Degenerative disc disease does not have to mean chronic back pain

Before we start the show clinicians, I want to invite you to take advantage of the premium version of the podcast that we have specifically for you. It was created for you. This podcast you're going to hear today is lay public friendly and it's intended to be so all of the stuff that you wish we would have covered more of like, Hmm, I wonder what the underlying biomechanics are of that. What's the clinical reasoning process? What positive orthopedics tests are there? I wish they would do more case presentations on X, Y, and Z. We're covering all of that in the premium version. And we have been for the past two years. So take advantage of it. Scroll all the way down, click on it and listen to it. It releases every Monday for about 15 minutes. You're going to love it. See you guys in the show. Here we go.

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 with the restoring human movement podcast. Thanks for joining the movement movement. This is your first time in the show. Welcome. This is about, I think, 270 now. And we've had a lot of episodes that have covered various different topics, diagnosis, treatments, and controversial topics, even associated with things like lower back pain, hip pain, groin issues, shoulder ones, foot ones, knee ones, and so on.

We used to be a little bit more clinical and perspective onto the show. And it was more catered to a clinical audience. But recently we've kind of moved the show towards a lay public audience. So if there's any clinicians out there still listening and wondering why we're not going into technical stuff, that is why. Go to the premium show if you'd like. Now for all the listeners out there who want to learn a little bit more about what's going on with their lower back, especially in regarding to degenerative disc disease, then you should remain for the entire show. In this podcast, I'm going to help you dissect down what it means to have degenerative disc disease, also known as DDD, and why some traditional treatments may not be working for you.

By the end, you should have a good understanding of what could be going on with you, as well as a new perspective of what could be done. There's going to be some myth busting I'm going to be doing in here, but also I'm going to go through just some general information about what you guys might have seen already on things like Dr. Google, what is degenerative disc disease, what is relevant maybe in your image, and really what's needed to diagnose you with that in the first place. I think we've done a pretty good job over the years at Performance Place helping people understand that degenerative disc disease is not a death sentence in regards to lower back pain.

You don't have to have chronic lower back pain because someone over the years gave you a diagnosis of degenerative disc disease. By the way, it's important to realize there's a possibility that person that gave you that could be wrong. Sit on that one for a second. So don't become your diagnosis, but we're going to cover a lot of great information for what true degenerative disc disease might be, as well as an enlightening way of looking at things so you can start to improve the way you feel sooner than later and get back into the activities and goals that you want to do. Being active, per se, would be a really good starting point.

Get your head around that you might be playing recreational soccer or baseball or hockey or football again. That would be crazy, right? Now, generally when I go through these podcasts and just figuring out what degenerative disc disease is or the diagnosis is, I don't want to necessarily, don't hold me accountable for some of the information on here, mainly because I'm looking at the information that you guys see on Dr. Google. I want to make sure that if there's any stuff in here, I want to help you dissect down what the important parts are. Now, the first thing I looked at is I pulled up a website, which I won't necessarily say who it is necessarily, but I'm going to give you some ideas of what they think causes degenerative disc disease.

They said there's a few factors associated with it, including age, and they said it's when the disc of the spine, basically the disc is the area between the vertebra, the bones of the spine. There's an area in there that's kind of like a disc, squishy type of thing, we say. They say it dries out, and they say that when we're born, we have a large amount of water in there, and as we start to age, the disc dries itself out and doesn't absorb shock quite as well. They say that daily activities, such as sports, can also cause wear and tearing of the disc, and they associate it with, by the age of about 50, 60, a lot of people are going to have signs and symptoms of this.

Now, I've done some podcasts in the past. I think they're probably aired about six months or so ago, where we cover a lot of the technical aspects of imaging and why some of the imaging finding associated with degenerative disc disease are not really that important. Although people have leaned their hat upon them for many years, and a lot of people will even say, well, I have degenerative disc disease, and someone told me I did. Well, why do you say that? Well, because we saw it in my image. Yeah, but there's other parts to it. There's other ways of diagnosing this. I'm actually very optimistic.

A lot of times I'm not optimistic when I read some of these articles online because a lot of them have been written. You know, 10 years ago or so. Not everybody updates them. But in this one in particular, I'm really excited that actually they say that a diagnosis is based upon a medical history and examination. And then you start by figuring out what's generating the symptoms. And then maybe you get an MRI done to show any potential damage to the disc because the image cannot confirm degenerative disc disease alone. And that's an important part. This has been thrown around a lot over the years of, well, I can see it.

So it is degeneration of the disc. The disc is wearing itself down. It doesn't have as much water. There's a loss of disc height, as they say, that they might see on x-rays. But generally, an image like an MRI or an x-ray are helpful for information. But it's not the best starting point. Usually, the physical exam and the medical history taking process is the best. Now, some of you self-diagnosers out there, I don't want to misconstrue this. This means somebody else should be taking it on you. I spoke with a gentleman recently. It was someone who came in years and years ago with a different type of problem.

And then they started to come in. In this case, we're talking about his elbow. And he said, well, I've had it for about like three, four months now. And it only happens when I do my sport. And during the day, I generally don't feel it. What do you think? And I said, well, I think that maybe you should come in and we should do a medical history taking process and a physical exam where we can figure out what's going on. And he's like, well, maybe I should come in after I get my MRI, get an MRI done. And he actually had a really good thought process with things, which isn't always necessarily the case in the spine.

You can't do this in the spine. But he said, I want to image my elbow on one side and elbow on the other and see if they compare and they're the same and see if there's any damage associated to the other one. I said, you could. Like money talks, man. But if you were to spend money on one elbow and then the other elbow and you didn't do a precursor course of treatment to show that you failed treatment and then treatment didn't make you feel any better, no one's going to approve or pay that for you. You know that, right? Oh, oh, I just thought it would be covered. No, it's not covered. It's not like everyone's thrown out expensive images all over the place just as a willy nilly thing.

It has to be merited. And I told him in the same thing that happens a lot of times with people with low back degenerative disc disease or chronic low back pain is that the person is very wanting. They very much want to know what the problem is, they say. So they want to use the image to confirm that. I said, look, we don't need the image to confirm what you have. We need to do a good physical exam and history taking process. And it's oftentimes confusing to people. They say, well, what will a history taking process in an image show you or sorry, in an examination show you say, well, the examination, we can stress certain areas of your body.

Like, let's just say we thought it was the disc and it was degenerated and it's not really tolerating compression. Well, we can test it to see if compression is tolerable. There's actually a test for that. Now, not everybody does it. There's also a test to see if your pain is worse with bending forward or backwards. Not everybody does it, but there are tests for that. It's called stress testing, looking for your body's tolerances. In this case, looking for the spine or low back's tolerances. And that's really important because that's not really seen on your image. So the history taking process also gives us a lot of information to figure out if you even fit the bill for a possible degenerative disc disease.

A really good example is for a frozen shoulder. We've had people come in and say, well, I have frozen shoulder. Well, why do you think that? I just woke up with it like a week ago. That's impossible. It's literally impossible. How come? Well, because frozen shoulder is not actually allowed to become a possible diagnosis unless it's beyond three months old. So it doesn't make any sense. Well, so degenerative disc disease is kind of similar. It's like you don't just wake up as a 15-year-old kid and have degenerative disc disease. It's a process that shows signs associated with how you've been using your spine.

And there's consistencies with history that will typically matter. And again, those things aren't necessarily found on imaging. Imaging shows you what's going on in regards to structure, but it doesn't show you how things are moving, how they play well together, and what the tolerances are. A lot of people that have tried some of their self-care, you guys might resonate well with this, and I was going to save this a little bit more to the end, but we're going to also go into it now a little bit, is considering things that may work for you and also hopefully change your mindset a little bit about what's going on with degenerative disc disease and your pain.

I know a lot of people who have had ongoing lower back pain and who have been given the diagnosis of DDD try eventually to stretch their hip flexors. And although hip flexor stretching is not probably my go-to thing that I would give people to do, although it does help for a lot of people, it's surprising to see how many people I've met who have said, well, I've had back pain for three, four years, and I tried this stretching program. It included hip flexor stretching. Wow, I feel way better. Now, I'm not telling you guys to go do a stretching program because that's not super specific, and quite honestly, full transparency, it does make people sometimes feel worse, depending upon what your problem is.

But sometimes doing something like adding movement to a joint above or below the area of the degenerative findings is actually very helpful. In this case, moving the hip, moving the hip through extension, stretching the hip, gaining mobility of the hip can be super, super helpful. And also adding mobility to the mid-back is also really, really helpful. I'll double down on that. If you have neck pain or hand numbness or headaches or shoulder blade pain and low back pain, probably your mid-back is a big part of this thing. We sit a lot throughout the day. I don't like blaming things on sitting. But as we know, sitting, the disc takes substantially more load and wear on them than withstanding.

And the reason is because a lot of times people slouch. Now, I'm not telling you to sit up and have neurotic perfect posture, but I'm just telling you the brass tacks of it. Is sitting, you'll have more load on the lower back disc than you will standing or walking. Also, too, a lot of the people who are seated tend to round their upper back. They tend to poke their head forward. And sometimes doing this, can you imagine over the course of like 20 years of working and you've been sitting at the desk and you've been doing Zooms now and virtual calls. And you're sitting and kind of rounding your back, upper back the whole time and lower back.

At some point, you've got to consider that when does the body start to adapt and say, look, that's just your normal. Like, I'm going to help you support this normal. But at the same time, you're going to lose mobility in other areas. If you look down a little bit further when you're in that seated position, you're going to see that your hips are flexed forward. Again, remember I said earlier that extending the people's hips tends to help. Also, extending their upper back tends to help, their mid-back. Like in a stretching mobility type of fashion, foam rolling, if you will. So kind of reversing the things that make people feel worse with degenerative disc disease.

Back on that same thread, we're going to go back on to this article here when it says the typical person with degenerative disc disease is active and otherwise healthy in into their 30s or 40s. Pain is worse when sitting. It's worse when bending over, twisting, or lifting. It tends to feel better when walking or running. When things get bad, sometimes there's periods of intense pain that can come and go. They can last for days, weeks, or even months. I've met people having this for months. Sometimes there's pain only into the low back. Sometimes it goes into the buttocks, the thigh, the hamstring, the shin, the calf, the foot, the heel.

And sometimes it can present not only as tightness, but also numbness and tingling. So there's a lot of different things that could be happening here. But generally, if you think about it, a lot of these are rounding mechanics. Worse with sitting, rounding. Worse with bending, typically rounding. Better with walking, not rounding. Better with changing positions. This kind of goes along the lines of a lot of times people's static positions. When they're not moving, their back or their hip or their leg will tend to feel worse. When they start moving around, things get better. Before we get too far in the show, I want to make sure everyone knows about the free low back webinar that we have available.

It's in a link description for the show. A colleague and I cover the three most common types of lower back pain that you may not be familiar with. And it's over the course of about 20 minutes. There's great video, great information that you can actually take to your clinician if you'd like. Or just learn a little bit more about your body and what it likes and doesn't like. So, you won't find it anywhere else on the internet. Please take advantage of that. Now, on to the rest of the show. Now, I'm not going to say that everybody necessarily needs an elaborate type of treatment plan or program associated with getting rid of their back pain.

Some do, though. Some really do. I remember I had a friend that he got sick. He just had a sickness, cold. And so, he was laying in bed for a couple days. And he's generally a pretty active person. And he said, dude, my back hurts more now than it ever has. And I said, why don't you get up and do something? And he's like, well, I'm coughing and stuff. And I said, just go for a walk around the block. And let your lungs be your guide, if you will. And so, he started walking around. He said, wow, that feels so much better. And he didn't have to go crazy and get an MRI done. He didn't have to get a big history taking done.

He just had to do something different than what he was doing. The sad reality is a lot of people end up getting blinded by the idea that they think their pain is chronic. And they think their pain is only going to get worse. Their condition is only going to get worse. And why even bother with things? And this is the sad thing with the diagnosis, degenerative disc disease. Just think about what does it sound like? It sounds like you're going to wither away and there's no hope of getting back. One of this is called exploding spine syndrome. I mean, like, it's a horrible... I don't know who made this name, this diagnosis, but I think it's terrible.

It's mentally defeating. Sometimes, though, when you just kind of put the problem on its head and think, well, you know what? I sit a lot throughout the day. What if I just sat less? All of a sudden, good things can happen. They really can happen. People who are inactive, get them more active. People who are really active, get them a little less active. Get them to do less. So there's a lot of helpful, easy things, movement things that can help you. Movement is essentially a form of medication. I know I've told people before, jokingly, just walk it off and they feel better. Rub some dirt on it.

It makes it feel better. Now, going back to the image, I won't spend too much time on imaging findings, but generally, things that are found on x-ray, they're just spacing issues, spaces, or fractures, a lot of times we're looking for. I've mentioned this on a lot of podcasts before is that x-rays are helpful for some things and they help rule out some things because you got to rule out things if you have back pain. There's, what, 3%, 5% of people have something very serious going on they need to be treated urgently for if they have lower back pain. And you need to screen that stuff out. An image is one way.

Again, a history taking and an examination is another. But imaging is one way to screen that out and x-ray can be helpful for that. However, I've had people misunderstand what the point of some of the x-rays are. They're looking at the x-ray and they say, well, I think there's less disc space there. Well, yeah, there can be. Like, you can see it's generally smaller in one spot than another and you can insinuate it. And they say, well, I think I have a disc herniation or a protrusion or prolapse or they're, you know, throwing words around. And I said, well, you know, you, you know, you can't see that and say, well, no, no, it's right there.

It just looks like it's less height, right? Less height does not equal herniation, protrusion, sequestration, different disc. It doesn't mean any of that. It could just be that it's loss of height. As we mentioned earlier that the body has the potential to hold a lot of water in there. And actually in the morning time, you're actually taller. If you measured yourself, you'd be taller than you would at the end of the day, because the disc naturally lose height and every night they gain height. But if you're not able to gain a lot of height anymore, just because the disc has had some injuries or wear and tear over the years, then there's just a loss of height.

But it doesn't mean you have the other things. I only bring this up just because I'm not saying get another image, but let's just not misconstrue what the images will do. An x-ray does not show the health of a disc. Actually, the best way to figure out the health of a disc or a health of the spine is the exam. I'm not BSing anybody either. I know there's a lot of you out there who have probably been told otherwise. Well, I saw my specialist. They said I need an MRI to figure things out. I'm going to disagree. I've been in this industry for about 13 years now. And what I realized over the years was hearing some really smart people talk, smarter than me.

They said that the reason why we would get an image in our industry is because we want to rule out the things that it could be. If our examination and working with the person indicates that there's something like degenerative disc disease, a disc herniation, facet syndrome, pinched nerve, we don't need an image further. We don't need an image to confirm that. We just need to work with it with what it is. Well, how can you work with the thing if you can't confirm that it's that? Well, you'd be surprised. There's a lot of things that we can do in conservative care to help out with pain associated with those things, with pain associated with degenerative disc disease, and get you on your feet again and get you going.

What's traditional or conservative care? Well, this is the hard thing to talk about. It really is a hard thing because there is no consistency. If you called up your local PT clinic or chiropractic clinic or pain management location around you, you should actually everyone. I invite you to play this game because it's going to be a little confusing. And the sad reality is I realize this is what people go through when they're looking for an answer. And by the way, post on Facebook and tell someone that you've been dealing with degenerative disc disease and then see what they say. And look online and look for the forums and see what they say.

So there's no consistency of care or suggestions. We have people who call and they say, well, I've been through physical therapy. And we're like, and then so we further that conversation. We say, well, what what did they do for you? And they said, well, they put me on this ice pack. And then this they put this tingly, like kind of vibrating unit on me. And then I was stretched out for a little bit. I took I did a massage and that was it. Great. Did it help you? Yes. Good. Why don't you go back? Well, because my pain came back. OK. You know, and let's just try some other things possibly. Like we're trying to figure out what worked but didn't work so we don't supply the same thing again and give you the same outcome.

That same person, though, may call back a couple of months from now and say they've tried another PT clinic. By the way, I'm not bashing on PT clinics. This is just this could be for any clinic, chiropractic and acupuncture or whatever. Same thing. Well, I went to a PT clinic. What would they do for you? Well, they gave me glute bridges and planks and they did a little active release on me and then they mobilized my hip. And did it help? Yeah. Or no. You know, the difference between these two scenarios is you notice how the first clinic that we did the scenario with, there was a lot of passive stuff.

Not a lot of work done. Not a lot of work the person has to put in. Well, the second one, it sounds like a bunch of exercises and probably some painful tissue work and mobilizing not the back. They're different things. They're completely different animals. And some places may call and say they like we we have a chiropractor in our clinic and and they say, well, I don't want to get chiropractic done. Well, how come the last chiropractor I went to? I didn't like it. What do they do? They pop my back. OK, so you're familiar that chiropractors can do other things, too. They can also suggest corrective exercises and show you how to lift a weight and show you good posture, do tissue work.

Oh, no, I didn't know that. That's because that was their experience with their version of traditional or conservative care. Generally speaking, I would say conservative care would be something that's not really that invasive, non-surgical, non-invasive. It doesn't require medications at all. But the problem is, is the tools or strategies used are really all over the board. People don't use a framework. And there's typically a lot of a lot of times this happened to me personally is there's no specificity in mind for me and my goals. I'll tell you, when I was in high school, I went to this clinic and we did a lot of foam rolling.

A lot of I think it was metrics. We did a back extension machine because I was having back pain and my score was going up. I was riding the bike and stuff like that. But, you know, I looked around and I saw that there was really not a lot of people in there like me. There was a lot of people that looked like, if I had to guess, they probably weren't as active. And not to say that I was like a big time or anything, but I was coming off of a high school sport. I wanted to get back to the high school sport. And there was not a lot of challenging things for me to do just because the clinic didn't have anything challenging for me to do.

Fast forward later, I found a place that there was a lot of challenging things to do. I did strength training. I remember leaving the place thinking that actually I had a stick shift car. I could barely hold my foot down in the clutch just because my foot was shaking so much because I was challenged so much. Now, the strength training or exercises was not the only thing that we did, but it was an important part. It was different. It was a different type of still conservative care. And that part really helped me. Well, the first type of clinic that I went to, it did help me reduce pain. I'm not going to lie, but it did not help me to my goal, which was getting back to a sport again.

And I'm not making this up is I felt better. I was out of my sport for three weeks or sorry, three months. I went back into my sport, took a swing in baseball and was literally doubled down in pain again. I had been away from the sport for three months and have been doing things that weren't necessarily challenging. So what do you think happened to my body? It's weaker, less tolerant, less conditioned. Now, obviously, when I was 15, when I originally had the back thing, I probably didn't have anything like degenerative disc disease. But now at the age of 40, I can probably tell you that I do. I probably have degenerative disc disease.

And I've had a lot of the symptoms that are on this chart. Pain worse with sitting, worse with bending, lifting, twisting, better with walking, better with running, better with sprinting, worse when getting up from a prolonged seated position, sometimes tweaking when twisting in bed. And I've also had numbness and tingling, as a lot of you probably have as well. I'm here to tell you that you guys can get better. You need a strategic approach. You need to make sure that the type of care that you're getting is specific to you, your exact tolerances, your back's tolerances, the reason why this may be a thing in the first place, and the goals that you want to get back to.

What do you want to do with your life again? Recently, I was working with somebody, and we were talking about what did she want to do after she started to feel better. And she said, well, I can't do the dishes. I can't sit for a long time. I can't really work that much. I said, well, what do you want to do? And she's like, well, I can't do those things. And I said, yeah, but I'm sure that your goal in life when you were a kid wasn't, I want to be able to work my whole life. Now, obviously, we need to do those things, but that is far from having a passion. It's not the same thing as getting back to an activity that you like or love.

Sometimes people really struggle to find the thing they like and love, again, because they've been so far removed from it, either because of pain associated with degenerative disc disease, or they've been told this, I don't want to say this lie, but this myth that as you get older, you will have pain all the time. You know, people I play with all the time say, ah, don't get old. How come? Well, because you don't recover as much. You don't recover as well. I can agree with that. I mean, personally, I can agree with that with my adventures. Well, you know, just, you know, your knees go bad and your back goes bad.

And I don't want to be disrespectful, but that's you. That's you and the way you've treated your knees and your back. I feel fine. And a lot of you out there may be older than me. Some of you, though, might be younger than me. I'm 40. I play with people who are 30 years old. And they say, ah, you know, after 30, it goes downhill. For you, because of the way that you're choosing to live your life and the mentality that you have with your recovery. Many people have had degenerative disc disease given as a diagnosis before. The people who are willing to get better and are willing to put in the work tend to feel better.

And a lot of people are wiser with how they choose to use their body, how they choose to look at their physical and mental health and get back into the sport that they want to do. I tend to think degenerative disc disease is not really disease. And as I'm looking through this article here, actually, they put degenerative disc disease, not actually disease. I feel very excited about the help. I hope this article gets lots of traffic. But it's not a disease. But more so, it shows the signs of how you've treated your body, where you've been loading your body from. Okay. I don't really like this analogy too much.

But, you know, if your car pulls to the right, your right tire is going to show probably a little bit more wear than your other tires. Or the tire that's deflated over time, you don't have adequate air, and it's going to show more wear than the others. Now, fortunately, in a car, you can just change the tire and you're good. But we all agree that there's another problem here. There's your alignment, your neglect of adding air to the tire. Maybe, I don't know why that one's going lower. I do have one tire that gets lower on me, but I check it every couple weeks. Maybe even one day I'll go in and actually have them address it, you know.

But a lot of you out there have been using your spines unknowingly. It's important to acknowledge unknowingly for a long time. And your spine takes on a lot of the work. In the neck, usually C5 area tends to take on a lot of the work, which is why a lot of people tend to have a lot of neck pain in that region. And they have that shoulder blade pain that drops in that feels like it's between their shoulder blades or under their scapula. So, in their back, people tend to use their back a lot. They tend to bend it forward, bend it backwards, take Instagram pictures, become what we call spinal hinge cases.

And that could be from tendencies of what they like to do. But also, it can be from something like an old hip injury that doesn't hurt anymore, but is now lacking motion. As I mentioned at the very beginning of this podcast, sometimes as simple as stretching a hip that was an old injury could be really, really helpful. Mainly stretching it in extension. Can it be stretched in a flexion or knee to chest? It can, but normally it's not. If I had to gamble and I was going to Vegas on these odds, I'd say that's probably not the right guess. So, something like stretching an old injury, adding a little bit of movement to it, a little bit more movement today than you had yesterday, can be such an easy way to add a better canvas to paint on as you start to recover from your degenerative disc pain.

The reason why I'm saying this is adding mobility to a separate region is because that just like the alignment issue, we can keep changing the tire and keep doing treatment directly to your back or your spine. But as long as that alignment issue is a problem, you're not, it's going to keep returning. And it's not anything that you're knowingly doing. It's just the problem is the area, say that in this case, the hip, it does not work well, but it does not tell you to pay attention to it. It doesn't have any pain. And this is the value of having pain. I know everyone will probably disagree with me on that, but pain is valuable because it lets you to pay attention to the area of, in this case, the back.

But it'd be great if the hip would speak up a little bit so we can address the hip and then it would settle the back down. Now, at Beforne's Place, we do have a structured way of looking at things. We tell everybody now that we need generally three things to put the pieces together to help them unravel this madness of degenerative disc disease pain that they're not getting any help from. And there's three basic things that we need. Number one is a working diagnosis. I say working diagnosis because there is also a bunch of other diagnoses that you could be. In one of the books that I wrote recently, which I'll put the link in the description as well, it's a diagnosis book.

It covers low back diagnosis and probabilities. And mainly, the probability will narrow down based upon the history and exam findings, but we call it a working diagnosis because it's not set in stone. As much as you may think that using an MRI or an x-ray or seeing a specialist who says, it's this, I'm sure it's this, there's always uncertainty. There always is, and there should be. Nobody really knows 100%. And if they tell you that they know 100%, they don't. All right. We try to be fully transparent with the people we're working with. And we say, look, it's probably this. And we're going to know it's this because you're going to respond.

If you don't respond, it wasn't that. Or if you weren't doing your homework and we gave you the wrong things to do, then it won't respond still. The solution is only accurate and useful if we can identify the problem. And that's what comes down to really using a very useful examination process. So number one is we need a good working diagnosis or symptom generating structure. What's what structure is generating the symptom if you have one at all. The second thing we need is tolerances. What does your body or spine tolerate? Does it tolerate compression? Does it tolerate round? Does it tolerate extension?

Does it tolerate twisting? Does it tolerate shear? These are all things that could be figured out with a very strategic examination. Usually parts one and two, the diagnosis and the tolerances, you can be done over the course of about an hour working with someone who knows what they're doing. If you're looking for someone, performance plays has them. The third thing you need to do is find what we call dysfunctional, non-painful regions or contributing regions. This is the alignment scenario. The alignment does not hurt. It does not show signs of a problem other than maybe the pulling of the right.

But what you see is the symptom is the worn down tire. And so a lot of people who experience back pain, they tend to have it because of an area that is not speaking up, but it also does not work well. Maybe it's not mobile. Maybe it's not flexible. Maybe it's not strong. We don't know. But when you check out people's movements by performing something like a movement assessment, it brings to light the areas that could be contributing. Sometimes we find it's the hip. Sometimes we find out it's the mid-back. Sometimes we find out it's a shoulder. Sometimes we figure out it's balance. Sometimes we figure out it's a knee or an ankle or something else.

And so, obviously, we all have different experiences. Everybody has different trauma in their life. They had different sports. They fell over a, what is it, Legos. Parents step on Legos and trip and fall. You know, so there's a lot of different things that you could have done that not everybody did. And this part three is helpful because, quite honestly, most people won't look for non-painful dysfunctional reasons as contributing factors because they're so stuck on looking at the diagnosis and the symptom-generating structure that they cannot look elsewhere. And I wish I could tell you that every single place will do this.

But, again, earlier I mentioned that conservative care, there's no consistency. It's all over the place. It is literally all over the place. Sometimes you need to be coached a little bit more, too. And in that case, you might need to be seen more frequently than somebody who's really, really coachable and has good accountability. All right? Everybody's a little bit different. So, if you guys are looking for help, we can help you at Performance Play Sports Care. You can reach out to us in the link description in the podcast player or you can email us at info at p2sportscare.com or call us. 714-502-4243.

Again, 714-502-4243. We'd love to talk to you on the phone, learn a little bit more about you, and see if we can even help you at all anyways. We turn cases away because if we can't help you, why would we waste your time and money? So, we try to only take the cases we feel like we can help with. So, we do a good screening process on them. If you guys are looking for more information of what you may want to learn about degenerative disc, as well as other types of low back diagnosis, as well as other treatments that I didn't cover today, like acupuncture, chiropractic, massage, foam rolling, mobility strength, all that kind of stuff.

I wrote a four-part series book that you can find in the link description. The first one is a really good starting point, but if you're looking for the other ones, there's diagnosis is book two, treatments that work is book three, and book four is becoming a really popular one because it's called – it gives you different exercise options and variations in a way of looking at weight training as a way to rehabilitate yourself, but also a way to not flare things up. I guess I should probably note that although we say the word rehabilitation, I think it's ideal. I have a friend who mentioned it this way.

I think it was really a good, clever way of doing it, but also, too, I think it was very honest. He said that a lot of times people look at rehabilitation of the spine or the lower back as what they need to do because they had an injury to the lower back, their lower back hurts, their imaging shows X, Y, and Z. But he said, you know, after the person has that problem, they have degenerative disc disease, there's less space, there's less height, there's a disc herniation, there's whatever. It's not going to go back to what it was. It really is not. You're not going to gain more height from disc.

It's not going to absorb more water. It's not going to push itself back in place. It's not going to become realigned or whatever you want, whatever you've been told that may happen. You won't be putting it back or, quote unquote, fixing it. I'm not talking about pain or function. I'm talking about putting it back to where it was before you ever had this problem. It's not going to happen. And that's not a bad thing. Look at it in the way of that that is your new norm. That is your new body. It's like getting a mole on your skin. It doesn't change anything, but it's not going away. If we look at how can we adapt to the new scenario, the new norm that we have, we're in a better shape.

We can get to the root of this thing. We can make it so our body has a means to function at high levels without putting more load into the spine, without creating more pain, more of a problem. But let's just not look at it as you're going to rebuild that spine. You're not. You can build support. You can build stabilization. You can build some mobility. But you're not going to put that thing back to where it was when you were 15 years old. Let's stop looking at it that way. Let's think, what can we do now in our normal, in our new normal state to adapt to the situation? Humans have been adapting for many years.

Let's adapt your body to the scenario that it's in now so we can get you back into what you love to do. So reach out to us at Performance Play Sports Care. We'd love to help you out. And subscribe to the show, and you'll get more podcasts just like this on different topics. We cover a variety of different topics, but our favorite we specialize is in low backs, hips, groins, sports hernias, hip impingements. And basically, we call this lower quarter. We love the lower spine, and we love the pelvis region just because it's something that's easier for us. And our success rate is really good. Not that we don't see people for other scenarios like mid-back, neck, shoulder, elbow, knee, and so on.

But it's just if I had to have my pick, I'd rather have a low back and hip any day of the week just because it's so much cleaner and it's easier to manage. So let us help you. Let us create a framework and a consistency of care and create a program specific to the goals that you have, not the goals that the other clients at the facility have. So I'll talk to you guys soon. Thanks for listening.