This text attempts to identify the causes of back problems and outlines how to prevent or eliminate them. Much like a patient advancing through Dr. McGill’s stages of rehabilitation, the text follows a logical progression with subsequent chapters building on previously established concepts. The early chapters review the functional anatomy and injury mechanisms of the lumbar spine while challenging many commonly held beliefs and laying the foundation for the rest of text. The middle section outlines how to reduce the stressors that can cause low back disorders with guidelines for both worker and employer. The final chapters focus on a Five-Stage Back Training Program, beginning with identifying faulty movement patterns utilizing provocation tests then progressing to building stability and endurance using variations of Dr. McGill’s “big three” exercises.
The text’s strength lays in the author’s research background and the labs that he has developed, which he frequently relies upon when determining spinal loads and when suggesting preventative or rehabilitative strategies. From a chiropractic perspective, a discussion on the role of manipulation in rehabilitation would have been valuable. Little is said about chiropractic other than noting that a small group of patients may benefit from initial mobilization while warning that many make the mistake of trying to mobilize an already unstable joint. Regardless, this text offers a systematic and evidence-based approach to addressing low back disorders that should be read in its entirety and then used as a reference tool by practitioners incorporating exercises into their treatments.