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Beating Lower Back Pain Starts With Your Mindset

Episode 123

68 Minutes – Jan 23, 2019

0:00 / 68:56

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Questions this episode answers

Is lower back pain all in your head?
No. The pain is a real sensation, and in a lot of people it can be reduced without surgery. Your mindset just decides whether you stick with the plan long enough to get there.
Why did my back pain come back after physical therapy?
Mine did because my rehab chased pain reduction, not performance. I built back extension strength, but I needed torso endurance and the ability to handle rotation. I felt better without actually getting better.
Is it normal for sciatica symptoms to change during recovery?
Yes, changing symptoms are often normal. If leg symptoms retreat out of the foot, calf and thigh toward the back, that's progress, even if the back feels worse for a while.
Do I need stem cells or new gadgets to fix back pain?
I don't think so. People have been recovering from back pain and sciatica for years without stem cells, vibrating guns or copper products. Moving and following a solid plan is what gets people better.
Am I too old to recover from back pain?
Blaming your pain on age is one of the fastest ways to become disabled. I had that exact thought at 35 and had to drop it. Focus on what you can control.

Why knowing the fix isn't enough

Millions of people deal with back pain and sciatica every year. Yet only about 28% seek medical attention of any type. Only around 3% ever start a formal spinal rehab program.

So what's the barrier? It usually isn't bad treatment, money or insurance. There is a lot of good, free information out there. People just don't act on it.

I see it with friends and family all the time. A friend brought his mom in twice. Did she do anything I suggested the first time? No. Once the sharp, acute pain fades, a lot of people will live with a dull ache for years.

The solution to your problem will present itself when you're ready to hear it. That's why getting your head right comes before the physical recovery.

Inertia and friction

Think about pushing a car. Getting it rolling is the hard part. That's inertia. Stop pushing and it rolls to a stop. That's friction.

Spouses, friends and clinicians can shove all day. But if the friction is still there, the person doesn't get going.

Friction looks like this:

  • "I'm getting old."
  • "I have disc degeneration."
  • "It runs in my family."
  • "I've tried everything and nothing works."
  • "I failed last time and don't want to look like a failure."

I don't care what created your problem. You have it. Own it, make a mental about-face, and figure out what you need to do. Nobody will care about your back more than you.

One more thing. The pain is not in your head. It's a real sensation, and in a lot of people it can be reduced without surgery.

What my first back injury taught me at 16

I hurt my back in high school, reaching for first base to beat out a ground ball. I lost half a season and a summer. Rehab took around eight months.

The first round was rest, then mostly passive care: adjustments, electrotherapy, deep tissue massage, foam rolling, stretching and a machine that measured back extension strength. My extension numbers went way up. I was cleared.

First game back, first swing, I went down to my knees. Four months gone.

I felt better, but I didn't get better. The plan chased pain, not performance. What I needed was torso endurance and the ability to tolerate rotation. Strength of the back muscles alone has little to do with back pain.

My second round was different. Active release, then about 45 minutes of work: squats, hip hinges, lat pulls, single-arm rows and presses, lunges, split squats, planks, carries and bridges. The torso got challenged in every direction. I went over 20 years without real back pain after that.

The body works as a unit. If you want to run, hike or play pickup games again, your rehab has to train the whole body, not just the spot that hurts.

Getting hurt again at 35

In 2017 I hurt my back again lifting. I was following Dan John's Easy Strength loosely, broke its rules, added too much weight and didn't warm up well. I was negligent.

The back ache was only a 2 out of 10. The next day I had odd sensations on both thighs and the tops of my feet, plus muscle twitches. Symptoms on both sides pointed to something central, not the piriformis or the IT band.

I froze. I stopped exercising, got quiet and got depressed. And I had the same thought I tell people to drop: maybe I'm getting too old for this. Blaming pain on something you can't control, like age, is one of the fastest ways to become disabled.

So I swallowed my pride and called Dr. Cody Dimak, the friend who once told me I knew 15% of what he knew about spines. He ran a full exam, ruled out the scary stuff and calmed my brain down.

The first week: tolerance, bracing and changing symptoms

Cody tested what my spine could tolerate. Mine were flexion, compression and shear. Knowing your tolerances tells you how much to modify your day so your body has a chance to heal. Mother Nature gets really frustrated at scab pickers.

Week one was end range loading, bird dogs, McGill modified curl ups, side bridges and split squats. On day three I found that bracing and a neutral pelvis cut my symptoms in seconds. That's your locus of control. What reduces your pain at a moment's notice?

My symptoms moved around and I freaked out. But when leg symptoms retreat toward the back, that's progress, even if the back feels worse.

By the end of the week I was 75% better. My body healed faster than my thoughts did. Even fully recovered people can stay afraid of squatting, running or flying. I needed a coach, a mentor and graded exposure to get past that.

Key takeaways

  • Most people don't stay stuck because of bad treatment; they stay stuck because of beliefs and barriers.
  • Feeling better is not the same as getting better, so train for what you actually want to do.
  • Torso endurance and tolerance to rotation matter more than raw back extension strength.
  • Find what reduces your pain in seconds, like bracing or a neutral pelvis, and use it.
  • Changing symptoms during recovery are often normal, and leg symptoms moving toward the back is progress.
  • Get help: I couldn't guide myself, and you don't have to do it alone either.

At a glance

Conditions and injuries
  • Flexion intolerant low back pain
  • Sciatica and nerve root irritation
  • Small lumbar disc herniation
  • Recurrent back injury in baseball
Anatomy involved
  • Lumbar spine and nerve roots
  • Spinal erector muscles
  • Torso and abdominal wall
  • Hips and glutes
Symptoms described
  • Ache near the sacrum
  • Tingling in thighs and tops of feet
  • Muscle twitches in the legs
  • Neurogenic hamstring tightness
  • Fear of sitting, flying and lifting
Treatments and exercises
  • Mindset work and goal setting
  • Spine tolerance testing and activity modification
  • Abdominal bracing and 360 breathing
  • Bird dogs, curl ups and side bridges
  • Whole-body strength and anti-rotation training
Episode Transcript

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

Why do people in pain not always seek advice? And why do you even less actually engage in a plan of attack that yields a very high success rate? What's the barrier? This book is going to help you explore that and actually help you explore your personal blockade that's shielding you from your solution that could just be only an arm's reach away. 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 guys, it's Dr. Sebastian Gonzales, again your host with the Restoring Human Movement podcast.

Thanks for joining the movement, movement. If this is your first time, welcome, welcome, glad to have you. You actually came into an episode which is a very super special episode because it's unlike any other one so far. And as you see by the titling, it is I Will Be Back Pain Audible Sneak Peek. So it's the audio version of the book that I've been mentioning over the past couple weeks that I wrote specifically designed to help people to get through back pain. And it's unlike any other back pain book that I've ever read or hopefully that's ever been out there. I've never found one like this before because a lot of books are based upon what to do when you have back problems.

But in this one, there's literally no exercises. There's no stretches. There's none of that. So you might be wondering, why the heck would someone want it, you know? The thing is, it focuses on the one thing that I think proceeds, precedes all of those other things. Before you can actually accept the solution to your problem, you have to be ready to accept it, right? What is the thing? The solution to your problem will present itself when you're ready to hear it. So I think the thing that we need to get to as healthcare providers or even as humans is that when you have someone who has a problem, rather than just force something onto them that is a big solution, it might be the perfect solution, but maybe they're not ready for it.

So this book, the entire thing focuses on how to get yourself mentally back into a winning mental mindset before actually the physical recovery even happens. Because I think that if you don't have that winning mental mindset, you're not going to really stick or adhere to or have success with the physical recovery process, no matter how good it is. So if you're like me, you've had loved ones with back pain, and a lot of them really don't do the effort that you need to. And I know that as a clinician, I have a lot of friends and family who ask me for advice on multiple different types of conditions.

And honestly, they don't do it, you know. It's funny, like I have a good friend who he's brought his mom in a couple times, and he's like, hey, can you look at my mom's shoulder via ultrasound and maybe give her some recommendations? And I'm like, first off, on the other end, like I don't know if he knows that I have to document and do a write-up after all this stuff. It's not just like take a peek and see because nothing's really off the record. But I told him a second time, I was like, look, did your mom do anything that I suggested last time? And he said no. And I said, let's not waste your time by bringing her in.

Let's not waste her time, and let's not waste my time. So perhaps then with something like that, we need a better inception point. I just think it's interesting how a lot of people say they feel really shitty and they want to get better. But beyond that, like nothing really tends to happen once they get out of that minor acute pain. And like they're willing to live with that dull ache for a very long time because it's not as bad as it was anyways. But I personally found that any time you give free advice, treatment, rehab to friends and family, it's just a big waste of everybody's time. And they tend not to accept nor implement the advice given.

And I think of this a couple ways with this. And this is the whole reason for the book here is that there's two forces that we need to overcome. And if you've taken a physics class, you're going to know what I'm talking about with this. Hopefully, everyone else who hasn't taken one is familiar, at least. So there's inertia and friction. And they're both extremely strong. And consider just pushing a rock, right? You can really push a rock. Actually, let's say a car. So you're pushing a car. You push, push, push. It's hard to get it started, so you've broken through that initial sticking point of inertia.

And after that, once you stop pushing, it stops. So why does it stop? Well, it stops because there's friction. There's friction with the tires against the ground. So you really need to address both. So we as healthcare providers or as the spouses, husbands, wives, friends of the people with the problem, we can push as much inertia as we want to. We can overcome inertia as many times as we want to. But as long as that friction is there, they're not going to get going. They're not going to get better throughout this entire process. So I appreciate when everybody does the shove. Like I do the same thing.

I've done it a lot more often in the past where I'll do the shove. I'll push the inertia through. But I get really frustrated. They get really frustrated when it rolls to a stop very quickly. This book is designed to reduce the friction. And the friction can be many things. It could be the fact that they feel like they deserve their pain. Maybe they feel like there's some false belief systems in there. Like they feel like they're old. They're getting older. They have disc degeneration. Or maybe they feel like it's inherited in the family. Or maybe they feel like they've tried everything and nothing works.

So they're reluctant to try again. Maybe they feel like they failed last time. And they don't want to look like a failure. So there's a lot of different friction points. So throughout this book, I have lots of exercises where they should write down their sticking points. And hopefully we're going to reduce friction. They need to goal set. And they need to take responsibility. I do believe wholeheartedly that the back pain epidemic that we have is not because of poor treatment. Or that people don't have the money to do it. Or insurance won't cover or whatever. Because realistically, there's a lot available to people.

There's a lot of free stuff on the internet. I mean, I should know. I got like 250 pages of free shit on my website. But a lot of times people won't even read the articles or go through the videos. And there's friction points there. So I believe that the reason why we have this back pain epidemic is mainly because the people suffering with back pain, number one, they might not have anyone helping them push through the inertia. And that's where loved ones like you come into the picture is that you help them push. But maybe also, too, they don't have the force to overcome friction. And that's based upon themselves.

Or maybe they don't have both. Maybe they don't have a support group. And maybe they don't know what to do. Or maybe they have false belief systems. Maybe they have inertia, friction, or both. Okay? It could be a lot of them. So I believe that people with back pain, including myself, they need to have a winning mental attitude about recovery. And after that, we're going to see more success stories as this friction starts to reduce. I think too often we as back pain sufferers have a very self-defeated type of mindset or even a victim mindset. And I personally don't care what created someone's problem.

Like it doesn't, I don't want anyone pointing fingers. I don't care. The fact is that you have the problem, own up to it, and have a mental about face. And just figure out what you got to do to get rid of it. And just own up and realize that no one's going to help you through this if you don't help yourself. No one's going to care about it more than you should care about it, too. So in this podcast, I'm going to give you a sneak peek of the audio version of the book. I read it myself, by the way. So I hope it's as high quality as these podcasts. But consider, too. I was having to go through a little bit of a, I had to follow the flow of the book.

But I did try to ad-lib when needed to keep it entertaining because books aren't always entertaining, in my opinion. I dig when people read their own books because they know where they can tangent off. So I'll give you a sneak peek of the audio version today. It's called I Will Beat Back Pain, Setting a Winning Mental Mindset or Setting a Winning Mindset for Recovery. So if you like what you hear, buy for your loved ones with back pain and help them push through that inertia and that friction. So, again, your push of buying them a book is part of the inertia. The book will start to decrease the friction.

It will lubricate the process. And after that, we're going to have much, much more success cases, I believe. So if you're digging what you hear, get the book on Amazon today. Don't wait. Just get it, okay? I'm going to be hammering this thing over the next month because I do believe it will help a lot of people. So get the book on Amazon. It's available in print, audio, and Kindle there. So there's literally no excuse to not read it, okay? I know people drive a lot more than me, and maybe I exercise more than most people, but I listen to a shit ton of audio books a week and podcasts. So even if you're driving a little bit in your car, if someone commutes to work, buy them the audio version.

They're just going to have to get a little notepad too. But the book, I think, is going to be the best bet so they can keep it on their shelf. So the next time they have some type of problem, they can go through that whole thing as well. So when you buy it on Amazon, please, please, please review it because part of the Amazon algorithm is that when you get someone who purchases through there, that it will ask you to do a review, and it'll post it as a verified buyer. So even if you send a review to me, you're like, oh, it's great, I love the book, it helped my mom, helped my wife, and so on, it won't help the book rank, okay?

And the reason why I want the book to rank again is obviously I do get some money from it. I don't get a ton, but if you want to get people into care, if you want them to buy the Stuart McGill Back Mechanic book, if you want them to buy the McKenzie book, if you want them to do something, you've got to get them through the inertia first. You need to make sure that they get there. So I would love this book to rank first, and if you can help me do that, down, okay? So before we get into the actual audio version, we're going to do this personal corner, just like always, so you can get to know me a little bit more, and I hope you enjoy the content.

All right, so if you guys have been following along, you're going to remember that I love America's best holiday, the 4th of July. And I don't know if you know, so if you went back, back in the archives, you're going to realize that it's not just the 4th of July, it's the 4th of July. You've got to get excited about it, right? So every year, usually around January time now, so now we're closer to the next 4th of July before you were to the last one. So usually after the 4th of July, the next day is actually the most depressing time of the year for the entire, I'd say, Earth. I'm going to venture to say Earth.

So you kind of got to whisper it, like you can't get excited about the next one yet because you're so far away from it. So usually right after you get past the new year, you can start saying it. So when someone says July, you've got to say July, you've got to get them excited. So this is when I start sending out emails. Last year, I actually sent out, it was, gosh, what was it? I think it was actually January 4th. I sent out an email six months prior to the party, to the date, to America's birthday. And I started getting people hyped about, hey, six months from today, this is going to happen. Then it went five months, then four months, then three months, then two months, then one month.

So, and people thought I was nuts for it. But realistically, you know how like you invite people to your like Halloween party or your birthday party and they're like, you know, I don't know. I got some, I might have other things going on. So when people say that to me, they're like, I don't know. I don't know what's going to be happening. I'm like, you got nothing happening. That's what you got. You got nothing because I'm the first person who asked you. So you better come. So that's why I try to get a good turnout for the 4th of July party. Now, before I actually get into that actual, the book, just know you can't pick this thing up on my website or on Amazon.

So just search, I will beat back pain and you will find it. It's on ebook, it's on print, and it's on audio, as you can tell by this podcast. Now, before we get into the boring disclaimer, I feel the responsibility to get you hooked and get your interest about this book. Are you stagnant about your back pain or your sciatic recovery? Have you ever fully, wholeheartedly attempted to recover and regain your past life prior to back pain or sciatica? Are you tired of feeling run down by your back pain or leg pain? Don't worry, you're not alone. This happens to a lot of people. In fact, millions of active and non-active people suffer yearly from back pain and sciatica, yet only 28% actually go seek medical attention of any type.

And only 3% ever engage formally in a spinal rehabilitation program. So what's the deal? Why do people in pain not always seek advice? And why do you even less actually engage in a plan of attack that yields a very high success rate? What's the barrier? This book is going to help you explore that and actually help you explore your personal blockade that's shielding you from your solution that could just be only an arm's reach away. Do you feel lost or unsure about the recovery process which is stopping you from starting in the first place? Are you hesitant or fearful that you won't actually succeed or even worse, suffer another failed attempt at your recovery?

If your back or leg pain was correctable by resting, stretching, foam rolling, and massaging, it would have fixed it within a couple weeks. By the way, back pain and sciatica oftentimes go hand in hand. If these methods helped you regain your prior life prior to injury, great, amazing. This book is not for you. If not, you may need to consider a brand new plan of attack. If you failed at getting your life back to what it was prior to a bout of back pain or sciatica in the past, it's not your fault. There's lots of information out there and it can be really confusing. Many times that information overload will keep you from success.

It's okay. If you've been concerned in the past that you haven't been able to succeed in improving your back pain or sciatica, I want you to put all those fears to rest. You can do this. You just need to have the right person walk you through the process of recovery. Gurus on Instagram and Facebook and other social media will want you to think you need the newest type of technology and treatments to get better, like stem cell, vibrating guns, and copper products. I'm here to tell you that they're wrong. People have been recovering from back pain and sciatica for years without these. How do you think animals in the wild actually recover from their back pain and sciatica?

Because they have it too. Do they gather all their nuts they squirreled away and finance the stem cells that will go three times a year? No. They just started moving and they got better. Mother nature has this way of repairing us. If you ever thought there's a faster, more efficient way of recovering from back pain or sciatica than months of unfruitful stretching or rest, you're right. I know you have aspirations of running your dream destination race again or hiking on the weekend or surfing or what we call slapping the lip. In case you haven't seen that YouTube video, you probably should. Weightlifting or just maybe plain old moving from the bed to the car on your way to the dinner reservation with your significant other without wondering if you're going to trigger your back pain in the process of actually getting to dinner.

I'm here to assist you in that process, but guess what? It starts with a mental about face. It starts with a mental process first. What would you do tomorrow if your back pain was gone? I mean, completely gone. Like, gone as in the way that it was actually never even there and you don't have any fear of actually injuring it anymore. What would you do without having even a thought in your mind about having a quote-unquote bad back? Write it down. Keep your eye on the prize as you devour this book. Enjoy. Introduction. Hey, I'm Dr. Sebastian Zollis and I'm a back pain survivor. Now, you're listening to the audio version of the written book, obviously, and you're going to get some bonuses through this.

Number one is I'm not going to do this whole thing verbatim. I'm going to do it as the flow is intended. I wrote this whole book. It's supposed to be in my voice and that's how it's going to sound coming out of this. So feel more natural, conversational. Also, too, you'll get some of the audio that I had taken throughout the course of time as I recovered from this back injury. So you're going to get all those bonuses because the audio is not going to go into that book, obviously, and those are snippets that we couldn't put in the actual text. Now, I'd have to admit that saying that I'm a back pain survivor feels really good.

It feels good to say that. And sadly, not a lot of people can really say the same. And here's some rough statistical encounters if you peruse the internet about back pain. First, 80% of people have experienced back pain at some point in their lives. 50% of people can say they've actually had back pain sometime over the last year. And about 33% of people have said that they've had back pain over the last three months. So why is back pain so prevalent? Well, that is the billion-dollar question. And we have many clues, yet very few solid answers. Why is there so many mysteries surrounding back pain?

Simple. It's because humans are complex beings. Not everybody's the same. And everyone's going to respond a little bit differently. You and I have many differences. One of them is body type, and also we have gender differences, possibly, maybe. We don't know yet. Upbringing, past and current jobs, hobbies, life experiences, what beliefs we created from those life experiences, support systems, financial status, educational background, and so much more. The list can go on and on. But in my opinion, the number one most forgotten step of recovering successfully from back pain is getting your head right first.

You need to be mentally ready for recovery before you actually go through a formal back rehab program. As the saying goes, the solution to your problem will present itself when you're ready to hear it. How many times have you heard people say, I wish I would have known that years ago? To be honest, they probably did hear it years ago. They heard that piece of advice years ago. They heard that suggestion a long time ago, but they weren't in the right frame of mind to do anything with the information. Evidence-based rehab programs surrounding back pain or what you might call treatment plans actually are working pretty good now.

We know some things that work, but again, the water's muddy because people are different. As a rehab expert, I know what will work in a lot of cases, yet back pain continues to be a nationwide, maybe worldwide epidemic. Why? For all the reasons I covered above. My insurance won't pay for it. I have three kids and I don't have time. I tried everything and nothing worked. I can't stop doing the things that create my back pain. Everyone has different reasons why they still have back pain or sciatica. Just like everyone has their own reasons for really not eating healthy. We all kind of roughly know what we're supposed to be doing.

Let's just talk about nutrition. We should probably be eating vegetables and not eating a ton of red meat, right? And all diets kind of change a little bit, but for the most part, we kind of get it. But there's something blocking us from actually doing it. Back pain is really no different. I also, too, had a mental block in my recovery process from back pain. Mine was pride. I knew what I probably should have been doing, but my emotions and fears got in the way of following my own instructions. Eventually, I had to swallow my pride, appear to not know anything about back pain to a colleague, and so came to his direction over mine.

The guidance that I had for myself clearly wasn't producing the results that I wanted. I, too, was too close to the problem to logically guide myself. I've been depressed. I've been confused, overwhelmed, and frustrated about my back pain, as well as you'll learn through this book. Getting my head in the right mental state for recovery was the missing link in my own recovery. Just to be clear, the pain is not actually in your head. It's a real sensation that can successfully be reduced without surgery in a lot of people. I want to make sure I'm clear with that because a lot of people will be told the pain's in their head.

The pain's not in your head. It's a real thing. We often jump at the fear of having surgery at the very first hint of back pain, but it rarely needs to go that far. I was just like you. I was frozen by fear of making it worse, and also I needed some assistance, some guidance. My personal goals within my rehab or my recovery was to survive a plane flight to Europe and also play recreational baseball again. My clinical and personal experiences shaped this book. I'm confident this book will assist you in finding your correct mindset for recovery. I look at my experiences defeating back pain as a real-life education and what it's like from a patient's point of view.

I've heard many people disagree with their doctor's recommendations and say he or she never listened to their concerns. I feel this book will provide some insight to you as I blend my clinical knowledge about back pain with concerns I've had as a patient. Allow me to begin by sharing my clinical perspective. Over the course of my clinical career, I've worked with hard-working weekend warriors for over nine years, since 2008, actually. I've worked with them in decreasing symptoms of back pain and nerve pain and issues into the glutes and leg and calf and foot, or what you guys might consider as sciatica.

I've seen some really hard cases over the years that have ended up requiring surgeries or injections, and other ones who have felt better, way better, over 50% improvement in just a matter of a couple weeks. In my early years, I would consider myself a quote-unquote soft tissue doc and had the belief that soft tissue care was literally the only thing that these people needed to get better. I had some failed cases that I just chalked up to being quote-unquote tough cases. I was great with hips, knees, ankles, and shoulders, but I was subpar at low back cases. I thought many of the acute low back cases were just quote-unquote hard cases that needed a little bit more time before I could actually get to what I was good at with them.

The problem was that I actually didn't know what I didn't know. In reality, these acute cases weren't that hard. I was just missing critical pieces of the puzzle. My treatment plan was incomplete, yet my practice was thriving. My patients were happy, but there were some people who I just couldn't help. There were cases that ate me up inside, actually. In fact, there's many nights where I've had restless sleep thinking about what I could have done better. How could I have helped these people who were clearly suffering? During this point in my life, I was fortunate enough to have a good friend and fellow chiropractor, Dr. Cody Dimak, to drink beer and eat pizza with.

We'd bounce ideas off each other and discuss what we could have done better in certain cases. We shared stories of success and failures. As you can guess, many of my failed cases were spine cases. And one day, after way too many beers, I asked him, Abra. So, how much do you think that I know, that you know, about back cases? By the way, the Abra, that's something we did. Now, if you've met Cody before, sometimes he's very short with his answers, so he tells me very directly, 15%. He thinks I only know 15% of what he knows with spine cases. Now, he's a bullshitter at times, and I don't know if he was bullshitting me or not, but this sparked my interest to learn more.

Long story short, he was right. Nobody likes to admit when they don't know what they're doing. I'm no exception. I did well with some cases, but I would continually strike out on low back people. Some doctors are satisfied with people coming in for weekly pain management. I'm not. I expect better results. I expect people to have huge reduction to pain within a few weeks. Then we would continue to reverse adapt that process of how they got in pain in the first place. I never seemed to have this type of success with low back patients. I expected more than having patients lean on my hands as their weekly quote-unquote adjustment or tissue work.

In other types of cases, I had amazing results in getting people out of pain fast and then coaching them into reintroducing what they wanted as their long-term goals. Playing baseball, surfing, running, these are just a few of their long-term goals. Getting out of pain wasn't the only goal with my patients, and it wasn't their long-term goal either. Within this book, you'll learn part of the other 85% I learned specifically in regards to low back pain management. You'll learn the myths and guidelines of how to return to life and your favorite activity after experiencing a quote-unquote bad back.

I can now say with confidence that I feel really good at assisting people with lower back pain. I feel good at it, but I'm getting better every week. I love learning because the more I know, the more I don't know as well. In fact, recovery from back pain starts with a mental about-face. I've been there. I've had back pain take me out of weightlifting, running, throwing, hitting a baseball. I know what it's like to be depressed. I know what it's like to shy away from hikes, not want to go on long plane flights because of fear of sitting, and to mentally be preoccupied by my thoughts about my back.

Knowing that a lot of other people have been through it before me, who have gotten better, who've been able to recover, was one of the most important aspects of my recovery, which is what I'll be sharing in this book. An advanced version of this book is available with a program that I start people on typically with flexion intolerant low back pain. If you don't know what flexion intolerant low back pain is, it's basically that type of back pain where you can't bend forward to touch your toes, to tie your shoes, to get out of bed, to get out of a car. These are all ones that are usually flexion intolerant.

You can't bend forward or rounding, but backwards is pretty comfortable, or way more comfortable. The advanced version is going to include detailed videos that I walk you through the process step by step. You can find the advanced course at p2sportscare.com slash courses hyphen list. You can also find it on the tab on top under courses. As for this book, consider it a step one in your journey to recovery. Who will benefit from this book? Weak in oars with a passion to work hard and play hard. The busy moms who keep up with their kids. The dads who relive their glory days watching their sons play high school football.

The 30-year-old marathoner who's pushing for Boston. Best part about getting your head right for recovery is that everybody has the same building blocks. Asking yourself what you believe to be true about your back pain and comparing it to what research says. I'll provide all the common myths and facts about back pain in this book. By the way, if someone else bought you this book, thank them. They are absolute angels and they care about your mental and physical well-being. They care. They can see you suffering, so they want you to get better. This book is just a stepping stone to get better. If you bought this book, you care.

You care about how your body works. You care about how to make yourself age well and feel well. You care about what you put in your body. That's cool. I dig it. Perfect. You're going to get a ton from this book. More than you ever would out of 24 visits to a local rehab center that are going to cost you your co-pay times 24. Now all you need to do is actually tell your friends and family that you're starting to do this. Tell them the exercises and the answers that you create with those exercises further in this book. Share because a lot of people need that support team. I'm no exception. Don't be turned off by the technical aspects of this book, please.

Please. The reason why most people continue to have back pain or discomfort or sciatica is because they decide to not take a vested interest in their own body. They don't really care how it works. Some people who have come into my clinic have been very open about not wanting to learn a darn thing about how they move, why they hurt, and so on. Which is cool. I'm down with that. But just to be clear, this book is actually not for them. Those people are a different breed. They want to be told what to do, how often to do it, how long, and so on. That's fine. But if you're reading this book, you are someone who cares about how your body works.

Read this book a couple times over and fill out the exercises. They might change. And the next time you have an issue with the back or the hip or the leg, you're going to know exactly what's going on and where you were mentally here. Keep this book. Put it on your shelf. I want you to actually use this throughout your entire life. Exercise. What do you believe to be true about your back or leg pain? Write it down. What do you believe to be the missing piece of your treatment puzzle? Write it down. Do you feel like you've done everything in your power to recover? Yes or no? Write it down. What's your largest barrier for your success currently?

Write it down. In what ways can you improve your chances of successfully adding time into your day to resolve your problem? Write it down. Ask yourself, am I honestly ready to get better? If the answer is no, write down why. This is really important. Chapter 1. My History of Back Pain One thing you should know about me from the get-go is that I grew up playing sports. I played soccer as a kid. I played a lot of baseball. I actually played baseball probably for almost as early as I can remember. I never remember having any major ailments. I didn't pitch much as a kid because I played infield and outfield.

I was active as a kid overall. I skateboarded a lot, snowboarded, played tag, and even played that forbidden game. Now it's forbidden. Who knows why? Formerly known as Butts Up. I did a lot of stuff. I was very active. But it's kind of funny. When you listen to kids now, you hear a lot about injuries. You hear a lot more injuries. Yet, they're less active. But that's another topic for another day. My first injury came as a result of trauma. I hurt myself in high school playing baseball. Overall, I was a quicker runner and always hustled. I would run out every single ground ball. And honestly, I made it most of the time.

The second best feeling in baseball is beating out a ground ball for a single. The first is having an outfield assist. Ask any outfielder that. During one game in an attempt to beat out an infield ground ball, I hurt my back as my leg stretched out to reach first base. I hit the ball to the left side, right around shortstop third base, for those of you who don't play baseball, and I ran my ass off. I ran it out as hard as I could. Yet, when I was getting to the base, I was between steps and had to reach. I had to reach my leg forward, and I impacted the front of the base. As I impacted the front of the base, I felt a jolt come up from my leg into my back, and immediately it started hurting.

Afterwards, I took myself out of the game. This injury caused me to lose half of a season in an entire summer of baseball. I was 16 years old. In total, my rehab took around eight months, which is a really long time for a high schooler because a lot of them bounce back quickly. The first batch of care was about four months, and it came after that initial moment that I just mentioned. The second four months came after I became lame, again, after my very first game back from injury. My doctors did a great job ruling out major injuries such as stress fractures, disc herniations, and more. Yet, when they found me to be pretty normal, they suggested that I rest for a couple weeks.

After rest was unproductive, they suggested physical therapy, and at the time, I doubled up with some chiropractic adjustments and massage, as my mother requested. This first batch of care lasted about four months. They kept me out of baseball the entire time during rehab. During my first bout of rehab, I had seen a standard adjustment-focused chiropractor and mostly passive care physical therapist. The chiropractor did a lot of lower back, mid-back, and neck adjusting, as well as some electrotherapy. He had me doing a lot of deep tissue massages there at his office as well. I remember the massage therapist's name was Olga.

She would beat the shit out of me for about an hour. It was painful. Really painful at the time. The physical therapist I saw at the time had me doing a lot of foam rolling, a lot of stretching, and a few back-strengthening exercises that were directed to build up the strength of my spinal erector group. The exercise we primarily used to strengthen that was a machine. I forget what it was called, but it basically measured the amount of extension strength that I had. It was almost like I was sitting in a chair, leaning back against a pad that had a computer program measuring my strength every single effort.

This machine showed that my strength had greatly improved in extension-based movements of the spine, so I was released from care and cleared to play. I had no pain during the last few months of therapy, but also I hadn't played in months either. Funny, I now know that strength of the back muscles really have no relevance of back pain anyways. We're looking at endurance. And in the case of baseball, we should have been working on anti-rotational movements. Also, we spent minimal time working on glute and hip strength. I remember at the time, I was pretty excited about my improvements in my extension strength.

I'd done a lot of work, and it was a long time, but little did I know that actually that was not the metric or measurement that we actually needed to prevent injuries of the back in rotational sports such as baseball. My first game back, in my very first at-bat, in the very first swing, all of the progress I'd had in four months of rehab was lost. I went down to my knees, and I was actually out of the game again. During the course of my first bout of rehab, I had started to really feel better, as I mentioned before, but I didn't really get better, if that makes any sense. My rehab was centered around the goal of pain reduction, not performance, or even retraining my body to rotate again, or at least rotate in a pain-free way such as baseball swings and throwing.

A strong majority of rehab was stretching, ice, heat, foam rolling, and adding back strength. What I really needed was to build my torso endurance and train my body to tolerate the rotational forces encountered in swinging a baseball bat. Looking back, I remember my MRI and CT didn't show anything that was really that bad. I mean, there was a small herniation. It was around two to three millimeters. There was no nerve impingement. There was no fracture. And I guess this still begs the question, was the second injury actually the original one, but unrepaired? Or is it a brand new one? I tend to think it was actually the original one that was unrepaired.

And over the course of rehab, we actually didn't build the support systems needed to protect my spine against the strong rotational forces of a baseball swing. This was all over 20 years ago. So some of the emotions surrounding my first battle with back pain are a little bit fuzzy. I do remember a couple things though, like being very frustrated and really angry when I hurt myself again with the first swing of the bat. I remember thinking at that moment that I had just erased months and months of work and not really understanding why. I remember when it first started, how excited I was to really finally be able to sleep throughout the night without having any pain.

And that actually started when I started sleeping on the ground next to my bed. In fact, I slept on the ground for almost a month before we found a mattress that actually worked for me. At the time, I was at the end of my sophomore year, about 16 years old. And I was asked to play at a varsity level, which I couldn't do, obviously. So I didn't get to play varsity until the next year. That was really frustrating to me since one of my goals was to play varsity in my second year. I was on my way to obtaining my goals and I got a smackdown from an injury. Back pain is frustrating. I know that. And I've dealt with a lot of baseball players in my clinical practice and remember how during high school, every day, every game, every practice is important.

And I remember feeling that. It's just a lot of pressure to be able to get back into the game or at least back into practice. Because if you don't, then you're going to lose your position. My second round of treatment landed me in an office where I was subjected to a lot more focal tissue work and building the supportive system around the spine, not just the ones that perform spinal extension as before. The soft tissue work, which was called active release, was simply amazing. And it was one of the big, major reasons why I was able to return, I think. But also, too, after the 15-minute active release session that I had, I stayed to lift, mostly with machines, but some free weights and some free movements, for about 45 minutes after.

And I remember driving back home, not being able to actually shift my car. I had an old 84 BMW that I had to ship the clutch. And I remember just hovering over the clutch. My leg would literally shake. I had nothing left in the tank. Not in my gas tank, but in my personal tank. People at the office work me hard. I remember it was Victor. Victor would always tell me, one more rep. I'd do the rep, and he said, one more. And I did the rep, and he said, one more. And I said, Victor, come on. Like, you've got to give me a little bit of, you've got to give me the truth here, man. So they would work me hard.

Yes, we did extension-based training, but we also did a lot of other movements, too. Ones that targeted the hips and the shoulders, which are really important in regards to return to baseball or to sport, squats, hip hinges, lat pulls, single-arm dumbbell rows, single-arm presses, lunges, and split squats. We did all those. And notice that we're actually challenging the torso in all directions with those movements. Single-arm dumbbell rows and presses, they're actually anti-rotational movements. We also did planks, carries, and bridges. Dr. Ron Higuera was amazing. His staff was amazing, and they helped me out a ton.

And they've actually influenced a lot of how my current practice works today. I even worked there for Dr. Higuera for about seven years after the injury. And he was a big influence about why I started to get into the field that I did today. It's the only reason you guys are really hearing this book is because he had an influence to push me into this sports injury realm. My experiences at his clinic allowed me to see there was other ways to treat and rehab that I actually would have never guessed because based upon my experiences at the time, I'd really only experienced the conventional, the stereotypical way of doing it.

And I really wouldn't say his style was unconventional. It's probably more proper to say that it was actually in common at the time. As of 1998, I'd probably venture to say that about 20% of physical therapy and chiropractic clinics or rehab clinics operated in the more progressive fashion. The other 80% probably practiced more like the first type I experienced, which might be great for some people, but it certainly didn't work for me. As of 2018 or now, the industry hasn't really changed a lot. It changed a little. My estimation now would be probably closer to 30% of the new way, 70% of the old way or the stereotypical way.

I guess we could say now it's probably progressive versus traditional. Funny though, the public a lot of times when they think the stereotype of physical therapy or chiropractor, they think the traditional, which I guess makes sense. But I hope we're starting to blend that into more progressive now. A lot of rehab centers, or at least the basic traditional stereotypical ones, tend to focus on the region of pain and forget to include supportive care for the areas of the body that will assist the person in getting back to their goal. When I swing a baseball bat, I do it with my entire being. I do it with all of my legs, my hips, my back, my spine, my shoulders, my hands, all of it.

So realistically, training a movement of rotation is more important than just first dating the spine. Remember in the beginning of the book, I said that some clinicians are really satisfied with being your weekly pain management session. Well, this is kind of what I'm talking about. And just treating the region of pain will a lot of times just get you to pain management. Athletic people and weakened words or people who expect more out of their bodies need to build support for active human movement because they're going to do a lot more with their body in free time than just Netflix and chill. If you're reading this book, you're probably pretty much like me.

You really want to get up early every morning to go for a weekday run if it feels good, if you can do it. I know that you might have spine pain right now, but if you could get out of spine pain, you probably want to go for that weekday run. You probably want to go for hikes on the weekend. You probably want to play recreational pickup games again, baseball, softball, basketball, whatever, and enjoy that beer and pizza after. People like us require more than Netflix and chill rehab. If you want hands-on direction like I used, you need to find a rehab specialist who's progressive, someone who works with your entire body, not just the location of pain.

The body works as a unit. You cannot separate it. You must rehab the entire unit in order to retrain movement to overcome stubborn injuries like mine and probably like yours. After receiving treatment on that second bout and performing rehab and strength training for my back, I actually didn't have any pain for over a level of 0.5 out of 10, 10 being the worst pain you've ever felt. I didn't have a 0.5 or more for over 20 years. That's a long time, right? I mean, I had it when I was 16 and I didn't have another incident of back pain until I was about 35. When I say I had a 0.5 to level discomfort at some point in time, I really mean the small issues or tightness that goes along with every person being active.

Any rotational athlete's going to get a little bit of back tightness from swinging a ton one day. It never really held me from playing. It never really held me from any activity that I wanted. It was great because I remember how frustrating it was back in high school to not be able to play and do the stuff that you love. Fast forward to the ripe age of 35, and this time I documented my early days of the injury to be able to share it in this way with you. In late summer of 2017, I injured my back for the second time in my life, but this time it was in a very different way than the first. The first time was a little bit more traumatic.

This time, 20 years later, I was obviously 20 years older, and I did it with something like weightlifting. I can't say the specific exercise that created my symptoms because my clinical experience tells me there was probably a lot more than just a single thing. What you'll be reading today is my account of the injury, how I assessed it, how it happened, and how I rehabbed it to overcome it. One of the hardest things of getting back pain at 35 now that I know is different than 16 was that I have to mentally wrap my head around the idea that it is not the end of my youth. It is not that I'm getting too old for this because patients tell me all the time that maybe I'm getting too old for this, maybe getting old just kind of sucks, and this is the way it is.

I always tell them that way of thinking is extremely disabling, extremely disabling, and there is no faster way than to be disabled than to blame your body's pain on something you can't control like age. Funny though, the hardest thing for me to shake during the first week of having back pain again was these exact same thoughts, thinking that it's age-related. Remember, getting your head into the recovery mode comes first before physical recovery can start. Why do our minds get directed straight to the concept of mortality? I have no idea. The day of the injury. I have a nice little 500 square foot gym at my facility.

Olympic barbells, plates, power racks, kettlebells, basically everything you need. I've been following Dan John's Easy Strength program loosely for the past four weeks. I can say loosely because one of the rules is don't even struggle. I struggled a bit over the last week as I added too much weight for the protocol and not warming up efficiently. Don't get me wrong, Dan John's program is amazing. I was just negligent. It was so damn easy and so effective at getting me stronger over the month that my confidence was up and I broke the cardinal rules. Don't struggle. Don't ever miss a rep. Walk away feeling fresh every time.

These are rules I have for my clients at my clinic too, but apparently I consider myself an exception. My workout had been five rounds of kettlebell swings, 63 pounds, 12 reps. Back squats, 205 pounds, 2 reps. Suitcase carry, 63 pounds, 1 minute. Deadlifts, 215 pounds, 2 reps. Front lever holds, 2 reps. By the way, if some of you are kettlebell lifters, you might wonder why the heck I said pounds is because I believe in saying the pounds and that's just one thing about me. I don't like referencing things as kilos. So you'll hear me say that over and over again. One of my subtle nuances. Now you know me better.

I started to feel a small ache in the right side of my lower back around the sacrum for the remainder of the day, but it wasn't bad. On a scale of 1 to 10, it would have been as low as a 2. So small that if a client came to me with this same scale of pain, I'd be excited for them because it could be so much worse. Could I have shook it off and lifted through it? Yes, but working in the sports medicine world, I felt the need to be responsible. Do as I do. The next day, my back felt better, but I was experiencing some increased sensations on the sides of my thighs, sides of my legs, and tops of my feet.

It wasn't painful. It was just different and transient. The feeling of tightness in my legs was different from post-lifting tightness. Within the book, I've included an image to get you a better picture of pain distributions based upon nerve roots. I wasn't pulling enough weight frequent enough to experience tightness anyways. Lastly, I felt transient muscle flutters, not cramps, but twitches. Kind of like when your eye twitches. It was really weird. Taking a step into my clinical shoes, I know all these symptoms are neurological in origin. My spine and nerves were compromised, regardless of severity of the back pain.

The symptoms were bilateral too, which means I had a central origin. We can't really say there's any piriformis syndrome or IT band that's really going on because all the stuff was very much on both sides and a little bit symmetrical. A small disc injury, a tumor, stenosis, or something odd like MS, maybe were the origins. I know I'm fortunate there wasn't much there, but I also know that it can get worse really fast if I didn't address it soon. Another way people ignore their body's natural alarm system, which is pain, is how they end up with arthritis, spinal stenosis, pinched nerves, and back surgeries that are hard to recover from.

If I wanted to have a healthy spine for the remainder of my life, I needed to form a game plan now. I responded to my injury, just like a lot of you. I felt something was different and I froze in my tracks. I cut off exercising, decreased my house chores, and even became very depressed. I noticed that when I met friends for a drink, they would ask me if everything is okay. I wasn't talking much or making jokes. I wasn't my normal self. Social situations made me realize about the mental state of an injury. People have a choice to be antisocial, distant, or angry. I asked one of them during their first week of care at my office how he kept such a positive attitude.

His response was, I guess it's not in my personality to be a downer. I know myself and I decided at that point to reach out for help. I needed to get my head right if I was going to get better from this injury, if I was going to beat this injury. That week, I mustered up. I called a good friend in sports chiropractic, who also happened to be the guy who I was drinking and having pizza with, who told me that I only knew 15% of what he did about working with spines. Dr. Cody Dimak was the guy. Was he bullshitting me? I don't know. Thanks, Cody, though. You helped me out a lot. And I learned a lot from this experience and working with you.

I told him I wanted an exam and a game plan of how to recover. I even offered to pay him, which he declined. But most of all, I needed someone to confirm I was going to be okay. I needed to hear that it wasn't going to be the end of my physical activity, baseball, running, and sprinting. I realized now how many movements in life require your back to feel normal. He agreed and took me through his complete exam head to toe. He ruled in and out major concerns that I had, such as multiple sclerosis, cancers, and other oddball diagnosis that can present as simple flexion intolerant low back pain as well.

This whole process and exam calmed my brain so I could focus on the plan of attack. That I'll go over in the coming sections. Remember, I said the mental aspect is the number one part of the recovery process. He also took me through stress testing the spine and investigated what types of verbal or tactile cueing supported my spine and made me feel better within a few seconds. Stress testing, or what I call tolerance testing, is seeing how much of certain movements your spine can take at that point in time. An easy way of thinking of this is being able to bend backwards but not forward, or turning left but not right.

There are many more to investigate, but without muddying the water too much, just know that finding your tolerance sheds light on how much modification of activity you need to do throughout the day so Mother Nature has a chance to heal up the spine. I've come to find that modifications of certain activities for a period of time is one of the missing keys in recovering from back pain, but the nature gets really frustrated at scab pickers. My intolerances were flexion, compression, and shear. I also had some aspects of nerve pressure, which is why my legs had the creepy crawly sensations. The whole examination took about an hour and a half, and at the end we were able to come up with a plan of attack for my recovery.

I'd love to say that everyone has the power to recover from back pain on their own, but as you can see, I couldn't either. I needed someone to tell me that I was going in the right direction, that everything was going to be okay, and what exercises to do after I've grown out of the exercises that I've done for the first week. How can you find somebody? Ask if they practice the McGill Method. Professor Stuart McGill is a PhD from University of Waterloo, Canada, who became the leader of research-based information on resolution of flexion intolerant low back pain. I'd choose a back specialist who's familiar with his work and actually gets excited that you are as well.

I always get excited when a patient calls and is familiar with Dr. Stuart McGill's work, or at the very least, that he's actually in existence. The week after the injury. I'm including this section for you to better understand what I went through the first week of my recovery path. These are summaries of my day-to-day notes from the first week. Everything from my emotions to the way my body felt, all the strange sensations, and even some of my thoughts of the mechanics of the injury. It may be a little hodgepodge, but it definitely helped me better understand that time in my life. And my hope is that it will help you better understand and get through yours as well.

Rehab day one. Location, my facility. After decreasing my mental turmoil and getting the game plan together, I was off to the races. My first day of rehab was exciting to me because I had an action plan, a new mental mindset, and a goal in mind. I wanted to play baseball again. Just like many of you, I hope to be 50% better or more within a day, but that wasn't the case. I had a slight flare-up in the form of some increased tightness into my legs, and also increase of creepy-crawly sensations. The freakiest part, I think, was the odd muscle flickers, the odd sensations in the leg like the creepy-crawlies.

And it was kind of feeling like I didn't have control of my own body. The back tightness really wasn't fun either, but as all these things started to come into play, I started to think a little bit about those oddball conditions again, even though we had already ruled them out in the comprehensive examination. Problems like multiple sclerosis or MS, restless leg syndrome, and Parkinson's were all in my head. But my training reminded me of one fact that I'd read that had helped ease my worries. In Dr. Stuart McGill's book, Low Back Disorders, he wrote that of all of the severe back pain cases that he'd been involved with over the years, only 2% had these types of oddball conditions.

The rest were people who were just seemingly in pain, just like me, from mechanical overloading, poor posture, or other crappy habits. Taking a breath, I decided to follow the plan of attack. I'm not going to lie, I would have gone back to Cody's office a few more times that week to shut my brain off and simply do the work. I work with patients for a living as well, and I recall how often times they call or email the next day with a few more questions after their first exam. I've always wondered why they keep wanting more information about exercises and suggestions, We all need a little bit more reassurance that we can do things that were recommended safely.

The rehab for my back during the first week was the following. It changed week to week like any other skill building system. End range loading, bird dogs, McGill modified curl ups, side bridges, diagonal sits on the left side, split squats. In a different course, I created videos on this. Again, that's a comprehensive course. It has over 50 different videos that most people need as they start to rehab into a program. I'd be lying if I said you couldn't find some of these references on my website because I like to pad them into other types of articles as video references. But I've laid them out in an exact order and fashion for those of you who'd like to purchase them at our courses link.

If you do decide to search for them, don't just jump into them right away. Remember, these are ones that help me and people have different phases and different types of back pain. I can't stress that enough. Rehab, day two, location, the beach. Now on day two, I went to the beach to perform my rehab in the sand with a nice view. Shit, if I was going to have to do this stuff, I might as well do it in a place that most people would want to spend their dream vacation in. I was just fortunate enough to do my rehab in it. Amazing. Lucky for me, it was wintertime and the sand at the beach was cold enough to where it can kind of numb your feet and if you're out of the sun, it's actually kind of chilly.

The temperature was still a perfect 64 degrees, so I got nothing to complain about really. As I got down to the sand, I did my rehab and about 20 minutes later, I took a walk. As I walked, I contemplated life with and without back pain. If it remained, would I be the same person? I started to ask myself all these odd questions, you know? Would I be the same person? Would I be happy as that new person? Could I ever play baseball again? I actually recorded some of these thoughts down in an audio format because I thought, you know what, this is a very unique situation. I might as well record it so I can document it and share it with people and just kind of have it as part of a podcast one day.

But if you've purchased the audio version, like you probably did if you're hearing me right now, but I'm going to include it right here. You know, so as I was paddling, this is October 7th again. You know, I was just, I was thinking about this the last couple days and just kind of reflecting on, you know, what it is to have an injury and, you know, how it makes you question your identity as, you know, like what do you, you know, what's your passion like? What's your purpose, what's your, um, like why are you around? And, you know, I'm, I've always been athletic. I'm in shape. What if this injury was something that kind of took me out of that?

You know, like what if that wasn't part of my identity anymore? So, you know, I, I think about it. Like what if, you know, what if I gained, you know, 20, 30 pounds or I wasn't able to play baseball anymore because I haven't really hit that point yet. And I did have that injury in high school and I remember it was really tough. Um, but, you know, as an adult, I don't, you know, it's, it's not a, uh, there's no definitive stopping point for like playing baseball or doing the things that I like. And, um, unless you want it to stop or you, you, you know, you call it quits. So I don't know. I was just kind of thinking that, you know, do I, why do I like playing?

You know, is it being outside? Is it like the camaraderie? Is it that I'm good at it? Is it that, you know, I, I like the excitement? So I've done this drill with my patients a few times. Um, there's one guy in particular that he likes to run and running just wasn't working on his knee for a period of time. And, you know, he eventually did go back and run some, um, but is the reason why he wanted to run is, is, uh, what we had to get the bottom of. And he, he liked, um, he liked being outside. He liked the excitement, you know? So all that we have to take into account. And I have to take that into account when I'm figuring out what my purpose or identity is.

And I know as I make these podcasts and blogs and stuff, and these will be around a lot longer than I am, uh, if it gets, as long as the internet's still around. So, you know, helping people should be part of my purpose and not just athletics. Although I'm, you practice what I preach. So I don't know, just, just thinking, looking outside the box. Now I'm telling you guys all these symptoms that I had and the way they changed, because I want you to feel that when you start to eventually improve, that a change in symptoms is not always necessarily bad. Sometimes it's really good. And actually, if you're experiencing leg pain or sciatica, as the pain starts to come up out of the foot, out of the calf, out of the thigh, and eventually resides into the back.

If that pain was actually worse than the actual leg pain was, actually that's still progress. So I want you to know that a lot of these changing symptoms, although people like me, freak out. You might freak out as they start to change, but I want you to know that they're normal through the recovery process. I started to question my need for recreational sports like baseball, weightlifting, and running, period. Why did I need them? Were they actually that important to me? Did they actually define who I was as a person, or could I be the same person without those same activities, dreams, sports, etc.?

What was my purpose in life? It's really funny what an injury will do to a person. And if you've been able-bodied, athletic throughout your entire life like I have, and that's taken away from you, like it was for me for a period of time, who are you? That's part of your identity. Like you might tell someone, like, you know, what do you, tell me about yourself. Well, I'm a baseball player. I play baseball. I like to run. You know, these are things that honestly a lot of times people define themselves as. What would you do? Who would you be, actually? This day was actually a very pivotal point in my life because I realized at that time I needed a little bit more purpose, a little bit more definitive purpose.

What did I want and need to accomplish to feel fulfilled if it wasn't a physical goal? I don't recall deciding that day what I actually thought my life's goal was, but as I'm finding, as I've already gone through back pain now twice, and I've recovered from it, that I'm starting to meet more and more people that need the same guidance that I needed, probably both times. I included these thoughts for you today because I now understand that I was blessed with a personal, tough, but enlightening situation, which gave me a unique opportunity to help others through this education and through sharing my personal experience.

I've had back pain at multiple ages now. I've dealt with it a few different ways. I've had different types of physical therapy, chiropractic. I've had different types of imaging, and I've responded in different ways. And now I have the platform to have a formal education that I can actually relay some of the thinking back to you guys so I can now write it in a book just like this. So here it is. Exercise. What would you do with your life if your back actually never recovered? Write it down. How would you describe yourself if you couldn't use any physical attributes or athletic endeavors? Write it down.

What's your purpose in life? Write it down. Does your back pain interfere in any way with your passion in life? Write it down. Rehab day three. Location. The beach and my facility. I went down to the beach again before work because I found in the past that if I get caught up into work and working with people and watching them move, then I really don't take time for myself. I decided to do my block of stiffness work that was already in my program, as you saw earlier in a different section, and I decided to do it before the day actually started to get going. I decided to take some time for myself.

When I started to get into some split squats, I started to feel some tightness that developed in my upper region of my hamstrings. Looking back, this is probably neurogenic hamstring tightness and not really an issue with hamstrings at all. This is a common symptom with light pressure of a nerve root from the back. Later that day, I was demonstrating abdominal bracing as well as alligator breathing, which, by the way, can be found in the video course, to a couple patients. Funny, my hamstring tightness actually decreased. This made sense because in my exam with Cody Dimak, increasing intra-abdominal pressure in my belly area, aka the bike tire, by the way, more on this to come, decreased my back pain significantly.

I found my locus of control. Finding a way to reduce your pain in a moment's notice is a huge step in recovery, and I found it. I had an epiphany. What's your epiphany, by the way? What decreases your pain at a moment's notice? Many times it can take people days and sometimes weeks for them to look at their symptoms in a logical way and apply some of the supportive strategies that was found in the detailed examination. Bracing was one of mine. Another one was a neutral pelvis position. This is how we get around things like sitting and driving. I went to bed that night feeling much, much, much more comfortable than any other day, but there was also a slight ache near the backside of my buttocks region on the right side.

You might think of that as the piriformis muscle, but honestly, it wasn't. That's also referred pain, but my neurological symptoms have become more progressively centralized and much less sporadic, which is what we want. Again, let me reiterate, this is not a sign of piriformis syndrome. It's just more referred symptoms from a nerve root, kind of like the hamstring tightness. We'll get more onto this later. I purchased the core 360 belt and it finally came in the mail, so I was really excited to try it since it really worked well in my examination with Cody Dimak to improve my breathing into a 360 degree fashion or what we would call belly breathing.

By the way, breathing can come in a later chapter. It will be in this book, but all the subtle nuances will not be in it. I manually cue 360 breathing with a lot of my patients at work, but I was excited to use the belt and see how it worked for me without having to put my hands on my hips all the time. I won't go too much into the belt because it wasn't a long-term solution. It's merely a tool to assist in learning to keep abdominal pressure through breathing cycles. I've been asked a lot about this belt by patients. It has four beads on the inside part that gives your belly some direct pressure on four points so you can breathe directionally into them.

You can do the same thing, though, by pushing your fingers into the sides and front part of your belly, both sides at the same time. However, if you want more information on this belt, visit core360belt.com. I won't be spending any more time on it, though, because it's a very small part of my overall solution. After day four, I found that I was way better and moving a ton better, too. After day four, I found that I was much better overall when I was moving. I was less fixated on the transient leg symptoms. I can also tell I was overall just getting better, but it was mentally hard to shake the mental fixation on some of the small symptoms.

Constant mental fixation on my symptoms really weighed on my mind, and in fact, at the end of the day, I felt just damn exhausted. Looking back, this was all normal as my symptoms were changing for the better. My body was starting to remodel and my brain would just continue to wander. I now realized that the physical and mental aspects of recovering from an injury actually happen in different rates. My body had been repairing according to plan, but my thoughts were just shit. They were running wild. Over my years of clinical experience, I've seen the physical aspects of my patient's back and leg pain get 100% better, but they still have a very real fear of certain activities like squatting heavy, running, sitting, flying on a plane.

I get it now. As I reflect on my recovery process, I see that I was afraid of doing many things, and it took a change of mental outlook, a coach, and a mentor, and graded exposure to these certain activities to overcome these fears. You might have to do the same thing as you recover. By the way, in case anyone wonders, when I started to lift weights more, I actually had to hire a strength coach. Even though I know how to teach these things, I needed someone to tell me it was okay and help me through the process. So I'm living the process that I'm talking about with you as well. Recapping my story.

Recapping my first week. At the end of the first week of constant rehab, I wrote the following to remember my mindset and how far I would come. Allow this to assist you through your first week of recovery. Now I'm flashing into what I wrote down. I feel 75% better. All that's remaining are small tightness in my right side of my lower back with rounding. I feel it when I don't use my hips and legs to go down to feed my bunny. Yes, I do have a bunny. He actually needs eye drops placed in his eye twice a day because he's a tear duct, which really isn't working, so he gets his corneal ulcer. To get to him, I have to lean far into his cage or at least bait him with some food.

Grab him, pin him down, and put some drops into his eye. With most people about two weeks out of a flexion intolerant back injury, I would tell them at least to discontinue some activities like this until we can safely restore some flexion. And I now understand that sometimes the need to take care of other life forms like bunnies, like Ozzie, like kids, like dogs, kind of trumps one's own needs. I would crawl into the cage if I needed to. I feel mentally much better knowing that transient leg twitching and the loss of sensation into the legs and feet are diminishing. It's not completely gone, but it was occupying my thoughts way more than the standard localized low back pain.

Overall, I mentally feel much better. Throughout this first week, I missed rehab only on one occasion. I got up early. I modified activities as I was directed. I even wasn't able to do some of the fun stuff that I wanted to do. The end result was 75% improvement, which is amazing. For the most part, I was becoming sane again, which was the biggest improvement I needed. I began reading a book at the end of this week called The Gift of Injury by Dr. Stuart McGill and Brian Carroll. It was a gift given to me at the right time in my life. It's the story of Brian's journey through a devastating, devastating back injury from power lifting and how he was able to successfully recover to win competitions again.

My takeaway was the raw, unedited truth about the psychology of an injury in an athlete. You question your existence. Brian actually revealed this horrific scene sitting in a car, debating if he can continue living with the amount of pain he was in or not. His injury was obviously much, much, much worse than mine, but I can empathize. He recovered from his horrific back injury and leg pain in a similar fashion as I. He decided one day that he needed help and he was willing to do anything to overcome the injury. His recovery, much like mine, took a lot of dedication and know-how, but for the most part, we decided we wanted to get better and we got better.

He was able to squat over a thousand pounds again. Amazing, right? His recovery is a true testament of how resilient and adaptable the body really is. Your body is so damn resilient, it too will adapt to a program if you start doing the right things. Your body is also really damn resilient. It too will adapt to a program if you start doing the right things. Now, I find that I'm about 75% better, which is really awesome, and it's easier to dismiss rehab on a daily basis and also avoid things like lifting because I just feel really good. It's funny, too. I've noticed some odd soreness in the right side of my oblique and flanks, and I believe this to be from training the muscles to tolerate the normalized breathing that I've been working on.

Reading a book like The Gift of Injury really assisted me in seeing that there was light at the end of the tunnel, and this is exactly why I'm writing this thing for you. I want you guys to see that other people have been there before you and actually that you can come out on the other side just as we have. Don't reinvent the wheel and don't give up. You can recover to a normal, healthy life and active lifestyle as well just as we did. Cool. So I think that will take you through at least a good snippet that what you're going to need to figure out if you like that book or not for your husband, for your wife, for your brother, sister, grandma, whoever has back pain and is just not doing a damn thing about it, get them that book, okay?

It's not that much. So go on Amazon, I'll supply a link in the show notes as well, as well as a link through your podcast player. So it'll take you straight through there. It's on print, it's on audio, it's on ebook. There's no excuse, okay? I'm going to say it over and over again because I don't know how many times I've spoken to people about, I have videos up, I have a ton of videos up, and they're like, well, maybe I've had a video just of you showing it to me. I'm like, cool, I could do that. And then someone says, you know what? I like those videos, but what would remind me more is flashcards or post-it notes.

I'm like, well, I'm not going to do all this stuff, guys. But in the book, I literally did. There's no other way to do it other than doing a video format. So do it. Buy it for your friends and family, and I will see you guys next week. If you like this podcast, give it a thumbs up on iTunes or Android. And gosh, I forget my exit because I get so amped up. So leave people better than how you found them. And always, if you're dating, date an Eagle Scout. Badass. Later.