Lower Back Pain Questions: Massage, Stretching, Beds and Braces

Clinicians, before we start, I want to draw your attention to the premium version of the podcast that we released back in January. This is where we do case presentations. We do what worked, what didn't work with specific types of scenarios, as well as orthopedic testing and so on. So this is all the stuff that you have been asking for. Many of you have been emailing me and asking, when can we do more case presentations? When can we get a little bit more specific into this and so on? So this podcast is for you. So please take advantage of it. It releases every Monday. It's 15 minutes. It's very, very detailed and stuff that you can actually use or at least consider using when you go back in the clinic on Monday. So this is something you can always cancel if you need to, but I don't think you're going to want to. And everybody in there so far, I think, has liked it. Nobody's complained yet. So I'll see you guys in the real podcast right here, right now. 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, this is Sebastian, your host for the Restoring Human Movement podcast. Thanks for joining the movement movement. This is your first time, Michelle. You missed a lot. We release once every two weeks at this point. It's about a 30 to 45 minute podcast format where it's intended to help you guys figure out what care is best for you with various different types of problems. Musculoskeletal, mainly in origin, we're going to cover low back today. And we have on Dawne Costantino. What's up? Who, her headphones died or went in the washing machine with her pants or jacket. So we're on a laptop mic.

Remember, it's free podcast. So we're going to do a little bit of back and forth on some common questions that we get from people when they're trying to resolve their back pain. And I mean, these are all valid questions. So if it sounds like we're kind of joking about it, it's because we're trying to make it fun. You guys, if you have lower back pain or hip pain or any associated symptoms with that type of thing, and you're struggling to find an answer, we'd love to help you. So at any point, if you want to reach out to us, you certainly can. Our contact is in the description or just email us info at p2sportscare.com. But we'll go over some of these. We do have other podcasts that we covered other questions and there is more coming on this same topic as well. So just subscribe to the podcast and you'll see them all come through. Dawne Costantino, you have the list there.

Do you want to start? Sure. I love this first question, actually. Should I go get a massage? Well, do massages feel good for you? I'm the patient, by the way. All right. No, I'm, oh, I'm the dark today, right now. Do they feel good to you? Yeah, but it feels like it's only like for a couple of days, it helps. Okay. So yeah, it sounds like then it feels good, but it doesn't really stick. Does that sound right? Yeah, it sounds about right. Okay. For a long time now. How long have you had your back pain? A couple years. Okay. Um, does, this will probably go a little bit too far, but, uh, does it hurt to sneeze?

Uh, it used to, not anymore. Okay. So mainly I bring that up because with, at least for me, if you still have pain with sneezing, bearing down, um, coughing, uh, first out or first hour in the morning is a little bit stiff and painful. Like you're having trouble walking up, right? I wouldn't personally do a massage. Uh, I don't think it'll hurt you, but I don't think it's really worth the time and money. Uh, I think later on it might be more helpful when you just kind of have this stiffness and you don't really have any ability to round forward or bend backwards again like that. And you've had it maybe for 10 years. Like that's a little bit more of a time where I would at least personally spend a little bit more money on massage versus some other type of intervention. Does that answer your question?

I think so. So you don't think I need, you don't think it would be anything that's like a good addition to what we're already doing. Um, well, uh, oh, and they changed the situation. Oh, we're doing stuff. Oh yeah. We're working together. You're the doc. Okay. Okay. Uh, well, is what we're doing working? I think so. Then I wouldn't add anything. Uh, more is not always better. More is more. So, uh, I don't need you to, but if you feel like you want to get a little, you know, TLC and, you know, get stretched out a little bit and you don't have that problem, coughing, sneezing, bearing down first hour of the morning or so, then, then yeah, you can do that. Um, but remember if you start to add more stuff, it might muddy the water a little bit. So, um, by the way, it's important to know we do offer some deep tissue work here. So we do suggest it at some point in some circumstances to people, but in this scenario, maybe not.

Yep. I think that's a great answer. I think a lot of times when people ask me this, especially when they see the sign in our office, um, for massage, they always ask, do you think I should get that? Um, and most of the time my answer is, you know, based off of what I've seen and what your exam is showing, what's going on with you. I'll either tell them whether I think it's going to hurt them or help them. Um, but I always make sure that they know that a massage most of the time isn't going to be, you go get a massage and that's the end. I'll be all you're good to go. You're a hundred percent better. It can sometimes be a nice addition, but, um, there are some circumstances where we notice that maybe pressing into the area or putting a lot of pressure or going and getting a massage can actually make it a little bit worse. So it's good to get it checked out before you actually go and get someone to work on it in that way.

Yeah. Well, I think it's an important part of, uh, um, you made an important note was that, uh, pressing on the area. Sometimes I know for some people they're like, well, it just, it feels like it needs to be pressed on. So I feel like I need to have a massage. So what do you mean the massage won't be helpful? Um, yeah, tenderness can happen with various different types of back pain. Definitely. Do you think there's any circumstances in low back pain where you would be like, Hmm, I definitely don't think a massage you should be getting at all. Like, have you ever had any circumstances like that? Um, I, I think it just muddies the water some, you know, like the, like the situation I mentioned when you were the client. Um, I think that's one that I really wouldn't want them to do too much with mainly because, um, the muscles might be in spasm to help you their protective mechanism. And so for some types of problems like low back disc herniations, um, uh, or even like a sciatica, um, maybe like a static massage, like we're nearly not moving too much is probably a little bit more benign than being stretched all around and, and so on. Cause there's movement based massages too. Uh, and sometimes the, the stretching part might actually make you feel worse in the, in the longterm, not to say you shouldn't do it later. Uh, but it's all comes down to what you find it in a good detailed exam. Uh, and I think we both know that like there's like everybody can benefit from soft tissue work at some point in their recovery journey.

Yeah, absolutely. I actually have a story. Um, I'm a patient who came in, it was her first visit and she, you know, I always ask people, what are you expecting out of today? What would you like to get out of this visit? Blah, blah, blah. And she says, I want it all. So we made sure to get for everything that she was expecting, right? Some rehab, some soft tissue, maybe an adjustment if it was necessary. Um, and I, at the time didn't know it was going to be a mistake, but did just a little bit of light tissue work on her before we even started doing anything. And then we had absolutely no pain to work with to figure out what was going to help her. Um, and listening to that, that sounds like that's a good thing. Great. You took my pain away with massage, but her pain came back. It's just in that first visit. Now we had nothing to work with because in our office, we use your pain as a way to guide us into what's going to be right for you guys to take home. So, um, there's a time and a place for it. I now wait and use massage at the end. If there's a little bit of something left that we need to see if we can get rid of, I'll leave it to the very end. Cause it can definitely, like you said, muddy the water. Yeah. So you didn't give them money, fast cars and diamond rings.

Sometimes I have no idea what you're talking about. What are you too young for that? That there's a rap song. Giving them everything. Oh, I want it all money, fast cars and diamond rings. I mean, she got it all, but then eventually the, you know, we got to the rehab part. It was, I was like, well, shoot. Yeah. I've had, I've had it the other way actually before we're like, though, like things are going okay. Uh, and then at the end they say, Hey, how about a little bit of this? And I said, okay. And so I lay him face down and do a little tissue work. And at the moment, like it's, you know, it's painful to do, you know, obviously sometimes, uh, and when they got up, whether it be the tissue work or they got up, they couldn't really walk. And so I've had it the other way. So it is dependent upon the circumstances. Yeah. It always depends. Yeah, it does. Okay. So, uh, I will be the patient this time. Doc, doc, I got this low back pain.

Do you think I should go see an ortho before seeing you? Before seeing me? Uh, yeah, I haven't seen you before. So, um, I don't think that that's necessary, to be honest. Um, because most of the time, um, what we can figure out here in the office without you having to see multiple people or spend a lot of money, we can figure it out. Um, just with one person in a visit, going through an exam, I can give you a better idea of what's going on after the exam. Um, if something shows that maybe you should go see an ortho or we need to dive a little bit deeper, then we will definitely have that conversation, but I don't think it's necessary to have you have that have you go see an ortho before coming in to see me. Yeah. But you know, my friends told me I need to go see a specialist. Um, so I don't think that I need any extra information from them in the, from the get go. Um, most of the time I need more information from a different specialist after we have found out more information, um, through your exam, are you coming to see me? But I don't think it's an absolutely necessary beforehand. Is there a tsunami over there? Like, I feel like I've heard this before. It's like a once a month, once a month test where like the tsunami sirens go and they're like, follow this route inland away from the water. Honestly, I live right here on a corner that's just so busy all the time that we always get a lot of sirens. Okay. Where are they going?

Who knows? There's a lot of more accidents. Like right here outside my house, I can see it out of my bedroom window. It's crazy. Oh, okay. Well, so, uh, you were saying that you don't need more information before they see you. You need, you might need more information after. Yeah. And I definitely have never had the conversation where I'm like, don't go, don't go see this person before you see me. Like, I don't think I've ever really had anybody have to do that. Um, if I said to them, it's your choice, right? So if you want to go and, um, you want to go and just get a second opinion and ask a couple people before you decide on what's the right route for you, then that's completely your choice. And okay. But, um, before coming into seeing you, you don't need to get imaging done. You don't need to go see a specialist or a spine ortho or whatever. Um, it's not necessary. Yeah. Sometimes I feel like the, I tell them similar, like I don't, I don't need the, I don't need the opinion at the moment, but, um, the thing that is like, I would prefer they come in to see us first or at least see me first because, uh, sometimes waiting for that opinion will take months. They're like, well, I couldn't get an appointment for two months. So then, uh, yeah, I'll see in two months. And in the meantime, this person is just suffering with this problem, which could be a very simple problem, but they, they want to go kind of a little bit higher to a surgeon to see what their opinion is in there. Their opinion might not even any, be any different than, oh, you know what? Things look good. Go ahead and do some rehab, which we would have been doing that two months ago if they didn't wait and stall a little bit. So, um, but we have sent people to orthos and neuros for opinions. And, uh, I think you might've froze. Are you still there? I can hear you. Okay. So, but yeah, so we've sent people for an opinion, but it's usually after the fact when you find certain things, right? Yeah. When we have too many people, I mean, I say this lightly, but when you have too many people on your team, it can get a little confusing sometimes too. Everybody has their own opinion on what's going on. Just stick to one person, see what they have to offer first. And if it's not working, go somewhere else. And if you're, you know, your, your case looks like you need some more help, then we promise we will send you to where you need to go. Yeah. A lot of experience in that at this point. I think the, uh, I think the, the question roots from the idea that there's is maybe there'll be some testing that needs to be done at the specialist versus the ones that you'll do that way that information will give you information or that information will give you guidance of what to do with me. And I don't know if people quite understand that there is a lot of physical exam tests that you can do combined with history that actually give us a really good idea of what's going on with you. And we can start helping you like immediately and telling you what to do, what you can do at home and so on. Um, and if things don't quite match up with the history and, uh, some of your movement findings and orthopedic exam findings, which we can do because we do all neuro neurological testing, orthopedic workups. We do all out here too. If things don't add up, then we're like, Hmm, I think we need to ask somebody else.

You should go see an ortho or a neuro. Yeah, definitely. 100%. So, uh, who is the, I forget who's the, Oh, you asked them. You're asking this. Okay. Um, okay. So doc, do you think I need to stretch my hip flexors for my low back pain? No. Why? I love that. No. Uh, is it working for you? Does it help you? I tried it yet. I actually just watched a video that said, uh, you know, that it might help. So what do you think? Yeah. I mean, I know it's hard. I say hard. No, but yeah, if it helps you go ahead. I don't, it doesn't matter to me. Um, if it hurts you, that's a different story. Um, my general rule with things that, by the way, I, I guess some people we do suggest they do this. Other people don't, but my general thought with whatever you're doing is if it makes you feel better now and later, meaning tomorrow or later in the day, go ahead and do it. But all the, but if you feel hip, hip flexor stretching helps you now, but not later then don't, but it has to accomplish both. It can't be like, yeah, uh, you mind if I drink a bottle of wine today? Well, why? Cause it makes my, makes my back feel better. Well, how do you feel tomorrow?

Well, I got a hangover. Okay. Well then no, you know, so it has to accomplish both goals and that will come with any type of stretching or activity that the person might want to do, including ice and all that kind of stuff. So why do you think a lot of people then I'm still patient. Why do you think a lot of people that I've heard with low back pain have gone in and seen people and they get their hip flexors, you know, worked on, they're told to stretch. Like, why do you think that that's such a common thing with low back pain? Oh, you're getting deep. Uh, I honestly think that the hip extension helps because it starts to drive a little low back extension. And we tend to find that a lot of people, a majority of people, not everybody have what we call inflection intolerant spines. Like they don't tolerate at the moment bending forward, which is rounding. And so the knees being to the chest, probably a lot of you have experienced laying on your back, bringing your knees to your chest. Oh, that doesn't feel good. Sitting doesn't feel good. Forward folds don't feel good.

Bending forward doesn't feel good. All these things don't feel good. And they're all rounded positions. So at this point, any type of extension position, even stretching your lats overhead might actually help you. So some type of extension pattern might generally help. It's not, not as specific as I would want to make it, but I think it provides enough relief where it gives them a break of time where it feels better, but it doesn't last because it's not extremely specific unless the hip is the actual primary source of their problem. In that case, this is a different conversation, but if it is stemming from the low back, which it might be, then we might have to drive the extension right at that segment versus below it. Makes sense.

I think that, I think you're absolutely correct. When I think people talk about their hips and low back pain, a lot of times people come to the conclusion of the psoas muscle because it does attach at the lumbar spine. And so it needs to be stretched or it needs to be worked on or pressed on or whatever. And I think that sometimes that stuff can help, but it always seems to just be very temporary. So how do we figure out how to get you to a point where you don't always need that passive treatment to make you feel better? Yeah. Well, you know, there's a lot of things that attach to the lumbar spine that no one thinks about stretching, like the transverse abdominus. They always want to strengthen that thing. And the obliques, does anyone want to stretch those things? I don't know.

I mean, they all, they all attach there, you know, they only want to stretch two things. It's the QL and the, in the hip flexor, it seems like. So this is true. I don't know. Food for thought. Um, let's move on. Uh, doc, doc, should I get a new bed? It hurts when I wake up in the morning. I love this question. Cause I get it from everyone. Really? Everyone wants to buy a new bed and we're in the wrong business bed or sleeping position or just things like that. Right. Um, and a lot of times it's because it's always that waking up in the morning. That is the most painful for people. Um, so they always, you know, blame the bed, which I mean, don't get me wrong. There's people who are like, when I sleep on the floor, I'm fine.

When I sleep in my bed and it just hurts. So maybe I need a new bed or maybe I just need to sleep on the floor. Um, I think that's a part of it. And I think that in our approach of treating people, that's where we talk about habit changes. You know, if, if we need to put you, you know, talk about sleeping somewhere different or sleeping a different way, um, we can absolutely do that. But once we address the underlying issue, a lot of times it doesn't really matter where you sleep. You end up feeling better. So let's not go spend money on a brand new bed yet. Let's just try some things first, unless you want to, you know, well, I think testing to be on the floor, maybe, I mean, I know that you can spend five grand on a new bed now and sleeping on the floor to see if your firmer mattress might help. I mean, at least at that point, if you were thinking about a new bed, you can test it a little bit because you might just think you might find out the floor sucks as much the bed does. So, um, uh, actually, I don't know if I told you, I had a waterbed growing up and I had back pain and that sucked. And so I slept on the ground and then we got rid of the waterbed, uh, the actual cushion of the bed and we filled it with a firm mattress and I felt much better.

So I was sleeping on the ground for like two months. I wonder if anybody has waterbeds anymore. Uh, I heard the other day, there's, there's someone that, uh, I was listening to the radio show and they were like, Oh, I have a waterbed. And so I'm like, I didn't know anyone has, I heard that you can't actually get insurance in your house because of them. Cause that's a flood issue. Yeah. Wow. How funny. Okay. Well, uh, doc, doc, what do you think, uh, what, uh, or do you think core exercise will help me with my back pain? I think the right kind of core exercise absolutely can. Well, I really like to do planks and it hurts sometimes, but other times it doesn't. I don't quite understand it. Okay. Well then maybe we can find, uh, or we can look at your movements, see the way that you're performing these planks. Maybe there's times you're doing it really well in times where you're just maybe, you know, trying to just get through the exercise cause you know, you need to do it. And those are the times that it hurts. So let's work on it. Let's see if we can find a variation, um, of this plank that works better for you and we can go from there. But, um, be honest with you, we do core exercise with almost every low back, uh, that we have. So it's not just, you know, doing situps and doing all this stuff or having a hour long routine of a bunch of different core exercises. It's a very good, efficient, few core exercises that can help. And it's different for everyone. So you don't, uh, I've actually seen some circuits that have like 20 different core exercises and it's like, and then the next day it's a different 20 ones. Uh, so how many do people really need? Good question. Um, a very solid two or three for, for variety. So you don't get bored.

Okay. Uh, and you can progress those probably. I know that they're, so then people probably wondering like, why are you holding back? Why don't you tell me which ones I really do need? Well, because it's just, it's so different for everyone. I can, I can take a wild guess and say, Hey, do a hard style plank or do McGill's curl up, whatever. Choose your, your one. It may work for some people and for other people, it may be the exacerbating movement. So, um, we don't know. We individualize it for everybody. You just have to come in and we got to see which one works for you. I've had a lot of people who find those, uh, those little 20, like 20 minute ab circuits on YouTube and they come in and they show me all the things they're doing. And it's like, we got to narrow this down to a, you know, a select few. Cause we don't know which one could be adding to this. So when you have 20 different things you're doing, um, it makes it a little bit harder. So let's narrow it down. Pick your favorite. Let's stick with those. And if you're not getting better, maybe we'll change them. Wait, hold up. You're saying that all of those core exercises might not be helpful. Yeah. Some may be exacerbating. Yes. Well, it did start when I started my core routine. I think I gained a couple pounds last year. So I started my core routine and all of a sudden my back pain started. Sounds like we have a, uh, triggering event and let's work on that. Let's start there then. Okay. So, uh, it's kind of not, you, you probably went the route I wouldn't have taken. You're, you're, you're nicer than me. I would just tell them all that. Just forget it for now.

I'm going to give you two, three things to do and that's it. You're allowing them to keep some of their exercises. They already like, and you're just narrowing the field. Yeah, absolutely. And that's worked. And I currently still have a patient where we're working on, are you willing to, you know, we want some time. Um, you stick to everything that you're doing for a while. Just add in a couple of things that I have for you and let's see how this goes. And we're at a point now where it's like, let's start tailoring back. I'm not somebody wants to take away what you love to do, but you're not getting better than the way that we want you to, or as quick as we want you to. So maybe we need to start taking away. Okay. Sounds good to me. Uh, you're up patient. Where are we here? Do you think cord will help? Um, I was told one leg is longer than the other. I don't want this.

I don't want this one. Uh, you know, the, the way I honestly usually answer this one is I wouldn't worry about it. Like I wouldn't like, it's not a big concern, you know, unless you came in with like you, you, like you had a broken, like femur, like when you were 15 and there's an actual discrepancy. I wouldn't worry too much about it. Usually I stand there and I kind of show them, I just hike one hip up and then my foot lifts off the ground, like by, you know, three, four inches. And I said, look, my leg is longer now too, you know? And so are we going to put a lift under this shoe or are we just going to relax the muscles up on top? So I'm like your, your leg length can be from various different things. Uh, I don't think it's a big part of this puzzle. I wouldn't worry about it too much. Um, I personally never fit anybody with a heel lift. Maybe there's a time place for it. Like I said earlier, people with actual, um, actual discrepancies of length, like, like of different bone lengths, not just a functional leg length discrepancy, such as I mentioned with me hiking my hip up. So the, the hiking might be a compensation for something that's already occurring. In that case, let's just settle that problem. And your foot length, your leg length will be generally normal. So that's the way I kind of address it. Cause we can talk for hours about that thing. Uh, and it would rob them of time of doing things that are actually productive for them.

What do you think? Different conversations I've had about leg length discrepancy. Um, and one of them is cause somebody has asked me, are you going to measure? You know, I told you that somebody's told me one of them is longer than the other. Do you notice it? Do you measure it? Whatever it may be. Right. My response to that is there's different techniques in chiropractic. That is not one of my techniques that I specialize in. So I'm going to leave that to the people who are better at it than I am, but the, um, let's just see if we can do other things where we're not necessarily focusing on this leg length discrepancy to see if you can get better. And the second thing too is, well, how long have you had pain for? Um, and you know, it'll, it'll vary the answer, but you haven't, if, if you've had a leg length discrepancy without the trauma that you're talking about, um, and it's been like this your whole life, you haven't been in pain your whole life. So why are we going to blame this for your normal anatomy? We need to look a little bit further. Does that make sense? Yeah. Well, there was a, um, uh, there was a, there was a study I wrote up on the website years ago. It was probably like, uh, five, six years ago or something like that. It's part of a blog post buried somewhere deep in the website. I don't even know what the link is at. Um, but it, it cited a study where they were talking about leg length discrepancies and if there's any relationship with, uh, back pain at all. Um, I want to say it said something like it was yes, but pretty, pretty much not. I don't remember the exact number of millimeters, but I remember thinking, damn, that's a lot. And it doesn't matter. You know, at some point there was a tipping point where it was like, damn, that's a lot. Um, and then it did matter, but they said for the most part, people are walking around with uneven leg lengths, um, all the time and they don't have any problem. So unless it hits the certain tipping point, then you might want to consider addressing something, uh, some intervention for that. Absolutely. And I don't think that an adjustment in a certain area, like the actual hip socket or the SI joint is going to change it, that amount that you're talking about, you know, like if that really truly is the issue here and you're just getting adjusted in those areas to see if we can even out the legs. Um, I don't know the research behind it, so I'm not going to claim that I do, but I just don't think that an adjustment can really change the leg length that much to the amount that you're talking about. Well, if it is trauma based or like say someone had a bone infection or like some other thing, like some odd thing that you can recall, yeah, I was in the hospital for a while. Like there's not, I don't know anything that's going to change that. That's there. Like, so you just have to work around it somehow. It doesn't mean you're going to have pain the rest of your life, but that, that, that is there.

It's probably not going to change. So, okay. Good one. Say that a lot. Yeah. Oh, you get the other hard one. Uh, do you think I'm out of alignment? Is that the reason for my back pain today? Uh, no, I don't. Um, the way that I answer, the way I go about answering a lot of these is never really truly like a yes or a no in the very beginning. Um, I like to try to find more out about the person before we say what's really truly wrong. But, um, when I think about this question, do you think I'm out of alignment? Most of the time people are asking, put it back in place, put me back in alignment and I'll feel better. Um, and I don't, I just don't think that that, at least the way that we work in the way that we've seen people get better. Um, it's not the, it's not an alignment issue or something that you need to be adjusted back into alignment. When we talk about alignment, people get really, um, what's the word? Just like overly focused on needing to be straight, needing to have perfect posture. They walk around like robots. They don't want to throw out their alignment. Um, you just adjusted me.

So now I'm going to be super careful and bubble wrap. Um, I just, I don't know. I just don't think that. And we never really talk about, I don't talk about alignment with any of my patients. Do you? I don't either. It's, it's kind of on the same grounds of the leg length thing. Like, you know, I don't, I try to redirect them away from it because it's not, again, it's not something we ever really check, uh, nor do I really think has a big relationship with what they're experiencing anyways. Like, uh, I'm sure we're all, uh, having some alignment issues that doesn't, but it doesn't mean we're in pain, you know? And, uh, so I kind of redirect them around it a little bit because they pay a lot of money for our time and I don't want to rob them of a good experience by discussing things that I don't think really important.

And I mean, they can, if they're going to, if they want to discuss that, they're probably better, uh, it's probably better money spent to discuss it with somebody who actually practices in that manner, which we don't. So, um, there's a gentleman that came in the other day. He's like, I was told I am, uh, here's my, uh, they call them listings. And so here's my listings. And, uh, he's like, what do you think about that? I'm like, uh, do you feel better when you, then when you walked in, he said, yeah, I said, great. I'm like, I am like, it's not, I don't think there's any such thing as perfect alignment nor posture. So I'm like, I don't have any problems with, you know, the, the, the way that people have practiced the way that they told you that, but you know, uh, that didn't seem to work for you. Let's see if this works for you. Let's just try a different style. Are you good with that?

You know? Yeah. Yeah. Uh, well, a lot of times too, though, if we go a different route, uh, cause we think alignment and you think, I don't know, people take their hands, they feel the spine, they feel one is out or moving a different direction that may actually just be your normal. But there's times too, where, I mean, someone walks in the office, we call it antalgia. You see them actually truly leaning to one side or the other, or when they squat or when they move, they favor one side compared to the other. And there's alignment in that way. That's more of a motor patterning issue that we need to work on and retraining the brain rather than pushing a bone back into place to fix that. I think that we need to kind of get away from that.

Yeah. Well, if, um, there, so there is true dislocations, we should probably note that like when your shoulder dislocates, that is truly out of socket. Um, it would hurt a lot and you can see that on an image pretty good too. Um, but then there's kind of like subcategories, which they call the, um, sub luxations, which is kind of like what people are talking about when they're talking about alignments. Um, so, uh, I forget what you just mentioned there. Oh, so for the, uh, the leaners, the, the crooked people, I remember seeing like books on showing that that was like, they're like, Oh, it's the hip flexor. That's why you're crooked. Um, it, I think antalgia or leaning to the side in that way, especially from low back pain is pretty classic of low back pain from a low back disc. And there's a true threat happening there. That's like disc is pissed. It's, it's your body is subconsciously trying to get away from something that's pissing it off. And, um, it's trying to deload itself automatically. It's basically like a spine limp. Like you step on attack, you limp, like it's okay to limp for a little bit, but then at some point you have to stop limping. So that alignment in that case is, uh, it might be helpful, you know, until it's not. And then, but, um, so I wouldn't really put anything back in place in that regard with that case, but there is things you can do for them to make them feel better. And then everything will just naturally feel better and they will stop being crooked.

Yeah, absolutely. And there's probably people listening to this where they've seen someone who has told them they're out of alignment, they get put back into alignment and they feel better. Um, if that's the constant recurring thing for you, then maybe we should go down a different route. Sometimes people go get an adjustment. They feel great for a really long time. There's power. It is a powerful tool. Um, but if you're noticing you're reliant upon that being put back into place, um, I would suggest a different route. Yeah. I remember this one kid came in, uh, he was a kid and he's like 25 years old. And so he had some neck pain. Right. And so he's like, I think, I think I got an alignment issue.

Can you, and I was like, I don't know. I think you got something else, you know, and I feel my honest opinion about it. And so, and so we tried some stuff I thought was gonna be helpful and then it wasn't. And so he's like, I think you really, I think if you adjust me right there in the mid, he's pointing at his mid back, I'm like, okay, let's do it. I did it. All of a sudden he can move his neck real good. And he's like, thanks. And he walks out and he's better. I'm like, well, crap, that was not first on my list, you know, but it helped him in that regard. Personally, I don't think you're putting anything back in place. I think you're just blasting the air with movement. He just needed movement in that region, which helped offload his main symptom generator, which is in his neck somewhere in this case.

But I think it's the movement that helps versus actually specificity of where you're putting it. Yeah. A lot of different ways you can find some movement through the spine. It doesn't always have to be with an adjustment, but if that's what you prefer, we can try it. Yep. Yep. I'm a back brace doc. What's that? But what about a back brace doc? Oh, you're still going. Okay. So this will be the last one of this podcast, by the way. How much time do you have in that location you're in, by the way? Do you have time for another one? Yeah. Okay. So then we'll do this last one here and then we'll break off into a second podcast on the ever growing list of questions. There's so many of them. By the way, you guys should subscribe to get to the next ones coming up. So do you need a back brace? You know, I used to think they weren't really that helpful. When I was in high school, I actually used a back brace when I was dealing with my back pain at 15. I don't know if it really helped, but it was kind of nice for like mental support. Allie had some back pain and she was really suffering having, getting to the point where walking was comfortable. And so we used some of the methods. So you said, Murray, Dr. Murray, Brennan Murray over in LA uses a back brace just for like a crutch to get them to a certain point. And so I said, look, we're having a lot of trouble here. Let's get you a back brace. And so she put it on and she was able to walk. We went on like hour walks and she felt minimal pain. And so it was kind of like a crutch to get her to that point of walking, which helps build other supports that she was not able to do because she was stuck on the floor for so long. So I don't usually have people do back braces, but if I saw someone in her scenario where normal things weren't working for us, then I would probably say, go ahead. I mean, worst case it's on Amazon. What is it? 10 bucks. I mean, probably a good amount of money spent if it works. Yeah. I, my answer to that is always, if it helps right now, I don't see anything wrong with it. As long as we're not reliant on it. If we're using this for long-term, we may be doing more harm than good. You should not be reliant on something passive. You should use it as a way to get to, like you said, walking something that can help build support so you don't have to use it forever. Yes. What about in lifting? What's your opinion in, in lifting? In, I say that one more time. In lifting. So like how about in back brace and that, how about in the, in the athletic realm?

I, I don't, I don't know. I haven't really, I haven't thought about it too much because I know people that do use it and they do okay with it. You know, they, they say they help it. They use it mainly with heavier lifts, like, you know, one, two rep maxes type of things like that. But it's funny to see that they put the back brace right on the area where their spine bends, you know? So I don't think the back brace is doing anything really productive for their movements, but they, I think they brace against it, which helps them with some other form of protection to do the lift and feel okay with it. But I remember this one guy, like we'd lift all the time. And so he'd wear a back brace and I just, we, you know, we, we always tell him he looks like a pooping dog. And then there's that one area that he keeps like dumping in, like in the, in the upper low back. And you know, I'm like, I don't know what that back brace are doing for you, but he was strong dude. Like he would lift like double what I would. So maybe I'm wrong. What do you think?

I mean, I haven't had this conversation very much with a lot of people to be honest, but if people are using it, I don't know if I'm in a place where I'm like, you need to not use it. Um, if they're, if it works for them and they're, they're reliant on it and heavy, heavy, heavy lifts, they take it off and they go to lift and they hurt themselves. And I'm the one who told them don't use it. Um, I may work around, I mean, I haven't been put in this situation yet, but if I was, I may work around teaching them how to use it as a form of feedback, like that little belt that we have in the office. Maybe if you have that belt, let's, let's make it even more efficient for you and teach them some of the pressure cues into it to help build their own nature's back brace along with it.

Nature's back brace. Is that a brand you're going to start? It's a thing already. Okay, cool. Um, so, uh, as we close, close this podcast out, uh, Dawne Costantino, do you have any last bits of information you want to give them before they have to wait two weeks for the next one? No, I think you always ask me this question, but there's something specific you're looking for me to say. No, I don't know. I'm, I just want, I want to give you the opportunity to close the show efficiently. Cause I know I'm going to sound like a robot cause I've done it so many darn times now. So maybe you have more flair. I don't know.

Thanks for being a part of the movement. Yeah. Thanks for being part of the movement, movement. Uh, but yeah. Yeah. If you goes guys do need some help, uh, you can certainly reach out to us. I know it sounds funny, but sometimes we have people fly out to see us. I know they go to the Mayo Clinic. Why not go see us? We're totally 70 here. It's nice. Uh, and I think we do a very good job. We're pretty thorough and, uh, we like to take time with people. So, um, yeah, that's, I think all I got. So subscribe to the podcast and we'll see you guys in a few weeks.