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Low back pain from lifting: how to squat, deadlift and brace again

Episode 66

66 Minutes – Dec 20, 2017

0:00 / 66:37

Chapters

Questions this episode answers

Why does my lower back hurt when I squat?
A common reason is the butt wink, where your low back rounds near the bottom of the squat under load. Seth's view is that flexion under compression makes the area sensitive. Hip anatomy often drives it, and a wider stance or squatting to a box can help.
Should I stop deadlifting if my back hurts?
Usually not. Shorten the range instead: pull a kettlebell or barbell off blocks or stacked plates so you don't bend as far. Seth has flexion-intolerant people doing this within the first couple of visits.
Are sit-ups bad for low back pain?
If sit-ups or toes-to-bar make your back achy, shift to planks, side planks and suitcase carries. The goal is a stiff trunk that transfers force. You should still be able to bend forward without load.
How do I brace my core for heavy lifts?
Right before the lift, expand your belly and sides as big as you can. That raises pressure inside your abdomen and stiffens the low back, like a sealed pop can. Practice it on every heavy rep so it holds up when you're tired.
How do I get back to lifting after a back injury?
Start with a reduced range of motion that matches your goals, like box squats, block pulls, and hang power cleans or snatches. Increase depth as you get stronger and look better in those positions. Build weekly volume gradually instead of jumping.

Why lifters hurt their backs

The most common pattern in lifters with back pain is pain bending forward. Dr. Seth Myers calls it flexion intolerance. Bending forward hurts, or they just don't do it well.

Seth is a chiropractor, a CSCS and certified through USA Weightlifting. His exam looks at movement first, not at which tissue is damaged. A classic finding is the butt wink. Halfway down a squat, the low back rounds and the butt tucks under. Add a barbell and you get flexion under compression, which tends to make the area sensitive.

Seth leans on Professor Stuart McGill's spine research. Repeated flexion and compression with some rotation can damage discs in pig spines. But those are dead spines that can't heal, bent thousands of times. So don't get scared before your next barbell squat.

Fixing the butt wink and scaling the range

Seth's take: minimize the butt wink under load, but you probably can't make it disappear completely. A big driver is hip anatomy. Picture a ball in a socket. Some sockets are shallow, some fully cover the ball. When the ball hits the rim, the pelvis tilts and pulls on the low back.

His quick check: lie on your back and let your knee drift toward your chest until it finds its natural highest point. As a rule of thumb, many people squat deeper without rounding if they move their feet wider. I had my own hip impingement and hated being pushed deeper in group classes. Seth agreed. Depth should match your goals.

You don't have to stop a lift that hurts. Change the range of motion:

  • Squat to a box.
  • Deadlift a kettlebell off stacked plates or blocks.
  • Pull Olympic lifts from the hang into a power position.

Seth gets flexion-intolerant people deadlifting a high kettlebell within the first or second visit. I usually wait a few weeks. Either way, the point is the same. Picking something up with good mechanics can be close to pain free.

Fear, goals and the mental side

Some people are scared to bend over at all. Seth builds the hip hinge first, pushing the hips back to a wall, then works a little deeper. A good hinge eventually looks like bending forward.

He keeps sessions lighthearted, plays music, uses models and pictures, and tells people they can stop any time. For chronic cases he shifts focus from pain to outcomes: running, CrossFit, a competition. I agree. A goal that isn't about pain is a big driver to get better.

Trunk training, carries and bracing

Seth uses loaded carries a lot. Farmer's carries load both hands. Suitcase carries load one, so the opposite side has to fight to keep you upright. The spine doesn't move, but it is challenged hard. He cites McGill's strongman work: during a yoke carry, the stance-side glute and the opposite quadratus lumborum (a muscle in your low back) share the job of holding the pelvis level. If someone leans into the weight, it's too heavy. Lower the load.

His view on the core, which I prefer to call the trunk: during athletic movement it should be stiff and transfer force. If sit-ups or toes-to-bar make your back achy, shift to planks, side planks and suitcase carries. He still thinks you should be able to bend and touch your toes without load. The body is built for it.

Intra-abdominal pressure is the other piece. Seth's analogy is a sealed pop can you can stand on. Break the seal and it crumples. Before a heavy lift, expand your belly and sides as big as you can. When you're gassed in a workout, your neck and upper back muscles take over breathing and bracing gets harder. The fix is practice, every heavy rep, until it's automatic.

Managing load and returning to lifting

Seth cites Tim Gabbett's acute to chronic workload ratio. Your last week compared with your last month or two. A sudden spike raises injury risk. Jumping from about five weekly squat sets into a high-volume squat cycle is a classic way to get hip pain. I see the same in runners who skip training, then go hit 10 miles.

Return to lifting means shortening the range, then growing it as you get stronger. For deadlifts, Seth likes lowering the bar instead of dropping it, a slow descent of about three seconds with a clean bar path. In my office, I now ask people to reset every rep, no touch and go.

Key takeaways

  • Pain bending forward is the most common back complaint in lifters.
  • Shorten the range of motion with boxes, blocks or hang positions instead of quitting the lift.
  • A wider stance can let some hips squat deeper without the low back rounding.
  • Carries and planks train the trunk to stay stiff and transfer force.
  • Brace by expanding your belly and sides before every heavy rep.
  • Build training load gradually; sudden weekly spikes raise injury risk.

At a glance

Conditions and injuries
  • Flexion-intolerant low back pain
  • Lifting-related disc sensitivity
  • Hip impingement limiting squat depth
  • Acute deadlift back injury
Anatomy involved
  • Lumbar discs
  • Hip ball and socket
  • Glute medius and quadratus lumborum
  • Diaphragm and abdominal cavity
Symptoms described
  • Pain bending forward
  • Butt wink in the squat
  • Nagging low back ache from squatting
  • Fear of bending over
Treatments and exercises
  • Box squats and block deadlifts
  • Hip hinge drills
  • Farmer's and suitcase carries
  • Planks and side planks
  • Intra-abdominal pressure bracing
Episode Transcript

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

This is session number 66 of the Performance Place Sports Care Podcast. Right now! Welcome to the Performance Place Sports Care Podcast, where you can learn about sports injury theory, rehab, diagnosis, and how to understand the doctor lingo you didn't understand at your appointment. And now, your host, Dr. Sebastian Gonzales. Hey everyone, it's Dr. Sebastian Gonzales with the Performance Place Sports Care Podcast. And I don't expect anybody, except for those who know me really well, to know what these personal phrases are. But I think pretty often, people tell me I'm the most annoying person they've ever met.

And I think in grad school, they call me the annoying little brother. And just recently, it seems like all of the things that get me excited, such as the 4th of July and right now, are things that make me excited because I get to yell something, you know? It's just, you just get to yell it. I just dig it. So, yeah, I start screaming that sometimes, like, when I get excited about, like, people coming over. Sometimes we have these garage parties on holidays when it's sunny and so on. And, like, I get really excited, we're going to start to cook. And we're like, we're going to do this right now! That's kind of how it goes.

So, yeah. Okay, we're done with that. So, right now, we are going to have on Dr. Seth Meyers. And we're going to go over the topics of the day, which we are on the low back month. We're going to go over some weightlifting, prevention and corrections with low back pain. And Dr. Seth Meyers was actually, it's funny, like, I was actually introduced to speak with him by, I contacted, actually, I was looking around for a really good qualified strength coach around the Southern California area because I want to talk to someone new. So, I was looking around and stuff, and I couldn't really find anybody that really stood out to me when I was doing some Google searches.

So, I thought, you know what, I'm just going to ask the NSCA. So, that's the National Strength Conditioning Association, and they're the one that delegates out the Strength Conditioning Certifications, or CSCS. So, I contacted the regional person there, and they said, you know what, you've got to talk to this person in Kansas. And it's Seth Meyers, and he's a doctor of chiropractic, and also a CSCS, and he also has certification through USA Weightlifting. And I'm like, God, that's a small world. I didn't, I didn't think, I really didn't think I was going to be speaking to another chiropractor today, but I dig it.

So, in this interview, Seth did not disappoint whatsoever. So, he prides himself on being evidence-based medicine and focusing on active care. And as you'll hear, he does spend a fair amount of time lifting on his own, and he does do some CrossFit, some Olympic lifting, and he did spend about four years in college playing football. So, he's a very educated guy, and I'm glad at the end of this conversation, actually after we got off the air, I said, I'm pretty sure now that since we've been speaking for an hour, and everything that he said, I was already writing it down. I was writing it down before, and I feel like we had the same brain with this.

So, I dig it. So, we are, we're friends now. We're going to text often, Seth, Dr. Seth Meyers, we're going to text often. Anyways, we're going to have him on without any further ado. Let's get into the interview. All right, everybody, welcome on Dr. Seth Meyers, who is going to tell us all about low back pain, lifting, and some things you guys can do to improve the way you lift. Dr. Seth, hi. Hey, how's it going? Great, how are you doing? Thanks for coming on. Thank you. It's good to be on. Doing pretty good. Just relaxing after working all day in the clinic, so. Are you in like a rocking chair, I imagine, on your porch?

No, I'm in a little recliner chair in my little backyard area here. Does that account for proper hip hinging and intra-abdominal pressure? Not quite. Not right now. Right now, I'm resting. Oh, good. So, make sure you're breathing diaphragmatically, though. Exactly. So, can you tell everybody then, at least your experience with working with people with back injuries, and especially in the lifting population, and how to getting them back to lifting again? Yeah. So, we'll just dive right into it here. I mean, there's, you know, when you talk about back pain, there's a laundry list of potential things that people could have as a diagnosis, right?

So, you know, when someone comes to me with low back pain, one of the first things that I'm wanting to do is make sure, one, it belongs to my office. So, just kind of doing an assessment and seeing where we're at with that. So, with that, you know, when I assess somebody, I'm kind of looking at more movement, really, than trying to really particular pinpoint a specific part of anatomy that's damaged. So, most of the time, and I'll just use generalization here, because if people are lifting, they might fit well into a certain category. Generally speaking, people tend to have more pain or get low back pain with kind of bending forward.

And I see this a lot, and typically, you might hear this just termed like flexion intolerance, so flexion meaning bending forward, and intolerant just it hurts or they don't do it very well. So, you know, I'm kind of going to go down that rabbit hole a bit, and we can talk about some of that stuff. And so, when you're talking about a population that lifts, and I guess we can just use some classic lifts, like a deadlift or a squat, and we can start with a squat. One of the big things that you see is some people, and I see this a lot, is they'll come in, they'll tell you they got low back pain, they'll bend forward, touch your toes.

They say, yeah, that makes it worse. And then you look at them doing an air squat, and when they go down, they get about halfway down, and then what you see is this little butt wink going on. And so, if you're not familiar with what a butt wink is, it's basically, you know, someone's, so imagine someone's squatting in front of you, and you're looking a side picture of this person. As they start to descend into the squat, about halfway down, what you see is the low back basically starts to round, or why they call it a butt wink is you see their butt starts to tuck underneath them. And that, especially when you get into loading it as doing such like a barbell squat, that mechanism or that flexion under compression is typically what causes some of that injury or some of that sensitivity for that area.

And so, that's kind of one of the main things that I see a decent amount. And so, a few things, you know, I'll kind of go into some more about this. But where I get some of this stuff, where I assess people, but also kind of give them correctives, is from a guy, Professor Stuart McGill. He's done a lot of research up in Canada. He's a spine biomechanics guru, essentially. And so, what they've done is they've taken pig spines, and they've put them in a special device that he's got, where it'll, you know, give him all sorts of different types of forces that he wants to create, whether it's just a sheer compression force, a pure flexion, a pure extension, all this stuff, right?

So, he will put it in there. He'll give it a little bit of compression, and he'll start bending the spine back and forth into flexion and rotation. And what he can start to see, or what he has been able to see, is with that flexion and compressive load, as well as a little bit of rotation, you can start to do some damage to the disc. So, I'm not suggesting that these people have a huge bulging disc or a disc herniation, anything like that. But what I'm telling them is, basically, they've made their back a little bit sensitive via that mechanism, if that makes sense. And the other caveat to that, that research, is they're doing it in dead spines, so they don't have the capacity to, you know, heal themselves after the fact via, you know, blood and nutrients, things of that nature.

And then, they're also doing it, like, thousands and thousands and thousands and thousands of repetitions. So, keeping that in mind, you know, listeners out there, don't get too, you know, scared when you're doing your next waterbell squat. You know, actually, you bring a good point with that, with the pig spine thing, actually. So, the overall, like, repetition of, I'm sure he bent into flexion plus rotation, or just purely flexion or purely rotation, and is, when you, when you're talking about the butt winks, so that's flexion or bending forward, is, is there, is there a combination that's worse, or is there a certain range that's okay to have a butt wink?

Because I know some people say, well, it's just me, you know, this is my squat. Yeah, so, so that's kind of a debate. You know, a lot of people will say, you want to minimize it as best as possible. And, in my opinion, when you're talking about lifting weights, so you're going to put, you know, weight on a barbell and squat, I would be in that camp, though, and say, you want to try and minimize it, but also, and there's some research, even McGill's done some research for some of the lifts, but there's research that says, you can't really totally make it go away. There's got to be a little bit of a butt wink, but, again, the caveat to that is, well, you know, if someone's having a little bit of pain, and they're butt winking during a squat, and we can make that butt wink less, why not go ahead and try and do that?

And so, oh, go ahead. Well, I was going to say, what is the common thought on how to get rid of it, if not just a control issue? Yeah, so, and I'm probably going to share a few links with you after this, but one of the big mechanisms for that butt wink really comes down to hip anatomy, and Professor McGill explains this really, really well. Um, so, basically, when, and then there's another article by a guy, uh, Dr. Ryan DeBell, he's another chiropractor, and he's got a great article with, uh, pictures on there of why people have to squat differently. And, uh, so, basically, what it explains is that everybody's hips are a little bit different.

And what I mean by that is, if you can imagine a ball in a socket, uh, that's what your hip is going to look like. But some people's ball might be really big, and the socket might be really shallow. So, think of, uh, uh, the, the, the socket not totally encompassing the ball. And then with other people, their, their ball is totally encompassed by the socket. So, if you can imagine, you're trying to move this ball around in the leg. So, once you get to a certain range of motion, you're just going to hit the rim of that socket. Does that make sense? Mm-hmm. So, uh, if you've got this particular hip anatomy that you run out of room, what's going to happen is, if you still go to descend into a squat, you will get a little bit of pelvic motion with it, which starts to pull on the low back.

So, you get this pelvis that's tilting, and then the low back is tilting, and then that's essentially a bow link. Now, there's other things that can lead into it, such as maybe some hamstrings, which, uh, you know, you could talk about. But, but that's one of the big things. So, um, this is, you know, obviously audio, so you can't really see a great demonstration of that. Like I said, you could put some links to YouTube clip in the, in the show notes, and it would be really, really great for people to see. Um, but, uh, you know, when you're talking with CrossFitters, a lot of times they're squatting, uh, you know, ass to grass.

So, as far down as they possibly can. And so you want to try and, you know, in, in between, you know, me and you clinicians or even coaches want to try and optimize that position that they're going to be in. And so what we can do is we can very gently have the person, have the person lay on their back and very gently take a leg and just nice and easily let it go like up. So taking your knee basically up towards your chest. And if you put just a little bit of pressure, like going up, the leg should go up and kind of fall into its natural highest point in that socket that it'll want to go. And again, just, you know, something that people can take home after listening to this, um, as a general rule of thumb, you find that people's hip sockets will allow them to squat.

What would be a little bit deeper without starting to pull on that low back if they move their feet or their leg out wider than they maybe currently are, if that makes sense. So again, there's awesome article and awesome video that professor McGill has on there. We're on YouTube that people can see this and it'll probably put obviously a better picture in their mind of what is going on with the hip anatomy. Um, but so, so I see that a lot. So people come in and they'll do a squat and then I'll have them lay on their back, do this quick little assessment. And then I'll say, Hey, you know, based off what this looks like, maybe if you put your feet in this position, uh, and try squatting, you might be able to get a little bit lower.

So maybe below parallel or even all the way down into a nice deep squat, uh, without getting as much of that butt link. And so a lot of times if, if person's not in like huge acute pain, but they've got a little bit of achiness, I'll have them do it again. And they might report, you know, okay, yeah, it doesn't hurt as bad or maybe it hurts the same, but they're further deep into a squat. Does that make sense? Um, so, so then, so then squat depth, I know that, um, I mean, this, this is something that's, that I've had personal experience with, um, not wanting to go deep for a long time just cause I had some hip impingement.

Um, and every time I would go into a group class, they would want you to go lower. And my, my argument was like, well, number one, it hurts. But second is that I think there's a certain point where, and I don't know your take on this, but when, when, when does squatting below parallel with, you know, 200, 300 plus pounds on your back become useful anymore? Um, yeah. So, I mean, is there a limit here? I know we're kind of like in the realm where everyone's like, I just want to lift more. It's functional and blah, blah, blah. But is there a limit at all? Uh, no, I would say like to your answer, basically like when you're doing a powerlifting meet, honestly.

Um, so, so that's one of the things I wrote down is, is when you're talking about lifting, whether it's squatting, deadlifting, clean snatches, things of that nature. Um, first and foremost, you know, just knowing the person's goals, whether that's the coach knowing them or the person themselves knowing their goals. So if you're somebody who wants to go do CrossFit and just stay healthy, maybe lose a few pounds and try your best when you're, you're doing the WOD. Like there's not necessarily any reason why you necessarily have to be pushing that much weight. And I'm going to be, you know, the first one to try and get people lifting heavy as quick as we can.

But again, keeping in mind, like, are you somebody who's a 45 year old female who just wants to be able to move around the house pain free and chase after your kids without running out of breath? Um, if that's the case, then, you know, uh, one of the things kind of to add onto your point is I'm a big advocate for doing those types of strength training movements, but doing things that limit the range of motion. So something that I think people, it's really weird people will not really consider is you can do these movements and like change the range of motion and still be doing the movement. So if someone has pain at the bottom of a squat, they just stop squatting as opposed to, you know, setting up a box and just squatting to the box.

So shortening it up or deadlifting is another good example. So a lot of people might have pain pulling from a certain position, like from the floor. Um, but if you put a couple of plates or a box again, so that you're pulling a, give yourself a few inches there so that it's not as deep down when you're going to bend over to pick it up. Um, you can still do a pretty good deadlift and put some weight on the bar. And, uh, you know, you might be surprised that you can do it with a lot less pain or discomfort. Yeah, I'm, I'm a huge, huge advocate of that in, in my office. We do have, we have platforms and everything too, but the, I've, I've noticed that, I mean, there's some people that, um, it's just, I don't know if the risk or reward is there yet to have them go to the depth that they're having issues with.

So I, I also too start them into the range of motion that I think they have a lot of control over. And if we're exploring maybe getting more range of motion, then I'd like to load through that range too. They haven't had it for a while, you know? Yeah. Yep. Yeah. So, and I try and do that where, uh, kind of switching over to deadlifting now. Um, if someone who with low back pain comes into my office, especially if it's kind of that flexion intolerant, like I mentioned earlier, I try and have them deadlifting within the first or second visit. The caveat, the caveat to that is, is I set it up in a way that they can do it, um, it's with a kettlebell and it's off of, you know, a few stacks of plates, meaning they don't have to bend over very far.

So they can try and, and get back what it feels like to, to pick something up and, and again, realize that even if they have pain bending forward, you know, going to pick something up with correct, I guess, mechanics, uh, can be relatively pain free. And, uh, so yeah. Okay. Well, so since you, you start on deadlifting, I was, I was going to go there with the butt wink, but, uh, since you started on the, uh, I've, I've actually never deadlift them within the first couple. I usually start within the first few weeks, but with the, I'm sure you've noticed the fear of some of them, right? Yeah. So is there a certain way that you, you typically address that or explain to them about the need or?

Yeah. So, I mean, and I've had, I've actually have had, there's one lady in particular that stands out in my mind. She literally was scared to bend over and pick something up. And when I say bend over, you know, I'm, I'm meaning in a good manner. Um, she was still scared to do that. So, you know, I just, like you mentioned earlier, um, if we're trying to work on mechanics and work on hip hinging, uh, what I try and do is again, put them in a position that they're going to, have pretty good success. So that means we've done some hip hinging where maybe they're pushing their hips back to the wall as a drill.

Um, maybe I can do a video for this. Uh, but you're in my mind. Cause every time you say, right before you say there's a video, I'm going to, I'm already writing it down. I was going to ask you to make one. So, um, but doing a hip hinging drill so that they know the movement and then doing a drill where they're maybe trying to work a little bit further into the range of motion. So they've done the, the movement that I'm asking them to do that. Maybe they're scared of doing, so they're not afraid to hip hinge, but they're afraid to bend forward. Well, eventually if you get them hip hinging really well, that starts to look like them bending forward.

If you know what I'm saying, um, and we'll get into this if I, if I make a video and then you take that into a deadlift, which like I said, I usually use like a kettlebell and I'll just set it really, really, really high. So like they hip hinge and their hands might move down a couple of inches. So I'm not saying we're picking something up where they're, um, you know, pulling something all the way from the floor, uh, you know, in terms of them being scared of, of a certain motion that might cause a little bit of pain. Uh, the other thing with that is, is I, I, I try and do it in an environment that's lighthearted, uh, and where they're having fun.

So it's not like a strict and stern type of scenario where if they mess up, you know, something bad is going to happen. Does that make sense? So, so anytime, you know, you're dealing with pain, uh, and you're dealing with pain with particular movements, and then you're going to try and put them in that position. You have to understand that just trying to get them maybe to crack a smile every once in a while or have some fun with what we're doing, um, can kind of help ease the, the fear that they might have for that thing. Do you have a bag full of jokes you typically tell them? Oh gosh, not really.

I mean, I just try and keep it, you know, relatively fun when we're, when we're doing stuff. Um, you know, I might play music at their request and, you know, just small stuff like that to, to get them to kind of buy into, to what we're doing as a whole. Um, I should though, I should have some stuff written down. Yeah. Um, I'll send you a couple of mine. Okay, good. Good. Um, it sounds like you deal with the, the psychological approach of the injury a lot too. Yeah. And I, I, I probably spend, who knows, maybe more time than I should talking about that, but I think it's pretty big just educating the person on what's going on.

Um, so I use, you know, diagrams and, and pictures and, uh, uh, models and stuff as often as I can to try and explain it. But I also try and let them know that, uh, they're the ones in control of it a lot of times. So if I'm asking them to bend down to do a particular motion, like they can stop at any time. Um, let's see again, I, I just try and keep it fun and a little bit more lighthearted when we're doing some of the rehab stuff. So that, uh, that emotion of maybe that fear or, uh, maybe if they've been dealing with pain for a while, that chronic pain issue, uh, I wouldn't say I've necessarily had somebody dealing with depression, but you can tell when somebody has just been dealing with it for a while.

And it's just something that's very, very annoying. And so just trying to, uh, flip that, uh, so that it's not so big of an issue when you're there with them, you know, one-on-one, uh, can be really helpful in the long run. And, and then, you know, going back to the psychology of it is like people, you know, kind of get focused on the pain, both clinicians and the, and the patient. Um, but sometimes what you can do to kind of break that cycle is step away from pain and look at maybe outcome markers or maybe things that that person wants to do. Um, so whether that's running, whether that's getting back to doing CrossFit, whether that's signing up for a specific competition.

And so they might have a little bit of discomfort or pain and sometimes in chronic cases, it's really, really tough to like a hundred percent alleviate that. But if you start switching the viewpoint from pain to kind of performance or outcome, stuff like that, um, you might see a little bit of a shift in kind of their mindset for, for how they approach doing some of the activities, even if there's a little bit of discomfort. Yeah, I, I, I, I'm glad you brought that up. Actually, the, one of the reasons actually, I, I actually had a, I had a friend in school that he was focusing on, he wanted to focus on general population because he said there's more of them.

And I'm like, well, I want to focus on athletes and sports. And he's like, why? He's like, this, this person over here could help you and they're not, or it could be helped and they're not an athlete. And I'm like, I know, but you have to goal set for them. And I'm like, I don't, I don't want to do, I don't want to say I don't want to do the goal setting, but the, the athlete already has some type of outcome. Like you said, they have a non pain related outcome. So there's, there's a big drive to get better. Um, so you can set their sights on something else. So I know exactly what you, what you mean with that.

Yeah, well, and it's a little bit more fun because if it is an actual athlete, uh, they're, they'll usually be compliant with what you have to tell them. Now, now, when we're going to go back to butt wing for a second, because, um, you mentioned, so you mentioned on squatting. Um, so do you see more people that have disc injuries with squatting with a butt wing or deadlifting poorly, or is there, doesn't seem to be a difference? Uh, so I would say you probably get more low grade, low back flexion intolerant pain with a squat, but you probably have more acute pain with a incident that was a deadlift.

Does that make sense what I'm saying? So it's like a single incident. I did one lift. I'm in here on a deadlift and the other one's like, this has been bothering me and nagging with the squat. Yeah, that, that, that's what I would say. And to answer your question on like, if it's a disc, like obviously, you know, it's hard to, you know, if we've got MRI and x-ray and whatever, we can do all that imaging. And, and even then it's not definitive to say, oh yes, this is the thing that's causing your discomfort. But again, I like to use that, that flexion intolerant term. And, uh, and I think in a lot of the cases where it's squatting, it, it has been that kind of like low grade nagging hurts more when I bend forward, uh, type of discomfort.

Okay. So the, the second part I wrote down your kind of assessment thing, the second part was, you said you're looking at movements more so than, I mean, you kind of looked at structure or like structural deformity in the, in the beginning when you said you might refer them out. Um, but the movements, so, uh, I want you to touch on again, where we're not, I'm, if you're like me, I'm, we don't focus as much on what the diagnosis is. Obviously we have to, we have to address and figure it out, but it's more of how they move correctly. Correct. Or what they're tolerant to. Exactly. Um, yeah. And, and, and that's what I, you know, sometimes that's hard to get the patient to understand that as well.

And I think doing things that they can see, whether they're moving good or moving poorly, uh, is, is also a really good indicator of, you know, you know, them having, uh, good mechanics or, or good, uh, quality movement is going to decrease some of the discomfort that they're having. But for the most part, when you're talking about lifting anyway, um, because, because you do, or I have seen, you know, people will come in and maybe they ask if it's this, or if they ask if it's that. It's that structure. And then when you have this idea of a certain structure is damaged in their head, uh, then you get back into that.

Like we talked about earlier, that kind of fear of wins for, they don't want to damage that structure even further. Um, but, but yeah. So, um, when someone comes in, you know, like you said, for the assessment, a lot of the stuff that I might try and do is, is looking at, uh, how they're just general range of motion. But maybe a squat as well as some of the other, if you're familiar with like an FMS movement screen. Um, so, and, and obviously this is audio again, but looking at, uh, like single leg position where you're maybe standing on one leg. And what I like to have people do in, instead of necessarily doing like a step over test, doing a step down.

So you're standing on, you know, even something, just the height of a stair that someone might have in their house, standing on one leg, putting the other foot that you're not standing on out in front of you a couple inches. And just trying to squat down. So you tap your heel and you can see side to side differences and maybe how the knee moves, how the hips are moving, how the foot moves. Um, but then you can even just have the person subjectively tell you, wow, that was like not very easy on my right leg. Or like I, you know, you can see them fall over a couple of times. Yeah. And so that's, that might be one way you can tell, okay, you know, I know your, your low back is hurting, but looking at this, you know, there's a little bit of stability issue we're having on this one side.

So if we can fix that or help, you know, encourage that to get a little bit better, that might help resolve some of this nagging issue you've been dealing with. Okay. I like that. I haven't used that test before. I'm familiar with the FMS step over. Um, yeah, yeah. And that's kind of what I was talking about earlier, but I like that step down. You get a similar, I think, answer in terms of like what you're getting, you know, is there a side that, that, uh, is very stable or moves well? Um, and then, uh, it's quick and easy. You don't have to have a thing. You just have to have a step. Mm-hmm. So a lot of people can do at home.

Yeah. I, you know, one, one that I've used is, I don't know the exact name. I want to say I've called it the stars test, star test. I've called it dynamic. Yeah. Dellenberg. It's where you're basically doing a clock, but I've never used a step with it. I don't know if that would work too. I suppose it could. Yeah. I don't see why not. Yeah. We're just, we're even just like the Y balance. I've done that before with, uh, certain rehab, but yeah. Yeah. Okay. Um, so going back to lifting a little bit and you, you, you spoke about McGill earlier. Um, how does something like, uh, McGill's work carry over to lifting?

Um, cause I'm sure that, uh, when, when kind of treating someone in a, in a McGill method, you're not necessarily working on like the standard chiropractic adjustment or stretching or things of that nature. It's, it's more of a stabilization approach, right? Yeah. And that's a cool thing about McGill is, is he's not a chiropractor or a physical therapist. He's a, he's a PhD in spinal biomechanics and he happens to have a passion for, you know, helping patients with some pain as well as performance. So he does, he's actually got a bunch of studies on strongmen stuff. Um, and so when you're talking about lifting in that type of, um, with that type of influence, um, things that I actually use a decent amount are, uh, loaded carries.

So what I mean by that is if, if listeners know what a, uh, farmer's carry is, where you've got two things in your hand and you're just walking, those are really great, uh, for kind of challenging just stability. So if you can imagine, you know, you take one step as one foot is in the air, you have to balance all this extra load that you're holding onto on the opposite leg. And so he even did research on this. So a lot of, uh, you know, you mentioned the word Trendelenburg and for the listeners, what that means is when you stand on one leg, if your hip kind of pops out to the side or your body kind of tilts over, um, that glute meat or one of the glute muscles that helps hold you up is kind of weak.

That's what that sign is. Well, he found that, uh, when he was doing these, uh, studies, while people were carrying a yoke, which, you know, similar load in terms of a farmer's carry is the glute was only providing enough force for, Oh, I forget the numbers, but not a hundred percent of the load. So there is another set of muscles that was help holding up the pelvis or help helping hold up the leg. Um, and that was the QL on the opposite side. So your one side that you're standing on leg glute muscle is holding up your pelvis. So you don't tilt over. And then your opposite side QL muscle, which is a muscle in your back, your quadratus lumbum is helping hold up the pelvis, uh, from the top side.

So, I mean, I'm sure you can imagine that in your head. Yeah, that'd be a great actually written or an illustration. I don't know if there is one. Yeah. Um, but so, so he, he figured this out just by studying these strongmen. And so when you're doing a farmer's carry, you're not moving or twisting the spine in any manner, but what you're doing is you're creating a lot of chance to challenge the stability of it. You know, you get on one leg and you're challenging the stability of that leg, that hip. And then even the, like I said, the opposite side QL on the obliques. Um, and then you can take a step up.

So he'll, he'll start with farmer's carries and you know, that's kind of maybe what I'll go to also, but then suitcase carries. Um, so farmer's carries is when you've got it in two hands, a suitcase carry is when you've got it in one hand. And so if you can imagine you've got all this weight pulling you to one side, uh, your muscles on the opposite side have to contract really hard to help hold you up. Otherwise you will literally fall over. So again, you're not twisting, moving, flexing, bending the spine in any manner, but you're giving it a huge stressor or huge challenge to try and make these muscles contract and stabilize the spine.

So it doesn't move. Um, so anyway, so in terms of McGill influence, in terms of training, those are some things that I've really implemented, even with patients with some of that low back discomfort, doing some suitcase carries side to side if they're ready for it. Um, and, and it seems to, to work really well. Okay. And so you, you haven't had, so with, with carries and suitcase, like you've, you've never, how many times have you actually experienced anyone not being able to do it with, with acute or chronic low back pain? Uh, gosh. So I don't know if I've experienced anybody not able to do it.

I think part of it is just the, an appropriate amount of load. Um, because the thing is with suitcase carries, what you'll see is if someone loads it up too heavy, they're, they'll literally lean to the side to almost have the load resting against their leg. Um, and again, you don't want the spine moving, tilting, uh, anything like that. So, so really it's just about addressing the right amount of load. And if it is too heavy or they say they've got pain, uh, then we can just lower the load. Um, and that seems to, uh, help with anything that they might have going on. Okay. So in preparation of, since we're going down like the, the core or the trunk stabilization route, um, in preparation to getting your body ready for lifting a lot of weight, I know that McGill did that study, that six weeks one on dynamic for a static or, uh, it was, it was isometric trunk stabilization.

Um, so when people are, when people are preparing themselves, should they be doing things like sit-ups or Russian twist, or I know that the carries are in that study. Is this kind of like the, or can you go down that route a little bit and explain the, uh, yeah, yeah, yeah. And that was kind of on our, our little list of topics here is, is core training and I'm all for it. So, and I, and that's kind of, again, you know, he's one of the influences and, and how I might prescribe things. Um, I think it's okay to do maybe a little bit of trunk motion, but, but again, looking at being athletic and doing athletic movements, um, and we can get into a few other topics here as well, but the, the core is, or, you know, I say the core, um, basically your mid section or your torso, when you're doing athletic movements should pretty much be stiff and just be transferring energy or forces.

So, um, let's see, an example might be like throwing something. You're going to push off with your legs and you want your core to be nice and rigid so that that energy that you've pushed off with your legs just transfers through there and goes through the arm and you don't have to use as much just arm force to get that ball out of your hand. Okay. And so if you train your core in a manner to be able to, uh, contract really, really hard isometrically and not have a whole lot of give, you get a really good transfer of energy. Um, especially when you train it in certain ways, like a suitcase carry, where you've got a force that's wanting to push you or pull you in that case in one direction and your body has to fight against it.

Does that make sense? So the bell wants to pull you over, but you have to contract to pull against it. That does really, really awesome job at, at getting those muscles ready to handle, uh, those huge external force loads that you might be experiencing in an athletic type of movement. So I typically will have people, uh, start or try and move towards more isometric core training. Uh, you know, if they've already been doing a lot of, uh, sit-ups are really big in CrossFit, even toes to bar if they start getting some achiness, like low back achiness from doing stuff like that. Um, I'll try and, you know, have them shift over to, to something like planks, just straight up planks.

Side planks are really awesome. And then even some of the suitcase carries. Um, so, so yeah, I am all for core training. I, I think people should implement it, but doing it in a way that, that, uh, minimizes again, that extra motion or that extra, especially flexion load that people typically want to do with their sit-up, uh, is probably best if they, uh, do that. Yeah. Well, I was, I actually asked, um, a colleague this, um, we were having a beer one night and we, I don't think we came to the conclusion of it. Um, but he, I was, we were talking about this one study or with isometric trunk stabilization.

By the way, I'm glad you said trunk. It seems like people are trying to not say core because there's a public misconception of what the core is. Um, but so we were talking about this and I'm like, do you ever train anyone to control their flexion extension, um, or, or other spinal movements not under load because they're probably going to do them. Do you want them to be under control or not? You know? Yeah. Do you have a take on that? I do. So, um, you know, if you get into, uh, some of the topics we're talking about here, at the end of the day, someone is going to eventually bend over and probably pick something up off the floor without hip hinging.

Uh, at the end of the day, people are probably going to sit in their chair with some, uh, spine flexion. Um, and I think if you're talking, creating, or trying to create pretty high loads or maximal forces via like muscle contraction. So squatting, deadlifting, athletic movements, you want to try and, you know, do those things with, uh, mechanics that are, uh, what people might consider optimal. But when you're talking general range of motion without external load on the body, so simply bending forward to touch your toes, bending backwards as best you can, I think people should have, uh, some ability to do those things, um, without necessarily having to keep mechanics in mind.

And, and they should be able to do it without too much discomfort. I mean, if, if the body is made to be able to do that, uh, does that mean like you shouldn't do it? You know, I can bend forward to touch my toes. So just because it might, you know, cause damage to my low back, if it flexes and compresses and rotate, should I never flex, compress and rotate? And, and, uh, so I think people should be able to do both. And I think people should be able to control both, just like you said. Um, and even, I mean, in my training, I do toes to bar a lot in CrossFit. Um, so I think as long as people are smart with how they progress and load those things, they should be able to do them, um, without causing too much damage.

Okay. Yeah. I was definitely curious the, cause, cause I see people do it all the time. Like I take my dog to the beach and, you know, see people picking up their small animals and their small dogs. Yeah. So it's going to happen, but I just don't want them to get hurt in my office. Yeah. So I don't know. I've been on, I've been on the fence with it, but I do recognize that they, they need it. Um, you know, actually side question. Cause I, I was talking to a friend about this yesterday. We were talking about, um, we were, we were actually lifting at the time. We are, we were back swatting and dead lifting and he had an injury back in the day.

It was actually, um, so he's flexion and he was flexion intolerant. And so he took about two months off or so, and he's been following all these people that are strong men and so on. He's like, you'd be surprised how many people hurt themselves. He's like nearly all of them, the quad tears, hamstring tears, disc injuries, and so on. He's like, that's just like his ambition is to be a strong man. And he's like, that's just what's going to happen. I'm like, well, can't we, can't we kind of see what their deficiencies are? And I don't think all these injuries had to happen. It's not just part of the, it's just not going to happen to everybody.

Yeah. Do you have anyone with those, that mindset or, or. Oh yeah. Yeah. Um, well, I just treated a dude yesterday. He's got that mindset about, you know, being banged up. Uh, the caveat to that though, is he does rodeo. So doing strong man is a little bit different than hopping on like a hundred pound animals. So I don't know, you might always kind of be banged up if you're doing rodeo because those guys are pretty nuts, but, but no, if you're doing something where you get to control what your body's doing, um, you know, you're the one who chose to back squat and deadlift and you kind of have control of how you're gonna load it and manage it, then I don't know if there always has to be discomfort, especially if you're doing it in a manner where you're maybe not looking to compete or be really competitive, you know, now those people, like maybe your friend was mentioning who are always damaged, those dudes are probably pushing it mostly because of the competitive part of it.

Um, and maybe they're doing that because they're just not managing their load. workload like really well. So, yeah, I mean, I feel like the body should be able to, it should be able to accommodate. It should be able to adapt. Oh yeah. Yeah. And so, um, what I try and explain to people, there's some research, but I think the guy's name is Tim Gabbitt. Um, I think he's a physical therapist and researcher and, uh, he's done some research on, uh, what's called like acute versus chronic workload ratio. And so I might butcher the explanation of it, but my understanding is that your chronic workload is basically what you've done over the last month, uh, or a couple of months.

And then your acute load is what you have been doing over the last week. And so if you see a drastic spike in acute load compared to what you've done over the last couple of months, the relative risk for injury, uh, increases. And so when some of his research, he was looking at rugby players and basically how much time they spent like sprinting. And so if you saw a drastic increase in sprinting over the last week compared to the last month, you saw increased, uh, I want to say it was like hamstring injuries. So, and, and, and so that makes sense, right? But what that also suggests is the body is able to adapt as long as your chronic load is gradual and nice and steadily increases.

So as long as you're not going from, uh, so let's use back squats, for example, as long as you're going from, so let's say on average, you do about five, uh, working sets. Oh, this is a terrible number, but just for sake. So five working sets over a week. Right. And then that's what your average has been for a month. And then one week you're like, okay, I'm going to change up my squat cycle. I'm going to do small of whatever. Right. Which is a, for people who don't know what small of is, it's a squat cycle that has just like a lot of squatting in it. So, and then you do that. And now in one week you've already accumulated three days of squatting with like, I don't know, 15 plus sets, like working sets.

And so your acute load is just huge. And now you start to get a little bit of hip pain. And so that's kind of an example or how you could use that in real life. So instead of like that drastic change in workload, if you wanted to improve your ability to do attack, so you're looking at strongman implements, whether it's a yoke, whether it's like farmer's carries, um, having a slower increase over time of those things, you'll probably see less and less like, you know, musculoskeletal, uh, uh, disorders. Yeah. No, I totally agree. I think proper programming with, with any sport. Um, I mean, I see this a lot of time with, with runners, like especially ones that have been battling injury.

Like they'll, they'll say, I'm just going to go out on a Saturday and let's just hit 10 miles. And then they don't do anything for like two weeks and then they wait and wait and wait and well, let's do it again. Oh, it's still there. So it's, I, I know that their, their brain thinks that it will, that their body can still do it, but I think they have to train responsibly, you know? Yeah, no, I totally agree. Um, but, but, you know, with all that being said, so if you're, if you're programming well, then no, I don't think your body has to be in pain just because you're doing a specific sport such as powerlifting or strongman or weightlifting or CrossFit.

Yeah, I totally agree. Um, so now I, I know we didn't talk about intra-abdominal pressure yet, but I feel like it's probably needed here. Um, tell me, tell me about that. And, uh, actually it's funny, I've, I've had probably five, six different people independently bring it up, not even a prompted about, um, about intra-abdominal pressure. And, but I, I still see a lot of patients that I see resistant to the idea. They don't understand why it's important. So there's a lack of understanding, I feel. Oh yeah. Yeah. And I think there's a, just a big misconception in the fitness industry in general.

So people who go work out, um, I think they just don't understand, uh, how the best way to stabilize the low back or midsection is. So I, I, I actually wrote a blog about like how to use a weightlifting belt and I think it fits in with this really well. Um, but basically, so explaining intra-abdominal pressure. So inside your, everybody's gut essentially is just a cavity. Okay. And so your diaphragm, the diaphragm that everybody uses to breathe looks like a parachute or a dome, right? So when you breathe in, this diaphragm is going to contract. And as it contracts, that dome is going to basically close down where it gets smaller, but as that muscle itself contracts and closes down, it's pressing or giving more pressure into basically where all your guts are, uh, or your abdomen.

That's why it's called intra-abdominal pressure. So, um, as it presses down, the pressure gets higher and higher and higher inside your gut. And all that pressure is going to help stabilize the, the low back, uh, while you're doing stuff. So a really, really awesome analogy is like a pop can. So if you've got a pop can that's closed, uh, it's sealed, you could probably set it down and step on it and nothing's going to happen. So there's a lot of pressure inside of there. Um, but as soon as you break that seal and so breaking the seal on your intra-abdominal pressure might look like, um, basically, uh, a little bit of maybe flexion, a little bit of, um, you know, not a total huge breath in to create a huge amount of intra-abdominal pressure.

Um, and you'll start to get a little bit less stability. So if you break the seal on a pop can, uh, that you go to step on it again and it might crack or crinkle over. Um, but so the best way to create intra-abdominal pressure for yourself is trying to, so let's say you're getting ready to do a deadlift or a squat, trying to expand your belly as big as you can and not just your belly, but even on your side. So you're oblique muscles trying to get that as big as you possibly can, uh, right before the lift. So what that does is that fills up or it doesn't really fill up with air because your lungs are in your chest, but it puts a lot of pressure in that area and it makes that low back really stable, hard to bend, hard to flex.

Uh, and it's going to be able to give more stability centrally. So basically in the midsection while your arms and legs are able to do more athletic things peripherally. So, um, so in regards to safety with, uh, I mean, so that provides more stabilization to the spine. So how does it, what about when we're exhausted or labored breathing or does that change anything or like presenting challenges? Yeah. So when you're labored or when you're doing like, uh, say it's a middle of a CrossFit workout, where you're going to start to do is you're going to start to use other muscles. So I said your diaphragm earlier, your diaphragm is a big muscle that pretty much all of us use when we're breathing in.

Um, but when you're exhausted, you're going to try and expand your chest in other ways. So your diaphragm is going to push down on the lungs and kind of open up, uh, from that angle. I like that, but you're going to get involvement of traps. Um, basically all the muscles around your kind of like lower neck, upper back, they get sore after doing something like that. You can kind of feel them, but those are going to try and raise up the long or the, the, the rib cage so that you can breathe more and more. And so that makes it tough when you're labored to really create a whole lot of intra-abdominal pressure because you see this chest rise in this chest expansion, as opposed to this belly expansion.

So how do, how do they control something like that? If they're, if, if they're kind of a, in the midst of a workout and they're like, well, I just, I just got to keep going. Like, is there, is there a way to mitigate risk with that? Oh, so, you know, with that, I would say it's just, it'd be more of a practice thing. So being mindful of it. So if you, uh, have the choice to be in the middle of a really intense workout and you're trying to do something that's kind of heavy, um, having some awareness of what intra-abdominal pressure is basically creating stability in the midsection before doing something, um, being mindful and practicing that during those times is what's going to create better, uh, ability to do it, you know, when you are more labored.

So that's, I mean, that's kind of the best answer that I can come up for that is just practicing it when you're tired. Um, but also practicing it, obviously just like skill acquisition is going to come from doing it over and over and over and having it become second nature, even when you're not in that tired state. So every time you're going to set up for a heavy squat or heavy deadlift or clean and jerk or snatch, uh, really any heavy movement at all, um, while you're not fatigued is going to set kind of just kind of that neurological, uh, uh, pattern for you to do that thing before you, you know, lift a heavy barbell.

Yeah. Does that make sense? Yep. Perfect practice makes perfect. And, uh, there you go. So there's, there's some times too where like I'll actually, so I have an, I have an urgrower in the office and, uh, I'll, I'll keep stuff fairly light, but I'll, I'll fatigue them out a little bit on that. And then I'll put them into, um, some, whatever movement we're trying to improve on and keep the pressure with. And, uh, so I, I tell them that they're going to keep moving until I've seen seeing their form degrade and I'll cue them once. And if they can't get out of it, then I'm going to stop them. Um, yeah, but I want them to get a chance to, to get into that labored state a little bit so they can have the chance to control it rather than stopping them quickly.

Um, so yeah, pretty much. I use, I don't have them do it with weight, like that much weight on them, but so I guess they're going to have to carry that over. Um, what, how come, how did you start to, to practice in this manner? Cause I know you, you, you probably, you didn't go to the same school as me, but, um, you, you've, you've taken the, uh, the, the McGill route. What's your, what's your reason? Oh, I mean, I think it just fit really well with, I guess my philosophy on health and wellness beforehand. So, I mean, I, I played college football. I've always been kind of into, uh, strength and conditioning in terms of just trying to get bigger and stronger.

And then when I went to chiropractic school, I also did a master's degree in sports medicine. Um, and then at our school, uh, we had a big, uh, kind of rehab based group of, of people. Uh, and the more I saw that style or that side of, of chiropractic, it, it really, uh, kind of sucked me in a bit. And, and then obviously seeing, you know, that there's kind of a disconnect between, um, moving well and a lot of other stuff that you treat like pain and dysfunction. So it's not just doing hands-on stuff, but it's also providing them with the tools to be able to help themselves. Um, that really helped.

And that's kind of what McGill teaches as kind of what, uh, some of the other things in terms of rehabilitation kind of gear themselves towards. And so that was really awesome. So being able to me help educate the person, you know, the patient that comes in with discomfort and not just do a few things so that they're reliant on me, but teaching them a few things so that they can go a little bit longer in between visits that they see me because they're able to help themselves. And then eventually, you know, maybe they've got a cute little flare up, but they know how to manage it because of things that, that I've been able to show them, which, you know, came from some of those influences.

So, yeah, that's, that's cool. I, you know, I, I don't, I, I think I told, or I, I guess I didn't tell everyone how, how we've come to talk, but, um, so I got, I got your, your name and your contact from, from Whitney at the NSCA. Um, and so the email I sent her originally was, Hey, do you have a strength conditioning coach to talk about lumbar spine injuries with lifting? And she handpicked your name from everyone else she could have picked. What, uh, I think it's probably, I think it's an honor. I don't, I don't know how you, you know her, but she, she holds you in high regard. So I'm glad to have you on.

Yeah. Well, I'm, I'm glad I was able to talk and yeah, it is kind of crazy. It ended up being, uh, uh, another chiropractor, I suppose. I know. I didn't expect that at all. I thought she was going to like throw like some, like, like a UCLA strength coach at me or something like that since she was a Southern California rep. Yeah. But, uh, yeah, this is good stuff. I think we have a lot to talk about. Um, so I, I think, so there's one more thing before we, we close out. I think returning to like, I guess, return to play or return to lift. Um, do you have suggestions? Is there certain scaled approach you might take to something like a snatch or a deadlift or a jerk?

Does speed important? Would you take out certain ranges of motion? Would you scale it somehow? Yeah. So, um, so I can kind of go through kind of all of those things. Uh, so initially, you know, obviously if I'm treating a patient or if a person is having some pain in an area, you know, one of the first things that we might do is try and, uh, decrease that as best we can, but then we're going to try and get them into the position or the thing that they want to do. And again, this all comes back to what are their goals? Do they need to be squatting full depth or can I have them squat to, uh, a certain point?

And that's what I might do first. So they might squat down to a box. Um, so we're limiting range of motion. And as they progress and get stronger and look better in those positions, we can decrease the depth more and more and more, uh, same with the deadlift. So you can start, you know, pretty close to lockout where you're basically just doing pulls off of, off of blocks. So, you know, one of the first things that I might go to in terms of returning to doing, you know, barbell movements is just changing the range of motion a bit. And then the other thing that you might do is try to, uh, change maybe how the person does that movement.

So this sounds kind of weird, but, um, so deadlifting, everyone usually picks it up off the floor. Well, if it's hard for someone to pick it up off the floor, you could do something like a true Romanian style deadlift where you pull it off of blocks, step forward or backward and then start doing the lifting. So that works well for the deadlift example. Um, maybe not as well for like a squat, obviously, but, um, but again, just getting creative with how you start and stop those certain movements. Um, and then the other thing that I wanted to mention about, like some of the Olympic style weightlifting stuff is so, uh, USAW or the United States weightlifting, uh, coaching style is they call like a top down method.

And so basically all that means is you're having that person do the lift from a higher position. So, uh, snatched might be from the hips or, uh, from the thigh versus from all the way from the floor. So again, you're changing the range of motion and you're getting them back to doing that thing, uh, without having to put them through the full range. Something else to mention with the, uh, Olympic lifts is in CrossFit. What you see a lot is again, they're trying to do these lifts where they're doing a full squat with it. So I usually will have people do what you would call like a hang position. So like above the knee, but a power.

So power just means you're basically not taking it down into a squat. So you're limiting the range of motion on both ends, but you're still getting that explosion that you're getting, uh, from the lift itself. And so going from squatting to deadlifting, to maybe cleans and snatches, that might be how you could start is changing the range of motion on all these things. And so with squatting, it might be to a box with deadlifting. It might be off of a box with cleans and snatches. It might be from a hang just into a power so we can still get the, the lift that we're looking for, but we're going to do it in a manner that puts them in the best position so that we're not stressing the tissues that might be already irritated.

Okay. I like that. Start from the hang, go from, go to the power. Yeah. Um, you know, just a side question. Maybe you made me think about it. So actually a couple of weeks ago, I started implementing with, with my patients that I, whenever they're in my presence, I am not allowing any deadlifting touch and go. Yeah. I want them to reset every time. Um, I don't know if you, if you have any, any thoughts on that or not. Um, it's something new I'm trying just because I want to make sure that they have intention when they lift it. And I mean, obviously it, it, I, we start with lighter weight, but when you go to heavier, I, I want them to feel, I want them to be stable when they move it, you know?

Correct. And yeah, so actually, um, one of the things that I wrote down that I wanted to mention, and this is kind of, again, for the crossfitters out there is deadlifting. Uh, you see it a lot where they will pull it from the floor and then they'll drop it from the top. And I think you're, you're almost doing yourself a disservice there. Because, um, people are typically stronger in the eccentric portion of the lift. So for that means lowering it down typically. So for the deadlift, lowering it back down, you're almost cheating yourself out of half a rep if you don't take it back down. And, and then what you were saying with the, uh, not doing touch and goes, I think that's great, especially if you're working with a patient that might be dealing with some pain to make sure that they've got a really great setup.

They don't lose position in between lifts, but I think it's really important. And I'll have somebody do this. If, if someone sends me a video or they haven't watched them deadlift and it just kind of looks a little off. It's not too bad, but their motion isn't amazing. I'll tell them, you know, go ahead and do your lift to the top. But then once you get to the top, I want you to envision and practice a perfect descent. So the bar path should be exactly where you want it. Your knees and hips should be aligned where that you want them to be on the decent part of it, because that should be easier to do because you usually are a little bit stronger.

And then that, you know, doing those negative reps can help set the, the motor pattern up so that when they do the concentric pattern of it, it looks a little cleaner over time. So, um, I like setting up in between each lift, just like you mentioned, but I think something that people can stress even more if they're trying to clean up how the lift looks or just get stronger is slow down the decent part of it or the eccentric portion of it. And really focus on that bar path with that motion. Okay. I like it. 30, 30 second descent, high time under tension. Oh man. I don't know about that. Maybe about, maybe about three seconds.

Yeah, I think so. Uh, well, cool. Um, so anything else you want to add and, um, it does, how would, how does everyone contact you? Uh, oh man. I know that, I know that you're, you're, one of your websites was dead, I think. Oh yeah. So we were, uh, the clinic that I'm at, we were, uh, updating our website. So it's, it might be back on now, but, um, so my email, I can give out my email. I don't feel too ashamed with that because I can filter through that. Um, is it an MSN hotmail one? It's not. No, it's, it's the, the one that I think you have. It's just Seth Meyers, my name. So that's M-Y-E-R-S-D-C.

So just the letters, DC at gmail.com. So if anyone really wants to send me an email, go for it. If they've got any questions or anything, I'll be happy to answer any. Okay. And then I, I've got a Facebook page, which is just my name and then a bunch of different letters after it. So DC, MS, uh, I think CSCS. And if they want to follow some content that I put on there, they, they're more than welcome. Is that where you're most active with the, uh, articles, articles you're writing on Facebook? Yeah, I'll, I'll share them there and I'll also share other people's articles and maybe have a little paragraph blurb where I say what I like about it.

So that's probably where I'm most active. I haven't done as much recently as I maybe would like, but, but yeah. Yeah, it takes, I'll be honest with you, it takes a bit of time to even, uh, to, I saw you had some, some articles up, but I mean, it takes forever to, to, to write and then edit and then the pictures and so it's a lot of work. Um, well, cool. So then, um, yeah, well, thanks for coming on and, um, don't hang up just yet. I'll, uh, I'll come right back. Okay. Awesome. All right, everyone. That was Dr. Seth Meyers. Again, Seth Meyers with an E R S at the end. Um, go to his stuff. He is a very, very smart guy and I'm going to try to get him to make some videos correlated to this podcast.

Um, he said, he's going to try to make some on his phone, um, with the loaded carry as well as some intra-abdominal pressure, some hips to the wall and butt wink, I think. And also maybe that step down test. So that's all the, that's all the stuff we talked about in the podcast today. So if you've been listening to this podcast and you haven't gone onto iTunes yet, you should. And I'll tell you the reasons why. Number one, you can't get all of the stuff when it comes out, right when it comes out, if you're listening to it on someone's site, even mine, it'll be delayed. Okay. You can get all the show notes on p2sportsk.com slash podcast, but I would love it if you went over to iTunes and subscribed.

So subscribe, give me a review, tell me what you like and don't like about this show. I'm open to constructive criticism and I'm only making the show for you guys. I'm super appreciative that now we have people listening from, uh, I think it's 12, 12 to 14 different countries. Uh, I think I saw, um, even like, uh, East Asia was on there. I'd have to get the notes in front of me to see, but I'm on, I'm honored to have everyone listen in and I've had people say they listen to this when they run, when they drive, when they're at the gym. So that's what I want to hear. I want to hear that you guys are enjoying this.

So again, go onto the site, p2sportscare.com. There's lots of correlated articles and all the show notes will be on there that you're looking for from this podcast. I'll talk to you guys soon. Thank you.