#685: Dr. Shirley Sahrmann — A Legendary PT Does a Deep Dive on Tim's Low-Back Issues, Teaches How to Unlearn Painful Patterns, Talks About Movement as Medicine (or Poison), and More

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Aug 4, 2023

Dr. Shirley A. Sahrmann, a trailblazer in physical therapy, shares her expertise on overcoming low back pain through innovative movement techniques. She discusses the fascinating link between abdominal strength and spinal health, revealing how both can influence pain triggers. Breathing methods, like pump handle and bucket handle techniques, also play a crucial role in alleviating discomfort. With humor, she emphasizes alignment in daily activities and offers insights on the significance of personalized movement patterns for long-term health.

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INSIGHT

Movement-Based Diagnosis

Dr. Sahrmann's book revolutionized physical therapy by focusing on movement as a source of musculoskeletal problems.
It introduced diagnostic categories based on movement, guiding treatment towards root causes instead of just symptoms.

INSIGHT

Low Back Pain: Symptom vs. Diagnosis

Low back pain is a symptom, not a diagnosis itself. A diagnosis should identify the specific movement causing the pain.
Treatment involves modifying that movement to alleviate or resolve symptoms, addressing the root cause.

ADVICE

Checking for Pelvic Rotation

Check for pelvic rotation while walking by placing hands on the pelvis to identify potential symptom causes. If hip flexors are stiff, they can rotate the pelvis during walking, leading to pain.
Faster walking may not cause pain because of more symmetrical movement, while slower walking can exacerbate rotational issues.

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Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines

Shirley Sahrmann

This book provides an organized method for diagnosing and treating musculoskeletal pain by identifying muscle and movement imbalances. It includes detailed explanations of examinations, exercise principles, and corrective exercises, supported by evidence-based research and case studies. The book is accompanied by a companion Evolve website with video clips and printable resources.

Diagnosis and Treatment of Movement Impairment Syndromes

Shirley Sahrmann

This book presents a classification system for mechanical pain syndromes, providing tools for physical therapists to identify movement imbalances, establish diagnoses, and develop corrective exercise prescriptions. It covers both evaluation processes and therapeutic treatments, offering detailed descriptions of exercises and case management strategies.

The paleo solution

The Original Human Diet

Robb Wolf

In 'The Paleo Solution,' Robb Wolf combines cutting-edge research from genetics, biochemistry, and anthropology to advocate for a return to the ancestral diet. The book proposes that modern humans should eat in a way that mimics the dietary habits of our Paleolithic ancestors, focusing on whole, unprocessed foods such as meat, fish, vegetables, fruits, nuts, and seeds, while avoiding grains, legumes, dairy products, and refined sugars. Wolf provides practical advice, meal plans, and real-life success stories to help readers transition to a Paleo lifestyle, which can lead to significant health improvements including better blood sugar control, lower cholesterol levels, reduced inflammation, and improved weight management.

Wired to eat

Robb Wolf

In 'Wired to Eat', Robb Wolf explains how our genetics are working against us in the modern world of highly palatable foods. The book delves into the science behind appetite regulation, the impact of sleep, stress, and community on health, and introduces the concept of personalized nutrition. It includes a 30-Day Reset program to normalize appetite regulation and a 7-Day Carb Test to determine individual carbohydrate tolerance. The book also discusses ketogenic diets and intermittent fasting as potential tools for health improvement. Wolf emphasizes that each person's metabolism and nutritional needs are distinct, advocating for a personalized approach to dieting rather than one-size-fits-all solutions.

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Resources from this episode: https://tim.blog/2023/08/04/dr-shirley-sahrmann/

Shirley A. Sahrmann, PT, PhD, is Professor Emerita of Physical Therapy at Washington University School of Medicine in St. Louis, Missouri. She received her bachelor’s degree in physical therapy and her masters and doctorate degrees in neurobiology from Washington University, where she joined the physical therapy faculty and became the first director of their PhD program in movement science.

Shirley became a Catherine Worthingham Fellow of the American Physical Therapy Association in 1986 and in 1998 was selected to receive the Mary McMillan Award, the Association’s highest honor. She is a recipient of the Association’s Marion Williams Research Award, the Lucy Blair Service Award, the Kendall Practice Award, and the Inaugural John H.P. Maley Lecturer Award.

She has also received Washington University's Distinguished Faculty Award, the Distinguished Alumni Award, the School of Medicine’s Inaugural Distinguished Clinician Award, and an honorary doctorate from the University of Indianapolis. She has also received the Bowling-Erhard Orthopedic Clinical Practice Award from the Orthopaedic Academy of the APTA. She has served on the APTA Board of Directors and as president of the Missouri Chapter.

Her first book, Diagnosis and Treatment of Movement Impairment Syndromes, has been translated into seven languages. Her second book, Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines, has been equally influential in promoting movement diagnoses.

Please enjoy!

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[07:12] A brief terminology primer.

[13:00] Why Shirley's first book is so influential among physical therapists.

[15:54] The correlation between lifestyle and health hasn't always been obvious.

[18:16] Low back pain: not a diagnosis, but a symptom.

[20:41] The trouble with overdeveloped abdominals.

[22:32] What's my problem?

[30:14] The Movement Systems Syndromes (MSS) approach.

[31:29] The wrong walk home.

[33:01] Correcting bad habits.

[35:00] Psoas it goes.

[37:03] Other commonly repeating culprits.

[40:36] Pump handle and bucket handle.