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In this “Ask Me Anything” (AMA) episode, Peter delves into the topic of high-intensity interval training (HIIT), starting with addressing some common misunderstandings around this type of exercise and breaking down what HIIT truly entails. He examines the correlation between HIIT and VO2 max, a vital metric for overall health and longevity, and describes the beneficial impact of HIIT on longevity when incorporated properly. Additionally, he emphasizes the importance of building a wide base of cardiovascular fitness, reveals the optimal protocols for incorporating HIIT into a balanced routine, and discusses the risk of injury and other potential drawbacks of HIIT.

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We discuss:

• Common questions about high-intensity interval training (HIIT) [1:30];
• The origins of HIIT [3:15];
• Defining HIIT training and differentiating it from sprint interval training (SIT) [5:45];
• Why HIIT is often touted as a more efficient way to exercise [14:00];
• Navigating the nuances of HIIT research: understanding limitations and the importance of a blended exercise routine [20:30];
• The four pillars of exercise [24:15];
• Using HIIT to improve VO2 max [26:00];
• HIIT training for the untrained individual: impact on VO2 max and the interplay between exercise-induced adaptations and potential weight loss [33:00];
• Sprint interval training (SIT) vs. HIIT: comparing the relative improvements in VO2 max and the impact of longer duration intervals [40:00];
• Benefits and limitations of HIIT, drawbacks of overtraining with HIIT, and the importance of a diversified routine to increase total cardiorespiratory capacity [44:15];
• HIIT protocols Peter recommends [58:45];
• The risk of injury and other potential drawbacks of HIIT [1:02:15];
• The importance of incorporating a balance of continuous moderate-intensity cardio and HIIT when aiming for longevity [1:04:00]; and
• More.

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View the Show Notes Page for This Episode

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Stuart McGill is a distinguished professor emeritus at the University of Waterloo and the chief scientific officer at Backfitpro Inc. where he specializes in evaluating complex cases of lower back pain from across the globe. In this episode, Stuart engages in a deep exploration of lower back pain, starting with the anatomy of the lower back, the workings of the spine, the pathophysiology of back pain, and areas of vulnerability. He challenges the concept of nonspecific back pain, emphasizing the importance of finding a causal relationship between injury and pain. Stuart highlights compelling case studies of the successful treatment of complex cases of lower back pain, reinforcing his conviction that nobody needs to suffer endlessly. He also covers the importance of strength and stability, shares his favorite exercises to prescribe to patients, and provides invaluable advice for maintaining a healthy spine.

We discuss:

• Peter’s experience with debilitating back pain [3:30];
• Anatomy of the back: spine, discs, facet joints, and common pain points [14:45];
• Lower back injuries and pain: acute vs. chronic, impact of disc damage, microfractures, and more [24:45];
• Why the majority of back injuries happen around the L4, L5, and S1 joints [31:00];
• How the spine responds to forces like bending and loading, and how it adapts do different athletic activities [36:15];
• The pathology of bulging discs [43:15];
• The pathophysiology of Peter’s back pain, injuries from excessive loading, immune response to back injuries, muscle relaxers, and more [46:00];
• The three most important exercises Stuart prescribes, how he assesses patients, and the importance of tailored exercises based on individual needs and body types [56:15];
• The significance of strength and stability in preventing injuries and preserving longevity [1:08:15];
• Stuart’s take on squats and deadlifting: potential risks, alternatives, and importance of correct movement patterns [1:19:30];
• Helping patients with psychological trauma from lower back pain by empowering them with the understanding of the mechanical aspects of their pain [1:30:00];
• Empowering patients through education and understanding of their pain through Stuart’s clinic and work through BackFitPro [1:39:00];
• When surgical interventions may be appropriate, and “virtual surgery” as an alternative [1:46:45];
• Weakness, nerve pain, and stenosis: treatments, surgical considerations, and more [1:55:30];
• Tarlov cysts: treatment and surgical considerations [2:00:15];
• The evolution of patient assessments and the limitations of MRI [2:02:15];
• Pain relief related to stiffness and muscle bulk through training [2:07:00];
• Advice for the young person on how to keep a healthy spine [2:14:15];
• Resources for individuals dealing with lower back pain [2:25:30]; and
• More.

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Feeling blocked with it comes to starting an exercise habit? You can actually get the health benefits of exercise with just 22 minutes of exercise a day — and you might be surprised what "counts" as exercise. Kiss your excuses goodbye!

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