Full Transcript for 469: How We Fixed Kevin's Back Pain in Less Than 2 Weeks

because there was just no, no way. 00:04:28.605 --> 00:04:33.725 I was walking the dog still, so I was still, moving, but walking the dog was painful. 00:04:33.925 --> 00:04:35.714 so I thought running was gonna be real bad. 00:04:35.814 --> 00:04:36.204 Yeah. 00:04:36.475 --> 00:04:39.975 and then you suggested that running might not make it worse. 00:04:40.154 --> 00:04:41.894 So I gave it a shot, and 00:04:41.894 --> 00:04:41.915 it was- 00:04:41.915 --> 00:04:43.334 I tried to do, our neighborhood. 00:04:43.644 --> 00:04:51.355 And, my normal running pace, and these are all just numbers, but they're numbers that kind of help explain paces and how I w- how uncomfortable I was feeling. 00:04:51.454 --> 00:05:14.264 I generally will head out, and I'll run somewhere around, a 7 to 7:30 mile, and I was going out, and I would walk for a couple minutes to get things moving, and then I would jog for, 30 seconds, and then I'd take another walking break, and then I'd jog for about a minute, and then I'd take a little walking break- and then I could run, and that's how I did my first, two miles, and it took me, I don't know, 15 minutes or so. 00:05:14.444 --> 00:05:21.095 Yeah, I just pulled up your Garmin, and it looks like you did that long, 20-mile run on June 7th. 00:05:21.365 --> 00:05:21.555 Yep. 00:05:21.584 --> 00:05:30.064 And then your next run was June 11th, and you did three miles and then walked two miles, at a slower pace. 00:05:30.144 --> 00:05:31.694 So it was about four days later. 00:05:31.694 --> 00:05:32.225 No, other order. 00:05:32.805 --> 00:05:33.144 Okay. 00:05:33.154 --> 00:05:36.475 I walked two miles- Okay'cause I walked, the big loop of our neighborhood. 00:05:36.535 --> 00:05:50.154 And then I felt okay, and I think that walking two miles maybe even had some jogging in it, and so I was like,"Em, I'm gonna go out and try to run a little bit," and my run was even, it was purposely designed as a run/walk. 00:05:50.235 --> 00:05:54.595 And it, it just, it felt stiff and uncomfortable the entire time. 00:05:54.824 --> 00:06:00.925 And but that was also when I was just trying to deal with it myself of, I've seen Angie deal with back pain- when she's had it herself. 00:06:01.285 --> 00:06:12.785 I'm going to do bridges, and I'm gonna roll around on a lacrosse ball, and I'm trying to think of what else I came up with in my own head that sounded like a good idea. 00:06:12.785 --> 00:06:16.504 I think I was basically, I was fishing for help without asking for help. 00:06:16.504 --> 00:06:17.865 We had that on a previous episode- 00:06:17.935 --> 00:06:18.225 Yeah 00:06:18.404 --> 00:06:29.084 of any little bits that you would possibly give me as suggestions, or I'd make comments about what I was doing hoping that you would maybe give me, one extra thing to do. 00:06:29.204 --> 00:06:29.615 and it... 00:06:29.795 --> 00:06:31.904 I don't think that I was doing anything wrong- 00:06:31.915 --> 00:06:32.334 Yeah 00:06:32.454 --> 00:06:34.165 but I wasn't really doing anything right. 00:06:34.214 --> 00:06:35.444 I wasn't going in... 00:06:35.555 --> 00:06:39.384 we've got a great podcast outline here- Yeah of, this is a good way to progress. 00:06:39.615 --> 00:06:41.894 I was doing random things. 00:06:41.894 --> 00:06:42.004 And like- 00:06:42.004 --> 00:06:43.875 So were you, throwing spaghetti at the wall? 00:06:44.375 --> 00:06:45.504 I was just gonna say. 00:06:45.704 --> 00:06:47.564 it's similar to, like, when I cook. 00:06:47.634 --> 00:06:52.875 there's a recipe- and I'll follow the steps, but the order I'm doing them in doesn't make any sense. 00:06:52.904 --> 00:07:00.944 And now instead of eating at 6:30, we're eating at, 9:00- because I was like,"Oh, I probably should have preheated the oven," or"Oh, I forgot to do the... 00:07:01.125 --> 00:07:07.995 I also need to make sides." I just, I was missing pieces, and so it was just gonna take a really long time. 00:07:08.055 --> 00:07:15.384 I was still doing things, and I think maybe possibly, four months out it could have started improving. 00:07:15.384 --> 00:07:18.595 But there's just a much more efficient way of going at things. 00:07:18.944 --> 00:07:19.235 Yeah. 00:07:19.235 --> 00:07:40.774 And so f- for us to, help you guys understand what we did with Kevin and his back pain, I'm gonna tell you a little bit about the anatomy and physiology of, understanding what was going on in Kevin's back first, and then we'll get into kind of what we did and the three principles that we want you guys to take away, no matter what kind of pain it is, to be honest with you. 00:07:40.774 --> 00:07:48.394 So this, what we're gonna be talking about today definitely applies to lower back pain, and it al- often applies to a lot of other different types of pain as well. 00:07:48.394 --> 00:07:52.125 So we're gonna zoom out and generalize of how you can apply this to other things. 00:07:52.454 --> 00:07:56.165 So the first thing that you need to know is what kind of pain Kevin was having. 00:07:56.165 --> 00:07:58.915 Now, he hurt his back doing a squat. 00:07:58.925 --> 00:07:59.274 So he... 00:07:59.274 --> 00:08:00.894 It was at the bottom of a squat. 00:08:00.904 --> 00:08:03.654 Ke- te- tell them specifically, Kevin, when you felt that pain. 00:08:04.305 --> 00:08:20.274 I was on, Literally I was almost done, and this is what drives me nuts, being a month later and, just of having lost, a rhythm and momentum of summer- training that I had going, is I think I was on, my last or second to last rep of my third set of squats. 00:08:20.384 --> 00:08:32.794 I was just so fatigued that I was at the bottom of the squat, ready to start pushing back up, and I just felt this just stabbing pain in my lower back- and still pushed up. 00:08:33.394 --> 00:08:36.414 I could've, I should have just, racked it where it was, but I didn't. 00:08:36.434 --> 00:08:37.154 I pushed up. 00:08:37.154 --> 00:08:42.499 It was super uncomfortable,

and- And then I just thought that, bridges would fix it. 00:08:42.808 --> 00:08:43.068 Yeah. 00:08:43.678 --> 00:08:48.349 a- and who knows, maybe, I know you keep saying that about,"I should never have pushed back up. 00:08:48.349 --> 00:08:50.158 I should've just let it be." But, who knows? 00:08:50.158 --> 00:08:53.499 y- you could have done the damage already, and maybe it didn't even matter. 00:08:53.749 --> 00:08:54.538 But to- And when, 00:08:54.538 --> 00:08:57.759 when I retell the story in my head, now there's, a crunching sound that I heard. 00:08:57.869 --> 00:08:58.028 Okay. 00:08:58.038 --> 00:08:58.639 I have no idea. 00:08:58.639 --> 00:09:00.129 I think I've just added that to the story in my head. 00:09:01.028 --> 00:09:02.379 Our brains are so fun that way. 00:09:02.609 --> 00:09:09.448 But also, the, that lifting session that you did was also after several other activities. 00:09:09.458 --> 00:09:14.149 So I want the, our listeners to understand too, it's not like it was just this one isolated session. 00:09:14.149 --> 00:09:21.448 There was the 20-mile run the day before, and then you pressure washed our entire driveway, or our entire, sure, that was the patio, right? 00:09:21.749 --> 00:09:23.119 Yeah, I pressure washed the patio- 00:09:23.178 --> 00:09:23.408 Yeah 00:09:23.489 --> 00:09:30.278 and all of, the tiling around the edge of the pool- which I think was what really did me in because- You 00:09:30.278 --> 00:09:30.599 had to kind 00:09:30.599 --> 00:09:37.302 of bend over to get to it if you're so pressure washing the ground, you can stand there and do it, but you have to, really lean and hunch and angle over to get where I was doing- 00:09:37.322 --> 00:09:37.663 Yeah 00:09:37.932 --> 00:09:39.302 after I had run 20 miles. 00:09:39.363 --> 00:09:39.663 Right. 00:09:40.163 --> 00:09:42.623 And the squats were not the first exercise I did in my lifting session. 00:09:42.633 --> 00:09:44.582 it was- mid lifting session. 00:09:44.842 --> 00:09:51.033 Yeah, so I want you guys to all understand, it's not like this was that one movement that just totally did him in. 00:09:51.043 --> 00:09:58.442 It was the combination of things over the, two days, that two-day period that was likely what led him to this. 00:09:58.673 --> 00:09:59.493 And so what- 00:09:59.493 --> 00:10:03.702 So it wasn't just the squat, but it was- It was in fact, the squat that broke Kevin's back. 00:10:04.113 --> 00:10:04.773 There you go. 00:10:04.783 --> 00:10:05.013 Perfect. 00:10:05.153 --> 00:10:05.302 Thank you. 00:10:05.602 --> 00:10:06.273 There you go. 00:10:06.273 --> 00:10:06.842 Wonderful. 00:10:07.113 --> 00:10:15.643 Now, Kevin never went and had an X-ray or an MRI, so I cannot say with complete certainty that there was a, no disc involved or any of that stuff. 00:10:15.643 --> 00:10:27.952 But what I will tell you based on my clinical expertise and the presentation of how Kevin was presenting, it was, it's his SI joint, his sacroiliac joint, that was the p- part of his lower back that was affected. 00:10:27.962 --> 00:10:33.322 So the sacroiliac joint connects the sacrum, which is the triangular bone at the base of the spine. 00:10:33.322 --> 00:10:36.763 So essentially, your spine is a stack of vertebrae. 00:10:36.763 --> 00:10:41.883 If you think of, I always like to think of your vertebrae and your spine as like building blocks that are just stacked on top of each other. 00:10:41.883 --> 00:10:44.832 And at the base of that is a triangular shaped bone. 00:10:44.873 --> 00:10:56.722 It's an upside down triangle, so the base of the triangle is touching the spine, and the point of the triangle is pointing down, and that triangular bone both connects to the spine and it also connects to both sides of the pelvis. 00:10:56.962 --> 00:11:01.163 so it is a very important joint because of, there's two joints. 00:11:01.163 --> 00:11:07.753 There's a sacroiliac joint on the left and on the right, and then of course where the lumbar spine meets the sacrum as well. 00:11:07.763 --> 00:11:22.479 So it's a very important- part of the body and part of the spine f- as far as force and load, like taking on load from the body, and it is not a highly mobile joint by design. 00:11:22.479 --> 00:11:23.938 It is a very strong joint. 00:11:23.938 --> 00:11:35.158 So the sacroiliac joints themselves, it's just two bones that are connected by very strong li- ligaments, and that joint is very stable because its job is stability and load transfer. 00:11:35.158 --> 00:11:51.499 So load transpor- transfer means, it's taking all of the forces of the upper body and transmitting them down through the pelvis and into the legs, and then also transmitting ground reaction forces from the body all the way up through, or from the ground all the way up through the body. 00:11:51.928 --> 00:11:53.778 is this, are we on track so far, Kevin? 00:11:53.778 --> 00:11:57.928 Kevin's my, my monitor to make sure I'm not getting too science-y here. 00:11:58.178 --> 00:11:59.629 Yeah, I will help to translate anything. 00:11:59.668 --> 00:12:06.698 It just, it bothers me on an innate, going all the way back to high school level, that it is my SI joint that bothers me. 00:12:06.749 --> 00:12:07.038 Why? 00:12:07.129 --> 00:12:09.215 Cause my high school's rival high school was SI. 00:12:09.215 --> 00:12:09.250 Really? 00:12:09.250 --> 00:12:09.287 yes. 00:12:09.287 --> 00:12:09.359 That's random. 00:12:09.359 --> 00:12:09.763 Yeah,'cause they were the other Jesuit school, so we 00:12:10.243 --> 00:12:10.523 were Bellarmine- 00:12:11.623 --> 00:12:11.952 Perfect and they were St. 00:12:11.952 --> 00:12:12.633 Ignatius. 00:12:12.673 --> 00:12:18.352 They were the other Jesuits, and it was, it, yeah, it was a whole thing. 00:12:18.962 --> 00:12:20.783 Okay, so so far you're with me, right? 00:12:20.793 --> 00:12:20.812 Yeah. 00:12:20.822 --> 00:12:22.692 That des- that description makes sense. 00:12:23.072 --> 00:12:28.942

Okay, now runners are particularly susceptible to SI joint dysfunction for two main reasons. 00:12:28.993 --> 00:12:32.273 So first of all, running is a single leg sport. 00:12:32.273 --> 00:12:37.503 If you think about what running is, you're essentially jumping from one leg to another over and over again. 00:12:37.503 --> 00:12:48.212 And so every single time your body, your foot hits the ground, you're essentially asking that leg and your pelvis to absorb that force while your other leg is swinging through. 00:12:48.503 --> 00:13:01.793 And so if your hip mobility is limited or that rotational control is poor because there need, there's hip rotation happening while that leg is swinging through, then those forces get absorbed somewhere else, okay? 00:13:01.822 --> 00:13:05.702 Whenever there's a restriction in the body, compensation happens. 00:13:05.702 --> 00:13:11.952 And so if one area is restricted, another area of the body will come in to take up the slack. 00:13:12.332 --> 00:13:19.812 And so that SI, the SI joint often becomes the thing, part of the body that is starting to take up that slack. 00:13:20.352 --> 00:13:26.284 The second piece that's involved here- is the coupling pattern of the hip and the spine. 00:13:26.294 --> 00:13:29.634 And so I'm gonna be getting into more detail, of that a little bit later. 00:13:29.634 --> 00:13:35.894 But basically what it means is that restriction anywhere in the chain gets compensated for somewhere else. 00:13:35.924 --> 00:13:46.664 And so the lower back and the SI joint, just because they're at the end of that chain, they're at the bottom of the spine, oftentimes, they're, they take a lot more of the pressure and the force. 00:13:46.695 --> 00:13:48.014 they take more than their fair share. 00:13:48.065 --> 00:13:48.804 Does that make sense? 00:13:49.174 --> 00:13:52.975 Yeah, because everybody else just keeps passing the buck and you reach the end of the line- and your SI joint's like- And 00:13:52.975 --> 00:13:53.205 there 00:13:53.955 --> 00:13:54.975 you are"All right, fine. 00:13:54.975 --> 00:13:55.684 We'll deal with it." 00:13:55.754 --> 00:13:56.705 And there you are. 00:13:56.754 --> 00:14:03.764 Okay, so the second thing, as far as Kevin goes, like when I was doing my examination with him, was the psoas muscle. 00:14:03.774 --> 00:14:13.634 So the iliopsoas is one of your main hip flexor muscles, The, so it's responsible for, hip flexion and it's also, pelvic and spinal stability here. 00:14:13.955 --> 00:14:14.985 Now, the issue- 00:14:15.154 --> 00:14:17.654 Okay, when you say hip flexion, that literally means lifting your leg off the ground, right? 00:14:17.664 --> 00:14:21.794 Lifting your leg, yeah, so like knee towards the ceiling or- Yep knee towards the air, right? 00:14:22.365 --> 00:14:32.924 So the thing with the psoas that makes this so connected to lower back pain is that the psoas actually originates on the front of the lumbar spine. 00:14:32.934 --> 00:14:43.304 So

the part of your spine that's facing your belly button, that's where the, that muscle starts and then it goes down and attaches into the femur, so into the thigh bone. 00:14:43.695 --> 00:14:54.493 So because it actually literally attaches to the spine, if that is tight or if there's restrictions there, it can pull that, pull your spine forward Makes sense? 00:14:54.732 --> 00:14:55.533 That makes sense. 00:14:55.633 --> 00:14:56.023 Okay. 00:14:56.552 --> 00:14:57.822 That's why my back's all weird and curvy. 00:14:58.052 --> 00:15:10.273 Right, and so because of that attachment and the anatomy here is like when that psoas is tight or if it's overactive, it not only pulls the hip into flexion, it pulls the leg up, it also pulls directly on the lumbar spine. 00:15:10.273 --> 00:15:23.952 And so that can increase anterior pelvic tilt, which means tilting your p- your, pelvis is tipping forward, which is increasing the arch in your lower back, and that puts your lumbar spine, the lower back, under sustained compression. 00:15:24.243 --> 00:15:32.052 And so when we analyzed Kevin's squat pattern, we found that anterior pelvic tilt was excessive at the top of his squat. 00:15:32.293 --> 00:15:41.452 and hi- his lower back was excessively arched before he even began the movement, so that's gonna put extra pressure, on the pro- or extra pressure on the spine and the SI joint. 00:15:41.903 --> 00:15:44.893 All right, so let me see if I can translate a little bit of that- hopefully. 00:15:45.003 --> 00:15:48.212 'cause every time you talk about the pelvic tilting, I always... 00:15:48.513 --> 00:15:49.633 I get the words backwards. 00:15:49.712 --> 00:15:50.062 Okay. 00:15:50.113 --> 00:15:52.413 So this thing is super, super tight. 00:15:52.663 --> 00:15:58.552 It connects to my lower spine, and it connects that to the top of my thigh bone. 00:15:58.743 --> 00:16:04.263 Since when I'm standing there, I'm not gonna overcompensate by just lifting my leg off the ground. 00:16:04.633 --> 00:16:05.143 I could. 00:16:05.383 --> 00:16:09.033 I could overcompensate by just always standing like a flamingo. 00:16:09.352 --> 00:16:09.423 But that's... 00:16:10.123 --> 00:16:13.312 Instead, I'm gonna keep both feet on the ground- 00:16:13.312 --> 00:16:13.613 Yeah 00:16:13.653 --> 00:16:17.413 but I'm gonna curve my back and stick my butt out behind me. 00:16:17.462 --> 00:16:20.852 and so it's kinda it's like sticking your butt out and, tilting your pelvis forward. 00:16:21.113 --> 00:16:21.442 Yeah. 00:16:21.942 --> 00:16:22.293 Okay. 00:16:22.352 --> 00:16:26.482 and I've tried to go the other direction, and it just, it feels so awkward. 00:16:26.543 --> 00:16:29.133 It doesn't feel uncomfortable, it just feels so awkward. 00:16:29.232 --> 00:16:29.592 Yeah. 00:16:30.052 --> 00:16:35.293 All right, so then that leads us to the next issue that we figured out with Kevin's, squat. 00:16:35.312 --> 00:16:39.423 'Cause like we a- I analyzed his squat pattern to figure out like why did this happen during the squat. 00:16:39.692 --> 00:16:51.472 And so Kevin started off with this anterior pelvic tilt, so that excess arch in the lower back, with his hips tilted forward because of the tightness in his psoas, because of the weakness in, the spine and the glutes. 00:16:51.783 --> 00:17:02.712 And then what would happen is Kevin then went from that excess forward tilt, and then at the bottom of his squat he went into an excess backward tilt, or a posterior pelvic tilt. 00:17:02.972 --> 00:17:05.123 So the pelvis like tucked under him. 00:17:05.393 --> 00:17:12.252 And when that lumbar spine was like then undergoing an excessive amount of flexion under load. 00:17:12.522 --> 00:17:14.893 And so there was this alternating pattern of extremes. 00:17:14.893 --> 00:17:21.863 He had too much, like he had a big arch in his back at the top of the squat, and then that arch disappeared and that back was completely flattened out. 00:17:22.123 --> 00:17:24.823 The spine was flattened out at the bottom of the squat. 00:17:25.063 --> 00:17:32.682 And so there was too much extension at the top, too much flexion at the bottom, and so his lower back was just absorbing load that it wasn't designed to absorb. 00:17:32.682 --> 00:17:37.053 And so h- the SI joint was being stressed with every single rep that he was doing. 00:17:37.292 --> 00:17:47.613 Add in the fatigue that he was having because of the 20-mile run, because of the pressure washing, because this was the last set in his whole strength session, and his SI joint was just like,"I'm done. 00:17:48.282 --> 00:17:49.673 Tapping out here." 00:17:50.272 --> 00:17:52.173 Yep, which is essentially what it did. 00:17:52.173 --> 00:17:56.343 It literally just tapped out, and then my whole rest of my body freaked out. 00:17:56.492 --> 00:17:56.712 Right. 00:17:56.712 --> 00:18:05.845 But okay, so the issue is I was excessive, let's- Excessive forward at the top- Yeah and excessive backward at the bottom. 00:18:05.884 --> 00:18:06.265 Yeah. 00:18:06.704 --> 00:18:11.214 If I was one or the other- it would have put less strain on it. 00:18:11.575 --> 00:18:12.255 Most likely. 00:18:12.585 --> 00:18:23.595 But becau- but the reason that happened for you is because you wanted to go lower in your squat, and so you didn't have enough of the flexion and internal rotation to get lower. 00:18:23.595 --> 00:18:27.664 And so in order for you to get lower in your squat, you decided that you were... 00:18:27.775 --> 00:18:29.204 you didn't consciously decide this. 00:18:29.234 --> 00:18:29.454 I decided. 00:18:29.555 --> 00:18:35.095 But you, your bo- you wanted to go lower, and so your body wasn't able to do that because you didn't have the hip mobility for it. 00:18:35.325 --> 00:18:42.765 And so that mobility then got transferred and you had your lumbar spine compensated and, really flexed under to allow you to go lower in the squat. 00:18:43.184 --> 00:18:44.075 Which is bonkers.

00:18:44.085 --> 00:18:44.105 Yeah. 00:18:44.174 --> 00:18:47.654 Because, I'm not thinking,"Oh, I'll just posteriorly tip my 00:18:47.654 --> 00:18:51.674 pelvis." This all just happens automatically unless you are aware of it. 00:18:52.035 --> 00:18:52.345 Yeah. 00:18:52.535 --> 00:18:53.894 But the body's phenomenal. 00:18:53.904 --> 00:19:00.055 Y- I wanted to do this motion, and my body figured out,"Oh, we'll do this to allow you to go into that position." 00:19:00.174 --> 00:19:00.984 Exactly. 00:19:00.984 --> 00:19:02.449 Cause it wasn't what was supposed to happen. 00:19:02.469 --> 00:19:03.118 Exactly. 00:19:03.469 --> 00:19:11.028 And so that's the what when it came to, what exactly happened with Kevin and why this caused a pain with him. 00:19:11.459 --> 00:19:17.689 Now, getting back to and maybe we'll get to this a little bit later in the episode of, like, when it, when is it okay to run? 00:19:17.689 --> 00:19:20.709 'Cause I'm sure that's, one of the top questions, that every single runner has. 00:19:21.078 --> 00:19:21.945 And we are- That was my question. 00:19:21.945 --> 00:19:23.605 and we are gonna talk about that, for sure. 00:19:23.875 --> 00:19:30.766 but before we talk about, treatment and getting back into running, it's important, for us to also understand the neuroscience of pain. 00:19:30.776 --> 00:19:38.316 And this is one of the comments that, has come back to bite me'cause it was received in a way that it was not intended. 00:19:38.576 --> 00:19:40.986 So Kevin says that one he... 00:19:41.086 --> 00:19:47.175 I'll let you tell the story of, what I said when- I didn't know- When you told me about your pain what the story 00:19:47.175 --> 00:19:47.566 was. 00:19:47.566 --> 00:19:48.486 because I'm very... 00:19:48.516 --> 00:19:50.105 I wish we had, a video camera. 00:19:50.115 --> 00:19:50.925 Actually, we do. 00:19:50.945 --> 00:19:52.355 I think it was, it happened out here. 00:19:52.355 --> 00:19:53.556 we should check the Zoom cam. 00:19:53.806 --> 00:20:05.096 actually, I don't think I have that much r- history in our recording, but, you said that I just told you,"Oh, this is all in your head." And, clearly that's not exactly what I said, but that was the way that you perceived it. 00:20:05.175 --> 00:20:06.715 No, this is exactly what happened. 00:20:06.726 --> 00:20:19.826 So I was sitting at my computer trying to get work complaining that my back was hurting because I couldn't sit for very long- because sitting was remarkably uncomfortable, but so was laying down and standing. 00:20:20.115 --> 00:20:24.336 The problem was is I couldn't maintain any position for an extended period of time. 00:20:24.705 --> 00:20:40.425 And so I was sitting and then moved to standing and probably said some sort of complaint about my back, about how uncomfortable it was and painful it was, hoping that you would fix it instead of just saying,"Hey, please come help me fix it." And then you looked at me and you said,"Pain is all in your head. 00:20:40.586 --> 00:20:43.816 Deal with it," is actually, I think, you may have cursed. 00:20:43.846 --> 00:20:45.566 There may have been profanity involved. 00:20:46.746 --> 00:20:47.395 And then she might have- 00:20:48.435 --> 00:20:48.965 Come on 00:20:49.195 --> 00:20:50.195 might have kicked me. 00:20:50.596 --> 00:20:51.486 It's possible. 00:20:52.236 --> 00:20:57.715 It's possible that she just walked over and pushed me out of the chair, and then pointed at me on the ground. 00:20:58.135 --> 00:20:59.256 No, none of that happened. 00:20:59.476 --> 00:21:05.881 But- you are entirely correct that a good aspect of pain is in your head. 00:21:05.881 --> 00:21:14.455 And amusingly enough, I don't know, two or three weeks before this happened to me, I had listened to an entire podcast on the psychology of pain. 00:21:14.566 --> 00:21:24.117 And, one of the things that happened in it is one of the hosts was talking about they had done a deadlift and hurt their back, and they went and they saw a doctor to make sure that they didn't, herniate a disc or anything. 00:21:24.327 --> 00:21:27.178 And they hadn't, and they went back to the gym the next day. 00:21:27.617 --> 00:21:31.768 They did it with a ridiculously reduced weight relative to what they're used to. 00:21:31.798 --> 00:21:40.022 But they did it because of exactly what we're gonna wanna talk about- is they didn't want to tell their body,"You're more hurt than you are." Yeah. 00:21:40.022 --> 00:22:01.083 And yeah, part of that is in your head, because your body wants to freak out and be like, no, you're in an extreme amount of pain." And there is actually something wrong in my lower back, but what level of pain that is, of w- is that a one, is that a nine, is interpreted in my head. 00:22:01.212 --> 00:22:06.403 And so pain is technically all in your head, but it is also wherever that pain is actually coming from. 00:22:06.782 --> 00:22:15.123 So yes, the interpretation and per- and pain perception is in your head, and there's literally people out there that don't have pain. 00:22:15.343 --> 00:22:18.133 There are people out there that do not experience pain. 00:22:18.133 --> 00:22:32.143 There is a medical condition where people don't experience pain, and it's actually a very dangerous condition, because they could literally put their hand on a hot stove and not know that their skin is burning off, because they can't feel the pain. 00:22:33.803 --> 00:22:35.742 So- Yeah, their sensation is the smell of their burning skin- 00:22:35.883 --> 00:22:35.962 Yeah and 00:22:36.113 --> 00:22:36.853 by then, it's probably too 00:22:36.853 --> 00:22:37.026 late. 00:22:37.026 --> 00:22:37.198 Ugh. 00:22:37.198 --> 00:22:38.353 Oh, God, that sounds terrible. 00:22:38.363 --> 00:22:42.333 So yes, there is a neuroscience behind this, and I think that... 00:22:42.403 --> 00:22:56.643 I can't remember exactly what I told Kevin, but, I did say something, about how part of the pain is in

your head, and that's the part that we have to get over, because it's very important for us to understand that pain is not objective. 00:22:57.396 --> 00:22:59.446 Pain is very subjective. 00:22:59.446 --> 00:23:04.946 And it's so funny to me how many people have said to me throughout the years,"Oh, I have a high pain tolerance," as if that's a thing. 00:23:05.146 --> 00:23:12.517 You just have a different perception of pain, and you have a different way that you're able to push through pain versus maybe other people. 00:23:12.787 --> 00:23:19.727 And so it's important for us to understand that the pain that you're experiencing is the way that your brain is perceiving it. 00:23:19.727 --> 00:23:22.906 It is not just a signal of tissue damage. 00:23:22.906 --> 00:23:27.997 Just because you're having pain doesn't mean that there is excessive amounts of tissue d- damage. 00:23:28.237 --> 00:23:32.467 It's your brain's best guess about whether a threat exists. 00:23:32.477 --> 00:23:35.666 So it's this, it's a protective mechanism in the brain. 00:23:35.876 --> 00:23:41.957 There is likely and usually some sort of tissue damage that s- starts the pain cycle, right? 00:23:41.957 --> 00:23:51.467 Because there are different, pain fibers that transfer, a signal from the damaged tissue to the brain, and that is a real thing, right? 00:23:51.487 --> 00:23:56.126 It's, there's something going on in the body that tells the brain something's wrong here. 00:23:56.136 --> 00:23:57.527 There's a threat here. 00:23:57.797 --> 00:24:02.567 And so you- your brain, your, nervous system perceives that as pain. 00:24:02.797 --> 00:24:13.247 it also perceives it as dangerous, which is important because if there is actual tissue damage, then you need to stop doing certain activities because you don't wanna make that damage worse. 00:24:13.876 --> 00:24:27.426 However, a lot of people can end up in this pain cycle where the pain, the experience of pain is actually much worse than what the tissue damage is, because of the meanings that they have around it or because of the fear that they have around the pain. 00:24:27.686 --> 00:24:33.757 And also the pain sensation can last longer than the tissue damage itself. 00:24:33.757 --> 00:24:41.156 And there's actually, again, medical conditions where pain is actually experienced long after the tissues have actually healed. 00:24:41.457 --> 00:24:46.416 So pain itself is a science, like neuroscience phenomenon. 00:24:46.517 --> 00:24:46.886 All right? 00:24:47.237 --> 00:24:57.336 And so the second thing we need to understand is that pain can also be present without significant tissue damage because the nervous system has become sensitized to it. 00:24:57.557 --> 00:24:59.467 So Kevin's pain was real. 00:24:59.497 --> 00:25:00.356 It was limiting. 00:25:00.366 --> 00:25:07.467 it wasn't like, I think that when we say,"Oh, it's all in your head," it just, a lot of people take that as, like meaning, oh, you're just making this up. 00:25:07.467 --> 00:25:08.176 It's not real. 00:25:08.176 --> 00:25:08.747 It's fake. 00:25:08.906 --> 00:25:10.586 No, it's definitely real. 00:25:10.606 --> 00:25:17.707 It's definitely, it was definitely limiting him in e- literally e- every single activity that he was going through that first week. 00:25:18.297 --> 00:25:24.497 But part of what was keeping the pain at that level was his nervous system was just so guarded. 00:25:24.507 --> 00:25:33.807 His nervous system was in high alert mode, and so he was guarding the area and restricting so many of his movements as a protective strategy because... 00:25:33.957 --> 00:25:36.817 and all of that, m- most of it was happening unconsciously. 00:25:36.826 --> 00:25:42.186 May- there might have been a, a piece of it that's conscious, but most of that happens at an unconscious level. 00:25:42.396 --> 00:26:06.807 And so when we went into actually trying to get to the core of Kevin's pain, and w- the things that we're gonna be talking about today with what we actually did, part of my strategy was to help actually improve the area of damage and work on mobility and the strength and those kinds of things, but also on the nervous system's sense of safety, to let the nervous system and the muscles know it's okay. 00:26:06.856 --> 00:26:07.977 y- you can relax. 00:26:07.977 --> 00:26:09.987 You don't have to, tense up and guard. 00:26:09.987 --> 00:26:15.527 it's, it was about restoring that gentle movement so that the body felt safe. 00:26:16.176 --> 00:26:32.952 Yeah, which is really trick- tricky because you can't just, I mean- If someone is freaking out over whatever the situation is, like emotionally freaking out, they're very upset about something, walking over to them and telling them to calm down is never a helpful process. 00:26:33.393 --> 00:26:44.022 So like telling the various muscles around my hip- Oh, just calm down." Like just, oh, if I just sit here and I breathe for a second, I'll be able to relax that muscle. 00:26:44.022 --> 00:26:44.298 I just... 00:26:44.298 --> 00:26:44.682 I could. 00:26:44.702 --> 00:26:50.282 They were so tight, and trying to actively relax them- was not fixing anything. 00:26:50.373 --> 00:26:57.803 it was having literally the same result of, having somebody coming out of a burning building being like, just take a breath and calm yourself." that's not gonna work. 00:26:57.833 --> 00:26:58.212 Yeah. 00:26:58.603 --> 00:27:09.083 And that really highlights the big other, the last thing that we wanna kinda talk about before we get into what we did, which is this fear avoidance trap that so many people fall into. 00:27:09.083 --> 00:27:14.863 So back pain is one of those things that so many people are scared of, right? 00:27:14.863 --> 00:27:17.803 Because your back, y- you can't get away from back pain. 00:27:17.803 --> 00:27:25.823 It's pretty much involved in all of your activities of daily living, whether, r- regardless of what- Way more than you think it is

Way more than you think it is, yeah. 00:27:25.873 --> 00:27:27.833 and regardless of what position you're in, too. 00:27:28.083 --> 00:27:31.212 And I think that's really the scary part for a lot of people. 00:27:31.833 --> 00:27:40.752 And so what I often see happening is that runners and people in general, but sp- specifically runners, tend to go in one of two main directions. 00:27:40.762 --> 00:27:45.343 The first one is that they just push through the pain, and they're like,"Screw that, I'm not letting this limit me. 00:27:45.343 --> 00:27:48.613 I'm just gonna push through it," whether it's back pain or some other t- type of pain. 00:27:48.992 --> 00:28:12.113 Or they just try to avoid it completely, and they just, they say,"Okay, I need to rest, and, I have to make sure that this goes away because I don't want this to affect my running long term." But neither of those things are the most effective thing to do, because oftentimes, like if you push through it, that's just going to aggravate not only the tissue damage potentially, but also the nervous system, because the nervous system is already sensitized, and so the pain can be prolonged. 00:28:12.432 --> 00:28:19.593 But if you stop moving entirely, then that can increase stiffness and weakness in the surrounding musculature, which is also not helpful. 00:28:19.593 --> 00:28:23.502 And it also confirms to your nervous system that the area is dangerous. 00:28:23.512 --> 00:28:26.982 you're reinforcing that point of you're right, something's seriously wrong here. 00:28:27.212 --> 00:28:28.673 And so neither of these things work. 00:28:28.673 --> 00:28:43.835 And so this is why- The old method of back, back pain recovery, decades ago, several decades ago, I don't wanna say, 20 years ago because I've been doing this for 20 years now, but 50 years ago when someone got hurt, the re- the, prescription was always rest, right? 00:28:43.835 --> 00:28:45.295 you're, oh, you're on bed rest. 00:28:45.325 --> 00:28:47.634 Bed rest was the thing that they prescribed to everybody. 00:28:47.914 --> 00:28:59.424 We now know that is a terrible prescription, especially for back pain, that we need to gently reintroduce movement, and this is pretty much goes for most types of pain unless we're talking about a bone injury. 00:28:59.714 --> 00:29:06.075 We want to reintroduce movement safely, slowly, effectively, gentle, in a very controlled manner. 00:29:06.265 --> 00:29:10.434 We don't wanna be at complete rest, and we don't wanna just force everything and push through it. 00:29:10.644 --> 00:29:13.545 We wanna be somewhere in the middle to allow the tissues... 00:29:13.805 --> 00:29:15.384 we don't wanna increase tissue damage. 00:29:15.384 --> 00:29:29.474 We wanna make sure that those tissues are healing and also helping to recalibrate the nervous system in the process to know that it's okay to not be so tense because the nervous system is just tensing the muscles up to try to protect the area. 00:29:29.484

--> 00:29:30.414 That's its job. 00:29:30.414 --> 00:29:37.855 And so we have to let the nervous system know it's okay to relax and let go, and that's a big piece of the framework, that we used with Kevin. 00:29:38.384 --> 00:29:42.755 But this is why it's super helpful to work with you because you knew how to progress things. 00:29:42.815 --> 00:29:48.105 this is why what I was doing was not working,'cause I knew that bridging was not gonna be a bad idea. 00:29:48.384 --> 00:29:50.884 It was better than absolute rest. 00:29:50.884 --> 00:29:50.924 Yeah. 00:29:50.934 --> 00:29:53.894 I was trying to make sure that I was still having some movement, but- 00:29:54.035 --> 00:29:59.464 Yeah, but, bridging for you was one of the most painful things that you could do at the beginning when you s- first started. 00:29:59.765 --> 00:30:00.035 Yeah. 00:30:00.035 --> 00:30:05.464 I couldn't actually just lay on the ground and pelvically tilt without- Yeah a whole lot of pain, and then trying to take it and do a bridge. 00:30:05.724 --> 00:30:07.924 I could do an, inappropriate bridge. 00:30:08.244 --> 00:30:10.494 I could curve my back too much- Inappropriate bridge? 00:30:10.634 --> 00:30:11.275 and then lift my hips off. 00:30:11.325 --> 00:30:16.644 if I, anteriorly rotated my pelvis while laying on the ground- then I could bridge- without pain. 00:30:16.825 --> 00:30:17.105 Yeah. 00:30:17.115 --> 00:30:18.454 But I couldn't do a proper bridge. 00:30:18.565 --> 00:30:23.634 Yeah, because you were shortening your hip flexors, and so that was helping to take the pressure off of your spine. 00:30:23.994 --> 00:30:24.355 You see- Yeah. 00:30:24.355 --> 00:30:25.785 I didn't know why it worked- Do you see now why that works? 00:30:25.855 --> 00:30:26.974 but I knew that it did. 00:30:27.035 --> 00:30:27.384 Yeah. 00:30:27.694 --> 00:30:30.894 But do you see now, based on, what we talked about already, like, why that worked? 00:30:31.204 --> 00:30:32.055 Yeah, of course. 00:30:32.144 --> 00:30:36.785 But, and w- before I started actually getting help from you, I was like,"Oh, s- I'll do some bridges. 00:30:36.994 --> 00:30:41.575 Oh, doing bridges that way doesn't feel good.""I'll do bridges this way." Yeah. 00:30:41.575 --> 00:30:48.230 But doing bridges in a way that, that- That I was avoiding the pain was essentially n- not doing bridges. 00:30:48.570 --> 00:30:51.030 You weren't activating the right muscles that you needed anyway. 00:30:51.121 --> 00:30:51.391 All right. 00:30:51.401 --> 00:30:53.580 So let's talk about what we actually did. 00:30:53.631 --> 00:30:53.971 All right? 00:30:53.971 --> 00:31:04.601 So now that everyone has a good background of kind of what was going on with Kevin and his back, I do have to add my little medical disclaimer here, is that, everything that we're gonna be talking about today is not a prescription. 00:31:04.631 --> 00:31:05.631 I'm not your doctor. 00:31:05.641 --> 00:31:06.780 I'm not your physical therapist. 00:31:06.810 --> 00:31:08.351 I'm not telling you what to do here. 00:31:08.590 --> 00:31:15.760 I'm simply telling you what worked for Kevin and the things that we focused on for Kevin and his specific back pain presentation. 00:31:16.000 --> 00:31:17.480 They are good principles. 00:31:17.691 --> 00:31:20.181 if you use them, you do so at your own discretion. 00:31:20.191 --> 00:31:40.184 I highly suggest that if you have back pain, you possibly consider, consider getting it cleared by a medical professional, to make sure that there's not something more serious going on, especially if there's any sort of, loss of bladder control, loss of bowel control, if there's radiation of pain, if there's numbness, if there's significant trauma involved. 00:31:40.414 --> 00:31:45.285 We need to go make sure that there's nothing really bad going on here, okay? 00:31:45.285 --> 00:31:48.184 So let that's, let's get that disclaimer out of the way first. 00:31:48.545 --> 00:31:49.384 Excellent disclaimer. 00:31:49.384 --> 00:32:08.484 But if none of those apply to you- if you're working kind of the way I am, is you could point to the activity that you were doing- that brought about the pain, that you can go to positions that change the pain, increase or decrease the pain, certain movements make it feel better than others, then this is probably going to be a good approach for you. 00:32:08.565 --> 00:32:08.914 Yeah. 00:32:09.305 --> 00:32:09.575 All right. 00:32:09.575 --> 00:32:10.434 So the first thing- I'm 00:32:10.434 --> 00:32:12.194 not a doctor at all, so I'm just going for it. 00:32:12.404 --> 00:32:13.565 I'm just going for it. 00:32:13.994 --> 00:32:14.335 All right. 00:32:14.345 --> 00:32:23.884 So the first thing that we focused on is mobility, and specifically mobility above the area of pain and below the area of pain. 00:32:23.894 --> 00:32:35.134 So the important principle that you need to understand is that when a joint is restricted or painful, the body compensates by stealing, essentially stealing mobility from the joints above and below it. 00:32:35.244 --> 00:32:41.404 if this area doesn't move properly, I've got to get that movement from somewhere, and so that's what was happening with Kevin. 00:32:41.644 --> 00:32:51.414 And so if the lumbar spine and the SI joint are affected, then oftentimes it will go to the thoracic spine or the hips, or vice versa. 00:32:51.654 --> 00:33:03.065 if the hips and the thoracic spine are limited, more force goes through the lumbar spine and SI joint, and that's one of the reasons also why those areas tend to get more injuries and more pain. 00:33:03.065 --> 00:33:07.194 It's because of restrictions in the hip and the thoracic spine. 00:33:07.365 --> 00:33:08.615 So you can't just fix- That was my 00:33:08.795 --> 00:33:10.214 issue that caused the pain. 00:33:10.595 --> 00:33:11.065 Exactly. 00:33:11.065 --> 00:33:13.775 And so you can't fix the lower back in isolation. 00:33:13.785 --> 00:33:22.285 This is

one of the biggest mistakes that I see most people making, is that if I have pain in my right knee, I'm going to do right knee exercises to fix it. 00:33:22.555 --> 00:33:24.674 But you have to address the full chain. 00:33:24.855 --> 00:33:34.035 So with Kevin's lower back, we had to address above the area of pain and below, so the upper spine, the thoracic spine, and then h- specif- and also his hips. 00:33:34.085 --> 00:33:37.894 majorly we had to address what was going on in his hips. 00:33:38.285 --> 00:33:39.775 So if it's the knee, same thing. 00:33:39.805 --> 00:33:44.234 Above it you have to address the hip, and below it you have to address the foot and the ankle. 00:33:44.454 --> 00:33:49.954 So your whole body, it's like that wonderful song that we all learned when we were kids, everything is connected. 00:33:49.964 --> 00:33:53.410 The thigh bone's connected to the- Hip bone Knee bone, right? 00:33:53.410 --> 00:33:53.880 I forget the 00:33:53.880 --> 00:33:57.190 order of it But it's actually not really,'cause your patella's just free-floating. 00:33:58.049 --> 00:33:58.500 But that's what the song said. 00:33:58.880 --> 00:33:59.420 Thank you. 00:33:59.819 --> 00:34:00.200 Perfect. 00:34:00.549 --> 00:34:05.069 it depends on what you just define as your knee bone, It could be the femur or the tibia, too,'cause- 00:34:05.130 --> 00:34:05.859 I know. 00:34:05.950 --> 00:34:07.500 That's- technically it's a joint- Just the fact that- and not a 00:34:07.500 --> 00:34:08.130 bone 00:34:08.400 --> 00:34:14.760 the knee bone- Yeah is part of the song was suggested that maybe it wasn't actually solid anatomy lesson. 00:34:14.820 --> 00:34:15.110 Yeah. 00:34:15.760 --> 00:34:19.590 So for Kevin, we, again, we're addressing mobility first, okay? 00:34:19.590 --> 00:34:22.059 Mobility is your body's available to move. 00:34:22.070 --> 00:34:40.530 It is decreasing restrictions of movement, whether that comes from tissue restrictions or just, restrictions in your movement patterns, because one of the things that we were talking about with our members today, like inside of our membership, in the workshop, we were talking about movement patterns and how movement patterns just oftentimes get reinforced in the body. 00:34:40.539 --> 00:34:42.030 you start moving a certain way. 00:34:42.239 --> 00:34:46.170 Maybe you've been moving that way since you were a kid, since you were a teenager. 00:34:46.369 --> 00:34:52.900 Maybe you had an injury 20 years ago that changed the way that your body moved, and you've just been moving that way ever since. 00:34:53.320 --> 00:35:01.280 At some point, that's going to catch up to you, because the joints that movement is supposed to be occurring in aren't doing their job. 00:35:01.659 --> 00:35:08.170 Other joints are picking up the slack, and so they're, those joints are getting overworked, and those areas of the body are getting overworked. 00:35:08.420 --> 00:35:16.384 So the thoracic spine in Kevin's specific-

situation here, and this is something that's very common for anyone that has low back pain. 00:35:16.773 --> 00:35:19.724 Oftentimes there's restrictions in the thoracic spine. 00:35:19.724 --> 00:35:24.164 So the, your spine is separated into three main areas. 00:35:24.164 --> 00:35:31.023 There's your cervical spine, which is your neck, your thoracic spine, which is your torso, and then your lumbar spine, which is the lower back. 00:35:31.304 --> 00:35:37.623 And each of the, those areas of the spine have different jobs, and the thoracic spine is designed for rotation. 00:35:37.653 --> 00:35:48.293 And when it loses that rotational capacity, like if you have restrictions in rotation, then your body compensates by asking your lumbar spine to rotate instead. 00:35:48.494 --> 00:35:51.693 But the lumbar spine is not designed to rotate. 00:35:51.853 --> 00:35:57.143 It is designed more for flexion and extension, which is bending forward and bending backwards. 00:35:57.253 --> 00:36:00.074 The thoracic spine also does that, but not as much, right? 00:36:00.074 --> 00:36:09.563 And so again, each area of the spine works together and has its own job, and when one person's not doing its job, the other pieces have to come in and pick up the slack. 00:36:09.804 --> 00:36:10.684 So if we are- Yeah, 00:36:10.684 --> 00:36:11.753 but they're not designed to do it. 00:36:11.753 --> 00:36:12.244 But they're 00:36:12.244 --> 00:36:12.614 not 00:36:12.884 --> 00:36:15.114 So they're picking up slack that they're not really great at doing. 00:36:15.153 --> 00:36:15.434 Yeah. 00:36:15.494 --> 00:36:25.903 They can sorta do it, but y- they really shouldn't be, and so you're having, you're literally fitting a square peg in a round hole- and being like,"Yeah, but that's my plan. 00:36:26.103 --> 00:36:27.213 That's my plan for life. 00:36:27.253 --> 00:36:29.773 That's the movement I'm gonna do forever." Yeah. 00:36:29.903 --> 00:36:37.034 And if you put enough stress on a movement where the wrong muscles, the wrong joints are doing the action- you're gonna get hurt. 00:36:37.344 --> 00:36:49.293 Yeah, and if it's just like at work, like one of the things I think about is if you work in an office and there are certain people that are supposed to do the mail, and there are certain people that are supposed to talk to clients, and there's s- other people that... 00:36:49.414 --> 00:36:57.974 everybody has different roles in an office, and you all, if you work in an office or in any sort of company, you know that there are those people that don't pull their weight. 00:36:58.324 --> 00:37:04.614 And when those people don't pull their weight, the work still has to get done, so oftentimes it falls on you or it falls on somebody else. 00:37:04.804 --> 00:37:12.233 And if that weight falls on you, then you don't have the full capacity to do your job as well, and then the rest of the stuff that you're supposed to be doing suffers. 00:37:12.494 --> 00:37:17.903 Or you get it done, and then you go home, and you're completely burnt out and exhausted, and you snap at your family. 00:37:18.034 --> 00:37:21.773 it's going to play out somewhere in the chain, right? 00:37:21.773 --> 00:37:23.664 And so the same thing is happening in the body. 00:37:24.184 --> 00:37:31.293 And so when the lumbar spine is being asked to rotate, which it's not designed to do, it's going to put more wear and tear on that spine. 00:37:31.304 --> 00:37:37.884 It's going to help, or I'm sorry, it's going to weaken that area because it's j- it's just not designed for that. 00:37:37.884 --> 00:37:56.853 And so when- Anybody has lower back pain, one of the first things I look at is trying to restore mobility in the thoracic spine, specifically rotation and extension, to help take some of that pressure off the lower back because the lower back's been being asked to do a job that it's not well-suited for. 00:37:56.853 --> 00:38:10.153 And so if we can try to give some of that stress and give some of that job back to the people that are supposed to be doing it, which is the thoracic spine, that just starts to remove some of that stress and that strain from the lumbar spine, which will allow the tissues to heal. 00:38:10.873 --> 00:38:16.733 Okay, so what did we actually do for me that helped my thoracic spine rotate? 00:38:17.014 --> 00:38:23.983 'Cause to me I'm like, why don't you just have me sit in a chair and kinda like turn from side to side?" But like we had like specific things. 00:38:24.014 --> 00:38:24.443 Yeah. 00:38:24.653 --> 00:38:34.724 And I feel like lay on the ground with my feet, with my knees bent- and then let my knees drop to the left and the right- is one of the like easiest things that we did. 00:38:34.963 --> 00:38:47.653 That was one of the first things that we did, to try to get some of that rotation back, and we did that, and I had you h- with your arms out to the side as well so that we were allowing more of that rotation to happen through your thoracic spine. 00:38:47.983 --> 00:38:53.173 so we're, and then we were also adding breathing into it and head rotation. 00:38:53.364 --> 00:39:06.204 So when you drop your legs to one side and you rotate your head to the opposite side, you're rotating not only your neck, but the upper thoracic area away from it, so you're trying to get more of that rotation through the upper spine. 00:39:06.434 --> 00:39:06.954 the other th- If 00:39:06.983 --> 00:39:11.134 you, if you rotate your neck, then you're rotating, what's that, cervical spine. 00:39:11.173 --> 00:39:14.903 Does that then tell your thoracic spine,"Hey, we're doing a rotating thing?" 00:39:14.954 --> 00:39:19.244 it doesn't tell it, but like the cervical spine's- connected to the thoracic spine, so you're probably- Kind of 00:39:19.244 --> 00:39:19.773 encourages? 00:39:20.063 --> 00:39:23.123 Yeah, you're, you're kicking in like the upper thoracic spine, right? 00:39:23.123 --> 00:39:23.143 Yeah. 00:39:23.143 -->

00:39:25.833 And so you're again, you're just, it's everything is connected. 00:39:25.853 --> 00:39:46.114 we're trying to get everybody on board here, and then we, I was also very, directive I guess is a good word about how to breathe through these movements because breathing is going to not only help your nervous system, it's going to help your tissues relax into some of these movements as well to help, reduce some of that muscle guarding that was going on with you. 00:39:46.184 --> 00:39:47.704 Yeah, I'm not gonna lie, that was super annoying. 00:39:47.923 --> 00:39:48.034 Yeah. 00:39:48.074 --> 00:39:48.153 I, 00:39:48.753 --> 00:39:49.043 I think it was- 00:39:49.043 --> 00:39:52.143 I know, because runners don't like to do things slowly. 00:39:52.483 --> 00:39:52.943 I know. 00:39:52.994 --> 00:39:55.304 I think it was probably remarkably helpful. 00:39:55.313 --> 00:39:55.333 Yeah. 00:39:55.454 --> 00:39:59.724 And trust me, that week I was doing things on my own, I was probably holding my breath for most of it. 00:39:59.773 --> 00:40:00.538 But then you gave 00:40:00.538 --> 00:40:07.184 me the- a lot, and, I have to interrupt because a lot of runners do, like a lot of people do, they do hold their breath because there's pain, right? 00:40:07.193 --> 00:40:07.213 Yeah. 00:40:07.224 --> 00:40:14.574 And so one of the first, inclinations, one of the first things that we do is hold our breath to try to brace the area, but that's not helpful. 00:40:14.583 --> 00:40:14.603 Yeah, 00:40:14.824 --> 00:40:17.253 you brace because therefore you're gonna hold everything. 00:40:17.253 --> 00:40:17.594 Yeah. 00:40:18.014 --> 00:40:26.393 And you gave me very specific breathing patterns to do things, and like breathe in as your legs move this way and breathe- out as you go this way. 00:40:26.514 --> 00:40:26.784 Yeah. 00:40:28.516 --> 00:40:32.396 it just, it made the mobility routine take so long 00:40:33.266 --> 00:40:33.635 Yeah 00:40:33.916 --> 00:40:40.635 which was extra frustrating to me, and I share this hopefully that it connects to some people who are listening also. 00:40:40.846 --> 00:40:49.431 But then it made the m- mobility routine take so long, and since I try to avoid mobility routines in general, now I'm having this- Which is what 00:40:49.431 --> 00:40:50.576 led you to this problem 00:40:50.766 --> 00:40:51.976 I know. 00:40:52.186 --> 00:40:57.885 But now I've got this, 30 to 45-minute mobility routine that I'm supposed to, calmly breathe my way through. 00:40:58.226 --> 00:41:03.795 And for the first two days I was super annoyed about it, and then I just accepted that's just what it is- and it's getting me better. 00:41:04.146 --> 00:41:08.315 I was about to say, and then you started running and realized,"Oh, wait a second." 00:41:08.655 --> 00:41:09.076 I know. 00:41:09.085 --> 00:41:12.635 it was improving things, but I- Yeah did not make it just... 00:41:12.635 --> 00:41:18.096 it wasn't an easy thing for me to do- to slow down

and calmly breathe through the mobility. 00:41:18.226 --> 00:41:23.516 Yeah Because I, it doesn't feel like you're doing as much as, going out for a run. 00:41:23.596 --> 00:41:25.226 I know what I'm doing when I go out for a run. 00:41:25.626 --> 00:41:29.436 you can check your watch and be like,"These, this is the amount of miles that I've knocked off." Yeah. 00:41:29.726 --> 00:41:36.675 laying on our garage, moving my legs in various positions as I calmly breathe did not feel like I was doing as much. 00:41:36.706 --> 00:41:37.536 It didn't feel productive. 00:41:37.536 --> 00:41:39.195 In fact, I was in fact doing way more. 00:41:39.525 --> 00:41:39.885 Yeah. 00:41:40.166 --> 00:41:43.545 And that's, going back to, again, the mindset of, redefining productivity. 00:41:43.556 --> 00:42:01.346 redefining what is productive, because by you taking the time to do these mobility things, you were able to actually get out on the road a lot faster and resume getting back to running the way that you wanted to run a lot sooner than you would have if you would've just kept pushing through it and just getting it done versus actually focusing on it. 00:42:01.865 --> 00:42:02.295 Yeah. 00:42:02.376 --> 00:42:02.615 All right. 00:42:02.655 --> 00:42:04.746 So that's thoracic spine rotation. 00:42:04.746 --> 00:42:04.916 What else did we do? 00:42:04.916 --> 00:42:05.436 Yeah. 00:42:05.505 --> 00:42:11.585 And then thoracic extension, so w- the foam roller we did of, it getting you to extend over the foam roller. 00:42:11.746 --> 00:42:11.755 Oh. 00:42:11.755 --> 00:42:14.626 Remember I, when I had you put the foam roller, around your shoulder blades? 00:42:14.876 --> 00:42:15.246 Yeah. 00:42:15.286 --> 00:42:25.266 So this is, was ridiculously hard because I could, with a lot of pain, get into the position the foam roller was under my shoulder blades, but I couldn't... 00:42:26.135 --> 00:42:37.275 Trying to relax and breathe in that position, because to get there was so uncomfortable for my hips and lower back and everything, and then I couldn't, roll at all as I was on it. 00:42:37.275 --> 00:42:40.311 So I just had to, be in this remarkably uncomfortable position. 00:42:40.510 --> 00:42:43.751 It didn't feel like it was doing anything to my thoracic spine- 00:42:43.791 --> 00:42:44.030 Yeah 00:42:44.041 --> 00:42:47.731 because my whole body was tense just to get into it. 00:42:47.831 --> 00:42:48.871 I can do it now. 00:42:49.050 --> 00:42:49.451 Yeah. 00:42:49.451 --> 00:42:51.541 It just, it took me a few days- 00:42:51.610 --> 00:42:54.181 Oh, yeah, and you were so annoyed with me about that one. 00:42:54.181 --> 00:42:56.880 You're like,"What is this even doing?" I could-"I don't even feel this. 00:42:56.880 --> 00:42:57.990 I can't even relax. 00:42:57.990 --> 00:42:59.150 What am I supposed to do here?" 00:42:59.391 --> 00:42:59.911 Yeah, no. 00:42:59.911 --> 00:43:14.090 I was- I think what may have been better feedback to my physical therapist at the time is- I don't feel as though I can relax into this position, so I don't think the foam roller's gonna be as effective. 00:43:14.371 --> 00:43:18.661 Maybe we could try it again tomorrow, I think may have been better feedback. 00:43:18.990 --> 00:43:23.800 But much like when you walked over and told me it was all in my head and pushed me down, I think I, And kicked you in the 00:43:23.800 --> 00:43:24.090 shin 00:43:24.791 --> 00:43:25.521 I just yelled at you. 00:43:25.521 --> 00:43:27.311 I think is probably how I handled that. 00:43:27.840 --> 00:43:29.030 You didn't yell at me. 00:43:29.030 --> 00:43:30.721 It's just the tone of voice. 00:43:30.771 --> 00:43:31.891 Kevin never yells. 00:43:31.911 --> 00:43:34.871 that's not who Kevin is, so don't let him fool you. 00:43:34.880 --> 00:43:35.690 He's not a yeller. 00:43:35.891 --> 00:43:41.260 it's just the tone of voice, the annoyance in the voice with certain things, and the shortness of your tone. 00:43:41.451 --> 00:43:41.710 Yes. 00:43:41.710 --> 00:43:45.780 What I should have said is,"Dear love, I'm so tight right now and so tense. 00:43:45.831 --> 00:43:48.900 Can we maybe try the foam roller again tomorrow?" There 00:43:48.900 --> 00:43:49.280 you 00:43:49.280 --> 00:43:49.384 go. 00:43:49.384 --> 00:43:49.795 Is what I should 00:43:49.795 --> 00:43:50.001 have said. 00:43:50.001 --> 00:43:50.240 All right. 00:43:50.240 --> 00:43:59.751 So we focused on the area above the spine, and then, or above the lower back, the SI joint, and then we also focused on the area below the joint, which is his hip. 00:44:00.041 --> 00:44:05.291 So his hip specifically, in internal rotation and external rotation. 00:44:05.300 --> 00:44:08.221 He also had some flexion issues, which we're gonna be talking about, too. 00:44:08.240 --> 00:44:15.561 So quick anatomy reminder, the hip is a ball and socket joint, and it's designed for movement in all directions. 00:44:15.561 --> 00:44:22.971 And so in a lot of runners, and this is what was going on with Kevin, hip internal rotation, which is the, Let's see. 00:44:23.021 --> 00:44:23.760 Make it s- I can... 00:44:23.800 --> 00:44:26.811 I'm doing this on camera, so there's a visual here. 00:44:27.101 --> 00:44:30.751 But those of you that are, like, listening on the podcast, it's to- it's toes in. 00:44:30.760 --> 00:44:31.490 that's what it is, okay? 00:44:31.490 --> 00:44:32.840 So you got a ball and socket joint. 00:44:32.851 --> 00:44:37.710 It's if you were to rotate your leg so that your toe's in, like you were being pigeon-toed. 00:44:37.911 --> 00:44:39.391 That's internal rotation. 00:44:39.601 --> 00:44:44.150 And then external rotation is rotating the feet out to the side, like a duck, like walking like a duck. 00:44:44.210 --> 00:44:45.751 Is that a good description, Kev? 00:44:46.090 --> 00:44:46.320 Yep. 00:44:46.641 --> 00:44:46.951 Okay. 00:44:47.181 --> 00:44:53.701 And so in most runners, internal rotation is limited, and that's what

was going on with Kevin. 00:44:53.891 --> 00:44:56.820 And this matters because of coupling patterns. 00:44:56.820 --> 00:45:06.414 And so coupling patterns- are a thing that happens in the hip and in the spine, and this is one of the fundamental things we need to understand with how these injuries happen. 00:45:06.425 --> 00:45:15.945 So hip flexion, which is bending the knee, like lifting the leg off the ground and bending the knee, t- up towards the ceiling, that is coupled with internal rotation. 00:45:15.954 --> 00:45:29.974 So if internal rotation is limited, it can also limit hip flexion, which is why with Kevin, when he got into that bottom of his squat, he didn't have the internal rotation that he needed, so he didn't have the hip flexion that he needed. 00:45:29.974 --> 00:45:40.514 So that flexion needed to move into the lumbar spine, and that's why the spine was taking up some of that flexion movement, because he didn't have that mobility available at the hip. 00:45:40.864 --> 00:45:41.505 Make sense? 00:45:41.925 --> 00:45:42.284 Yeah. 00:45:42.315 --> 00:45:44.204 Everything being connected is super annoying. 00:45:45.625 --> 00:45:57.074 So as you run, and you walk, and you squat, your hip should naturally internally rotate during the loading phase, which is when all of your weight is on that leg, okay? 00:45:57.074 --> 00:46:06.795 So when you're running and you've got all of your late, all of your weight on one leg, that's called the loading phase, and the other leg that's swinging through, that's called swing phase, okay? 00:46:06.795 --> 00:46:16.324 So when you're in the loading phase, your hip is naturally rotating inward, and then it s- naturally rotates more outward during the push-off phase, okay? 00:46:16.514 --> 00:46:20.164 So if internal rotation is restricted, then the body compensates. 00:46:20.175 --> 00:46:26.675 So that could be either twisting through the pelvis and the lumbar spine or by changing the entire movement pattern. 00:46:27.235 --> 00:46:33.474 that kinda makes sense,'cause I tend to, if I don't, if I don't pay attention or I start getting really tired, I land with my toes pointing out. 00:46:33.605 --> 00:46:33.894 Yeah. 00:46:34.195 --> 00:46:39.344 And so hip, we, so we really focused a lot on Kevin's internal rotation work. 00:46:39.344 --> 00:46:50.635 So one of the big things that we did was hip 90/90s, and y- Kevin, you can tell them a little bit about kinda where you were when we started, and then where you were yesterday, because that w- you've made significant improvement in that. 00:46:51.005 --> 00:46:57.045 I, that, part of that is the internal rotation, and part of that is just that all the other muscles have started to relax. 00:46:57.184 --> 00:46:58.195 Yes, for sure. 00:46:58.324 --> 00:47:10.824 Cause when we first started, mo- okay, so w- we head out to our garage and Angel's"Okay, just lay down on the floor." Now, her saying,"Lay down on the floor" on day, one, was like a 30-second

process. 00:47:11.614 --> 00:47:15.655 it took a while carefully holding onto things just to lay down on the floor. 00:47:16.405 --> 00:47:24.472 So- To then she was like,"Okay, now sit with your feet in front of you." My hamstrings are super, super tight. 00:47:24.893 --> 00:47:28.132 before injury, after injury, I- my hamstrings are super, super tight. 00:47:28.222 --> 00:47:36.983 So to sit on the floor with my feet out in front of me means I have to put my hands back behind me because I'm making, 120-degree angle. 00:47:37.072 --> 00:47:38.382 I lean back pretty far. 00:47:38.382 --> 00:47:41.032 I can't just sit up against a wall with my legs out in front of me. 00:47:41.103 --> 00:47:46.402 So now bend your knees up in front of you and just sit there. 00:47:46.682 --> 00:47:47.402 I'm almost... 00:47:47.413 --> 00:47:55.983 A- as I'm trying to do this, to sit upright with my legs out in front of me and to then bend my knees, I almost fell backwards. 00:47:56.293 --> 00:48:01.193 I was about to start doing, old-school sit-ups, where, my knees are bent in front of me and I'm laying on the ground. 00:48:01.523 --> 00:48:04.592 And then you wanted me to let my legs, move side to side. 00:48:04.882 --> 00:48:17.893 I couldn't move my knees from, both of my l- knees laying towards the left to both my knees lea- leaning towards the right unless I was almost completely laid backwards. 00:48:18.413 --> 00:48:28.733 I was nowhere near sitting upright, and to get anywhere close to upright, I was pushing with both hands so hard off the ground to try to just not fall backwards. 00:48:29.282 --> 00:48:31.983 And now, what are we, th- two weeks in? 00:48:32.483 --> 00:48:33.583 Just over two weeks in? 00:48:33.632 --> 00:48:34.632 Now I can actually... 00:48:35.603 --> 00:49:01.842 my restriction is hamstrings, but if I can get into the position where my knees are going over to the right side, I can, without having to put my hands on the ground, I can flip them now so that both legs go over to the right side, and then I can lean forward onto my knee and breathe appropriately as I do it, and almost fall forward onto my knee forward, which is apparently I thought was a hamstring issue, but apparently it was absurd tightness through my hips. 00:49:01.963 --> 00:49:02.302 Yeah. 00:49:02.592 --> 00:49:09.402 And so we really worked on that, that was one of the big things that we really worked on, was helping Kevin to start to restore some of that mobility. 00:49:09.402 --> 00:49:17.813 He's nowhere near where he needs to be yet, but hopefully he's gonna continue working on his mobility and that's gonna help him moving forward. 00:49:18.342 --> 00:49:24.563 what's super key here is you've told me for a while that I should do 90/90s, that it will help with my hip mobility. 00:49:24.603 --> 00:49:24.932 Yeah. 00:49:25.092 --> 00:49:26.682 I don't think I was doing them correctly. 00:49:26.902 --> 00:49:28.592 Because I was just leaning back. 00:49:28.853 --> 00:49:28.963 Like- 00:49:29.052 --> 00:49:29.463 Okay 00:49:29.643 --> 00:49:37.163 when I would go from on the left side to on the right side, I would just lean really far back to allow my knees to swing through. 00:49:37.603 --> 00:49:41.132 Because it, it compensated for the tightness through my hips. 00:49:41.282 --> 00:49:46.572 I just, I couldn't make that motion happen, so I would just lean backwards so that my knees could pass on the way through. 00:49:48.413 --> 00:49:57.182 So it's so much of this along the way, like every exercise you gave me was like, okay, I get what the exercise is supposed to look like. 00:49:57.402 --> 00:49:59.313 Now also, where am I supposed to be feeling it? 00:49:59.382 --> 00:50:03.813 Because I could trick my body into doing the motion- 00:50:03.853 --> 00:50:04.163 Yeah 00:50:04.193 --> 00:50:05.762 by doing other things. 00:50:05.782 --> 00:50:07.342 That's what I've been doing all along. 00:50:07.543 --> 00:50:10.253 I don't know when I started squatting incorrectly. 00:50:10.253 --> 00:50:13.992 It's possible that I've literally never done a correct squat in my life. 00:50:14.353 --> 00:50:22.373 It's possible that I screwed this up when I started trying to increase weight, and I overcompensated by trying to get deeper with higher weight on the bar. 00:50:22.572 --> 00:50:28.373 It's possible that I just used to take shallow squats, and now I take deeper squats, and that's when I fixed it. 00:50:28.603 --> 00:50:32.052 It's possible that having a hernia a few years ago caused the issues. 00:50:32.512 --> 00:50:33.103 I don't know. 00:50:33.112 --> 00:50:33.132 Yeah. 00:50:33.293 --> 00:50:37.882 But I don't squat correctly, and so now trying to squat correctly is a very difficult process'cause I have to... 00:50:37.943 --> 00:50:41.402 It takes so much mental focus to just do the movement. 00:50:41.922 --> 00:50:49.322 All right, and then the third thing that we did for Kevin's mobility was trying to work on releasing the iliopsoas. 00:50:50.032 --> 00:50:56.592 So we talked already about how the psoas attaches to the lumbar spine, and when it's tight, it's pulling on the lower back. 00:50:56.592 --> 00:51:12.572 And so we have to be, we had to be really careful here, but I taught Kevin how to do a self-release, on the iliopsoas muscle, because every time I tried to do a manual release on him, he started laughing because te- Kevin is one of the most ticklish humans you'll probably ever meet. 00:51:12.583 --> 00:51:17.032 And so I tried to release it, and he just couldn't, he couldn't tolerate it. 00:51:17.413 --> 00:51:18.262 I tried breathing. 00:51:18.313 --> 00:51:18.625 it didn't work. 00:51:18.625 --> 00:51:18.833 It didn't 00:51:18.833 --> 00:51:19.362 do anything. 00:51:19.422 --> 00:51:20.757 And so- I really tried breathing. 00:51:20.757 --> 00:51:25.603 I tried very calm, focused breathing- Yeah and I was laughing so much that- Oh my 00:51:25.603 --> 00:51:25.963 God. 00:51:26.273 -->

00:51:31.222 Yeah I couldn't even do it for myself,'cause I had to, calm my nervous system down a little bit before I could even try it on myself. 00:51:31.472 --> 00:51:32.702 That was just- Yeah, you're a little tense. 00:51:33.023 --> 00:51:33.083 Yeah. 00:51:33.083 --> 00:51:33.672 You're a little tense. 00:51:33.682 --> 00:51:38.302 So I taught him a technique using a softball where he had to lay on the softball. 00:51:38.532 --> 00:51:51.163 But you have to be very careful, and I'm not gonna go into detail about this, specific technique because it can be dangerous, if you don't get it right because there's a lot of stuff in the lower abdomen, that can be a problem. 00:51:51.182 --> 00:51:55.693 So basically we did some soft tissue release on the iliopsoas as well. 00:51:55.922 --> 00:52:03.603 And so if that's something that you think you might need, I would highly recommend seeing a practitioner, a physical therapist that's skilled in that area. 00:52:03.882 --> 00:52:08.012 or if you wanted to look up your own videos on YouTube or something like that. 00:52:08.032 --> 00:52:16.213 I don't want to, really talk too much about that because, there's a bunch of nerves and blood flow issues and stuff that can happen in there, if you don't get it right. 00:52:16.543 --> 00:52:17.393 Yeah, 100%. 00:52:17.432 --> 00:52:19.492 Look up a YouTube video, but it's not Angie's. 00:52:20.313 --> 00:52:21.443 It's not gonna be mine. 00:52:22.463 --> 00:52:23.202 that is the answer to that question. 00:52:23.202 --> 00:52:23.307 Yeah. 00:52:23.307 --> 00:52:23.588 All right. 00:52:23.588 --> 00:52:23.927 It's, it's... 00:52:23.927 --> 00:52:25.297 The problem is it's painful. 00:52:25.557 --> 00:52:28.887 doing it correct is gonna be uncomfortable- and doing it wrong is gonna be uncomfortable. 00:52:29.148 --> 00:52:29.268 Yeah. 00:52:29.268 --> 00:52:31.248 And so it's gonna be tough to tell that you're doing it wrong. 00:52:31.248 --> 00:52:34.148 So that is probably one where you actually need a PT to- Yeah 00:52:34.148 --> 00:52:34.318 set this stuff up for you. 00:52:34.318 --> 00:52:37.407 I think that it's definitely g- best un- under supervision. 00:52:37.657 --> 00:52:43.018 and if you are in our membership, I will be posting a video of specifically what we did w- with Kevin. 00:52:43.257 --> 00:52:46.338 but again, it's always, at y- at your own, use at your own discretion. 00:52:46.358 --> 00:52:47.518 so the thing- 00:52:47.518 --> 00:52:48.588 Yeah, and I saw that video also. 00:52:48.588 --> 00:52:54.947 That is a members only,'cause it's more of like a OnlyFans kind of video, so maybe- we keep that in our members only area. 00:52:55.038 --> 00:52:58.927 I am gonna laugh so hard if we get, 20 new members this week because you just said that. 00:53:00.998 --> 00:53:11.538 So the key to, that we need to remember is that the goal when we do soft tissue release, a lot of people think that they're, like, breaking up tissue and they're improving the length of the muscle. 00:53:11.538 --> 00:53:12.617 That's not what we're going for. 00:53:12.617 --> 00:53:16.788 What we're actually going for is what's called neuromuscular inhibition. 00:53:16.788 --> 00:53:30.440 It's helping the- psoas and those tight, overactive muscles let go and learn how to relax so that the pelvis can find a more neutral position before your different movement begins. 00:53:30.639 --> 00:53:34.550 Because the muscles just get tight, and they get overactive, and they don't know how to relax. 00:53:34.550 --> 00:53:42.469 And so part of the soft tissue release that we do is really, restricting blood flow to those muscles to help the muscles actually just relax. 00:53:43.429 --> 00:53:47.599 Yeah, I was doing soft tissue release in the week I was treating myself. 00:53:47.659 --> 00:53:49.340 I was just on the complete other side. 00:53:49.530 --> 00:53:51.699 I was rolling a lacrosse ball around on my butt. 00:53:52.010 --> 00:53:56.099 Which is not bad either, And that's definitely s- a technique that I use with a lot of people. 00:53:56.289 --> 00:53:59.059 and for you too, that can also be helpful. 00:53:59.059 --> 00:54:05.110 And, doing soft tissue work in the back because th- your glutes were also very tight, so that is also a helpful thing. 00:54:05.130 --> 00:54:05.465 just everything was 00:54:05.474 --> 00:54:06.045 so tight 00:54:07.195 --> 00:54:09.894 at that point in time that- because your body is typically more tense. 00:54:10.014 --> 00:54:12.844 you have overreactive muscles, I would say. 00:54:13.034 --> 00:54:19.795 your body's natural inclination is to, tighten up to protect the area, and that's how a lot of people- It was my mind's natural inclination. 00:54:20.224 --> 00:54:22.204 But that's how a lot of people are wired. 00:54:22.204 --> 00:54:23.105 there's nothing wrong with that. 00:54:23.125 --> 00:54:25.184 It's just important to know that, all right? 00:54:25.434 --> 00:54:26.545 All right, so that was part one. 00:54:26.545 --> 00:54:27.525 That was mobility. 00:54:27.574 --> 00:54:36.264 I'm, I don't even know, since we're, like, recording on Zoom how long this episode is, so we're gonna just apologize in advance if this kind of goes longer, but I think that it's still helpful. 00:54:36.295 --> 00:54:40.405 so I guess you guys could always put us on 1.25 speed if you want to. 00:54:41.355 --> 00:54:41.498 Sure, we could. 00:54:41.498 --> 00:54:41.590 okay. 00:54:41.590 --> 00:54:46.110 The second thing that we focused on with Kevin was motor reprogramming. 00:54:46.121 --> 00:54:58.492 So mobility is really only half of the equation Mobility is restoring that normal, natural, gentle, available, usable range of motion. 00:54:58.862 --> 00:55:10.693 But if your nervous system doesn't know how to use that range of motion, doesn't know how to control movement in that new range, it's going to revert back to the compensation pattern that it already knows. 00:55:10.922 --> 00:55:24.572 And so

what we have to do is what's called motor reprogramming or motor control to teach the body and teach the brain new movement habits, because a lot of times we've developed these dysfunctional movement patterns through lots of different reasons. 00:55:24.742 --> 00:55:32.282 Like Kevin said, Kevin asked me this question and I don't really know the answer to it, which is, have I always squatted this way? 00:55:32.282 --> 00:55:33.643 And I'm like,"I don't know." maybe. 00:55:33.643 --> 00:55:42.822 there, there might be, you might have had a dysfunctional squat pattern for, since you were a teenager or since you were in your 20s or who knows, and maybe the hernia made it worse. 00:55:42.873 --> 00:55:47.052 Or maybe you were good before and then the hernia caused this problem. 00:55:47.052 --> 00:55:48.842 Or who knows what causes these things. 00:55:48.873 --> 00:55:52.512 different dysfunctional movement patterns can happen because you're sitting a lot. 00:55:52.523 --> 00:56:01.913 when you're very sedentary, your hip flexors get tight, and so then if you lose mobility and you lose range of motion in the hips, again, other things always pop in to compensate. 00:56:02.443 --> 00:56:03.963 So we have to- 00:56:04.003 --> 00:56:06.172 I think it made sense also that this happened over the summer. 00:56:06.313 --> 00:56:07.773 'Cause I sit more often over the summer. 00:56:07.804 --> 00:56:11.224 as a teacher, I'm up and walking all day long. 00:56:11.233 --> 00:56:11.554 Yeah. 00:56:11.583 --> 00:56:12.764 I sit more over the summer. 00:56:13.094 --> 00:56:18.954 But, Interesting a thing that I wanted to talk about on this motor reprogramming is- Yeah our body defaults to what it used to do. 00:56:19.014 --> 00:56:27.793 this is when the last time we moved, and we moved a long time ago, but I remember driving home from work, I turned the wrong direction- because I was going to our old house. 00:56:27.793 --> 00:56:28.980 it was like when... 00:56:29.409 --> 00:56:36.780 No, you don't live there anymore, but it's what your brain has done, and things like driving home you do on autopilot. 00:56:36.860 --> 00:56:37.019 Yeah. 00:56:37.019 --> 00:56:43.679 you're paying attention enough that you're following the rules of the road, you're not hitting other cars, but you're doing a lot of it on autopilot. 00:56:43.960 --> 00:56:46.500 Most of your body's motions happen on autopilot. 00:56:46.570 --> 00:56:53.121 That's why when we opened the e- the episode, you were talking about that your body is responsible for so many movements Not until you really think about it. 00:56:53.311 --> 00:57:01.512 Or that you've hurt your back and you're like,"Oh, God, my body's involved in everything." Because you do so many of these things without thinking about it. 00:57:01.521 --> 00:57:14.021 And that's why you have to do this careful, actual appropriate motor reprogramming- which is so hard because it's teaching your body to do something in a way that it has not done

possibly ever. 00:57:14.472 --> 00:57:22.251 Yeah, and the other important thing to point out here, too, is the difference between how you're actually moving and how you think you're moving. 00:57:22.251 --> 00:57:33.262 And this is a big piece, that Kevin learned yesterday when we started filming him doing his squat, and I started to show him because he watched the video and was like,"That's not what I'm... 00:57:33.362 --> 00:57:35.072 That's not what it feels like I'm doing. 00:57:35.121 --> 00:57:49.132 I fee- feels like I'm doing it the right way." And that's because he's, his brain, he's been doing it for so long this way that his brain has encoded his current move- or his previous movement pattern as normal. 00:57:49.431 --> 00:57:50.541 That's just the normal way. 00:57:50.541 --> 00:57:52.512 Of course I'm doing a squat the right way. 00:57:52.512 --> 00:57:55.061 I've been squatting since I was 14 years old. 00:57:55.061 --> 00:57:56.262 I've been doing this forever. 00:57:56.302 --> 00:57:58.271 You're an experienced runner, like, all of these things. 00:57:58.822 --> 00:58:05.282 But just because you feel like it's the normal thing doesn't mean that there aren't dysfunctional movement patterns happening under the surface. 00:58:05.882 --> 00:58:07.041 Yeah, literally the first time... 00:58:07.121 --> 00:58:10.231 Yesterday we were doing a bunch of filming, which was super helpful. 00:58:10.291 --> 00:58:16.021 But when I first got out and you were like,"All right, let's watch you do a squat, an unweighted squat." 00:58:16.081 --> 00:58:16.311 Yeah. 00:58:16.342 --> 00:58:22.755 And I first went down and you were like,"You moved your knees.""What do you mean I moved my knees?" You're like,"Your first thing you did- Oh, yeah is to bend your knees. 00:58:22.996 --> 00:58:30.286 I want the first thing you do is to put your butt out behind you." And so then I, I tried to squat, and I just, froze in place. 00:58:30.286 --> 00:58:33.885 I'm like,"How do I squat that my- butt moves first?" I'm like... 00:58:34.115 --> 00:58:40.641 So then I, I had to close my eyes and focus so much to try to get the right part of my body moving correctly. 00:58:40.690 --> 00:58:40.940 Yeah. 00:58:40.940 --> 00:58:44.990 And as soon as I wasn't thinking about it and I tried to squat, knee shot forward again. 00:58:45.050 --> 00:58:48.190 it takes so much thought to do the thing. 00:58:48.221 --> 00:58:48.420 Yeah. 00:58:48.530 --> 00:58:49.391 It's exhausting. 00:58:49.570 --> 00:58:51.190 I'm still doing air squats. 00:58:51.331 --> 00:58:54.010 I can definitely lift more than that. 00:58:54.061 --> 00:58:54.340 Yeah. 00:58:54.670 --> 00:59:00.101 But I don't know if I can lift more than that while I'm concentrating so much that joints are moving in the correct directions. 00:59:00.110 --> 00:59:00.510 Yeah. 00:59:00.800 --> 00:59:03.621 And so it's important for us to understand that this isn't... 00:59:03.630 --> 00:59:09.271 there's nothing wrong with Kevin, it's just the way that this movement pattern has been stored in his nervous system. 00:59:09.271 --> 00:59:19.041 Because your brain, your nervous system always wants to put as much as possible on autopilot, like Kevin said, because the less you have to think, the less decisions you have to make in your life. 00:59:19.041 --> 00:59:27.471 That's why it felt, it feels so exhausting for him to learn this new movement pattern, because he is trying to go against his stored motor programs. 00:59:27.471 --> 00:59:35.721 He's going against the body's- autopilot setting that it's just been doing for who knows how long, possibly for decades. 00:59:35.960 --> 00:59:51.541 And so it becomes very labor-intensive and attention-intensive when you're trying to do these things because you're atten- you're essentially trying to break a habit that has been there for who knows how long, and that habit has become encoded as the default. 00:59:51.550 --> 00:59:56.831 So you are now trying to essentially install a new program, which takes a lot of memory. 00:59:56.831 --> 01:00:00.481 It takes time, it takes space, just like it would in, in a computer. 01:00:00.721 --> 01:00:03.070 And so when you... 01:00:03.081 --> 01:00:09.960 And this is what, the other reason why j- a little bit of cuing isn't just going to automatically fix the problem. 01:00:09.971 --> 01:00:16.340 Like me saying,"Oh, stick your hips back instead of putting your knees forward." And then Kevin says,"Oh, really? 01:00:16.431 --> 01:00:19.521 That's all I have to do?" it doesn't work that quickly, right? 01:00:19.521 --> 01:00:31.090 Because there's a whole new motor program that he has to build and then encode, and then he has to do that enough so that the body now realizes that's the new default program versus the old way. 01:00:31.501 --> 01:00:33.231 And it's a movement that you're not used to. 01:00:33.420 --> 01:00:39.681 So once I finally realized, oh, put my hips back behind me, then I overcompensated and just I tilted my back. 01:00:39.681 --> 01:00:41.101 And tilted the pelvis, Exactly. 01:00:41.340 --> 01:00:48.251 So that you, when I said stick out your butt, your first reaction was to arch your lower back to, to stick out your butt, which is not what I wanted. 01:00:48.710 --> 01:00:49.021 Yeah. 01:00:49.081 --> 01:00:54.760 And I'm still working on- my default to stick out my butt to actually move the right things. 01:00:54.911 --> 01:00:55.150 Yeah. 01:00:55.150 --> 01:00:59.240 And it is very difficult, and I've been working on that for, a week. 01:00:59.251 --> 01:01:02.710 And I still struggle to make it move correctly, 01:01:03.030 --> 01:01:03.240 which is why- But 01:01:03.240 --> 01:01:03.331 you're 01:01:03.331 --> 01:01:03.561 getting... 01:01:03.800 --> 01:01:05.081 But are you getting better? 01:01:05.400 --> 01:01:06.311 I'm getting better. 01:01:06.320 --> 01:01:06.340 Yeah. 01:01:06.351 --> 01:01:22.590 But that's also why videotaping or having you watch me,

because- It feels like I'm doing it, and I've been working on this for a week, and so I'm like,"Okay, I'm doing it better." But if I film myself I'm like,"Oh, wait, I'm still doing it not right." Yeah. 01:01:22.710 --> 01:01:24.670 Better, but not correctly. 01:01:24.740 --> 01:01:25.150 Yeah. 01:01:25.150 --> 01:01:26.621 So it's, it's frustrating. 01:01:26.710 --> 01:01:27.181 Yeah. 01:01:27.181 --> 01:01:28.030 It's humbling is what it is. 01:01:28.121 --> 01:01:29.101 It's humbling, yeah. 01:01:29.150 --> 01:01:30.481 so the key... 01:01:30.490 --> 01:01:32.981 So I 100% agree with what Kevin just said. 01:01:33.440 --> 01:01:40.630 If you aren't working with a professional that understands movement, film yourself and start with that. 01:01:40.641 --> 01:01:46.181 Start with filming yourself and then watching that video back and seeing, what does your movement actually look like? 01:01:46.181 --> 01:01:47.231 Start looking for these things. 01:01:47.231 --> 01:01:50.771 Do I have an excess amount of curvature in my lower back? 01:01:50.800 --> 01:01:52.931 D- is my pelvis tilting forward? 01:01:52.931 --> 01:01:54.240 Is it t- tucking under? 01:01:54.300 --> 01:01:56.210 these are some of the things that you can start looking at. 01:01:56.920 --> 01:02:06.431 And then w- from there when you start to bring that awareness, one of the first things I had Kevin do as far as movement reprogramming was learning how to find a neutral spine. 01:02:06.721 --> 01:02:07.110 Because- 01:02:07.121 --> 01:02:08.280 Which I didn't know what that was. 01:02:09.490 --> 01:02:10.449 I did not know what that was. 01:02:10.449 --> 01:02:12.237 You said,"Just go to a neutral spine." Yeah. 01:02:12.237 --> 01:02:13.027 I'm like,"Yeah, okay." 01:02:13.077 --> 01:02:16.507 and I'm so glad that you said that because most people don't know what that is. 01:02:16.507 --> 01:02:17.476 Most people don't... 01:02:17.487 --> 01:02:27.226 N- not only do they not know it, they've probably never experienced it because most people tend to live their lives either in an anterior pelvic tilt, which is that tilt forward. 01:02:27.226 --> 01:02:40.617 W- and s- this is especially true for women and girls because w- like a lot of women, they tilt their hips forward so that they get their butt to stick back out, and they also stick their chest out because when they're teenagers they wanna look good in a bikini or whatever it is, right? 01:02:40.617 --> 01:02:44.936 And so they're doing all these weird like lum- like spine positioning. 01:02:45.246 --> 01:02:48.306 and they don't actually know what it feels like to go neutral. 01:02:48.467 --> 01:02:53.746 Some people are more a posterior pelvic tilt where they flatten that back out and kinda tuck the tush under. 01:02:53.947 --> 01:02:59.637 And so a lot of people don't understand what a neutral pelvis even is, and so this is one of the first things that I helped Kevin find. 01:02:59.867 --> 01:03:12.867 So for you guys that are listening To find neutral spine, what often what I'll have people do is, do an excessive pelvic tilt forward and then an excessive pelvic tilt backward, and then s- try to find a somewhere in the middle. 01:03:13.047 --> 01:03:14.976 so Kevin, what was that like for you to figure out? 01:03:15.436 --> 01:03:15.976 It was awful. 01:03:16.597 --> 01:03:18.606 It was so frustrating. 01:03:18.686 --> 01:03:18.956 Yeah. 01:03:19.097 --> 01:03:24.686 And the first- Because- The other thing that I also will say too is the progression of it is important also. 01:03:24.686 --> 01:03:34.847 So I started with Kevin doing this on the ground, like lying on his back with his knees bent, and then trying to figure that out because then he at least has the feedback of the ground. 01:03:34.856 --> 01:03:38.007 you feel your back if your back is flattening against the ground or not. 01:03:38.266 --> 01:03:43.447 Then we moved to sitting, then we moved to standing so that he could start to find neutral spine in different positions. 01:03:43.847 --> 01:03:49.396 Yeah, that's why, just laying on my back and pelvic tilts are helpful'cause I'm like,"Okay, these are the muscles that I need to use." 01:03:49.476 --> 01:03:49.726 Yeah. 01:03:49.737 --> 01:03:59.016 But to stand up and then go to neutral spine feels like I'm excessively, what, posteriorly rotated. 01:03:59.177 --> 01:04:00.806 Yeah, because you're- It feels like I'm gonna fall over backwards. 01:04:00.987 --> 01:04:03.777 because you're used to being more anterior rotated. 01:04:04.126 --> 01:04:04.436 Yeah. 01:04:04.637 --> 01:04:04.786 Yeah. 01:04:04.786 --> 01:04:06.646 And nothing about it feels neutral. 01:04:06.806 --> 01:04:13.356 It feels like I'm squeezing my glutes continuously- the entire time, and that it's gonna be difficult to breathe. 01:04:13.697 --> 01:04:13.967 Yeah. 01:04:13.976 --> 01:04:13.987 e- 01:04:14.487 --> 01:04:17.626 everything about it feels so remarkably uncomfortable. 01:04:17.947 --> 01:04:24.217 And I got to it, and,'cause you had me go, excessively anterior then excessively posterior and then try and find neutral. 01:04:24.376 --> 01:04:32.268 And you're like,"Yeah, that, that's neutral." And I'm like, this is, none of this is comfortable." it felt like I was straining to be in that position. 01:04:32.309 --> 01:04:38.309 And I assume at some point I'll be able to be in that position and not feel uncomfortable. 01:04:38.318 --> 01:04:38.338 Yeah. 01:04:38.338 --> 01:04:41.079 that could actually be a normal resting position. 01:04:41.159 --> 01:04:42.639 Yeah, that's the goal for sure. 01:04:43.068 --> 01:04:58.628 the other things that we did, are to really help improve the hip internal rotation in functional position, so not just internal rotation mobility, which was important for us to start with, but also learning how to control the internal and external rotation of the hip when he is, was in a standing position. 01:04:58.648 --> 01:05:08.739 So that's when I had you

start, starting to do, the airplane movements, Kevin- Yeah where you were standing on one leg and opening the hip, to the side, opening up the hip and then coming back down. 01:05:09.028 --> 01:05:16.539 And one of Kevin's compensation patterns, because he didn't have that strength and control at the hip, was he was again twisting more through the spine. 01:05:16.998 --> 01:05:17.398 Yeah. 01:05:17.809 --> 01:05:20.938 Yeah, again, I thought I was doing it correctly- Yeah until you watched. 01:05:21.179 --> 01:05:22.798 and- Or- and also until you saw yourself. 01:05:22.809 --> 01:05:24.728 again- Yeah that's where the video really helped. 01:05:25.099 --> 01:05:37.099 'Cause I think that when it's not just me watching and cuing, which can be helpful, but it's also when you're able to see yourself, you're like,"Oh, wow, that doesn't look right."'Cause, part of your brain's probably"Yeah, does Angie really know what she's talking about? 01:05:37.099 --> 01:05:38.039 I'm doing this right. 01:05:38.039 --> 01:05:41.179 It feels fine in the spine." But then when you see it yourself- None of it 01:05:41.179 --> 01:05:41.958 feels fine. 01:05:42.938 --> 01:05:52.998 But when you see it yourself you're like,"Oh, okay, now I get it." And then you were like,"Oh, I need that muscle to pull, not to push," and I'm like,"Yes, exactly," and then you were able to do it a lot better. 01:05:53.349 --> 01:05:53.668 yeah. 01:05:53.688 --> 01:06:00.599 So the benefit of having you, and, this is a benefit for people who are in our team also is when you have exercises you video yourself. 01:06:00.608 --> 01:06:05.978 So you could watch you do it repeatedly- Yeah but then you get a video of yourself so that you can compare the two of them. 01:06:06.179 --> 01:06:21.498 Because I can watch you do it, and then I can do it myself and be like, all right, I knew when I first started that it was not at all what you were doing, but I couldn't even figure out how to make my body move the way that yours was moving. 01:06:21.989 --> 01:06:23.259 And I'm like, am I not... 01:06:23.909 --> 01:06:28.318 I- is it, a limit in mobility, or am I just not using the right muscles? 01:06:28.369 --> 01:06:38.559 And it, none of things were moving correctly and, it's, the, having the video of myself really brought awareness of which parts weren't moving. 01:06:38.929 --> 01:06:39.719 But yeah, I would have... 01:06:40.418 --> 01:06:44.898 I'm always gonna try and overcompensate and figure out, how can I get close to that thing? 01:06:44.909 --> 01:06:52.108 And that's- that was the problem is I'm trying to, I don't know, impress you that I can get the movement correct, but I wasn't getting the movement correct. 01:06:52.108 --> 01:06:55.648 I was just, I was faking correct movement, and that's not- Yeah it's not helpful at all. 01:06:55.789 --> 01:06:58.099 Yeah, and a- and also rushing through it, too. 01:06:58.099 --> 01:07:00.659 And, this is not just you, but this is, a lot of my patients. 01:07:00.659 --> 01:07:03.208 And, the patient I was working with this morning was doing the same thing. 01:07:03.208 --> 01:07:04.838 I'm like,"Slow down. 01:07:04.838 --> 01:07:12.009 Slow down." He was just trying to move through a- and get the exercise done, but he wasn't getting good contractions when he was doing that. 01:07:12.028 --> 01:07:19.762 that's where you telling me to breathe is a All the exercises, and this is part of my issue that I have with yoga, and I will make this a very short rant. 01:07:20.032 --> 01:07:24.632 But I don't, I If I breathe slowly, I breathe really slowly. 01:07:25.202 --> 01:07:32.452 So if a yoga teacher starts with cuing of take a deep breath- and now exhale, but I haven't finished my deep breath. 01:07:33.043 --> 01:07:37.822 if that's the cue, take a deep breath- and now exhale, and now take another deep breath. 01:07:37.893 --> 01:07:40.043 I'm like- Yeah you are hyperventilating over there. 01:07:40.043 --> 01:07:41.813 that i- that pacing is off for me. 01:07:41.853 --> 01:07:42.143 Yeah. 01:07:42.143 --> 01:07:50.302 And so now when you're like,"No, but breathe slowly as you do the exercises"- it's gonna take me a couple of minutes to do 10 exercises. 01:07:50.512 --> 01:07:50.833 Yeah. 01:07:51.123 --> 01:07:53.242 And that's exhausting. 01:07:53.623 --> 01:07:54.422 and that's okay. 01:07:54.943 --> 01:07:56.492 because that's what you need right now. 01:07:56.902 --> 01:07:57.822 But that's the key- 01:07:57.943 --> 01:07:58.083 Yeah 01:07:58.342 --> 01:08:01.382 is having you be able to say,"And that's okay." 01:08:01.492 --> 01:08:02.163 And that's okay. 01:08:02.503 --> 01:08:02.762 Yeah. 01:08:02.762 --> 01:08:08.572 And then the final thing is, that I'll mention with the movement reprogramming is fixing his squat, right? 01:08:08.632 --> 01:08:14.172 and really understanding what his spine was doing in the squat, which we've already talked about, but then also what he needed to do to fix that. 01:08:14.503 --> 01:08:22.113 And part of that means finding that neutral spine, squatting down to the point where he could maintain that neutral spine. 01:08:22.132 --> 01:08:26.042 And as soon as that, that pelvis started to tuck under, he came back up. 01:08:26.342 --> 01:08:30.292 Like squatting down as far as you can with the neutral spine, and then coming right back up. 01:08:30.292 --> 01:08:39.302 Because if you are go- going down into that movement pattern where that pelvis tucks under, you're just reinforcing the ne- the dysfunctional movement pattern, right? 01:08:39.302 --> 01:08:46.872 So it's learning how to control that movement while maintaining good alignment, only doing what you're currently able to do, and then coming back out of it. 01:08:46.872 --> 01:08:49.042 And then you s- you start to build strength. 01:08:49.233 --> 01:08:52.662 You start to build range in, into, in that movement. 01:08:52.682 --> 01:08:58.893 And then your body's going to be able to relax and be

able to maintain that movement into greater depths. 01:08:59.443 --> 01:08:59.832 Yes. 01:08:59.842 --> 01:09:05.182 So at the start of 2026 we said,"This is the year I'm gonna get jacked." Instead it hurt my back. 01:09:05.552 --> 01:09:11.332 But now I can actually, I'm working on being able to squat correctly- which is probably gonna help a whole bunch of other movements. 01:09:11.382 --> 01:09:13.512 And it's- and you're also going to be able to squat more. 01:09:13.863 --> 01:09:14.252 Yeah. 01:09:14.262 --> 01:09:20.993 Because the way that you were doing it, at this point, the way that you were showing me, like there was gonna be a for sure a limit, and we found one. 01:09:21.002 --> 01:09:21.023 Yeah, 01:09:21.632 --> 01:09:23.076 we found the limit on that one. 01:09:23.076 --> 01:09:23.222 Yeah. 01:09:23.222 --> 01:09:23.743 We found 01:09:23.743 --> 01:09:23.993 one. 01:09:23.993 --> 01:09:28.104 Which is weird because I have squatted- Definitely more. 01:09:28.104 --> 01:09:32.045 Yeah Like substantially more than what I was squatting when I hurt my back. 01:09:32.154 --> 01:09:34.215 But that goes back to where we started, where I was doing all of this under a lot of fatigue. 01:09:34.444 --> 01:09:35.444 Yeah, exactly. 01:09:35.965 --> 01:09:54.734 All right, the third thing that we focused on, okay, so thing number one was mobility, thing number two was motor reprogramming, and thing number three that was, it's a very important principle when it comes to rehab, and this is a big thing that I see so many people getting wrong because it's counterintuitive, but it's one of the things that really helps here. 01:09:54.975 --> 01:10:03.024 so I mentioned before how a lot of times when people have pain, they either push through that pain or they try to completely avoid it, and neither of those things are helpful. 01:10:03.305 --> 01:10:11.814 So what I taught Kevin, which is one of, one of the things I teach all of my clients, is to gently and slowly move into the pain. 01:10:12.154 --> 01:10:19.715 What that means is we move to the place where that pain starts, where you're on the edge of that pain, and then you pull away from it. 01:10:19.984 --> 01:10:21.064 You move into it. 01:10:21.085 --> 01:10:23.824 So it's all about finding the edge of the pain. 01:10:24.095 --> 01:10:36.005 Move slowly and intentionally with control, with breath, and find that s- that spot or that movement that produces the pain, and then come away from it. 01:10:36.225 --> 01:10:48.774 So the whole goal is not to keep pushing through, because if you are pushing through it, basically you're telling your nervous system, like your nervous system oftentimes will tighten up when you're trying to push through it, which is counterproductive. 01:10:49.215 --> 01:10:51.024 So we gotta get to the edge. 01:10:51.095 --> 01:10:53.145 We teach our nervous system,"This is okay. 01:10:53.175 --> 01:10:53.975 You're safe here. 01:10:53.994 --> 01:10:56.670 Nothing's wrong here." And then, we're gonna, we're gonna relax a little bit. 01:10:56.670 --> 01:10:57.359 We're gonna pull back. 01:10:57.380 --> 01:10:58.359 It's everything is okay. 01:10:58.359 --> 01:11:00.800 See, look, you thought you were gonna have to t- tense up. 01:11:00.800 --> 01:11:03.729 You thought you were gonna have to protect me, and then we just back away. 01:11:03.750 --> 01:11:04.409 It's all good. 01:11:04.630 --> 01:11:05.829 It's all good, right? 01:11:05.829 --> 01:11:07.270 And so we hold at that edge. 01:11:07.310 --> 01:11:12.750 We breathe through it to let the nervous system understand that you're safe here, and then we pull back. 01:11:12.909 --> 01:11:27.630 And as you do that, you will continue to usual- you will continue to get more and more range, maybe not all at once, maybe not all in the same exact session, but the more you practice that, you're gonna be able to go deeper into that range with less pain. 01:11:28.279 --> 01:11:30.550 Yeah, this is like straight psychology. 01:11:30.550 --> 01:11:31.670 This is exposure therapy. 01:11:31.810 --> 01:11:32.039 Yeah. 01:11:32.090 --> 01:11:34.649 if you have a phobia, y- you don't... 01:11:35.060 --> 01:11:38.560 If you have a fear of heights, you don't go skydiving on day one. 01:11:39.547 --> 01:11:40.057 No, thank you. 01:11:40.068 --> 01:11:40.097 What? 01:11:41.408 --> 01:11:42.047 No, thank you. 01:11:42.257 --> 01:11:42.278 Yeah. 01:11:42.297 --> 01:11:43.307 I said,"No, thank you." 01:11:43.537 --> 01:11:45.347 Yeah, like it doesn't seem like a great idea. 01:11:45.568 --> 01:11:52.938 But like on day one, if you have a fear of heights and you wanna jump off of the high dive at the pool, on day one you go to the pool. 01:11:53.627 --> 01:11:55.978 Like you see that there's a high dive. 01:11:56.037 --> 01:12:00.438 Because if you have a fear of heights, you're already gonna freak out, but the just the fact that you,"Oh, yeah, look at that. 01:12:00.438 --> 01:12:01.377 There's a ladder over there." 01:12:01.467 --> 01:12:01.648 Yeah. 01:12:01.648 --> 01:12:05.698 And then maybe you get to the point where you can put your hand on the ladder, but you're not even climbing the ladder. 01:12:05.967 --> 01:12:11.417 Everything gets you to the point where yeah, this is scary, but I'm in a fearful environment, but I'm still safe. 01:12:11.478 --> 01:12:14.188 Like you never just are like,"Oh, you have a fear of heights? 01:12:14.387 --> 01:12:19.507 I'm going to drag you to the top of the high dive and shove you off." that's not a great approach. 01:12:19.518 --> 01:12:19.927 Really? 01:12:19.927 --> 01:12:27.547 if you're scared of roller coasters, the approach is not to take your five-year-old daughter on Thunder Mountain when she's scared? 01:12:28.416 --> 01:12:30.576 Oh, was that just some, is that just something that happened to me? 01:12:30.886 --> 01:12:31.466 I don't know. 01:12:31.466 --> 01:12:32.423 I took you on 01:12:32.423 --> 01:12:34.810 roller coasters- no

several years ago No, this is, but this is my dad. 01:12:35.581 --> 01:12:36.440 This is what happened to me. 01:12:36.440 --> 01:12:44.280 This is what my dad did, and then I was deathly afraid of roller coasters for my entire life until I went on a roller coaster with you, basically. 01:12:44.820 --> 01:12:48.350 Yeah, I know, and I was worried that we had done that to our own daughter when we took her on- 01:12:48.480 --> 01:12:48.881 Slinky 01:12:48.881 --> 01:12:50.171 Dog Slinky Dog. 01:12:50.171 --> 01:12:50.270 I know. 01:12:50.461 --> 01:12:50.890 And she was freaking out halfway through. 01:12:50.890 --> 01:12:53.150 She was freaking out, but she wants to go back, so we're good. 01:12:53.421 --> 01:12:53.801 I know. 01:12:54.911 --> 01:12:58.320 But that, that's what it is, is- Yeah you can't overexpose. 01:12:58.421 --> 01:13:03.970 that's just gonna be too much, and it's going to lead to, in your case, fear of roller coasters for a long time. 01:13:04.011 --> 01:13:04.280 Yeah. 01:13:04.291 --> 01:13:13.070 But in the case of the body, if you give it too much exposure, it's gonna freak out- Yeah and all of the muscles around it, like everything's gonna get so tense. 01:13:13.091 --> 01:13:14.140 You're going backwards then. 01:13:14.411 --> 01:13:14.591 Yeah. 01:13:14.591 --> 01:13:21.261 that was the problem right after I hurt myself, is all of the muscles were so tense that it was like, what is the actual issue going on? 01:13:21.470 --> 01:13:22.070 I didn't know. 01:13:22.100 --> 01:13:22.671 You did. 01:13:22.791 --> 01:13:22.911 Yeah. 01:13:23.051 --> 01:13:26.121 But I had no idea because everything felt tense. 01:13:26.211 --> 01:13:26.341 All. 01:13:26.341 --> 01:13:30.720 So I wasn't even sure what to deal with because everything was so exposed. 01:13:30.921 --> 01:13:32.461 If you're like,"Oh, no pain, no gain. 01:13:32.480 --> 01:13:37.161 Push through everything," you're just gonna get to a place where everything is now pain. 01:13:37.280 --> 01:13:37.560 Yeah. 01:13:37.560 --> 01:13:40.291 but complete avoidance is a terrible aspect also, which again- 01:13:40.291 --> 01:13:47.430 Yeah is one of the reasons- and that goes back, and that goes back to the story that you told earlier about the podcast that you were listening to of"Oh, okay, I'm good. 01:13:47.430 --> 01:13:48.560 I don't have a herniated disc. 01:13:48.560 --> 01:13:59.740 I can go back into the gym." a lot of times when you know that there's not, like it's not as bad as your brain is making it out to be, then you can push through certain things knowing that, we're gonna be okay here. 01:13:59.961 --> 01:14:01.940 and so I always put a threshold on it. 01:14:01.970 --> 01:14:10.520 I always tell my patients,"I don't want you ever above a five out of 10 when we're doing this type of thing." there's some people that come in at a six, a seven, an eight out of 10. 01:14:10.530 --> 01:14:11.770 th- that's different stories. 01:14:11.770 --> 01:14:13.501 that's not where Kevin was in this. 01:14:13.881 --> 01:14:16.881 Kevin was like, I was like,"Okay, what we're gonna do is we're gonna push to the edge of the pain. 01:14:16.900 --> 01:14:19.331 I don't want it increasing above a five, never above a five. 01:14:19.541 --> 01:14:31.511 We wanna kinda keep it where it is or have it decrease." And then the same thing applied, when it came to Kevin's running,'cause that's another piece that we really wanna talk about as well, is how do we know when it's okay to run? 01:14:32.041 --> 01:14:43.560 And that's one of the big rule of thumbs that I keep with Kevin, with myself, with a lot of people that I work with, is really understanding, okay, is running going to make the pain worse? 01:14:43.900 --> 01:14:53.052 And this is one thing that- like even, we work- we've done with our cross-country runners and other things, because- There, we as runners want to be active. 01:14:53.063 --> 01:14:54.882 We wanna be out on the roads, we wanna be doing things. 01:14:54.882 --> 01:14:57.052 We don't wanna just, rest and not do anything. 01:14:57.243 --> 01:15:03.823 And completely resting and not doing things is oftentimes unhelpful, except in the case of a bone stress injury. 01:15:03.823 --> 01:15:05.813 I will say that o- over and over again. 01:15:05.813 --> 01:15:12.953 If you have a stress fracture or any sort of potential bone stress injury, that is definitely the time that you need full and complete rest. 01:15:13.002 --> 01:15:14.533 and that doesn't mean you can't cross-train. 01:15:14.533 --> 01:15:20.953 you might still be able to, depending on what part of your body is involved, you might still be able to ride a bike or go swimming or doing other things. 01:15:20.953 --> 01:15:22.353 there's ways to stay active. 01:15:22.603 --> 01:15:26.203 but impact activities are a definite no when it comes to bone stress injuries. 01:15:26.932 --> 01:15:33.372 But with Kevin and getting back to running, you wanna tell, you wanna kinda tell, like, how we approached this? 01:15:34.132 --> 01:15:34.363 I just wanted- 01:15:34.363 --> 01:15:35.813 I feel like I've been doing a lot of talking. 01:15:36.762 --> 01:15:37.853 I just wanted to go run. 01:15:38.212 --> 01:15:38.302 Yeah. 01:15:38.552 --> 01:15:48.574 But it, to me, this was very similar in coming back from hernia surgery, is running post-hernia surgery hurt And so I just kept run-walking. 01:15:48.935 --> 01:15:59.685 And I would do it over and over, and eventually, And I would never come back and be like,"Oh, man, I feel good." I was better than when I left, but it was so frustrating because I just wanted to go out and run. 01:15:59.744 --> 01:16:03.225 And running was uncomfortable, so I kept taking walking breaks. 01:16:03.284 --> 01:16:08.685 Every time the pain would elevate, I'd be like,"Oh, it hurts" almost immediately on my first running step. 01:16:08.944 --> 01:16:25.034 And it finally got to a point where you were like,"Just try running for a couple

of minutes- Yeah and see if it relaxes." And so what was happening to me when I s- first started running, I started too soon, and then I took a few more off days, and then we started working together. 01:16:25.055 --> 01:16:25.784 And then I... 01:16:26.055 --> 01:16:31.555 When I started running, the pain was not immediate and shooting, and it was... 01:16:31.625 --> 01:16:36.265 Like, it was uncomfortable- but it wasn't throwing my running form off. 01:16:36.295 --> 01:16:36.574 Yeah. 01:16:36.675 --> 01:16:41.664 When I was trying to treat myself and then be like,"Oh, no, I can do it. 01:16:41.664 --> 01:16:46.305 I could go for a run," I was, like, awkwardly hobbling, putting... 01:16:46.324 --> 01:16:52.324 I was landing hard on my left leg, and then, swinging the right leg through, but, winging it out to the side. 01:16:52.375 --> 01:16:52.744 it wasn't... 01:16:53.005 --> 01:16:54.234 I was not moving correctly. 01:16:54.345 --> 01:16:59.515 When we started working together, after just a few days, I could go off and easily run. 01:16:59.574 --> 01:17:00.994 I was running on flat ground. 01:17:01.055 --> 01:17:02.595 I was running my normal loops. 01:17:02.755 --> 01:17:07.694 I, I was making sure that what I was on wasn't, pitched awkwardly off to the side. 01:17:07.694 --> 01:17:11.005 You know how, the road, tilts successively so that it can drain properly? 01:17:11.055 --> 01:17:11.265 Yeah. 01:17:11.364 --> 01:17:14.414 I was making sure that what I was on was pretty much flat. 01:17:14.425 --> 01:17:14.725 yep. 01:17:15.305 --> 01:17:18.744 And I kept it shorter than my cardio said. 01:17:18.994 --> 01:17:29.175 I kept it as, as much as, I knew was the appropriate thing to do- not as much as my brain wanted to do, not as much as- Yeah my breathing was gonna allow, but as much as, my back was actually gonna allow. 01:17:29.494 --> 01:17:34.694 Yeah, and I think that's important, is understanding that it is important to sometimes pull back. 01:17:34.755 --> 01:17:37.795 It doesn't mean that you have to rest completely, but we cut it. 01:17:37.845 --> 01:17:41.005 you don't, you're not doing your full load, especially at the beginning. 01:17:41.005 --> 01:17:50.204 The first couple of runs out, it was the instructions were essentially, go out and do half, at least, no more than half of what you normally would go out and run. 01:17:50.204 --> 01:17:54.925 So for Kevin, your typical weekday run is probably around seven-ish miles, right? 01:17:54.925 --> 01:17:55.784 Seven, eight miles. 01:17:56.064 --> 01:17:56.135 Yep. 01:17:56.145 --> 01:18:02.845 And so at the beginning, it was like, go out and run three miles, but see how you feel in that first mile." I always tell people,"Check the first mile. 01:18:03.154 --> 01:18:05.354 If the pain is increasing, you stop. 01:18:05.635 --> 01:18:12.994 If the pain is, the same, not really too bad, it's a d- more of a discomfort but not a pain, you can keep going." but then we... 01:18:13.055 --> 01:18:17.774 He cut it, had, shorter runs the first couple of runs back, and then the pain was fine. 01:18:17.784 --> 01:18:21.248 And then we always checked with- How did you feel on the run? 01:18:21.498 --> 01:18:23.719 And then how did you feel after the run as well? 01:18:23.719 --> 01:18:25.019 Because that also matters. 01:18:25.019 --> 01:18:30.599 Because if there's an excess amount of pain after the run, that's a sign from your body that you did too much, okay? 01:18:30.599 --> 01:18:36.609 So we always had to manage progression of things based on how he responded both during and after the run. 01:18:37.069 --> 01:18:38.559 Yeah, and I was never in pain after. 01:18:38.569 --> 01:18:38.588 Yeah. 01:18:38.599 --> 01:18:40.309 I always felt tightened afterwards. 01:18:40.309 --> 01:18:40.338 Tight, 01:18:40.338 --> 01:18:40.689 yeah. 01:18:40.828 --> 01:18:50.729 I was always like,"I should go back and do some more mobility afterwards-" Yep because it felt, just'cause the muscles were tired, so then you get the fatigue and then everything just tightens up to try and make sure that I'm not gonna hurt myself. 01:18:50.759 --> 01:18:54.029 but it, it never brought pain from the running. 01:18:54.448 --> 01:18:54.798 Yeah. 01:18:55.895 --> 01:18:58.664 Yeah, so that's how we d- how we handled it, okay? 01:18:58.664 --> 01:19:01.524 those were the three big main things that we did. 01:19:01.534 --> 01:19:04.255 That's how, we progressed his running. 01:19:04.274 --> 01:19:09.175 and then within two weeks he's back to running essentially seven miles per day. 01:19:09.175 --> 01:19:12.965 He did a 14-mile run this weekend with no pain, and he's feeling good. 01:19:13.204 --> 01:19:15.715 you tell them in your words, like how you're feeling right now. 01:19:15.715 --> 01:19:20.824 'cause you're not 100% normal at this point, but you're pretty darn close, right? 01:19:22.145 --> 01:19:23.104 it causes no... 01:19:23.204 --> 01:19:24.904 I don't feel my back when I run- 01:19:25.005 --> 01:19:25.345 Yeah 01:19:25.824 --> 01:19:26.295 at all. 01:19:26.864 --> 01:19:29.475 I can still feel it, like, when I first wake up in the morning. 01:19:29.475 --> 01:19:30.654 I wake up stiff. 01:19:30.694 --> 01:19:32.585 I wake up a little, achy in my back. 01:19:32.645 --> 01:19:34.774 But it goes away relatively quickly. 01:19:34.835 --> 01:19:40.444 If I sit for a very long period of time, but I feel like that's the case for most people. 01:19:40.805 --> 01:19:42.895 If you sit- th- for a couple of hours- 01:19:42.954 --> 01:19:43.265 Because 01:19:43.295 --> 01:19:44.024 think about- it's uncomfortable 01:19:44.024 --> 01:19:46.024 think about what's happening at your hips, right? 01:19:46.024 --> 01:19:52.145 Your hips, like those hip flexors are tightening and they're shortening, and that's putting pressure on the front of your spine. 01:19:52.154 --> 01:19:56.534 Now you understand why sitting for excessive amounts of time is problematic. 01:19:56.885 --> 01:19:57.204 I know. 01:19:57.265 --> 01:19:59.765 Now I have to go do a psoas release, and I'm not really excited about it. 01:20:00.795 --> 01:20:17.675 and then we also talked about moving forward too, which we don't have time to get into today, but maybe we'll do another episode about that, of like when Kevin does do, his longer runs, what kind of mobility exercises should he be doing throughout the run to make sure that those muscles are not all tightening up and he stays loose. 01:20:18.414 --> 01:20:18.734 Yeah. 01:20:18.845 --> 01:20:21.685 And I'm gonna give that an attempt this weekend, so we'll see how that goes. 01:20:21.694 --> 01:20:21.715 Yeah. 01:20:21.784 --> 01:20:22.704 We'll see how it goes. 01:20:23.045 --> 01:20:23.734 All right, you guys. 01:20:23.744 --> 01:20:25.064 Thank you so much for joining us. 01:20:25.085 --> 01:20:28.734 I'm gonna go ahead and say it early, happy early birthday, Kevin. 01:20:28.734 --> 01:20:32.204 I know you love all of the attention, and by that- I do? 01:20:32.204 --> 01:20:34.335 By that I mean he does not at all. 01:20:34.625 --> 01:20:38.954 But this episode is being released on July 9th, so your birthday's a couple days away. 01:20:39.234 --> 01:20:48.055 and I just wanna say happy early birthday, and I hope that, you're feeling better and all is well, and you can do some fun running adventure on your birthday. 01:20:48.074 --> 01:20:54.265 Might n- even if it's not exactly what you had in mind,'cause Kevin- I- loves to do very interesting things on his birthday. 01:20:54.635 --> 01:20:58.555 I'm going to attempt what I have in mind and be happy with whatever the results are. 01:20:58.614 --> 01:20:59.175 There we go. 01:20:59.685 --> 01:21:00.274 All right, you guys. 01:21:00.284 --> 01:21:01.465 Thank you so much for joining us. 01:21:01.475 --> 01:21:12.765 If you found this podcast helpful, we would love it so much and appreciate if you could leave us a review on Spotify, make a comment, leave us a review on Apple Podcasts, share the episode with a friend. 01:21:13.034 --> 01:21:19.045 you could also check out our YouTube channel, because we're gonna be uploading a recording of this so you could watch us on Zoom as well. 01:21:19.324 --> 01:21:20.614 and as always, thanks for joining us. 01:21:20.614 --> 01:21:24.364 This has been the Real Life Runners podcast, episode number 469. 01:21:24.645 --> 01:21:26.314 Now get out there and run your life.