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The Science of Back Injury: Some Inspiration Behind The Smartstrong Approach To Back Recovery

In this episode, we discuss some of the inspiration behind Smartstrong and the back-pain Solutions podcast. We detail one of the seminars we attended back in 2019, out in Eindhoven, where we spent several days with world renowned back expert professor Stuart McGill where we learnt some of the fundamental principles he takes in the management of back health with his clients, following years of research over in Canada.

The Science of Back Injury: Some Inspiration Behind The Smartstrong Approach To Back Recovery

Welcome to the Back Pain Solutions Podcast – The Science of Back Injury: Some Inspiration Behind The Smartstrong Approach To Back Recovery

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Listen To The Episode Below

Episode Introduction

In this episode, we discuss some of the inspiration behind Smartstrong and the back-pain Solutions podcast. We detail one of the seminars we attended back in 2019, out in Eindhoven, where we spent several days with world renowned back expert professor Stuart McGill where we learnt some of the fundamental principles he takes in the management of back health with his clients, following years of research over in Canada.

Dr. Stuart McGill is a professor emeritus, University of Waterloo, where he was a professor for 30 years. Over that period his laboratory and experimental research clinic investigated issues related to the causal mechanisms of back pain, how to rehabilitate back-pained people and enhance both injury resilience and performance. Professor McGill’s professional work has resulted in over 400 scientific publications, including four textbooks!! The first book, Lower back disorders: Evidence based Prevention and Rehabilitation is now on its third edition and was written for clinicians such as us. His textbook Ultimate Back Fitness and Performance provides the evidence base to design and prescribe the most appropriate exercise programs for the back. In the book titled Back Mechanic, seeks to guide readers through a self-assessment of pain triggers, then shows how to avoid these roadblocks on the road to recovery. Most recently, his book The Gift of Injury, in collaboration with champion powerlifter Brian Caroll, is about healing injury in the athlete and building resilience to compete once again.

Some of the things you’ll discover:

  • Why removing the aggravating factors is fundamental in the recovery of back injury?
  • How the extensor muscles in the back contribute stability to the spine
  • Why it’s important not to ignore the hips when assessing the back
  • Don’t be misinformed by additional investigational findings such as MRI or X-ray
  • Degenerative disc disease is NOT a diagnosis!
  • Why we should identify what is appropriate for the rehabilitation goal of the individual, and not simply take a generic approach to recovery

Episode Highlights

You wouldn’t tell your mother in law she had degenerative face disease so why is degenerative disc disease so commonly reported as a diagnosis for people with back pain?! Back pain always has a cause and degenerative disc disease, or degenerative joint disease, is not a diagnosis that should be given to a patient. All back pain always has a cause and for the most part, degeneration is rarely the cause of pain. Back pain complaints require a thorough history, and examination of the problem, if it is to be managed effectively for the specific individual, there are no short cuts!

Episode Transcription

Intro 0:00
When we’re young we move with freedom and confidence with a great resilience to injury. But somewhere along the line, we develop poor habits and become more vulnerable to back pain, back pain solutions features evidence based and practical advice to help you take back control of your health and get back to the activities you love. This is your guide to better back health through movement. So join us as we demystify some of the commonly held beliefs about back pain and build your confidence to stronger back the smart way

Ben James 0:26
Welcome book and lots of back pain solutions podcast with me, Ben James, my co host, Jacob steyn, this is an episode we recorded back in 2019. Previously, we given a lot of background, about our inspiration behind smart, strong and some of the people that have had an influence on us in the direction we’ve taken with regard to back health rehabilitation and functional training. And one of those people is Professor Stuart McGill, who spent over 30 years over in Canada doing research into the biomechanics of the back and understanding and really getting into the detail of the mechanisms behind a lot of the problems that we’re seeing and, and really just how we treat the low back effectively. And we had the opportunity to go out to Eindhoven over in Holland, and spend four days up to four days on his course recently, and we felt good to discuss that to discuss our experience and discuss some of the takeaway messages that we we got from that event. So, Jacob, you’ve done the course before. And McGill one and two, is that right?

Jacob Steyn 1:38
I’ve done McGill one or two. Yeah, I’ve done a couple of times. Actually.

Ben James 1:43
You’ve done it a couple of times before? Always out in Holland were you out in Holland previously?

Jacob Steyn 1:48
I did one in Holland and I did one in England. Okay,

Ben James 1:52
Yeah. Down in Bournemouth and Bournemouth. Yes. Okay.

Jacob Steyn 1:56
Quite a while ago, actually.

Ben James 1:58
Yeah, of course, that’s when you first first went to see him because your own back problem with your disc herniation. Right.

Jacob Steyn 2:03
Exactly. Exactly.

Ben James 2:05
Excellent. So I went to the the four days, Jacob, he joined for McGill, two and three, this time having done the other stuff previously, because it’s fair to say the first first couple of days on McGill one is very much around a bit of an introduction really laying the the foundation and the background in terms of anatomy in terms of some of the research behind the approach that Professor McGill takes with back pain. And a lot of that we it’s fair to say we we learn at college during our chiropractic studies. But it’s certainly interesting to get another perspective on on his approach.

Jacob Steyn 2:52
That’s a I think, during the course that we did, this weekend, takes us a little bit deeper into the understanding of the McGill method. And we learn about it in college, but we learn more. We learn the basics, and you know, you need to pass the exam. Yep. And like we’ve said many times, the real learning really starts when you finish college and you start seeing patients. So applying applying the stuff we learn from him, and especially the stuff that we get from his courses really makes it interesting. And for me, I think a big part of it is actually doing it alongside the chiropractic really enhances the effect I have with my patients.

Ben James 3:41
Yeah, because I mean, as we said, there’s there’s very much a movement based approach. And I think it’s important to say that, you know, Professor gore would would openly admit, as we know that he’s not actually a clinician by background, which I think is is an interesting point. He’s a biomechanist, and a researcher and has spent many, many years and has a wealth of experience in helping patients with back pain. And he often sees a lot of difficult patients, I think he said, he gets around 200 emails a day from around the world. So it just goes to show, you know, the level of influence and the experience that the guy has in terms of helping manage some really complex back back patients. But I think what what stood out for me is the focus, and so much time spent on that initial assessment and really getting out the detail from the patient about the underlying problem. And he talks about the three hour assessment to uncover that information, you know, talking about all those different movements and activities because, as we know, it can be something that someone’s doing On a daily basis repetitively, that is causing the problem that if you’re not really going into that level of detail, and if you’re not looking at those movement patterns, whether it’s just observing someone, tie their shoelaces or picking something off the floor, all those little things that could be contributing to the ongoing problem, then you’re going to find it very, very difficult to treat a patient effectively. And that stood out to me, because when you really look certainly in the UK, if you went to see a primary physician, a GP, a general practitioner, those guys are under so much pressure to see a patient in 10 minutes or less. Yeah. So how are they ever going to be able to help a patient with back pain? And similarly, what about other practitioners that maybe you’re just taking 30 minutes to an hour? Yeah.

Jacob Steyn 5:56
Yeah, I agree with you. I mean, I we’ve known for quite a few years now that he says it’s basically impossible to do it on there. I think he said three hours. Yep. Yeah. And everybody always goes like, Whoa, what, how they’re, how she has three hours. You can do a lot of the hours. But I think that it’s a very good point, you know, if you want to, if you want to do a proper assessment, and you don’t want to rush things, and you want to know, what exactly is going on, and you need to be able to take your time. And I think that I’m not exactly sure how Professor McGill does it? You know, I mean, it would be great to observe him sometime and actually see, you know, he’s, I mean, we’ve got the order of the, the, the tests, and we have the the form that he uses that he fills in when he when he does the assessment, but still, I would, I would really like to see how he does it. But my question really is, does he also give the correctives, the corrective exercises and the advice in the three hours, knowing that he only usually sees somebody once. And then he writes a report. And like you mentioned, he sees the patient, together with their condition or their therapist. And then he sends them off with the therapist or clinician to to carry on, basically what he instructed them to do. So I wonder if he’s in three hours, you know, or if he only does the assessment in three hours, but still, I think the like you said, the emphasis there is really on, on doing a proper job actually, really finding the cause of the problem. And I think, doing it in such a way that makes it very clear to the patient, that this is the problem because, again, like he mentioned so many times and you know, this man, if you don’t remove the the causative factor, if you don’t remove what causes the problem, then you have a very difficult time actually finding a solution for the problem. And I think removing the problem is often more difficult than we think, because we have to create this understanding in in the head of the patient, that this is causing a problem, and we need to make sure that you move around this cause of the factor for a lot of people that might be as like, might be driving to work. Yeah. And, and, and I’ve had patients where I, you know, I said, Look, we have a disc, we have a disc issue starting here, this disc in your low back between the vertebrae isn’t, is not happy. And we need to limit the stress that that goes through this part of your body. And driving at this moment is really not a good idea, I really suggest you you try to work from home. Or you take a week, at least, maybe more where you don’t go to work, because if this progresses, we were gonna have a much more difficult situation to deal with.

Ben James 9:18
And in that instance, just jumping in with that patient, particular patient driving long distances, as opposed to just maybe a 10 minute commute or 20 minute commute. Because that you know that patient we could say well, make sure that you wake up a little bit earlier and go for a walk, as we’ve suggested before, you know the first 30 minutes that they go for a walk, then get in your car and do that small commute. You’re going to be okay for that short period of time. But if you’re any longer duration, we’ve got to try and manage that and avoid avoid activity. So I suppose the contrast to that is if they’re on a two hour commute, or they’re on a two hour drive Well, you either avoid it and try and work from home as you say, or you’ve got to try as impractical as it may seem To drive for 30 minutes, take a break and plan that journey probably, because you’re just going to compound the issue. And this is where you got to challenge back and push back on employers, if required to say, this is the advice I’ve been given, this is what I need to do, because any soft tissue work, join adjustments, even exercises that are going to be beneficial. None of that’s going to help if you keep compounding the issue by aggravating that tissue. And I think that’s where Stewart was saying that, you know, when he does that three hours, I think he, he really, really does challenge the patient. Because this is the key for me, this is where there has to be some responsibility. I know we said it before. And podcast has to be the responsibility. And you and I both observed Professor McGill discuss in the back pain of one of the delegates at the conference. That Spanish lady Yes. And she was she was determined, well, I need to I want to continue swimming. And gradually over a five minute conversation, he had to get to the point where he said, Just stop it. This has to stop. You know, until we get on top of this back problem until we avoid these issues. You’re not going swimming. And if you are your back’s gonna get worse, or it’s certainly not going to get better. So you’ve got to take control.

Jacob Steyn 11:21
Just a little bit of background on that topic. The heel drop test with this lady, we get knees locked, standing, going onto the toes, you drop the heels down onto the floor. So the full body weight comes on to the heels onto the floor. And if there’s any sensitivity to come to compress a force in the low back, you’ll feel pain, whether that’s a disk or endplate or anything with a with the vertebrae. And this lady, she did the heel drop test and she nearly fell to the ground. Yeah, because of the pain. And she’s she’s not overweight, she looked fairly healthy to me, she was in really good shape. She’s a personal trainer. So like you said, it was very interesting for both of us. We discussed this afterwards, how Dr. McGill, Professor McGill had to stop this lady in a thought pattern of I want to do this, I want to do that. He said to a nose Stop it Stop, he got really agitated and told her No, you need to stop. No need to go. You need to in your head, take a different route to allow the healing you sit through you need at least a year of recovering before you can get back to anything like swimming, which is going to cause micro movements and anything that’s been irritated or get in the way of the instability which doesn’t allow it to heal the school problem that yes, that was very interesting. And I’m glad you mentioned that.

Ben James 12:54
Yeah, because because we get it we get what people people want to get back to the activities, they love that that’s the key aim to do smartstrand sometimes that might be quite quick. Sometimes that’s going to be prolonged, because you know, you’ve got an underlying problem that needs some work. And a lot of it is about stability and regaining that core strength. Yeah. You’re gonna say, Jacob, what do you…?

Jacob Steyn 13:16
No, I just wanted to say, maybe let’s speak a little bit more about the course, and interesting things we did on that. So the first two days, you did the McGill one? And what was it called Ben.

Ben James 13:31
So really, that was laying the foundation. So, you know, we’re, we’re very much talking about the research and about the anatomy and a lot of the findings and that, that Professor McGill has, you know, established over over the many years of research as well as a lot of the other researchers and also clinicians that, you know, he’s followed respected knows those very well. But it was all putting into context, you know, the following couple of days when we’re then going to assess and, you know, form treatment plans, exercise movement based treatment plans for back pain sufferers, you know, so, for example, we’ve talked in some of our podcasts around the anatomy, and, you know, one thing Professor McCall was saying was, let’s look at the musculature, the back, you know, the extensor muscles, the the resistance to, to share movement, so those birds were trying to slide across one another for forward and tyranny. those muscles don’t act as effectively if you’re out of your neutral spine. So again, back to really put in evidence behind why that neutral spine is so important. You know, your, your muscles are designed to work in a certain way and the and the angles that They pull and that they work and the fibers orientated are all designed to work effectively when we are moving effectively, if that makes sense. So, again, it’s put in evidence behind the neutral spine behind a lot of these activities, talked a lot about the hips, we often, again, if you’re looking at the time that some of the clinicians are taken to observe, assess their patients, are they actually looking at the hips, hips are fundamentally important to the low back, you know, those hips can be causing the pain, they can be the cause of the pain, because we know that they can refer pain. You know, what it was the movement of those hips, particularly in athletes, you know, is there a symmetries between those hips? Yes, no, if there is, is that contributing to a change in movement? That is then lead into that back pain? How can we solve the back pain if we don’t solve the hips, ankles, posture, balance, all these different factors that lay the foundation and give us real insight into just what is the baseline of that patient? You know, so and then we talked a lot about the different. The different areas of injury, we talked about the disc, the classic signs and symptoms of disc injury and the causative factors of disc injury, we talked about some of the other conditions that we just need to be aware of, as always, as clinicians during our training, it was very much around spotting those red flags. But also, one of the things that we talked about in those first couple of days was further imaging, we often see that patients will, you know, have been to see numerous different people, though, they’ll come in with an X ray, or they’ll come in with an MRI, and they’ll point to that MRI and say they said, so that’s where my damage is, or the radiographer said, so there’s a lot of disk high l four l five, or there’s a retro listhesis, or whatever it might be, that’s got to be the cause of your problem. And what Professor McGill was saying, well, not necessarily, you know, as always, it depends. Because that could be an old injury that could have stabilized that kind of griswald. And actually, the problems maybe being caused by that, but it’s higher up or lower down. So you know, don’t be as a clinician, don’t be influenced too much by further imaging. And I would suggest one of my takeout messages was great, if you’ve got an image in there perfect. Let’s look at that after we’ve done an assessment. Let’s not let that influences too much, let’s not let that cloud the water as it were.

Jacob Steyn 17:33
Exactly use it use it to correlate for example, finding, you know, you’ve after you’ve made the the hypothesis from a very good interview, and then you use the testing to actually try to confirm that. And then use the imaging to correlate with what you found. barsy but like you said, if you look at imaging, first, we’re not saying that the imaging is not important, it’s massively important. But if you look at imaging first and you do the typical radio, a lot radiological thing of Look, you’ve got some DJD, you got some degeneration of a disc here, or lots of disc height, or you’ve got maybe an anomaly change in the spine here, that’s not normal. That might be an old in most cases, it isn’t old. happening and it’s it’s the body is absorbed, that it’s, it’s perfectly fine, you don’t even feel that it’s something most likely something completely different. Or if it is a disc, height loss, you know, you see a fissure you see a fresh leakage of the of the nucleus pulposus through the disk post early. And many times this is overlooked. And Professor McGill spoke of this quite a lot. Actually. It was very, very interesting.

Ben James 18:50
Yeah. And he was very passionate as well about the this concept of degenerative disc disease. What is it genitive joint disease, you know, and patients have just been or you’ve got nonspecific, low back pain doesn’t exist. There’s always a cause, you know, we reiterate this, you know, throughout our, our messaging, but the what put it nicely into perspective for me, is, you know, we, we all get old, we all age, our joints age, you know, within time, we’re gonna see degeneration and joints, you know, some of that might be, you know, more than another’s because of injury, etc. But we get older and as Professor McGill said, you know, if he went to see your mother in law, she’s gonna get older, she’s gonna look a bit older, but you know, we’re gonna say to her, you got degenerative face disease. So, so why are we saying why are we just labeling degenerative joint disease for the back, you know, we don’t do that for the knees. We don’t do that for the ankles. So it seems to be something that again,

Jacob Steyn 19:54
Seems like we develop a disease as we get older.

Ben James 19:56
Well, yeah, exactly. And also, you know, is it just the easy the easy route to giving the patient some information, you know, we want to give them some form of diagnosis, that seems to be what p patients focus on, you know, I want to, I want to know, what’s the cause of the problem and degenerative joint disease, but actually, that doesn’t help them. Because how does that make a patient feel? So I’ve got degenerative joint disease, so that that’s a one way street. That means it’s just going to progressively get worse. But I think he was really passionate about saying that this doesn’t exist, you know, we see we see degenerative changes, but that’s not specifically the cause your problem. And also, let’s not, let’s not focus too much on the tissue of injury, you know, might be disc, it might be the facet joint, it might be, let’s identify those movements that are causing the pain, let’s take those away first. Because in doing that, we don’t have to worry so much about the tissue, let’s not get hung up on the tissue. But let’s look at the movement patterns that are causing pain.

Jacob Steyn 20:54
And let’s look at let’s let’s establish which dysfunctions or dysfunctional movements are causing those tissues to be irritated, then let’s fix those. So that’s

Ben James 21:04
Exactly and that’s, and that’s where day two, it helps, sorry, McGill, two, that the Saturday day was focused on.

Jacob Steyn 21:14
That was the assessment of the back pain patient to obtain a precise diagnosis.

Ben James 21:19
Yeah, so that’s where we were moving into all these different movement patterns and observations and assessing the hips and scarring the hips, and also take into consideration of genetics. For example, you know, you might see a patient that likes to go to the gym, they like to squat, and they go to the gym with a with a buddy, and they both squat. And they both want to squat to the same depth. But actually, genetic shows that people of Polish descent are that way, they have much more capacity, because of the structure of the hip joint. And that’s not, you know, sweeping generalization to everyone from that, that part of the world. But as a rule, they can squat deep, without a problem. Whereas those of Celtic descent, the you find that if you’re doing that hip assessment, their their hips aren’t really flexing to more than 90 degrees, comfortably. So if that person is trying to get to the same depth as a friend in the gym, then what you’re going to introduce, you’re going to introduce flexion of the low back, you’re going to increase your risk of back pain. So there’s all these little nuggets of information that are so important when doing that assessment, to try and identify Well, okay, what’s causing the pain? But also, what could be contributing to this problem? What could have started this problem in the first place?

Jacob Steyn 22:46
Yeah. Yeah, that’s a very good point. And that’s what we did on that. Saturday, we went through all the while the differential diagnosis of all the possible back problems, and that was very good, you know, to get a little bit of an oversight of the main things that you most likely will see in the practice the things that we do see in practice. And then you know, the slightly less common things, but also things that you if you look well enough, and you do good testing, you will come across. And then of course, there are the things that we hardly ever see. But if you know of them, and you know how to test for them, which, you know, that they have to be frank about this. Not a lot of clinicians even really know how to properly test for. But if you do, then, you know, if you can’t come out on a different diagnosis, you have to go to these possibilities, you will be able to find them that that was very good to see. And then we Yeah, we we, we looked at how Professor McGill does it, we had his assessment form. And the interesting thing for me was, like he said, Okay, so he has an assessment form. But he said, your assessment really, is led by, by the findings. And that’s where, where a lot of clinicians, you know, they have us they have a system, yeah, therapist talking missions, they have a system that they put people through in terms of testing, and then they, they kind of make a diagnosis based on what came from this. The system.

Ben James 24:25
Yeah, and, and so you just jump in. I mean, I think the system’s fine initially, when you’re saying, Okay, you’ve done all a thorough history with the patient, and then maybe your test in neurology or your test in blood pressure, all these different things. A system is good for the ruling out of red flags, no problem, you know, yes, absolutely. Then once you’ve got past age, it’s all about the individual. You know, and that’s why, you know, to the extent that, you know, we’re assessing abdominal endurance, you know, that’s gonna change for different people. You know, you might put them into the plank position, you’re not going to put everyone in the plank position, 70 year old lady, you’re going to do something different sports person, you might put them in a plank position, let’s test the endurance of those abdominal muscles. Actually, they’re really weak, and you’re trying to do this explosive exercise? Well, if you’re trying to do that repetitively and your abdominals are telling me that your endurance isn’t there, then what’s the risk, the risk is suddenly, during that explosive movement, throughout your sporting activities, you’re going to introduce twisting around the spine because your muscles are becoming fatigued. But it’s it’s taking the time and taking the direction that maybe that different sport is in tennis player versus powerlifter, badminton player versus soccer player, etc, etc. Like you say, you’ve got to take a very, you’ve got to be very flexible in your approach. And you’ve got to really have that vision to take it down the road as it were there that you need to take it down for the individual during that specific assessment. And I think that that really came through from what my professor McGill was saying, because a lot of the guys at the conference, you know, naturally, I guess were saying, Okay, what would you do in this instance? What would you do in this instance? And as Professor moville repeatedly said, It depends, because people are different. And and again, people just seem to want this system. Okay, how do I, how do I put Professor McGill’s work together in a system that I can remember? It’s never gonna work? Yeah.

Jacob Steyn 26:32
Yeah, it’s like, you see a really good exercise. You know, we know when we see a really high level rehab exercise, but you know, you can’t just use that exercise, it needs to be appropriate. And I really like the same that Miguel had. There is no bad exercise, just one to one inappropriate for the goal.

Ben James 26:54
Exactly.

Jacob Steyn 26:56
Yeah, that’s gonna stay with me, man. Because, yeah, I, I, you know, that’s really well put. And that’s, you know, a lot of people will will criticize Professor McGill for this resistance, that people say that Professor McGill has against flexion of the spine, for example, doing crazy setups, and, you know, back bends and stuff like that, especially when it comes to which he then says, if you use that to build strength, you’re not actually building strength. No, you’re not building stability in your spine. And well, that’s what he said, he will not tell you that you shouldn’t do that. It’s just, you know, you need, you need to look at what is appropriatefor the goal.

Ben James 27:42
Exactly. And I think, you know, Joel, who was who was also one of the trainers, and has worked alongside Professor McGill for many years gave a great example of this. You know, where, again, back to what you’re saying that we’re not saying, don’t do these exercises or activities, you know, for some people, maybe we don’t, for example, you know, if you’re not a high performance athlete, and you’re going to the gym every day, and one of the exercises you’re doing to train the abdominal muscles is a setup, then avoid the setup, we can give you much better exercises that are going to train the strength and endurance of your abdominal muscles that are not involved in a setup that is compromising your low back, for example, stir the pot, in fantastic exercise keeps your spine in neutral, takes all that pressure up. But you’re going to get those athletes that, as they say, have to make certain sacrifices. For example, a cyclist, if you look at any high performance cyclist in the Tour de France, was the posture of their spine for four days. They’re in a flexed posture, their spine are bent. And what Joel was saying was, and Professor McGill was saying, we’re not going to tell those guys that they can’t do that, you know, we can advise them that it’s not healthy. But you can’t really avoid that if you want to be a high performance cyclist. But we don’t need to train those muscles in that position. So what we can do is still to stir the bikes. So you can do all these different exercises that are going to build the strength of the abdominal muscles. And then when you go to do that exercise at that site, cycling event, your abs are really strong, but you’ve trained them in a much more healthy way for your spine. And near that, therefore you’re much more resilient when you’re on the bike in that position. And that was that that kind of theory of flexion moment to flexion movement. And the moment is where we’re looking for him. Yeah. And and like Joel said, in a great example of the the guy that he been working with that had back pain for a long time, he’d been working with him and he trained him up and he was getting stronger. And the guy who phoned him and said, Oh, look, I’ve got a problem. And everything’s been great, but I’m want to join the Royal Marines. And still one of the test for the Royal Marines is one minute, sit up max performance, how many? How many setups can you do in a minute? And he said, that’s going to cause me a lot of problems. Like Joel said, well, no, we’re going to train you with these exercises that are going to be far, far more effective to your abs. And then when you go do that one off test, we’re going to smash it.

Jacob Steyn 30:20
With no with no yo with, so they were training, no flexion extension, just building stability between the shoulders and hips. And then when you have to do these minute long setups, it was, he didn’t feel a thing, and he’s back because he was just so resilient, and the spine are so healthy, you could just you could nail it.

Ben James 30:35
Exactly. And then in doing that performance test, you know, as a one off, your backs can, you know, not be compromised, you’re going to be you could kind of be okay, but for those athletes for those athletes that are doing these activities, that that do put you at certain risk. That’s, that’s a trade off, you know, you’ve got to take for guys that are in better pain that aren’t at high performance. You know, there are activities and exercises we can definitely avoid.

Jacob Steyn 30:59
I just want to it’s almost time to finish up. But I want to just get back to what you said about the flexion moment training, the flexion moment, instead of the actual movement. were focusing on training, anti flexion, just to make it clear, and anti extension and anti rotation. So that’s what we do, we want to train the obviously the the brain and in combination with the brain, the the core, the trunk in between the shoulders and the hips, to resist the flexion. And to resist the extension, you know, creating stiffness and to resist the rotation of the shoulders on the hips. That’s where the power comes from being able to stiffen between the shoulders and the hips, generating the power from the hips, or the shoulders, the ball and socket joints. Yeah. Oh, yeah. And that leads to if we train in a good way, with a neutral spine, generally, it doesn’t always have to be exactly neutral, depending on the sport. But if you do that, then you create this resilience, that’s going to allow you to, for example, sit for a long time on a bike, or, or go into a competitive sport like MMA, where you fight, where there’s a lot of jujitsu or movement coming through the spine when you when you when you have to fight, and you’ll be more resilient.

Ben James 32:25
Yes, yeah, absolutely. And I mean, you know, talking about athletic performance, and, you know, in the back, etc, is, is beyond the scope of this podcast, because there’s a lot of information that we could cover, but I think, you know, we both experienced on the third seminar, McGill, three, or the fourth day, I was gonna say, the third day, but there’s a fourth day, some of the exercises that were introduced, were phenomenal in terms of the, you know, the effort and the work that you had to do. And yet a lot of people would say, Yeah, but you’re not putting a lot of resistance behind that, or you’re not lifting heavy weight. There’s a lot of work that you could do with your own bodyweight. That is gonna be so so good in terms of core training and strength. And I think that’s, that’s maybe a good place to leave it on. If you are someone that has had back pain or about has back issues and you are going to the gym, you really need to make a consideration of the exercises. And you really need to challenge the trainer’s because I think one of the other takeaway messages for me was there’s a lot of exercises out there that we should be avoiding, there’s a lot of exercises that we could be doing, that are going to be far more challenging, are going to be far more beneficial for your spine and your overall health. And they’re going to be far more beneficial in terms of training your neurology and movement, that really, that level of professionalism in the fitness industry needs to be challenged a little bit and it was great to see a lot of personal trainers there at the event, at the conference.

Jacob Steyn 34:10
It was, especially on the last day I was also there was 110 people not on the last day. We within this, sorry to interrupt you Ben

Ben James 34:18
No no.

Jacob Steyn 34:19
We were in this amazing gym. I was I was very impressed. Yeah, I’m critical when it comes to gyms. But I was I was very I was actually quite impressed with I did tell you Ben I wanted to make a few changes to make it even better but that’s just me but but it was nice to be in such it’s such such a jump and and and and then you know doing these things with the on a course it was just that. Yeah, I really enjoyed that. Yeah, it was. And I just want to say another quote that I got this weekend from from Professor McGill and Joel Proskewitz. Which, and Ed Cambridge, they said, you know, athletes or supporters, they chase and mythical idea of athleticism. Yes. And, and that’s, you know, I’m going to say that, again, supporters are athletes, they chase a mythical idea of athleticism. And, and then just to elaborate a little bit on that, the idea we sometimes have of what we should do, or what we are training for is not clear. So my, my, my, my message there is just for, for, for you, the listener to think about what what, why why are you training? What’s the idea? I mean, we’re saying all life, yeah, we’re training for life, we’re training to enhance our capabilities and our everyday enjoyment of feeling good and feeling fit and enjoying our body. Don’t break yourself in the process.

Ben James 35:54
No. Exactly. Exactly. And, and that involved in that, again, back to that challenge of clinicians we’ve talked about before, but challenge those, you know, health professionals or personal trainers, that is the activity you’re doing correct. And if they can’t give you some of the good theory behind it, then you really need to be doing your own research or finding somebody that can give you that honest guidance, because it is so important. And you know, we are at risk every time we go into the gym, if we’re not doing things properly. And like you say, you know, identify the goal, and establish why that goal is you know, is a focus for you and then develop the right movements and exercise to align to that goal that’s going to be healthy for your spine, don’t put yourself in a compromised position.

Jacob Steyn 36:42
And I’m sorry to interrupt but I want to say maybe if you need help find somebody to help you with that. Find somebody who’s familiar with the McGill method. It’s it’s the most research based way of building core strength in the world. Actually, Professor Stuart McGill is regarded as the leading spinal biomechanics researcher in the world. So you know, you it’s, it’s don’t go blind into a mythical idea of what’s good for you. And that and break yourself.

Ben James 37:17
Yeah. And I think before we finished Jacob, we have to just say at one point during that day three, someone was called out to do the hundred percent neural drive for their abdominal muscles. Mr. Jacob Steyn take the floor. But that just shows doesn’t I mean, just for the listeners, this exercise you were you were in the press up position. And then you walked your arms out? Straight, right. So you’re, you’re basically you’ve got your, your feet and your hands on the floor, and you’re, you’re in a standing position as it were, with your arms above your head, chest to the floor

Jacob Steyn 37:59
Just above the floor but yeah!

Ben James 38:01
But it just shows though, how much you’ve invested in yourself. In the last well, will it be seven, eight years now since your since your back issue to get that core strength to the level that it is now that you’re able to do that exercise, which was which is pretty impressive. I’ve trained you well!!

Jacob Steyn 38:21
I worked hard for it!

Ben James 38:24
You worked hard for it. But the resilience now to show that you said during the weekend, I think you said it to everybody. When when you’ve done an exercise, you know, the you won’t get back pain now. You weren’t you know, you won’t get a back problem because you’ve got such awareness now, and you’ve got such control of those muscles. And, you know, my wife says to me, you know, you’re for me personally as well, because I’ve done a lot of work around the core strength and functional training with your advice with Professor McGill’s and work that you you’ve got such you know how to move, you’ve got such an awareness of the body. And I think that puts us in such a great position of resilience to future injury. Also, it gives us a great opportunity to advise a lot of people who you can see me even badly, but it does take time. It does take effort, but you’ve you’ve clearly taken the time to build that resilience, because it’s so important. You recognize just what an impact it had on you. So…

Jacob Steyn 39:26
Yeah, well said. That’s true. Yeah, absolutely.

Ben James 39:29
Awesome. Well, I think that’s a great place to start. I think it’s been good to put into context. The seminar, a little bit of a, again, work that we do to continually develop and certainly Stuart McGill is someone that we we both respect there’s a lot of information out there that that is that his poor but certainly the the research and the the many years he spent in this area is has really helped a lot of people And we’ll continue to do so. So great legacy there. So again, listeners, thank you for listening in. And we’ll be back soon with another episode. Hope you’ve enjoyed it. Keep listening, give us some feedback on on iTunes. It’s always great to get some, some comments helps with the ratings and jump over on the websites, a lot of great information and videos that that are going to help you out. And we’ll be back soon.

Transcribed by https://otter.ai