Restoring Human Movement

SHOW NOTES In this podcast I'll go over my personal experience with a hamstring tear to kick off hamstring month. I was devastated but have completely recovered. I'll reveal all of my secrets: The story of how the hamstring tore The recovery period of the hamstring tear How I rehab a hamstring tear How to grade a hamstring tear How to return to play from a hamstring tear If you haven't seen yet, I'm doing a Youtube video a day for 2018 just for all of you to get extra information from the podcast. This month is all on hamstrings. Sebastian's Youtube Channel for hamstring videos. Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

SHOW NOTES Back pain isn't the death sentence you think it is. Majority of people can get better with a little understanding and dedication. Dr. Stuart McGill PhD is a spine biomechanist at the University of Waterloo. Over the years, he has conducted numerous lab experiments on the human spine to figure out how much load it can take, what motions cause it to become injured and more. He's the author of some awesome books, such as Back Mechanic: The Secrets to a Healthy Spine your Doctor isn't Telling You, which was written specifically for chronic low back patients to better understand and resolve their condition. Dr Stuart McGill's Bio: Dr. McGill is a professor emeritus, University of Waterloo, where he was a professor for 32 years. His laboratory and experimental research clinic investigated issues related to the causal mechanisms of back pain, how to rehabilitate back-pained people and enhance injury resilience and performance. This produced over 240 peer-reviewed scientific journal papers, many international awards, and has mentored over 40 graduate students during this scientific journey. I'm honored to have him on this podcast session. Our goal today is to breakdown the common questions patients have about back pain. If you're a healthcare provider you'll know what questions I'm talking about: Should I stretch my back? Is my pain from a disc herniation? How can I overcome a weak back? Why does it hurt when I sit? These are just a few of the topics. Basically this podcast was designed to fit the best spinal hygiene information within an hour and 15 min block. If you're a healthcare provider, share this with your patients. If you're a patient, share this with your doctor or your spouse with back pain. Get the books today! – Gift of Injury PERFORMANCE ENHANCEMENT – Back Mechanic FIX YOUR BACK PAIN Sebastian's Youtube Channel You can access the show notes at https://www.p2sportscare.com/podcast/ Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor. Here's the start of our show notes. More can be found at P2sportsCare.com - [Dr. Sebastian Gonzales] So, first off is all low back pain created equal? - [Dr. Stuart McGill]You're starting with the big philosophical questions first, well I'm going to give you probably a big answer on this, with maybe three levels, some logic, some examples. Let me reverse that a tiny bit and say well have you ever heard of non-specific head pain or leg pain, is leg pain created equal, I mean we don't even put up with such a notion, it could be torn knee ligaments, vascular complaint, a cut or whatever, so this notion of back pain, it is so non-homogeneous, and what I mean by that is one person might have back pain because they've got a disc bulge, the next person might have it for an entirely different reason, so starting out with that logic and setpoint, all back pain has a cause, and if we can obtain a specific and precise diagnosis of the pain mechanism, then we can address it appropriately, so is it created equal, right off the top three contrasting examples of back pain come to mind, think of a person who is in their mid-20s, 30s, 40s, say they work sitting at a computer eight hours a day, sitting at the computer for 20 minutes gives them back pain, and yet they can stand up and go for a three or four mile walk and that would be therapeutic, now let's take the next person who is newly retired, and they have more of a stenosis or arthritic mechanism to their back pain, and interestingly enough the precise opposite occurs, walking starts to cause back pain, and sitting down is relieving, and then I can give a third example, let's take a young athletic team, you can take a football team or a baseball team, and when you study the back pain patterns you will see that they form cluster groups, for example one team might have four stress fractures on their roster, in their back, and those stressed fractures were not caused by baseball, it was caused by the strength and conditioning coach, who was getting them to do full range of motion loaded rotations, and eventually caused a spondylitic fracture, and maybe full-blown spondylolisthesis, so each one of those would have a different time course, a different symptom pattern, and really a very different strategy to address them, and as you know in my books, I give many more examples, but there is an example, one is a programming flaw, one is the person who sits and works at a computer for eight hours, and then goes to gym for one hour at night, and basically does a bodybuilding program, and wonder why they still have pain, had they reassessed the programming to really try and create an antidote for the common stresses of sitting all day, that would be a very different approach than the older adult. So if I could just leave that notion and finish of the answer on a more philosophical level, because I've already talked about the importance of obtaining a precise, diagnosis of the pain mechanism, you know that there is no provision in the current medical system to get a thorough assessment of your back, if the patient is lucky they wait for a while and get a 15 or 20 minute assessment of their back pain, now your practice is probably different than that, I set aside three hours when I see a patient, and we do provocative testing, to really isolate precisely the specific motions postures and loads that trigger their pain, all the time I'm assessing their learning style, so I know how to coach and get what I need from the patient, I let them talk freely and they tell me about the various impediments in their life that have prevented previous attempts to reduce their back pain sensitivity, from working. Et cetera, et cetera. So that is certainly, a huge impediment in the medical system, but what that produces is many clinicians who really haven't been trained in the nuances and mechanisms of this broad spectrum of back pain, they will do some sort of non-specific treatment, to non-specific back pain, and they tell the patient there can't be anything wrong with my therapy, therefore the pain must be in your head. And the patients I get, who failed different approaches, many have been told that the pain is in their head, and this is just a pure default of incompetent clinicians, I've had people, who were on the brink of suicide, they are very solid citizens, some doctor has told them that pain is in their head, when they know it's in their back, and they can change the pain by doing different activities, or avoiding some activities, and it drives them to the brink of some of them considering suicide, so there would be a very iatragenic cause to pain with secondary issues as well, so there is a huge answer to a very huge question, I hope I didn't get too far off topic, but I really wanted to begin with addressing this idea of just generic back pain, there is no such thing, it's all specific and it needs to be sub classified and treated with precision and specificity. - [Dr. Sebastian Gonzales] Okay, you definitely didn't throw me off topic there, there are a couple of things we'll revisit a little bit there, so what I'm hearing is that first off, the majority of back pain has a logical reason, it's mechanical, and it's not in their head, is that what I'm hearing first? - [Dr. Stuart McGill] Well it does go into their head, when they have been told it's in their head, and it drives them crazy, so that's a little bit off at it depends answer, but generally speaking when their pain mechanisms are recognized, and they address them mechanically, the psychological sub issues can be resolved, but if all you do is treat the psychological through cognitive behavioral approaches et cetera, chances are that pain is going to come back to revisit them. - [Dr. Sebastian Gonzales] Okay, you said there is three kind of major categories, I guess we can differentiate back pain into, there was the young disc-based person, there was the older arthritic or stenosis, and then there was the special population athletic there in the middle, so each of them I'm guessing, they have different symptom patterns, within each collective group, let's just start with A disk young kid, are all these people going to be the same, or order different subsets in their how they feel and how they respond and so on? - [Dr. Stuart McGill] Well I teach a master level course in assessment, and the theme is we get right down to a subject category N equals one, and what that means is there are no two back pain mechanisms that are exactly the same, so if we keep slicing it down, what is the magic dose to wind down the pain sensitivity, what is the precise exercise, the order, the dose et cetera, to build that foundation for a pain-free movement, it's going to be slightly different, so you could have two people with exactly the same category, but they are in different positions in the program progression, one might be more advanced, so their program, you don't just give a person a set of exercises and say go away, there you are, you will start by establishing movement patterns, that avoid their pain mechanism and wind it down, and then you might add some hip mobilizing patterns, and then you might add some spine stabilizing patterns, and then if they eventually want to play tennis, you're going to have to add some footwork, but anyway you get the idea, when we're dealing with the person in the thorough assessment, will slice it right down, so they are a category of back pain of one, themselves.

SHOW NOTES I recently contacted the National Strength and Conditioning Association (NSCA) region director asking for an interview referral for the best person on this topic… her answer was Dr. Seth Myers. I thought it was funny he was the top suggestion because he is also a chiropractor. I thought I was going to be given the contact of someone who only does coaching. Dr. Myers didn't disappoint. Trained under the ideals of Dr. Stuart McGill PhD, he gave some great pointers on how we can address and prevent lower back pain while squatting, deadlifting, snatching and more. Here's some topics we hit: - Assessment - Direction of tolerance or increase symptoms and what it means - Disc and type of injuries - Outcome Measures other than pain - Butt Winking (Spinal Flexion) - Intra-abdominal pressure - Core work and why - How to return to lifting - Fear avoidance Dr. Seth Myer's Bio: "My name is Seth Myers and I am a Sports Chiropractor practicing at JointFit Chiropractic and Sports Medicine Center in Manhattan, KS. I practice with an emphasis in evidence-based medicine and focus on active care. The treatment I provide is focused on empowering the patient and helping them navigate through musculoskeletal issues that are slowing them down in life. I have a masters degree in sports medicine and a handful of other certifications in strength and conditioning (CSCS and USAW to name a few). I have a love for sports, played football for 4 years in college and currently spend most of my spare time doing CrossFit and Olympic style weightlifting. I try to bring the knowledge and experience I have from years of lifting and working out with me in the clinic when treating patients and finding the best path for them on their road to a better lifestyle." Contact him at sethmyersdc@gmail.com Website: https://sethmyersdc.wordpress.com Videos: Squat video: https://www.youtube.com/watch?v=PkQb2LJtLgo&t=175s (low res) http://www.backfitpro.com/documents/Spine-flexion-myths-truths-and-issues.pdf Pigs https://www.ncbi.nlm.nih.gov/pubmed/11114441 Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. You can access the show notes at https://www.p2sportscare.com/podcast/ Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

SHOW NOTES I know it sounds boring but it won't be. If you have back pain you must listen to this podcast at least twice. Think of it as a crash course in human anatomy and biomechanics. Why should you want to know about the anatomy when all you want is the pain to go away? Because to gain control of your condition, you need to understand the reason it's occurring. A strong majority of people develop back pain because of their lifestyle. If we change our habits then we change our back pain. Simple (in most cases). You may be thinking, "I have a disc herniation that's causing my pain." That could be true but much of the time the disc herniation was there well before your back pain presented itself… and if you find times throughout the week when you're pain-free then your back pain can be improved! Don't blame the disc, blame the pain triggers… empower yourself and fight for a pain-free life. This podcast will give you the necessary tools you'll need to understand the next two podcast sessions that will be nothing short of amazing! I promise! Here's the correlated GUIDE TO BACK PAIN. Enjoy. We are going to finish the year strong at Performance Place! Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. You can access the show notes at https://www.p2sportscare.com/podcast/ Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

SHOW NOTES In this podcast session, I wanted to share my personal story about low back pain. I developed lower back pain when I was playing high school baseball at the age of 15. It was not overuse related… it was traumatic. The reason I say this is because majority of people's low back pain seems to come out of thin air. Mine was a definite event. The injury put me out of my sport for 8 months, during which I saw a Physical Therapist for 3-4 months, a Massage Therapist, a Chiropractor, an MD, an Orthopedic Surgeon and lastly a Chiropractor specializing in Active Release Technique and Exercise Science. Dr. Ron Higura's office in Orange, CA was my last stop and my reason for working with people today. In this podcast I go over the follow: My Injury Mindset My Rehab My Treatments My Recovery My Strength Training My Mindset today My recover was a process. It took a lot of hard work. I have been without back pain for the last 20 years. Sebastian's Youtube Channel Attention Docs and Fitness Professionals: Access your client educational products, banners and posters here. Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

SHOW NOTES After receiving my copy of the Gift of Injury, the story of Brian Carroll's return to powerlifting after a horrific back injury, I asked the two authors to be on the podcast. Brian Carroll and Dr. Stuart McGill blend the worlds of science and powerlifting together perfectly… the moral of the story is that if Brian can feel better and win again then many other people/ weekend warriors/ athletes can overcome their back pain. Here's Brian's bio: Brian Carroll: Brian is a world class powerlifter with over a decade of elite class lifting under his belt. Coming back from a devastating back injury in 2012 that broke multiple bones that most experts said he would never recover from, he has returned to the pinnacle of world class lifting (while 100% pain and symptom free). He is now dedicated to helping others avoid the same mistakes that he made in the past through private and group coaching Brian flew to Dr. McGill's lab in Canada for a full assessment and develop a plan of attack. His goal was to be at the top of his game again… better than before his injury. Dr. Stuart McGill was the right guy to see. Here's his bio: Dr Stuart McGill's Bio: Dr. McGill is a professor emeritus, University of Waterloo, where he was a professor for 32 years. His laboratory and experimental research clinic investigated issues related to the causal mechanisms of back pain, how to rehabilitate back-pained people and enhance injury resilience and performance. This produced over 240 peer-reviewed scientific journal papers, many international awards, and has mentored over 40 graduate students during this scientific journey. The Gift of Injury was born of their experiences/relationship together. It's an excellent book packed with examples of loading programs, building tension, and the guy wire system all in an effort to allow Brian's spine to heal before his push to be at the top of powerlifting again. After Brian's recovery he was able to he lifted a 2615lbs total at the 2017 Arnold Sports Festival, claiming the 242lbs class open and overall titles for the 3rd time. Get the book today! www.powerrackstrength.com/ http://www.backfitpro.com/ Social Medias: @backfitpro @briancarroll81 Sebastian's Youtube Channel Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

SHOW NOTES Have pain you don't consider an injury but it lingers? Are you strong but constantly experience joint pain? Is your squatting form solid but your back still hurts? This is the podcast for you. Honestly this could be the most ground breaking concept you've ever hear as an athlete, lifter, runner or even health care clinician. I met Dr. Richard Ulm DC in Long Beach this year at the Perform Better Summit, where he was speaking about the concept of Functional Capacity, Functional Gap and Compensation Patterns. The concepts he talks about in this podcast are derived from Vladimir Janda's Lower Cross Syndrome and furthered by the work from Pavel Kolar. Dr. Ulm takes the concepts of both and translates them to high performance movements and the compound movements we use in the gym every day. Squats Deadlifts Jumps Etc Bodybuilding.com article (In the editing process to be published) Correlated Videos: Loading the Foot https://www.youtube.com/watch?v=JIfG9ihWZ3Q Shutting of the ECSS https://www.youtube.com/watch?v=_LShz2R33hA Correlated Article: Part1: http://docs.wixstatic.com/ugd/947213_72e4d390aa64402793a237282ba5dc8d.pdf Part 2: http://docs.wixstatic.com/ugd/947213_f9b2e52856a544e5be5f4e9990baadc2.pdf Part 3: http://docs.wixstatic.com/ugd/947213_b2641bd5407041ceabead30ba46fa7d7.pdf Website http://www.athlete-enhancement.com/ FB: https://www.facebook.com/drrichardulm/ IG: @drrichardulm Sebastian's Youtube Channel Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

SHOW NOTES Why is being strong important? Why do we need "Anaconda Strength?" Why should you put down your morning latte and listen to this at the gym? Dan John, a world renown strength coach and public speaker, goes over these points as my guest today. I first heard Dan speak over 8 years ago at a RKC Kettlebell certification. Simply put, he makes complicated exercise/ movements simple. We spent 2 days learning the Kettlebell Swing, Goblet Squats, the Plank, the Birddog and Turkish Get-up… I was doing them all wrong prior to going. Learning the Birddog was like no other… have you ever done a Birddog that made you sweat? I hadn't… that's because I wasn't creating enough tension. Knowing when to turn tension on and off is important for strength, injury prevention and being able to relax. Dan goes into this concept as well as physical attributes needed to be a healthy, functioning weekend warrior. The Quadrants - For Physical Goal Setting https://www.otpbooks.com/dan-johns-four-quadrants-infographic/ Tension Tips: Push-Position Plank (PUP) Gluteal Bridge (Picture, video) - squeeze the but cheaks, pull the arms, or abduction Goblet Squat (Moving Planks) Suitcase Carry (Moving Planks) Shake it off & Smile Tips for Strength Training Tension before Load Goals: Women 3 Pull-ups, 3 Dips, 5 x 135# BS or DL High School 275# Deadlift The Dan John Book Bundle https://www.otpbooks.com/product/dan-john-intervention-can-you-go-bundle/ Contact Dan at his website Articles Easy Strength Sebastian's Youtube Channel Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

SHOW NOTES Did you know there's no pitch count restrictions in youth softball? Baseball has implemented one to protect our youth, so why not softball? If our competitive softball players are going to play so much we should take the necessary steps in the off-season to get them healthy again. Nancy Newell dropped a knowledge bomb on us today. This podcast is a must listen for competitive softball players, softball parents, coaches and strength coaches. She gives a ton of great information on performance and prevention of shoulder pain. Here are just some of the topics: Owning the sagittal plane Put the softball down Get better sleep I wanted her to go more in-depth about an article she wrote about the top 10 offseason priorities for softball players. You can find her article here. Here's a few videos we covered: High Tension Deadbug Standing 1-arm Cable Row Push-Up Half-Kneeling 90/90 ER Holds DB Goblet Squat Anterior Humeral Glide You can reach Nancy through her website. http://nancynewell.com/ She has some awesome blog posts with tips and exercises. Sebastian's Youtube Channel Dr. Sebastian Gonzales is an expert in trouble shooting sports injuries and overuse conditions. This podcast is intended for sports medicine topics to become easier for patients and athletes to understand. Don't get confused by what your doctor told you in your appointment. If you like in Orange County CA, book an exam with Dr. Gonzales, your Huntington Beach Chiropractor.

SHOW NOTES Numbness and tingling of the hand, arm, and forearm is an extremely common "injury" for both athletes and non-athletes. I figured we needed to do a podcast session on the upper extremity exclusively and Dr. Fontaine was my go-to-guy. The causes of numbness to the hand range from a pinched nerve in the neck, to Carpal Tunnel Syndrome, to a peripheral neuropathy and much more… each condition is treated slightly different… it all starts with proper diagnosis. Dr. Matt Fontaine walks us through some reasons for paresthesia or loss of sensation into the upper extremity and some common questions. Some topics we cover are: Double Crush Syndrome The meaning of Negative Nerve Conduction Tests How much a nerve should slide Ulnar Nerve https://www.ncbi.nlm.nih.gov/pubmed/11466640 Radial Nerve https://www.ncbi.nlm.nih.gov/pubmed/16182056 Logic of how to find the location of the trapped nerve Treatment options What's the longest you should wait for the "wait and see" approach Dr. Matt is extremely knowledgeable and successful in treatment of conditions creating loss of sensation. If you live around the Northern Virginia area, here's his contact info! Website: http://potomacphysicalmedicine.com/ Podcast: coming soon Facebook: https://www.facebook.com/potomacphysicalmedicine/ Twitter: @potomacphysmed Youtube: PotomacPhysicalMedicine https://www.youtube.com/channel/UCoYlbuZzzok2YtmU5HTJ9UA