Introducing Back Pain Solutions

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Introducing Back Pain Solutions

The global incidence of back is on the rise, the number of people suffering over the longer term is increasing, and there is no single approach to curing back pain. However, back pain always has a cause, and if we can successfully teach people to understand their backs, and know the likely cause then we can help them to work their way out of pain, build strength, and get back to the activities they love.

In this episode we introduce The Back Pain Solutions Podcast and we discuss the motivation behind starting the podcast and the website.

With a background in Chiropractic and with experience of suffering from back pain we have seen the benefits of taking a movement based approach to back rehabilitation. Having seen a 50% improvement in his own back pain, from implementing movement based exercises, Jacob Steyn, one of the co-founders, became focussed on introducing these concepts to his own practice with amazing results.

Traditional approaches to back pain management often focus on ‘systems’ that practitioners follow because they become comfortable with a certain approach. Unfortunately whilst this can result in a great experience for a few, it doesn’t help the many. A movement-based approach helps each individual, it helps to empower people to take control of their own health and it is evidence based.

We discuss some of the things to consider to avoid back pain whilst touching on some exercises that you should avoid. As we explain, we need to focus on our core strength, and the ‘posterior chain’, and how you need to learn to train that safely, not by doing the exercises that are commonly advised in the gym! We discuss a consideration for the daily movements you’re likely repeating that are contributing to, or exacerbating, your back pain so you become more aware of the things you’re doing everyday.

If you suffer from back pain, have done so in the past, or fear experiencing it in the future, then this episode will introduce you to an active based approach to back health. Don’t accept being channelled through a system based approach to your back pain management, if you’re seeking advice from a practitioner. 

Show Highlights Back Pain Solutions

Back pain always has a cause, and so more often than not there is a cure. However, people must understand the fundamental factors that influence pain if they’re to get a long term resolution.

Interview Transcription for Back Pain Solutions

Ben James 0:00
When we’re young, we move with freedom and confidence with a great resilience to injury. Somewhere along the line, we’ve developed poor habits and become more vulnerable to back pain, smart, strong features, evidence based and practical advice to help you take back control of your health and get back to the activities. You know, this is your guide to better health. Join us as we demystify some of the commonly held beliefs about back pain. build your confidence, stronger back, the smart

Welcome to back pain solutions. I’m Ben James, and I’m with my good friend and co host Jacob stain morning aquabus. Good morning. So this is the very first smartstrong podcast and smart, strong was a company that we’ve set up because effectively we believe that back pain can be managed better. And in the world that we live in and the lives that we lead and incidentally nature those lives we kind of got a loss of movement, and we believe we have an interest in functional movement and realism.

And that’s really why we’ve started this podcast where we’re starting this company to help more people take control, get reassurance, and ultimately get back to the activities they love. So, in the first podcast, we talk a little bit about ourselves, because we’re going to put a bit of context behind who we are what we do. And also we’re going to talk about disc injury or disc herniation slip disc, as it’s commonly called, because that seems to be a common issue that people face with back injury or back pain, it also seems to be something that people fear. And, more importantly, our guest for this podcast has an important history for Jacob in terms of how he’s got to this place in this position and why he’s doing what he’s doing and believe in what he’s believing. So I guess Jacob a good starting point, on that note would be for you to give a bit of an intro about yourself and then I can do the same and then we can jump right into to the detail

Jacob Steyn 2:00
Alright, I am I’m a chiropractor, and I work in the Netherlands.

Ben James 2:07
I know you been because we studied together in England. We we did our chiropractic education. And after that I moved to the Netherlands. I started working here eight years ago to be exact.

Jacob Steyn 2:22
As I started working maybe I shouldn’t speak about my this problem yet. I will just tell a little bit more about what I do. Yeah. So I have my own practice here in place called my makeup. I’m also involved in a CrossFit gym where I train people and I help the coaches and the trainer’s the owners with their, their approach in terms of safety and making sure that we focus more on exercises that actually strengthen people in the long run and, you know, to avoid joint problems and CrossFit training which is quite a harsh way of training, becoming a problem on the musculoskeletal problem, musculoskeletal systems of the, the the athletes where we trade.So my passion really is chiropractic through functional approach. So, you know, I like to get people mobile, but also very stable in their everyday life. And that’s also why I see a lot of average patients, you know, people who sit behind a desk or who drive vehicles for for a job.

Ben James 3:38
And that’s really what I do. Awesome. Awesome. Yeah, and like you say, we met when we studied chiropractic, specifically at the Anglo European college chiropractic down in Bournemouth and lie to win in to a career as a chiropractor.

But I guess differently to you. I was in a clinic that wasn’t so much high volume, but it was very much around keeping those patients coming back for kind of pain free treatment over the long term. And that made me a little bit disillusioned with the industry, I guess, because it didn’t really sit Well, for me ethically to be trying to get patients back in the longer term I believed in in maintenance treatment for certain patients because of certain patients that you can only get a certain percentage better. But and there are also certain percentage of patients that weren’t prepared to help themselves. Let’s be honest. And I think over here in the UK, we grow up with the free healthcare system and sometimes patients or individuals believe that they can go and get a quick fix or a pill, which, as we know, and as we believe, is not going to ultimately help with back pain, certainly not in the long term, certainly not in terms of resilience to injury and reoccurrence. So I at the time left, work as a as a chiropractor went into the medical industry and worked in medical sales support in orthopedic surgeons with reconstruction of anterior cruciate ligament injuries and shoulder injuries, etc. But I came across a lot of patients or I came across a lot of surgical cases should I say during my work that involved disc and back surgery and fixation of the lumbar spine and that again, I guess, we evoke that passion in the back and back health. And during that time, as you know, because we spent a lot of time together, train together. I’ve done a lot of work in functional exercise and training myself and help friends and and family and reached this point, which is why we’ve come together to say actually, you know, this can be done better and how can we reach a larger audience? How can we help to educate and give back control I guess to a lot of things because I think if, if they’re educated and have a bit more knowledge, then there’s an opportunity for sending a good proportion of people to to help themselves get better. I think we agree.

Jacob Steyn 6:13
Absolutely.

To add to that, my, my ultimate goal is to get your, average guy, men and women just back to normal function and to, like you mentioned, work on their resilience to do their job, or maybe they have children, you know, so they don’t feel like it’s a strain but in fact, can actually enjoy the body. That’s the main goal for me. Yeah, absolutely. And I think, you know, that’s, that’s the real motivation here, isn’t it? You know, from a personal point of view, again, seeing a lot of people leading those sedentary lives in office work or in sales roles, driving around in cars all day. I think sometimes that lack of knowledge is is the enemy of a lot of people because if they just had a bit more awareness and a bit more knowledge about the back and about general musculoskeletal health, then I think people would be a lot more active, but they’d be also, I guess, prepared to develop those daily habits that are going to contribute to better spine health for one thing, and better overall health ultimately, as well. So I guess this podcast really is the start of that journey or part of that journey alongside the tools and information that we’re creating to help. I guess that layperson should we say to help themselves?

Ben James 7:40
Yep, agree more. So I guess a good a good next step would be to talk more in depth about the disc and your experiences of despain because that’s really, I guess, the start of your journey down this route to functional training, rehabilitation and movement.

Jacob Steyn 8:00
It’s been that experience that you had when you first went into practice and following your own problems.Yeah, it’s a long story, but I’ll try to keep it short. Trying to get to the points that makes it interesting. So I’ve always been very active and always been, you know, I just had this natural tendency to be to enjoy sport, especially growing up in South Africa, having done a lot of sports throughout school.

And, you know, mostly growing up outside barefoot until you’re about 14 and I really enjoyed that. And obviously I wanted to keep being active, especially when I went to England seeing that people are a lot less active and made it a point to keep training. Like you said, when we were in college in England, we were training together was a lot of fun. And back then it went quite well with my back and didn’t have a problem.

But towards the end of my study, especially in the last year started having problems with my back and of course being you know, coming from a background where I was very strong generally overall in my body I didn’t think it would be a problem I thought it would be just another you know a little couple of weeks in my back would be good again.

But I had a very stressful time I went back to South Africa I I was very busy. I maybe I would actually say maybe I overtrained trained my core in the wrong way that too much. And I came to the Netherlands to start work here and I had a bit of a stressful time it was the beginning of the winter didn’t know anybody had to learn a new language, new country new job. And within a month of working here, I woke up one morning with excruciating pain down my leg all the way to my foot.

I immediately knew that it was a hernia because it could only be one thing if it’s that bad and the line of pain went all the way from my my, my, my left bottom all the way to my foot and yeah you know I had in most cases more pain than my patients. Obviously I kept it to myself. And for me it was it was quite a daunting experience to feel like I’m sitting in a wheelchair and not being able to do but I could I could do very little with my body and especially in the morning I the first hour I was trotting around you know, hopping on my right leg because I couldn’t step on my left leg until I could I got going and then I could you know i i took a hot shower and I got moving and at work as well if I were to sit down for a while getting moving again was it was extremely painful. The pain was there. 24 hours you know, you wake up with it, you go to bed with it. I think that’s probably the worst aspect of it. The constant pain. And yeah, so after three months of having mainly chiropractic manipulation, I had about 5% improvement because maybe because I was still working, I didn’t stop working. And I realized that I need to do something because this is this is not good. It’s not going to get better. And I knew about Professor Stuart McGill, I knew he was giving courses in England. We knew quite well about him. From our from our studies also, and, but obviously I never really went quite deep into his work. He was giving a course in the UK at our college and I knew I had to go there. So after three months of having my hernia having direct treatment, I went off to the UK.

And two weeks after these course of just applying the things that I learned from him two weeks later, I had about 50 60% improvement.

Yeah, that was significant. You can imagine if you have constant pain and with almost no improvement and within one to two weeks you have 50 60% improvement what a eye opener that was and also it felt like I was giving I had hope. No, I had new hope that this problem would that there’s a solution for this problem and that at that point, that was very daunting for me because I thought, you know, I’m a chiropractor, it’s it’s terrible that this is happening to me and my career is looking very that the future of it and gave me a lot of hope.

Ben James 13:01
So you have a unique perspective from the patient as well then because I mean, it’s, it’s quite a fear, fearful thing from a lot of people, I guess when they and you, you’ll know from treating patients as well, they come in and and there’s that fear that they’re never going to get better. And I suppose one question that people might be asking is, did that leave you? A little bit disillusioned at the beginning? If someone was just manipulating your lower back? Did you start thinking or questioning what you were doing? Or did you just think that there was a better way? What was what was going through your mind at that point?

Jacob Steyn 13:44
I kind of already had the idea that the functional training aspect is how you get somebody to stay well, in the long term, you know, by not only manipulating and actually working on the stability training somebody teaching them also how to move better, especially at their job if they do repetitive things.I mean, I had the idea and I knew that that was better, but to experience it firsthand I think that just manifests my manifested back then my, what I thought and my, my feelings and it made me very passionate about how I will approach it patients in the future as I have the last years, but yeah, it was, for me it was it was a big deal. Because, you know, I mean, I I’m very ambitious and I want to help a lot of people and I want to do great things with my career. So I take it very seriously and obviously I took it very serious when I realized that this is a

Such an eye opening experience to see how a few very basic exercises which would fall under a functional approach compared to just being manipulated for this problem, which gets treated a lot by chiropractors, in this case my my low back hernia, but were a few of these exercises made such a big difference in such a short time, just because they were pressing the right buttons. Yeah. And, and, and yeah, yeah, obviously that was a mind shift for me. Yeah, absolutely. And I think it going back to what I was saying about my experience in initially in in that initial practice, it kind of is a shame. I guess that more focus is not given to functional exercise and movement and rehabilitation by numerous different practitioners, not just chiropractors, osteopaths, and even some physios as well. I guess the

Ben James 16:01
Getting patients moving and getting patients moving properly, is so fundamentally important. why more people not doing it? And is that just simply because it takes more time? Or is it a lack of interest? Or is it a lack of knowledge? Do you think? I think there are numerous factors that you can consider here. But I think one big factor is that is that we get comfortable in the system, which we place or put the patients in. So we have it we create a system and we we often want to push everybody through the system. And this is a sort of comfort zone where we can control the system, we can control the treatment time we can control the treatment, some people will get better and others won’t.

And I think we have to leave that mindset and we have to you know, you have to be open and ready to treat everybody walks through the door as an individual with a completely individual approach.

Jacob Steyn 17:07
Yeah, and that’s how you can, that’s how you can pull out the different tools that you need for that specific problem. And I think that’s where, if you see a lot of patients a day, and especially in high volume practices, this there are there are just No, there’s just no room for the individual approach, then you have to rely on the system to be great, because there’s just not enough time.

Ben James 17:32
Surely, to, to be doing to take an individual approach and I guess based on what you’ve said there, do you think that when we talking individual approach, clearly the individual approaches for the person that is suffering from pain, at that moment in time is the person that is not yet suffering, pain or has had an episode of back pain? Are there? Not a systematic approach? But certainly from a functional point of view? Do you think that there’s a more streamlined approach for people in terms of prevention and longer term resilience when they’re out of pain? From the point of view of, I guess, people listening that might say, well, I’ve had, I’ve had a back issue before I’m not in pain at the moment I saw somebody it didn’t really help. Is there anything that they can do now? Or some specific things that are advice that they could take to avoided in the future? Or is there again, an individual approach needed for absolutely everybody? And therefore, how do people know who to see and know where to get the best advice? Obviously,our website being one of them as we’re as we grow and develop our content.

Jacob Steyn 18:55
Yeah, that’s a complex question and let me break it down a little bit. I think that as a practitioner or therapist, you always have to be open for the individual approach. So where I treat people I, you know, I’m listening and I’m looking for if I have a patient that comes in on a regular basis, maybe they come in and every every two or three months to have everything loosened up, I will look and listen to if there’s something that’s sticking out in terms of an injury that they recently have undergone or or something, some kind of strain that they they had, because they worked in the garden or something like that. The idea is to, to go back to the individual approach and do a few tests and try to find out what is the problem there? Do they have a weakness? Is something not working well? Is there an injury that needs to be looked at. I think that’s very that it’s a good thing if you take that sort of approach.

I think the problem is, if you you, like I said, if you chuck everybody with a shoulder injury or you know, upper back injury, let’s say a knee injury and a low back injury, you put all of them through a system where you manipulate and loosen as much as you can in the spine and maybe at some extremity joints and hope that they get better.

Sometimes, it’s good to do that. If you have somebody like you said, who comes back for prevention, who you know, might be a person who sits a lot behind the desk, he has a very stiff back he’s not very motivated to move much more than going walking twice a week. You know that this type of patient is will definitely benefit from having you manipulating the spine and some extremity joint once in two months, for example, once a three months, there’s no doubt that this person will benefit if you keep the joints loose by manipulating it from time to time. But if somebody comes in, and you just put them through the system, instead of actually screening them with a few tests to check if there’s something you can do extra, especially from a functional approach, just to get them back on track, or to take care of the inhibition, because the brain is now stuck in a certain way of steering a certain group of muscles because of an injury they had when they worked in the garden a week ago. If you missed those things, this is not good.

Ben James 21:37
Then I explained that Robin, yeah, yeah. And I think another great example, you know, going back to your kind of system, based approach or avoidance of should we say, you know, I was speaking to a friend recently and giving them some advice who had recently given birth and suffering, a lot of back pain, sad. And if you, you know, take that same approach and put them into a lot of clinics, then the classic approach would have been to manipulate that joint. But the reality is the ligaments becoming more lacks during childbirth, etc, that joint was more likely to be in clearly to be in my mind, but certainly having look further and question further, hyper mobile, not hypo mobile, so clearly manipulating that joint is going to have no benefit whatsoever. Unless you’re gonna be looking at joints around it, and a functional approach to Glute Bridge, strengthen those glute muscles and ultimately, you’re making that joint more stable again.

Yeah, so I think you know, absolutely, as you say, there’s there’s got to be an individual approach and history taken certainly, to weed out those key facts.

Is that it could be problematic for that individual, whether it be work posture, whether it be an old injury, etc, etc. But I agree, I think, you know, those patients that are suffering from some stiffness and are only prepared to do a certain amount of exercise, then clearly passive care is is going to be important to keep themat the optimum, I guess, not the most optimum, because if they were prepared to put more input themselves, and they would get better, but I think you’re never going to get everybody 100% better unless some people are prepared to help themselves, I guess.

Jacob Steyn 23:37
Yeah, absolutely. And I think that’s part of part of the job of the therapist or the practitioner is to try and explain to to our patients, what it means to take a little bit of responsibility and go out there and make some effort and make sure that your body gets the right movement and if you can educate them on All the changes that the body on the goes when they make this effort. I think you’re already doing a great job.

Ben James 24:07
Yeah, absolutely. Absolutely. And going back to your herniated disc, I guess another common misconception for a lot of people is I did something, I missed it in something specific that caused that problem. And for you, you mentioned overtraining, though is obviously not likely to be one significant injury or factor or whatever it might be that caused that problem. Where do you think that issue came from in terms of giving some advice for people because I guess the best outcome was that you’re, you got better, you’re able to get better. And as we know, people with back pain suffering back problems can absolutely get better. And but where do you your issue came from.

Jacob Steyn 25:03
Yeah. I remember just before our last exams, at least my final exams. I was sitting a lot. And I was also working in a shop where I had to cycle quite, quite far to get to. And I had a usually had a big backpack on my back and I was on my mountain bike and I was going quite fast. And so my low back was taking strength. And then I was in the gym, where we used to train and i i at that point, I was doing wood jobs, so or, you know, like a wood chop movement with a cable in your hands. And I was actually keeping my hips still and I was chopping with my shoulders rotating on my hips. So returning to the spine, rotating through the spine, exactly with a little bit of a little bit of little bit of flexion Okay, so that was just terrible for my spine and I, I thought I was doing the right thing at that point, you know, but I mean, it’s difficult to say that I did that now that I know how bad that is for you. And I was I was doing it with 70 kilograms for example 7080 kilograms I was there was a lot of movement, I was creating a hell of a lot of instability, my low back that was going through this through the desk in my in my lower back spine. And so that’s where it started. And then I sat a lot during my exams, and that was really not good. And I’m sure that’s where the, you know, I had this dole, deep, unusual low back pain that just didn’t go away. It wasn’t really an intense pain, but it was present and I didn’t quite know what it was. And then I went to South Africa, and there I was doing some barefoot running on a gravel road. And that was a lot of pounding on my back. And again, I was you know, I was sitting in these high bar stools on the on high bar stools outside talking to my family a lot. So it was a very it wasn’t the best posture that I had most of the time. And then I after a few weeks there, I was ready to come to the Netherlands I came here and I went almost straight into work. And I, I you know, if you’re stressed in the beginning of your first job, but you have to speak a new language and you are in a different country and I didn’t know anybody here in the beginning of the winter.

My posture during work wasn’t you know, my way my my technique of how I use my body when I was treating my patients wasn’t my first priority. So if I think back I was you know, I was hanging through my back I was I was I still I still had to get into the flow of Okay, how am I going to protect my body when I have a very long day of seeing patients and my back suffered, and so I think I also had a fair bit of stress. That definitely had something to do with it. And, yeah, after a few weeks, I like I said, I woke up one morning with excruciating pain. And so I know it was a combination of things.

Ben James 28:12
Yeah, yeah, absolutely. And I think that’s, that was always the message for a lot of people. They’re not might have been an incident that they said, Oh, yeah, that that definitely caused it. But that was, as we say, in in the UK, the straw that broke the camel’s back. You know, it wasn’t that alone. It would have been factors and maybe lifestyle or repetitive activities or incorrect activities at the gym over a sustained period of time that that led to the problem. And and that one incident really just tipped you over the edge. I guess. That’s it.

Jacob Steyn 28:47
That’s it. In the Netherlands, we say it was the last drop that cause the bucket to overflow. Remember, I never heard this one before.

Ben James 28:56
Similar, similar concept, but I think that’s I think that’s a. And that kind of draws back to our real belief and and focus moving forward is that it is really that repetitive. Often, sidenote tree repetition that is leading to these bad problems and lead into these issues that people just aren’t aware of. And it’s about work postures, it’s about daily habits. It’s about breaks. And those small things that you can do that, ultimately over a sustained period of time are going to make a world of difference to the discomfort you suffer or avoiding any discomfort at all and in keeping yourself resilient to injury. And I think that’s where we hope to take this further is those snippets of information, video content, and obviously the podcast that will ultimately help to educate people to understand and have a better awareness of their backs, as well as other joints in the body and other you know, other areas for health I guess to, to be to be healthier in the long term.

Jacob Steyn 30:15
I want to I want to add just one thing then if I can, and that is, you know, I, we were talking about the the continent all the causes that are factors that contributed to my episode of low back earlier. This is one important thing I didn’t mention and that is that, you know, generally I was strong throughout my body. But I didn’t have the core strength to cope with my with with my tasks and the things I had to do. Not only core strength, I didn’t have the posterior chain strength in combination with the core strength to stand against the things that my body had to go through. When it came to my job or maybe cycle to work, like I said, with a backpack with a heavy backpack, so that’s a big deal. And that’s what I got from the McGill course I learned a hell of a lot about obviously the rehabilitation but also afterwards strengthening my core in a way where I’m not putting that many forces through my spine, but more working with the musculature and the stability factor, sparing my spine where I can now have a long day. And of course, my back will be a little bit tired and stuff, but I wouldn’t My back is now completely bombproof. I can go through a lot, and I don’t have any problems. You know, and that’s what I was really missing in terms of, now I’m hanging, I’m hanging over my patients. So I’m stepping forward or I’m hedging through the hips. I’m hanging on my poster chain, my course doing it’s working. So that’s just one thing I wanted to make.

Ben James 32:01
About the Yeah, one of the other factors that was not well causing a big part of the course. Yeah, absolutely. I think that’s, you know, going back to the the gym setting and an ABS in particular, you know, unfortunately, a lot of the common exercises for for abdominal strength are exercises that do put a lot of pressure through the lower back and could be contributing to injury, or even exacerbated injury for those that that are already suffering. And the classic office worker, sat in a chair all day in a flexed posture, goes to the gym and then starts doing abdominal curls, you know, is just, again, repeating that motion further, but often with weight added and, you know, fundamentally over the long term that’s that’s going to be detrimental to to that lower back. So I think you’re right, that core strength, but that core strength in the right way, is so, so important, because people are just too keen to throw a lot of weight behind it. And actually, it’s a lot of exercise and a lot of movements that you could do to improve your core strength that are going to be far more beneficial to the spine then the most. Yeah, we’re going to speak a lot more about core strength in the right way, as you mentioned, because that’s that’s a big focus that we’re going to be discussing. And yeah, talk a lot more about

Unknown Speaker 33:36
Yeah, absolutely. And, and, and with that, and just to put into context, what what we’re looking to do in terms of the podcasts and putting information together alongside the podcast, putting video content alongside the podcast, so that ultimately we can, you know, share that knowledge, ultimately to help people help themselves. So

Ben James 34:00
As we grow as we develop, will get the YouTube channel up and running. And alongside the website which is which is launched, will be bringing more content and we’ll be doing a weekly podcast. So certainly listen in keep keep your eyes out subscribe on the website. And as we grow and develop we’ll be we’ll be sharing more information, sharing more content and ultimately getting getting people back to doing the activities that they they want to be doing because ultimately, that’s, that’s the aim giving people confidence, give them people reassurance to get back to doing what they want to do, because no one wants to be suffering from back pain and no one wants to be losing confidence in doing those things they love. So that’s our message and that’s certainly our our aim and the start of the journey here today. So keep listening and keep subscribing and share some comments on on iTunes as well. Because the more people can reach the more people we can help so

Thanks for listening guys. Thanks, Jacob. And we’ll be back soon.

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