Our McGill, Who Art in Waterloo, "Hollow" Ain't His Game

So there’s a lot of debate running through the fitness industry about whether to use abdominal draw-in core training techniques (the “Australian” or spinal segmental training method), or to use spinal stiffness as the method of developing core strength (The “McGill” method). Most trainers and strength coaches are siding with McGill on this one, saying that using the draw-in method can actually decrease spinal stability and result in worse core function than training spinal stiffness, which would result in injury or worsening symptoms. This came from the research McGill’s performed in his Waterloo biomechanics lab, and which he organized into his clinical text Low Back Disorders (NOTE: Serious trainers, DEFINITELY pick this one up) Tell anyone to pull their belly button in to their spine at a major fitness conference and the reaction would be one of terror, like a vampire meeting face to face with a cross.

 Does this mean the entire concept of abdominal hollowing is pointless? Not necessarily. The concept was put forth by a group of Australian spinal rehabilitation researchers and physiotherapists (hence the term “Australian method”) and was put out in a book called Therapeutic Exercise for Spinal Segmental Stabilization in Low Back Pain: Scientific Basis and Clinical Approach, which quickly gained a lot of popularity in the rehab world. McGill’s book was essentially a counter-point to the research offered in here.

I’ll give you some bullet points on how the concept works:

1. Muscles attached to sites of damage will down-regulate their activity and actually atrophy with the presence of spinal dysfunction and pain. This actually happens at all joints, not just the spine. A lot fo the atrophy will be seen in localized sections of the multifidus and a reduced impulse to the entire transverse abdominus.

2. Training programs that focus on making the entire spine work without taking into consideration the specific segments affected will tend to result in compensation patterns and altered mechanics. This is seen in all other joints as well. An analogy would be working on squat mechanics with a faulty vastus medialis activation, which would lead to patellar issues and probably IT band problems.

3. Isolation work is needed to correct the specific dysfunctions before working on gross motor patterns to prevent these compensations and dysfunctions. We see this in all parts of the body. For instance, an individual with reduced thoracic spine mobility (let’s say it’s a stuck facet joint or two at T7-8, for example) won’t develop very good scapular mechanics until the specific issue of thoracic mobility is addressed.

They also produced a lot of research showing how the TvA shut down and atrophied with low back injuries, how the EMG muscle potential of the multifidus was reduced by using intramuscular electrodes, all sorts of stuff.

So why is it that we keep looking to McGill’s work if there’s evidence that the Australian method works well with low back pain? Is it just that we want to focus on those who are athletes or looking to get adaptation at the high end of the spectrum? Or is the Australian method complete bollocks?

I’ll be honest, I tend to use both. I use the Australian method work with clients who have acute low back pain to get them to sue their core and gain some foundational core stability before progressing them on to more advanced work, and I use McGill method concepts for training those with decent spinal mechanics and those looking to push performance. I definitely don’t see a need to have an athlete working on basic TvA activation, saying that it will increase their hitting power or whatever, because it’s too rudimentary. That’s like giving Stephen Hawking a copy of Cat in the Hat.

That’s why I found an awesome research paper out of Sao Paulo, Brasil of all places from last year, comparing the effects of TvA draw-in and McGill stiffness exercises on patients with low back pain HERE. In it, the researchers compared the two programs with subjects who had chronic low back pain, and rated their improvements in subjective pain, functional abilities, and TvA strength gains. They gave the participants the programs for 6 weeks, twice a week for 30 minutes each session. They found both groups reduced pain and improved functional abilities, however the group assigned to segmental stabilization achieved much greater results than those in the strength training group, and TvA gains were not seen at all in the strength training group whereas they were dramatically different in the segmental group. In fact, pain improvement was rated as a relative gain of 99% improvement using the Visual Analogic Scale, versus a relative gain of 55% with the McGill method.

So now I’m sure that after showing this research, a lot of people are re-thinking their ideals about whether hollowing is useless or not. Admittedly, this is just one study on a very large field of research, and I’m just a simply guy from Edmonton, but while the McGill method is definitely effective in training the core muscles to get stronger, there does seem to be a beneficial use of the Australian method, specifically when it comes to those suffering with low back pain. As someone who has had to deal with pain, and utilize both to get my own injury under control, I can attest to the fact that when you’re in pain, performing something like an abdominal draw-in or a segmental activation of the multifidus muscle is pretty difficult to do, but it’s way less scary of a thought than going through a deadlift or even a basic squat pattern. It worked to get me to a state of being pain-free so that I coul continue to strengthen the area with bigger and more integrated movements. Plus, my job is to get people closer to their goals than anyone else, so if their goal is pain reduction, 99% is way better than 55%, so I’ll use the draw-in until they get to a point where they have only minimal pain, and then progress them into performing more integrative exercises.

It may not be sexy, but being in pain isn’t sexy either.

I talk a lot about the research and differences between the Australian and McGill methods on Muscle Imbalances Revealed: Upper Body, so if you want to get some more info, plus some tools to use of your very own, check it out HERE. Otherwise, check out the two books I referenced above to get your learn on like you mean business.

What do you think works best? Leave me a comment below and let me know what types of core training you feel you respond best to and what you’ve tried that didn’t do jack all for you. Who knows, I might pick up something new.