I tell everyone that will listen to me how great your approach and the McGill method was and that it made a huge difference so I’d be happy to provide some feedback. Sadly it seems impossible to get people with orthopedic backgrounds to listen…
I was very impressed by how thorough the approach was and how much time you invested in the examination and diagnostic portion. The contrast to traditional PT and orthopedic appointments, which follow a very strict and hurried process, was evident. Dr. Tiltmann had a diagnostic flow he was were clearly following but happy to collect more evidence and go where it took him rather than a fixed outcome you were trying to justify as quickly as possible.
I learned a lot in the pain trigger portion, it was probably one of the most valuable portions of the session, as I had not previously known I was compression sensitive. The manual exam also correctly identified that I’m starting to have some problems up around T12/ L1 that I’ve become more aware of over time. I believe this is likely due to trying to limit lumbar flexion and having to make it up elsewhere in the spine along with twisting to the right to bend over to avoid straining the left side.
Although I was initially skeptical that some basic ‘spine hygiene’ steps such as modifying how I get up could make much difference it absolutely did. I would say learning to stop aggravating my back was the biggest outcome of the session we had and although it was the portion I enjoyed the least during our session it was the most impactful.
I thought the McGill Method was a great value. However, I also think people are reluctant to invest so much up front and are naturally more inclined towards a pay in small increments as you go type of approach you typically find in PT and that may be a challenge in scaling the model, particularly in more cost sensitive markets than San Francisco. However, for me personally the value was excellent and avoided the need to spread the sessions out across multiple trips. I would absolutely recommend seeing a McGill provider and Dr. Tiltmann in particular to people with back troubles.
One suggestion I’d like to make is partnering with CrossFit gyms to offer an abbreviated McGill program to help detect pending back injuries. I probably had a 6-month window during which I had a disc bulge and failed to recognize the symptoms of sciatica and could have avoided a herniation. A session to teach the basics of back pain, sciatica, hip anatomy and squatting form etc. would be great. This could either be a program for coaches and trainers or something delivered directly to gym-goers. Given this would be focused on prevention and recognition, the degree of clinical assessment could be minimized.
Alex of District of Columbia 35-year-old male with 1-year history of chronic low back pain after Olympic lifting exercise injury.