Deep Dive on Tim's Low-Back Issues, How to Unlearn Painful Patterns, Movement as Medicine, and More

Added: Aug 5, 2023

Dr. Sahrmann begins by explaining that the key to addressing low-back pain is to identify and correct movement patterns that contribute to the pain. She emphasizes the importance of understanding the relationship between different muscles and how they work together to create movement. Sahrmann believes that most low-back pain is caused by relative stiffness rather than muscles being too short. She suggests that improving the stiffness of the abdominal muscles can help elongate the hip flexors and alleviate pain. Sahrmann also discusses the importance of proper alignment and posture. She explains that many people wear their shoulders too low, which can lead to neck and shoulder pain. Sahrmann recommends exercises to strengthen the serratus anterior muscle, which acts as a sling to hold the shoulder blades up and reduce strain on the cervical spine. The conversation then turns to the topic of stretching. Sahrmann argues that stretching should be approached with caution and that it is essential to understand what is causing the muscle to be short in the first place. She emphasizes the need to address the underlying factors that contribute to muscle tightness rather than simply stretching the muscle. Sahrmann shares her own self-care routine, which includes quadruped exercises, modified push-ups, and hip rotations. She explains that these exercises help improve alignment and reduce stiffness in the body. Sahrmann also highlights the importance of maintaining a physically active lifestyle and avoiding sedentary behavior. Sahrmann emphasizes the need for individualized approaches to addressing low-back pain. She stresses the importance of understanding the specific movement patterns and postural habits of each person and tailoring treatment accordingly. Sahrmann also emphasizes the role of the individual in managing their symptoms and taking control of their own pain. The conversation then shifts to the role of the psoas muscle and the tensor fasciae latae (TFL) in hip flexion. Sahrmann explains that engaging the psoas can help protect the lumbar spine, while the TFL, with its low threshold for activation, can cause problems in the knee, back, and hip. She also mentions femoral retroversion, a condition that affects the rotation of the femur and can impact movement patterns. Sahrmann provides Tim with advice on exercises and movements that can help alleviate his low-back issues. She suggests engaging the psoas instead of the TFL during a straight leg raise and using the abdominals to protect the back. She also recommends controlling rotation with the trunk by letting the leg go out to the side while keeping the abdominals contracted. The quadruped position is another topic of discussion, with Sahrmann emphasizing the importance of monitoring hip rotation. She warns that immediate hip rotation when rocking back can strain the knee joint and increase the risk of an ACL tear. To prevent this, she suggests slightly laterally rotating the hips. Tim shares his experience of sitting with his legs splayed open and how it alleviates his low-back symptoms. Sahrmann explains that this movement pattern may be due to the tensor muscle holding the femur in medial rotation. She advises Tim to laterally rotate his hips to reduce the pull on the pelvis from the gluteal muscles. The conversation also touches on Tim's kyphosis and lordosis combo and its potential relation to Sherman's disease. Sahrmann suggests reducing the kyphosis and avoiding swaying back to prevent further strain on the back. Throughout the discussion, Sahrmann emphasizes the need for a holistic approach to movement and exercise. She believes that exercise should be tailored to individual needs and that a proper diagnosis is essential for effective treatment. Addressing movement impairments early on is crucial for improving quality of life and preventing physical disabilities. In conclusion, this podcast episode provides valuable insights into movement impairment syndromes, the role of different muscles in the body, and the impact of everyday activities on physical health. Sahrmann's expertise and advice offer practical solutions for addressing low-back issues and improving overall movement patterns. The key takeaway is the importance of a comprehensive understanding of the body's movement system and the need for tailored exercise and treatment based on individual needs.