Home / Courses / McGill 2 - Converging on a Precise Diagnosis: The Three Hour Assessment

McGill 2 - Converging on a Precise Diagnosis: The Three Hour Back Assessment

Instructors: Dr. Stu McGill,
Joel Proskewitz &
Dr. Edward Cambridge

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Global Objectives:

To update delegates on some recent developments in assessing the low back of the most challenging patients.

To create linkages to corrective and therapeutic exercises and drills.

Develop skills in pain provocation tests to reveal the pain mechanism.

To give practice and technique development with workshops at the assessment table throughout the day.


Restoring a painful back begins with a detailed assessment. McGill demonstrates and teaches pain provocation through mechanical and neurological approaches intended to reveal the cause of pain. The algorithm is based on branching logic. Delegates will hone their manual skills, together with clinical reasoning skills, work-shopping tests both on and off the exam table. This will lead to a precise diagnosis that forms the foundation for teaching the patient how to wind down their pain sensitivity. The second stage begins when pain is controlled, and the objectives shift to enhancing function and performance.

This is a smaller more intimate course, primarily around the exam table.

Structured outline:

8 am - 12 noon

1: The foundation

  • Background (Lecture)
    • Movement assessments and screens
    • Anatomy and mechanisms of function, injury and pain
    • Medical images (MR, CT, Ultrasound)
    • Differential diagnosis

-- Lunch 12 – 1 pm --

1 pm - 5 pm

2: The assessment (hands-on workshop at assessment tables)

  • Assessment Clinic
    • Assessment forms
    • Provocative tests, movement tests
      • These include motions, postures, loads and then specific tissues
      • Compression, shear, bending, tension, etc
      • Discs, end plates, vertebral bodies, sciatic and femoral nerve roots, SI joints, Facet joints, hip joints
    • Support material

3: Interpreting the signs and special cases Special Cases

  • Spinal shock
  • Neural resonance
  • Neural traps
  • Fibromyalgia
  • Scoliosis, Stenosis, etc


This presentation synthesizes many research articles. Rather than provide an exhaustive list, the interested delegate is encouraged to see them at: www.ahs.uwaterloo.ca/~mcgill/

However, the information has been synthesized into a textbook (the science of back function, prevention of back troubles and stabilization exercise, together with assessment of the pained patient):

McGill, S.M. (2016) Low Back Disorders: Evidence based prevention and rehabilitation - Third Edition, Human Kinetics Publishers, Champaign USA, 2016

While the textbook comes with access to many online videos, a DVD illustrating the Assessment and Therapeutic exercise techniques is also available:

McGill, S.M. (2012) The Ultimate back: Assessment and therapeutic exercise, Second Edition

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Dr. Stu McGill

Dr. Stuart M. McGill is a professor of spine biomechanics at the University of Waterloo (Waterloo, ON, Canada). His advice is often sought by governments, corporations, legal experts and elite athletes and teams from around the world. Difficult back cases are regularly referred to him for consultation.

Joel Proskewitz

Mr Proskewitz has been involved with Professor McGill for the past 12 years learning his approaches for assessment and performance training. He is a master trainer based in London UK. Professor McGill regularly refers difficult patients to Joel who assesses the individual to reach a precise diagnosis. Then an appropriate strategy to eliminate the pain triggers to wind down sensitivity is coached. This is followed with an exercise progression to create a foundation for pain-free movement. He has taught internationally with Professor McGill for the past year. He teaches McGill 2, McGill 3 and the Back Mechanic course.

Dr Ed Cambridge

Dr Cambridge has studied with Professor McGill for the past 6 years while completing his PhD. His thesis is entitled "Hip & Spine Mechanics - Understanding the linkage from several perspectives from injury mechanisms to rehabilitation". This work is focused on understanding this relationship through both normal and injury mechanics of the linkage and is comprise of a combination of biomechanical modelling and experimental research. He is an outstanding instructor and highly competent with the scientific history that is the foundation of the McGill approach. He has taught with Professor McGill internationally for the past 5 years. He is also an excellent diagnostician with a Doctor of Chiropractic degree prior to his years working side-by-side seeing patients with Professor McGill in the University research clinic. He teaches McGill 1, McGill 2 and the Back Mechanic course.