside plank?
And the answer is no, I neverhave.
But every single pro golfer whocomes to see me has a back pain
.
History playing a highlyasymmetric sport.
Playing a highly asymmetricsport.
And, by the way, if I had aprofessional baseball pitcher,
(20:14):
would I demand and expect andhave the goal of symmetry?
Absolutely not.
They're an asymmetric, elasticathlete.
So do you see how the nuance ofall of this just continues and
continues.
But you want somegeneralization.
So it would be.
Now maybe your shoulder is soreand that is the reason why you
can't hold a side plank.
It's not a spine or a coreendurance issue.
So we might have to do a sidelaying lateral leg hover as a
(20:41):
surrogate for the measure of.
Is it as good as a side plank.
No, it's not, it's a surrogate.
Anyway, does that?
Speaker 1 (20:49):
help.
Yeah, no, that's helpful and itleads my brain down a couple of
different avenues.
Yesterday the very first thingyou said in this part of the
conversation was a lot of it hasto do with genetics and say,
body style, um, I showed my dada video of the guy recently
(21:10):
breaking the world deadliftrecord, you know, thousand plus
pounds, and I made a comment tohim.
My wife was there and I made acomment like these guys are all
built the same way, like, if youlook at a high level power
lifters, strong men, there's aphenotype that lends them to
that type of capacity.
(21:30):
Obviously, training becomesvery important.
And you can go to the otherextreme and you look at, like
Kenyan runners, you're not goingto expect them to deadlift
tremendous amounts of weight,and so I totally understand that
body habitus.
There you know your, yourphenotypic expression, how, how
thick are your joints and yourbones, and maybe we can make
(21:53):
some correlations with ligamentand tendon strength, strength as
a result of that.
So I totally understand,totally get that.
So what I want as a professionalis I want and maybe we'll never
get there, but I want a set ofbasic guidelines, like one of my
great interests, because of thetypes of people that I work
(22:14):
with, who are, as I mentionedbefore, tend to be the sickest
of the sick, not with disease,but with dis-ease and
dysfunction, and many of themhave lost what I call exercise
tolerance.
They've either had to greatlyreduce their physical activity
to match their performance andrecovery capabilities, some have
(22:38):
given up on exercise altogether, because at least they perceive
that anything they do isproblematic for them, because at
least they perceive thatanything they do is problematic
for them.
And so I, as a clinician, I'malways asking myself, number one
, when is the right time to getthis person into an activity or
an exercise program?
And I do make a distinctionbetween those two things,
(22:59):
activity versus exercise.
And how do I blend that with myunderstanding of their, and how
(23:22):
do I blend that with myunderstanding of their what I
call their metabolic tippingpoint, and that's their ability
to basically perform and recover, as perhaps dictated by their
inflammatory state, their energymetabolism systems and a couple
of other things that we couldthrow in there as well.
And so the question is alwayswhere's the starting point and
how quickly can we progress them?
Because, as you said one of ourprior conversations, like you
know, there's there's aninfinite ability.
No, I'm sorry, there's alimited ability to perform and
recover, and when someone'sinjured, that goes down.
And I see the same thing from ametabolic standpoint, to the
(23:45):
point where people are sometabolically compromised and
deranged that even walking ablock is challenging for them or
doing their household chores ischallenging for them.
And so I'm always trying todevelop for myself and then to
share with colleagues how do weget someone into an exercise and
activity program for thebenefit of their whole body
(24:07):
health?
And I shared with you beforethat, when I started thinking
this way, one of the very firstthings that I adopted was the
McGill Big Three, just as almostwhat I call a low-load
preparatory phase of training,where I might have somebody
spend six weeks every other daydoing the McGill Big Three and
doing some shoulder girdlestabilization exercises and
(24:31):
watching how they can performand recover and handle.
That tells me a lot about howquickly I can progress them into
, say, gravity-dependentexercises and then full-body
exercises, whether it's assimple as an air squat or a
thruster with nothing in theirhands, for example.
And so I know I keep harping onthis like what are the basics,
(24:53):
what are the baselines?
Because for me in my world.
If I can find that lowestcommon denominator and then
progress people from there tosome semblance of sufficient
strength, sufficient mobility,sufficient flexibility and so on
, then I'm doing the best that Ican clinically to help these
people live a good life 10, 15,20 years down the road, from
(25:15):
wherever it is that we'restarting from.
I don't know if that helps youclarify what my thought process
is, or I don't even know ifthere's a question in there, stu
.
Speaker 2 (25:26):
Well, I can riff on the topics that you brought up,
and that was a great essay thatyou just wrote, by the way.
Well, you know you started outtalking about phenotypes and I
just have so many friends inthis whole area, chances are, I
know the person that you'retalking about, who set the
(25:47):
deadlift record.
But you know, I've learned somuch from someone like Ed Cohn
and if anyone's in thepowerlifting world they will
know the name Ed Cohn.
And Ed is just built to lift,but you know incredible strength
of mind and personality and allthe rest of it.
(26:09):
And he's absolutely verydifferent from a Kenyan runner.
One of my good friends is ShaneBenzie, who wrote the book Lost
Art of Running, and he hasspent years living in Kenya
working with coaching andstudying the Kenyan runners.
And you're absolutely right,these are not Ed Cohn, these are
(26:32):
elastic, tuned, elastic athletewith beautiful upright postures
, tuning the elastics to storeand recover energy, to enhance
efficiency.
You know nothing to do withEd's athleticism and a totally
different definition ofsufficient strength, but both
are world-class at what they do.
(26:56):
But I'm going to go back to apatient who I saw yesterday Just
a lovely fellow, and he came tome and he said I used to be
over 600 pounds and he came andhe was 300 pounds and not a tall
man, but what a lovelypersonality.
And you know I tried tounderstand what the pathway was
(27:19):
leading him to becoming 600pounds and he, you know, had a
challenge with the pandemic and,okay, I can understand what
happened and allowed him tobecome a prisoner of his room
and he could lay in bed and walkto his computer and go to the
toilet and then he became aprisoner of that room.
(27:41):
But he became.
He became started to work withone of my grand old friends who
used to be on our Olympic team,a fantastic strength power
athlete, but he now hasdebilitating back pain and I
think what you were talkingabout with some of your people.
(28:01):
They are an extremely low leveland they're extremely fearful
and they've given up on exercisebecause it's always hurt.
So I'm trying to give abackground now for the challenge
that I had yesterday.
And here is this fellow.
He's lost 300 pounds, half hisbody weight.
He's lost 300 pounds, half hisbody weight, but he's still 300
(28:24):
pounds through caloric deficit.
He can't go any lower.
His metabolism is so slow.
He's got to do some physicalactivity to change and reset the
caloric expenditure side of theequation.
So can he walk.
Yes, so can he walk, yes, well,we did some walking training.
(29:10):
Again, from my experience ofthe Kenyan runners, can we use
some elastics now and some bodypositioning, soing this?
You said they can only walk fora block Great Walk to the end
of the room and back and do itevery 15 minutes.
So the lower level that theperson is starting from the
principle of graded exposure istry and have a shorter interval,
smaller dose, more often, andthen, as they start to gain a
(29:35):
little bit of capacity, the dosebecomes larger, but so does the
time between the exposures.
And in the extreme you canbecome Ed Cohn, and even though
he was by far the bestdeadlifter in the world, he
really only trained once, maybetwice a week, but he spent that
(29:57):
much time between the exposuresbecause of the intensity of them
.
So that is a little bit of ascientific principle in this
idea of graded exposure.
Speaker 1 (30:11):
Do you know?
It's hard to jump in here, butyou know Marty Gabala at
McMaster.
Speaker 2 (30:15):
I know Marty well.
Speaker 1 (30:17):
Yeah, so I interviewed Marty last year.
We have a mutual friend, a guyI went to chiropractic school
with, and he was the one I don'tthink he coined the phrase, but
he was the one.
I don't think he coined thephrase, but he was the one that
introduced me to the idea ofexercise snacking.
Speaker 2 (30:32):
Well, Marty really is considered the father of HIIT
high intensity interval training.
Speaker 1 (30:37):
Yeah, yeah, yeah.
In fact, to this day, myinterviews with him are some of
the best, the most downloadedand listened to episodes in my
uh, in my funk meditationpodcast.
Speaker 2 (30:48):
Yeah, yeah, no, marty's fabulous.
Speaker 1 (30:50):
Yeah, he certainly is .
Uh sorry, and I know Iinterrupted your train of
thought.
I just wanted to bring his nameinto it.
Um, back to you.
Speaker 2 (30:59):
Well, and then you mentioned bird dogs and I was
thinking yesterday, okay, birddogs, and I was thinking
yesterday, okay, first of all,my client needed permission to
do physical things.
He was petrified that, with hisbody and its current condition,
that he might create an injuryand more pain, because he came
(31:22):
to me with back pain.
But it really was spine hygieneor movement competency showing
him how to squat.
So that same style of shortstopsquat that we talked moments
ago with that elderly woman atthe medical school.
I showed him and yeah, but weexpanded it with him.
(31:44):
We did the shortstop squat andthen I said now reach across
your body and touch my hand overhere.
And he reached out.
Oh yeah, that causes pain.
And I said, why did it causepain?
He said I don't know.
And I had to remind him yetagain that your pain is caused
when your spine gets out ofposition.
How do we keep position?
You're going to reach across,but turn your hips, put a
(32:06):
pointer on your rib cage, apointer on your pelvis and those
stay together.
It doesn't cause pain, does it?
No, it doesn't.
Why hasn't anyone shown me thatbefore?
So I got him to do a shortstopsquat reach across, turn the
hips, push his hips back alittle bit further, pull his
hips through, square up andrelax.
(32:26):
Let all of the control go, Justrelax and hover.
He says, yeah, that didn'tcause pain.
This was monumental in changinghis opinion of movement being
something to fear versusmovement being liberating and
now allowing me to accomplishthat.
So that was the first stepgiving him permission to move,
but also showing him a techniquenot to trigger his specific
(32:53):
pain mechanism.
Then we got down and we didbird dogs.
It was a challenge getting downand then to do a bird dog,
because his shoulders were alsoan issue.
Okay, well, there's bird dogs,and then there's bird dogs.
And here's where the expertisecame in.
I showed him how to do a birddog and his arms were way out in
(33:13):
front of him.
He said oh, my shoulders aresore.
I said get your handsunderneath your shoulders, your
knees underneath your hips andlift your tail.
Okay, did a bird dog Well, thathurts my shoulder that he's
supporting 300 pounds with.
I said, good, grab the groundwith your hands and try and pull
(33:35):
your hands to your knees.
Now you, with your training,knows what I just did with his
back.
We turned on the lower trapstrapezius, not trapezius, lower
trapezius, serratus anterior,and a little bit of lats, and
all of a sudden I tricked himinto a shoulder stability
(33:57):
pattern.
So now his shoulder didn't hurtand I said now push the earth
away.
And now do the bird dog, tryingto pull the stance heel of your
hand towards your knee, tookhis pain away.
So you know that was importantbecause it now gave him another
(34:17):
tool to really integrate thisgoal of he's got to have some
caloric utilization now becausehe's maxed out.
He's so calorie deficit.
His reset is now 300 pounds.
He wants to get to 200.
But anyway, it was such a wonder.
(34:38):
I called him, as I always dothe next day.
So this what's today?
Thursday, I saw him Tuesday.
So I called him yesterday andhe says yeah, you know, on the
verge of tears, I haven't hadany pain.
I gave him a lumbar to put inhis low back.
So the person who drove himhere, he is almost five hours
(34:59):
through the snow and I said,yeah, I didn't have any pain in
my drive home, so it's justfiguring out his mechanism and
giving him permission to moveand then showing him a few tools
so that he realizes wow, thisdoesn't hurt me, I'm safe and
(35:19):
it's what I need now to meet mygoal, which him?
He still needs to lose anotherhundred pounds, but that is the
scientific reality.
He needs caloric exposure now.
Speaker 1 (35:32):
Maybe in the beginning, what you did was you
removed both a physical as wellas a perceptual block to making
that next step right.
Speaker 2 (35:44):
You asked me earlier where's the misperception of me?
People say, oh, mcgill'sbiomechanical never considers
the psychosocial, fullbiopsychosocial rubric of pain
and anyone who comes here says,wow, that's the most
(36:04):
biopsychosocial assessment andintervention I've ever seen.
So again there are people onthe internet who they haven't
contributed to the science.
Speaker 1 (36:30):
Again social media they want to gain exposure by
right you know, misrepresentingother people.
I suppose I would imagine thatwhen, in you know, I I
approached this interview withyou with the express intent of
not doing just another stewmcgill interview where all we
did was talk about back pain,because I knew it's been
refreshing and fun.
(36:56):
Yeah, well, I knew that therewas more to you and more to your
expertise, and that's reallywhat I wanted to bring out, as
you were talking about thisgentleman and I'm sure it's more
multidimensional than this butbeing confined to his room and
being that large, he had such ahigh mechanical load on his
spine.
But being confined to such asmall space and unable to really
(37:17):
move all that much, he wouldhave fallen into such states of
disuse, atrophy, such states ofdisuse, atrophy, um, and it made
me think about you know this,and I'll, I'll, I'll bring this
out particularly like I'm inanother month, I'll be flying to
California to teach a weekendseminar on, uh, we call it brain
(37:39):
chemistry, but it's a, it'sabout a lot more than that, um,
and and I usually start theentire weekend seminar by
bringing docs through, kind oflike, the different
developmental stages, frominfancy to adulthood, so to
speak.
And just if you'll bear with mehere for a second, and I think
anybody who either has childrenor have spent time around
(38:03):
infants will recognize this, youknow, babies come out of the
womb and they're completelyspastic, they're all over the
place, they can't control theireyes, they can't control their
head, they're just movingspontaneously.
And as the brain begins todevelop, the first thing it
learns to control is theeyeballs.
That's like literally the firstmotor system that begins to
(38:25):
mature, is the eyeballs.
That's like literally the firstmotor system that begins to
mature.
And because the ocular motorsystem is linked to the
vestibular system and to theintrinsic spinal muscles, the
next thing that develops is somesemblance of cervical stability
.
And those get yoked together tothe point where, just even
after four or five weeks of life, a baby can see something
(38:46):
across the room and turn theireyes and their head to look at
an object of interest.
And then, as they continue todevelop beyond that, that
stabilization of the spinalstructure, which at this point
doesn't have any curvature toany great extent, and I should
say it's a big C curve, itdoesn't have a cervical or a
lumbar lordosis.
(39:06):
And as these core systemsdevelop, we get the cervical
lordosis.
Stabilization progressescaudally and now we get
stabilization of the pelvis.
This gets combined with theability to turn over, sit up,
then they can stand, then theycan walk, then they can run, and
(39:29):
from a neurological standpoint,this creates the platform from
which all higher cognitivefunctions develop.
There's a reason why mostchildren don't start talking
until a certain age.
The motor system has to developbefore we can acquire language.
In most cases, right, there wasalways outliers and that may be
(39:52):
actually a sign of a problem.
But and maybe this is the biasof a chiropractor talking I look
at the spine and spinalintegrity in many ways as being
foundational to health andwellness.
I think it's a critical part andit's not just because it's what
(40:13):
allows us to move and exploreour environment and to do things
you know, say, with the graceand beauty of a ballerina or an
elite gymnast a ballerina or anelite gymnast.
The influence of the spine andcapacity of that to neurological
(40:34):
health is scientificallyundeniable.
And even if we go into maybethe clouded history of
chiropractic and its origins,back before chiropractic became
known as a back pain modality,people in the early 1900s went
to chiropractors because theirguts didn't work, you know, they
(40:55):
had indigestion or they weren'tsleeping.
I mean, chiropractic in itsorigins was a true healthcare
discipline and then we gotpigeonholed into back pain and
neck pain, which is fine, itstill serves a purpose.
But I love talking to peoplelike you because you see things
(41:15):
differently.
Your experience is different interms of meeting people where
they are and treating them asindividuals and working to
remove barriers to allow them tohave basic functionality.
I look at that and go.
If I can get someone to gothrough that process and open
(41:40):
their mind to the possibility ofdoing new and different things,
I know that I'm going to have agreat result with them.
It doesn't mean they're goingto be a hundred percent and I
can't guarantee when that'sgoing to happen, but I look at
motion and movement as a keycomponent of health, wellness
(42:05):
and fitness for so manydifferent reasons.
But the spine is integral and Ithink we can track that all the
way back to how neurologicalsystems are designed.
And I could just keep going on,but I'll probably get lost in
my own thought process.
But what's your response tothose things that I just shared,
from my perspective?
Speaker 2 (42:26):
Well, again, I'm so enjoying this.
I was jotting down a few thingsas you triggered them and as
you spoke, so I'm just going togo back to the client that I
spoke of a couple of days ago,who was, and continues to be,
trapped in his body.
So, yes, he still has a goal oflosing weight.
(42:47):
But why?
What is the real root of all ofthat?
And it came out working withhim.
He says I just want tosocialize, I want to go out and
meet people, and he's juststarting to now.
And you know your heart, I'mtrying not to cry now as I not
now, but when I was with him andjust to you know, receive what
(43:12):
he was giving me and, as I said,he was had the most lovely
personality, good looking guy.
I can hardly wait for him toget out.
And you know, again I mentionedthis started with the pandemic
and you realize, for some peoplethat was such a challenge.
(43:35):
I loved it.
I hate to gloat.
You know my daughter was livingin Australia.
She came home.
My son, who's lived in the UShis whole adult life since he
was 18.
He came home.
My son, who's lived in the U?
S his whole adult life, uh,since he was 18, he came home.
I lived with my adult kids forhalf a year.
It was the most beautiful thingfor me.
And yet here was my patientyesterday who lost his twenties.
(43:57):
He said to me and uh, you know,so this is a huge thing that,
yes, losing the weight, theperson who has really developed
this idea of DNS dynamicneuromuscular stabilization,
(44:34):
which is really based onontological development, and
he's really opened my eyes tothe progression of the gaining
of ability and how sometimes anadult with pain, it's wise to
take them back to.
Some of those people refer tothem as primitive or child
(45:17):
development principles andreestablish those manipulation,
et cetera.
And I can give an example thereof we had a national level
gymnast come into the clinic forback pain.
Well, remember now we justdon't assess them.
We put on full instrumentationand measure them while they're
(45:40):
doing things.
And it was a bit curious.
They said you know, I also havea pain.
And they appointed laterally totheir oblique wall and they say
it's just nagging right thereand we put our electrodes right
over it and then we tried to getthem to relax and that muscle
(46:03):
wouldn't relax.
In other words, the motor unitsand neuromuscular compartments
in the abdominal obliques isn'tone.
In other words, the externaloblique is not a muscle.
The external oblique has manyneuromuscular compartments
within the area where they saidis always sore, it never relaxed
(46:28):
.
It was a local area of a spasmin their muscle.
Well then we had a chiropractormanipulate them Within 300
milliseconds.
Now this is going to inform ashort loop reflex Within 300
milliseconds.
That spasm was about a half.
So it was.
(46:49):
You know this controversy.
Does spinal manipulation affectneurology, distal in the body?
That's a huge question.
Well, there was a prettypowerful piece of evidence that
wasn't near the spine, that wasout in the abdominal wall, and
yet that neurology and whateverwas the source of that spasm, a
(47:11):
short loop reflex was stimulatedand changed immediately.
So where the spindles stretchedand, uh, created a control
delete, shall we say true tothat pattern?
That that would be myhypothesis and that's all it is.
Maybe I'm wrong, but anyway,the implications of that, of
(47:34):
distal influence, is huge.
And then you got on to talkingabout the dexterity of these
engrams.
To talking about the dexterityof these engrams and just to go
back to myself.
I don't want to.
I'm only using this as anexample.
But again, at my age, and I haveto face the fact that I'm not
(47:58):
going to become more physical,I'm only going to become less.
And every day when I getdressed, to become less.
And every day when I getdressed, I typically would stand
on my left leg, put my rightleg into my underwear first and
in my left.
Just a habit, it's what I do.
Well, now I reverse it.
I put my left sock on first, Itry and do everything in reverse
(48:20):
and then I will stand.
Do you know the stork in karate?
Yes, and I'll just stand in thestork.
Can I hold it, lock it anddon't fall.
Then I go in and brush my teeth.
I'm right-handed, veryright-handed.
I'm going to brush my teethwith my left hand.
Man, I have to really work mybrain to brush my teeth
(48:41):
left-handed.
So I play these games, justliving life, challenging myself
in balance, neurologicaldexterity, et cetera.
So I don't know if that helpsor no it does.
Speaker 1 (48:57):
And to that last point, like from a neurological
standpoint particularly, youknow, you see this a lot that
people get older and they getconcerned about their cognitive
capacity and so they becomeexperts in crossword puzzle or
Sudoku and they do the samething over and over and over
again.
And you know, one of the thingsthat we teach practitioners in
(49:20):
our brain seminars is that, well, I guess it's no different than
in physical training.
Like if I hired a personaltrainer who was good at their
job, they would put me through abattery of tests, find out
where I'm weak and train mewhere I am weak.
They wouldn't have me just keepdoing the things that I'm
already good and strong at,because my interest is general
(49:43):
physical capacity andpreparedness.
Like I don't want to be an EdCohen, I'm certainly not a
Kenyan runner.
I want baseline capacity acrossmultiple domains that we might
include in the word fitness.
And it's the same thing withthe brain.
If all you do is Sudoku puzzles, you get really good at these
number puzzles, but you mightlose some language capacity.
(50:06):
And so from a brain standpoint,it's important to do things
that you're not good at, likebrushing your teeth with your
offhand or getting dressed in adifferent order.
Like you said, left leg firstinstead of right leg first.
These things are helpful andany one thing like that might
not be all that great.
So any one thing like thatmight not be all that great, but
if you do a bunch of thosethings then they sum up over
(50:27):
time to put yourself in aposition where your brain is
better off somewhere in thefuture to do that.
The other thing that I wanted topoint out when we were talking
earlier that came to my mindabout neurological development
when we're kids we move throughlife three-dimensionally we hop,
(50:48):
we skip, we jump, we tumble, wetwist, we turn, we roll and
then we become adults and webasically sit up and down and we
move predominantly straightforward to some degree the
capacity to generate andtolerate rotational movements or
you know, you were talkingabout the gentleman and
(51:09):
obviously he would have otherchallenges but sometimes just
the ability to get down on thefloor and get back up again.
You know which we could train,for example, with some version
of a Turkish get-up, which Ithink is a fabulous exercise.
But I quite often think abouthow much we lose because of the
connection between movement andneurological and cognitive
(51:30):
health.
How much do we lose when westop doing the things that we
used to do all the time andnaturally, when we were children
?
And if you were to look at allthe athletes that you work with,
do you see any correlations?
Like you've talked about,golfers who swing in one
direction all the time, pitchersthat throw in one direction all
(51:50):
the time.
They practice theseasymmetrical movement patterns.
But then we have gymnasts, forexample, that do flip and twist
and turn and it seems, just byme watching their routines, that
they tend to do it to the rightand to the left.
Do you see, from yourobservation, do you see any
(52:12):
patterns that emerge?
And I don't want to constrainyour thoughts just to like
injuries, but any comment Ithink you have would be useful.
But do you see any differencebetween sport practitioners
where multidimensional andangular movement and the impact
(52:34):
on their body is different thansomeone who's just a repetitive
single motion sport practitioner?
Speaker 2 (52:41):
Sure, I think I know where you're coming from with
that question.
And do they end up in adifferent place when they're 70
years old?
Is that the question?
That's part of it.
Yeah, I don't know, except tosay that if they were an impact
(53:02):
or a collision athlete, they arein a very different place.
Also, if they were a high levelgymnast, I don't see many of
them at our age where they're asphysical as we are.
But of course it's a biasedselection in that they're coming
(53:24):
to me with back pain.
Chances are.
You know I had an NFLlinebacker here not too long ago
.
He was in his 30s and he had twoknee replacements and two hip
replacements In his 30s.
Yeah well, late 30s Couldn'tget off the floor.
(53:49):
You know I've had another veryhousehold name, shall we say,
from the NFL and he said oh, drMcGill, if I'd known it was
going to hurt this bad, I neverwould have done it.
And you know the the accoladesthat he has received in his life
(54:09):
and he would have given allthat up not to have the pain
that he that he has now.
But again, these are are one of.
There are some very, verysuccessful uh athletes.
I gave a lecture actually uh,to the NFL probably five years
ago, just before the pandemic,on returning the NFL player to
(54:33):
civilian life and the challengebecause we know that every year
you play in the NFL and I forgetwhether this has been updated
or not, but it was somethinglike every year you play is two
years taken off your lifestatistically.
Speaker 1 (54:51):
And is that playing above a certain level is like
collegiate or it's onlyprofessional?
Speaker 2 (54:56):
So every year, that you played in the NFL.
It took a certain amount oftime, a substantial amount of
time statistically from yourallocated years for your age
group.
Speaker 1 (55:09):
Aside from these impact type activities, are
there any other physicalactivities that you see that are
inconsistent with goals oflongevity and quality of life?
Speaker 2 (55:23):
Well, look at every high level sport and athlete.
Do any of them outlive the restof them?
Speaker 1 (55:31):
So you're saying pretty much anything to the
extreme.
Speaker 2 (55:34):
Right, it's a toll on your body.
And there are some people whotrain like Olympic athletes and
they're a computer operator notrealizing that if they don't go
quite as hard now, they willhave most likely a longer health
(55:55):
span.
Some of them are just way tooextreme for a variety of reasons
.
But anyway, that's myobservation now of watching
these people for over 40 years,like you, and you recognize
patterns.
(56:16):
When I go to a medical meeting,which occasionally I will go to
as an invited speaker now, andyou know, all the speakers sit
at a table and what, what do wetalk about at lunch and dinner?
Well, I remember the last timethe, the dermatologist, who came
in and gave a an overview ofdermatology and what they
(56:39):
learned over 40 years.
He says, well, I love publichot tubs, they keep me in
business.
And then, you know, know, theorthopedic, the there might be a
spine surgeon or a hip surgeon,and you know he can predict
who's sitting in his uh, waitingroom.
There's a pattern there thatthey've they've noticed people
(57:00):
who do certain things increasetheir risk of becoming a patient
for that particular yeah.
So you know, we all know thesekinds of things and I don't know
if that no, no, it's, I meanit's it's.
Speaker 1 (57:17):
I think it speaks to the idea, like I'll go back to
what I was saying before Like if, if you asked, let's say you
take 15, 20 people off thestreet and ask them you know
what are the best examples offitness?
You're going to get a varietyof answers that all fall to the
extremes, right the Kenyanrunner, the extreme BO2 max, the
(57:39):
extreme strength athlete?
Um, I would argue that neitherof those two extremes represent
true fitness.
I think fitness ismultidimensional, in the sense
that it probably encompassesstrength, speed, power,
endurance, agility, mobility,cardiorespiratory capacity.
Speaker 2 (58:05):
Just before you get too far ahead of me.
Steve, can I interrupt and askyou something?
Speaker 1 (58:09):
Yeah.
Speaker 2 (58:10):
This is a really interesting conversation that
I've had with a lot of differentcoaches, and health would link
to being the best athlete.
Speaker 1 (58:34):
And you're not talking about skill, you're
talking about I might be, youmight be.
Speaker 2 (58:39):
I might be, but that was a simple question what and
who is the best athlete?
What and who is the bestathlete?
So, to start my line of logicon that and how I've answered
that question in the past if youtake a long distance runner,
they have a unidimensionalathleticism.
(59:00):
If you are a swimmer and youare a world record swimmer and
I've worked with a number ofworld record swimmers they are
unidimensional athletes.
Are they the best basketballplayer?
No, and one of the examplesthat I would use there is the
sport of being a triathlete,obviously dominated by endurance
(59:22):
, and when you're on a bike,it's endurance power, and when
you're on a bike, it's endurancepower is the person who wins
the first leg of the event,which is the swim.
So their athleticism, in otherwords, a great swimmer, will
beat all of the triathleteswimmers.
(59:45):
However, to be a swimmer, youneed to be a fish.
It is a great advantage to haveloose joints.
Big feet act like flippers.
With a loose ankle joint,that's the kiss of death.
To run, where you need to havethe elasticity to store and
recover elastic energy andbasically be a kangaroo or a
bunny rabbit in terms of themost matched athleticism.
(01:00:10):
Because if you look at the bestrunner, they won't be able to
swim.
You know, again I'm talkinggeneralizations.
Of course there are thosetriathletes touched by the hand
of God who really have theability to do all of these
things.
So those kinds of sports, to me, are not the best athletes.
(01:00:32):
Those are the unidimensionalathletes and they're really good
at one thing.
I've asked this of docs who arein the Olympic program for their
country, so they're exposed toa lot of different sports and
then when they're, the Olympicsonly occur once every four years
(01:00:54):
, so they're doing things thatare usually associated with very
high level sports teams andthat kind of thing.
If you look at a basketballplayer, a basketball player has
to have pretty much of it all.
They are agile, they can changedirection quickly, they have
beautiful hand-eye coordination,they have game savviness and
(01:01:16):
sense strategy, a certain amountof endurance, a certain amount
of strength, a certain amount ofspeed.
From an all-around perspective,that's pretty good.
Some of the NFL footballplayers before they get too
banged up, I was placed in thehead of an NHL hockey player who
(01:01:39):
skating is interesting.
It's not running, it's notground-based, yeah, um, anyway,
there's a, there's a thought forsome of the best athletes,
shall we say.
Speaker 1 (01:01:58):
Who's your, what's your favorite type of athlete to
work with, and that can eitherbe sport-based or maybe both.
Comment sport-based commentmindset.
Speaker 2 (01:02:16):
Well, this will surprise you.
I'm not a sports fan.
In other words, I would neverchoose to watch sport, never.
That's my life, and the onlytime I watch sport on TV is if
one of my clients or patients ison the screen and I think it
was three years ago.
(01:02:40):
In the Super Bowl which is thebest players in the NFL I had
one guy.
In the World Series, I had apatient.
And then in the NHL Stanley Cup, I had a patient All in one
year.
All in one year.
Yeah, it was interesting.
(01:03:01):
Do I have a favorite?
And the answer is no.
My favorites are the ones whereI get the internal satisfaction
of changing their life.
So either I was able to getthem out of pain and they were
satisfied that they'd done theirbest and now they're ready to
retire, or wow, I'm here inBackFit Pro HQ.
(01:03:25):
There's several posters aroundthe walls here.
Thank you for adding a fewyears to my career, thank you
for adding a couple more records.
So those are ones that I feltsatisfied with.
Shall we say and I'm not sayingI can help everybody, because I
(01:03:47):
can't, but anyway that I don'thave a favorite sport.
I will say this I'm a littlebit mesmerized by anyone who's
really good at what they do.
If this person is the bestspine surgeon, I want to hang
(01:04:12):
out with them.
I want to see how they think.
I want to know their habits, Iwant to know their skills.
I have some people who live inthe small town of Gravenhurst
here who are fabulous at whatthey do.
They might be a musician, theymight be a nature artist, they
might be a canoeist.
(01:04:32):
I'm going to seek them out.
Yeah, so I love mastery, and itgoes way beyond sport.
I remember here's a funny storythat it's rather oblique and you
(01:04:53):
might enjoy it, though when Iwas a PhD student I was going to
quit, and the reason I wasgoing to quit was I was
terrified of public speaking.
It was so difficult for me togo to a medical conference or a
biomechanics science meeting andtell them what I'd been working
on, and even though I was theexpert at what I had done, it
(01:05:15):
was so difficult for me and Iwas going to quit.
And I remember 1983, theUniversity of Waterloo hosted
the World's BiomechanicsConference and there was a very
famous spine surgeon there namedHarry Farfan.
And I went to lunch with DrFarfan and he said oh, that was
(01:05:38):
a good speech you gave.
And he asked me a few questionsabout my work and he said so,
where are you headed next?
And I said Professor Farfan orDr Farfan?
I'm struggling.
I don't know if I'm going tocontinue with this, and this
will surprise a lot of people,because I made my life living
speaking and he said well, I'lltell you what he says.
(01:06:02):
That was a good talk you gavetoday.
Just keep doing it and if youever screw it up, they'll never
ask you back again and yourproblem is solved, problem
solved.
And that was what I needed tohear at that time and I fought
through it.
But I'll tell you.
Even today, when people ask meto come and give a talk and it
(01:06:23):
doesn't matter if it's in frontof 10 graduate students or
10,000 people at the nationalsafety convention my knees are
shaking.
Speaker 1 (01:06:35):
I, you know it's funny you say that that because
I in the last 15 years I've I'vetaught thousands of doctors of
all persuasions.
But thousands of doctors of allpersuasions, you know I would
(01:06:59):
do roughly depending on the year.
Before COVID I was doingprobably 15 to 18 three-day
weekend seminars a year.
And even now, even after 15years of teaching, the first 10
minutes I'm nervous.
And then you know, just kind ofget into the flow and you
forget what you're doing and nowyou're just talking to a bunch
of colleagues and then the restof the weekend is fun, but those
first 10 minutes for me alwaysnerve wracking.
Speaker 2 (01:07:17):
Same.
Speaker 1 (01:07:18):
Yeah, well, I'm glad, glad to hear that I'm not, uh,
I'm not alone.
Speaker 2 (01:07:23):
Well, listen, I never goes away.
Speaker 1 (01:07:26):
No, it doesn't.
I know that you have some snowshoveling to do, so I do.
I have one question I wouldlike to end on, and you can
choose to answer this or not.
You got to tell me about themustache.
The mustache, it's so iconic,it's even part of your brand.
Speaker 2 (01:07:43):
Well, it is, and the story behind that was I was
always I had a mustache since ora beard, actually from high
school.
That's probably the only thingI was good at in high school,
but in any case.
And then my daughter, who wouldhave been a very young girl,
(01:08:06):
maybe four or five years of age,and I'd always had a beard
usually a full beard in thewinter and then just a mustache
in the summer and she said Dad,I've never seen you without a
mustache.
Why don't you shave it off?
See what you look like?
I thought for maybe 30milliseconds, so I went and
(01:08:27):
shaved it off and I was kind ofsurprised.
There's a couple of photos.
They're rare.
And I went to work the next dayand I walked by my colleagues
who I've worked with for years.
They just walked by, no onerecognized me, and then a couple
would say, oh my God, andanyway, in those days the
(01:08:49):
internet was just starting andI'd be flying to different
places.
Like you, I was somewhere inthe world every month for 25
years and usually a graduatestudent or someone would be
assigned to pick me up at theairport.
And what was the instruction?
Because there was no internet,they didn't know what I looked
like.
They were just a senior studentand usually the instruction was
(01:09:13):
look for the mustache, you'llknow it when you see it.
But people were so upset thatwhen I showed up without a
mustache they said, well, that'snot a student, miguel, that's
not what we paid for.
So I realized, darn, I'm kindof stuck with this and that my
wife hates it, does she really?
(01:09:34):
Oh, yeah, she.
She hates facial hair andwhatnot, but I don't know it's,
it is what it is.
By now, I guess.
Speaker 1 (01:09:45):
I, you know, I've, I've grown, I've grown a full
beard a couple of times in mylife and I always ask my wife
what do you like better, shavedor not shaved, or goatee or
whatever?
And her answers are sononcommittal that it drives me
bananas, it drives me nuts.
So anyways, like I said, yourmustache is so iconic.
(01:10:06):
I know there's got to be morestories about the mustache, uh,
but maybe we'll save that forfor a different time.
Speaker 2 (01:10:14):
I would love do you want to hear one that that just
came to mind, since you saidthat I was coming into a Dublin
airport in Ireland and, uh, youknow how they swab different
things as you're coming in andthe woman who did it just said
(01:10:35):
just a moment.
And two burly guys came and onecame under each arm and took me
back to this room and they said, sir, why do you have, is there
anything you want to tell us?
And I said no.
And they said, okay, why do youhave explosives on your hands?
(01:10:56):
And I said no idea.
And do you know then that theywent through my mustache and
were Really, yes, yeah, gettingmolecules of TNT?
And then they heard my accentand they said, oh, you're
Canadian.
And I said yes, and they said,have you been around firearms?
(01:11:17):
And I said yes, I cleaned myguns two weeks ago, two weeks
ago, and there was residue offmy guns and gun oil I guess, and
it was still in the pores of myhands and I washed my hands a
lot because I washed my handsbetween every single patient.
(01:11:37):
But there you go.
I had gunpowder residue andthey picked up a molecule that's
how good those machines are.
Yeah.
Speaker 1 (01:11:46):
Well, I'm going to I'm going to have to grow some
facial here and go test out thattheory.
Speaker 2 (01:11:53):
Yeah, careful what you touch, that's right.
Speaker 1 (01:11:58):
Well, stu, this is.
This has been a hoot.
I really appreciate it.
I know you're a busy man andyour time is valuable, so thanks
for taking time to talk to meand and to talk to our community
.
Um, I would like to proposethat maybe we do this once a
year.
Speaker 2 (01:12:14):
Well, let's, let's see how it goes.
Maybe next time I can come outto the rock.
Speaker 1 (01:12:19):
There you go.
Yes, we'll come out and I'll,and I'll, I'll share my uh, my
favorite fish and chips placeand a brew pub.
Speaker 2 (01:12:26):
No, to hell with that .
Let's go out and catch one.
Oh there you go.
We'll have it on the back porcheven better.
Speaker 1 (01:12:35):
That sounds awesome, stu McGill.
Thank you, sir, I appreciateyour time.
Speaker 2 (01:12:39):
Dr Noseworthy, thank you so much.
I've enjoyed every second.
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