Male Announcer: You’re listening to From Pain to Possibility with Susi Hately. You will hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don’t have to hear it scream. And now here’s your host, Susi Hately.

Welcome and welcome back. With this episode I want to dig into a high-level conversation around reducing and eradicating back pain. There are four key factors that I focus in on to help my clients reduce and eradicate back pain. And I want to share those four things with you.

Now, there's a couple of caveats, of course, that I need to share here. The first is, this is a high-level conversation. There are myriads of reasonings for why people have back pain. And, of course, I can't speak about that in a podcast episode that's anywhere between 10 and 25 minutes in length, right? That's just not possible.

However, what I have found is that the approach that I utilize for supporting someone in learning how to move better has a huge biomechanical implication, as well as a huge psychological implication on the way people perceive their pain and become more functional and stronger overall.

So it's a very effective way, no matter what that diagnosis is. Because as I mentioned, there are bazillions of different diagnosis. And we know from a scientific standpoint that you could go to five different medical doctors and get five different diagnoses about your back.

Now, add in alternative care or integrative care like osteopath, physical therapist, massage therapist, chiropractor, and now you've got more ways of being diagnosed. Same etiology of symptoms, but the way that that person views movement, or their body, or the structure, the bias that they have, you're going to get another set of different diagnoses.

So that's why I'm not super focused on what someone's diagnosis is, especially when it comes to back pain. Because the diagnosis is interesting, but it's not a huge driver for what I do or I don't do.

Now, someone might be kind of scratching their head and saying, “Well, that's kind of crazy. What happens if they have an issue where you really shouldn't put them into a forward bend, or you shouldn't twist them?”

What I can say with quite a lot of clarity and a lot of experience behind me, and it's what I train my trainees to do as well, is that I wouldn't put them in those positions anyway because the tissue of their body will show me that they're not ready for it. So I don't need to cognitively stop myself a lot of the time, I just have to pay attention to the tissue. And the tissue will truly show me what to do or not do.

So to give you an example of this, I had a client come to me many, many years ago who was a referral from a physical therapist and had stated right up front, he was overcoming a disc protrusion. Stated right up front do not put him in a forward bend.

Well, when he came in and we got him laying on his back, it was like there is no way I would put him into a forward bend. There was not the availability to do that. So when we can simply pay attention to how a person moves, you'd be really, really amazed at what a body actually says, right? How tissue actually moves.

When you pay close attention to those relationships, you can really guide someone very, very effectively in supporting themselves in their recovery from pain and actually eradicate pain.

So I think that's an important point that I want to make mention of, is when we really and truly focus in on what's going on biomechanically, we can clear out so many key problems. And sometimes it will highlight and even reveal things that other diagnostics fail to see.

A great example of this is I had a client who went to a physical therapist, showed the physical therapist what she was doing with me and was saying all this benefit was getting from doing a twist and doing some side bending. And that actually opened the gates for discernment on the part of the physical therapist.

It was like, “Oh, okay, so if you're getting all this benefit from moving in that way, and this way, this then is telling me that we need to do X, Y, and Z from a physical therapy standpoint.” Because physical therapists have a very different skill set than I do. But by being able to blend what she was seeing and feeling in her own body, it opened the door for even better care from the physical therapist.

So by being able to teach clientele about how their body moves, there is this opportunity to really blend the data of their tissue and do even better work than just looking at someone from a diagnostic standpoint. Because a diagnostic standpoint merely is a label, it doesn't describe what function is or is not available.

So in that long winded way, let me get into some of these high-level key factors that I utilize when I'm helping someone reduce and eradicate their back pain. And again, I want to mention that it's really interesting when you look at a variety of different diagnostics, and when we simply help someone move better and tune in and grow their awareness about how their function is, it can be such a game changer. Such a game changer.

So this goes into the first point that's really important. The first one is about feeling. Yep, that dreaded F word. And by feeling, I mean growing awareness about what's going on, because we can't change anything we're not aware of.

So a big piece of my process is being able to teach a client skills and tools to help them resolve their problem. And I say that very, very specifically because, A, I can't fix anybody. I don't have hands-on techniques. I don't know if scalpels. I don't have needles. I don't have any of that stuff.

So my job is not to fix anything per se, my job is to help a person grow their awareness about how they move. To grow their awareness about their biomechanics. So I'm helping them grow that ability for them to tune into their body and how their body is moving.

And this is going to show up in the next two points very, very clearly about why this is effective and why it's so, so important. So I'm helping them grow their awareness, so that they can resolve their issue, because when they grow their awareness they are more tuned into what's going on and what's not going on, what's working and what's not working in their body.

As a result they grow their clarity, they grow better connection, and they grow better internal feedback mechanisms between their brain and their body. So that's number one. That's my job initially, is to really be a partner with my client to grow this fundamental awareness of how their body moves and doesn't move.

The second piece is to teach them about their biomechanics. And very specifically, one of the key biomechanical theories that I share with them is form and force closure. Every joint has this construct called form and force closure. And this is what contributes stability to the system.

Form closure is how the skeleton and the ligaments create structure. And it's not something that I specifically directly impact. That's more something like an osteopath, a chiropractor, a physical therapist who does manual work, a massage therapist, other body workers, they can get in there very directly and purposefully. That's not something I do. If I shift anything from a form closure perspective, it's been by happenstance, really.

Where I tend to get the biggest bang for my buck is this idea of force closure. And force closure is the muscular energy that brings stability to a system. So a great way to explain this is think about your pelvis and you’ve got a hip bone, two hip bones and a sacrum, and you've got leg bones.

And if you put your hands on the outside of your leg bones and press in, it's as if those leg bones are pushing into the hip socket. And then the hip bones are pushing into the sacrum, right? So it's kind of like your hip bones are embracing the sacrum.

That muscular energy is coming from your abductors and your adductors of your hip, as well as your rotators of your hips. When I'm pressing, if I have my hands on the outside of your hips and I'm pressing in. If the energy of the muscles are doing that same thing that I'm doing, then those are the muscles of your abductors and your adductors and your rotators.

Another group of muscles that contributes to this is your pelvic floor, as well as your transversus abdominus. Collectively, these create this hug of the hip bones into the sacrum and that's an example of force closure around those SI joints.

Now, when we can create that, that's an inherent and deep stability through the pelvis. And that stability can sometimes be the game changer for the way that someone experiences pain. The reason for this is because the sacrum and the pelvis to the legs, that's a bridge between the upper body and lower body.

Think about this right? So you're walking or you're climbing stairs. One leg swings forward places on the step, or places on the ground in front of you, and you bring the weight onto that standing foot now and then swing the other leg, and you step it forward. So you are moving from front to back and left to right.

Your pelvis, your pelvis is a bridge in that weight shift left to right, front to back, bottom to top, top to bottom. So if you don't have good stability between your legs and your pelvis, and your pelvis and your spine, then that act as a bridge is going to be limited.

And if it's not acting as a bridge between the front and the back, between the bottom and the top, and the top and the bottom, and then left to right, then something is going to give, right? Your bandwidth is going to be smaller and something's going to give.

So that's why I tend to focus first, when someone's got back pain, on helping them not only improve their force closure of their pelvis, but to explain why. So one way that I do this, it’s really, really, really simple, is I simply get them to move the leg bone in their hip socket the way it's designed to move.

I mean, it sounds really, really simple. And it is, right, so I teach them about their movement in planes of movement. So we've got three planes of movement. Think about it as like an X, Y, and Z axis. And so we can swing the leg forward and back, we can move the leg wide and then back towards mid-line, and we can rotate it.

So those are these three planes of movement. I want to make sure that their leg bone can move in each of those planes effectively. And more often than not, not all the time, but more often than not when someone's got back pain, there is one or more of those planes or movements that is somewhat limited in some way.

And so when I can discover that movement pattern that's not quite working as it should, and then help it move better, then the muscle structures in and around that are starting to work better and their force closure improves. Their overall stability improves, and the muscles that are meant to be doing the work do the work. And the muscles that aren't meant to be doing the work and relax.

So then the system is a lot less heightened. It can down regulate, it can relax, because now the parts that are meant to be doing the job are doing the job. And other compensatory strategies can start to fall away because the support exists better in the system. There's just more support present.

Now, something that I see often when I'm helping someone do this work is that oftentimes their hip flexors are getting way more involved in a movement than they need to. It's such a common occurrence. And one of the things I like to share with my clients is that when I can help you move better in these planes of motion and have your hip flexors be way less grippy, have them be way less compensatory, then your whole system settles out.

Because your hip flexors are real key compensators. They will like jump in and try and stabilize all things. And so you might be someone who's like, “Yeah, I totally get that. My hip flexors are so tight, I stretch them all the time. But it doesn't do any work.” I'm like, uh huh, because your hip flexors won't fully let go until there's overall more stability in your system.

If there's not support in your biomechanics, if there's not support in your overall system, then muscles that tend to be more limited, that tend to be grippy, that tend to be held, won't let go. They just won't let go until there's more support present. Just like anything, like us as human beings, it's almost impossible to let go if you don't have support, right?

So when I can support someone in improving their force closure and really help them tune in to the muscular structures that are meant to be functioning, and quiet the muscular structures that are not meant to be functioning, then we can make huge changes very, very, very, very fast. Because we're simply changing up the biomechanical relationships, which help improve stability, which help improve the way that we transfer load, which helps how we dissipate force and absorb force.

So it becomes really, really simple and really quite fascinating because what I'm also doing is, like I said in number one, I'm tuning them into the way that their body moves. I'm helping them learn the skill of biomechanics as it relates to their body and tune into what their compensatory patterns are, the ones that they have so effectively chosen to get them on in life that just aren't working anymore.

So then they can learn how to tune into that and settle those out for the ones that don't work anymore. What's really cool about this process is that it doesn't actually matter your age. Whether you're 90, or 80, or 70, or 30, your tissue can change if you give it the right stimulus. And I've worked with people through all of those age categories.

And interestingly enough, it's the people who are older who actually get better the fastest. Most of the time, I feel, because they're the ones who are really willing to do that work of paying attention to the way their body moves. But even the 30 year olds who are really game to go there because they've got a strong compelling reason, oh yeah, they can make the change to for sure.

Which then leads to point three, which is really notice results. Oftentimes, after a first session with a client, their pain levels have gone down. And what I will very specifically say to them is, “Your pain levels will likely come back because we don't have the stamina yet on the new pattern that you have created.

And so the new pattern only has so much bandwidth, and we need to help grow its capacity to move better and for longer. So what I want you to notice between now and the next time that I see you, is when did the pain start to come back? When did your symptoms start to come back? Can you notice the whispers of the good feeling fading, and the pain coming back?”

Because when someone can notice that, then the next time we can then go for a longer duration. We can start to see, okay, what are the other parts that need to come into play to really help someone tune into what's contributing to their symptoms escalating. And then when we can do that, then we just choose a better stimulus, the next level stimulus to help them get to a longer stamina for maintaining their symptoms, right?

So it sounds quite simple. And it actually is, it takes a lot of an ability to tune in to what's going on in your body. But when you can tune in, when you can pay attention to the way that your leg bone moves in your pelvis and your pelvis moves relative to the spine, settle out the muscle tissue structures that don't need to be involved and really pay attention to the way that your skeleton is functioning, change can happen really, really, really quickly.

So this then helps you really tune into the clarity about the way your symptoms are expressing themselves. And as you get more and more clarity on that, you get more data about how your body functions and the various things that impact you.

So you also might notice a relationship to sleep. You might notice a relationship to sitting. You might notice a relationship to just some of rigmaroles that come with day to day living. But when you can tune into that not everybody has the same triggers for their pain increasing. And so it's just making sure that you can tune into yours, because that is what will be so impactful for you.

So I've mentioned so far about my job being able to teach the skills and the tools so that my clients can reduce pain. It's then also to teach them about biomechanics, and how the biomechanics relate in their bodies so they can really tune into what's working and not working from a biomechanical perspective. Which then helps them tune into their results and really pay attention to the whispers or the yellow lights that are contributing to their pain coming back.

And when they're able to do those three things, they will gain more and more sustainability in the reduction of their pain. And you can see from this that it really doesn't matter what is contributing to their pain. So whether it's a disc protrusion, or whether it’s a facet joint deterioration, or whether it's a bursitis, or a piriformis syndrome, because what we're still doing, what a person still needs to be able to do is to walk, to run, to climb stairs, to stand, to sit.

So if I can support someone, no matter what their condition is, related to their back pain, help them improve their movement patterns, their neuromuscular communication, so they can do those things, they're also going to notice that the way that they feel their diagnosis changes dramatically. To the point where they will find that their pain goes down quite dramatically.

If this has resonated with you, if it's making sense to you and you are a health professional and you want to dig in more to these concepts, then listen up because we're doing enrollment right now for our certification program. And it would be just a dream to be able to work with you.

If you are someone who wants to help your clients and build a client base that really serves you and build a business that really, really serves you. It's absolutely possible. Many of our trainees earn 50, 75, many are on their way to 100 grand per year, really serving people. Helping them reduce and eradicate all sorts of symptoms because they're understanding what our job is as a yoga therapist, tuning into the biomechanical realities, understanding what it is to reduce pain, and then practicing it.

So if that is of interest to you, then do reach out to us at [email protected]. Have a great practice. Happy exploring.

If this episode has resonated and you're looking to deepen this idea of getting your body back on board, of listening deeply to your symptoms, of listening to the whispers so you don't have to hear the screams and you're looking for one to one support or professional training, then reach out to us at [email protected] where we can customize your learning path. That's [email protected]. Looking forward to hearing from you.