Discogenic Low Back Pain Case Study: An Acute Disc Flare Recovery

I understand or understood what was happening with my back like I understood what was causing me pain that it wasn't the end of the world that this is what needed to happen a b and c and it's still even though I agreed and I did what you said there was a like underlying panic that was just kind of always there and that's not my normal way of living so I was surprised with myself of that and I think that the fear of trying a movement after it's hurt like it took some coaching. You're listening to the Restoring Human Movement podcast where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery and now your host Dr. Sebastian Gonzales. Hey everyone it's your host Sebastian Gonzales with the Restoring Human Movement podcast. Thanks for joining the movement movement. This is the last one of the year. It's the last podcast of the year and so we've had this entire month of December 2019 is a month that I considered of giving back to the listeners because I'm really appreciative of all the feedback the listeners have been giving me and you are the movement so not like the bowel movement but you're like the movement like you like to be better. You strive to be better and so I thought I would give you guys some tools just to get better as well as I'm getting better all the time and if you have not done so already some of the past podcasts of this month I've given the opportunity to access my hip exam as well as shoulder exam and tension cues and clues and so on. Today we're going to go into a case study because this is what everybody wants to hear case studies and if this is your first time to the podcast by the way you should really go dig back in the archives and the whole point of this podcast is just to make us better as clinicians and learn from each other really and so if you're a lay public or a patient or client that is sitting in on this this is going to be a podcast that resonates well with you. I know I'm saying it's intended for clinicians but at the same time the conversation is so chill that you guys are just going to get a lot from it anyways. It's like we're all three having a beer at a local bar and I decided to get a Newcastle. I haven't had a Newcastle in a while and you for some reason got one of those stupid white claws but we're all having a good conversation either way. So as you heard on the intro today is going to be about a low back case, an acute low back case. I do have a video version of the examination we're going to talk about so you guys can learn from that examination as well as my we're going to go with lady friend, girlfriend. I don't know what to call it. So Allie's here. Hey guys. Hey guys. So Allie's here and she's going to be on here and I'm going to go with lady friend, girlfriend because it's I don't believe in labels. We don't believe in labels. Right, Allie? Well, we are together. Yeah, we're together but it's just a weird everyone wants to label you as like you going steady. Yeah, we've been together for long enough that like boyfriend, girlfriend doesn't seem like it's right but we're not married. So right. So we're just going to go with the non-label. I'm a man friend. You're a lady friend. Okay, we'll go with it. Okay. And so just to if this is your first time to the podcast, I tend to share a little bit of short story about myself so you guys can kind of understand where I'm coming from and just so you can like your host personally. Allie can jump in on this one. I don't know if, do we have anything?

You have any stories you want me to tell that? No, you don't have anything right now. Damn it. Didn't come prepared. She didn't come prepared. Let me pause for one second. There was something I had earlier. Screw it. I'm going to go to the pre-generated one. Pause for one sec. We'll do that and we'll go straight into the content. So if you guys know me, I like boating and so we've had this old boat for a long time. We've had this 1974 Glastron with a 1964, I think, engine that my dad's had for, God, years. I think he had it back when he was in dental school back in the day. So that was probably in the 80s. And so those things have been around for a while. It looks like a floating trailer park, but for the most part, it's taken us on a lot of good trips throughout the years. And recently, this last year, we had a little bit of a sputtering happen in the last trip. And so Allie was driving it. And so there was a little bit of... And I'm like, hey, just slow down. Something's going on here.

So we disassembled the engine a little bit, checked all the compression, looked pretty good. If you don't know about engines, you got to have high compression in the engine. So all of them were symmetrical and good and high. However, the bottom had like a milky type of, which means water coming in somewhere. So we didn't really know for a while where this water was coming from, and we still really don't. But water's coming from somewhere. And so you just can't let that happen. And so we started disassembling this engine. And so we disassembled it. And we were getting to the point with this engine so old that all the bolts started cracking and breaking off. We had to drill them out a couple times. And so we still didn't know what to do with it. But we can't use it anymore. But we can't throw it away. And so we just decided, me and my dad, we set up a cherry picker. We pulled the whole block off that thing.

Lo and behold, we couldn't get it back on. And so RIP, Mercury, it's been a good one. Maybe I'll post a picture of me in the face page. It looked kind of like a transformer. But that boat's been around a long time. And so hopefully this winter, we're going to be getting a new boat, new herb boat, a new used boat. Don't think I have that much money to get a new boat. And so if I find something up for under five grand or so, the theory is you go to a place like Salt Lake City, or St. George, or a place like Lake Havasu, where it hasn't been exposed to ocean water, because that salt will just erode the hell out of the thing. And I think that's what happened in this engine. So we think it got a little pinhole in the block. So the story is RIP, Mercury. Now into the content. Okay, so this is Allie. Allie is, she's going to be telling a story today about her back pain. And she's had a couple episodes of back pain, just mainly two over the last year or so. And it's, it's, she's going to be telling you from her own point of view, I'll tell you from a clinician side of it, since I was trying to help her out, obviously. And I'll tell you kind of where things went. And that was about four months, four weeks ago, I think, right? Mm hmm. Yeah. Okay. Okay. Allie, won't you tell us what happened? Tell us what happened? Well, the silly thing is nothing happened.

Scoot a little, eat that mic. Scoot a little closer to that mic. So I guess, I guess we start with about a year and a half ago, I probably did a small disc herniation. Um, it was very similar to what I did this time, but much less painful on the grand scheme of things. And, uh, about, yeah, about four weeks ago, I remember we were getting ready to, it was a Sunday night and we were getting ready to walk down to the beach and I said, Oh, my back is kind of hurting a little bit. Let's try this glute exercise. Cause that's proven to help with sensitivity in the past. And, uh, you, you got down and you helped me do the exercise and I stood up and I was like, Oh, it's worse. And then we did it again. And I was like, Oh, it's even worse. So I did it. Yeah. Yeah. You did. No, but this has been an exercise that has helped over the year and a half of rehab to make me feel more stable and better. Uh, so anyways, uh, we decided not to go. And within an hour I was face down on the floor in pain. And I remember thinking that, okay, this hurts, but I remember from last time, if I get up and get moving, it's going to take me some time. So I planned to, uh, wake up about three hours early before work to do some rehab, move around. And, uh, that next morning it took me three hours to get out of bed. Yeah. Yeah. It's very humbling when you're stuck on the ground for a little bit. And, uh, I know that you, um, you've, you've had this before, not to this severity. And it's, it's, I know it was with all, I'll tell everybody just from like, I, uh, I got a, I was downstairs and I got a text and I said, can you come help me real quick? And so I found her sideways on the bed and that couldn't get back on, but couldn't get off either. And so you're kind of stuck in that position. And so, um, you eventually got, but you got on your back. I think at that point you somehow got on your back.

Yeah, we were still on the bed and I got onto my back and if I just laid still, it was manageable. And you were saying like, okay, we have to get you on your stomach. Let's get you doing some McKenzie's and rolling was excruciating. We finally got myself onto my stomach. And I think we, I really think we spent about two hours trying to get me to like, get just prop up barely on my elbows. Yeah. You did, you did do very well, get into a prop, but it was, it took a lot of convincing. Yeah, it did. And I know that it works. I mean, I've experienced it working and I've watched you work with people with disc pain almost every day. So I know it works, but it was like a huge, uh, brain to body block where I was like, I know this will work, but my body wouldn't do it. Uh, but we eventually, I know you had to go to work. You're like, we have to get you on the ground.

Yeah. You got to stay on the ground at least all day. I know we joke about this too, but in the moment you are not happy. Oh, uh, yeah. I, we had just been having this conversation where we'd been talking about how much pain we'd experienced in our life because, um, you know, I'm, I'm a personal trainer. I work with dancers and I get people that come in and they're in pain and I say, okay, scale one to 10 and they're like, it's a nine. I'm like, really? Cause you look fine. And so we were talking about what we had experienced. Uh, what would, what do we think was the most pain we've ever experienced? And I was saying, well, it definitely had been passed back injury, but I'm not sure that was a 10. And then this happened and this is most definitely a 10. I was, it was like uncontrollable noises coming out of my mouth. Just, it was, yeah, it was excruciating. So now we can joke about it, but in the moment it was, it was scary.

Even though I knew I wasn't going to die, it was scary. Yeah. And you, um, I think, I think just, just the progression to things on that is that, um, obviously that it was worse in the morning. It wasn't really great at that night either, but that was the first morning. I think that, that, I mean, you tried to exit bed and you weren't getting off the bed, you got back on the bed and you were into, um, I don't remember if it was at that point or a little later, but I remember you were in a face up position. And so to try to get you to roll was challenging into that elbow prop position, which what we were looking for was what I was looking for was a position of comfort and just to like, it's not like I'm going to do an exam with you with you right there, but I needed to see if, if this was something that could be managed when I'm going to go to work and Hey, you go, you do this today. Right. Yeah. But I think you found that the, even the, um, in the first day, what did you find? You found that you were looking in the closet a lot. So the first day I didn't leave our bedroom, it was on the second story. So, uh, I couldn't get past my hands and knees and it took so much effort and so much pain to even get up on my hands and knees. Um, and I would consider myself a strong person, uh, you know, as far as core stability and the ability to understand that I don't want to be all sloppy as I'm trying to get on my hands and knees. Um, so it was really difficult. I could barely sit up to get onto the toilet. I had to like use a chair in front of me to prop me and lean. And it was like a wing and a prayer that I was going to get back down onto the ground. Um, and, uh, we actually had to clean the bathroom floor just prior to, cause I thought you'd be crawling in there a bunch.

Thankfully I did. I didn't walk. I crawled everywhere. I found that crawling forward was really painful, but I could crawl backwards almost no problem, like problem, but not, not in a lot of pain. Um, you had told me that I needed to do as many, uh, McKenzie's and sitting in a position that felt comfortable, which for me was on my elbows, um, as possible. And I knew that I wanted to get to the spot where I was able to do some bird dogs, side bridge, uh, modified curl up from McGill. I knew that was the goal, but it was not happening the first day. Right. And I think it took you how long to, to start walking.

I would say day three, day three in the morning after, you know, after that morning hump, I got to standing. Well, I think the interesting thing is that, um, I always find, I always find it comical, but at the same time, like interesting when people find like the things that you can't make up, like when you have a problem and it's like, oh, they really had this problem. Like they're not faking this at all. Cause I remember you saying on day two, Hey, when you leave today, can you shut all the closet doors? Oh yeah. Cause we were, you know, if I had known I was going to be looking at the closet in our bedroom for five days straight, I would have cleaned it. I haven't used those shoes in a while and Hey, that's stuff up there. You don't play mastermind. Yeah. Yeah. I was looking at everything that could be organized and wishing that I could move it with my mind and then be really productive while I laid there on the floor. Right. And all of the stuff that, uh, I think that you had, um, there was the dresser that I think you had started scattering all your belongings on because you didn't want to put them on the floor. Right. Yeah. Our dresser turned into the, the hump of things that I didn't want to have to reach down onto the floor to get as well as I realized how simply I can live because, uh, I would be home all day. Those for, well, I didn't go to work that whole week, which has never happened to me in my life. Uh, but it was basically water, like whatever food you gave me. Oh, it was great. I felt like I was going home to feed Ozzy the bunny. Yeah, it was. It was like, there's no eating unless you bring it to me.

There's not, if I finished my water too bad cause I'm not going to be getting any more. Uh, I think I had all my like back stuff and I had all my chargers and computer right there and that's it. That's how I, that's how I was for like three, probably three days. Yeah. Just left a bowl of food. I said, I was, if I was downstairs, just, just pound on the floor and I'll hear it from the ceiling and I'll come back up. That's it. Right? Yeah. Pretty simple. Yeah. Um, and you can really tell if people have, uh, have not been able to, um, um, uh, bend forward because all of a sudden they can't shave their legs anymore. Yes. So we figured out on day two or three that I was like, I can't wash my own feet. Oh wait, that means I can't shave my legs. I also would have shaved my legs if I had known I was going to hurt my back. So. Yeah. But also too, I mean, I think you, you started walking around the complex barefoot and stuff. And so all of a sudden there was a lot of dirty feet going on. And for some reason it's a season of worms. They like to come out and you're just destroying all these worms. Oh yeah. It was real gross, but it didn't even matter. Cause it was just like, thank goodness I made it down the stairs to walk around our little green belt.

So, so I feel fortunate at least that, you know, um, helping Allie through this, like she, she took direction very well, but also to, uh, the things that, the things that although she has seen work and have, uh, worked for her in the past, there was, it was, it took convincing to do, you know, but you took direction, I think fairly well. Not everybody will. Um, and certainly not everybody's spouse, mother, father, friends are going to take the direction, but I think you kind of knew deep down, you're like, I have to get walking. Right. Yeah. Yeah. Yeah. Well, I knew, I mean, like you said, from experience watching you work with people and then just my own people, I knew I had to get to a certain point if I wanted my healing to progress. And that meant I had to get through some of the, maybe the more, it was excruciating. That's the word. It was excruciating. But what I realized for my own movements was the first time I did something or the first 10 times I did something, it felt like, why is he making me do this? But then when I would come back to an hour later, it felt better. So after I saw that trend, it, it was, it got easier to move through the first time you wanted me to do something. Yeah. And so, uh, just so everyone kind of knows, like what, at least what our kind of plan was, or my plan was with her is number one, she needed to find positions of comfort and be able to feel comfortable through, I mean, just like a cut, like she has a five day recovery period. Like it's, it's hard, really hard to accelerate some, unless someone really knows how to do this and I don't, it's hard for me to, to accelerate those acute settings with, with disc or sprained ankles or whatever. There's just a, uh, there's a period of time that needs to do its thing, but you don't want to, you don't want to, um, poke the bear, I guess on it. Right. And so, um, once she kind of got a little bit more settled, we start, we tried to do side bridges or variations of side bridges as well as bird dogs. Um, and I think we went to push up plank, uh, over the curl up because there was a little bit of a problem there. Cause she was, um, she couldn't round forward. And so, um, the interesting one though, is that, so I know that not everybody tends to understand this is so you couldn't like, you couldn't get into a four point quadruped position for a while. And then your first bird dog, I think was, I think you had one leg back part way, still touching. And so we eventually scaled that thing out. Right. Yeah. It was a very, it was very humbling because I teach the bird dog every single day. And, uh, yeah, it was by time I got onto all fours and then could push just the single foot back halfway with a bent knee. I felt like those awkward, uh, skater videos or dancer videos where they're making fun of people and they're like, do I look good? Cause it was, it was so, uh, so short and what I, I could imagine what it looked like, but it was a lot of work to get there. And also too, it's like, uh, although say four might not be quote unquote perfect. That was appropriate for you at that time, uh, because it was not painful.

You went to a point where I think we were holding for five to 10 seconds. It was painful. If it was painful, five seconds, you went four. And then we started scaling that thing out and getting into bigger ranges and, um, eventually getting into a full bird dog. And in the side bridge, it was an interesting one because, uh, you, so you couldn't actually get up onto from knee, elbow and knee, like screw foot net, like foot and elbow, like that ain't going to happen. Like you went from knee to elbow, but you couldn't even get up from there. Yeah. And so I think one thing on with you is that, so you did, I don't recall, but did you ditch out on it and say, well, I can't do them. So you stopped doing them. Or I remember when I told you to push the floor instead.

Yeah, there was a, maybe it was like day two. Uh, I couldn't get up. Like I, it hurt to even think about it. And you on that night, I remember you said you have to get into some variation of a side bridge. So let's try this. So I think we just put, you just said, push your knee into the floor as hard as you can. And I just wimpily pushed it into the floor. You pushed pretty hard. Well, it felt like a big effort, but I'm pretty sure it wasn't. Uh, but yeah, by the next morning, I do think it was day three that I got up into a very, very like small hover of a side bridge. Uh, but like I said, once I got through that point where you coached me through it, I was able to then progress and move myself forward in that exercise. Yeah. And I think it was interesting how quickly your, your non side bridge came into a full side bridge. It's not like you had to build quote unquote strength. It was just that, that it, it just wasn't happening. Yeah. Right.

Well, I have, I mean, something I have to say, cause I've worked with through my past, I would, I used to be a dancer. So I've, you know, I've worked with chiropractors and different, uh, PTs and whatever. And sometimes those people just took me through pain to, and I never got better. But then my experience has been now in the last, you know, six or seven years working with you and a couple other people that we've reached out to. It's that I can trust that we're going to go through the pain and we're going to come out on the other side. And, or if it doesn't work, you're going to know how to fix me back to that beginning spot. Yeah. Just, uh, we'll just hit the restart button.

Yeah. Kind of. Yeah. Well, I think then, um, so just to give everyone an idea of kind of where we're going to go in this story too, is that you didn't get better a hundred percent under my care. I needed to actually ask for help. Um, and so the re one reason why I thought everyone would be interested in her story is number one, it's nice to hear it. Like Allie's going to be very like revealing with her story and, and, um, there's, it's a, she's a good storyteller, I think. And, um, but also too, uh, she's since some people try to manage spouses and friends and, and, and all that kind of stuff for like free, they're not always the best patients. And sometimes we mismanage them because you're too close to the problem. And so, uh, eventually I took her down for a second opinion. Um, because, uh, I know it's, I don't know about what I'll be posting on Facebook at the time of this, uh, time of this, uh, audio coming out. But in October I started saying, I think this is complete bullshit that people like people that we know are going through like 12 months of rehab and not really getting better. And so there's an expected time of recovery based upon the thing that's happening within five days or so you should be walking Allie. Okay. And so I think within the second week I said, I see, I need to see you do a hinge. And so you couldn't hinge, right? Yeah.

And you're still having quite a bit of pain walking. Well, and it was so frustrating because, uh, I spent the first week at home on the floor with my alarm set for every 15 minutes to do an exercise. So I would take, it would take me forever long to do my exercise. And then I would rest for 15 minutes in my position of comfort and my alarm would go off again. And they were the quickest days I've ever spent home. It actually didn't even feel that long. Point being that I feel like I was doing a lot for myself because I had to get back to work and want to feel good. And there was just a piece of the puzzle missing when you were saying you should feel, you should feel better. You should be able to make yourself feel better by walking.

I thought you lie. You have to be kidding me. Well, and I know that when, when I talk to people on the phone or like, like friends about this, it's like, like, I'm not pretending to know everything either. And it's like, if we have the solution to your appropriate solution to your problem, you will improve. And so I thought I had the appropriate solution. You did get better to some degree, but you paused. And so I didn't feel comfortable with it. You're not willing someone I'm willing to gamble with. And I know that you wanted to feel better. And so I actually took you down for a second opinion to Ben Ramos. We drove an hour and a half to get there. And so it's funny when, when you had, when we did this, actually Ben found, by the way, everybody, the exam that Ben did, I was a videographer. Allie was there. It was about two and a half weeks beyond the actual first onset.

Yeah. We were three weeks, three weeks. And the reason why I took her down is because she was doing so much extension. She started to have flank pain and groin issues. And so you started to have like some of that, those issues that come from too much lumbar extension. And so it just wasn't, it was, it wasn't a gamble I was willing to take. So I took her to Ben and Ben had other stuff to say, this is what I've been talking to all you guys about over the last like few months is you should be, you should fully know what your, what your outcome success should be. And you feel, should feel confident in doing that so much so that like if Allie comes in, I should say, this has been three months of, this is not right. I need to take you to someone else and just swallow, swallow my pride and send you there. And so that's what we did.

Yeah. And so when, what did, what, what did you, what did you think when we drove? I know we didn't want to drive down there because that wasn't, driving was not fun, right? Well, it was a long drive to me for, for how I was not wanting to sit. But I knew, well, I knew if you thought that he could help, then it was worth a shot. And I'd actually started to feel better. Like I feel like I had made a big turning point that almost the day before, but I threatened you, didn't I? Yeah. You kind of, well, you, yeah, you said if you can't do this exercise with this amount of weight in your hand, wasn't even significant. It was like 20, 25 pound, just hinge, like pick up an object from the ground. Yeah. I don't even think, yeah, it was like, just barely get your hips moving type of hinge. Then we need to go see someone. So I worked my ass off because I was like, I'm not driving to San Diego. You made up your own doorway hinge.

I did. I made up an exercise. I'll coin it. And the Rafiki squat. And the Rafiki squat and the side of couch hinge. So if you guys are interested in that, should we make a video? Yeah. No, but yeah, I made up my own variations to get me there. And I, but we, we knew there was still a piece missing, both of us. And I think, I mean, you knew better than I, but I could feel that there was a piece missing. So we went to Ben and, uh, we, we did that exam there. And I don't know, do you want to talk more about the exam before I do? So I just kind of shut up when I was there. Cause I just let him do his thing. Like it's, it's, it's, I think it's nerve wracking to have someone else watch you do your exam. And so I just said, look, whatever you find, let's just whatever you think. Right. And so I, I felt we were doing too much extension, but extension was, was relieving to you.

Well, it was, it felt for me, it felt like I understood in my body. I could understand that when I was having, um, kind of like referral pain, I guess, like into my stomach and groin and stuff or whatever you would call it. Um, I understood he, you would say like, you know, drop your ribs or tilt your pelvis slightly. And then that pain would go away, but then my back would start hurting. So I understood that the two, there were two different pains going on, but it was like, which is the lesser evil, you know, like which one makes me feel better at the moment. And at that point, my, my back was still a big, a big pain. So it was like, I was choosing that one over the, the, um, flexion. And so for, uh, I'm sure everyone's probably thinking right now, like, well, why not go neutral? Why not put a brace on her? Why not take anti-inflammatory? And the DNSers are probably thinking intra-abdominal pressure. We did DNSer. Yes, we did a lot.

We did some of that stuff. Uh, we did some, some, we did some chair squats. We did, uh, a bunch of McGill-based work. We did McKinsey. There was a lot of things we did. Anyways, it was to the point where it was, there was something a little bit missing, but I can see that there was a little bit too much extension happening as a secondary effect. And so, um, you, you are responding to that. However, um, it's funny, we were actually recently just before it. So Dawne Costantino, um, the intern here. So, uh, we were talking about differences of treatment or so. And, uh, so she goes to Dr. Brendan Murray. And so I like Murray a lot. Like I learned a lot from him through the DepoMite course. And so Murray, as well as some of the other clinicians at, uh, SCU, uh, the chiropractic school, they don't really use extension that much. And so they're like, how the hell do you guys use extension and, and how's it working? And then, so I was asking Dawne Costantino, what do they use? And they said, well, they do neutral or slight flexion, or they use a brace plus maybe some anti-inflammatory. I'm like, well, that's interesting. Cause I know Dr. Murray's, uh, thing, uh, with some of the research that he's read is that as the, as the, as the vessels tend to come into the outer third of the disc, then they also nerves follow it too, just from a, uh, um, the call factors. And so basically I didn't want that to happen to you. And so we actually got you a brace. Yeah. We bought a brace, which shocked me that you, well, I'm not going to take a damn gamble. Okay. And so when we started icing too, we did. Oh yeah. Cause they like icing. Yeah. So they're not going to hurt. No, nothing was going to hurt. And the brace did assist me. I think that was one thing that helped me get to the, over the walking hump. Um, the first day I put it on, which was two weeks after the injury. Uh, I was like, oh yeah, this actually, this actually helps a lot. So that did help me get over to the walking hump where walking wasn't painful. It wasn't comfortable, but I felt like we could, I could walk and kind of get that mechanic going after that.

So that was helpful. Yeah. And I think even that when we went down into Ben, so he did a similar exam is what I did. And so he puts you into a little bit of, um, like a distraction based flexion and you tended to feel better. Uh, and then I can see him scratching his head and you can see it in the video too. Like, I think at some point I said, she's not easy for you either. Is she, you know? And, uh, it's not that you're being difficult. It's just that there was, you, you're not a standard case. And so we kind of came to the conclusion that there's a, there's an inflammatory component occurring there, which is slowing down with these easy movement cures. And so I found it relieving to know that number one, I'm not a dumb ass, but number two is that there's other people that are competent around, um, with examinations in these advanced styles that, that can help me out to help you out. And, and like, I wish I could, I wish I could handle it all for you, but I can't.

And, but I'm, but I'm thankful that these other people are around. Yeah. Well, I mean, just working with your own family, it's, it's, it's hard. It is, even if you have the best relationships with people. Um, I think that your, how you feel about them can get in the way sometimes. And I mean, in this case, I hope it was love, but, um, you know, something that Ben did is he got me into that distracted flexion farther than you had. And that's probably because I was like, Oh, that hurts. And Ben was like, I don't care. We're going to keep going. He was just laughing at you. Yeah. You know, so I think where your, you know, your love and tenderness came through, Ben was like, no, we're going to keep going and see if this goes, which to the point I said earlier, I can trust you. And I've worked with Ben before. And, uh, you know, these, I've kind of developed, uh, uh, okay feeling about certain practitioner movement or qualities, I guess that makes me feel like, okay, if Ben lights me up, he's going to be able to get me out of it. So I'm going to trust him. And that's a huge thing to know that I'm at least not going to walk out worse than I came in. Yeah. Yeah. And it's a big, big trust factor.

Um, yeah, there was definitely, uh, like when you were, when you guys were going through that, I'm like, Hmm, I wonder how this is going to go. But you know, then he said like, so we kind of echo the same style, at least of like, this is a trial of care. We don't know if it's going to make you worse or not, but we already know you can just go into extension and be fine. Um, and, but, but you ended up implementing some, what'd you do after, um, when, what would you do after when you went down there and how would you, how'd you progress? Tell me about that. Uh, so I think when I, when I first came into Ben, it was like just looking down, if you watch the video, I think you can, I'm sure we have it on there. Like just dropping my head was like, that's it. Like, yeah, you couldn't see any food if it dropped onto your chest. Oh no. It was like, yeah, look at my toes.

No, I can't. Uh, so then nothing really, nothing really was like, oh yeah, that was the thing. Uh, but over time and then just, uh, I mean, honestly, just a little bit of coaxing after we had done, um, flexion supine with, uh, traction and you like put me up on a bolster a little bit that we hadn't tried that. And I was scared. I was like, oh my gosh, this is going to hurt so bad. Kind of like a hook line position. Yeah. Um, but once I, everything he did once it would initially be a little bit of a spike, but then it would soften right away when it keep escalating and it just keep coming down. So that's something I've added in. Uh, and we, he suggested that for the next, I don't know, few days, like instead of pushing all these exercises that we've been doing and things I've been having to modify, let's just let things chill out and do this. And then we also did, uh, like belly wall exercise, like a little bit of rolling kind of DNS kind of thing.

We're doing some attractor state work. Okay. Yeah. So it was just those two things basically like laying on my back with a flexion and with something distracting and then, um, that front belly and it's, it's made a huge difference. So now, now today, which is still only four weeks out, um, I feel like I can walk and move without worrying that I'm going to hurt my back. I'm getting in and out of my car without the like modified, crazy. Robotic. Yeah. Robotic, whatever. Um, I, I can pick, pick a weight up. I can do a hinge. You can put your shoes and socks on. I can put my shoes and socks on. Actually, after you, after you went down to, to implement those strategies for that point in time with your problem, the next day you can put your shoes on by yourself. Yes. So for three weeks you put my shoes on for me, which I know you hated.

Uh, yeah. So it was, um, I feel like some of it was the exercises and then I, I honestly feel like some of it was just, just plain old trust that I, I think you can see it on the video. I'm like, well, that kind of hurts. And Ben is like, okay, is it really bad? I'm like, no. It's like, can you go farther? Sure. So, you know, and then like I've, like I've noticed with this whole injury, once I did it one time, then my body kind of remembered that it could do it again and it's gotten better and better as it's gone. So, you know, now we're going to have to figure out what to do from here. I'm out. Well, so then I was going to ask you that because, uh, so how afraid are you of picking up a weight? Uh, if it was a, like from the ground deadlift style, pretty afraid. Okay. Just being honest. What about, what, what about, um, like the heaviest kettlebell we have in here at 60 pounds?

Uh, it depends on from what position. I'm not afraid to pick up the weight, but the, the position in which I move still has some, I did definitely have some deep seated fear with that one. But, uh, like I said, I'm a trainer. So this week I've been, uh, kind of like squatting down on two legs, like a one leg behind me and picking up a weight from the side. And I picked up 35 pounds, no problem. So I'm feeling more and more confident as we go. So I think now is probably a good point to talk about like the, like the implementation of care, like kind of this, um, months ago now I talked about this block system and this is how I explained stuff to Ali. She said, where do we go from here?

You know, we did first aid. The first day that I gave you lasted way too long in my opinion. And Ben gave you different first aid, but he also gave you corrective exercises a little different than the one that I gave you. And so they were intended to meet you at that point in time with the problem that you had then. Okay. Cause it changes. Yep. And so your block two is your, is your butt your senior or your corrective exercise, which we've done, which you're still doing a lot of, but, um, block three is a little bit of encountering, uh, load, not necessarily from a get strong physique type of thing, but from like a, uh, what if you had to pick up dog food? You know, what if I fell and you had to drag me over to the car, you know, like encountering, uh, loads, but in a controlled setting with coaching. And so that's where I would probably take you next and I don't need you to deadlift from the floor or anything. Right. Right. But you know, that was the movement that felt right. And my brain feels scary. And so you might, so people might know that I, I, I wrote a book on back pain. And so when I had it actually, so I took Allie kind of through the progression that I kind of did. So she went and saw me and then, so I didn't necessarily strike out, but it was slow. And so I had to go slower than I wanted to. So we went to go see a second opinion. Ben implemented the correct strategy at that point. She got much better. She did her corrective exercises. Now at the point, now we're at the point where we're in the lifting. I hired Brennan. I was just going to say Brennan.

Yeah. Brennan's the best. And so, because I was afraid of lifting weights too. Yeah. And a lot of people get like this, um, but they can easily not do it anymore. And I'm not saying don't do it because everyone needs to lift a weight, but it's the, it's the navigation of load through life. Yeah. Well, I, you know, I realize nothing like being injured to realize how much you have to use something or what's involved with a movement. So, um, picking up my, my water bottle the first two weeks, I couldn't pick up my water bottle. It was ridiculous. So, uh, when I first trip to Costco is an adventure. Oh yeah. I mean, I didn't touch anything. Um, but yeah, it's, it's, I think it's changing, not just my mindset cause I know I need to be there, but just in general, changing the mindset of the patient that that is the next phase and then realizing how much of their life they are loaded and moving with load, whether it's their gigantic heavy purse or it's their car seat or the dog food, whatever it is. So yeah, those are the things that are going to set my, set my back off if I'm, if I'm not prepared for them and that's going to take the training.

Yeah. So we might as well expose you a little bit here. And I know that, um, this is a side pitch by the way. So this is a good lead into it. If you guys didn't hear it already, this is, I'm not even going to break off for that, for that sponsorship for the pro power pro Cairo, by the way, pro Cairo is, um, when you go, uh, the reason why this is going to be important here is because this is a student thing. Only there's only 50 spots, 50 spots. You'll get the access to Cody D max version of exactly what the hell we're going to do with Allie. Okay. And so it's the strength conditioning portion of a flexion intolerant back. And so if you're wondering, Hmm, I wonder what they're going to do next, how are they going to start getting her to lift a little bit of weight without being scared and triggering and so on? It's on there. Okay. You will never get this discount ever again. It's $25. All of that money goes straight to Cody. I don't make a cent off it.

And you want to support Cody. You want to support the bomb. Cody is the bomb. Um, so, uh, get it the code for that. I should look for the code for that. Uh, I think it's, uh, RHM podcast strength 25, RHM like restoring human movement podcast strength 25. Okay. Only 50. I swear. I will not let this happen again. This is the only time. First 50. If you're 51st, you will not get it. Okay. Now we can talk more. I swear if you email me and say, Hey, I was wondering what you should do for like, what are you going to do with Allie? Dude, I already said it. Go on there. Yeah. I'm going to get it because I want Cody to coach me. Yeah. Hey, you know, actually I didn't tell, um, see, actually we talked this morning. Uh, and he wants to fly out here to work with me. No, dang it. Funny though. Um, no, no, actually this isn't even like intended to be on this podcast, but we'll talk about anyways. No. So our, uh, our two P is like, he said, he's like, Hey, this morning I had somebody or so he's like, I got designated with the job to set up like on the same day, somewhere between February and May or whatever. Um, there's going to be like a four to six hour workshop like here. So he's like, I want to come there. And so we'll, I don't know if it's gonna be him, but it's an R2P like students learn how to use these methods, um, here. And there's going to be one in like, say Florida and in Idaho. And these aren't real cities, uh, but all in the same day. Oh, wow. Yeah. That's awesome. So they're all going to spread out, do the same day of training so you can get it wherever, well, not wherever you're at, but hopefully spread out. I'm going to guess they're going to be different things, but I think they're trying to resurge a little bit more, uh, energy and, and, uh, student awareness and into the program or into that. So, um, but anyways, so yeah, ask him. I will. Cody, please come train me because I know, uh, I've seen some of his videos. Well, I've worked, I mean, I've, I know Cody, I've worked with him a little bit. I watched him work with you on your back when two, two, three years ago when that happened. And, um, and then I've watched his videos and I'm like, this is gold. Yeah. Don't worry. I can teach everything he's teaching now. Oh yeah. No, I still want Cody. He's nothing. I can even imitate him now. Break the bar, break the bar, break the bar, rip the floor, break the bar, break the bar. Yeah. That does sound like him. And then, there you go. That's all you guys. Um, okay. So, um, gosh, we're about, okay. 37 minutes in this podcast. Is there anything you want to add to any, any of that? Um, so, um, people who are actually some of the, some of the feedback I've gotten from, um, I had, I had released the audio version of part of the book that I had on, on, uh, back pain. And so one of the, one of the listeners actually said that, so that she was a, she was Hannah. Um, it was a student listener and she said that she's never really encountered anybody that's really had back pain before. And so she said that the storyline was useful for her because she can now empathize and understand what the hell someone's going through with that problem. And so right now you're a valuable asset to not only, um, other people listening on there and not clinicians, but all the clinicians who have never really had back pain or actually been in contact, like people who haven't been out of school yet, you're such a valuable asset to them right now. What do you think they need to know?

Um, well, what's, I think what surprised me the most about myself was the freak out. So, uh, you know, I, I don't know all the technical stuff. I didn't go to school for this, but I'm, I'm aware and I live with you. We talk about this stuff a lot. So I understand or understood what was happening with my back. Like I understood what was causing me pain, that it wasn't the end of the world, that this is what needed to happen, A, B, and C. And it's still, even though I agreed and I did what you said, there was like underlying panic that was just kind of always there. And that's not my normal way of living. So I was surprised with myself of that. And, uh, I think that the, the fear of trying a movement after it's hurt, uh, like it took some coaching, it took coaching from you and from some of the interns, like you can do this. I remember the stairs were my enemy for two weeks. We had a split level. So I have to go down two flights of stairs to get outside to go for my walk, which the walk sucked at that point.

So I was like, great. Uh, but the stairs, the stairs really, really hurt me. Um, and I, there was a point though, where going down or up both, both, but going, going up them was really hard, but down also hurt. Uh, but there was a point where I was really trying from the beginning to stay even. So I was trying to use my right and my left leg. I was trying not to limp. I mean, I was limping, but, uh, I remember that there was a point where I was like, okay, I'm going to step on my left leg up the stair and it shot up my spine. And I, and I was avoiding that left leg for a few days because I remembered that it hurt. And then there was something in me that was like, maybe you should just try to go through it. So I tried it again and it was less pain and it was less pain, but then on the third step or whatever, you know, it shot back up. But I just remembered that again, that I had to like progress myself kind of through the pain once I got past that first AIDS part.

And, um, I don't know how people go through back pain like this without having someone like you or, you know, your people listening because you want to clone me. You said you didn't want to do that. I don't want to clone you, but for, for, for real, uh, that first day, if I had been home alone or even with my, a family member, I would have had to call the, an ambulance and I would have never thought that about back pain or anything. Cause I couldn't get off the bed and you were coaching me in the best movement possible. So when people have this experience and you know, I kind of in the past would have thought, Oh wow, you called 911. But that would have been me if I, if it hadn't been for you being there and not everyone has a doctor in the family like you. So, Oh, so that brings up, actually I'll, I'll change it to one thing first and we should probably go back on that, that quote unquote doctor topic. Cause that was probably a good one. Okay. So, um, the also to, if you guys haven't listened to the, I interviewed, uh, uh, Don Murphy, uh, from the CRISP protocols. And I know that some of the people, some of the students I've heard, they're like, Oh man, I've heard so much about CRISP. And no, really Chris was legit. And, um, Don Murphy's legit. And so he kind of talks about how I had asked him about like, what is like the worst case scenario that she's like some bad stories that you've seen people that, you know, that you think you could have helped sooner because this whole thing is like, Hey, we should be as, as chiros and PTs and so on. Like people who have musculoskeletal education could be like the first line triage for things like this. Cause like we can coach her out of it. We can mitigate problems and she doesn't need to go on, um, uh, all these extreme measures to, to feel better. And so, but when I asked him about that, he's like, he's like, man, he's like, um, I'll see if I can summarize it. Remember, but imagine say Allie, she did call the ambulance. She went in there and they gave her some medication. She went home and rested for about 10 days, went to her MD or MD. He's like, you know what, you're rested some more and stop doing what you're doing, you know? And then she doesn't get better. She tries a little bit of spurt of say passive care or, uh, like extremely passive care, a little stretching, which might create neural tension. They trodled around her back. She did foam rolling. She didn't get better. And now she has to go to a specialist. The specialist, all these special tests, right? And they see the MR and they scare the shit out of her and so on. And so now she's like, also too, a lot of times they have to wait months and months and months and months for this. So now she's six months in a back pain. Now she becomes a chronic pain case. And so that was kind of like what he was saying. He's like, this is like, his goal was like, there's no reason we can't be primary, uh, triage people for these people and help them get over it sooner. Like I, I didn't want you to feel bad for two weeks. And I know it sounds horrible to be, you be on the ground for two days, but there's a natural occurring process. And right now you're doing just fine. You look normal, you know? But if you guys haven't heard that podcast, it's a useful one to go to. Um, it's probably back about three months now, four months now or 12 episodes. Now, um, Allie had some, she had some interesting experiences through this and I actually learned stuff through her back pain where she was walking around limping a little bit. And so she had, she had interactions with friends. Okay. You take this one and I'll, I'll pipe in later. Okay. Uh, I had, we have a lot of friends that with all love and kindness wanted to help. And, uh, I, the most surprising question to me was, Oh, I'm so sorry.

Did you go see the doctor? And I'm kind of looking at them blankly? Like, yeah, of course I did. And I said, you mean Seb? And they know you're, you're MD, you're primary. And in, in my mind, I'm like, why they're going to refer me to Seb. They're not going to be able to do anything. And in, in my experience and what I'm watching, you don't go to your primary care to fix your spine. You go when you have the flu, you go when you need a medication. Maybe you go in this instance to get like an anti-inflammatory, but you don't go to, uh, to have them work on your spine. So I was like, Oh no, I saw Seb. And they said, you didn't go to the doctor. And I'm like, no, I went to Seb who is a doctor. Uh, and he's the one who they would have referred me to. They said, Oh, did you get an image?

And you know, I guess depending on what your care style is, this could differ. But Seb was like, well, it looks like a disc. It's acts like a disc until we prove it's not a disc. Like we're going to treat it like a disc, you know? So, uh, it was just surprising to me that our close friends who know what you do were like, you didn't go see your general practitioner. Right. And so, and so this was like, probably like I took the approach. Actually, we've kind of talked, we both talked about this because, because, uh, somebody had asked you one time, like, cause your, your specialty is like improving someone's flexibility. Yes. I work with dancers. I mean, if you want to get bendy and stretchy, you come to me. Right. And so, but someone had told you like, Hey, there's this guy, he can really help you out with flexibility. And didn't you say like, huh? I don't think they really know what I do. Yeah. I was like, wait, why are they telling me this? Yeah. So I think the, for me, the learning experience with this is, is that I think I have done a poor job telling people what I do and allies probably can do a better job with this too. And maybe I don't want to like, I don't want to blame our friend. They mean the best. I don't want to blame our friends and our family for not doing this, but like they're like, if we're really passionate about like, if, if Ali's been passionate about improving flexibility and not having to sit on people to do it, you know, cause that's like the old school way. And if I'm passionate about like helping people through like really dramatically improve after a week or so or two weeks or whatever, and not having them have like long term care plans with no results and getting depressed and so on, we need to say something about it. And so I started saying something recently to, I told Ali at the time, I was like, look, next time we see Bob, I'm going to tell Bob, Bob, any damn thing you have that is not the flu, talk to me about it first.

Yeah. Well, but I have foot pain. I don't care. Talk to me about it. And I will be honest with you because we're friends. You're my boy. If I don't feel comfortable treating it and guiding you to it, I will tell you who to go to. Yeah. Well, I was telling, I was telling you that I have another friend who's a chiropractor and she was telling me that she had like, she'd seen somebody that had back pain that it ended up being like a twisted uterus. Like it was crazy. I said, how did you catch that? Like, she's like, I don't know. I just did, you know? And it's insane to me that you wouldn't start somewhere that with someone who has such a broad knowledge.

Right. And so, uh, again, just to make sure that everyone understands this is that we're like, we're not going to be bashing on like trainers, no different things than us. You know, different things than me. I, but I, I feel like our profession, at least PTs who really spent a lot of time in musculoskeletal as well. Like that's all we did. PTs, DCs, it's all we did. And if you've really upped your game realistically and you have the trust of your friends to, at least they can approach you about the problem and, and you can guide them, but also maybe there's a possibility too that here that they didn't trust me enough where they can say, Oh, normal back pain. That's okay. You can manage alley, a disc. That sounds horrible. Go to someone else. And so I think we, as the movement listeners should be better at clarifying what we do. Yeah, that makes sense. Okay. How are you going to tell people you're good at flexibility? I'm going to be like, here, let me show you. As you can tell, Allie's nicer than me, but we get along fine. Yeah, no, I mean, it's a, it's, it's true. It's a problem for me too. Uh, especially recently I've noticed people like giving me suggestions for stretches. I'm not like just a stretch coach, but I work with dancers and I'm like, I was a professional dancer. I think I know how to stretch that. And you know, it's, it's all well, well intended. Uh, but like you said, it's just kind of painting a picture of like, Oh, maybe, maybe I'm not actually sharing what I do. Yeah. Well, you know, um, I, so, uh, you know, Mark who, uh, he does the baseball gloves and stuff and bats and so on. So we have a friend, I have a friend, uh, Mark, we play baseball together. And so, um, I bought a helmet and, uh, in a, in a bag, a new bag, I haven't bought a new baseball bag in years. And so, uh, I text him and showed him and he's like, what the hell man? Like, you know, I do this stuff. And I'm like, yeah, but I didn't know you got rolling. You know, he's like, I can get anything you want, anything you want in baseball. Just tell me I will get you anything. Cause I bought batting gloves too. And he's like, why'd you get batting gloves? Yeah. Okay. Sorry. Okay. Anything, anything, uh, of baseball, uh, equipment or, or where of anything of uniform, I will ask you first now. Right. Because he was, he was good enough to tell me about it. Well, so I, this is kind of reminding me that I had a grandma that was very unhealthy and, uh, really liked to watch QBC and, uh, and, uh, whatever home shopping network there was, but she would constantly come to me and my mom and be like, Oh, I saw on the news that broccoli is healthy for you. And we're like, yeah, broccoli is healthy for you. And she's, it could, it could cure fill in the blank, but it's like, grandma, we've been telling you that for 10 plus years. It came from an outside source that wasn't within the family. And I, I do think that there is something there and you have to figure out how to speak to your circle of people to get them to trust you. Because my out, you know, my clients that trust me very, very well, they refer, they get great results. They get, they speak highly, but then my close family, I can't get them to come in for like general, general exercise, you know? So there's, there's these disconnects and I hear them kind of across the board. When you talk to people who work with clients in the health industry or nutrition or something like that. So there's, there's definitely, I think some work that we all could be doing in that area. Yeah. Well, I don't, I don't know what the actual communication should be, but I do feel that with, um, I think with anybody, it's like, if you're, if they're going to allow you to help them with something, it comes down to trust first. And so the, not that we're trying to make, uh, you know, like make enough money to get a boat off of our friends and family, but at the same time, I'm sure they're paying somebody to do work with them who they don't really even trust yet. Like they just barely met them. Why not pay you? And they're going to, they should trust you more anyways. And you actually care more about their outcome. Yeah. How's this not a win, win, win?

And I would get a boat. Yeah. Right. I just had a client that had, that text me and said, Oh, I saw this chiropractor that, you know, and I was like, yeah, I know. I suggested her like six months ago. And she goes, Oh no, I just Googled her. And I was like, Oh my gosh. So she ended up at the same person that I would have referred for in the area. Did you already send her there too? Yeah. I already like told her to go there. Um, but she had Googled her, felt trustworthy enough over Google. And it just so happened that that was the person that I would have recommended. Oh good. Yeah. But it was, it was funny. I was like, yeah, we could have saved ourselves a lot of pain on this one. The, uh, well just so everyone recognizes and can't let me caught that Allie refers to other chiropractors other than me.

I do. And it depends on the area too, but I have my, I wish I had someone for everywhere. I really do. Cause I get a lot of, uh, people over social media that ask for help, but I'm developing my circle of trust, especially in California. So it's nice. I really like when I can feel confident in telling someone where I would go. It's better than Yelp. Yeah. That's a whole new story. Um, so as we start to finish off this podcast, is there any last thing that you think, uh, uh, we, by the way, we didn't offend anybody yet, do we? I hope not. There was no offense intended, but if you're listening to Seb, you, you probably are used to a little bit. Yeah. A little offensiveness. I've heard other podcasts where they drop F bombs and they offend the hell out of people. I don't think I'm that bad. No, I think so. No, I think everything today was intended to help and hopefully no digs were taken. Yeah. So, uh, anything else you think that the young clinician needs to know about back pain in the, in your case that might help them navigate another type of person with the same problem? No, I don't think so. Okay. Um, so I think then just to recap on a couple of things is, is number one, um, make sure that you guys know, uh, what your skills are and what your intended timeline for outcome is. All right. As I mentioned earlier today, uh, or early in this, in this podcast, I, I, I expected a certain timeline for Allie. She was not complying with that timeline. It's not her fault. She was doing her homework. I was, uh, I was giving the wrong first aid for the timeline that she needed and I was afraid to change it because she's, she's who she is to me. Okay. Um, and, and we did, I did go around and talk to some podiatrists the other day. I don't like working with sprained ankles.

All right. Cause I'm not good at them, but I do feel very good about, uh, phantom, phantom plantar fasciitis. And so with that being said, if someone comes in with plantar fasciitis, I expect a near complete reduction within a couple of weeks, um, or at least really good success. I usually tell people about 30% within the first visit, within the first week, if you keep that 30% and go to 50, I'm happy. Anything above that is a bonus. But if it's less than that, I'm wondering, maybe I missed something. I refer him back to the podiatrist. So know which areas you're really good at and don't start venturing out and taking stabs at area without telling the person that you're actually, you feel a little uncomfortable in that, in that area and give them a short timeline for recovery. All right. Let them know that within two weeks or so, three weeks, whatever your timeline is, that if you don't find the change you're looking for, you're going to release them and send them somewhere who feels confident in the case. Um, also to don't be afraid of having second opinions. Um, we took a second opinion, uh, for, with Ben, it was very helpful. Uh, and she improved with leaps and bounds after that. I would stop having, stop having to put on her darn shoes. Yeah. Uh, and probably, uh, the last thing I guess is that since this is the last that you're going to hear of me this entire year is that you really should go get that $25 students only. If you do, if you, students or six months from your graduation date, all right, if you graduate in December and you're saying this is July or January, or sorry, July, I will say the answer is no.

There's only 50 of these spots. I guarantee it'll be the best clinical pearls you've ever seen in your life. And it's the cheapest thing you've ever done to, okay? This is my giving back to you guys. Um, I had to, I had to talk to the other guys that Philip Snell and Ben Ramos to, to allow this to happen at Pro Chiro. So don't disappoint me. Snatch all those things up and start leveling up. Uh, I think next year we can all do a really good job of improving, um, each other. And so I look forward to seeing you all on January 18th as well, a Saturday, five to seven Sandy's Huntington beach. It's right at the end of the pier. It's a bro sesh. There is not going to be any entrance fee.

I'm not booking the place out. It's basically, I'm going to go there. I'm going to sit down, order a beer and maybe some fish and chips, and I'm going to wait for people to come. If you guys want to come be part of the movement, there's going to be people just like you, students as well as doctors and people like me who are willing to talk and bullshit with you, okay? It's an opportunity to really meet other people around because, uh, if you heard my backstory, I really enjoyed having Cody here because we can bullshit eat pizza and learn and have beer and learn from each other. There's not always that opportunity everywhere. So I want you guys to reach out to the other parts of the movement community and just bro down. Allie, are you going to be there? I'm going to be there. Oh, good. I want to meet you guys. You're going to buy my drinks and fish and chips? Sugar mama. Sugar mama. Good. Okay. So, um, uh, that coupon code. Lastly, just one more time is RHP or sorry, restoring human move. Wait, restoring human movement. RHM podcast strength 25. I'll see you guys next time next year. Have a good new year's.

Thank you.