Why your lower back gets crooked and how it straightens out

Hey clinicians, before we start, I'm going to draw your attention to the premium version of the podcast that we have that we released back in January. It's going very well. It releases once a week and it's all the stuff that you care more about than some of the general conversation you might get in some of these free version podcasts. So it's about 15 minutes long. We do case presentations, all of the stuff that we tried, things that work, things that didn't work, and a little bit more specific to you and the things that you wish might be in there too. It's very affordable. You can quit at any time. There's a link in the description below.

Go check it out. You'll love it. Now onto the podcast. You're listening to the Restoring Human Movement podcast, where movement experts discuss the latest evidence-based practices to help you and your clients move with mastery. And now, your host, Dr. Sebastian Gonzales. Hey everyone, it's your host, Sebastian, with the Restoring Human Movement podcast. Thanks for joining the Movement Movement. This is your first time on the show. Welcome. You missed a lot of great information and we're going to cover more good information today. You can always go back into the archives and check out what we have available for low back, hip, shoulder, shoulder blade, neck, and so on. We have industry experts on who can help out with understanding a little bit more for those clinicians out there too. But as you see by the introduction, clinicians, if you want more information, there's a premium version just for you. Now the topic we're going to cover today is why does my lower back get crooked? As you noted, probably we have had a lot of podcasts over the recent few months that have been targeted a little bit more so at back pain. We see a lot of back pain in performance plays. We see a lot of hip and groin pain and people tend to have a lot of questions and concerns. And so these 10 roughly podcasts that I'm going through, about 250 through 260 roughly, are going to be targeted really understanding what could be going on or at least understanding it enough to know that, okay, so I know where I need to go. I know what I may need to do.

Then I just need to have someone help me and help, uh, help me. I want to trust them and do exactly what they say. Um, and the reality of it is, uh, a lot of you out there, if you're trying to manage your own low back hip or groin pain, it's way more challenging. I'm being completely transparent and completely honest with you. I've attempted to do the same myself and I do. I sound cocky. I think I know what I'm doing, but it's very challenging to manage your own problem. It's hard to be your own doctor and your own patient. Okay. So take this information as you will today. Uh, for all you clinicians out there who may be listening, uh, again, this is boiled down information, uh, to make it understandable for the lay public. Uh, we're not going to go into the nitty gritties of research and so on. If you want to, there's other podcasts for you, or we got the premium one. So what I thought, I thought we'd cover today is a few types of quote unquote crooked low backs because everybody has a little bit of a different definition when they're talking about their crookedness. Some people are talking about the sideways crooked. Some people are talking about the forward crooked. Some people are talking about scoliosis, uh, and so on. So there's many different reasons for it. However, generally speaking, there's about three types. There's a lordosis, which is also called a sway back.

There's a kyphosis, which is someone who's abnormally rounded in a position, by the way, a lordosis and kyphosis generally mean, uh, a direction or, or around or concavity in a certain, certain position. You can have it in different regions of the spine. In this case, we're just talking about the lower spine. So a lordosis again, would be like a big sway back, like booty out type of thing. Someone who's kind of locked into that position, by the way, it may or may not have any association with their back pain. It's just something that we're observing. It's data points. It's information that gives us, uh, a little bit of a lead into maybe how we can help this person. Uh, kyphosis is the opposite.

It's the opposite of the sway back, but out person. It's the, uh, quote unquote, no booty person. Uh, and then there's a scoliosis, which is kind of a crooked sideways, uh, S C shape. Uh, usually the scoliosis, uh, at least, um, when people are talking about in lay populations, you're talking about the mid back. Um, that is usually something that is going to be more, uh, I'd say urgent or need more medical attention. If you're a younger in age, if you're not skeletally mature, if you're older, if you're 40, I'm 40 years old, it's probably not a huge deal, but obviously, you know, you want to get checked out if it's dramatically changing things too.

The one that I think that everyone's going to want to know most about today is going to be the shift, the sideways shift, the crookedness. It seems like they're trying to scissor their body back together, like from side to side. They put one hand on the side of their body, like rib cage, the other side on their, on their, uh, pelvis and they try to push it together. Uh, I've met a lot of people who have said they've attempted to do that because they're like, one day I just woke up and I was crooked. Crazy, right? Uh, it's actually, it's, it's not super common, but it is common. I'll tell you right now, it's probably not the psoas muscle. I don't know where that myth has been coming from, but I gamble almost every penny I have that it's not the psoas or hip flexor muscle. So if you've been told that, or if you're reading literature on that, uh, I, I, I gamble and say no, I'm not saying it's not possible, but I gamble and say no. Okay. So the first thing we'll cover is, uh, we'll cover lordosis and kyphosis just generally speaking at first. I think a lot of you are going to get a lot more information out of the, the sideways one. Um, for those of you who are dealing with low back pain, you might notice that you're in a kind of, uh, the lordosis or sway back position. It's like you're locked in that position. Now there's a lot of reasons why that could be happening. Uh, Dr. Google says, here's some of the main reasons why, but I'll present some other reasons too. Uh, achondroplasia, by the way, I'm not going to spend a lot of time on these things.

These are just things that you probably don't have, but if you want to look them up, you certainly can. Achondroplasia, spondylolisthesis, osteoporosis, which is thinning of the bone. Uh, by the way, spondylolisthesis is, uh, like a slippage of a vertebra, an actual movement segment of the spine that shouldn't be moving that much. Uh, obesity, which makes sense because there's a forward, uh, the carriage or the weight of your body is more forward over your spine. So there's a compensation of the sway to offset that counterbalance. Uh, discitis would they say is inflammation of the disc space between the bones of the spine, which is often caused by an infection. It can also be, uh, there can also be disc sensitivity, which is going to be a little bit more of like, uh, like your disc injuries, your disc herniations, protrusion, prolapse, and so on. Uh, and then they mentioned like benign, harmless tumors as well. Uh, that's what the lordosis sway back people, uh, also to maybe something to note too, is if you're feel like you're locked in this position, I know I have one client that I've worked with that he said that for a lot of years after having really acute low back pain, he felt like he never wanted to round his spine again. Um, I've met somebody who said that they, uh, wish that they, uh, they were a mannequin. I think I mentioned this other podcast. They didn't want to move because movement was fearful to them. They were, they were afraid of movement. Uh, and some people do sadly, they do get like this and they get scared of moving again. Uh, the pain, low back pain can be the most intense pain that you've ever had in your life.

And I've never had it that severe, but I've witnessed people on the ground, um, not being able to find a comfortable position screaming in pain. Um, so I know how intense it can be. And that's a real traumatic experience for people. That's really traumatic. And so it makes perfect sense why they might not want to round their back again, because in that situation, a lot of times when it's that acute, rounding your spine forward is the worst, but not for everybody. And, but a lot of times it is. So with that being said, another cause, which is not really on here is, um, uh, Philip Snell, I think he, he called it in his workshop maladaption. And so it's, it's adaptation, but in, in a different way, it's, it's, it's kind of the way of like, uh, protecting the spine against round.

What happens oftentimes is the air starts to stiffen up. Uh, I've felt this personally too. I didn't want to round my back too much. And so it just generally felt stiff. It's like my arm was in a cast and my biceps felt like it was stiff. And so if you don't expose your back to a little bit of movement into a round, it will probably feel stiff. Um, theoretically, what can happen from that with not moving into the round every once in a while with your lordosis posture might be that you get facet arthropathy, which is arthritis. You might get degenerative findings in your spine, which is arthritis. You might get degenerative, uh, uh, degenerative disc disease, which is arthritis.

You might get stenosis, foraminal or central stenosis, which is generally arthritis. I know I'm being trying to be funny here, but those are just different fancy terms for, um, you know, your quote unquote bone spurs and so on. Uh, the theory why that might happen, by the way, I'm not predicting anybody's future here. I don't, I don't want to anyone to assume that I'm, uh, I'm taking a solid stand here. This is just theoretically what could happen because we don't always know what, why these things happen, but there's a possibility. If you load the backside of your spine, like we call it the posterior element, uh, all those little bones and joints, you look at a spine, there's this, there's this, uh, circle area of the bone. And then there's all those little, uh, protrusions and bony prominences in the back. Um, we call it the backside of the spine or the posterior elements. And so if you require a lot of load on your spine in a certain spot, in theory, it might actually grow some bone around it to help out. So there's something called the Wolf's, uh, Wolf's law in, um, uh, anatomy physiology. Wolf's law is basically, um, bone will build. If you stimulate it like weightlifting and walking, it'll stimulate bone growth. And if you don't stimulate bone growth by decreasing the load, then it will go osteoporotic or decrease bone density or become brittle. And so this is why a lot of times our osteoporosis, like a general recommendation is get out new body weight activity because gravity is the load. So in the scenario where you could create some things like your quote unquote arthritis and bones spurs in the backside from having too much, uh, lordosis chronically, uh, it's mainly because the bony response is what my theory would be. The bones are reacting to the load that you put on them chronically, meaning a lot over a long period of time. And it's adapting just as a bicep would adapt, uh, adapt to doing a lot of bicep curls. And all of a sudden you have a massive bicep on just on one side of your body. That's just what you've exposed it to the load that you've exposed it to chronically. The other one is a kyphosis posture or a, um, we'll call it a, uh, crooked, uh, back in a kyphosis direction, which is forward. Dr. Google mentions that this could be abnormal vertebral development in utero.

It could be poor posture or slouching. Uh, I, I know I, it's funny in one of the tests that we do today in the office, uh, I want the people to slouch and I say, can you, can you slash the kids do now? I don't know if I'm, if I'm 40 and maybe I'm becoming to the age where like you tell kids to get off your lawn, but I swear, I feel like I've seen kids next, just like they're looking down all the time. They're slouching all the time. Um, maybe, maybe they don't go out and play enough. I don't know. Uh, but I, I, I don't doubt in the future, there's going to be some, some problems happening from that is chronic load, right? Um, I'll reserve the right to change my mind on that, but, but overall, I think kids got to go out and play. So anyways, slouching your poor posture, I would say chronically in this probably, um, uh, osteoporosis, spina bifida, spine infection, spinal tumors, and so on. So there's, there's a lot of other things that could, it could be also too. This could be maladaption as well, as we mentioned maladaption one way, which is the body trying to avoid rounding. Uh, in my, that might be conscious or unconscious, by the way, I mentioned earlier that some people were knowingly afraid of stuff. Uh, sometimes you just get out of habit, you know, like you start putting your shoes on a certain way and then you realize, Oh, I've been doing this for like 10 years. This is just how I put my shoes on. It's called a habit. Sometimes it's hard to break habits. And if you weren't bending forward for six months because your back hurt, then you might've formed a habit. Uh, the same thing can happen the other way too. People who sometimes have problems like foraminal stenosis or, uh, sciatica, which is a little bit more of a primarily, primarily based non-discogenic, non-spinal disc based type of sciatica. Um, like just the nerve is pinched in the, uh, tunnel. We call the tunnel of foramen. Uh, they might not want to bend their back backwards. Quite honestly, it hurts and it shoots, shoots pain down the leg. Sometimes it makes the toes tingle. Sometimes it makes the hamstring feel like it's just in spasm. Um, and just standing up straight or even walking is so painful that they buckle forward. And so over the course of time, they might just find that actually just makes them feel better. Um, I've, I've never asked this question before, but I'm, I'm one day I want to, or if you guys know somebody who is like this, maybe ask them, uh, if you see someone in a walker, who's leaning on the walker and their low back is rounded, ask them how they feel in that position. I'd gamble. They'd, they'd probably say, I feel fine.

They feel normal. They feel good. They feel no pain. There might be a reason why they, they like the walker. They're rounded and they're trying to get away from the other one. So the body naturally tries to get away from pain. I don't know what it'll be like if you actually ask them to actually stand up and walk around without the walker, but there's a possibility they have really have trouble standing up straight either because they have stiffness or they have pain associated with standing up straight. I don't really know. Um, sometimes I guess I, I don't see a lot of, uh, geriatric populations, but I would, I'd assume that if they lay on their back, it might actually, they can go straight, but standing is challenging a standing upright. You ever notice like if that is the case, like the only difference is really that the spine is under load of gravity. So they need to be able to manage their load a little bit better, manage gravity a little bit better. Uh, and that would usually respond. I would imagine to, uh, rehabilitative exercise, strength training exercise, something that builds support within the spine and hip area. Uh, so that's your, that's your kyphosis. Now the one I thought I would spend a little bit more time on today is the lateral shift. Um, something I pulled up on, uh, Dr. Google again, it says a lateral shift may be caused by acute low back pain, disc protrusion, or disc herniation. When the condition is not serious, the Spain, the spine may shift, may be shifted when viewed from behind, i.e.

the bones of the spine will look and feel crooked. Uh, I guess in this case, they're talking about an x-ray. It will, will, the bones of the spine will look and feel crooked. Uh, I would, I would agree with that. Um, probably the first note on this is if you're looking at an x-ray, it is, it is an, it's absent of soft tissues. Pretty much. You don't see, you don't see muscles. You don't see ligaments. You don't see disc between the bones of the spine. You don't see tendons. You don't see any of that stuff. You see shadows, uh, you see shadows of stuff. Uh, and so you can theoretically see them, but you don't see too much information about them. It's not the standard to a standard image to really image any, uh, get information of any soft tissues. Um, you can see calcifications in hardened tissues because it images hard things like bones. Uh, but if you just looked at an x-ray, it's just going to look crooked. And so you can say, Oh, that's a scoliosis, but no, it might be a compensation. It's your body trying to get away from pain. Uh, and so this, this shift can happen to get away from pain. It's your body on, uh, subconsciously trying to help you out to get away from pain.

This can happen with a posterior lateral, uh, disc injury. Posterior means back, uh, lateral means to the side, uh, posterior lateral lateral disc injuries are actually pretty common and, but not all of them really have the appearance of the shift. Uh, if you guys don't know what these, these will look like, I encourage you to go on to Dr. Google and at least I don't love Dr. Google by the way. I just, you know, poke fun, but there are good references on there. Um, maybe take a panel of like 20 pictures that you see and just generally whatever one looks like the other one, what's the most common presentation. That's probably more accurate. It's not going to be the one that looks different and it's, uh, all the gory one, you know, and so on. And so if you look up kyphotic entalgia, lordotic entalgia, and lateral shift entalgia, uh, then I think you're going to get a good idea of, of what I'm talking about here. So we already talked about the other two. Um, but now I'm going to take some information from, uh, this, uh, this book is actually one that I have a lot of my interns read.

I think it's a really great book to start with. Uh, if you're a physical therapist, if you're a chiropractor, um, even if you work with, uh, if you're working people in a training setting, I think these are, this is really good information to have. It might be over your guys's head a little bit just for some of the diagnosis. Um, but generally speaking, this is really good information, uh, on, uh, there's one section where they're talking about, uh, lumbar disc derangements as entalgia or what they call shades of entalgia. Uh, I'm going to reference the book cause I will be reading from it a little bit. I don't want to be plagiarizing or anything, but this is called clinical reasoning of the, of spine pain volume one by Donald Murphy. Um, the book I think is like under a hundred bucks. It's not necessarily lay public friendly, but if some of you are engineers and you've been reading up on all these different, uh, websites over the years and getting the gurus information, um, maybe this could be a cornerstone to your education. So, uh, they said, as mentioned above one of the most characteristics, uh, common characteristic of disc derangements is entalgia.

That is entalgic positions, uh, posture is common in patients with disc derangements, particularly in acute stages. However, entalgia is not universally, uh, seen universally with disc derangements as a, as a majority of patients with, with this diagnosis will not exhibit entalgia. Okay. Remember earlier I said that it's probably not the psoas. It's probably not the psoas. Okay. So this is usually very characteristic of some type of disc injury. Disc injuries don't require trauma. You could just wake up with it. You could be sitting a lot. You could have gone through what a lot of people did these last couple of years is they started working from their home office, doing a bunch of zooms. And all of a sudden they had shoulder blade pain, uh, neck pain. They had a low back, probably SI joint, and maybe they got crooked like this, you know, but not everybody does. Uh, I think over the course of the last 10 years, I've only seen, uh, probably five, six, seven people with, uh, a lateral shift. And whenever we see one come in or if I've, you know, I hear about one, I say, oh, that's, it's, it's unfortunate. It's, it's not to say it's, it's hard, not to say it's, it's impossible to improve from, uh, but it's, it's a little harder. There's some precursor steps that you need to cross. So, um, I don't say this to give you advice, uh, like no hope of recovering if this is you, but I want you to know that you can improve and usually it does not require a surgery that none of the people that we worked with that improved required surgery. It just required a little bit more attention work on their part and, uh, due due diligence on our part, because we needed to screen for a couple more things. Uh, and we needed a lot more touch points with this person. It wasn't like there's this magic show that you see the person three times or one time. And then they all of a sudden they're just raving, you know, from the rooftops about how, how great your care is. Um, it's, it's a little bit of a process. Um, if we hit the nail on the head the first time, they'll start feeling better. Hopefully within, uh, I think I've, I think roughly under a month, I think is fair. Um, but the challenge for you guys, if you're trying to manage this on your own is that sometimes, even though you're not, you don't have progress uh, over the course of a week or two, like some situations are a little bit more challenging like this one, like you, you kind of put your nose to the grindstone and this is what you might have to do for, you know, three weeks, four weeks, five weeks before you see any real change. I remember we had this one, um, person come in that they had numbness into the arm, um, under a certain, uh, it was a certain section of their hand, which is very characteristic of a single nerve root, uh, uh, uh, like a ridiculitis, like a single nerve root coming from the neck. Um, one single level and it didn't, it didn't affect the function of her hands. Uh, the only thing that it was just numb.

And so the challenging thing sometimes with scenarios like this is you don't always get what we call an outcome measure. You don't need to always get an, or an audit process. Um, some people with hand numbness, we can just go ahead and look down. Oh, that's worse. Look up. Oh, in a way, like there's normal, um, movements that we can check out that might give us better information on which way to go. Um, a really thorough exam will give us, uh, enough information to where we can at least establish a game plan. But this person in particular, there was, uh, there was almost no, um, there was almost no information, no neck stuff, no shoulder snuff, no stuff, no wrist stuff, no hand stuff that would really give us any real direction. We did all the reflexes. We did all that kind of stuff and really no good direction. And so we just picked the most logical direction. And then we kept the nose of the grindstone for about three to four weeks and it, and it did go away. I was so happy when it went, when it went away. Um, and it was just knowing that you got to keep your nose on the grindstone and just keep trying that, even though it's not producing a result. Uh, you, and just make sure that you test it. Cause the problem is, is something like this, like a, like a lateral shift.

If you try something for like a day, you're like, ah, it didn't work. And then try something for a week and all that didn't work. Uh, I stretched the hip flexor. Uh, it didn't work, you know? So you might have to just have someone a little bit more, uh, as a team member who can help you out to figure out what route to take. Okay. Uh, let's see what else I can read in this, in this, uh, document. Um, but understanding the identification and treatment of derangements that exhibit entalgia helps the practitioner understand the identification treatment of derangements that do not exhibit entalgia. So just because you do, or do not have that shift forward, backwards side, and so on, it doesn't mean that you don't have some type of disc injury either. Um, entalgia involves being, uh, the spine being fixed, stuck, or crooked in a certain direction with the inability to move enough in the opposite direction to achieve a neutral position.

It's like you're stuck in that position. Uh, this inability is due to the perception of pain or mechanical obstruction. So there's actually something, uh, stopping the movement, which could be some of the disc, uh, or it can just be painful. You know, it's painful to move through the direction that the body's trying to get away from. And so if you're stuck and your hips are shifted to the left and you tried to push them to the right and it started to hurt, like naturally you'd want to stop. Um, but over the course, course of time, there's, there's a chance that you might actually find that actually pushing your hips the opposite direction might actually be one of the best things for you. Um, now there are situations where it's, again, it's not quite as clear. Um, I'll give you the easy situations. If your back is stuck into a sway position, sometimes rounding it like a child's pose might be the easiest thing you can do. And if it doesn't hurt, you just hang in the child's pose for, you know, five, 10 minutes a day on and off. And then all of a sudden in a weak spirit of time, you start feeling quite a lot better. Other people are kind of stuck in the rounded position or the lordosis where they might find that actually, um, uh, that I, I, I take it back. There was the round, there was the lordosis, which would respond to the child's pose maybe. And then there's a kyphosis, which is the arched one or the kind of butt out one who might respond, uh, to, uh, actually go in the opposite direction. Now these aren't always as simple as they could be. I, I wish everybody's back shift and sway and crookedness is all in very textbook and easy, but it's not, uh, sometimes people who have the kyphotic, um, entalgia it's, it's fixed into a round, uh, and so they're leaning away from back pain. And so sometimes you might just want to allow that rounding to occur a little longer because you're letting it go away from pain. Sometimes you want, want, want to challenge that.

You might want to extend it a little bit more so, and to kind of get through, uh, to reposition the, the, the disc as they say. Uh, other times, uh, you, with the lordosis one where the lordotic intelligence is affixed into extension, we got that big old, like arched back. Um, you're, you, you might want to allow that and extend the back a little bit more, or you might just want to round that person, maybe into a non-gravity position, like being in child's pose. I've met people who have had, uh, have done child's pose on a daily basis and it hasn't worked. I've met people who have done child's pose, uh, and it has worked miracles for them with the shift stuff. You might want to shift your hips towards the other side, or sometimes you just allow it to happen. Uh, it really depends what your examiner finds to be the most useful for you. Now I'll, I'll give you a couple stories of people that I've worked with, with the shifts and just give you some general outline of what they've tried, uh, and what they have, uh, experienced throughout their time. And these two cases were pretty, uh, they're pretty fresh to me. Uh, one of them was, uh, uh, she was shifted immediately when she got out of the car. Um, she was the sideways shifter one, you know, walking in and kind of crooked, like, uh, she parked and I'd watch her walk from the car to the office door. Um, and she said, you know, when I got in my car and drove like 10 minutes ago, I wasn't like this.

So driving even that far would set it off. Um, for her, bending backwards was really painful the first few times, but then after she, she'd bend backwards a little bit, she felt better. Um, I actually struggled to give her good rehabilitation at the time. Uh, I think I spent a month with her, uh, giving her various things to do. We did bird dogs and side planks and, uh, um, a little bit of crawling. And so we, we did some rehabilitation corrective exercise. Um, but it wasn't sticking. Uh, she would, it was like clockwork groundhog day. She would come in and I'd see her walk through that door and being crooked again. Uh, for her in particular, I decided after a month period of time, just as I mentioned earlier, a month is probably about fair in this. Uh, I took her to a colleague and I went to the examination. Lo and behold, he decided to push the shit, uh, push the shift away. So she was shifted, let's say to the left.

And so he decided to actually push it a little bit to the right. Um, but do it in a, in a position where she was in like an up dog position. So she did the, the chest up in the air and a little bit of the, the shift into the hips, the opposite direction. And she was doing reps and reps and reps. She stood up and she was actually straight. I was so amazed. Um, I want to say she did about like 20 reps or so 30 reps. And she was much, much better. She can reach her hands over her head at this point when previously she couldn't even straighten up high enough to where she can get her hands over her head. Uh, as she started to stand there a little bit longer and we were talking about what the protocol would be, um, she started to get a little crooked again. And so my buddy said, okay, you see, there's a hallway in the office. And he said, go, go down that hallway and just, just walk briskly, like quick, quick, quick, quick, quick, but don't run. And so she started out crooked and she started swinging her arms and all of a sudden she got upright. And once she got to the door, she flipped around and she continued to walk quickly back to us straight the whole time.

And then she started to, when she stopped, she started to get crooked again. And so it was really enlightening to me because, uh, in this case she was, uh, I'd worked with her long enough to where, you know, I developed a good relationship with her. And so to see her go through the pain of, of trying to push through the crookedness was too much for me to bear. Uh, and so I just let her be in the position, which again, as I mentioned earlier, in some cases that might be the right thing to do, but in this case over the course of a month, it didn't work. And so, uh, my colleague was just like, look, I'm just going to have her push through it. And, uh, you know, in a calculated, nice way, um, she actually, it was surprising how quickly she got better over the course of two weeks. She was straight again, pretty much straight. She still had moments of crookedness.

It would still come back a little bit. Um, but I want to say she was probably 50% better. She get out of the car. I'd see her come into the office cause we were still in doing rehabilitation. Uh, once we got that nugget that was dropped into her rehab, walking and doing some of the press-ups and she, uh, uh, over the course of time, she's became normal. Uh, I want to say in full, we worked on that diligently for about four to five months. Maybe, uh, we did a lot of core work, a lot of hip work, a lot of split squatting and deadlifting and carries and so on. Um, she was interesting where she became so, uh, pain free with walking. She, she used to run a bunch. She did marathons and triathlons and so on. And so, uh, she still wanted to do that. And by the way, she does that today cause this was probably almost 10 years ago when this happened. And so she, uh, um, she felt so good walking during this period of time because she was in so much pain for so long. She had it for a year and she would walk to my office and it took her about 45 minutes to an hour to do so. And sometimes she was late and she's like, I walk up to five, six miles a day. She just loved walking because it was the time where she felt no pain whatsoever. I want to say this was about two months into her recovery. Um, it was amazing to see now the prior stuff that she had experienced such as, um, she had, she had a lot of adjustments done to her. Um, she had a lot of rehab, which wasn't working, which, um, I would contribute to that because what I first implemented was not working.

Uh, she was even told by two surgeons that she would need a surgery. One person was even so direct about it. He said, look, you might not want it today, but you just come back when you're ready. And so to this day, she's still, I still hear her. And she's like, I'm so glad I didn't listen to that guy because he, uh, he just wanted to do surgery too soon. And, um, she's so good now she runs, she bikes, she lifts weights. Um, she has no pain in her lower back whatsoever. And it's amazing to see. It's, it's totally amazing to see. So people can get better, but normally people with back pain, I wouldn't say they would, I don't want to say it, it took too, uh, took longer necessarily in her case. It took longer to get the crookedness out of her than, than in most scenarios. But, uh, most people that aren't necessarily the crooked type of back pain, most of the time they're, they can feel pretty good within a month's period of time or less. Um, a lot of times after the fact, they're doing a little bit more, uh, advanced rehabilitation, which is AKA weightlifting or general physical activity or exercise. Um, movement is medicine. It doesn't always have to be structured. Uh, in the beginning, it will have to be probably, especially if you're in a crooked case. Um, another person I worked with more recently, um, she was a mother of three kids and she was crooked and she had, had problems with the crookedness for a couple of years at this point. Um, she said that she really struggles to, uh, take time to herself because the kids are always needing feeding and taking care of and so on. Uh, and so she was in pain and crooked and didn't know quite what to do. Uh, for her, she, I don't want to say she didn't do exactly what was asked, but she didn't have all the time. And so we really cleaned everything up as much as possible with her to make it. So it was really time efficient and it covered as many bases as possible. So what we asked of her to do was about 30 minutes of total rehabilitation per day. If she missed a day, don't worry about it. If you did four to five days a week, that would be more than enough. So a lot of her time was actually spent walking just as the past person was, uh, for her, we didn't do quite as, as a direct, like press-up type of, uh, remedy, but we did use an end range loading protocol, uh, which is like wall sweeps. And so she would lean her crooked area, like into her, into the wall. And so, uh, almost pushing her hips back into the quote unquote correct position. She was actually pretty surprised when we did the exam. When I had her standing, I had her slide her hand down her thigh and try to touch her knee on one side. And then the other side too, one of them, she slid, I think past her knee. The other one, she could barely get past her mid thigh. And she's like, what the hell? I said, yeah, this is different. So I decided because of that, you know, that protective posture, uh, intelligence that you have. So, um, over the course of about a month, uh, both range of motions came back. Uh, she was crooked only, I think about once a week, you know, and not severely, but she noted that it came back. Uh, mainly a lot of her rehabilitation was walking because, uh, the floor stuff that we typically like to do like bird dogs and side planks and sour side bridges and hard planks are, um, we gave it to originally, but it was just, she wasn't really doing them. And so we had to find out something that was going to be more doable for her. So I think the most impactful things that she could do was the, the wall slides and the walking. Now, over the course of those few months, I'd say it was three months I worked with her.

I saw her once a week or once every two weeks when she came in, we just did as much rehabilitation within her capacity there. We did all the floor work there. We did all the challenging stuff that was in her wheelhouse there. We got her to split squats and carries and overhead presses, which are all very helpful. If you're trying to incorporate a decrease of triggering movements or activities with regular stuff throughout the day, picking up objects on the floor, like laundry baskets is something someone's going to do, you know, carrying a carrying a, like I have this big, like a toolbox with all my drama, my drill motor and stuff in it. It's gotta be like 50 pounds. I carry that thing up and down the stairs into the garage and so on. Like that is a loaded carry. Uh, and then putting stuff up on top of the car, you know, like overhead pressing and so on. So anyways, all the exercises that we use are useful and we didn't load it up too excessively, but for the amount of time that she spent, actually, she did very, very well. Um, when she was in the office, she spent a lot of, spent a lot of time.

Uh, I think we spent about 45 minutes, uh, just doing as much as she possibly could, but also not to the point where we were crushing her every time. Uh, I didn't want her to necessarily feel sore. Like she's doing a workout, uh, or like a CrossFit workout or, uh, you know, I don't want to say just CrossFit workout, but like, I don't want her to feel like she's been physical, uh, like cardiovascular challenged, like muscular, muscular challenge. I'm okay with, and I'm okay with her feeling a little sore, but I didn't need to trash her, you know, each and every time. Um, anyways, uh, she's doing well today. Uh, that was about six months ago. Uh, to my knowledge, she does not have any back pain either. Uh, and she was by the way, age, age range. She was about 40 years old. So, uh, there's two people. The first person was about, uh, late fifties or so.

There's two people who recovered from it. Uh, it's not impossible. It's certainly not impossible, but we have seen people who have come in who, uh, they're kind of in, I want to say disbelief about, uh, what it will take to get better. Uh, and I hope somebody along the road, you know, uh, resonated well with them and let them in the right direction because there are things that can certainly help. Um, I know that, uh, I've heard a story from, uh, some of my interns about people that they know who are suffering from this, who are only getting deep tissue work, who are only getting stretching, who are only getting, um, uh, like, like traction, uh, decompression and so on, because there's certainly other things to do. It'd be important to note that we didn't do any of that with any of these people and they still improved. So I hope that was helpful to you guys. And I hope you, um, learned a little bit of insight of what different types of crookedness are, what could be some causes, but I hope the takeaway was that a lot of times is it's that low back disc of some type of form of, uh, or severity of, of injury or acuteness. Um, so if it is a low back disc, I know that I had a patient recently that she said, uh, I told my friends that I have that and they said, Oh no, that's like the worst. And I told her, I was like, I, I, I know what you mean. It's gotten a bad rap over the years, but imagine if the boogeyman actually turned out to be a good guy. Like I think of all the injuries that I've seen for low backs, like, um, having like a, uh, like a pinch nerve, uh, having, uh, even a muscle tear, a muscle strain, like a true on like scar tissue, all the things that I would rather have a disc any day of the week. I wouldn't want to have like a crooked one, like a, like an intelligent one to the side. But, um, we've seen so many people with disc injuries, uh, at performance place and, and most of them do very, very well, as long as they just are realistic with their timeline and okay. And trusting with what we're suggesting to them. Uh, so if you guys are looking for any of the resources that we have, uh, P2 sports care, there is a way to contact us in the link description below as well. Uh, we do have online resources and we have ways to coach people virtually as well. Uh, as you know, through the whole, uh, you stay at home order, telehealth has become more common as well. We see people with this type of problem with telehealth as well. Obviously it does not substitute for being in person because we can't examine everything we want to examine, but we've seen people and they've responded super, super well just by giving them exercises and strategies throughout virtual. But if you're willing to come see us in person, we'd love to see you as well. Okay. We have online programs. Uh, those links will be in the description as well, as well as there's other literature that you might want to read about low backs and hips. Uh, I have three books that I created. One of them is a very, very basic book. It's, it's called, uh, it's six, uh, powerful exercises that will help you reduce back pain. But a lot of times people had questions about diagnosis and other treatments and so on.

And so I wrote other, uh, pretty intensive, uh, manuals for the lay public. This is really not clinician based stuff, but you guys can always pick it up if you want to. Those links will be in the description as well. Um, diagnosis is book two and then treatments that work for people is called book three. Thanks for listening, subscribe, and I'll see you guys in a couple of weeks.