Well, it is good to be here in southern California, especially Santa Barbara and it's so beautiful and I always enjoy being here with, it's actually sunny, warm and not humid from Miami. We get the sunny warm part all the time. I finally have gotten used to the humidity after 15 years of living in Miami, but I am a California and through and through, uh, we are going to talk about low back pain in particular and talk about some very specific pathologies that we see walked through our door every day. People say, um, you know, I only treat healthy people. I only work with healthy people, employees. And the truth is, is what, what's a healthy person these days? I mean, 90% of all adults in the United States are going to suffer at least one episode of serious low back pain in their life. 90%. Now, when I started doing my research, it was 70% 15 years ago. So just give me an idea. The numbers have changed. We're more sedentary. Uh, we have less labor intensive work, but we like to do intense recreation.
So when your body's not used to doing or moving in certain directions and we increased the intensity of your recreation the weekend, the pathology seemed to increase and we are about to go into an epidemic of low back pain with our children in our next generation because they are so sedentary and so overweight and deconditioned and untrained. It's a really sad thing across the country. So we're seeing some real, you know, you've heard this statistic saying this will be the first time that we have children who don't live as long as their parents in I think 10 or 12 generations will be the first time. So like your doors kick your kids out of the house may come play outside, don't let them in unless their bones are sticking out of their flesh. You just make them go out there and play, take the computer away from them. That's what I told my kids, you can stay outside. It's too hot, don't care.
You're outside. Go climb trees, get in the swimming pool, jump off the roof, do things that kids do. Just let me know if you break a bone or something. So anyway, we're going to talk about low back pain, but before we do that, we sorta have to have a clear understanding of normal mechanics of the spine. Normal activities of the spine with the spine is made to do and take fear away from working with people with back pain. And that's really what my objective is with this is that everybody has back pain. So if we understand a few simple things, you can treat these people and you're going to have a much better outcome. When we think of pathology, everybody familiar with the word pathology, some kind of disease process or injury process that normally for us results in pain.
We're actually already pretty far down the chain of where that injury took place. If we go back up their chain, we're going to find out that probably the first thing we see are restrictions. So we have some type of restriction in our movement, in our daily activity, in our thought, in our perception of who are and how we move. Uh, could be structural restrictions, resistance in the hamstrings or stiffness in the thoracic spine, but some type of restriction. And then restrictions cause compensations. So compensations are motor patterns or movement patterns that we use to compensate for the restriction. So if you think of a restriction, let's say of a restricted thoracic spine.
So this part of my spine is really stiff. Okay, where am I going to move more to compensate for the lack of movement in my thoracic spine? What parts of my body are going to move too much lumbar? What else? Cervical spine. Where else? Shoulders, right? So the most three common pathologies that we see are lumbar, cervical and shoulders that often are due to a restriction in the thoracic mobility. So a lot of times people come in with specific pathology of things like stenosis and herniated disc and fossette injuries and a spondylolisthesis.
And then all these different diseases asked your process. And we want to go immediately and treat the area of the pathology as a physical therapist or as a physician. So we get very specific to work on the theology and pain when in reality, what should we be working on? Restriction, compensation. And then after compensation actually comes give. And what give really means is deformation.
So if you think of Saran wrap, you know, and you've pressed it in their plastic wrap, if you press far enough, it'll deform the plastic rats. When you pull your finger out, you can still sort of see where your finger was in it, right? Different from elastic, where I put my finger through it and I take it out and it looks normal, right? A lot of our tissues are much more plasticky. So ligaments are plastic, capsules are plastic, um, tendons and muscles tend to be more elastic. Okay. So I have restriction compensation, deformation, and then eventually pathology. So the deformation that we're talking about today often is too much movement or too much stress from compensating in restricted areas and too much movement in the Lumbar, typically l four five and l five s one those are typically the two segments of the spine. They get abused the most.
So if you were to take a poll of everybody who had low back pain and all the disease process out there, you would find out that probably 80% of them are occurring at l four, five l five s one. Now, interestingly enough, we did a study down in Angeles at Loyola Marymount back in 1995 with piles and low back and we took 20 healthy students who had never had back pain and who had never done any politesse and we took them and we had a machine and we were able to measure their for bending and we could measure the segmental movement from T2 of the thoracic spine all the way down to the sacrum. And we measured the full range of motion of flection on each one of them. And we had them practice it until they got a standard measure. Everybody, before they were split up into two groups. So what we found with everybody was that the majority of the movement was all four or five or five s one almost a 50 more than 50% of the movement. And then very little movement in the upper lumbar and no movement in the thoracic spine. So these are healthy people, young, healthy people that never had back pain, split them into two groups.
And we had our control group that just laid on a table like this for 45 minutes, came back and measure it again, and we had our experimental group that we took them. We put them on the reformer and did five exercises in about 40 minutes, brought them back and did the measures again. So the control group looked exactly the same. And the politesse group, they just did one class, they'd never done it before, had three of the following changes and all statistically significant. The first one was the total range of motion was greater and you could say, yeah, you did feed in strap, she did a little bit of bridging, you did some spine articulation work, you did some spring assisted roll downs. It makes sense to have more movement. Fine. Number two, there was a significant increase in the upper lumbar and in the thoracic spine.
So you could say for the same reason, but the third and most important finding was that the l four five l five s one decreased by 50% and that's why we think when people with back pain come to you as pilates teachers, you're dealing with restrictions and compensations. So when you manipulate the strategy of their movement, what do you do to the amount of stress going through the pathological segments? You reduce it and you reduce it such that they no longer perceive that they're having a problem. Okay, so that's one thing I want you to keep in mind. We have restriction compensation, give or deformation, then pathology and then pain. We typically only treat in the medical world, pathology and pain polarities teachers teach. We work with restrictions, compensations. As you're looking into whole body, how do you know if it's not the ankle restriction that's actually causing the compensation, this leading to the low back pain? Right? Well, it doesn't matter to you as a Pi of teacher because you're going to work with that ankle restriction anyway cause you're working on alignment and congruency and fluidity and continuity of that movement. Right. And control and efficiency.
And when you start dealing with those kind of qualitative measures of movement, you automatically address restriction and compensation. And I think that's why we have such a good shift when people come to you for your, for their, uh, for their training. Um,
the other thing that we want to look at when we look when we consider the, uh, the low back population is that who do people usually go to when they have low back pain? Uh, doctor, right. And I hopefully, no offense, any doctors watching this video, but um, doctors are not typically trained in low back pathologies. And so what's the first thing that they do is they order an MRI and then based on what the MRR findings are, they then send them to an orthopedic or a neurosurgeon for a consultation who make their living doing what, sorry? Doing surgery. Yes. And when we look at that, the studies now show that they took like 600 people that had never had back pain and they did an MRI study on them and 60% of them showed pathologies that required surgery or suggested surgery according to the radiologist that read it. So the question is how many of these people that are manifesting low back pain really are because of these pathologies or just those pathologists were there and later on they had back pain because 90% of the people are going to have low back pain and they're deconditioned. They have bad strategies, they have compensation patterns that aren't allowing them to do well.
They come and do piles and what happens? They get better, right? They feel better and they believe all that herniated disc in my back is gone. It's not gone. If we did the MRI, it's still be there. But we, if we reduced the stress by 50% what have we done? We've gotten rid of the painful mechanism and we've gotten rid of the force that was causing the degeneration to begin with. So now what happens to that disc? Starts to get healthier because it has a normal amount of movement in all planes. Okay, so that's another problem we have out there in society.
The third problem we have in society is that because we think pathology based, we start limiting activities thinking that we're trying to protect people. Can you think of some limitations that the fitness world and medical world and physical therapy world had put out there? So you have osteo process precautions, right? So what don't we do with osteoporosis? Compress fluxion good. What are some other things that are out there that even just in the aerobics world or the exercise world or weightlifting world, what are we not allowed to do anymore?
How many lumbar vertebrae do we have? Five lumbar vertebrae. What's the primary purpose of a lumbar vertebrae? Any idea? That's right. It's the bare weight and hold us up. That's its primary purpose. It's large in nature and embarrass us up. Then we think of the thoracic spine. How do we know it's a thoracic vertebrae?
What's attached to it? A Rib. So how many ribs do we have? Do men and women have the same number of ribs? Yes. Okay, so that's a fallacy thinking that eve, because eve gave her, Adam gave his rib up that there's less ribs in a man than a woman. There's the same number of ribs. Some people do have cervical ribs, which is an anomaly and it's not an uncommon one. I have a patient right now, his cervical ribs. So it does happen, but typically we define thoracic vertebrae by having a rib. Okay. And the thoracic cage, it's responsibility is to protect the, not to be stiff, but to protect our vital organs. So it's protecting our heart and our lungs. It protects our sympathetic nervous system.
The ally's right on top of the cost of retrieval joint. It protects our liver and even down low protects a little bit of our kidneys and some of the organs down low. So we know that we have this theoretically supple cage is not a cage like one that's rigid. It's one that moves and has mobility. And when I think of it, I think of here you have 12 vertebrae, 12 ribs on each side. The 12 ribs rib is the softest and most elastic bone you can just bend your bone like this and the on that. You can't do that with your femur thing. Goodness. But you could do that with your ribs, right?
And it's attached to a floating bone. That's your sternum that just floats there with rubbery cartilage. So everything I mentioned moves. So why do we as an adult population have such rigid thoracic spines and cages? Well, it's because we just don't use it. We don't breathe. We don't exercise.
One of Joe's basic philosophies or guiding principles was breathing with the idea to get every atom of air out of the lung and to be able to constrict that space and expand that space. And he didn't realize it, I don't think. But the expansion and minimizing that, that rib space, both directions provides the mobility. This needed to preserve integrity of the lumbar, cervical and shoulders. So sort of interesting, this naturally built into the work that we do as platas teachers. There was some great insight in that. Um, when we think of cervical spine, what do you think the cervical spine, his primary job is? So Mo moves the head, right?
And why is it important that the head has movement? What does the head do for us? So our sense is, right, so we receive visual, auditory or factory tastes talking, hearing all those things. Imagine with we're down here, the world looks, sounds and smells and even tastes different in this posture. It's been proven. Then when you're in this posture, interesting and people are sad down here and they're happy up here. So give it a try.
Slouch down some you already there and smile and how it sort of feels awkward to smile when you're in a slouch position, right? And then frown. It's very easy to frown in a bad posture and then sit in a nice posture and smile and it's almost natural. It just naturally happens. It's almost like the skin or the corner of your mouth picks up when you lift the back of your head and try to frown from here. That feels awkward, right? So it's interesting that it's not just about bank pain, it's not just physiological, but it does have a direct relation with psychology and spirituality is posture. How many times have you had somebody come up and say, when I take your class, I feel so good and I'm so happy. And then I go back to work and I'm just so miserable at work.
But when I come and take your class and you watch, their body literally is shifting. And so you'd say, why don't you do a little bit of Platas at home and work? All you gotta do is just be aware that posture. Now, Joseph PyLadies, um, was quoted an article in the reader's digest. I don't know how many of you saw that back in like 1934 38 and he talked about posture. The whole thing was on pasture. And he said, you know, when you love walking down the street in front of Macy's in New York during Christmas time and you're window shopping over display, he said, look at the reflection of yourself first and make sure that you have good posture and then look at the display. And every time you go to a different display, look at your posture first and reflection and then look at the display. So the idea was he already was thinking, creating some kind of reminder of that every time they see it.
Now I learned from each entry and exit, it's called paint the ceiling. And have you ever heard of paint the ceiling? Yeah, a little bit. So paint the ceiling is an extra is where we can all do it together. But just sitting up nice and tall on your seat. And if you imagine had a artist paintbrush, not a, not a mechanics paintbrush, but an artists write a little paint brush that reaches to the ceiling and just with the head, you're going to do a little bit of a head Bob for them.
Back to paint a line forward and back. And then we're going to paint a little line side to side, and then we're going to paint a little circle around that plus sign up on top. And then we reversed that circle. So we literally want to just get sort of the a and the OAA. So that's the head and the first two cervical vertebrae. And by doing that, the way that I teach the exercises, I tell people, if you're a woman, every time you go to the bathroom, do the exercise. If you're a man, wait until you're done going to the bathroom and then do the exercise.
Same exercise. It's just when men tend to do the exercise, when they were in the bathroom, they tend to paint the walls and the floor and everything else. So paint the ceiling women during the bathroom, man afterwards. You can also time it with things like when you sit in your car, you know how you set your rear view mirror and then about 15 minutes in your drive, somebody moved your mirror. Nobody really moved your mirror did they? You just slashed down in your seat. So then you go to read, adjust the mirror, don't readjust them. Here we adjust yourself. When you sit at your computer, put a little sign up there, paint the ceiling.
So every time you sit down, you do a little bit of paint to see. And because if you do that five or 10 times a day, you're always going to maintain the awareness in that axial length. It's essential for us to be healthy. And I think that's what we're sort of, one of the Joe's intentions for us was to make it our lifestyle, right? Not just an exercise. And that's what a lot of the elders have talked about.
So let's talk about another structure in the spine.
We have our disc and unfortunately disk it tend to receive a very bad rep. Would you agree with that? When people talk about disc, they talk about, oh, I got a slipped disc or herniated disc or ruptured this. My disc is out. Um, you know, degenerative disc disease. Exactly. And the reality is is that there is not a structure in our body that has greater integrity than the disc because man has not figured out how to make something to take its place successfully. Right? Even the artificial disc we're using now have not proven to be as successful as we had hoped they would be. Okay. Because they don't have the same property.
So let's take a look. We're gonna use a little ball to help us understand the properties of a disc. The disc has more degrees of freedom than any other joint in the body. What the joint in the body, you tend to think of has a lot of degrees of freedom. A lot of mobility had been shoulders, right? Ball and socket joints. They have six degrees of freedom, each lumbar vertebrae.
Each segment has 12 degrees of freedom because of the disc. So let's take a look at it. The disc can handle compression, decompression from above and from below. It can handle flection and extension from above and flection extension from below. It can handle side bending right in the left from above and right and left from below. And it can handle rotation right and left from above rotation, right and left from below and translation forward and back from above and from below and side to side. Lowly Egyptian movement, above and below and circumduction right and left from above and circumduction right and left from below. So you have 12 degrees of freedom that exist inside of each vertebral segment.
Now the other thing to understand is that the disc is made up of many different layers and what we call the Angeles, it's all plastic connective tissue. Inside the middle we have the nucleus build policies. It's like a little jelly fill, right? So we're surrounded by these ligaments that run in all directions. Now there's a law in physics, it's called Wolff's law, w, O, l,F , e, PostureFit s Wolff's law.
And Wolff's law says our body will adapt to the stresses applied. So if you think of the ballet dancers foot, if we X-ray, a ballet dancer has been dancing on point for about 10 12 years, we're going to see a gnarly second metatarsal and the X-ray. And a doctor who doesn't know that that particular young lady was a ballet dancer is going to freak out and thinks she has some kind of tumor or bone cancer. Well, all of our tissues respond that way. So here's another common problem we have in society. I turned 55 years old. I've been a sagittal beast my whole life, right? So I'm an attorney or I, you know, whatever I do, I just work in this plane and all of a sudden my wife says, honey, we need to do yoga. Yoga is good for your back, or I'm going to start playing tennis or golf, right? Well if you think about it, these tissues that have the rotation or side bending restriction, which is what we want our week, they haven't been challenged for decades, right?
And so the fact that they don't have good mobility means that they're not going to have good distribution movement. And that some joint, probably l four five l five s one is going to absorb the majority of that movement and it's going to have deformation, which is the gift that we talked about. And that's going to lead to pathology. So here's the question, is rotation the problem or is there inactivity for decades? The problem, the inactivity. And that's where we get confused sometimes because if you look at it, yes, the injury of the herniated disc occurred with a rotation and flection. Why not? Because the activity was a bad activity and should not be performed.
But because their body was not prepared for the stresses that were applied to it, right? They didn't prepare the tissues correctly. So what we tell them is come to Polarez for, you know, six months and we'll get your body ready for Yoga and we'll get your body ready for dancing or ready for golf or ready for tennis so you can do the activity for the rest of your life. Now there's two things we're going to teach. One is conscious, which is how to be aware of your body and space. So they're going to know where their limits are and how far they can move. The other one is subconsciously teaching the tissues to start strengthening themselves based on the new movement patterns.
So by putting gentle rotation into the disc repeatedly in all directions, what happens to that annulus? It starts to get strong based on that direction of force. So we start simulating activity of golf. Similarly, activity of tennis, simulated activity of yoga and the pastures and the poses so that we can gradually increase the strength of those tissues. Aunties, them to be aware. If you think about, if you were going to, you know, just put somebody in a position and ask them to do a rotation or something and they've never done the rotation, they're going to get a cramp in their shoulder blade. They're going to complain about pain in their hip.
They're going to overuse a ton of muscle to compensate for the lack of awareness of mobility. Where if you teach them how to move with the bridge and some roll downs and some pre swan work and maybe some extension over the chair and the barrel, pretty soon their advisors, oh, I can actually move from there. Remember I said restriction and then compensation. Often when I think of pathology, my job is to differentiate between is it straight really structure. That's a problem.
Like there's really something stuck or there's a bony problem or is it strategy? Now here's the good news. Eight out of 10 times. I believe it's strategy, which means that 80% of the people are going to get better with somebody who is working with strategy, who works with strategy. All of you do, right? Well, all of your work with strategy. So politesse teachers, Alexander felled in Christ, Gyrotonic, Yoga, those are all strategy looking for a balance of movement, balance of force, distribution, right? Awareness, consciousness of body and space. All of those are addressing strategy. And by doing that, what's gonna Happen to your restrictions? And your compensation's up here, they're going to dissolve, which means you're going to quit putting abnormal forces that are causing the pathology. Okay? So when we think of the disc, we appreciate our disc.
We tell our disc how much we love our disc, right? We love our disc. Say it. We love our desk. Good, right? So we love our desk and we're going to continue to put good forces through that disc to help it continue to be healthy. Now where do injuries occur in a range of motion? In the middle or in the end? In the end.
So when we teach movement, all we have to do is avoid hitting up against the end of range. So a lot of people are like, well, when do you know to Gnosis is a problem? When do you know osteoporosis a problem? Well, if you're getting close to any kind of resistance where they have to start really recruiting a lot of muscles to move that space, you're there already. You've probably gone too far. And that's why one of my pet peeves in our industry is that we tend to have this concept of over recruitment and that over recruitment actually leads to many different problems.
We were trying to put in the eighties hard body exercise regime into Pisces Joe's. I've never really talked a lot about core control. He just talked about control. He did mention the powerhouse with the powerhouse word a little bit different meaning to it. It was almost more energetic, like the horror or the pelvic floor. The shock was, I mean there was, there's an energy source here. So when we contain that energy source, we were stronger and more flexible and more lean. If we think of always holding those areas, then we ended up doing problems as interesting. Um, Pam Downey physical therapists that works with me as plot, he's trained, um, teaches in our industry, specializes in pelvic floor and women's health and I have a ultrasound machine that's an imaging ultrasound. So we have been having more and more Piela Terrace, um, coming to us with incontinence and pelvic floor dysfunctions and irritable vaginitis and those kinds of things because they have tightened this area of so much now that it actually is structurally restricted.
So if I give the cue of lift your pelvic floor or stop the flow of urine, what I see on the ultrasound is a pelvic floor dropping down instead of coming up because there's no place to push. The visceral is now like an open space. If you have a contracture around, cause you're always want to have this powerhouse connected, you're always holding it in, then you're going to have pelvic floor weakness because it's not made to always be being pushed out. It can't handle that. That's what happens in childbearing, right? So vaginal childbearing, that pelvic floor gets pushed down so long sustained that it actually does some damage. And then women experiencing continents. Now you can go back and reeducate it so that you can get over the incontinence or you can just believe that the old wives tale is once you have babies, your pelvic for a shot and you know you're going to incontinence Russ your life, which is an absolute fallacy, not true at all. And we see women that have completely reconstructed pelvic floors that have had very serious prolapse problems and they get back to very normal lifestyles. But the education is important. If we misunderstand those muscles, we often create problems.
So we've talked about the bones a little bit. We've talked about the disk.
We need to go in and talk about the fossette in the bones. So if we understand the angle of the fossette in the spine, it helps us also understand the direction of movement that's going to occur in that part of the spine. Okay. So the lumbar spine, um, does everybody know what the Fossette is? May start there? The fossette. So fossette means face and in the back of the vertebrae, the vertebrae is a tripod. So it has the vertebral body in front and it has two legs in back and the two legs in back articulate with two legs that come up from the vertebrae below.
Okay, so you have a body, a disc and other body that's the front leg of the vertebral segment. The back two legs, like a tripod are the two full sets that come down and the two pathetic come up and they articulate just like this, like face to face. That's why they call them for sets. And they are regular joints. They have a capsule around it, they have cartilage on the surface, they secrete synovial fluid just like your knee or your ankle or your hip does, or your shoulder. And they move and you can have arthritis there just like you can any other joint. Okay.
So the fossette in the lumbar spine is sagittal. So it looks like my hands and vertical 90 degrees. So it is like this. Okay. In the thoracic spine it changes its orientation. So it goes from being sagittal to coronal.
And it has an incline of 60 degrees, and I'll explain why that's important in each of those. The cervical is like the thoracic, but actually 45 to zero degrees. So the higher you go, the closer you get to zero, right? So the OAA and AA and the top of the neck are zero degrees. The head sits right on top of the atlas and the atlas, it's right on top of the axis. The zero degrees are completely horizontal. Okay, so lumbar spine, sagittal on vertical thoracic spine, coronal and 60 degrees cervical 45 degrees to zero.
Okay. Now, why is that important in the lumbar spine? If my fa sets are sagittal and vertical like this and I want to rotate, there's not a whole lot of rotation happening there. But if I want to bend forward or go into extension, I can. And if I do just one side, I'm doing side bending and we'll play with this. We'll play a game with this in the thoracic spine, the sets lie this way, so it still has flection and extension, right? But it's side bending is limited, right? But if I do a unilateral movement, now, what am I doing?
When you teach somebody to move from the thoracic spinal rotation, offsetting massive amounts of rotation come. So I always like to show my golfers pictures of tiger woods or Singh who have these massive amounts of thoracic rotation, whether their opposite shoulder will come pass the midline by 30 40 degrees in their backswing. That's how much segmental mobility they have. Of course, they practice yoga and pilates all the time, and they're tall men, right? And that's why their swing and their drive is 300 plus yards. Okay? So I always play this game with my golfers that come in and I promise them, I bet them that they will add 20 yards to their drive within two visits because I know all I have to do is add one segment of rotation in the thoracic spine and I'll add 20 yards for that segment of mode of emotion. It's mathematics.
Now I can't promise where the ball's going to go, that's not my, that's not my Gig, but I can promise them that they're going to get more range. Okay, so let me have a volunteer come up here and I'll introduce you to the fossette dance.
So if I slide up her arms, I'm going into flection to the end of range and if I slide down her arms and I come into the crease there, I'm going into extension. Okay. She can slide on me too. So she slides down. That's like doing flection from below talking your bottom under. If she slides up, she's sticking her butt out from below. Okay. That's extension from below. Come back to neutral. Yeah.
So I do just one side that side bending. Right. But if I try to rotate, be strong cause your bone, I don't, I don't have a lot of rotation there. Okay. Then we go to the thoracic spine and now the world changes. So 60 degrees, coronal, same cassettes as far as the capsule. So I slide forward flection, I slide back extension, she's slides underneath me, extension, she slides down underneath me flection.
We do a unilateral side from above or from below. And that's rotation. Now this is rotation that if I want a side, Ben,
Or The lumbar spine. You got five segments rotation. You might get five times three 15 degrees. And if you're trying to get 45 degrees or 50 degrees out of your lumbar, what are you doing to the capsules? Do forming them. Right? And that's pathology. So stand up with a partner. Two, four, six. I mean you can go with her. So we have an equal number.
Let's just take a second to do the fossette dance.
So if I slide up on her fossette, that's flection. If I slide down on her fossette, that's extension. If she slides down on my elbow, Dat flection from below. And if she slides up on my arm, that's extension from below. Okay. And if we do just one side like this opposite, that's going to be side bending and then just get a feel of what rotation feels like. There's not a whole lot of rotation in there to go side the side.
So you're here. Oh, we're going, we're going to go thoracic. So if we're going to thoracic here, if you're going to do side bending in, it's here. So you can do, you have that motion, right? So start in neutral and let's go to the right. Drop your right up or down. So you go to the end of this capsule, that side, Benny. But if you try rotation, there's not a whole, there's not much to go there. Then if it sets are saying, yeah, we're already kissing, we're not going to move. There's no sliding in this direction because the sagittal orientation, you go corona. Yeah, lumbar. Now you go here, what happens when you want to slide unilaterally? You can slide. So now you have rotation when you go opposite, right?
So here, that's the rotation fluxion extension from above. Now you do the same thing from below. Right? And unilaterally. So rotation. That's right. Okay.
When I'm teaching movements, so the question that was brought up is if I'm teaching somebody seated spine twist, right? So I'm gonna teach them, see the spine twist, where does that emotion come from? So we always want to get an axial elongation first.
So actually long engage action is pulling all your body parts as close to the center axis as possible. So that's what makes us tall. There was a great, uh, one of our teachers used a youtube thing and it said, um, lose 10 pounds in five seconds and she had like 4 million hits and now youtube pays her to put commercials on her, on her thing. And it was a stupid, silly thing. It really, and B of what she was saying was posture. That if you just got in a good posture, it looks like you lose 10 pounds, right? Because mass distributes. So if I'm here, all that mass comes out to the side. When I come up nice and tall, it's like I lose 10 pounds. But it was hilarious cause everybody wants to lose weight. Whenever we move, we always want to be an actually elongated position.
So whether we're going into fluxion extension, rotation, doesn't matter. We always want to be in that optimal place where we have the greatest degrees of freedom available to us. Right? So when somebody gets really anal about, oh, you got to stay in neutral all the time, that is exactly what I said. It's anal, right? It's not good movement. You can be healthy that way. There was a, a physio and in south Florida who made all their patients maintain neutral all the time and uh, and put the fear of God in that. But it was really crazy because like if you came and something dropped out of your pocket on the floor, it was like, ah, and you could see that so personally because it's like, okay, here we go again. I'm going to do the thing. And again down like there it is and they get back up. And I, and I said that, I said, you know, flection is such a normal part of our movement.
I mean going to the bathroom, procreating the most basic parts of life, you know, require that, you know, how dare somebody who is supposed to know movement put a restriction like that on somebody. That's crazy, right? So actual engagement is always there in the lumbar spine. We know that primarily weightbearing now cause we said that already cause the size of the body of the vertebrae. And it's also gonna allow us to do fluxion extension inside bending and a little bit of rotation. So just think of it and those proportions, Thoracic Vertebrae, 12 ribs, 12 vertebrae 12 and these sites are 24 ribs actually. And they articulate, and because of their plane, they're going to have their greatest degrees of freedom in rotation.
You're gonna have the greatest amount of movement in rotation if you know how to access it, right? So there's a lot of soft tissue strategy that has to happen to find rotation in the thoracic because we have our intercostal muscles muscle between our ribs and all the muscles that connect to the ribs and up the neck and the ribs and down to the low back. And we have to be able to move that. So I want you to sit on the edge of your chairs. I'm going to try a little, a little trick. And what I'm gonna do is I'm gonna do recall scrambling your eyes and get rid of what's called the visual ocular reflex. So we tend to over recruit muscles to maintain our head stable so that our eye gaze can be focused and stable so it doesn't move around.
But we tend to over recruit those muscles and then we realize we don't have good rotation, right? So go ahead and rotate as far as you can. Keeping your sit bones square on the mat to your right. I'm supposing if you're married me, and then with your eyes, you're going to look very quickly to the left or to the right, to the left, to the right to love just the eyeballs, right, left, right, left, right, left, right, left a little faster, little faster. Just to the point you feel like you're gonna throw up, rotate a little bit more to the right and see what frees up. You might find you get another five or 10 degrees of rotation and then come back to center. Go to the other side. Same thing.
Go to this where we get to the end of range without getting cramps or forcing it. And now with your eyes, you're going to go right, left, right, left, right, left, right, left, back and forth fast. As you can get full movement of those eyeballs back and forth, back and forth, back and forth, back and forth, and now relax them and turn a little bit more to the left. And so some of you might find a little more range of motion. Um, those that got a little more range of motion, God, because that, that was the reflex that was holding the thoracic spine. Still there's many things that are cause rigidity, but that's a simple one to rule out right away and get rid of and give somebody an extra 10, 15 degrees of rotation. Right. That's just like get rid of that over recruitment. Yes.
All of a sudden you realize. Yeah.
It's the vestibular ocular reflex that we think that we're messing with. So that means the vestibular system, the inner ear. Okay. Right. With it's movement and I and the eyes moving, they work together to maintain a certain amount of stability for eye gaze. All right, so we're walking down the road, pounding our eyes actually don't look like they're doing this. Like you think of a camera, the old cameras, the video cameras, and if you are walking with the cameras like you know, what was that movie that they made that was so awful that I couldn't watch?
Yes. Yeah. The Blair is Blake who is at project something. Yeah. Oh my gosh. I was nauseated. But that was because they didn't use their shock absorption component. All the cameras now you can walk in. It has a steady and factor it. Yeah. They learned that from our head. Right.
So our vestibular system anticipates the movement recruits a certain amount of muscles and allows the eyeball to be absorbed in the head so the head can move and I twitch can maintain the gaze on object. You're looking at people who lose that often have some severe balance disorders that don't have that motor control of the eyeball. Good. All right, so now we've talked about vertebrae for sets disk. We have one more thing we need to talk about before we go into pathology and we're going to talk about the ligaments. Okay. Now there are a number of ligaments. We have the anterior longitudinal ligament, which is the big thick ligament in front of the vertebrae, all the way down to the sacrum and the coccsyx. Then we have the posterior longitudinal, which is behind the body of the vertebrae, which means that the spinal cord is running right next to it. Okay.
And that's The d that's the ligament that we often complain about. Also, we say the lumbar portion of the posts, your lawn show ligament is very thin, very narrow because we're in a lumbar curve and it's thought that we're to be more of a quadruple animal where we're hanging on the thickness here and don't need to really have thickness back there. But in just the last years, we've become what? Flagstaff animals. So the tissues have not adapted yet to the type of activity that we do the most of, and that's why flection with rotation in the lumbar spine predisposes that weak area of our disc to be injured. That's why we just need to avoid the end of range in our activities. That's where the herniations going to happen. Okay. Then behind that is what's called the ligament and flavor.
The ligamentum flavor and flavor means yellow and yellow is for elastic. So when we talk about elastic fibers, their color is yellow. The plastic fibers are Collagen and they are white. So the more white and shiny the tissue, the more collagen and the more stiff it is. Like your Achilles tendon is shiny, shiny, white. He could pick up a car, your it band could pick up a truck there really strong. So when people say, can you stretch my tee ban? Nope. Why not?
Because I'm not strong enough. I can stress your tensor Fascia. Lata I can stress your gluteus muscle. I'm not a big fan of stretching, but I could if I was, but I can't stretch your it banner, your Achilles. Impossible. But the ligament of flavor is elastic and it sort of acts like sort of acts like an elastic band. So let me have a volunteer come up here and I'll show you another little trick and then we'll play with it. Alright, so if we think of this elastic band and let's turn sideways so we can, everybody can see it if I Hook it onto your head and I hook it onto your tailbone, right?
So now let's go ahead and do a little roll down through your spine, right? And soften the knees a little bit and let the elastic band bring you back up. So soften the knees and just let the elastic band recoil. Beautiful. Let's do that again, right coming down. And this time even less work on your behalf.
Let me bring you up with the elastic band. Just let it just let it come up. All right. Use the imagination of it and I'm going to take it away. But you still have the elastic band there because it is the ligament and flavor. So instead they come down those knees soften forward. And just imagine that the lastic band, it's already in your back.
Let the knees come forward. Tell bungalows down the spine, comes right up. The spine is
Now see if you can find that same feeling in your own body. Cause we just use way too many muscles with everything we do. I get over that button there. There we go.
You were just working a little too hard and I sort of felt that. Just let it recoil. There it is. Oh yeah, that'd be really, that'd happen. And go again and just like, there it is. Yeah. So what we do is we tend to get our muscles in the wade.
And just had a coil backup. Right. So what we tend to do is we tend to over recruit our muscles when we don't need to. Yeah, you guys are just challenging my ambidextrousness go now, just that's it. And don't even don't use so much muscle. You can even use less belly to bend down and just let it come out. There it is. Do it again. And just imagine that'd be an inside of you. [inaudible] okay. Alright.
Now we're going to do one more of those images so everybody can stand up. And now we're going to put some things together. So remember we talked about the disc being like a ball. Now you got to think of it being like a really tiny ball. All right? Little gelatinous ball. So when I start to incline my head, the desk is going to move where? Back, right?
So when I go into flection, the disc are going to move posteriorly. When I go into extension from my back, the disc are gonna move anteriorly and I want you to of that segmental
And from there, now take a breath in. Knees will come forward a little bit. But really think, imagine that disc at l five coming forward and forth,
Where do you feel the compression? Low back and neck, right? The two areas we talked about. Okay, so now let's think of the idea of creating an organization around the thighs spiraling and that fountain lifting up in our pelvis so that there's this energy here and then at the sternum, just go up towards the ceiling and see what happens. So the FA sets now are going to come from below up underneath the vertebrae above, right? Rather than bringing the facade down, we're going to think of the set coming up underneath and lifting our sternum up towards the ceiling. Can you fill a different in where the movement is occurring in your body? So it should come out of the low back and now the neck and have a little bit more of the lift in the length in the thoracic spine.
Now if you have some structural restriction and thoracic spine, you might feel the compression of thoracic. But that's okay cause thoracic is in Kyphosis. So for us even you get to neutral, and this is what I do with my patients with osteoporosis. They hate extension but they need extension. They love flection, but they can do flection. They already ruined their chances of doing fluxion. Right. So we have to minimize that in the thoracic. Okay. All right.
Last thing, we have to talk about his muscles and I do not teach PyLadies by muscles. Just so you know, I never teach a contraction. I never talk about organizing by contracting the muscle. And the reason is is that I am not as smart as your nervous system. I mean, I know it scientifically probably better than most. And if you ask me, I can tell you what muscles working and approximately what percentage, but we're talking about milliseconds. We're talking about submaximal, sub-threshold contractions that work synergistically with your fashional and your 10 segregate system that we're just not that smart.
So we have to teach a little bit more like where the bones are in space and look at efficiency and energy. So that's why the cuing of flow, the queuing of less is more the cuing of continuity transition. Those are all things that represent qualitative analysis. Paez is not about quantitative, it's not about how much range and how much muscle contraction. It's about how the movement transitions and are we working within our limits as he says in his second principle of whole body commendment we maximize our limits. So if I have a little more rigid spine, my swan should not look like the person who has an incredibly flexible spine. That person is real flexible, is not the ideal for the person with the stiff spine.
They're two different spines. The ideal is inside his own or her own spine. It's maximizing her potential in a safe range of motion with a safe contraction. Okay, but you do have to know what muscles we're dealing with. So we often talk about abdominal muscles and core control. So as far as I'm concerned, you can take the word core and throw it in the garbage because what we're really talking about is connectivity and if we really want to dive deep into it, what we're really talking about it, it was called the 10 segregated model.
Have you ever heard of the 10 Segretti model? 10 Segretti is integrity intention. It's a made up word. It's one of the last maybe 20 years. They started showing up in some of the Myo fashionable people who do mile fast release. We'll talk about 10 Segretti and also be able to talk about biomechanics.
We'll talk about 10 segregated. If I took your body and I put Velcro straps on your hands and your feet and your head and your neck and a thing around your waist, and I put springs and I sprung you up on the trapeze table, so as you are perfectly suspended on the trapeze table, that would be an example of 10 segregated meaning that tension is pulling in, suspending our body in all directions. So when I'm standing or sitting in a good posture, what's really happening is the tension of the tissues around my body are able to maintain with very little work in upright posture. If I restriction here, right, that it's matted down the fashion in the front. Now my muscles in the back have to do a lot of work to try to keep me up.
And now I have imbalance and I have that imbalance is going to cause different types of pathology. So we want to have our tissues as balanced as possible so they're like little guy wires that hold us up. So if you stand up for a second and just feel the tension or the lack of tension in your thighs to stand with both feet in a very relaxed position. So let your body weight come forward just a little bit to your legs are as relaxed as they can be in squeeze them and notice there's a little bit of tone in and that has to be there to push against the Fascia like a hydraulic lift for your car. It's the same kind of idea. Every muscle surrounded by Fascia. Every muscle group is surrounded by fashion.
The whole leg is from my fascia called the Fascia Lata, right? So when I stand, I recruit enough muscles to push into that fasher to create enough stiffness to hold my body up. But happens when I go onto one leg. Now squeeze that leg and tell me what happened to the tone of that light. Did it go up? But now do a value voluntary contraction of your quadricep or hamstring.
And tell me, does that feel different than just the transference of weight? And it should be different, right? So when we teach people to move by muscle contraction, it's like me telling you, okay, now you're staying on top of this leg, nice and balanced with the appropriate amount of stiffness. And then I say, make a muscle, tighten those quadriceps up. That's a very different contraction is not needed. You already found it. You already, we're efficient. We interfere. Okay?
That's the same thing that happens with us in our abdominal muscles. In our back muscles, we have a seat. So when we think of the core or that connectivity of the rib cage to the pelvis, that connection to the upper, to the lower spine, we often think of that. We call it a hydraulic amplifier. So we have the diaphragm from above that lines the inside of the rib cage and connects to the lungs.
That diaphragm not only connects to the base of the ribs, but has slips that come down all the way in the front of l four and l five okay. And through those holes come esophagus being a caregiver and the descending aorta. Okay, so three big vessels that go through that, bless you. And those tissues work in create pressure. So when I inhale, I'm contracting my diaphragm and pushing my viscera down and forward, okay? The other end of that is the pelvic floor. Now remember the pelvic floor is not flat like this. The pelvic floor is like this.
It angles posterially the pelvic floor. When you see my pelvis, the pelvis is in like a bowl of soup. It's tilted like this so that the nominate stacks up on top of the femur and the whole of the pelvis is posted, inclined at the same angle that the thoracic cage is inclined forward. So I have pelvic like this and I have diaphragm like this. And then I have the anterior abdominal wall, which I'll talk about in a second.
And that transverse abdominis that wraps all the way around from the Fascia of the rectus sheath to the Fascia of the Thoracolumbar Fascia. Now those fascist also don't stretch and they're filled with muscle belly. So when the muscle contracts a little bit enough, it creates a stiffness in the front, in the back wall. And then my transverse creates enough tension to be able to draw together and to manage the amount of displacement of my breath. So if I wanted to do the hundreds right, and I'm in 100% gonna go way down cause the microphone, but I'm here and I have to breathe. Look how beautiful that is.
Oh my gosh. Right? And you're here. And what happened? I have to maintain my body in the same position. If I let go of my abdominal wall, I'll get wrecked as PUFAs, right? Am I low back, comes up off the mat and now I'm in a risk of sheer force injuries to my spine, hip fakes or injuries cause my psoas becomes dominant. So I can't really let go of that abdominal wall. What do I have to do? So the a hundred is a valuable lesson.
It teaches us how to sustain a load. Now in 100 the load is gravity on our legs, right? Legs extended out, gravity's pushing down. I don't want my back to pop up every time that I breathe and I send my diaphragm down. So what has to happen? He ecentric Li my transverse abdominis and abdominal muscles have to Ecenter Cli expand, right? And my pelvic floor has to essentially descend.
And then when I exhale, my diaphragm rises up my abdominal muscles drawback in content or clean. So does my pelvic floor. And what they're trying to do is to maintain the intra abdominal pressure constant based on the load. If the load varies, our muscles are smart enough to vary the intrabdominal pressure so that we use enough energy to move safely through space with a load. So if I'm lifting a box or I'm a firefighter carrying a hose, I'm an athlete doing some kind of sport lifting or cranking something or surfing, whatever I'm doing, there is an appropriate amount of stiffness for the anticipator load and that is the definition of stability. I'll repeat it. The appropriate amount of stiffness for the anticipated load.
And we know that cause we watched children learn that. How many of you have children or have had children? Yeah. So the two year old or one and a half year old is figuring out how to pick things up off the floor. So he or she comes up to the object, they bend down to pick it up. Their headway so much they fall forward and hit their face on the ground. They don't like that. So the next time they go to pick up, they stick their butt way back. They picked an object up and boom, they fall back on there. But not so bad with the pampers.
So they're going to air, they're typically going to air falling back now after they've done their first face plant. But they practice that until they sort of perfect picking up the doll and then they pick up somethings a little bit heavier, some a little bit lighter. So by the time we're four or five years old, we sort of figured out that game. And the only time we really have a problem is when we get surprised. We anticipate something incorrectly.
One time I worked for ups during the high school cone, the school during the winter season. And uh, I emptied trailers right in the middle of the night and they had a 70 pound limitation. So I knew there was nothing that weighed over 70 pounds at that time. And that was fine. And I cleared out this whole truck and there was a little box about that big in the middle of the floor and I thought, oh, it must have fallen off the top or something. And I swung down to scoop it up and it was like a 60 pound box of lead pellets.
My anticipation was wrong. Right? And the classic joke of gluing the quarter to the floor, like in high school, the kids would do that and somebody come by. That's a really dangerous joke because we anticipate the weight of a quarter and it doesn't move. It creates a tremendous amount of sheer force through our bodies. So the same kind of thing.
So the magic of of being stable, that word stable is not being rigid, right? Rigid and stability are not the same word. We confuse it in April, I had a four level fusion in my neck from pole vaulting accident in January last year, and the doctor came to me afterwards and goes, your neck now is very stable. I said, stable. Hell, there's no stability in my neck. It's fused, it's rigid. I don't have any control over four segments. Stability and control. Ology are the same thing, right? So whether I am moving through space with my body, right, I have to have stiffness in that movement to be able to move gracefully through space. Or whether like Stuart McGill, I'm lifting 600 pounds, which he seems to forget about the other kind of movement that we want to do.
Stuart McGill is just fixated on powerlifting that we have that dynamic ability to shift the stiffness based on the anticipated load. Okay. So the problems usually lie in bat anticipation, right? Or pathology. And that's where we're going to go to next. Okay.
So in pathology we typically will see neuromuscular compensation patterns. Okay. That was very important to understand this. When I am hurt, my protective mechanism or strategy is to turn my deep local muscles off.
A rotators in your hip and pelvis could also be considered that we call them rotators cause they have a direction rotation. But when they work synergistically, they prepare movement and there is no direction they prepare for the direction to happen from the larger muscles. Global stabilizers in global mobilizers are the same movers. It just depends on what's direction and they have direction and momentum. So if I am throwing a ball right, the muscles that are accelerating my arm through space, right, are global mobilizers. So it's going to be my Pec Major, mild bleak externalize the rotate through my hip, pushing through my legs.
Those are all accelerating. As soon as that ball is released from my hand, now I'm decelerating with the antagonist. So my extensors, my post to your deltoid, my lats, my butt, my hamstrings, my calf. Okay. But then if I say, you know what, I'm tired of playing baseball. Now I'm going to play Frisbee. Right? So now you've got the Frisbee and I throw the Frisbee. I just completely switched the mobilizers with the stabilizers. Okay.
So the global stabilizers job is to decelerate the movement. So we don't run into the end of range. So global stabilizers decelerate global mobilizers accelerate, and it just depends on the movement. Okay. Local stabilizers for both, they create the necessary stiffness for those long, those global muscles to be effective. Okay, that makes sense. Local muscles don't have direction. They create stiffness. Global Muscles have direction of acceleration or deceleration.
Okay. I'll give you another little tidbit here. The local stabilizers also are six times higher in the number of mechanical receptors or muscle spindle fibers. So the appropriate perception of the local is much, much higher. It's sort of like a long algorithm. So you have a muscle that covers one, it must covers two or muscle covers three. And when they come into your retina, accurate, I'm in the back of your head.
It can tell you we have the ability to know I'm inflection a l five s one 10 degrees. We have the capacity to know that and how do we know that? Because Cirque de Solei exist, right? We know there's people that have amazing control at segmental levels and all it is as a matter of training. So they're training six hours a day to have control of 24 vertical segments throughout a range of motion and a professional athlete. I will take up to that 95% range of motion of that joint.
We can warriors, I won't take past 80 because where does injury occur in the range? Okay, so you start getting an idea of how much stiffness, how much mobility. Now let's think of a traditional Palazzos exercise like sidekick. Okay. Sidekick to me is one of my favorite because it really is the balance between anticipated stiffness and mobility. The objective is to be able to move my leg through space as far as I can without losing control of my pelvis in my lumbar spine.
So I have stiffness happening here in my pelvis and spine and I have mobility happening in my hip. A beginner who over recruits is going to limit the amount of motion of the lake. A beginner who doesn't recruit enough is going to have a sloppy movement of the pelvis and the spine and through practice and practice practice, we refine it until they have a nice efficient movement of the leg with a nice amount of stiffness in the core. Then we bring them up onto a single arm, right? They come up into advanced sidekick. Well now there's a little more recruitment that has to take place to be able to stabilize, so they have to disassociate even better.
Right now pathology turns local stabilizers off. It's called pain inhibition or neurological inhibition. Okay? It's a pattern. When there is a pain fire, we're coming up that spinal cord to the brain to be interpreted. It's going to stop offering, give him a couple of messages on the way up and part of those messages come back down to the local stabilizers and turn them off. So this is the work of jewels and hide in Australia where they looked with an ultrasound and an EMG at this size of the Matific die. Okay.
So then we'll TIF for, they look like medallions in the, uh, in the ultrasound you can see like these nice beefy medallions k and if they had a unilateral injury, so they just hurt one side. Even after they got better, the local stabilizers looked a lot smaller and were inactive compared to this unaffected side. And they were the ones that were predisposed to having multiple episodes of low back pain because they didn't have the proprioception and they didn't have the right stiffness on that side of their back. Now, if you had a bilateral lesion, you would have the same thing, but it'd be bilaterally, which means that you wouldn't have the right amount of stiffness with the majority of your basic activities. So when you sneeze the two or you're putting your shoe on, or your being able to get a bar of soap, boom, your bag goes out and you say, all I did was put my shoe on. All I did was pour some laundry detergent into the washing machine and my back blew up. Right? It was because a local stabilizers were turned off.
So the globals take over and substitute globals like quadratus Lumborum, so as major rectus Abdominis, rectus erector spinae, Piriformis, those were all muscles that tend to substitute when your local muscles aren't working and they're not made to be on all the time was flaming young. That's a local stabilizer, right? They're not very tasty, but they're very tender and they're very bloody. Okay. You get to the ones a little more marbleized and that kind of stuff, like an outer body. The little longer, they tastes a little bit better, but they're a little tougher and they're not as bloody, which means they don't last as long. They fatigue faster because blood brings oxygen to the muscle and the muscle fiber contracts. As long as there's oxygen coming in. Okay. Does that make sense? You can sort of see what's going on.
So when we think of injury, we shut locals off. We over recruit the global to substitute in our mind and western civilization. The show must go on. So we override and we keep perpetuating those symptoms and we never really address the issue again. Now they come in and do PyLadies and we start doing some footwork and some bridging and some feet and straps and some quadrupled exercise in these stretch and roll downs and some single leg press on the chair.
And the next thing you know, they're filling a whole lot better. What you did is you woke up the segmental movement through segmental movement, the local stabilizers. So immediately that shuts off those global stabilizers that were substituting and you change the compensation. And typically in low back pain, the compensation is causing the pain, not the pathology. After the first three, four days, it's not the pathology anymore, it's the compensation. So the sooner we can get to the spine, the sooner we can decrease the symptoms on it, the faster they get better and the less than negative experience they have. Yes.
Um, then, then you have that new pattern and that new pattern is a compensatory pattern that does let him heal up, I think. Yeah, I agree with you. I mean, I get frustrated with it too and all I see is fine. They turn off and it is a good question that you have of how, you know, why don't the local stabilizers participate in the splinting mechanism? The quadrates is saying, you bend forward, I'm going to take your breath away.
So they're going to sit down with back pain. They come in and they do this,
So I'm not sure all the time if who I'm seeing is biased, but the research shows that there is a neurological inhibition and I think that's normal in any joint. So for example, if you've ever had a knee or an ankle injury or a hip injury, a shoulder injury, you may go weak. You can't weight bear on that leg. And it's sort of like the body's way of saying get off of it. And I think it's our drive to say, no, I got to do it. That we tend to recruit the globals or it could be American as the globals are better at splinting and they just come in and do that. The question of somebody calling in with acute low back pain. So you know, I can't come in tomorrow, I lifted something heavy and I injured my back. Um, what should I do? And you know, for me, I ask a series of questions real quick, but I do it almost more diagnostically as a physical therapist and a pilates teacher. But I, you know, as a [inaudible] teacher, you want them to get the right attention right away.
So if they have a therapist or chiropractor or a doctor or something like that, you almost need to, from a liability standpoint. Now from the practical and realistic standpoint, I mean the first thing I do is just get on ice and be on ice all the time. And then the question I asked is, are you able to walk? So if they can't walk them coming in to see you, probably is going to irritate them. And it's probably what they have to do is rest. Right?
So they need to rest but ice on it and rest. Now by the second or third day they're probably feeling worse as far as pain, but they can walk and that's when they need to come in because I can get rid of the pain. Okay. From a movement standpoint, we don't like them to be still too long and this is where I want to talk a little bit about treatment. Strategy is three levels of strategy. Stage one we refer to as a biomechanical counseling and it's really paint controls like, like I just showed you sitting down, teach them to bend from their hip. So we teach them footwork, we teach them single leg press, we teach them seated leg press on the chair. We might use the trapeze table with a tower bar sprung from below lightly and have them working on that mechanic. But learning how to move their legs and keep this part of their body quiet.
Okay, so that stage one, it's just like you put them in a cast. If we break our arm, we put in a cast, we heard your back. You can't really put them in the cast. The braces don't really do a good job. And if they're over recruiting their hip muscles, they're going to keep moving from that weak link, which is where the injury is and they're going to keep doing damage to it. Okay, so this association stabilization, we disassociated the hips. We stabilize or increase the stiffness around the pelvis. Okay.
We minimize the stress going through the injury. The second stage is introduced movement with nondestructive force, and that's what we do so well in platas. So I can create an assistive environment without gravity's effect and gently introduce segmental mobility to the side of the lesion without harmful forces. How do I know they're not harmful forces? What's the indicator that they're not harmful? Huh?
They don't hurt. There's no pain. So are they decrease pain? So if I'm introducing a gentle bridging activity or a pelvic clock activity and they say, oh, the first one hurt, but then he feel a little bit better in the second and they don't fill up by the third time, then you're, you're doing good. If you get to the fifth or six and it's getting worse and worse than already, you're introducing harmful for us. Okay. Just a little rule thumb. Okay. Typically, they're not going to be feeling worse after the second, third movement of that. Typically they're gonna feel better because introduced introduction and movement with nondestructive forces.
That segmental movement is going to wake up which muscle group? The locals. So when the locals wake up, the ones that are in spasms turn off and they immediately feel better. So when I do the first bridge, they're bridging with the quadratus. They're bridging with the Piriformis. They're bridging with the solo ass. So when they're coming down, they going like, oh no, that hurts. That hurts.
It hurts. And say, do two more for me. They do the second one and maybe I'm do a little side to side or drop one side down and up. Just anything you can do to get a little segmental movement at the cliff. Right? So they're rolling it up. You see them coming down, they go that well that tells you the local stabilizers are completely off at those two or three segments. You wake those segmental stabilizers up, you solve the problem, they're better. Then the third stage is to challenge the new stability, mobility, and proprioception.
So Thursdays we decrease springs, we increased challenge, we decrease basis support, we move them towards more functional, upright activity until they're back to their normal activity. So those are our three stages of rehabilitation in low back pain. First one, pain control with biomechanical counseling. So we teach them to take the stress away and there's nothing better than politeness to do that. The pool is not as good because for them to have a closed chain, their feet on that bar, they're back widely supported. You can teach them how to bandit their hips and take the stress off their low back. You can even do it as simple. We do some, it's called 90 90 and the trapeze table where we put a velcro strap around the knees and we spring them back to one corner of the trapeze table and then the yellow springs with the Velcros chapter on the ankles to the other.
So their legs are just suspended in 90 90 and then we just gently move their legs around in a very acute state to be able to get the spasms to let go. And then I have them start to move their legs on their own. Then we take off the yellow springs, put their foot on the foot bar, sprung from above, have them push it through, and then they go to the reformer. So they go from sort of a completely supported passive almost with traction or gravity eliminated to where they're actually pushing a close chain. And then from there to the chair into either a seeded or a standing leg press, right?
So you can see that nice little progression and then standing up and walking. So when they came walking in all slumped over and holding on to everything, now they walk out 30 40 minutes later feeling much, much better. And all you did was create that shift.
So we have pain in the hips or the Piriformis muscles. Where are possible restrictions that are causing the compensation that are causing the deformation of that muscle to be sore?
Where are we missing movement? Thoracic. Yeah. And it could also be knees and ankles. Remember? So in a golf swing, you're getting movement coming through all of the limbs, right, including the shoulder. So if I take movement away in any of those distribution and movement, it could result in, you know, Golfer's elbow tennis, elbow, shoulder tendonitis, hip tendinitis, which is what you're talking about. Low back pain, herniated disc, pronated foot, Hallux valgus. I mean it can manifest in a lot of different parts of the body depending where is the deformation happening. So for him, the deformations happening in his Piriformis, or possibly a disc in his little back that's putting pressure on the sciatic nerve. There could be either one could cause that pressure there. Right.
And the pain would be exactly the same. So I spend my time trying to differentiate, is this really a back injury or is this a hip injury? And as an injury related to immobility somewhere else in the kinetic chain. So for you as applies to you, you're looking at the kinetic chain and you're looking in saying don't have very good mobility in his thoracic spine. So that means when he gets to this end of range rotation, he's moving too much or over recruiting with those hip rotators.
And that's why he's having pain there. So if I can give him a little more thoracic mobility and I can free up that hip strategy and get rid of some of that over recruitment there and make him more efficient. So his swing is more relaxed, is going to be a better golfer, he'll golf more, which is going to give him improvement in his golf game. And the more he golfs, the more efficient he can become. Right? So he'll have more movement because he'll use less muscles to do the same thing and become a better golfer. Right. So you gotta think again, go back to that rule. Restriction compensation. Give pathology pain. Don't look down here.
That already manifest. If you show the as pain as Piriformis or in a disk, why something up here? And the pilot is teacher looks up here, you know, and that's why sometimes he is so caught up in that pain that we get stuck down there. All right, so let's, let's take two types of back pathology of flection pathology and an extension pathology. Okay, so flection bias pathology would be something where the pathology is worse when the lumbar goes into flection. Okay? So that could be like a Sciatica, herniated disc, disc fishers. It could be, um, those are the main ones that caused the problem. There could be a torn capsular ligament of the fossette in the back. It could be a strained muscle. Those would be your tissues who would most likely injure in reflection. So I bent over, I picked up something heavy and I injured something in the posterior part of my back. So I pulled a capsule strain of a set capsule, a ligament, uh, the muscle, or I even could have herniated or damage the disc.
That'd be the worst case scenario. Okay. So in flection biased injuries, what we do is we minimize the amount of flection in the lumbar spine where the pathology is, but we teach them how to move inflection, extension other parts of their body. So we teach them how to flex their hips and how to flex their thoracic spine without doing too much fluction in their lumbar spine. So that's the modification. And we want to put those, those tissues a little bit on slack so that they can heal up. So if they're inflamed, you want to put them a little on slack. So if anything, they'll tighten. Shorten again. Now, the most common orthopedic injury is a sprained ankle.
How many of you in here have ever sprained an ankle before? How many have sprained it? More than once or twice? So what happens is once you deform those ligaments on the lateral side of the ankle, they're predisposed. They don't shorten back up, right? So the mechanical receptors inside those ligaments don't respond in time and you just keep injuring it over and over again unless you tape it up or teach your muscles how to move again. Right, and the problem with Mussels is you've got to keep training them. You got to train the muscles over and over and over and over again.
So somebody who has a chronic low back and stability needs to do Polonius for the rest of their life. It's not a choice of like, oh, I'm going to get better and I'm going to stop and go back and do my other activities. No, you have to do. Whether you're doing it at home or with a video or with a trainer is irrelevant. You have to do those kinds of exercises for the rest of your life. The same thing with somebody sprains their ankle. They have two choices. They can either put a brace on it when they go out to play basketball or run, or they can do their therapy and exercises before they go out and wake up all the neuromuscular components to be able to have that proprioception of where is my ankle in space? And those are your two options unless you want to do surgery.
Spine is exactly the same. Okay. So if I have an instability, the best way for me to treat that instabilities to wake up my local stabilizers, not to hold it, but just to be awake and then distribute the movement somewhere else that fluxion happen. Like we showed in that, in that study that happened in the upper lumbar and the thoracic and the hips instead of always at l four, five and l five as one. So when you shift the strategy, he gets better. And if you always apply acts along Geisha, you're always going to be safe. So if you're thinking of that sort of lifting field, when they go into flection, they're gonna feel better than if they just dropped down into fluxion. Okay. Extension pathologies, extension pathologies.
We're talking about things like stenosis, right? Austin gnosis means is a narrowing, so you're going to have a stenosis of an artery. You can have any lumen that gets narrowed. So typically when we talk about spine stenosis, we're talking about the frame and a off the sides where the nerve root comes out. That's most common one or a central stenosis, which is around the spinal cord. Okay, so spinal cord coming down and that space there is choking it off or spinal nerve, the nerve root coming out the side and as choking it off. Now what kinds of things can cause the stenosis? Herniated disc, bone spurs, cyst tumors just degeneration.
When that Verta the desk degenerate, the virus come together. So the space, it was that high. Now is that high? Okay, so it's a chronic degenerative kind of change that typically, unless it's a tumor that causes to gnosis. When you go into extension or side bending with the extension of rotation, you are even narrowing those frame in it even more. And that's why if somebody has typically stenosis l four oh five l five s one and they go to reach up over their head, they're actually moving from the low back. Most tennis players when they go to serve, come here to serve instead of here to serve. You see the difference in the two pastures. One's here, that's a strategy in my low back and the other one is in my chest.
The strategy here, that puts my shoulder blade in the best place to be able to come through or for volleyball or throwing any kind of ball, anything overhead. Does that make sense? So when we have stenosis, depending on the gravity of it, how severe it is, again, distribution and movement equals distribution of force. So if I can get them to actually long gait and create movement in that upper spine, I'm going to be able to minimize the stress going through. They'll fiber [inaudible] oh four oh five the other pathology that we hear about quite often is spondylolisthesis. First you gotta learn how to say it. Always when somebody comes to me, I always make up words. Like, I'll say, yes, that's a acute spondylosis of the undeleting lady.
Pedulla and they're looking at me like, is that really bad? It's like I've never heard of it before, so it must be, I just made it up. But I'm, I'm not a big fan of Hayne diagnoses on things because people tend to get fixated on their diagnoses. Um, that's why I don't like them to get MRIs on this. We need a clinical confirmation of it because what they'll do is they'll hang their hat on the MRI and they'll walk around all day thinking, I have a disc herniation, you know, you know, or my disc is bulging out at l four l five or five x one. And they become fixated on it and they create their own prophecy, right? They fulfill that prophecy. So I tend to minimize those things and, and we'll often say, you know, let's just see what we can do today. Let's see what we can do. And rather than thinking of what you can do, and pretty soon they start realizing that they can do a lot of things.
And when they start realizing that that fear avoidance that comes in changes. I'll leave you with one more story. We have to end in a few minutes. I had a patient who came to me that had very clear disc herniations symptoms down the leg, lost power, reflexes sensation, clearly, uh, a major disc herniation. And within three weeks we localize the symptoms so that it was just pain in the low back. So we got rid of all the neurological signs on the leg, but as insurance company came through and said, guess what John, we can, uh, you're approved to go get your MRI. So he comes home and he goes to your theory, you should get my MRI. And I said, [inaudible], I don't think it's such a good idea to get your MRI. We know you have a herniated disc, we know is pretty bad, but right now it's localize and you know, I'm prompt on your leg and I don't want you walking around with that image in your head from the MRI. So he doesn't, most of my patients do any, when they hadn't got an MRI ignored me.
And the next time I saw John is coming in and he's dragging his left leg. Well guess what's in his right hand, his MRI. I said, John, when did you left leg start bothering you again? About half an hour after I left the doctor's office. I said, well, the doctor see you. He said, John, that's the worst discrimination I've seen in a long time. It's a miracle you can walk. So now I have to deal with that authoritative statement. The image, it took me six months to convince him that he was okay and he was nonsurgical because he didn't have any more neurological signs down his leg. That makes sense. And I always tell people, if you don't have neurological signs, I don't care how much pain you have.
If you don't have neurological signs, you don't do surgery because the pain is coming from something else. Don't you know, don't do the surgery unless you have neurological signs. So like with me, with my injury, I lost all the power and reflexes in my right arm and the sensation. I had all three neurological signs and I didn't have pain. That was a frustrating thing. It was like, I'm going to let somebody cut on my throat in my neck and put a titanium plate in there and I don't have pain and I didn't have pain after the surgery.
So I mean for whatever reason. And I immediately got my strength and my power and my sense of since a sensation back within, you know, they said even before they pulled the tube out of my throat, I was already going earlier in my home. Right. So typically I will avoid having them do that. Right? I mean we said 60% false positives, 60% false positives. So have you any, if we took everybody here knew I had healthy spines and we took MRI, five of you, six of you are going to show up with disc pathology. But it's not important because we all have it. It's just part of life.
God gave us 24 motion segments, so 24 motion segments and we lose two or three. We get 22 more and it's okay and we can handle it as long as we learn the right strategy in our job is as teachers is to teach strategy. So when I work, even when I see a structural in the back, I still use my Palladio's teachers a lot because they have a healthy perspective. They're dealing with strategy and that, um, you know, what we talked about in the beginning of the restriction and the compensation and the conditioning for them just to sort feel like they can move. And I'll leave you with a phrase that if it's a, if it's the common theme of your treatment, you will not fail. And that is to provide a positive movement experience without pain. Whenever you're dealing with that kind of population, if you can provide a positive movement experience without pain, you will succeed. You will be successful, right?
You can't use the other mentality of you know, hard body squeeze, hold more, resist, you know, those are words that are not part of efficiency. And our goal right now, especially with baby boomers is efficiency. Like I'm in the, I'm the tail end of the baby boomers and I, and I know more than her. I was like, I just want to be efficient. I want to be able to go skiing. I want to go around and play a game of tennis or golf and not have to worry about blowing something out. I promise I won't pull volt anymore. I, how am I track spikes up? But you know, it's like that process. How do we help our people to be more, uh, what do you call it? Subtle. Subtle. It's not subtle. I want to be supple.
So back here we talked about spine mechanics that we need to condition wall slaw. Our body responds to the stresses as to we have to create the right stress in all planes of movement based on what we anticipate doing the neuromuscular system as much smarter than us. So we just have to look at things like quality assessments of things like fluidity, efficiency, continuity, connectivity, those kinds of things. In our teaching, we talked about the importance of distribution and movements. So the mobility of the spine by teaching them to move from other segments of the spine, take away the stress from others.
So typically my spawned is and my stenosis, you know, a typical pattern of stenosis is to come into this pasture here. The stenosis is just here. There's no reason for this to be collapsed. Can we get this to come up? Can we open our hips, bring them forward, even if we're still keeping that lumbar space open, at least now they're much more efficient here to go for a while. Then here and here. Now guess what? Now I got neck and shoulder problems, right? Yup. Can't turn my head. Can't move. All right. I gave you some images to use.
Paint the ceiling moving as if the vertebrae were Var. The disc were balls moving in your spine, the elastic band. Those are all ways that I teach the spine to move without them having to use their muscles. Now the muscles work that I'm not cuing the muscles cure the bony landmarks, the ligaments, the disc, and you'll be much more successful in getting your movement. Yeah. So remember we said that you could close the fossette from below or you could close it from above. They're both extension.
When you think of closing from below, the vertebrae is moving up, so it's a little better image of thinking of the vertebrae from below, pushing up in the vertebrae above, pulling down into the artery below from an energy standpoint. I'll give you one more quick roll and then ask your question where the disc goes. The rib goes. That's a whole nother lecture, but I want you to think about it. The head of the rib connects to the disc and a little bit of a fuss set above on the vertebral body above, and a little bit of the [inaudible] in the vertebral body below. So here's the rib, right when my spine goes into extension, my ribs slide forward. When my spine goes into flection, my ribs slide back. When I go into Wright's side, bending my ribs, slide to the opposite side. Both of them, which is what you're talking about in shower, they both slide, they follow the disk, right? You feel that, so your side bend into your right, your ribs are both sliding to your left, right? And you're thinking of segmental.
You can't think of it like the whole thing, but when I do that segmental movement, those two, those two ribs at that segment, this actually flexing or translating are going to go where the disc goes. Okay? Now here's the second part of the rule. When the rib goes forward, it inclines down
It's going to do this relative to the rib above it and that Ribs gonna do the same thing, rod to the rib above it as I send the extension higher up the spine. Okay, so go forward. Now the big mistake we make and why people hate things like the swan and stuff is because their thinking ribs come forward and up. Lift that sternum up, bring it up and immediately my whole rib cage moves together. It's still in Kyphosis and I go into hyperlordosis and I don't like it. Right. It's like your Yoga Cobra, sorry, but you're only recovering.
Most people do wrong, right? It's not meant to be that way, but that's how we do it because we don't understand those mechanics where if you look and you go and study yoga in India with some of these really good yoga teacher, you realize they're actually doing that naturally. They're supple. The rib cage is moving when I go into flection because they're kickstand. Back to the transfer of process. The ribs are going to go back, but they're going to come up. Can you feel that? Which is also actually a longer duration, which naturally gives you the Halloween that we often use as a cue that I don't like to use. I rather have them feel like those ribs are coming up as they're going in deflection, like they're doing a rollout, they're going to get a much better roll up and segmental movement from the thoracic spine. If I send my ribs down, which is one of the most common cues, then I'm gonna move from my low back now for my thoracic spine. Okay, forward and down. Do you want an extension to get the extension?
I want extension from here. Not from here. Okay. And when I go into flection, I'm going to have the ribs are going to go back and up underneath my heart, so go into flection and gonna roll, do a roll up and the ribs come under and are going to lift up underneath your heart. It's going to give you space here and we really learned that as in Gyrotonic, right? Yeah, exactly. Exactly. It's the natural movement of that. If you want it load, and that's what Jared tonic is so good at is getting into the thoracic cage that we don't do in plot is enough, but the mechanics are right.
Eventually your roots are going to have to point out.
It's not for my stenosis and my spondylolisthesis and that's the point that I'm saying is that you have to determine where you want movement to happen and the key is distribution and movement is distribution of force. So if I can get 10 segments to move three degrees, I get a beautiful 30 degrees without ever coming close to an end of range and that Swan looks gorgeous. You don't have any pressure in there. Low back, no pinching or pain. They use a 10th of the amount of muscles at the other person's using this, this during the swan from the low back.
So he said side bend in both ribs. Go to the opposite side. But where does inclination,
Well, the whole idea is to make it easier, right? I mean our goal is applies teachers to make hard things easy, let him come in and struggle with it. And then Sean, how smart we are by making the hard things easy. Are you doing hip extension and plank or hip flection and plank? You're doing hip flection and playing gravity's doing hip extension in play, right? So you're resisting hip extension. So glutes are relaxed.
So if you tell people to tighten their glutes up while you're doing it, you're saying in a bad message, you're pushing them down into the direction of gravity. That's why I'm saying we are not that smart and I'm pretty damn smart only because I've studied it for so many years. But I can tell you the more I learned, the more I realize I'm not smart enough to tell body what muscles to contract, but I know it's a beautiful movement. When I see the buns actually a little relaxed and I see that body looking long and fluid and moving and they can go into up stretch and they can just drop that neck and head down and roll through that spine so beautifully while they're resisting gravity. And then I know they're using the right amount of muscles as much as necessary, as little as possible. And that's efficiency, right?
So if I tell you tighten these muscles tighten here. Now what I might do is I might give you a tactile cue that I know is going to create a response on your ribs or on your low back or reach through here. My fingers are reach out length, but as soon as we use the word contract or tighten or use these muscles, we've interfered. It was just like what we were doing in the standing work and I said one is just shift your weight and fill the difference. What happened? How the muscles did get tighter because you've narrowed your base of support and they need to push out against that. Fascia to me are effective.
But as soon as you went, boom and you tighten the muscles, that was a very different experience. And it's the same thing. If I'm going to be in a plank position, right? I don't have to use my glutes to be in this position unless I'm going to do work Lakeport use hip extension and then I want to be very efficient with that. The same thing's true, like if I want to do the opposite. So let's say that I want to go into leg poor, right?
So I'm here, right? If I over recruit my glutes here, I get my leg up.
A cute like in shoulder brace where you often hear someone say you're going to lift your right leg, stabilized with your hamstring, opposite sides,
Every time they raise their hand to play tennis, they don't have to have rotator cuff tear. The rotator cuff was man induced, recruit, recruit, recruit, throw those dumbbells up with a curled spot. I mean, we did stupid stuff, you know, and I'm paying for it now because I was part of that generation. Right. You only the people who didn't do anything and now we're starting in and doing piles and stuff. They're going to live to a hundred years old without pathology.
My body feels so great. I'm so happy I'm doing pilates. I've never felt as good. And the instructor's like, is it five o'clock yet my back is killing me. You know? So yes. You know, one of the things we insist on is that all of our pilates teachers are actually PyLadies enthusiast and we're all guilty of it. When we get so busy and teaching Yoga Pilati is Gyrotonic and we don't do it ourselves. Our work is so labor intensive, it takes us away from being able to be healthy. It is an unhealthy behavior to be a teacher of movement because our body posture, which means even more importantly we have to to work on that.
And I'm just as guilty, you do an eight hour a day or six hours a day and it's like the last thing you want to do is jump on a reformer. But you have to, yeah, we want to do a little study at PMA. It's actually a very big study, but to bring in for ultrasounds with, for ultrasound, um, technicians and then have a history of, you know, where are you trained, how often you practice, so what we know, what kind of style you do. We know how often you practice. And how long you've been practicing and to be able to look at how many have pelvic floor dysfunction and the inability to distinguish between transfers and Oblique. Yeah. So what happens is, you know, the transverse contractions very subtle. It's very light. Um, and it's sub threshold submaximal so you don't even know you're really doing it, except you sort of feel lifted and lengthen and fluid. You know, in t when that ta is working, you're actually fluid. You know where you're here, you lose fluidity. There's not, you compress that spine, you lose the fluidity. Here you have fluidity.
But he just really doesn't understand plot. He's, no, no, no, no, no. Nobody has even met about Pollstar.
And very wise, I learned from her every day. She's now 17 and, and she just blesses our life and we're down there and I was dealing with my own issues that particular week. I wasn't feeling real good. A lot of travel wasn't really into, I didn't want to get too personal than anybody. And typically I'm very personal, so it's like you get to know me, I remember who you are the next time I see. And um, there was a woman that was in a lot of emotional pain riding around on the floor, like throughout the whole first half of the day. So you knew, it was like, I know that I could do a little energy work with her and unwind her and she might froth at the mouth or yell or cry or whatever she's going to do, but that she had some real stuff going on and I was ignoring her and my nine year old daughter, her lean is looking at me like, Bobby, come on, this is what you do. You fix people. This woman's in pain, have some compassion on her. And I was like, you know, stop. We're looking at me like that with those eyes, you know, three o'clock comes in the afternoon, another break and I'm fiddling around with some things and she's looking at me like, poppy, c'mon, you know, it's like take care of this lady. And um, I ignored it and she walks over, she puts her hands on her head and another hand on her heart and the woman goes through a complete unwinding. I mean crying, grunting, frothing at the mouth, shaking and moving all around the floor. And she stayed with her for like 10 minutes and calmed her down.
So there is a lean or playing with something in her hands, right? Nine years old, not even sure. It's like, I'm like, go wash your, your hands and your arms, baby, go get all that stuff off your arms. But there is, there is stuff that we don't see when we treat people, when we work with that and we do, you know, and even even from a spiritual side, you know, I wear another hat as a Mormon bishop and you know, you can take a lot of agony and pain and suffering home with you. And you got, if you don't want your family to, to fill that, you know, so a lot of times it's place teachers, you'd become that counselor or that psychologist without even asking to be, but you hear things, there's times where I've been doing feet and straps, circles and they break down crying. It turns out that they were sexually molested when they were nine and I just opened up a whole restricted area emotionally. Right.
Or that there was somebody who goes into a past life regression, right. While I'm working with her on the [inaudible] freaked me out. But I mean it was like I was there, so I, I had to go through it. And there are toxicities that are happening. These are horrible things, tiled abuse, you know, horrible things, horrible, horrible things. And, um, we have to be able to purge ourselves of those.
And you know, I don't know of studies that have said, yeah, there's, we can see this toxicity level in somebody, but we just feel it. And the best thing to do, to me, meditation is probably the most powerful clock. Resetter, you know, um, barefoot on the ground is also incredibly important. Or to go in the ocean and at the saltwater diffuse it. Um, there's a book out called earthing look that up there now getting to the point where they're making beds and hotels that are grounded. So when you lay in the bed or you walk on the floor there, it's laced with silver and it grounds into the ground.
And so you can get rid of all those electrons and photons that are negatively charged for you. And it's thought that the main cause of all of our diseases, inflammation and that we have inflammation because we wear a rubber soled shoes and walk on cement all day. And so we can't get rid of the negativity charge. And so we stay inflamed. And then the other process and inflammation is the processed foods that we eat. So we're putting in our mouth, we're taking it from people, we hear it in the news, we see it all over the place, you know, and we don't have a way to diffuse it and the earth is made to take it away from us. So if you can get outside of it, I think I said even like five minutes just to stand out and do like a little Chigong standing out on the grass barefoot or something like that.
You dig your feet into the sand and just breathe and exhale the toxins. Let it run through your hands, your feet. Do a meditation. This to synchronize your systems again and make sure that your immune system is high. I mean those are the things we have to do as healers to be able to, to stay healthy. Otherwise we could say, can you see him? I mean, I see a lot of places are always sick and it's like you are always sick. You're always beat up. Why are you so beat up was because are not taking care of themselves.
And Carol Davis says, Doctor [inaudible] says we have to be okay to be able to take care of other people. So that could mean just a frame of mind. When you walk through those doors, you leave all your worldly stuff out, you shift your mantra to I'm okay and I want to do good, I'm going to do good for that person. And it's amazing how the universe can sweep in and lift you up and inspire you and inspire me to be able to do our job. And then we walked back out that door. All of a sudden the world falls back on us again.
So just take a deep breath and allow the back of the neck to drop down. As you exhale, the shoulders widen and the lumbar actually gets a little bit longer. So we want to avoid the concept of tucking or pulling the back down. And rather than doing that is letting this often down. And relax this a little bit. There you go. So now I have a little more life.
You feel that? So now we'll let the knees bend down, bringing the carriage back home and repeat. Let's go ahead and do about 10 repetitions there. A lot of times what we tend to do is we want to get that space to decrease a little bit of gravity. What we ended up posts really tilting the back instead of letting the ribs open and relaxed down. So it's, we're trying to concentrate on as to let that back. Just relax that at length and as you press out with your legs.
Now this next one is bring your feet together. And same thing, just reaching out nice and long. Feel that length. And again, we're using it as much as necessary, as little as possible. So we're just moving fluidly through it. And an image I like is, uh, like a bicycle. There's really no start or stop to it when you're pedaling. And that's what I want you to feel here. You just a continuous, you get to that tallest point and you come back down and I sat a little bit of rotation and just keep the rhythm going. And again, here, now you can feel a little bit of the allowing the knees to go out to the side, which allows the hip to drop into the socket. So when you bend down the hips coming in, you dropped down, hips dropping in, think more of the bone gliding and moving and allowing that.
We call it disassociation in the hip. So we'll get rid of the muscles and just think of the skeleton moving. The springs are acting like your muscles. And one more time. And then let's take it out nice and wide. Now from here we're going to think more of sit bones.
So press out and the sit bones actually come together, drop down, sit bones widen. So initially, yes, yes, yes. And that's it. That also creates that release that I want you to feel rather than thinking of pulling down or pushing up, just do the movement from the pelvic floor and really thinking of the bones moving rather than even the muscles moving. And that looks great.
[inaudible] so we get a nice little massage in the hips. Just get familiar with it. And what should happen because the femur is ball and socket, there shouldn't be any stops. So the stops are going to be muscle induced. So just allow, that's right. You feel how you just let go of that. Perfect. So here with a low back problem, we're trying to get rid, I don't want you to use muscles. You're using too many muscles already.
You're guarded up. We don't know where to move from. And now we're going to learn, oh I can move my hips and I can get a lot of freedom in my hips and let my back rest reverse the direction. And that's, it just gives you, so you've never feels a little odd. It's a Huh? Yeah, because internal rotation is going to stretch and open up the back of the pelvis in the hip. And that's where you know when you get the butts squeezing together to protect your back. We actually do more damage to our back. Let's do that one more time and relax. Good.
So let's come with the feet together here and press out. Stay out this time and let your heels come down towards me and I want you to use the image of the Fascia of your whole back is like a hammock between two coconut trees. I'm one of those coconut trees in somebody else's pulling on the back of the head. So you just feel that now taking a deep breath, expand, expand, expand belly to let everything expand. Yes, and as you exhale, everything drops into the hammock. Don't force it. Let it drop. [inaudible] one more time. Deep breath. There you go. Let it just drop it in the hammock. Now bringing the carriage back home, you're going to initiate the knees that the knees bend up towards the ceiling and bring the carriage home. There it is.
And initiated the carriage going out by pushing your heels into my hand. Yes, that's it. Good. Bend the knees to come down. Press the heels to go out. So now what we're doing is we're disassociating that idea of I have to push on my toes to push out with my legs, right. And really feel that sink underneath. So we're tightening that fabric every time it comes down. And then loosen and tighten. Yes.
And same thing here. Yes. And stay out this time. And again, just so that open. I'm good. Okay, so now rise up onto those toes, keep the heels up and bend the knees down, then hit. So now we're challenging a little bit. The same thing we just learn. So without having to push anything down. And then you just feel that length that opened the Fascia and just now challenging through the ankles in the knees.
And let's just do eight of those now we'll give you some nice strength work as well. So our goal is to sorta hit all of the muscle groups through the lower leg in a way that they all still warming up. All the joints we've plantar flection, Dorsey flection, circumduction of the hip, internal, external rotation, flection, extension of the knee. So we've hit all of those. Now in about three minutes and are ready to move on to some bridging. So we're going to bring the feet in. Let's go out wide. Drop your headdress down, make sure your headdress is down before you go into the bridge.
And what I want you to do first is actually tilt anteriorly [inaudible] and then come back into your bridge. Yup. Pill.
So they give us a nice moment immediately up in your thoracic and don't worry about a whole lot of tilting down the low back for you. Right? Again, we're focusing on a low back pain, so we want to make sure that we don't do too much there. Right? So there the ribs are going to come forward and down. So we never feel the ribs jumping out. Taking a deep breath. Now the ribs are coming down and up. Yes. Yes. Very nice.
So this time we're going to come up and we're going to do what I call the typewriters. So you have to be a vintage age to understand what a typewriter is. Have you ever seen a typewriter before? Yeah. Okay. So roll out. Got Start right there. So what I want to do is I want to wake up the local stabilizers a little bit and we're just going to purely Lowry translate to the right and to the left. Yup. And try not to tilt with it cause all we want to do is just slide.
Care from the, drop that down. That's the typewriter for him to ride on that. There it is. Good. And drop it down. Another centimeter. Same thing. Slide and slide caravans a drop. Right. It's good though. Keep going cause this is what we want. This is how we wake up, those local stabilizers. So when she sliding back and forth side to side, the local stabilizers are waking up and the globals have to let go. If the globals were on, they pull her into rotation and you can sort of see that rotation happening and drop down. Okay.
Now you're going to notice a big difference when you roll up this time. So do the regular bridge again and no effort just let, it's just going to come up. You see that? Yeah. I don't know what happened but I felt, yeah, just sorta just pilled up without any muscles. You didn't have to use a lot of glutes or hamstrings. So let's do that one more time. So dropped down an inch, slide side to side and just keep pricing and you feel like you're almost like on a skateboard, this rolling back and forth. Yes. Drive down an inch. Same thing.
So if you can get like five segments to slide back and forth, that's, that's like 150% more movement than most people have anyway. Healthy people strategizing on it from our four or five or five s one
And I'm going to block this area here. So you're gonna roll down normal and you're going to let that left side drop down.
Nice and easy and just feel yourself float up. Beautiful. See you picked up like three or four more segments of movement. So the idea is your flections are going to be much easier, and we got rid of the Guardian muscles in your lower back. So now we're going to challenge that control a little bit. I'm going to drop you down to a red and a blue spring.
If you want your head rest up, you can put it back up again. We will feet and straps. All right, straighten the legs out. You're like, okay with the head rest down, it's up to you. Let's stay parallel because remember when we do it turned out what we're ended up doing is we're over recruiting the rotators and right now we're trying to say, let's get those hips Sakis to drop in. So here are visual image. Again, here's the socket, here's the femur. It's going to be rolling.
The femur is going to be rolling down and back. This way the head and the pelvis will be going in the opposite direction. So as this goes down, the pelvis actually goes a little bit anterior anterior. And what it should look like is the pelvis doesn't move at all. Okay. So it's almost like you're just allowing the femur to slide back. Okay.
So let's give that a try.
As long as you can keep that pelvis nice and quiet. That looks great.
Right. So that's that middle, right? The springs are doing the work. Okay. So now what I want you to do is actually turn your feet in towards each other and do the same thing now and see if you can, you won't go as high. There you go. Yup. And just be aware of that. The odd, right? Yeah. You should see how the ballerinas respond to this is even worse. Okay, good.
Now go ahead and bring it into parallel at 45 okay. Drop it down about 10 15 more degrees. Stay there and now just open and close the legs from there. Yup. And close. Now be careful of this position. So as you open those femurs are rolling in this way and yes, you just corrected the torsion there and back
That's it. That's what I want right there. Okay, good. And let's just do a little bit of bending the knees in with the straps floating on top of the shins. Yeah. And only as far as you can keep it quiet. Good. And again, so we're going to do here is use your own proprioception to be aware of it by separating the legs about 10 inches. Yup. And now close your eyes, press the legs out and be really observant. So you're going to feel when you close your eyes you're going to feel the asymmetry between the legs cause almost everybody has at one leg bands before the other one, LinkedIn's before the other.
Just closing your eyes and allowing the legs to move and recognize it and then correct it from the inside. You correct your own torch and you correct you're on leg length discrepancy. You correct that instability in the pelvis because the organizations inside of it, you can do it. Let's do two more of those is looking really good. Things are waking up. I like that. And last one good.
Okay. So open your eyes, bring your knees in. You can just going to slip your hands right into those loops. And leave your legs at 90 degrees and sort of the tabletop position. And I'm going to take you down to one red right now. Okay, so here let's go ahead and just do some simple arm arcs, bringing the hands down towards the hips and I want you to notice the pressure of the shoulders wanting to come up and you push down. So we're only going to go to where we get that optimal congruency in the shoulder. So it's going to be about right there to come down too far.
That shoulder starts to pop up and you actually have a really good range of motion. Christie, most people when they go down at four, that shoulder's going to jump up. But very important that we don't let it go down that far cause then we're going to lose the orientation. So now arms up and down and I want you to think of the arms being drawn down by the ribs. So this is drawing the arm. Yes, good. Find that connection and then it's almost no work at all for the arms and you see that? Good. Now from here, we're going to prepare ourselves from, I can it do a hundred but we're going to do a preparation for it. So we're going to bring the arms down and think of those ribs.
Remember they're going to go back and up underneath as you bring your head and shoulders up. That's it. And then go back down, arch the arms up, draw the arms down with the ribs and then as you roll up the ribs going to come underneath. Yes, yes. Did you see how easy that was and where your head's just really relaxed. They're exactly what we want. Let's do four more of those. So we are getting some exactly. So you see we're not going down in the lumbar at all. Can you tell that?
So when the ribs move the right way, the lumbar can chill and you get that nice roll up without feeling you've got a tilt or posteriorly squeeze the butt together. Anything like that. You've got two more of those in you, right?
Straighten your legs out over the bar. Yep. And reach your hands up towards the ceiling. And I'm just going to help you peel up and again, thinking of those ribs coming underneath you. Enrolling ourselves up into the position. Good. Okay. In the ladies, I'm going to go quadruple position. So hands and knees and I'm going to start, you honor. Ah, let's see this down there. We got two hands on the frame and I'm actually gonna take you down to a balloon.
The key is to keep the ribs and the hips connected. Yes, there it is. There it is. So it's very dynamic. As the knees come in, the ribs have to come up. There it is. You feel that good. Now stay there and push out with the arms just a little bit. Now remember we're filling that connection here. Good and back end. And it's all about connection. So it's not really recruiting muscles.
Just like where, where that stiffness comes from.
So if you can feel a little bit of that preparation for the quick response, that's it. That's it. And, and, and, and, and, and, and, and in this, even in the low back care class, I don't mind challenging people. So if I wanted you to take your knees off, I felt you were strong enough and still challenging. Keep this area to do. Let your knees come off two inches and that come down perfect. Okay. So from here, let's go right into an elephant position. And again, we'll start with a little bit more of the neutral. So even if you had to bend your knees so that the hills can be a little bit, it's fine. And then we'll go into around back.
So we'll start introducing round back into the spine. Okay. So from there, pressing the legs out and the, I'm going to give you the resistance to pull in. So pull in against my foot. That's it. And, and pull in. Poor, poor, poor, poor pork. That and poor. Again, this is disassociated. Be careful of the hip flexors pulling the spine forward so the ribs are going to draw up underneath. There it is. There it is. There it is. That's what I'm looking for. You feel the difference? Okay, give me two more there and then we'll go into a, around back.
We keep the same alignment. So it's that suspension between the pubic bone. Amy, come to your sternum just like feet and straps. Think feet and straps upside down. There you go. There you go. That much more. Yeah. Two more of those. And let's stay down on this next one and just give me four Jack Rabbits.
So knees come in. That's a Jack Rub right there. Yep. Keep this connected. So now it's just like we're doing with the feet and straps, right? Everything's the same. It's just we're now going into that stage three where we're the same things that we did before.
And that's introduced a little bit of extension. So a down stretch. So hips are going to come forward. Opening up the hips. Yup. That's plenty. I'm going to make it a little bit lighter and just press out with the arms
I'm going to introduce our first rotation. Okay. So we're gonna bring both hands over to the left.
Okay. So pressing out and I want to feel as you're pushing down this, pushing down is going to facilitate that rotation. It's like this pushes this pulse [inaudible]
Yup. And this is a beautiful exercise to teach where movement's going to come from. So just to a couple of leg presses and see if you can feel that you have enough balance that you could do without your hands. We're good. Okay, so now take your hands out into a second position here and as you straighten your legs out, you're going to sweep your body down into flection. As the knees band in, we're going to bring chest up to the ceiling. So it has to happen here is you have to use core muscles to some degree to keep your balance and you have to free up the thoracic and chest to be able to move through space in that loves and she act to stay nice and Elongate it.
Opening up and sweep down. That's it. And he's banned in and open up and feel a little more extension. That rib cage, when we talked about those rubs going to go forward and down. Gimme the sternum up pie. Yep. Good. And circle downs around and it goes forward. The ribs come up underneath. Yes, and up and down.
That's it. Good, good. It's not about the range of motion, it's about that connection and looks really nice. You got a nice, beautiful arc in your movement. Exactly. Exactly. Nice. Feel the extension of Pie. Yep. There it is. Last one. And let's add a little rotation to it while I got you. So you're gonna come up and lead with this arm. Come into the extension. Knees bend in, come here hoping and spin and sweep.
Lead with the left arm. Open, spin and sweet. And so we're getting to where we're teaching a thoracic mobility. That's it. You see how you're not rotating at all here? Because if you rotate in your low back, what's gonna Happen? You're gonna fall and relax. That's great. Good.
Let's finish up a little bit of reverse work. So I'm gonna have you go on your hands and knees facing this way. I'll drop you down too. You can go with a single blue spring or a single red spring. Typically hands are gonna be here and we're gonna make a perfect square.
And I want about two or three inches between your knees and the pad. Yep. From here without moving the carriage, let's just go forward into a parallelogram till your face hit. Yup. Ribs are going to come up, right? Their hand. Stay here. Thumbs out of the tracks. And now just draw the knees towards the hands.
Now just come up into a nice tall kneeling position. Grab your straps and let's just do finish up with a little chest expansion. So I'm gonna stay here with my hand just so you don't take a dive, but you're going to bring your hand straight back with an inhalation and we're going to really feel that expansion. But I want you to feel expansion back here. So we're gonna use that breath all the way around. Xcel. Look into the right to the left and at the hands. Come forward.
Continue to exhale and grow and inhale, expand into my hands and look left and right and exhale hands come forward and you get rid of that air. You're filling everything up.
We're coming to the side and fill the air, expanding to the back as well as the front, the head just sitting on top. Let the hands come here rather than back here because this will sort of make you go into a little bit too much extension and even choke up. Choke up a little bit on the cables. Soon we'll give you a little bit of fill on it. There you go. Let's try it. Stop there. Good and Xcel side. So I like that a lot better.
Yes, grow with that exhalation. Challenge Yourself. Get right on the edge like you're going to go forward. I won't let you fall, I promise. There it is. It's a much better connection. Getting out of that. A little bit of extension. You'd like to put your low back here and relax. Good. All right. Let's see. We've got time for one more little thing. We're going to do a little scooter.
Okay. We'll do something and weight bearing. So I'm going to have you stand with your left foot there and your right foot here and we're bringing you up to a single red to start. And on this one I want you, let's, as we start with a here, I want you to come here and drop down with it as best she can. You might lean little forges so your knees clear on it, but I want to have this leg down as far as you can get it to standing away. There we go. So now again, hip flexors challenging your core.
When you push that right leg back, that hip flexor wants your back to do this right and you're not going to let it. Okay. It could be as small little stroke. It doesn't have to be a big stroke. That what I want right there. So I want you to have this vertical if possible, and your body and that little Paul to the challenge. That's when you're walking. That hip flex when you go into toe off isn't going to pull you, keep pulling your back into an extension and insulting that that ligament or that fossette that's giving you trouble. That looks fantastic.
Do two more there and there's a lot more challenging. You're glistening powder and switch sites and again, that's just with one red spring. So again, a lot of times mostly what we do is use a red or a single blue spring for most of the things. It was really just about, you know, are you, you don't need to put that much stress on the body to figure it out.
You can fill a different on this side. So only go to where you feel control that rib. The Rib is responsible. So think of the rib coming forward and down a little bit to counteract.
And we're able to hit a number of things that had a good purpose. We hit almost everything in your body. Mobility, all the planes of movement, core back extensors, your hips, this association, the hips release in his well, it gets rid of the over recruitment patterns that we use a lot. So the circular motion, right? Remember, motion frees up unwanted muscle recruitment. So we're looking to refine and have a little bit more, um, continuity of the movement. Low more flow to the movement. We don't want muscles in the way the bones are made to move well.
And so what we do is we try to get the bonds to move well by allowing that to happen. So you're in a closed chain and free and a up to, same thing as me walking, allowing my pelvis to do is figure eight on top of my femur. It's no different. Okay. Thank you. Thank you. No, it is prevents back pain, right? Yeah. Okay. Yep. You're welcome. Thank you.
If you complete this workshop, you will earn:
2.0 credits from Pilates Alliance Australasia (PAA)
The Pilates Alliance Australasia (PAA) is an independent and not-for-profit organization established by the Pilates industry as a regulatory body for control of quality instruction, member support, and integrity within all legitimate approaches to the Pilates Method.
3.0 credits from National Pilates Certification Program (NPCP)
The National Pilates Certification Program is accredited by the National Commission for Certifying Agencies (NCCA)