McGill Method Master Clinician: SF/Austin/Denver/NYC

07/25/2025

69 Y.O. Male Runner and Sailer flew to San Francisco from Washington for his McGill Method appointment. He suffered a head on MVA collision with combined speeds of about 80 MPH - Resulting in Low Back and Leg Pain for 2.5 Years. Improving after only a month with the McGill Method.

Here is his review of his McGill Method experience.

"I am in my late 60s and was an avid runner until a distracted driver crossed the centerline and totaled my vehicle, leaving me with low back pain and pain down my leg. I have spent the last two and a half years dealing with Doctors, Physical therapists, and chiropractors. They would spend very little time just ask a few questions before sending you down the next step of the medical assembly line with no long-term relief. Most imply that I am too old to be running, and back pain is something that comes with getting old. I contacted Dr. Tiltmann and the experience was completely different and very positive . He actually took the time to find out what movements were triggering the pain and then gave me tools I could use to avoid or reduce the pain. Some of the triggers were movements that my PT had given me to do. It's now been a month since I saw Dr. Tiltmann in person and my back pain is greatly reduced. I have even started adding some short runs to my daily walks. For the first time since the car wreck, I'm positive about my future.

Thank you!"

Mark.

07/09/2025

Why be evaluated by a McGill Method Master Clinician if you suffer from chronic low back pain?

This information is directly from the Backfitpro.com website from Professor Stuart McGill.

A McGill Method Master Clinician is an elite clinician who has demonstrated clinical competency with patients. Becoming a “McGill Method Master Clinician” requires candidates to first become McGill Method Certified. They must also possess a clinical degree, pass the Master Clinician exam having both written and live patient components. McGill Method Master Clinicians will be actively referred patients from Professor McGill and passively referred patients from the Backfitpro website and other sources.

Achieving the status (McGill Method Master Clinician) is rare and has a very high standard. Professor McGill’s work over the years has shown that back pain has a cause. The cause may be quite simple in terms of mechanism, or it may be very complex. There are often elements of mechanics, neurology, personality and psychology, anatomy, load exposure, age, and social forces, to name a few. Some patients have several mechanisms that may be independent of one another or they may feed into one another. Nonetheless a thorough assessment will reveal the pain mechanism. Obtaining an understanding of the pain mechanism guides the approach to wind down the pain sensitivity as the first priority, followed with a plan to build a foundation for pain-free activity.

A McGill Method Master Clinician has competence to conduct the assessment and execute the therapeutic plan. Professor McGill has confidence in their abilities demonstrated with an exam and an in-person observation of their assessment skill abilities.

A McGill Method Master Clinician patient:
Has failed several clinical approaches and upon leaving the assessment will:
Understand their pain trigger mechanism
Clearly understand what to do to allow pain de-sensitization
Clearly understand how to build a foundation for pain-free movement
Clearly understand some progressions and milestones
Have a report with a precise diagnosis (most of the time) sent to the referring clinician with a recovery plan
Have read Back Mechanic
Have a follow-up contact to quantify efficacy
A McGill Method Master Clinician:
Performs an assessment that reveals the pain mechanism
Has the skills to coach the patient to understand their pain trigger mechanism
Has the skills to coach the movements that allow pain de-sensitization, followed with how to build a foundation for pain-free movement
Prepares a report with a precise description of the pain mechanism sent to the referring clinician with a recovery plan
Is competent with the material in Low Back Disorders

If you are suffering from chronic low back pain, consider being evaluated by a McGill Method Master Clinician.

https://www.backfitpro.com/backpain/master-clinician/

What is the difference between a McGill Method Master Clinician and a McGill Method Certified Practitioner? McGill Method Master Clinician: Has attained the highest level of clinical competency and has the full confidence of Professor McGill to assess the pain mechanism and show the patient how to s...

07/08/2025

The benefits of seeing a McGill Master Clinician - Diagnosed Ehlers Danlos Syndrome in a thoracic spine pain patient.

55 y.o. male with thoracic complaints (not the typical McGill Method patient), has never been diagnosed properly and is receiving inappropriate treatment including nerve ablation, for his instability. Here is what he said.

"I would like to say how much I appreciated your thorough evaluation. Even though I had RF ablation and PT by doctors at a top hospital in the world, none of the practitioners at any point in time (including before the ablation procedure!) gave me a thorough physical examination, nor did they put me through any diagnostic exercises with loading in various directions like you did. In fact, the practitioners made spinal adjustments and had me doing daily exercises that were not only not productive, but if anything, they made my condition worse. As a result of the non-diagnosis at that institution, I had no idea what was causing my mid-back pain or how to address it. With your help, I have begun to move in the right direction, and I am hopeful that I can minimize further damaging movement patterns and live my life pain free. As a bonus, your exam helped me potentially diagnose a connective tissue disorder that makes me hyperflexible, and that may come in handy in addressing my overall health.

Best,
Fred"

06/16/2025

2 interesting spine cases addressed with the McGill Method

I recently returned from seeing patients in NYC, Denver, Austin and Houston. 2 notable cases presented:

1) 21 year old college track athlete injured from olympic lifting at her college. Now has disc herniation, foot drop and walks with a limp and recently became medically discharged from track. This could have been avoided with better supervision of her training program and a better understanding of how the spine works under load. Watching a video of her squat (under supervision and with a spotter) it is clear she was going too deep for her hip anatomy and creating a disc herniation mechanism, which eventually resulted in compromised spine integrity, tissue failure and symptoms.

I am seeing more and more young patient who have been injured by their school's athletic training / weight program. I understand that there is an inherent risk with weight training, but that does not have to be exacerbated by poor coaching.

2) 50 year old male with thoracic spine pain. Normally I focus on low back exclusively but this case was intreging. Patient has mid back pain not responding to conservative treatment and received thoracic nerve ablation (burning away the nerves) at 4 levles. It did reduce his symptoms, but did not address the cause. Based on that result, they were going to burn away more nerves above and below. During the examination, I discovered systemic hypermobility similar to Ehlers-Danlos syndrome a connective tissue disorder that can lead to skin and joint hypermobility. With proper cueing, he was able to eliminate his pain through various loaded and unloaded movement - a significant revelation for the patient. We modified his training program and focused on stability vs mobility exercises.

I will be back in Sept/Oct. 2025 to see more patients for their low back complaints in my 4 travel locations and of course San Francisco where I live. Maybe I will get to see you too. Take care.

Best regards,

Dr. Kai Tiltmann, DC

Phone: 1-415-321-9462

www.drtiltmann.com
dr@drtiltmann.com

Dr. Kai Tiltmann, DC - Chronic low back pain treatment applying the McGill Method for patients that have failed all other therapy

06/06/2025

Here is a longish review from a patient that was seen in Austin last week for his 14 years of back pain. He works in the fitness and powerlifting space and is only 35 years old.

"Review to forward Dr. McGill:
--------------
I've been suffering with back pain for many years following a series of barbell back squat injuries 14 years ago that left me with disc herniations and an annular fissure that's pressing on my nerve root. After failing PT and rehab numerous times, combined with my general hypermobility, I largely gave up hope on trying to fix my back pain which I had chalked up to SI joint pain from my Psoriatic Arthritis condition (sacroiliitis is a hallmark symptom). Unfortunately this means that I haven't slept properly in years and have endured persistent chronic back pain that has made it a challenge to keep up with my very physically active lifestyle.

I was previously familiar with Dr. McGill's work having read Back Mechanic many years ago and saw Dr. Layne Norton's and Brian Caroll's rehabs, and even did a "second opinion" consultation with Dr. Lysander Jim (also McGill method certified) back in 2019 while I was under the care of a different PT. I incorporated some aspects of Dr. Jim's guidance which I think may have helped some, but I never gave the protocol a full effort as it was in conflict with the guidance I was receiving at the time from a different PT. In hindsight this was remarkably foolish.

After receiving another clean MRI showing no sign of inflammation in my SI joints, I renewed my commitment to trying to resolve my back pain and sought out the assistance of Dr. Tiltmann with the goal of fully committing to following the program 100% and becoming pain free.

I came to see Dr. Tiltmann for a full 3 hour consultation, and I'm very pleased with the experience. We first discussed my injury and symptom history, as well as reviewed all my activities (lifting, cardio, etc.). Dr. Tiltmann convinced me that it's highly unlikely that I ever had any SI joint issues and the pain was caused by my lumbar injuries (as shown on MRI). We then proceeded to do numerous pain trigger and movement assessments which identified my specific pain triggers and movement modifications to reduce the pain and not risk putting my spine in a position that might jeopardize proper healing. Dr. Tiltmann then had me demonstrate the big three exercises and helped correct and refine my technique and ex*****on. We ended the session by going through my questions and modifying my workout routine.

Though of course I'm very early in my rehab process, I do feel empowered and optimistic about being able to get to being pain free. Dr. Tiltmann set a very realistic expectation that it's going to be a slow process that might take 1-2 years. I appreciate his proactive scheduling of 30 day, 3 month, 6 month, 12 month, and 24 month follow-ups which will absolutely help hold me accountable and keep me motivated to "stick with it". While I know that there is no guarantee, I'll do my best on my part and very much look forward to being able to put 15 years of back pain to rest and leave the most glowing review possible for both Dr. Tiltmann and the McGill method."

I am currently in Denver and have one appointment for Sunday, June 7th 12:30-3:30 PM if you are interested.

Dr. Kai Tiltmann, DC

Phone: 1-415-321-9462

425 Divisadero Street, #204
San Francisco, CA 94117

1720 South Bellaire Street, #305
Denver, CO 80222

1602 East Riverside Drive
Austin, TX, 78741

8564 Katy Freeway #142
Houston, TX, 77024

29 West 38th Street, #601
New York, NY 10018

Certified McGill Method Master Clinician www.BackFitPro.com

www.drtiltmann.com
dr@drtiltmann.com

Dr. Kai Tiltmann, DC - Chronic low back pain treatment applying the McGill Method for patients that have failed all other therapy

05/15/2025

27 y.o. chronic low back pain patient with sciatica. Injections and pain medication. Looking for an alternative.

11/20/2022

Recent McGill Method Review from San Francisco

"Dr. Tiltmann is the real deal! The three hour in-person consultation was the best investment of my life! I herniated a disc ten years ago and I thought I was healed with rest and traditional physical therapy. Lo and behold, I recently herniated another disc a couple of months ago since I was never taught proper form and treatment for my specific condition. Last month I battled the most excruciating pain of my life that led me to multiple ER visits and a general treatment plan from an orthopedic doctor (medications, rest and general physical therapy). After researching on my own, I thankfully found the Back Mechanic book by Dr. Stuart McGill and promptly reached out to Dr. Tiltmann since he is the only McGill trained doctor in my area.

I never would have received such a thorough assessment from any other kind of doctor. Dr. Tiltmann really took the time to evaluate my specific condition and I left feeling better and more empowered than ever before. I came into the appointment in a wheelchair and left walking and in a lot less pain; it was incredible! It has now been a week since my evaluation and I am feeling better and stronger every day. I hope to be pain-free soon since I am being diligent with my daily exercises and maintaining a neutral spine with everything I do, such as getting on the floor, opening a drawer that's lower on the ground, brushing teeth etc. I am simply happy to finally be on the right track with my recovery - no longer relying on narcotics and harmful stretches. I now have the necessary tools to heal, not risk re-injury and maintain a healthy spine for the rest of my life. I'm excited to see my improvement in the coming weeks and months and definitely plan on checking in with Dr. Tiltmann once I am ready to incorporate more exercises at the 6 month and 1 year mark. Thank you Dr. McGill and Dr. Tiltmann, I'm forever grateful to both of you!

Jenny"

11/20/2022

WHAT ARE THE CHANCES OF DEVELOPING LOWER BACK PAIN AFTER A DISC HERNIATION?

After a literature review looking at 15 studies, 2019 patients demonstrated that the chances of developing lower back pain after a lumbar disc herniation (compared to not having a disc herniation) were higher than expected. In lumbar disc herniation patients, these people had a 46.2% chance of developing long-term lower back pain compared to the general population of only 11.9%. That means that 53.8% do not. So be careful when your doctor relies only on your MRI imaging to diagnose your chronic low back condition. This study means that half the time they are wrong.

LDH patients are more likely to experience long-term LBP compared to the general population (46.2% vs. 11.9%). Additionally, understanding the relationship between radiological findings and pain outcomes remains a major challenge as the presence of radiological changes and the degree of LBP do not a...

06/25/2020

McGill Method Testimonial for Low Back Pain

Athletic 38 year old male patient with acute onset low back pain with history of sciatica the prior year.

"I was incredibly impressed with the McGill Method Assessment, in particular the time and care Dr. Tiltmann took in discussing my background and performing the examination. For background, I am a 38 year old male, former professional/university athlete who experienced a major pain episode about three months before the assessment. While I did not have a long history of back pain, I had experienced one other significant pain episode about a year prior. In comparing my MRI (which showed a bulging disc) and performing the hands on examination, Dr. Tiltmann was able to provide me with the most comprehensive assessment of pain triggers and areas of instability I had received. Other doctors I had visited only looked at one aspect of my situation - MRI, response to medication, symptoms, etc. - instead of taking a more comprehensive approach that more specifically identified the root causes. I had a million questions and the structure of the McGill Method assessment, conducted over three hours, allowed me the time to receive answers. As a result, I feel like I have a solid plan towards recovery that is built around the McGill Big Three and other exercises tailored to my specific issues, while understanding movements that would likely cause me pain. I have since recommended the McGill Method Assessment to a close friend suffering for over a year from back pain. This type of assessment - detailed, not rushed, and specifically tailored to the individual patient - is exactly how medical consultations should always be conducted.

Thanks!

Josh"

06/02/2020

I receive monthly emails from Prof. Stuart McGill and like to share some key points. This one is addressing sit-ups and core fitness. We all have done sit-ups, either in school as part of physical education or at the gym working on that six pack and although sit-ups do develop abdominal muscles, they do so (even crunches) at the expense of the lumbar spine. Not everyone will develop a back injury right way as that will depend on frequency, intensity and duration of the sit-up routine as well as what other types of loaded flexion exercise and stretches are done. There are much better abdominal and core exercises (like the plank & sit-the-pot) that do not compromise the lumbar spine. Enjoy this post.

Thank you.

Dr. Kai Tiltmann, DC

Patient Files – From the desk of Prof. Stuart McGill.
Lessons learned: Passing the sit-up test

“I get many emails from around the world every day. It is not uncommon to receive one from a military person who has difficulties passing the fitness test due to back pain. In particular it is the sit-up test that gives them the greatest challenge, leaving them with the most pain.

There are several sources of evidence to consider regarding the mechanisms, injury pathway, and enhancement of resilience and performance. Our scientific investigations have documented stress distributions in hip and low back tissues while performing many exercises, including a variety of forms of sit-ups and alternatives. Combined with our clinical studies that address pained patients and clients together with investigating the variables linked to performance, we have concluded that sit-ups are rarely the best choice. Finally, our own epidemiological investigations on service personnel (military, police, firefighters) and athletic groups like combat athletes and sprinters have proven the efficacy for our approaches that create resilient performance without sit-ups.

Athletic groups who have used sit-ups to gain anterior chain athleticism are associated with higher rates of disabling back pain. Jiu Jitsu athletes are one group that fit this category. Traditional training involves a lot of flexion-based stretching and the performance of many sit-ups. We have been asked to consult with many of them. Assessment of these athletes showed generally that they had developed intolerance to repeated full range loaded flexion movement (not moment) meaning their training of sit-ups was in fact no longer tenable.

The argument and rationale for doing sit-ups was that hip and torso flexion movement is required by the combat athlete and explosive hip flexion power is needed by sprinters. Thus, as the argument goes, since the sport demands hip and spine flexion movement, moment, and power therefore it must be trained.

Our approach to restore these intolerant athletes is to avoid the pain trigger mechanism. We replace the concept of hip and torso flexion movement with flexion moment. Moment is the rotational force needed to stop torso movement thus allowing full power transmission across the hips. We build torso and hip fitness with exercises such as stir the pot, and a rolling side plank - that being a side plank, then rolling to a front plank, then rolling to the other side plank. We progress with elbow taps under speed etc. Hip flexion power is developed using a device like a Roman chair where the athlete stiffens their torso and then flexes one hip with the knee bent while driving the opposite hip and gluteal muscles robustly back into the chair support. Thus hip flexion power with proximal stiffness is developed in a way that does not trigger pain their specific pain mechanism. Resiliency and training capacity is restored as the pain now winds down.

We have had several military personnel as clients who must perform speed sit ups as part of the annual fitness test became painful and disabled – as a result of training the test. We supervised their training in the manner described above and not only did they eliminate their pain triggers but they passed the speed sit-up test with flying colors. Further we have had candidates wishing to become special operations soldiers in the Marines, the FDA special operators, navy seals, and Royal Marines in the UK. Everyone following our program passed the rigorous physical fitness tests which included a sit- up requirement.

To summarize, assessment of the demands give a clear direction of the training goals. A thorough assessment of the individual reveals the mechanism of their pain, specific deficits, and their current training capacity. Combining these two assessments provides the background information necessary to create a program for that individual to follow to regain pain-free ability. Our proven record of success in restoring athletic careers and empowering hopeful military candidates to fulfil their dreams gives validity to the evidence-based approach.”

Just to clarify, this was writing by Prof. Stuart McGill.