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How I Beat Low Back Pain From a High School Baseball Injury

Episode 64

43 Minutes – Dec 6, 2017

0:00 / 43:51

Chapters

Questions this episode answers

Does a disc herniation on my MRI mean that's what's causing my back pain?
Not always. Plenty of people walk around with two or three millimeter disc herniations and no pain, and I'm one of them. What matters more is which movements irritate your back.
Should a teenager with back pain from sports be checked for a stress fracture?
Yes, especially in rotational sports like baseball. My rough estimate is that about half of high school rotational athletes with back pain have a stress fracture called a pars defect, and it's often missed.
How do I sleep with lower back pain that's worse bending forward?
Avoid a surface that lets you round into a C shape. My waterbed did that and I woke up hurting every morning, so I slept on the floor for about a month, then switched to a mattress.
Why does my back pain keep coming back after physical therapy?
Feeling better isn't the same as getting better. My first rehab was mostly stretching, foam rolling and passive care, and nothing trained the rotation my sport needed, so the first swing back flared it up.
What exercises helped fix your lower back pain?
Heavy strength work: hack press, Bulgarian split squats and lunges, back extensions, lat pulls, plenty of pulling and squatting. More than 90% of my time in rehab was me doing the work.

How my back pain started

I was about 15, playing high school baseball. I'm a quick runner, so beating out infield hits was my thing.

I hit a ground ball to the left side and ran as hard as I could. A step and a half from the base, I reached for one longer step to hit the front of the bag. I felt a jolt go up my leg into my back. It hurt immediately.

Looking back, I overstrided. That one moment turned into roughly eight months of back pain. I couldn't hit. I'd been asked to play up at varsity, and I couldn't.

What the imaging showed, and what it didn't

We looked for stress fractures and disc herniations with an MRI and a CT. Nothing was that bad. A small herniation, two or three millimeters. No pinched nerve. No fracture.

If your kid plays a rotational sport and has back pain, get them checked for a stress fracture (a pars defect). My rough estimate is that about half of high school rotational athletes with back pain have one. It's often missed.

Even my herniation may not have been the pain generator. Plenty of people walk around with two or three millimeter disc herniations and no pain. I'm one of them right now.

Feeling better is not getting better

My first round of care was mostly passive. A chiropractor adjusted my low back, mid-back and neck. A deep tissue therapist worked my glutes and back for an hour at a time. Lots of stim and ice. My physical therapist gave me real attention: foam rolling, stretching, and a back extension machine hooked to a computer.

I was released after about three months. My first at-bat back, I swung and knew it wasn't right.

I felt better. I didn't get better. Nothing in that plan trained rotation, and baseball is rotation. Stretching and foam rolling didn't change how I moved.

Round two: active release and a lot of hard work

The second round was different. Dr. Ron Higuera used Active Release on my hips, pelvis, mid-back and low back, 10 to 15 minutes a visit. I felt better within a month. For years I gave it all the credit.

Then he handed me to Victor, who crushed me with weights. Hack press. Bulgarian split squats and lunges. The back extension machine. Lat pulls. A lot of pulling and squatting. My legs shook so badly I could barely hold the clutch driving home.

More than 90% of my time there was me doing the work. That work is why I stayed better past that season. Twenty years later I play baseball every week, deadlift, squat, run and hike without back pain.

Find what irritates it, then train the whole body year round

My back hurt bending both ways, but more bending forward. That flexion intolerance points to the front of the spine, most likely the disc. When an injury won't tolerate a movement, stop picking the scab. So I removed triggers. My waterbed let me round into a C shape, so we deflated it and I slept on the floor for about a month. At school I tucked a small library book behind my back so I'd sit upright.

Local rehab like bird dogs, dead bugs and side planks builds pressure inside your abdomen, which stabilizes the area. It's needed. But you function with your feet on the ground, so look above and below the injury. Are your legs strong enough? Do you squat, deadlift and swing well? Do you run without a sway back?

Then keep training through the year. In the off-season I push strength, power and core work; in season I lift once or twice a week and do cone or deceleration drills once a week. I don't believe in quick fixes. If the injury wasn't traumatic, the reason it happened is still there.

Key takeaways

  • A small disc herniation on an MRI is common and isn't always the source of pain.
  • Young athletes in rotational sports with back pain should be checked for a stress fracture.
  • Passive care can make you feel better without fixing how you move.
  • Find the movement that irritates your back, like bending forward, and cut those triggers first.
  • Hard strength work through the legs, hips and trunk is what kept my back pain from returning.
  • Build your body year round for the sport you love, not only after you get hurt.

At a glance

Conditions and injuries
  • Lumbar disc herniation
  • Pars defect stress fracture
  • Flexion-intolerant low back pain
  • Recurrent sports back injury
Anatomy involved
  • Lumbar disc
  • Pars interarticularis
  • Hips and pelvis
  • Trunk and abdominal wall
Symptoms described
  • Pain bending forward
  • Back spasms from guarding
  • Morning stiffness and pain
  • Pain with sitting and swinging
Treatments and exercises
  • Active Release Technique
  • Heavy lower body strength training
  • Trunk stabilization exercises
  • Removing flexion triggers
  • Year-round sport conditioning
Episode Transcript

This transcript was generated automatically (whisper.cpp large-v3-turbo) and may contain errors.

This is session number 64 of the Performance Place Sports Care Podcast. Man, this Yoo-Hoo's good. But you know what else is good? Smoking dope. I ain't gonna rat you out. You know, puffing the Sheba, go by the Seesaw, smoke a J. You know what I'm talking about. I got a belly button. You got a belly button. Well, we all got belly buttons. And you know what? We all love Yoo-Hoo with a little rum. 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.

That's Big Daddy right there. Hey, everyone. It's Dr. Sebastian Gonzales again with the Performance Place Sports Care Podcast. And this time, we're actually doing it video format as well. So, I see you. You see me. And you'll see how these podcasts are basically done. You know, this is the first month that I actually wanted to start doing some type of theme. And for this month, I actually have it all written down until we have the next couple of months actually planned out theme-wise of different types of conditions that I would like to highlight. And this month, we're actually going over some lower back conditions, mainly because this is a condition that I actually had.

And this is what started me in this whole venture down the sports medicine realm. I remember that if you haven't heard my personal story before, I have it all written up actually onto my website. By the way, if you haven't been on the website yet, it's p2sportscare.com slash podcast. This podcast is where you'll find all these podcasts and anything I talk about or reference on this podcast today. So, if you haven't been on iTunes either, go on to iTunes, look up Performance Place Sports Care Podcast, and you'll find these. And you'll get them weekly. They release every Wednesday. So, I thought today I would go into my own personal experience and battles with lower back pain.

Next month, I'll go into another condition that I've actually dealt with as well, which is a hamstring injury. And then we'll go kind of more along that realm. And I'm going to try to blend in YouTube, Instagram, and all the topics that we're doing around this time of month or this whole month and kind of blend them together because I know I've had a lot of questions on YouTube about, hey, what do you recommend for this X, Y, and Z? Hey, do you have a podcast on this? And I think maybe I'm doing a really poor job at actually blending things together. And so, this is my opportunity now to do so.

So, here we go. Lower back conditions. You are going to actually, during this month, we're going to do a lower back condition. This is my own personal case today. Then we are going into, let me look at my notes. We're going into lower back anatomy next week. After that, we're going to go into an interview with an industry expert and then another one with an industry expert. And finally, we're going to go into some integration of how I like to program people in, high reward, low risk for back condition rehab. So, those are the kind of thought process I'm going to go through on this month and then we'll go into hamstring conditions.

We'll see how this plays out. So, if you have any suggestions, good or bad, I want to hear about it because it's a new thing for me. So, one thing about me is, so I grew up playing sports. I played soccer when I was a kid. I played a lot of baseball. I played baseball all the way from the, I mean, I could barely even remember how old I was. And I didn't go into t-ball. So, I want to say it was minor B was the one around Southern California here. So, I think that puts me around the age of eight or nine, I think, when I went in. So, I never really remembered having any major ailment, pain, shoulder, elbow condition.

I didn't really pitch much as a kid. I did it every once in a while. But for the most part, I played infield, outfield, no catching. So, I was active as a kid overall. We skateboarded. I snowboarded. So, we did a lot of stuff, you know. But it's funny, when you listen to kids now, you don't really get as, you hear more injuries. And so, thinking back on my first injury, actually, funny story, I was around 15 or so. So, I was in high school baseball. And at the time, I was still in Boy Scouts. And we went to this event down in San Diego. It was called, it was the Campery or Jubilee, I forget which.

But either way, so, we were at this event. And when you're around a bunch of other kids, you sometimes get jokes played on you. So, which I did. There was a kid that came up and said, hey, do you know the capital of Thailand? And I said, no. And it was actually, the answer was Bangkok. So, don't ever answer that one. They hit you in the nuts. So, that was actually, actually, no, I take that back. That wasn't actually how my back, oh, I know how my back condition started. But that was another bout. That was actually kidney stones. I'm sorry. I have had kidney stones too. But I'll finish that story before I continue forward then.

Anyways, my back started hurting from the back part of my back to the groin region. And I thought it was because a kid kicked me or punched me. But realistically, I had kidney stones around the age of, I think it was, I guess, 12 or 14 or so. I think that's when we had it. Another story for another time. We're not going to edit any of this out, though. So, we'll keep it. But anyways, so, when I hurt myself in high school playing baseball, it was actually, I was, I was, I'm a quicker runner. So, usually, I like to attempt to beat out infield hits. I try to stretch singles into doubles and so on.

That was kind of like my thing. Like, I wasn't going to hit for power. I wasn't going to hit home runs. That's just the way it kind of goes. So, you just kind of know your place. So, but you do get the opportunity to try to run out ground balls. So, I know I hit the ball to the left side, which is shortstop or third base, for those of you who don't play a sport with a diamond. So, I ran out as hard as I could. And I took a little, I probably had one and a half more steps until the base. But in order to make it there before the ball, I had to kind of lean in a little bit, get another longer step, and hit the front part of the base.

And I felt just a jolt coming up into my leg, into my back, and immediately it started hurting. So, after that, I kind of took myself out, if I recall it correctly. Keep in mind, this was, I mean, at this point, it was 20 years ago. Currently, when I have a condition that pops up, I like to write a blog posting about it so I don't forget any of this stuff, or I do a post like this. So, basically, I took myself out. And this was, if I can recall, gosh, I feel like it was a point where it was a big chunk of the season. It wasn't the end. It wasn't the beginning. I think it was in the middle. Because this whole thing carried out for another eight months or so where I was having back pain.

I couldn't hit. We were looking for stress fractures. We were looking for disc herniations. And this whole thing carried out. I remember until we were playing, I believe we were playing a game in Cerritos. So, it was in the summertime because we didn't play them during season. So, during the course of my whole first bout of rehab, I started to feel better, but I didn't really get better, if that makes any sense. Because I was actually held off of all activity. And I remember looking back at my MRI and CT, and nothing was really that bad. I mean, there was a small herniation around two or three millimeters.

There was no nerve impinged. There was no fracture, which I am thankful, actually. They checked me for a fracture. If your kids, if you have a kid in sports, especially a rotational sport, you should always check them for a fracture. I think the rough estimation is about half of kids in high school in rotational sports that have back pain, half of them have a stress fracture. And that's a PARS defect is what we call it. So, they checked me for that. It was negative. By the way, that condition is often missed. That's why I bring that part up. But for the most part, I was fairly normal. So, they kind of kept me out of playing for quite a long time.

And I remember I finally got a chance to go back in around that Cerritos game. And it was my first at-bat, and I swung the bat, and it was like, okay, that's not normal again. So, I went out again. And at the time, I mean, before I'd actually gone to my first bout was I remember I went to a chiropractor first. Maybe not first, but I went to them at some point. He did a lot of lower back, mid-back, and neck adjusting. As well as some, he had a deep tissue therapist there. And I remember them really working in my glutes and back and so on. I remember the lady's name was Olga. She was just, just beat me up for a whole hour.

And there was a lot of stem, a lot of ice and things of that nature. I also went to a physical therapist at the time. And I remember the setting of the physical therapist place. It was, we started out with a lot of foam rolling, a lot of stretching. The physical therapist really did give me a lot of attention when I was there. So, it's not like they were leaving me alone or anything like that. We were getting to the point where we were on this machine that, I forget what we called it. But it basically measured the amount of extension strength that I had. It was almost like I was in a chair leaning back against a bar or padded bar that had a computer on it.

So, that's how they were measuring like my, the strength of my back. And so, it was improving from what I recall. And eventually, they did release me. And I think I was there for about three months or so. So, it was interesting to see that all of that didn't actually decrease the risk of me getting hurt again. And I guess we can still beg the question, was it the same injury, just unrepaired or was it a new one? I didn't think it was one that was unrepaired. And the rotational aspect that I have not been doing playing baseball, actually, I mean, so I started doing it again and it flared it up.

You know, I really think there is a need for someone like me, at least in that type of condition, to kind of work in rotational patterns. And we weren't really doing that. And if I recall a lot of the stuff, there are things that I would call, it's what I call passive care, a lot of it anyways. There was a lot of stretching, a lot of foam rolling. There were things that really didn't improve my movements. I would imagine if I had to take my best guess of what my actual condition was, looking back on the notes that I had, I mean, I would say it was probably the disc injury, which was the problem.

I didn't have any leg pain. Sure, there was back spasms, but also that happens when the area guards around it. So, and the stress fracture was negative from the CT scan and the MRI. So, I just remember it being a very frustrating condition because I, at the time, was, I think it was the end of my sophomore year and I, or beginning of my sophomore year, and at the time, I was asked to be played up at varsity, which I couldn't do, obviously. So, I didn't get to play again until the next year, but it's frustrating knowing that, you know, and I've dealt with a lot of baseball players here now after the fact, and it's funny that you feel that every day, every game, every practice is important.

And I remember feeling that. It was just the pressure to get back because you're eventually going to lose your spot, you know, and every year they could cut you. I got my spot back pretty quickly from what I recall, but, you know, other people aren't as fortunate, and I remember a kid that I worked with this year, he was kind of fighting for a spot, and he wasn't able to get his spot really back and secure it, so it really turned his season a little bit, you know. It wasn't the same experience that he was going to have, but. Oops, sorry, I had a little cut out there. I had to, I saw the video stop on the YouTube end, so.

But, yeah, not everyone's that fortunate. They're not as fortunate to have a spot that's secured or, I guess that's the only way I can put it, you know, like it, but I can tell you it was very frustrating. So, you know, I wanted to go on and share my experience today, and I'll probably cut the YouTube off very quickly here because we can go even deeper into the podcast. By the way, if you're on YouTube and you're watching this, go find the remainder of this on the podcast. So, we'll dive the rest, we'll dive a little deeper into the podcast with things that I actually did further to improve myself for the long run because, as you can see, right now, as we stand, like I, if you've read any of my stuff, like I don't have any fear right now of doing, of playing baseball now.

I play every week, I deadlift, I squat, I run, I hike, I do basically anything I want to unhindered by back pain, and that was 20 years ago. And I'll say this before I actually shut the YouTube video off. By the way, if you haven't subscribed to this channel on YouTube, you really need to. By the way, in the podcast, I guess I'm almost talking to two separate populations here. If you haven't been on the podcast, if you're on the podcast and you haven't seen a YouTube video yet, there's a ton of the stuff, which actionable stuff over there. So, search Performance Place Sports Care on YouTube, and you'll find a lot of the stuff.

Just subscribe, and you'll end up getting all the stuff that I share visually. But anyway, so the point that I was going to go back with was when I had my second go-around with rehab, it was much better. And the things that I was actually able to do to get proper rehab was I ended up going to a guy who helped me out with a deep tissue work called Active Release, which was extremely helpful. It made me feel better very quickly. But the fact of the matter is, I'm pretty sure I probably moved poorly still. So, we strength trained the heck out of, like, my pelvis, my abdominal area, my legs. I remember, like, so I had a stick shift car growing up, and I would drive all the way out about 30 minutes away, and we would strength train.

And I would barely be able to drive my car back stick shift-wise. And the doctor I had out there, his name was Dr. Ron Higuera, I haven't mentioned before on the podcast, but I'm extremely thankful for what he was able to do for me and with me, and his staff as well. And he really got me to go into this profession. It was a lot of his influence that helped me out. So, we'll keep the podcast going, but we'll stop the YouTube video right there. If you guys want to hear the rest of this, go on to the podcast. So, yeah, Dr. Ron Higuera was really a big influence in my life to let me see that there's other ways to treat in rehab.

And I would guess, I would assume at the time, like, the things were, I don't want to say unconventional that he had me do, but it was more of the realm of, like, strength training. And this is a lot of what I have my patients here do, my athletes. And I'm trying to kind of make it so all the areas where they're missing, we've started to round those corners a little bit. If you remember back when I had a guy on, it was one of my friends, and I questioned him about all the things that he was doing for his injury. And at that time, it was an Achilles one, but also he had a past hamstring one. There was a couple things missing, and I always think that if you're an athlete, you need to be trained like an athlete.

And a lot of the rehab, the basic, the basic, basic rehab, a lot of them are very focused on the region of pain. And if we talk about the back, you might have stretches for the hips, you might have core work, you might have bird dogs, dead bugs, side planks. Some of these are just basic examples, but when we actually look at how an athlete functions or how a person functions, they function with their feet on the ground. And if we look back to all these examples I gave for the actual trunk or torso, those are designed to mainly learn how to have high intra-abdominal pressure, which is a high pressure within the abdominal cavity, which helps stabilize the area.

It helps to build endurance and coordination and strength and firing pattern and all that jazz of the trunk area or the core area to protect the actual area against further damage. Because if you're like me with that disc injury, theoretically, because I guess we don't know for sure, we never really identified the pain generator, then you have a responsibility to protect the region of the actual tear or injury. And again, in that case, it was the disc. Now, in the back conditions, definitely we can have facet injuries, which is a lot of times what adjustments could help. We could have back spasms.

We could have, gosh, what's another one? That stress fracture. So, there's quite a few things that you can have, but it's important to realize that that local, that area around where the rehab, if the rehab's happening where the injury is, then a lot of times it's what we consider local rehab. And there's nothing wrong with it. It's needed. But, at the same time, we need to improve how we function. In my case, my personal experience with back pain was the impulse of the base. I can identify there was a one certain time where it happened. Not that anyone hit me, but I kind of hit myself with the impulse of the leg to the base.

And, technically, if you're looking at gait, it's overstriding is what I did. So, I'm surprised I didn't tear a hamstring or something of that nature. But, when we're talking about someone who is not trauma-based, it's a, quote-unquote, not injury. It's just an ache, pain, or boo-boo, then we have to consider movements. We have to consider, are the legs strong enough? Are we considering, are they squatting and they're deadlifting well? Are they moving their body well through a baseball swing? Are they running without a sway back or extension? So, there's so many parts that we need to look at that we need to stabilize globally, or we need to improve the way you move.

I can't say that enough, and I've probably mentioned it on almost every podcast to come or that we've had. But, I think it's really important. And, I've actually had a patient, it was really funny. She listened to one of the podcasts, and it was on a completely different topic. And, she comes in the next time, and she's like, You know, I really like the way the guy said that we need to look above and below the injury to really correct the injury. And, I said, I was like, that's awesome. And, I walked away thinking, we've been talking about this. We've been talking about this. So, I believe that I'm going to probably keep adding it to almost every podcast.

Because, it's something that a lot of healthcare providers, or at least people who are well-versed in sports injuries, mechanism of injury, of non-traumatic injuries, a lot of them are familiar with this. Other professions, primary care, I can't speak for them. I definitely don't know the things that they know. But, at the same time, I'm personally not a jack-of-all-trades, but I know the stuff that I know. But, for the most part, a lot of patients don't understand how injuries occur. And, that's the whole point of this podcast, an explanation with the back injury here. By the way, I didn't mean anything, I'm not stabbing at primary care.

I love primary care, actually. But, it's, if you work on sicknesses and colds all the time, I wouldn't expect you to know the mechanism of injury for these other things. So, some do, some don't. Same thing with chiros and PTs and so on. All right, I'm done apologizing for misspeaking there. But, I think everyone gets the intention. There's good and bad of every profession. And, yeah, I'll stick with that. So, what typically happens with, let's consider, let's go back with thinking about what the possible pain generator was in my condition. So, I impulsed the base with my leg. The force of the ground or the running jolted up into my leg and affected my back or SI joint or something somehow, right?

So, I believe, since my pain was, it was painful with bending forward, with bending backwards, but more so painful with bending forward. It makes me believe that it was a possible disc injury, which is the pain generator. It was seen on an MRI. Yes, I get it. It was seen on an MRI, but it's not always the pain generator. There's people all over the place walking around with two, three millimeter disc herniations. They don't have pain. I'm the same way right now, and I've been that way for a very long time. Let's knock on wood, because I want to make sure that I don't get hurt. But, it was, it's, when the injury is resist or not tolerant towards bending forward, then we can't keep picking the scab off.

So, we need to figure out what movements are irritating it. In some cases, bending backwards irritates a back injury. In my case, it was bending forward. So, bending forward, you've got to consider all the things that I was possibly doing that I was aggravating things with. The first thing, actually, that I got rid of because I couldn't sleep at night was, I actually had a waterbed back then. It was a, what's the bigger than a twin, super twin, double twin, I don't remember, twin plus. Anyways, it was big. It was bigger. So, I had a waterbed. We deflated that thing immediately. I started sleeping on the ground.

And, after about a month of realizing that it was feeling better to at least lay on the ground, we got a mattress for that same bed frame. Because, definitely sleeping with face up, the thing wouldn't support me that well. And, I would kind of round into a sea. So, I'm guessing that's what made me wake up feeling like crap every morning. Bending forward to time of shoes. Perhaps I want to start kneeling. Sitting at school, I remember, was really painful because I would carry around this novel from the library, which I wasn't reading for any purpose, but I checked it out because it was small. And, I put it behind my back between the, there would be student chairs, so pupitries, right?

So, I put it right behind my back and it would make it so I'd sit upright or I would extend backwards and that was really helpful to me. So, again, flexion intolerant, which means a possible anterior spine injury, which would be a probable disc herniation, would be the highest of the possibilities. So, again, back to that. There is people walking around everywhere with disc injuries, with muscle strains, with tendonitises, with all these different things. But, it doesn't always mean they're painful, okay? So, I want you to remember that. Also, too, looking back at my rehab that worked. So, what we actually did, and I guess I didn't go into it in full detail, but I will now.

So, when I went in to get treated, I actually don't, I'm sure he adjusted me, but for the most part, I don't recall him doing it a lot. The first thing he did was actually work on the muscles of the hip and the back. And, again, we used active release technique, which is a patented type of pin and stretch, so you say. So, it is, I forget how my mom found to go to him. I think he was doing a seminar at his work or at her work. But, anyways, so we did the active release, which actually for a very long time, I thought, oh, my gosh, like this active release is, it's the thing that made me better. But, I mean, it did make me feel better, I'm not going to lie, and I felt better really quickly.

I'd say within under a month, and I was actually already going to therapy for, I mean, what was it like, if I had to do the math, five, six months. It took me roughly eight months to totally recover. And I remember I was there for about a month before I started feeling really better, and then we strength trained for another two or three. So, and I was already playing at that time. So, I think, I mean, I've always accredited that feeling better thing to getting active release or manual therapy done to me, because it was something I hadn't really done yet. I mean, sure, I did have deep tissue work in that first go around, but it wasn't as specific and effective as this.

I mean, it was the overall thing. And I actually remember thinking after that, I'm like, I don't know what this active release thing is. I can't believe it helped me, and I can't believe that someone else isn't doing this with me, or hasn't done it with me already, because I already burned so much time. And I remember thinking after I had that second injury, it was, I mean, it was so frustrating, because I'd already spent, you know, three to four months doing the stuff that I've been doing, thinking it had been better, and it wasn't. So, when this guy came around and started treating me with active release, it was amazing.

So, after that, though, we really did strength train a lot. And I remember doing a handful of stretches here and there, but for the most part, we'd go in, do 10, 15 minutes of active release, and just kind of in and around the hip, the pelvis, the mid-back, the low back as well. And then I would just go out, and he would hand me over to a guy named Victor, and he would just, he would just crush me with weights. I mean, I remember us doing hack press. We did Bulgarian split squats or lunges. We did that same kind of lower back extension machine, but there was no computer attached to it. We did lap pulls.

Gosh, what else did we do? We did so much pulling, or what we'd say, posterior chain and squatting. We didn't do dead lifting, which was interesting, but he did have that back extension machine, which has a lot of science behind it. But I remember doing this a lot, and I remember that I didn't really give it the credit that it needed, because thinking about the amount of time that I spent with treatment done on me versus me doing work, I mean, me doing work was more than 90% of the time, probably, that I spent there. And the amount of effort that I put out, again, I couldn't barely drive the car home because my leg was shaking.

I couldn't keep the clutch in. I mean, working that hard, it was probably, I'm not going to say probably, I'm going to say it was, an extremely large part of the reason why I started feeling better longer than just the end of the season. And even into now, I mean, I would say that the changes that we made there, the impact that it had on the remainder of my life, I'm not dead yet, but my life up to now, I started training more. I started weight training more, I'd say, I don't want to say smart, but I would say effective. You know, they ingrained a lot of ideas, at least in my head, to where, like, if this is what I really try to do with my student athletes is, I try to get in my idea of how the body works, why they should program kind of this way, and I know things change over time.

And even things have changed since I started rehabbing my injury back 20 years ago. But for the most part, it really set a direction in my life where I started strength training more. I mean, right now, I think, I look back at my weight when I was in high school at the same height. I think I was, like, 130, maybe, 125, and now I'm 165, 160, and, I mean, I'm not really obese. I'm, like, 12% body fat, which is a little lower, which is lower. And I'm not saying that to brag or anything. I'm just saying, like, I've set time aside a lot of time to strengthen myself so this back injury doesn't come back.

Because I remember what it feels like. I remember the frustration of not being able to do what I wanted to do. All your friends are doing the things that they want to do when they're playing, and they're playing the sport they like, and you can't do it. And this is what happens to a lot of people that I've met, you know, that I've played with. Because I play in an adult league now, and a lot of the guys are, I mean, I would say I'm not the youngest on the team, but I'm definitely not the oldest. And some of the guys, you know, like, kind of come and go. We've had a lot of players drop over the years.

You know, one guy was because he hurt his shoulder throwing. Another guy, same thing, shoulder throwing. Another guy had a hamstring condition. Another guy had a pinch runner all the time. Another guy, a phenomenal player, by the way, this guy. I've wanted him to come back and play because he's one of the best guys to play with. He would just totally, like, he hit the ball. He would just bomb it. Like, at the age of 45 or whatever he was, like, he's a phenomenal player. Still one of the best in our league anyways. And he just, he wanted to catch. He couldn't catch because he said he couldn't walk for multiple days after that because of his knees and so on.

So these are the things that, you know, I always sit back thinking, like, we could address this. We could strengthen this. And when I'm playing, I don't want to, you know, poke my head in where it's going to get cut off. But, you know, if people ask me, I tell them. But, you know, I personally train, like, I still value playing baseball. And I think I've said it before on the podcast that I still try to train for playing baseball. And I know not a lot of club teams or youth teams are, it doesn't allow players to do it this way. And by the way, age dependent, like, if they're too young, they can't really do what I'm going to be talking about.

But, I mean, our season goes from, like, when does it start? Probably, Jennifer, March, and it goes all the way to September. So during the off-season, I really try to increase my strength training, improve power development, improve how my body's functioning, work on core strength. And during the season, I try to at least lift one time a week, if not two. Ideally, I would like to lift heavier one day a week. But I don't always get to it either. During the season, I try to do cone drills or deceleration drills, change of direction, one time a week. I don't always get to it, which I should. But these are the things that the cyclical process of improving how your body functions for the sport you want to play or your hobby you want to do is extremely important.

And the reason why they don't allow it much in club sports is because they never really have a break. But that time during, was it September or October that we stop all the way to, like, January, February, March time frame is grind time. You know, that is where you improve your body to function how it's going to in the season. So I'll expand this out a little bit here. So if we're talking about runners, runners are one of the hardest. Triathletes are the hardest, too, because they're adult athletes who never really have a down season. They have race after race after race. And granted, there is a time of year where it's more prevalent, especially with triathlons, since there's water.

But marathoners, half-marathoners, holy crap, I mean, they're all the time. And if they're not local, like, they travel to go to them. And I know people that sign up for five, six races at a time spread out within a month, two months. So there's not enough time to make the change that you want to, unless you're willing to sacrifice some of your running during a certain time of year to improve how your body functions long term. Okay? I can't tell you how many injuries come from running just from a quote-unquote overuse. And a lot of times it's because we're not addressing how our body functions over the course of the year.

Another example. Let's see. Gosh, who does it? Softball. Ooh, we're going to softball. Adult League Softball. Where are you at? So Adult League Softball, I mean, I have quite a few friends that play it now. Friends that I've actually played baseball with. And there's pinch runners all over the place. And I remember playing, I played a tournament with them at a place called Big League Dreams. Big League Dreams has all these replica stadiums. And there's about four in a complex. And there's a center area where they have food and beer and so on. And sometimes you've got to wait like an hour, two hours, three hours before your next game.

So it's an all-day tournament. We started the one that I did around 10 o'clock. So we showed up there. We had 10 o'clock, 1 o'clock, I think 4 o'clock, and like a 9 o'clock game. I remember we didn't get out of there until almost, I think, 9, 9, 30, 10 o'clock. And the next week, and keep in mind, I was still playing. I was already playing baseball. I was already running. I was already lifting. I was doing things to make myself sore. But since softball, like the probability of hitting the ball into the outfield is so high, and I was an outfielder, oh my gosh, I could not walk for a week. Just the amount of sprinting in a softball series, in a tournament, was enough to make me almost double under and not be able to walk the next day.

I mean, I was scuffling, seriously. It was sore than I've ever been from playing a game of baseball on a Sunday. But it was interesting to see that the people that were playing, and I'm going to stereotype them, they're not in the best shape, nor do they do a lot during the week to improve how their body functions, or at least the people on my team weren't. The ones that do it, more power to you. And I totally respect that. I know that some softball players do that. But I remember, too, our team, like we were having beers between games. It was hot out. I remember like one guy, he had so many beers between games, I was kind of concerned being in the field next to him.

So it was just a little reckless. You know, it's my point. And it was, I mean, it was fun, but that's just the way, and I know I might be sticking my neck out on this because I don't play softball all the time anymore, but at least that tournament, the tournaments that I was part of, and this happened a couple, actually we played against teams who had beers in the dugout. You know, like the culture of it was very different than at least playing hardball, and that's why I like playing hardball now. Not that I like having some fun every now and then, you know, but it's, I've seen the injuries that can happen, you know.

I've seen the injuries that can happen from disrespecting your body, but also too, I mean, if you add in like the overall inability to know where your body's moving and feel where it's at, I mean, they've shown that even people with changes in, or the concussions, mainly concussions or eye tracking movements, they don't, if your body doesn't, if your eyes don't know where your body's supposed to go or where the object's going to be, there's a higher probability of injuries, and obviously an altering substance like alcohol will do that to you, so it was just a little reckless is my opinion, and the, what I've decided to do, and this is what, I'll probably touch on this again with a hamstring thing, but I've decided that if I'm going to keep playing baseball and I want to decrease the probability of back pain and hamstring injuries and all this stuff, then I need to be responsible with my body during the week and especially during the season, and also too, I know that from, I mean, my point of view is if I'm not playing well, if I'm not hitting the ball, if I'm not throwing people out, and I'm not able to run and steal, I don't really want to play, it's not fun anymore, and you know, it's not what I like doing, it's not my athlete personality, you know, like I want to do my best, I guess that's a Boy Scout thing, but also too, like, you know, there's, there's a point in time where, I mean, I remember watching, was it Brett Favre, I think, just killer during his, like, younger years, and then, like, he started, he kept kind of adding the seasons on it, and it was just not, it wasn't, like, true to form, and you kind of want to remember them in their true form, I think, and that's the way I want to remember myself, at least playing sports, so that was my back pain, that was my back pain story there, I guess, I will probably put, I don't know if I have a write-up on back, on my back injury, at least a full write-up, but I will put it up, hopefully I'll have it by the time this podcast hits, and if it is, I'm going to put it in the show notes there, I really like to, I mean, I wish I can give people more guidance on, you know, what to do with their back injury, but for the most part, I really think over the next month here with the podcast, if you really listened, and listened a couple times to each podcast, I think you'll get what we're looking to teach, and first off, every type of back pain is different, every person responds differently, so I guess we can give, we can give what we like to do, and I'm going to, on YouTube, give some of my favorite low back pain exercise stretches and corrections, also kind of how I program for some back injuries, obviously not all types, because it's really, everyone's really different and have different severities, and we're going to go into some anatomy of the back, because the more you guys really understand about a back injury, because I remember looking back at, when I think back of my condition, I think of all the things that I probably could have asked for, or done, or done at home, or I could have suggested, all right, maybe I tried something different, maybe I should have known better the timeline, because, you know, even going back and playing that first game, and getting hurt again, I mean, maybe I should have asked them, or asked my coach to co-manage with me, or ask if I could, you know, swing lightly, or run, or, you know, there's all these things which I probably could have done if I would have known more, and that's really what I, where I want to put you guys, I don't believe in quick fixes, although some things do decrease pain very quickly, I think a lot of times it doesn't do a lot of favors, because still the reason, the mechanism for injury, if it wasn't traumatic, is still there, and I actually mentioned this with one of my friends, he said, hey, my mom has back pain, she was recommended to do, to have this medication, to decrease the pain, but also they recommended PT, and blah, blah, blah, blah, blah, like said, all this other stuff, and the blah, blah, blah was things that she would have to do to make it so her body functions better, so my friend said, should she take the medication, I'm like, you know what, I bet the medication will make her feel phenomenal, but your mom is 65, how many days of her life have you ever seen her exercise, and he's like, not much, maybe walking around the neighborhood, and I said, if her pain wasn't there, would she do the other part of the recommendation, go to PT, and blah, blah, and he's like, no, I'm like, well, I would, unless she's dying inside, you know, like, if it's really terrible, and we've cleared out all these other types of injuries that she could have that are serious, I don't know if I'd take her pain away, you know, because pain is a really big motivator, I mean, it's almost like you want to have a hint of it, or you want a little bit of fear, you want to strike the fear into these patients, these athletes, a little bit, just enough to get them to comply with what you want, or we can take the other approach, let them understand what's needed, and that's the approach I'm taking right here, so I hope this is going to be helpful for you guys in the future, so if you want to hear the rest of these podcasts, and get them right on the spot, and correlate them to the YouTube videos, and correlate them to the Instagram, by the way, the Instagram is at performancehp, then you need to subscribe, you need to go onto iTunes, go right through from whatever website or place you're listening to this podcast, and subscribe, you'll get everything as it comes out, and if you want to go onto my actual channel, or sorry, my actual website, that's p2sportscare.com, there's a couple spots when you go and dip into those articles, which there are some on back pain, you're going to be prompted to possibly sign up for an email list, and this isn't a spam email list, this is the stuff that I think I wanted to share, and I wanted, I think you guys are going to get the most information from it, there's a lot of things that, a lot of questions that I get over, I've gotten over the weeks, over the months, that I've, this is going to sound, it's going to sound like I don't want to do work, but it's really, I'm trying to think of what's possible, you know, if I had a dollar for every question that I get, I'd be a rich man, and I don't see any point in answering questions twice, if I've already answered it in full detail, like if someone said, what is your, what is your story of back pain, I might just give them, take them to this video, or this video, or this podcast, and it's not that I don't want to answer, but it's just that, especially on topics that are, ones that I can't actually answer, like, you know, what's the reason for your back pain, because I don't, I haven't seen, if I haven't seen you, I can't answer, but I can direct you to a video, or an e-book, or something with a top five injuries of back pain, by the way, these are the things we use to address it, here's all the anatomy, here's all the therapies you can get, and blah, blah, blah, you know, these are the things that I think you're going to benefit most from, rather than me going back and answering one by one, I mean, I only have so much time in the day, I can't, I want to share, and this is the best way I can share, so go on to the area, and you'll see through the, through the article part, you'll see little pictures of people, there's little dots, you can click on them, go through, that's your region of pain, and there's going to be, if it's already live, there's going to be prompted to put in a email, okay, you'll get a bunch of free stuff from me, you'll get the best information, you'll get suggestions of what I do with my people in the office, and I'm going to try to categorize all of these podcasts, videos, and articles for that type of condition, if you sign up through that page, okay, there's nowhere else where I categorize as well as in those email lists, okay, if you go on to YouTube, and I've had this people say this many times, they're like, I can't find the video you're talking about, I'm like, I know, there is like 400 videos on there, okay, there's a ton of videos, and I release them weekly, and I try to categorize them, but I really don't get to them quick as I want to, so, and you'll probably never find the old videos, okay, so go on to those email lists, sign up, I have one currently on generalized sports injuries, which is on the front page, we have one on knee conditions, we have one on sports hernias, and there's going to be shoulders, as well as hips to come, if it's not on there already, so, guys, thanks for listening in, and I know this is a shorter one today, but I thought there's no point in dragging it on any further, so, I appreciate you guys listening, thank you so much, and share this with anyone who has back pain, to hopefully give them a little bit of insight, and a little bit of hope that their condition will get better, because mine certainly did, just talk with you guys soon.