Slipped A Disc While Weightlifting? Listen to Seth Myers66 Minutes - Dec 20, 2017
I recently contacted the National Strength and Conditioning Association (NSCA) region director asking for an interview referral for the best person on this topic… her answer was Dr. Seth Myers.
I thought it was funny he was the top suggestion because he is also a chiropractor. I thought I was going to be given the contact of someone who only does coaching.
Dr. Myers didn’t disappoint. Trained under the ideals of Dr. Stuart McGill PhD, he gave some great pointers on how we can address and prevent lower back pain while squatting, deadlifting, snatching and more.
Here’s some topics we hit:
- Direction of tolerance or increase symptoms and what it means
- Disc and type of injuries
- Outcome Measures other than pain
- Butt Winking (Spinal Flexion)
- Intra-abdominal pressure
- Core work and why
- How to return to lifting
- Fear avoidance
Dr. Seth Myer’s Bio:
“My name is Seth Myers and I am a Sports Chiropractor practicing at JointFit Chiropractic and Sports Medicine Center in Manhattan, KS. I practice with an emphasis in evidence-based medicine and focus on active care. The treatment I provide is focused on empowering the patient and helping them navigate through musculoskeletal issues that are slowing them down in life. I have a masters degree in sports medicine and a handful of other certifications in strength and conditioning (CSCS and USAW to name a few).
I have a love for sports, played football for 4 years in college and currently spend most of my spare time doing CrossFit and Olympic style weightlifting. I try to bring the knowledge and experience I have from years of lifting and working out with me in the clinic when treating patients and finding the best path for them on their road to a better lifestyle.”
Contact him at email@example.com
Squat video: https://www.youtube.com/watch?v=PkQb2LJtLgo&t=175s (low res)
Sebastian’s Youtube Channel
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You can access the show notes at https://www.p2sportscare.com/podcast/
Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don’t get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.
0:00:00 Sebastian Gonzales: This is session number 66 of The Performance Place Sports Care podcast. Right now.
0:00:05 Speaker 2: Welcome to the Performance Place Sports Care podcast where you can learn about sports injury theory, rehab, diagnosis, and how to understand the doctor lingo you didn\'t understand at your appointment. And now your host, Dr. Sebastian Gonzales.
0:00:22 Sebastian Gonzales: Hey everyone, it\'s Dr. Sebastian Gonzales with The Performance Place Sports Care podcast, and I don\'t expect anybody except for those who know me really well to know what these personal phrases are, but I think pretty often people tell me I\'m the most annoying person they\'ve ever met, and I think in grad school they called me the annoying little brother, and just recently it seems like all of the things that get me excited, such as the fourth of July and right now are things that make me excited \'cause I get to yell something. You know, it\'s just... You just get to yell it. I just dig it. So yeah, I start screaming that sometimes when I get excited about people coming over, sometimes we have these garage parties on holidays when it\'s sunny and so on, and I get real excited, we\'re gonna start to cook, we\'re gonna do this right now. That\'s kinda how it goes. Okay, we\'re done with that. So right now, we\'re gonna have on Dr. Seth Myers, and we\'re gonna go over the topics of the day, which we are on the low back month.
0:01:29 Sebastian Gonzales: We\'re gonna go over some weightlifting, prevention and corrections with low back pain. And Dr. Seth Myers was actually... It\'s funny, I was actually introduced to speak with him by... I contacted, actually, I was looking around for a really good, qualified strength coach around the Southern California area \'cause I wanted to talk to someone new. So I was looking around and stuff and I couldn\'t really find anybody that really stood out to me when I was doing some Google searches, so I thought, \"You know what? I\'m just gonna ask the NSCA.\" That\'s the National Strength and Conditioning Association and they\'re the one that delegates out the strength conditioning certifications or CSCS, so I contacted the regional person there and they said, \"You know what? You gotta talk to this person in Kansas.\" And it\'s Seth Myers and he\'s a doctor of chiropractic and also a CSCS and he also has certification through USA Weightlifting, and I\'m like, \"God, it\'s a small world.\" I really didn\'t think I was gonna be speaking to another chiropractor today but I dig it.
0:02:31 Sebastian Gonzales: So in this interview, Seth did not disappoint whatsoever. So he prides himself on being evidence-based medicine and focusing on active care. And as you\'ll hear, he does spend a fair amount of time lifting on his own and he does do some crossfit, some Olympic lifting and he did spend about four years in college, playing football. So, he\'s a very educated guy and I\'m glad at the end of this conversation, actually after we got off the air, I said, \"I\'m pretty sure now that since we\'ve been speaking for an hour,\" and everything that he said, I was already writing it down, I was writing it down before and I feel like we had the same brain with this, so I dig it. We\'re friends now, we\'re gonna text often. Seth, Dr. Seth Myers, we\'re gonna text often. Anyways, we\'re gonna have him on without any further ado. Let\'s get into the interview. All right, everybody, welcome on Dr. Seth Myers who is gonna tell us all about low back pain, lifting, and some things you guys can do to improve the way you lift. Dr. Seth, hi.
0:03:32 Dr. Seth Myers: Hey, how\'s it going?
0:03:34 Sebastian Gonzales: Great. How you doing? Thanks for coming on.
0:03:36 Dr. Seth Myers: Thank you. It\'s good to be on. Doing pretty good, just relaxing after working all day in the clinic.
0:03:43 Sebastian Gonzales: Are you in like a rocking chair, I imagine? Like on your porch.
0:03:46 Dr. Seth Myers: No, I\'m in a little recliner chair in my little back yard area here.
0:03:52 Sebastian Gonzales: Does that account for proper hip hinging and intra-abdominal pressure?
0:03:58 Dr. Seth Myers: Not quite. Not right now.
0:04:00 Sebastian Gonzales: [chuckle]
0:04:00 Dr. Seth Myers: Right now I\'m resting.
0:04:01 Sebastian Gonzales: Oh good. Make sure you\'re breathing diaphragmatically though.
0:04:05 Dr. Seth Myers: Exactly.
0:04:07 Sebastian Gonzales: So, can you tell everybody then, at least your experience with working with people with back injuries and especially in the lifting population and how to getting them back to lifting again.
0:04:18 Dr. Seth Myers: Yeah. So we\'ll just dive right into it here. When you talk about back pain, there\'s a laundry list of potential things that people could have as a diagnosis, right? So when someone comes to me with low back pain, one of the first things that I\'m wanting to do is make sure, one, it belongs in my office. So just kind of doing an assessment and seeing where we\'re at with that. So with that, when I assess somebody I\'m kinda looking at more movement, really, than trying to really particular pinpoint a specific part of anatomy that\'s damaged. So most of the time, and I\'ll just use generalization here because if people are lifting they might fit well into a certain category, generally speaking, people tend to have more pain or get low back pain with kinda bending forward. And I see this a lot, and typically, you might hear this just termed like flexion-intolerant.
0:05:16 Dr. Seth Myers: So flexion meaning bending forward and intolerant just it hurts or they don\'t do it very well. So I\'m kinda gonna go down that rabbit hole a bit and we can talk about some of that stuff. And so when you\'re talking about a population that lifts, I guess we can just use some classic lifts like a deadlift or a squat, and we can start with the squat. One of the big things that you see is some people, and I see this a lot, is they\'ll come in, they\'ll tell you they got low back pain, they\'ll bend forward touch their toes, they say, \"yeah, that makes it worse,\" and then you look at them doing an air squat and when they go down they get about halfway down, and then what you see is this little butt wink going on. And so if you\'re not familiar with what a butt wink is, it\'s basically someone\'s... Imagine someone is squatting in front of you, and you\'re looking a side picture of this person. As they start to descend into the squat, about halfway down, what you see is the low back basically starts to round, or, why they call it a butt wink is you see their butt starts to tuck underneath them, and that, especially when you get into loading it, as doing such like a barbell squat, that mechanism or that flexion under compression is typically what causes some of that injury or some of that sensitivity for that area.
0:06:41 Dr. Seth Myers: And so that\'s one of the main things that I see a decent amount, and so a few things to go into some more about this. But where I get some of this stuff where I assess people but also give them correctives, is from a guy, Professor Stuart McGill. He\'s done a lot of research up in Canada. He\'s a spine biomechanics guru, essentially, and so what they\'ve done is they\'ve taken pig spines and they put them in a special device that he\'s got where it\'ll give him all sorts of different types of forces that he wants to create, whether it\'s just a sheer compression force, a pure flexion, a pure extension, all this stuff. He will put it in there, he\'ll give it a little bit of compression and he\'ll start bending the spine back and forth in conflexion and in rotation, and what he can start to see or what he has been able to see is with that flexion and compressive load as well as a little bit of rotation, you can start to do some damage to the disc.
0:07:53 Dr. Seth Myers: I\'m not suggesting that these people have a huge bulging disc, or a disc herniation, anything like that. But what I\'m telling them is basically they\'ve made their back a little bit sensitive via that mechanism, if that makes sense. And the other caveat to that, that research, is they\'re doing it in dead spines so they don\'t have the capacity to heal themselves after the fact via blood and nutrients, things of that nature. And then they\'re also doing it thousands and thousands and thousands and thousands of repetitions. Keeping that in mind, listeners out there, don\'t get too scared when you\'re doing your next barbell slot.
0:08:32 Sebastian Gonzales: [chuckle] You know, actually, you bring a good point with that, with the pig spine thing, actually. The overall repetition of... I\'m sure he bent in to flexion plus rotation or just purely flexion or purely rotation and is, when you\'re talking about the butt wink, so that\'s flexion or bending forward, is there a combination that\'s worse, or is there a certain range that\'s okay to have a butt wink, \'cause I know some people say, \"Oh, it\'s just me. This is my squat.\"
0:09:00 Dr. Seth Myers: Yeah, yeah. That\'s kind of a debate. A lot of people will say you wanna minimize it as best as possible. And in my opinion, when you\'re talking about lifting weights, you\'re gonna put weight on a barbell, you squat, I would be in that camp though, that\'d say you wanna try and minimize it, but also, and there\'s some research... Even McGill\'s done some research for some of the lifts, but there\'s research that says you can\'t really totally make it go away. There\'s gonna be a little bit of butt wink, but again, the caveat to that is, \"Well, you know, if someone\'s having a little bit of pain and they\'re butt winking during a squat, and we can make that butt wink less, why not go ahead and try and do that?\" And so... Oh, go ahead.
0:09:50 Sebastian Gonzales: I was gonna say, what is the common thought on how to get rid of it, if not just a control issue?
0:09:57 Dr. Seth Myers: Yeah, so I\'m probably gonna share a few links with you after this, but one of the big mechanisms for that butt wink, really comes down to hip anatomy, and Professor McGill explains this really, really well. Basically, when... And then there\'s another article by a guy, Dr Ryan DeBell. He\'s another chiropractor, and he\'s got a great article with pictures on there of why people have to squat differently, and... So basically, what it explains is that everybody\'s hips are a little bit different. And what I mean by that is, if you can imagine a ball in a socket, that\'s what your hip is gonna look like. But some people\'s ball might be really big and the socket might be really shallow, so think of the socket not totally encompassing the ball. And then with other people, their ball is totally encompassed by the socket. If you can imagine you\'re trying to move this ball around in the leg, so once you get to a certain range of motion, you\'re just gonna hit the rim of that socket. Does that make sense?
0:11:15 Sebastian Gonzales: Mm-hmm.
0:11:17 Dr. Seth Myers: If you\'ve got this particular hip anatomy, that you run out of room, what\'s gonna happen is, if you still go to descend into a squat, you will get a little bit of pelvic motion with it, which starts to pull on the low back, so you get this pelvis that\'s tilting and then the low back is tilting, and then that\'s essentially a butt wink. Now there\'s other things that can lead into it, such as maybe some hamstrings, which you could talk about, but... But that\'s one of the big things. This is obviously audio, so you can\'t really see a great demonstration of that. Like I said, you could put some...
0:11:55 Sebastian Gonzales: [chuckle] I\'ll put some links.
0:11:55 Dr. Seth Myers: Links to a YouTube clip in the show notes and it would be really, really great for people to see. But when you\'re talking with CrossFitters, lot of times they\'re squatting ass to grass, so as far down as they can possibly can. And so you want to try and... Between me and you, clinicians, or even coaches, wanna try and optimize that position that they\'re gonna be in. And so what we can do is we can very gently have the person lay on their back and very gently take a leg, and just nice and easily let it go up. So, taking your knee basically up towards your chest and if you put just a little bit of pressure going up, the leg should go up, and fall into its natural highest point in that socket that it\'ll wanna go. And again, just something that people can take home, after listening to this. As a general rule of thumb, you find that people\'s hip sockets will allow them to squat what would be a little bit deeper, without starting to pull on that low back, if they move their feet or their leg out wider than they maybe currently are, if that makes sense.
0:13:09 Dr. Seth Myers: So, again, there\'s a awesome article and a awesome video that Professor McGill has on there, there on YouTube, that people can see this, and it will probably put, obviously, a better picture in their mind of what is going on with the hip anatomy. I see that a lot. People come in and they\'ll do a squat and then I\'ll have them lay on their back, do this quick little assessment and then I\'ll say, \"Hey, based off what this looks like, maybe if you put your feet in this position and try squatting, you might be able to get a little bit lower, so maybe below parallel, or even all the way down into a nice deep squat, without getting as much of that butt wink.\" So, a lot of times, if the person is not in huge acute pain, but they\'ve got a little bit of achiness, I\'ll have them do it again and they might report, \"Okay, that doesn\'t hurt as bad,\" or maybe it hurts the same, but they\'re further deep into a squat. Does that make sense?
0:14:02 Sebastian Gonzales: Mm-hmm. So then squat depth, I know that... I mean, this is something that I\'ve had personal experience with. Not wanting to go deep for a long time, just \'cause I had some hip impingement, and every time I would go into a group class, they would want you to go lower. And my argument was like, well, number one, it hurts, but second is that I think there\'s a certain point where... I don\'t know your take on this, but when does squatting below parallel with 200, 300 plus pounds on your back become useful anymore?
0:14:41 Dr. Seth Myers: Yeah.
0:14:41 Sebastian Gonzales: I mean, is there a limit here? I know we\'re in the realm where everyone is like \"I just wanna lift more, it\'s functional, blah, blah, blah,\" but is there a limit at all?
0:14:50 Dr. Seth Myers: No, I would say to your answer, basically, when you\'re doing a power lift [0:14:54] ____ honestly. That\'s one of the things I wrote down is when you\'re talking about lifting, whether it\'s squatting, deadlifting, clean, snatches, things of that nature, first and foremost, just knowing the person\'s goals, whether that\'s the coach knowing them, or the person themselves knowing their goals. So, if you\'re somebody who wants to go do crossfit and just stay healthy, maybe lose a few pounds and try your best when you\'re doing the lot, there\'s not necessarily any reason why you necessarily have to be pushing that much weight and I\'m gonna be the first one to try and get people lifting heavy as quick as we can. But again, keeping in mind, are you somebody who\'s a 45 year old female, who just wants to be able to move around the house pain-free and chase after your kids without running out of breath? If that\'s the case, then one of the things to add on to your point is, I\'m a big advocate for doing those types of strength training movements, but doing things that limit the range of motion. So something that I think people... It\'s really weird, people will not really consider, is you can do these movements, and change the range of motion and still be doing the movements.
0:16:21 Dr. Seth Myers: So, if someone has pain at the bottom of a squat, they just stop squatting, as opposed to setting up a box and just squatting to the box, so shortening it up. Or deadlifting is another good example. A lot of people might have pain pulling from a certain position, like from the floor, but if you put a couple of plates, or a box, again, so that you\'re pulling, give yourself a few inches there, so that it\'s not as deep down when you\'re going to bend over to pick it up, you can still do a pretty good deadlift and put some weight on the bar, and you might be surprised that you can do it with a lot less pain, or discomfort.
0:16:57 Sebastian Gonzales: Yeah. I\'m a huge advocate of that in my office. We have lift platforms and everything too, but the...
0:17:03 Dr. Seth Myers: Awesome.
0:17:04 Sebastian Gonzales: I\'ve noticed that there\'s some people that it\'s just... I don\'t know if the risk or reward is there yet, to have them go to the depth that they\'re having issues with. So I also, too, start them into the range of motion that I think they have a lot of control over. And if we\'re exploring, maybe getting more range of motion, then I\'d lighten the load through that range, too. They haven\'t had it for a while.
0:17:27 Dr. Seth Myers: Yeah. Yep, yep. I try and do that. We\'re switching over to deadlifting now. If someone with low back pain comes into my office, especially if it\'s that flexion intolerant, like I mentioned earlier, I try and have them deadlifting within the first or second visit.
0:17:45 Sebastian Gonzales: That\'s awesome.
0:17:46 Dr. Seth Myers: The caveat to that is, I set it up in a way that they can do it with a kettlebell and it\'s off of a few stacks of plates, meaning they don\'t have to bend over very far, so they can try and get back what it feels like to pick something up and, again, realize that even if they have pain bending forward, going to pick something up was correct, I guess... Mechanics can be relatively pain-free and... So, yeah.
0:18:21 Sebastian Gonzales: Okay. So it\'s in [0:18:22] ____ you started on deadlifting. I was gonna go there with the butt wink, but since you started on the... I\'ve actually never deadlift \'em within the first couple, I usually start within the first few weeks, but with the... I\'m sure you\'ve noticed the fear of some of them, right?
0:18:37 Dr. Seth Myers: Yeah. Yeah, yeah.
0:18:38 Sebastian Gonzales: So is there a certain way that you typically address that or explain to them about the need? Or...
0:18:45 Dr. Seth Myers: Yeah, and I actually have had... There\'s one lady in particular that stands out in my mind. She literally was scared to bend over and pick something up. And when I say bend over, I\'m meaning in a good manner, she was still scared to do that. So I just, like you mentioned earlier, if we\'re trying to work on mechanics and work on hip hinging, what I try and do is, again, put them in a position that they\'re gonna have pretty good success. So that means we\'ve done some hip hinging, where maybe they\'re pushing their hips back to the wall as a drill. Maybe I can do a video for this.
0:19:27 Sebastian Gonzales: You\'re reading my mind because every time you say... Right before you say there\'s a video, I\'m already writing it down. [chuckle] I was going to ask you to make one.
0:19:33 Dr. Seth Myers: Yeah. But doing a hip hinging drill so that they know the movement and then doing a drill where they\'re maybe trying to work a little bit further into the range of motion. So they\'ve done the movement that I\'m asking them to do, that maybe they\'re scared of doing, so they\'re not afraid to hip hinge, but they\'re afraid to bend forward. Well, eventually, if you get them hip hinging really well, that starts to look like them bending forward, if you know what I\'m saying. And we\'ll get into this if I make a video. And then you take that into a deadlift which, like I said, I usually use a kettlebell, and I\'ll just set it really, really, really high, so they hip hinge and their hands might move down a couple of inches. So I\'m not saying we\'re picking something up where they\'re pulling something all the way from the floor, in terms of them being scared of a certain motion that might cause a little bit of pain. The other thing with that is I try and do it in an environment that\'s lighthearted and where they\'re having fun. So it\'s not like a strict and stern type of scenario where if they mess up, something bad is gonna happen. Does that make sense?
0:20:48 Sebastian Gonzales: Mm-hmm.
0:20:48 Dr. Seth Myers: So any time you\'re dealing with pain and you\'re dealing with pain with particular movements, and then you\'re gonna try and put them in that position, you have to understand that just trying to get them maybe to crack a smile every once in a while or have some fun with what we\'re doing can help ease the fear that they might have for that thing.
0:21:08 Sebastian Gonzales: Do you have a bag full of jokes you typically tell them?
0:21:12 Dr. Seth Myers: Oh, gosh, not really. I just try and keep it relatively fun when we\'re doing stuff. I might play music at their request, just small stuff like that, to get them to buy into what we\'re doing as a whole. I should, though, I should have some stuff written down.
0:21:34 Sebastian Gonzales: Yeah, I\'ll send you a couple of mine.
0:21:37 Dr. Seth Myers: Okay, good. Good.
0:21:39 Sebastian Gonzales: It sounds like you deal with the psychological approach of the injury a lot too.
0:21:46 Dr. Seth Myers: Yeah, yeah. I probably spend, who knows, maybe more time than I should talking about that, but I think it\'s pretty big just educating the person on what\'s going on. So I use diagrams and pictures and models and stuff as often as I can to try and explain it. But I also try and let them know that they\'re the ones in control of it a lot of times. So if I\'m asking them to bend down to do a particular motion, they can stop at any time.
0:22:24 Dr. Seth Myers: Let\'s see... Again, I just try and keep it fun and a little bit more lighthearted when we\'re doing some of the rehab stuff, so that emotion of maybe, that fear, or maybe if they\'ve been dealing with pain for a while, like chronic pain issue... I wouldn\'t say I\'ve necessarily had somebody dealing with depression, but you can tell when somebody\'s just been dealing with it for a while, and it\'s just something that is very, very annoying. And so, I\'m just trying to flip that so that it\'s not so big of an issue when you\'re there with them one-on-one. It can be really helpful in the long run.
0:23:05 Dr. Seth Myers: And then going back to the psychology of it is like, people get focused on the pain, both clinicians and the patient, but sometimes what you can do to break that cycle is step away from pain and look at outcome markers or maybe things that that person wants to do. So whether that\'s running, whether that\'s getting back to doing crossfit, whether that\'s signing up for a specific competition. And so they might have a little bit of discomfort or pain. And sometimes in chronic cases, it\'s really, really tough to 100% alleviate that, but if you start switching the viewpoint from pain to performance or outcome, stuff like that, you might see a little bit of a shift in their mindset for how they approach doing some of the activities, even if there\'s a little bit of discomfort.
0:24:00 Sebastian Gonzales: Yeah, I\'m glad you brought that up actually. One of the reasons... I actually had a friend in school that he was focusing on... He wanted to focus on general population \'cause he said there\'s more of them, and I\'m like, \"Well, I wanna focus on athletes in sports,\" and he\'s like, \"Why?\" He\'s like, \"This person over here could help you, and then Eric could be helping, and they\'re not an athlete.\" And I\'m like, \"I know, but you have to goal set for them,\" and I\'m like, \"I don\'t want to do... \" I don\'t wanna say I don\'t wanna do the goal setting, but the athlete already has some type of outcome, like you said. They have a non-pain-related outcome. So there\'s a big drive to get better, so you can set their sights on something else. So I know exactly what you... What you mean with that.
0:24:44 Dr. Seth Myers: Yeah. Well, and it\'s a little bit more fun, because if it is an actual athlete, they\'ll usually be compliant with what you have to tell them.
0:24:54 Sebastian Gonzales: Now, we\'re gonna go back to butt wink for a second because... So you mentioned on squatting, so do you see more people that have disc injuries with squatting with a butt wink or deadlifting poorly? Or is there... Doesn\'t seem to be a difference?
0:25:17 Dr. Seth Myers: So I would say you probably get more low-grade, low back flexion intolerant pain with a squat where you probably have more acute pain with a incident that was a deadlift. Does that make sense what I\'m saying?
0:25:35 Sebastian Gonzales: So it\'s like a single incident, \"I did one lift, I\'m in here on a deadlift,\" and the other one\'s like, \"This has been bothering me and nagging with the squat.\"
0:25:43 Dr. Seth Myers: Yeah, that\'s what I would say. And to answer your question, if it\'s a disc, obviously, it\'s hard to... If we\'ve got MRI and X-ray and whatever, we can do all that imaging, and even then it\'s not definitive to say, \"Oh yes, this is the thing that\'s causing your discomfort.\" But again, I like to use that flexion intolerant term, and I think in a lot of the cases where it\'s squatting it has been that low-grade, nagging, hurts more when I bend forward type of discomfort.
0:26:15 Sebastian Gonzales: Okay, so the second part I wrote down in your assessment thing, the second part was you said you\'re looking at movements more so than... I mean you kind of looked at structure or structural deformity in the beginning when you said you might refer them out. But the movement... So I want you to touch on again where... If you\'re like me, we don\'t focus as much on what the diagnosis is, obviously, we have to address and figure it out, but it\'s more of how they move, correct? Or what... What they\'re tolerant to.
0:26:44 Dr. Seth Myers: Yeah, exactly. Sometimes it\'s hard to get the patient to understand that as well, and I think doing things that they can see whether they\'re moving good or moving poorly is also a really good indicator of them having good mechanics or good quality movement is gonna decrease some of the discomfort that they\'re having. But for the most part, when you\'re talking about lifting anyway. Because I have seen, people will come in and maybe they\'d ask if it\'s this or if they ask if it\'s that structure, and then when you have this idea of a certain structure is damaged in their head, then you get back into that, like we talked about earlier, that kind of fear avoidance, where they don\'t wanna damage that structure even further.
0:27:39 Dr. Seth Myers: But yeah, when someone comes in, like you said, for the assessment, a lot of the stuff that I might try and do is looking at how they\'re just general range of motion, there may be a squat as well as some of the other... If you\'re familiar with an FMS movement screen. And obviously, this is audio, again, but looking at single leg position where you\'re maybe standing on one leg and what I like to have people do and... Instead of necessarily doing a step over test, doing a step down. So you\'re standing on even something just the height of a stair that someone might have in their house, standing on one leg, putting the other foot that you\'re not standing on out in front of you a couple inches and just trying to squat down so you tap your heel, and you can see side-to-side differences and maybe how the knee moves, how the hips are moving, how the foot moves.
0:28:36 Dr. Seth Myers: But then you can even just have the person subjectively tell you \"Wow, that was not very easy on my right leg,\" or you can see them fall over a couple times. So that might be one way you can tell, \"Okay, I know your low back is hurting but looking at this, there\'s a little bit of stability issue we\'re having on this one side, so if we can fix that or help encourage that to get a little bit better, that might help resolve some of this nagging issue you\'ve been dealing with.\"
0:29:02 Sebastian Gonzales: Okay. I like that. I haven\'t used that test before, I\'m familiar with the FMS step over.
0:29:06 Dr. Seth Myers: Yeah, yeah. And that\'s kind of I was talking about earlier but I like that step down, you get a similar answer in terms of what you\'re getting. Is there a side that is very stable or moves well? And then it\'s quick and easy, you just have to have a step, which a lot of people can do at home.
0:29:27 Sebastian Gonzales: Yeah. One that I\'ve used is, I don\'t know the exact name, I wanna say I\'ve called it the star test, I\'ve called it Dynamic Trendelenburg. It\'s where you\'re basically doing a clock, but I\'ve never used a step with it, I don\'t know if that would work too.
0:29:42 Dr. Seth Myers: I suppose it could, yeah. I don\'t see why not. Or even just like the Y balance, I\'ve done that before with certain rehab, but yeah.
0:29:51 Sebastian Gonzales: Okay. So going back to lifting a little bit, you spoke about McGill earlier. How does something like McGill\'s work carry over to lifting? \'Cause I\'m sure that when treating someone in a McGill method, you\'re not necessarily working on the standard chiropractic adjustment or stretching or things of that nature. It\'s more of a stabilization approach, right?
0:30:19 Dr. Seth Myers: Yeah, yeah. And that\'s a cool thing about McGill is he\'s not a chiropractor or a physical therapist, he\'s a PhD in spinal biomechanics, and he happens to have a passion for helping patients with some pain as well as performance. So he\'s actually got a bunch of studies on strongman stuff. And so when you\'re talking about lifting and that type of... With that type of influence. Things that I actually use a decent amount are loaded carries. What I mean by that is, if listeners know what a farmer\'s carry is, where you\'ve got two things in your hand and you\'re just walking, those are really great for challenging just stability. So if you can imagine, you take one step, as one foot is in the air, you have to balance all this extra load that you\'re holding on to on the opposite leg. And so he even did research on this, so a lot of...
0:31:19 Dr. Seth Myers: You mentioned the word Trendelenburg, and for the listeners, what that means is when you stand on one leg, if your hip kinda pops out to the side or your body kinda tilts over, that glute med or one of the glute muscles that helps hold you up, is kinda weak. That\'s what that sign is. Well, he found that when he was doing these studies while people were carrying a yoke, which similar load in terms of a farmer\'s carry, is the glute was only providing enough force for... Oh, I forget the numbers, but not 100% of the load. So there is another set of muscles that was help holding up the pelvis or helping hold up the leg, and that was the QL on the opposite side. So your one side that you\'re standing on, leg, glute muscle, is holding up your pelvis so you don\'t tilt over, and then your opposite side QL muscle, which is a muscle in your back, your Quadratus Lumborum, is helping hold up the pelvis from the top sides. I\'m sure you can imagine that in your head.
0:32:23 Sebastian Gonzales: Yeah, that\'d be a great actually written, or an illustration, I don\'t know if there is one.
0:32:27 Dr. Seth Myers: Yeah. So he figured this out just by studying these strongmen. So when you\'re doing a farmer\'s carry, you\'re not moving or twisting the spine in any manner, but what you\'re doing is you\'re creating a lot of chance to challenge the stability of it. You get on one leg and you\'re challenging the stability of that leg, that hip, and then even the, like I said, the opposite side QL, and the obliques. And then you can take a step up. So he\'ll start with farmer\'s carries, and that\'s maybe what I would go to also, but then suitcase carries.
0:33:02 Dr. Seth Myers: So farmer\'s carries is when you\'ve got it in two hands, a suitcase carry is when you\'ve got it in one hand. And so if you can imagine, you\'ve got all this weight pulling you to one side, your muscles on the opposite side have to contract really hard to help hold you up, otherwise, you will literally fall over. So again, you\'re not twisting, moving, flexing, bending the spine in any manner, but you\'re giving it a huge stressor or a huge challenge to try and make these muscles contract and stabilize the spine so it doesn\'t move.
0:33:35 Dr. Seth Myers: So anyway, so in terms of McGill influence in terms of training, those are some things that I\'ve really implemented even with patients with some of that low back discomfort, doing some suitcase carries, side to side if they\'re ready for it, and it seems to work really well.
0:33:51 Sebastian Gonzales: Okay. So you haven\'t had... So with carries and suitcase, you\'ve never... How many times have you actually experienced anyone not being able to do it with acute or chronic low back pain?
0:34:04 Dr. Seth Myers: Gosh. I don\'t know if I\'ve experienced anybody not able to do it. I think part of it is just the inappropriate amount of load. Because the thing is with suitcase carries, what you\'ll see is if someone loads it up too heavy, they\'ll literally lean to the side to almost have the load resting against their leg. And again, you don\'t want the spine moving, tilting, anything like that. So really, it\'s just about addressing the right amount of load. And if it is too heavy or they say they\'ve got pain, then we can just lower the load. And that seems to help with anything that they might have going on.
0:34:50 Sebastian Gonzales: Okay. So in preparation of... Since we\'re going down the core or the trunk stabilization route, in preparation to getting your body ready for lifting a lot of weight, I know that McGill did that study, that six weeks one on dynamic versus static, or it was isometric trunk stabilization. When people are preparing themselves, should they be doing things like sit-ups or Russian twist, or I know that the carries were in that study, is this kinda like the... Or can you go down that route a little bit and explain the...
0:35:26 Dr. Seth Myers: Yeah, yeah, yeah. And that was kind of our little list of topics there is core training, and I\'m all for it. And that\'s kind of, again... He\'s one of the influences in how I might prescribe things. I think it\'s okay to do maybe a little bit of trunk motion, but again, looking at being athletic and doing athletic movements, and we can get into a few other topics here as well, but the core is... I say the core, basically, your midsection or your torso, when you\'re doing athletic movements, should pretty much be stiff and just be transferring energy or forces. So let\'s see, an example might be like throwing something. You\'re gonna push off with your legs and you want your core to be nice and rigid so that that energy that you pushed off with your legs just transfers through there and goes through the arm and you don\'t have to use as much just arm force to get that ball out of your hand, okay? And so if you train your core in a manner to be able to contract really, really hard isometrically and not have a whole lot of give, you get really good transfer of energy, especially when you train it in certain ways like a suitcase carry, where you\'ve got a force that\'s wanting to push you or pull you in that case in one direction and your body has to fight against it, does that make sense?
0:37:00 Sebastian Gonzales: Mm-hmm.
0:37:00 Dr. Seth Myers: So the bell wants to pull you over, but you have to contract to pull against it. That does really, really awesome job at getting those muscles ready to handle those huge external force loads that you might be experiencing in an athletic type movement. So I typically will have people start or try and move towards more isometric core training. If they\'ve already been doing a lot of... Sit-ups are really big in CrossFit, even toes to bar. If they start getting some achiness, like low back achiness from doing stuff like that, I\'ll try and have them shift over to something like planks, just straight up planks. Side planks are really awesome. And then even some of the suitcase carries. So yeah, I\'m all for core training. I think people should implement it, but doing it in a way that minimizes, again, that extra motion or that extra, especially flexion load that people typically wanna do with their sit-up. It\'s probably best if they do that.
0:38:08 Sebastian Gonzales: Yeah. Well, I actually asked a colleague this. We were having a beer one night and we... I don\'t think we came to the conclusion of it, but he... We were talking about this one study with isometric trunk stabilization. By the way, I\'m glad you said trunk. It seems like people are trying to not say core because there\'s a public misconception of what the core is. So we were talking about this and I\'m like, \"Do you ever train anyone to control their flexion, extension, or other spinal movements not under load? Because they\'re probably gonna do them. Do you want them to do them under control or not?\" Do you have a take on that?
0:38:48 Dr. Seth Myers: I do. If you get into some of the topics we\'re talking about here, at the end of the day, someone is gonna eventually bend over and probably pick something up off the floor without hip hinging. At the end of the day, people are probably gonna sit in their chair with some spine flexion. And I think if you\'re talking creating or trying to create pretty high loads or maximal forces via muscle contraction, so squatting, deadlifting, athletic movements, you wanna try and do those things with mechanics that are what people might consider optimal. But when you\'re talking general range of motion without external load on the body, so simply bending forward to touch your toes, bending backwards as best you can, I think people should have some ability to do those things without necessarily having to keep mechanics in mind. And they should be able to do it without too much discomfort.
0:39:52 Dr. Seth Myers: I mean, if the body is made to be able to do that, does that mean you shouldn\'t do it? I can bend forward to touch my toes, so just because it might cause damage to my lower back if it flexes and compresses and rotates, should I never flex, compress and rotate? So I think people should be able to do both and I think people should be able to control both, just like you said. And even in my training, I do toes to bar a lot and CrossFit. So I think as long as people are smart with how they progress and load those things, they should be able to do them without causing too much damage.
0:40:41 Sebastian Gonzales: Okay, yeah. I was definitely curious, \'cause I see people do it all the time. I take my dog to the beach and I see people picking up their small animals and their small dogs. So it\'s gonna happen, but I just don\'t want them to get hurt in my office doing it. [chuckle]
0:40:58 Speaker 2: Yeah, yeah.
0:41:00 Sebastian Gonzales: So I don\'t know, I\'ve been on the fence with it but I do recognize that they need it. Actually, side question, \'cause I was talking to a friend about this yesterday. We were talking about... We were actually lifting at the time, we were back squatting and deadlifting. And he had an injury back in the day. He was flexion intolerant, and so he took about two months off or so and he\'s been following all these people that are strongmen and so on. He\'s like, \"You\'d be surprised how many people hurt themselves.\" He\'s like, \"Nearly all of them, they had quad tears, hamstring tears, disc injuries, and so on.\" He\'s like, \"That\'s just... \" His ambition is to be a strongman, and he\'s like, \"That\'s just what\'s gonna happen.\" I\'m like, \"Well, can we kinda see what their deficiencies are? I don\'t think all these injuries had to happen. It\'s not just part of... It\'s just not gonna happen to everybody.\"
0:41:51 Dr. Seth Myers: Yeah, yeah.
0:41:51 Sebastian Gonzales: Do you have anyone with that mindset?
0:41:55 Dr. Seth Myers: Oh yeah, yeah. Well, I just treated a dude yesterday, he\'s got that mindset about being banged up. The caveat to that, though, is he does rodeo.
0:42:09 Dr. Seth Myers: Doing strongman is a little bit different than hopping on hundred pound animals. So I don\'t know, you might always kinda be banged up if you\'re doing rodeo, because those guys are pretty nuts. But no, if you\'re doing something where you get to control what your body is doing, you\'re the one who chose to back squat and deadlift, and you kind of have control of how you\'re gonna load it and manage it, then I don\'t know if there always has to be discomfort, especially if you\'re doing it in a manner where you\'re maybe not looking to compete or be really competitive. Now, those people like maybe your friend was mentioning who are always damaged, those dudes are probably pushing it mostly because of the competitive part of it. And maybe they\'re doing that because they\'re just not managing their load really well.
0:43:05 Sebastian Gonzales: Yeah. I feel like the body should be able to accommodate, it should be able to adapt.
0:43:10 Dr. Seth Myers: Yeah. And so what I try and explain to people, there\'s some research, I think the guy\'s name is Tim Gabbett, I think he\'s a physical therapist and researcher. And he\'s done some research on what\'s called acute versus chronic workload ratio. I might butcher the explanation of it but my understanding is that your chronic workload is basically what you\'ve done over the last month or couple of months, and then your acute load is what you have been doing over the last week. And so if you see a drastic spike in acute load compared to what you\'ve done over the last couple of months, the relative risk for injury increases. And so in some of his research, he was looking at rugby players and basically how much time they spent sprinting. And so if you saw a drastic increase in sprinting over the last week compared to the last month, you saw increased, I wanna say it was hamstring injuries.
0:44:15 Sebastian Gonzales: [0:44:15] ____.
0:44:17 Dr. Seth Myers: And so that makes sense, right? But what that also suggests is the body is able to adapt as long as your chronic load is gradual and nice and steadily increases. As long as you\'re not going from... Let\'s use back squats for example, as long as you\'re going from... Let\'s say, on average, you do about five working sets. Oh, that\'s a terrible number but just for sake.
0:44:43 Dr. Seth Myers: Five working sets over a week. And then that\'s what your average has been for a month. And then one week you\'re like, \"Okay, I\'m gonna change up my squat cycle, I\'m gonna do Smolov,\" whatever. For people who don\'t know what Smolov is, it\'s a squat cycle that has just a lot of squatting in it. And then you do that and now in one week you\'ve already accumulated three days of squatting with like 15 plus sets, working sets, and so your acute load is just huge and now you start to get a little bit of hip pain. That\'s kind of an example on how you could use that in real life. Instead of that drastic change in workload, if you wanted to improve your ability to do attacks, so you\'re looking at strongman implements, whether it\'s a yoke, whether it\'s farmer\'s carries, having a slower increase over time of those things, you\'ll probably see less and less musculoskeletal disorders.
0:45:49 Sebastian Gonzales: Yeah. I totally agree. I think proper programming with any sport... I see this a lot of time with runners, especially ones that\'ve been battling injury. They\'ll say, \"I\'m just gonna go out on a Saturday and let\'s just hit 10 miles.\" And then they don\'t do anything for like two weeks. And then they wait and wait and wait and then, \"Let\'s do it again. Oh, it\'s still there.\" I know that their brain thinks that it will... Either their body can still do it, but I think they have to train responsibly, you know?
0:46:21 Dr. Seth Myers: Yeah. I totally agree. But with all that being said, if you\'re programming well then no, I don\'t think your body has to be in pain just because you\'re doing a specific sport such as power lifting or strongman or weightlifting or CrossFit.
0:46:35 Sebastian Gonzales: Yeah, I totally agree. Now, I know we didn\'t talk about intra-abdominal pressure yet, but I feel like it\'s probably needed here.
0:46:43 Dr. Seth Myers: Oh yeah.
0:46:44 Sebastian Gonzales: Tell me about that and... Actually, it\'s funny, I\'ve had probably five, six different people independently bringing up, not even prompted, about intra-abdominal pressure, but I still see a lot of patients that I see resistant to the idea. They don\'t understand why it\'s important, so there\'s a lack of understanding, I feel.
0:47:06 Dr. Seth Myers: Oh yeah, yeah. I think that\'s just a big misconception in the fitness industry in general, so people who go work out, I think they just don\'t understand how the best way to stabilize the low back or mid section is. I actually wrote a blog about how to use a weightlifting belt and I think it fits in with this really well, but basically, explaining intra-abdominal pressure. Inside everybody\'s gut, essentially, is just a cavity, okay? And so your diaphragm, the diaphragm that everybody uses to breathe, looks like a parachute or a dome. When you breathe in, this diaphragm is gonna contract, and as it contracts, that dome is gonna basically close down or get smaller. But as that muscle itself contracts and closes down, it\'s pressing or giving more pressure into basically where all your guts are, or your abdomen. That\'s why it\'s called intra-abdominal pressure. So as it presses down, the pressure gets higher and higher and higher inside your gut, and all that pressure is gonna help stabilize the low back while you\'re doing stuff.
0:48:24 Dr. Seth Myers: A really, really awesome analogy is like a pop can. So if you got a pop can that\'s closed, it\'s sealed, you could probably set it down and step on it and nothing\'s gonna happen. So there\'s a lot of pressure inside of there. But as soon as you break that seal, and so breaking a seal on your intra-abdominal pressure might look like basically a little bit of maybe flexion, a little bit of... Not a total huge breath in to create a huge amount of intra-abdominal pressure, and you\'ll start to get a little bit less stability.
0:49:02 Dr. Seth Myers: So if you break the seal on a pop can, you go to step on it again and it might crack or crinkle over. So the best way to create intra-abdominal pressure for yourself is trying to... So let\'s say you\'re getting ready to do a deadlift or a squat, trying to expand your belly as big as you can, and not just your belly, but even on your sides, so your oblique muscles. Trying to get that as big as you possibly can right before the lift. So what that does is it fills up... It doesn\'t really fill up with air \'cause your lungs are in your chest, but it puts a lot of pressure in that area, and it makes that low back really stable, hard to bend, hard to flex, and it\'s gonna be able to give more stability centrally, so basically, in the midsection, while your arms and legs are able to do more athletic things peripherally.
0:50:04 Sebastian Gonzales: So in regards to safety with... So that provides more stabilization to the spine. So how does it... What about when we\'re exhausted, or labored breathing? Does that change anything or present any challenges?
0:50:21 Dr. Seth Myers: Yeah, yeah. So when you\'re labored, or when you\'re doing like... Say it\'s in the middle of a CrossFit workout, what you\'re gonna start to do is you\'re gonna start to use other muscles. I said your diaphragm earlier. Your diaphragm is a big muscle that pretty much all of us use when we\'re breathing in. But when you\'re exhausted, you\'re gonna try and expand your chest in other ways. So your diaphragm is gonna push down on the lungs and kind of open up from that angle. But you\'re gonna get involvement of traps, basically all the muscles around your lower neck, upper back. They get sore after doing something like that. You can kinda feel them. But those are gonna try and raise up the ribcage so that you can breathe more and more. And so that makes it tough when you\'re labored to really create a whole lot of intra-abdominal pressure, because you see this chest rise and this chest expansion, as opposed to this belly expansion.
0:51:21 Sebastian Gonzales: So how do they control something like that? If they\'re kind of in the midst of a work out and they\'re like, \"Well, I just gotta keep going,\" is there a way to mitigate risk with that?
0:51:34 Dr. Seth Myers: With that I would say it would be more of a practice thing, so being mindful of it. So, if you have the choice to be in the middle of a really intense workout, and you\'re trying to do something that\'s kind of heavy, having some awareness of what intra-abdominal pressure is, basically, creating stability in the midsection before doing something. Being mindful and practicing that during those times is what\'s gonna create better ability to do it when you are more labored. So, that\'s kind of the best answer that I can come up with for that is just practicing it when you\'re tired. But also practicing it, obviously, just like skill acquisition is gonna come from doing it over and over and over and having it become second nature, even when you\'re not in that tired state. So every time you\'re going to set up for a heavy squat, or a heavy deadlift, or a clean and jerk, or a snatch, really any heavy movement at all, while you\'re not fatigued is gonna set kind of a neurological pattern for you to do that thing before you lift a heavy barbell.
0:52:49 Sebastian Gonzales: Yeah, I agree.
0:52:50 Dr. Seth Myers: Does that make sense?
0:52:50 Sebastian Gonzales: Yeah, perfect practice makes perfect.
0:52:53 Dr. Seth Myers: There you go.
0:52:54 Sebastian Gonzales: There are some times too where like I\'ll actually... So, I have an erg rower in the office, and I\'ll keep Duff fairly light, but I\'ll fatigue him out a little bit on that, and then I\'ll put him into whatever movement we\'re trying to improve on and keep the pressure with.
0:53:12 Dr. Seth Myers: Nice.
0:53:12 Sebastian Gonzales: So I tell them then they\'re gonna keep moving until I\'ve seen their form degrade, and I\'ll cue them once, and if they can\'t get out of it, them I\'m gonna stop them. But I want them to get a chance to get into that labored state a little bit so they can have the chance to control it rather than stopping them quickly.
0:53:31 Dr. Seth Myers: Exactly. Practicing it a bit.
0:53:32 Sebastian Gonzales: Yeah, pretty much. I don\'t have them do it with that much weight on them. So I guess they\'re gonna have to carry that over. How did you start to practice in this manner? \'Cause I know you didn\'t go to the same school as me.
0:53:48 Dr. Seth Myers: No.
0:53:50 Sebastian Gonzales: You\'ve taken the McGill route. What\'s your reason?
0:53:58 Dr. Seth Myers: I think it just fit really well with, I guess, my philosophy on health and wellness beforehand. I played college football. I\'ve always been kind of into strength and conditioning in terms of just trying to get bigger and stronger. And then when I went to chiropractic school, I also did a master\'s degree in sports medicine. And then at our school, we had a big kind of rehab-based group of people, and the more I saw that style or that side of chiropractic, it really kind of sucked me in a bit. And then obviously seeing that there\'s kind of a disconnect between moving well and a lot of other stuff that you treat like pain and dysfunction. So it\'s not just doing hands-on stuff, but it\'s also providing them with the tools to be able to help themselves, that really helped.
0:55:03 Dr. Seth Myers: And that\'s kind of what McGill teaches. That\'s kind of what some of the other things in terms of rehabilitation kind of gear themselves towards. And so that was really awesome. So being able to... Me help educate the person, the patient that comes in with discomfort, and not just do a few things so that they\'re reliant on me, but teaching them a few things so that they can go a little bit longer in between visits that they see me because they\'re able to help themselves. And then eventually, maybe they\'ve got a acute little flair up but they know how to manage it because of things that I\'ve been able to show them, which came from some of those influences.
0:55:39 Sebastian Gonzales: Yeah, it\'s cool. I guess I didn\'t tell everyone how we\'ve come to talk but... So I got your name and your contact from Whitney at the NSCA and... So the email I sent originally was, \"Hey, do you have a strength conditioning coach to talk about lumbar spine injuries with lifting?\" And she hand-picked your name from everyone else she could\'ve picked. [chuckle] I think it\'s an honor. I don\'t know how you know her but she holds you in high regard so I\'m glad to have you on.
0:56:16 Dr. Seth Myers: Yeah. Well, I\'m glad I was able to talk. And yeah, it is kind of crazy it ended up being another chiropractor, I suppose.
0:56:25 Sebastian Gonzales: I know, right? I didn\'t expect that at all. I thought she was gonna throw some... Like, a UCLA strength coach at me or something like that, since she was a Southern California rep.
0:56:33 Dr. Seth Myers: Yeah.
0:56:34 Sebastian Gonzales: But yeah, it was good stuff. I think we have a lot to talk about. So there\'s one more thing before we close out. I think returning to... I guess return to play or return to lift... Do you have suggestions? Is there certain scaled approach you might take to something like a snatch or a deadlift or a jerk? Is speed important? Would you take out certain ranges of motion? Would you scale it somehow?
0:57:03 Dr. Seth Myers: Yeah. So I can kind of go through all of those things. So initially, obviously, if I\'m treating a patient or if a person is having some pain in an area, one of the first things that we might do is try and decrease that as best we can. But then we\'re gonna try and get them into the position or the thing that they wanna do. And again, this all comes back to what are their goals. Do they need to be squatting full depth or can I have them squat to a certain point? And that\'s what I might do first. So they might squat down to a box, so we\'re limiting range of motion, and as they progress and get stronger and look better in those positions, we can decrease the depth more and more and more. Same with the deadlift. So you can start pretty close to lock out, where you\'re basically just doing pulls off of blocks.
0:57:55 Dr. Seth Myers: So one of the first things that I might go to, in terms of returning to doing barbell movements, is just changing the range of motion a bit. And then the other thing that you might do is try to change, maybe, how the person does that movement. So, this sounds kind of weird, but... So deadlifting, everyone usually picks it up off the floor. Well, if it\'s hard for someone to pick it up off the floor, you could do something like a true Romanian style deadlift, where you pull it off of blocks, step forward or backward, and then start doing the lifting. So that works well for the deadlift example. Maybe not as well for a squat, obviously, but again, just getting creative with how you start and stop those certain movements. And then the other thing that I wanted to mention about some of the Olympic style weightlifting stuff is... So USAW or the United States Weightlifting coaching style is...
0:58:57 Dr. Seth Myers: They call a top down method. And so, basically all that means is you\'re having that person do the lift from a higher position. So a snatch might be from the hips or from the thigh versus from all the way from the floor. So again, you\'re changing the range of motion and you\'re getting them back to doing that thing without having to put them through the full range. Something else to mention with the Olympic lifts, is in CrossFit what you see a lot is, again, they\'re trying to do these lifts where they\'re doing a full squat with it. So I usually will have people do what you would call a hang position, so above the knee, but a power. So power just means you\'re basically not taking it down into a squat. So you\'re limiting the range of motion on both ends but you\'re still getting that explosion that you\'re getting from the lift itself. And so going from squatting to deadlifting to maybe cleans and snatches, that might be how you could start, is changing the range of motion on all these things. And so the squatting, it might be to a box. With deadlifting, it might be off of a box. With cleans and snatches, it might be from a hang just into a power. So we can still get the lift that we\'re looking for, but we\'re gonna do it in a manner that puts them in the best position so that we are not stressing the tissues that might be already irritated.
1:00:24 Sebastian Gonzales: Okay. I like that. Start from the hang, go to the power.
1:00:28 Dr. Seth Myers: Yeah.
1:00:30 Sebastian Gonzales: Just a side question, you made me think about it. So actually, a couple weeks ago, I started implementing with my patients that whenever they\'re in my presence, I am not allowing any deadlifting touch and go. I want them to reset everytime. I don\'t know if you have any thoughts on that or not. It\'s something new I\'m trying, just because I wanna make sure that they have intension when they lift it, and I mean obviously, I would start with lighter weight, but when you go to heavier, I want them to feel... I want them to be stable when they move it. You know?
1:01:06 Dr. Seth Myers: Correct. Correct. And yeah, so actually, one of the things that I wrote down that I wanted to mention, and this is kind of again for the cross fitters out there, is deadlifting, you see it a lot where they will pull it from the floor and then they\'ll drop it from the top. And I think you\'re almost doing yourself a disservice there because people are typically stronger in the eccentric proportion of the lift. So that means lowering it down typically. So for the deadlift, lowering it back down, you\'re almost cheating yourself out of half a rep if you don\'t take it back down. And then what you were saying with the not doing touch and gos, I think that\'s great, especially if you\'re working with a patient that might be dealing with some pain, to make sure that they\'ve got a really great set up, they don\'t lose position in between lifts. But I think it\'s really important, and I\'ll have somebody do this if...
1:02:00 Dr. Seth Myers: If someone sends me a video or they have me watching them deadlifting, it just kinda looks a little off, it\'s not too bad, but their motion isn\'t amazing, I\'ll tell them, \"Go ahead and do your lift to the top, but then once you get to the top, I want you to envision and practice a perfect descent.\" So the bar calf should be exactly where you want it. Your knees and hips should be aligned where you want them to be on the descent part of it. Because that should be easier to do because you usually are a little bit stronger. And then that, you know, doing those negative reps can help set the motor pattern up so that when they do the concentric pattern of it, it looks a little cleaner over time. So I like setting up in between each lift, just like you mentioned, but I think something that people can stress even more if they\'re trying to clean up how the lift looks, or just get stronger, is slow down the descent part of it, or the eccentric portion of it, and really focus on that bar path with that motion.
1:03:00 Sebastian Gonzales: Okay. I like it. 30 second descent, high time under tension.
1:03:04 Dr. Seth Myers: Oh man.
1:03:06 Dr. Seth Myers: I don\'t know about that. Maybe about three seconds.
1:03:09 Sebastian Gonzales: Yeah. I think so. Well, cool. So anything else you want to add? How does everyone contact you?
1:03:18 Dr. Seth Myers: Oh man.
1:03:20 Sebastian Gonzales: I know that one of your websites was dead, I think?
1:03:25 Dr. Seth Myers: Oh yeah, so we were... The clinic that I\'m at, we were updating our website. So, it might be back on now. But... So my email, I can give out my email, I don\'t feel too ashamed with that because I can filter through that.
1:03:41 Sebastian Gonzales: Is it an MSN Hotmail one?
1:03:44 Dr. Seth Myers: No, it\'s the one that I think you have. It\'s just Seth Myers, my name, so that\'s M-Y-E-R-S, D-C, so just the letters D-C, at gmail.com. So if anyone really wants to send me an email, go for it. If they\'ve got any questions or anything, I\'ll be happy to answer any. And then I\'ve got a Facebook page which is just my name and then a bunch of different letters after it. So D-C-M-S, I think C-S-C-S, and if they wanna follow some content that I put on there, they\'re more than welcome.
1:04:14 Sebastian Gonzales: Is that where you are most active with the articles you are writing on Facebook?
1:04:19 Dr. Seth Myers: Yeah. I\'ll share them there and I\'ll also share other people\'s articles and maybe have a little paragraph blurb where I say what I like about it. That\'s probably where I\'m most active. I haven\'t done as much recently as I maybe would like, but... Yeah.
1:04:34 Sebastian Gonzales: I\'ll be honest with you, it takes a bit of time to even... To... I saw you had some some articles up, but it takes forever to write and then edit, and then the pictures, and so...
1:04:44 Dr. Seth Myers: Correct.
1:04:46 Sebastian Gonzales: It\'s a lot of work.
1:04:47 Dr. Seth Myers: Yeah.
1:04:48 Sebastian Gonzales: Well, cool, so then... Yeah, well, thanks for coming on, and don\'t hang up just yet. I\'ll come right back. Okay?
1:04:55 Dr. Seth Myers: Awesome.
1:04:57 Sebastian Gonzales: Alright, everyone, that was Dr. Seth Myers. Again, Seth Myers with an E-R-S at the end. Go to his stuff. He is a very, very smart guy. I\'m gonna try to get him to make some videos correlated to this podcast. He said he\'s gonna try to make some on his phone with the loaded carry, as well as some intra-abdominal pressure, some hips to the wall, and butt wink, I think. And also maybe that step down test. So that\'s all the stuff we talked about in the podcast today.
1:05:29 Sebastian Gonzales: If you\'ve been listening to this podcast and you haven\'t gone on to iTunes yet, you should. And I\'ll tell you the reasons why. Number one, you can\'t get all of the stuff when it comes out, right when it comes out, if you\'re listening to it on someone\'s site, even mine. It will be delayed. Okay? You can get all the show notes on P2sportscare.com/podcast, but I would love it if you went over to iTunes and subscribed. So subscribe, give me a review, tell me what you like and don\'t like about this show. I\'m open to constructive criticism, and I\'m only making this show for you guys. I\'m super appreciative that now we have people listening from... I think it\'s 12 to 14 different countries. I think I saw, even like East Asia was on there. I\'d have to get the notes in front of me to see. But I\'m honored to have everyone listen in. And I\'ve had people say they listen to this when they run, when they drive, when they\'re at the gym. So that\'s what I wanna hear. I wanna hear that you guys are enjoying this. So again, go on to the site, P2sportscare.com. There\'s lots of correlated articles, and all the show notes will be on there that you\'re looking for from this podcast. I\'ll talk to you guys soon.
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