Pelvic Health – Addressing Dysfunction with Exploration and Awareness

Until fairly recently, pelvic health was a topic that didn’t get a lot of love. That’s partly because it’s complex, and partly (sadly) because some of the issues are embarrassing for people to talk about.

If you’ve been concerned about your pelvic health (and you should be), this episode is for you. Jarlo talks with GMB Trainers and movement specialists JJ Thomas and Jenn Pilotti about one of the most important yet mysterious areas of the body.

Points covered:

• Understanding that the pelvis is the bridge/connection between upper and lower body
• Removing the mystery and stigma of the pelvis (“black box”)
• How locomotion work and similar movements are “body awareness” exercises and can immediately affect how your body feels

Resources:

• Jenn Pilotti’s Be Well PT
• JJ Thomas’s Primal Physical Therapy

Transcript for Pelvic Health Episode

Jarlo: Hey everybody. My name is Jarlo-

JJ: Hey there.

Jarlo: … and I am one of the co founders of GMB fitness, and this is our podcast. GMB, of course, stands for, Give Me Bacon. That’s Give Me Bacon Fitness Podcast.

Introducing JJ Thomas, Jenn Pilotti

Jarlo: And I’m excited today because we have my friends here, Jenn Pilotti and JJ Thomas, and we’re going to be talking a little bit about the pelvis, which we were talking a little bit before this meeting, sometimes it’s a mysterious area shrouded in secrets and all that type of stuff. Both of Jenn and JJ are GMB trainers with us, but they also have their own specialties. JJ is a physical therapist, my fellow physical therapist, and I met both of you, what? It was an Austin in real life, when was that? Almost three years ago now, I think. Crazy. Yeah, we were all there for a trainer get together. So, let’s do a little bit of an introduction. How about Jenn. Why don’t you start? Tell us a little bit more about what you do.

Jenn: Alright. My name is Jenn Pilotti. I am a movement generalist. I love movement, and I work with people of all ages and abilities. I work a lot with people who have struggled in traditional exercise settings for whatever reason. So, that’s my niche, and that does mean that I see a lot of people that have coordination issues or connection issues with various body parts. I own a personal training studio in the Carmel, California area, and yeah, that’s me.

Jarlo: That’s awesome. Yeah. We were talking a little bit, I know you work with different pain clients, but also like you said, in general, just people that maybe weren’t doing well at the gym with a regular training, “regular training.” You’re able to find some avenues for them to move better. I think that’s awesome. JJ, over in Philadelphia area, right?

JJ: Hey guys. That’s right. Yeah, as you mentioned, I’m a physical therapist. I’ve been a therapist about 20 years, and I started off like a real heavy manual therapist. I’m still a heavy manual therapist, meaning I see my role with the patient one-on-one as finding ways that I can put my hands on them and facilitate better movement patterns so that when we go and use those muscles or use that integrative pattern, it works better, but with that, I found about five years ago, I came across GMB, actually a patient told me about GMB.

JJ: Because I was trying to integrate some manual work that we did with that patient, and one of my foundational principles is, in order to reestablish good movement patterns, we have to really integrate, as you said Jenn, head to toe, almost bringing it, reeling it way back to how we initially learned to move from infancy to our first year of life, and so I was integrating scapula with hip for this guy, he had a shoulder problem.

JJ: Anyway, he told me, he was like, “Hey, I think you should check these guys out, GMB. They do a lot of things that are very similar to what you’re telling me I need.” So, cool. That’s how I became a trainer. About five years ago I came across you guys and that was it. So, that’s it. Now, I feel I’m more balanced. I do that manual piece, but I also really value that integrative exercise piece.

Jarlo: Yeah, that’s awesome. I remember when we first met that we got talking really easily. I think my background, very similar to yours, had a lot of manual, even in my thing, like manipulative therapy, manual therapy, that was what I wanted to do for years and years, and then even I started needling, right?

JJ: Yeah.

Jarlo: We met our friend Paul. So, yeah. It was really funny. He was like, I mean we started talking about the same kind of things, right?

JJ: Yeah.

Jarlo: But I think that’s a lot of what GMB Fitness, what we’ve tried to do, is we brought in a lot of different people from a lot of different backgrounds, but it seems like we have the same goal, which is getting people moving well, but also just like, I think what you put Jenn, you had said earlier really hits it.

Jarlo: It was like helping people that the traditional types of training really weren’t working for them, for whatever reason. I’m not saying that they’re wrong or whatever, but they needed a little bit of a different approach and we integrate it with that as well, right? I mean, we’re not saying you can’t do the traditional sport and athletic training thing, saying that’s wrong, right?

JJ: Absolutely.

Pelvis is the Essential Bridge

Jarlo: So, I wanted to talk about the pelvis and like I said earlier, just remove a lot of the mystery from it. Now, one of the things that I’ve noticed over the years, working with patients and even in answering emails and doing all these things for GMB is just the awareness is really low about even what we mean when we say the pelvis, even just the word pelvis just conjures up, well, that automatically means women, right?

Jarlo: Women’s issues and all these thing that have nothing to do, but really, almost every patient I’ve seen with any kind of lower body diagnosis or even spinal diagnosis from the doctor or even self-diagnosed, “Oh, it’s my back. It’s my hip.” And you look, or even just talking with them for a few minutes, then you know in your head like, well, that’s the pelvis. It’s the pelvis.

Jarlo: So, from my perspective, in therapy, in school was always, we go joint by joint, right? We know the muscular attachments, we know all of these types of things, but I think that’s a little too technical. Really, we want to think about this, the pelvis is this essential bridge between your back and your lower body, right? It’s the true core of the body, right?

JJ: Absolutely.

Jarlo: One of the things that I’ve noticed is when you talk with these patients, there’s usually, the injury is less than specific. I wonder if you guys can talk a little bit about that, because usually you can say, “Oh, I fell…” right? “… and it hurts right here.” Right?

JJ: Oh, you mean it’s more like this. They can’t put a finger on when it started or when… is that what you mean? How it-

Jarlo: Yeah. Do you guys see that too?

Jenn: I definitely do.

Jarlo: Yeah.

Jenn: People will gesture vaguely to an area when I say, “Well, what are you experiencing?” And they’re like, “Well, sort of over here, like the left gluteal region.” In this diffuse way, and then you watch them move and you’re like, “Oh, I can see why it’s over there.”

Jarlo: Right. Right.

JJ: Yeah. I think part of the reason, I think that’s interesting because like you say that Jenn, because I think that’s true, and also I think some of the reason that is, is because the pelvis is so important, neurologically it covers such a broad range in broad perspective that a lot of times these people with pain in that area, it moves, right? Because it’s like, it’s got this big input mechanism neurologically, and so the output is oftentimes multiple levels. So, I think it moves and it is so important foundationally, like as Jarlo said, it really is the core.

JJ: Everything moves off that rib to pelvic connection. I mean, I think, we didn’t talk about this earlier, but I think it’s important, yes, the pelvis is the core, and I think if we really think what’s the most important function of our bodies, it’s longevity, and with that, we have to protect our organs, our brain, our internal organs, our lungs. So, I think that’s where this high importance of this pelvis to rib connection is, right? Just from a fundamental survival mechanism perspective-

Jarlo: Well, let’s go a little bit with what you said there, just for everyone else, or not everyone else, but I think we’re all nodding our heads here and like, yeah. So, let me maybe try and explain a little bit of what… there’s a lot in that statement there.

JJ: Sorry.

Jarlo: For example, like when you say protection, an easy example is our brain encased in our scull. Yeah. Makes sense, and the ribs the same way, we all know our ribs and our chest hold our lungs, and even to extend the organs to there. For the pelvis, it’s the same thing. We have two big bones, right? That connect to the ball and the socket for the hips, right? And then we have the sacrum in the back and then it connects in the front with the pubis symphysis and the pelvic bowl is a term that’s very common. And so that’s what JJ is talking about, and this thing is huge.

Jarlo: We don’t even really think about it, but it’s essentially 20% of our structure, is the pelvis, and so that pelvic bowl that wraps around, has our organs and has our essential, not just reproductive organs, but really all of that underneath, and so that’s protected by those massive two bones, the coccyx, the sacrum in the back around into the front, and then you have all the connections with the musculature and we are walking on it, right? We are on our feet, but all of that force goes into the pelvis, and so I think what you’re trying, and I’m just trying to expand on what you’re saying a little bit.

JJ: Please! I put my balls out there, and I’m like, “Whoops!”

Jarlo: But that’s why I think a lot of these, I hate to say complaints, but issues that people have, maybe they aren’t as specific as we’d like to see or that we can come and sink our teeth into, or the patient themselves, the client themselves are like, “I don’t know why. Why am I dealing with this?” But that’s one of the things, what I want to do with this podcast is remove some of the mystery, but I think what you put there, JJ, is really important. It is. If you look at, it in that pelvic bowl, there’s a lot of important things in there, like massive, and again, it’s a part of our body that it’s a huge percentage of ourselves, I think.

JJ: Yeah, and I think it’s surprising. There’s this funny dichotomy socially, right? Because as you mentioned earlier, many people get shy when you even mention the word pelvis. For some reason, that giggle from when you’re 10 or 12 and your mom says, “Pelvis.” When you’re 40 and your therapist-

Jarlo: Exactly.

JJ: I don’t know why that does. I mean, I think some of it’s cultural. I have some British patients that are like, “Oh, you Americans are such prudes.”

Jarlo: Right.

JJ: But I don’t know that it’s true everywhere, but I know at least where I treat, it’s often people are shy when you talk about the pelvis, as you mentioned earlier, but yet it’s so important.

Jarlo: Oh yeah, and we always… It’s interesting over the last, wow, we’re almost at 10 years at GMB, right? The first few was essentially me and Amber, Andy answering every question that came through, and you’re talking hundreds of emails a week, up into thousands a month, and now there’s more of us, thankfully, but perhaps the anonymity of bit of email, but we did get much more questions about that, then that, I would have expected, especially in practice. People are very reticent to say it. I think so. And Jenn, have you noticed that? And so to get this away from the therapy world, have you noticed that with your clients as well?

Jenn: Oh, for sure, and there’s, as you guys have both said, there’s such a misunderstanding of what that area is. I mean, once I explain to people that there’s two sides of the pelvis, they’re like, “Wow. Really?”

Jarlo: Yeah, that’s another massive thing.

JJ: Really good point.

Jenn: People just don’t understand, they don’t understand that it’s supposed to move, they don’t understand that it’s supposed to rotate. I was working with a 14 year old a few years ago, teaching them how to deadlift, do some basic lifts, and I said to him at one point, I’m like, “Well, you need to move your pelvis back.” And he said, “What’s my pelvis?” He just had no idea.

Jarlo: Right. Absolutely.

Jenn: So, it’s definitely just an area we don’t… it’s not socially acceptable to talk about or to understand.

Jarlo: Yeah, and I think it is that, I mean, it’s just immediate sexual repression type of thing. I remember specifically, and this is way back in the beginning of my career. I wasn’t even a therapist yet. I was in the clinic with my CI, and my clinical instructor, and he was like, “Okay, you can work with this person to work on pelvic tilts.” I’ll say, “Yeah. I can do that. Pelvic tilts easy.” And it took me like half an hour.

Jarlo: This person just didn’t get it, right? And back then I didn’t have the experience, “How come she’s not…” I’m doing it. I’m showing it to her, I’m teaching, I’m telling, talk, and there was nothing. Absolutely nothing, and I’m not making fun of her, but that’s the way it was. That’s what it was, and that’s part of the mystery. Part of it is just not knowing what’s there. That’s like you said, that there are two big bones that attach to the hips from the spine, right?

Jarlo: People think, well, it’s almost this area that’s a black box, right? And one of the thing there… let’s talk a little bit more. It’s not even technical, but about what it is and how it can be affected is essentially with the transmission from the ground, right? When you’re walking or even standing, or anytime your legs are split. Let’s say a lunge or stepping upstairs, getting up and down, kneeling, right?

Jarlo: That affects your pelvis immediately. Immediately. Then once you start adding on weight to your upper body or trying to throw things or trying to carry things, that’s immediately the pelvis. There’s a specialty in therapy and even in training where that’s all they think about, right? I remember one of my teachers, he loved the keystone idea.

Jarlo: Cliff Fowler, he’s an amazing therapist out of Canada with North American Institute of Orthopedic Manual Therapy, and he loved it. Everything was the pelvis. Straight up. Pelvic girdle, right? You didn’t even need to talk to the patient about anything else, just go straight for it, right? Just go straight for it. I loved that time.

JJ: You hurt your finger? It’s your pelvis.

Jarlo: Right. It is, right? And of course that’s the extreme of it. Like, “Oh, you have a headache?” You’re going straight to it, straight to the pelvis.

JJ: Yeah.

Jarlo: Right? But I think it’s easy, I fell into that too. I was like, “Oh yeah.” Right? Or even IPA is coccyx. Greg Johnson, oh man, what a great therapist. He’s like “probably the coccyx,” and you can move every joint in your body, right? Yourself, except for the coccyx. Right? So, the tailbone, but that’s what it is. It’s hard for me, I think, to even talk about this without going really in-depth.

Jarlo: I think one of the big takeaways, like you said, Jenn, is understanding that there’s two sides of it and there’s two sides of it that connect, right? And it is supposed to move. Now that’s a big controversy. Is it like 0.5 degrees, it’s 15, whatever, but to me that doesn’t matter. All of all of that is, it’s just a construct to understand why the techniques we’re using, why the movements and the visualizations that we work with clients and patients, why they work.

JJ: From the training side of things too. I mean, I see this as PT as therapy and training side, but just what you said about how important that stability is in progressions of single leg stance, right?

JJ: And earlier you mentioned, here we are with this core pelvis that’s so important in survival and protection, and then we challenge it by these single leg stance activities, and I think one thing that’s really important for people to remember too when they’re doing these “higher level things” like walking or running, right?

JJ: Is that we’re not born walking, right? We’re not baby giraffes, or is it baby giraffes now? It’s deer. Sorry about that. Whatever, but the point is we’re not born-

Jarlo: Maybe it’s giraffes too though.

JJ: … and we have to meet these progressive milestones developmentally and musculoskeletally, and I think that’s, again, why GMB fit for my model and for so many people, that’s why people do well with our programming, is that, not to sound like I’m tooting our horn, but I am, but is that it reestablishes those foundational movement patterns because it makes you go back to the pelvic to rib connection, right?

Jarlo: Right.

JJ: Before you go back to those advanced single leg stuff.

Jarlo: Right. Absolutely. That’s why the locomotion work that we really emphasize, even straight from the beginning, can be so helpful. Rose Calucchia and I talked a little bit about… Calucchia, sorry. I always say it wrong. Rose Calucchia and I talked a little bit about this as why, she asked, we get a lot of feedback from our clients in person and emails as like, “Why was my back feeling so much better after just a few minutes of doing this?

JJ: Yeah.

Jarlo: Right? And this means, whether it was the bear or any kind of locomotion variation, and I think one of the things is, the inputs. We’ve changed the inputs.

JJ: Yeah.

Jarlo: We’ve gotten rid of gotten rid of, not gotten rid of, but we’ve toned it down, we’ve removed some of the threat response from… and you think, “Well, I’m just standing. I’m just standing or I’m just barely putting my foot forward, trying to do a lunge.” That shouldn’t be much at all, but it is, and obviously, anytime you have pain, the body has that as a protective mechanism. So, there’s some kind of threat into the system, and one of the ways that we reduce that is to change the inputs, right?

Jarlo: And I think what you said there, JJ, is big. A lot of this thing about developmental processes, we go from on our backs to then on our bellies and then up on our hands and knees and then up on to our hands and feet, and then up into kneeling, all of these types of things. That’s huge in therapy and rehabilitation. That’s also really good for getting different inputs to people that are “healthy” already.

JJ: Yeah. Absolutely. Yeah.

Jenn: And-

Jarlo: Well-

Jenn: Yeah.

Men Have Pelvises Too

Jarlo: I want to talk, before we go on to some specific examples, I also want to make sure we bring up the point that when you think pelvis or someone says pelvis, or even if you go to a doctor and all of these types of things, it doesn’t automatically mean women.

JJ: Yeah.

Jarlo: Right? And we get a fair amount of emails coming in from men describing issues, and it’s almost like you were all saying here, they don’t even know what language to speak with.

Jenn: Right.

Jarlo: Right? They don’t say pelvis, they’ll say hip, they’ll say lower back, and when they do say it, and this is an example, we got an email from a man who described it as, he can only describe it as genital pain, but even from the email when I’m reading, and I don’t know, I hope he responded back with a little bit more of a history. I’m like, it’s not necessarily straight up genital pain, right?

Jarlo: JJ, you we’re talking earlier, before we started, about the connection between the fine muscles, right? Into that area, and also the nerve roots, the peripheral nervous system, it can translate, again, that threat response from muscles in the hips, right? Into that area, into the perineurial area.

JJ: Yeah. Yeah, absolutely. I think what we were mentioning is how, yeah. Your adductor magnus muscle, one of the biggest adductor muscles, well, it is the biggest adductor muscle and lies right along the hamstring, but it refers exactly to the pelvic floor. So, people feel that… I’ve had definitely multiple patients, particularly men, who say that same exact thing, like, “It kind of feels like it’s in my testicles.”

Jarlo: Right.

JJ: And they’re afraid to say it, but when they do, they’re so relieved because we can look and see if there’s a musculoskeletal component, not to say that we would neglect making sure they get things-

Jarlo: Exactly, exactly. And that’s another thing too, whenever, and now I’m a man here, but if I didn’t know anything and I started feeling pain in my testicles, I’m not going to go to a personal trainer.

JJ: Right.

Jarlo: I’m going to go to… and if I wasn’t a physical therapist, I wouldn’t even think about going that, I would go to the doctor, right?

Jenn: Yeah.

Jarlo: And if you’re going to say those things, of course, the doctor’s going to go and check your… going to go, “Oh hey, pee in this cup, let me do some ultrasounds.” Of course, they’re going to do that because that’s what they’re supposed to do. They’re supposed to rule out those huge things, right? And especially if you’re in the age group like I’m in my mid 40s. Well, yeah. There you go. let’s get your prostate checked, let’s do all these things.

Jarlo: And they’re not going to think about your thigh muscles. They’re not going to think of, “Oh, this guy just started working out.”

Jenn: Right.

Jarlo: Right? Or he just started working out, but he started doing some new things. That’s not going to be in their thought process. Maybe it should, that’s another issue or not, but no, I think maybe not. They’re looking at red flags, they’re looking at the things that they need to take care of right away, and Jenn, you mentioned earlier about working with a person on the deadlift and all of these types of things. That’s the real thing. What can we relate to our clients and our patient to what they’re doing and what they’re experiencing?

Jenn: Yeah.

Jarlo: So, just with that out of it, there are specific things more related to the female pelvis, right? And sometimes it’s an issue of structure, wider hips, postpartum, right? Hormonal patterns, and all of those types of things. So, yes. That’s why there’s definite specialties with that, but again, we’re all human, right? And I always try to look at it as, okay, what is this person experiencing? And then we add on all of the factors that could be contributing to it.

JJ: Yeah.

Examples of Common Pelvic Issues

Jarlo: So, with that, I’d love to go, and it provide a little bit more specific examples and see if we can maybe create some things that people listening can relate to very well. Jenn, do you have any great things to say right now?

JJ: No pressure.

Jenn: It’s no pressure at all. Well, it is funny because I would say probably 70% of the people that show up to me who are having trouble with some sort of pain issue, it is almost always pelvis related. 30% of the time, it’s not, but it probably about 70% of the time it is regardless of if they’re male or female.

Jarlo: Yeah.

Jenn: So, this is definitely an issue I see a lot of, and your example earlier of teaching the woman to pelvic tilt, I trained a man for years who first started seeing me for low back pain and for the life of him, he could not differentiate his pelvis from his ribs and just did not understand that those two areas were different.

Jarlo: Yeah. It’s massive.

Jenn: Which makes it really difficult to move into more complicated movements, kind of like what JJ was saying, you have to take the more developmental process, work from the belly up or the back to the belly, and then up to teach the connection, because otherwise, if you throw someone into something like a weighted squat or whatever, it’s not going to work.

Jarlo: Yeah. Absolutely.

Jenn: Or even lunging patterns, it just doesn’t work at all. So, that’s definitely understanding how to break down the movements and regress appropriately. It’s super important for anything.

Jarlo: Right. I think that’s one of the things too, is like I was in the beginning of my career, I was really into talking. If I could talk this out with this person and then, right? Transfer my knowledge into them, and so of course that doesn’t work almost at all, and so I realized, well, let’s just get them moving.

Jenn: Yes.

JJ: Yeah.

Jarlo: Right, but not just, oh, let’s just get them moving, meaning let’s start running, let’s start doing this crawling thing, this advanced crawling thing, and they’ll just get it, but what you said, Jenn, about breaking it down, and then actually looking what’s happening when they’re doing a movement, and instead of trying to talk them through it, break it down even more, or switch it around, right?

Jenn: Mm-hmm (affirmative).

Jarlo: With the variations. That’s what I love right now about social media and Instagram, Facebook, all of these things. Man, there’s so many creative people out there now, that I’m like, “Wow!” Some stuff I’ve seen, of course yeah. It’s been 20 plus years. I’ve seen it, but some stuff, I’m like, “That is really good.” I love it, and for me it is that movement variability, right? Just novel inputs, I love it. Whatever we can do to do that. And so, I love the new stuff coming out.

Jenn: Yeah.

JJ: I do too.

Jarlo: Well, not just the new stuff, but yeah.

JJ: And I think people have a little bit more time to actually put their thoughts, like I know even for myself, I’m able to post a little bit more than I could before, because I was just too busy.

Jarlo: Oh yeah, right now. Absolutely.

JJ: I do think even, you’re getting a broader picture of what’s out there right now. We, you meaning we. Yeah, I really love Jenn, what you said, you took the words right out of my mind with the regress, you didn’t say it this way, but regress to progress and that just brought a patient. Literally, I just was working with her yesterday and basically, she has low back pain, same thing.

JJ: It’s obviously there’s a pelvic component, a huge pelvic component, but for example, we were in quadruped and part of her therapy/training is important to get that scapular foundation with straight arms so that the scapular is engaged and then have just a simple knee to elbow, if she can get the foot flat, bring that in with it.

JJ: What I noticed from watching her is that every time she went to slide her knee up in quadruped, she would shift out of quadruped. So, she would unload the shoulder, basically, and that was her compensation mechanism, and I’m like, “Look, okay. Let’s reel this back again.” Because that’s a pretty fundamental movement pattern that we ran and she walks nine miles once a week. I mean, she’s not inactive, right?

Jarlo: Right. Right.

JJ: But I noticed that and I said, “You know what? Let’s reel that back. Keep your weight in your arms.” And she’s like, “Well, I can’t go as far.” I’m like, “That’s okay. You need to reestablish that pattern.” Right? So, that’s that same thing you were saying about tying it back to fundamental movements and then she’s going to progress much faster when we bring it back to the right foundation.

JJ: So, that was one thing that came to mind, and then another patient example that came to mind was, we have this, I think we’re intentionally trying to stress the importance of the pelvis here, and I think it is so important, but one thing I think is worth mentioning is, because the body is so integrative, remembering that everything in our body is fed basically by the nervous system, and at different levels, right?

JJ: So, I think it’s also still important, recognizing how important the pelvis is, and we can focus, say, 70% of our people we see have pelvic problems and they need help. Absolutely, but remembering how to tie in other pieces like the foot, because you do need the foot in walking, but also there’s a… I know I’m a little big on neural connections and the foot is controlled by basically L5 through S4, and that’s all your pelvis right there, right?

Jarlo: Mm-hmm (affirmative).

Jenn: Yes.

JJ: L5, meaning lumbar segment 5 and sacral segments 1 through 4, and so there’s that other piece that’s important. So, I had a patient that actually had hip pain, it was really hip kind of groin pain, and I was doing all my best stuff to get her hip moving well, and it would get better, but it would come right back and I was still giving her developmental exercises and it was getting a little better, but I was just, I was unsatisfied.

JJ: So, I started looking elsewhere and then I realized, “Your foot is really tight.” So, we started working on her feet, and wouldn’t you know? I didn’t touch her hip, worked on her foot and her hip started moving, and istayed moving. It was like, the body was like… and that’s what’s cool about what you said, Jarlo, about the body, it’s a threat. The pain is a threat response. Because that was her way of saying, “Yeah, you didn’t get it yet, JJ.”

Jarlo: Yeah. Exactly.

JJ: “Yeah, still didn’t get it.” And if we didn’t have that threat response, I would have been treating the hip incessantly.

Jarlo: Yeah. And I think that’s what it is when you talk about compensations, and I think a lot of times we, to me, I think it’s empowering when there is some pain actually, and when we see that we have patterns, because then we know we can change it, right?

JJ: Mm-hmm (affirmative).

Jarlo: The body, when it’s trying to adjust, and you, say, for example there’s someone walking and maybe you notice, as a clinician, as a trainer, as a good person looking at movement, you notice a pattern that’s a little off, it’s a little off. It’s not a massive limp, but you look at them, you’re like, “Oh, I see something a little funny there.” And then you go and you look and you drill down into it and you see what’s happening. Whether it’s the foot or the pelvis, or whatever, we don’t need to be really specific.

Jarlo: But I like that because I’m like, their body was trying to protect themselves. That’s what I see there, and when I try to explain to patients, of course the pain and their suffering doing all the thing, but it’s also very empowering to know your body’s trying to protect you in that way, right?

JJ: Absolutely.

Jarlo: And so we’re trying to help you figure out a way to remove that, right? And we can look at your example, JJ, it’s just like, “Oh man, how many times have we seen that?” Right?

JJ: Yeah.

Jarlo: Needling away, it’s freaking glutes, I’m like, “Here. What’s wrong with you.” Right? “I got to poke it harder. Now let me throw some electric in there.” Right? But it’s their knee, it’s their foot… that’s just, it stresses the importance of wholism. Holistic thing of what we’re trying to do. Our body is not just a collection of parts.

JJ: Yeah.

Jarlo: Right? And that’s what it is and why I wanted us talk about the pelvis is like, we need to make every piece of ourselves not mysterious.

JJ: Yeah.

Jarlo: That’s what we’re looking for. When we’re training, when we’re trying to do these things, for me, that’s what it is. That’s the comfort in our body, the physical autonomy we talk about in GMB is the ability to do the thing that you want to do, but also that means the awareness of what your body is doing.

JJ: Yeah. I think that’s a great point. We were talking, I know beforehand about just how people get funny, not just when you say pelvis, but like I was mentioning how, when I want to rub someone’s abdominal muscles, sometimes they look at me like, “What?” I mean, and many people, they had abdominal surgery or they had an abdominal injury and even those guys were like, “You want to rub my stomach?” Yes, I want to rub your… because you hurt your quad, I would rub your quad. I don’t understand the difference.

Jarlo: Right. It’s just significant. It’s significant. That’s why the more room where we can talk about and do it and explain it, and I think the better for sure.

JJ: Yeah.

Jarlo: Yeah. We don’t want a black box and the body doesn’t know what’s going on, and then we have to go to somebody else to figure it out, right? And that’s the trouble, right? With the healthcare system and all of these types of things we can always complain about, but it’s essentially one that was brought up with like, “Okay, we’re here to fix you, come in here, fill out this paperwork. We’ll do exactly what we need to do and then get you out in 20 minutes.” Right? That’s just the wrong model for health and longevity and actually us taking care of ourselves, and I think…

JJ: Yeah. Yeah. That’s a good point too, the struggle, right? The, I don’t know if struggle’s the right word. The journey, I guess I should say, that I think whether you’re injured or not, getting stronger, getting improvements in a skill or in a task and recognizing that you need to tap into a little bit of that struggle and progress it when appropriate.

JJ: I just had another, I’m doing a lot of online stuff right now with COVID, the way it is, and I had a client text me on the app that I’m using, and she’s like, “My arms, I’ve been doing this six week, and six weeks and I still feel weak in my arms.” And I was like, “We just progressed you again. You should feel weak again.”

Jarlo: Yeah. That’s another thing I think people don’t realize, that we do things, then we change and adapt as the body changes. It doesn’t get easier. Well, it shouldn’t get easier.

JJ: Right.

Jarlo: I don’t know.

JJ: When it gets easier, we move the bar.

Jarlo: Right, and so the things that are easier weren’t easier before. I think that’s another thing. It’s hard to step outside ourselves, and I think that’s the benefit of having a good coach or a trainer type of thing. Well, let’s talk a little bit about that too. So, right now we’re doing a lot of this online work and, either video cam or email or correspondence.

Jarlo: So, Jenn, how would you, I know you do a lot of writing, whether articles and you have a new book coming out that’s on my list to read, and I think it’s awesome. How would you say you can, when you’re trying to impart these really, actually fairly complicated principles to someone, where do you start with that?

Jenn: It’s interesting listening to you two talk since I don’t do any manual at all. Everything I do is movement based. So, I don’t ever… if I look at the pelvis, I’m looking immediately at the feet and the ribs and the shoulder. So, that’s one of the things when I’m working with someone online, like I’ve worked actually with quite a few movement professionals during this time who’ve reached out and said, “Hey, I’ve got this thing going on. Do you have time to help me?” I”m like, “Sure, let’s look at it.”

Jenn: And almost always, it’s a lack of connection. And you can see just in simple movements, “Oh, look your foot and your pelvis aren’t talking to each other. How can we make that connection a little bit more clear?” Or, “Oh look, your ribs and your pelvis, they’re not really coordinating. Let’s try to make that a little more clear.” So, that’s how I do it online, is I look and I see what looks like it’s not communicating and how can I make those parts talk together a little bit, in a little more coordinated fashion.

Jarlo: Yeah. I like that, and that goes back to our body’s connected, or should be connected, and I like that because if there is a lack of connection, then for sure there’s something there that either the body has chosen to make it that way, or for whatever reasons outside external stimuli and all of that. JJ with the same thing with, I know you’re doing more, well not more, well, yeah, maybe more.

Jarlo: Like for me, I haven’t been in a clinic for actually a couple years now. I’ve been doing more GMB stuff. I do see people like friends and family, but that’s a lot different than what I used to do is, a person comes in, I don’t know them at all. Right? And you have 40 minutes or whatever if you’re lucky, right?

Jenn: Yeah.

Jarlo: They come in late, they didn’t fill out their paperwork, all of a sudden, you got 15 minutes. Now I’m complaining, and now I’m like realizing why I’m not in the clinic anymore. I’m getting flashbacks of… people, they’re like that, but where do you start with someone that, again, they can’t pelvic tilt or they don’t even know that they’re-

JJ: Yeah. I love what you said earlier. I was thinking this earlier, but it came and left and it’s back now. So, I think it’s important what you said about trying to talk people through things versus putting them in a position where their brain can just remember.

Jarlo: Yeah. That’s massive. It’s massive.

JJ: You know? I feel like you think about our brains, they’re the best computers ever made and how many things are stored in there that we’re not even aware of? Down to muscle memory and positional memory, and so I think a lot of times, what I try to do, is put them in a position that their body will recognize, and their subconscious brain will recognize and and their body will

Jarlo: Yeah, totally.

JJ: … recognize, and they don’t have to really think about it.

Jarlo: Yeah, that’s so good. So good.

JJ: And if they can’t get that position, then I used the manual skills, if I’m with them in person. That has been the cool thing about COVID, is it’s forced me to clean up or actually reemphasize really the exercise component with people, and it’s been really, really fun for me to see how great people do, because when you’re one-on-one with someone face-to-face, it’s easy to just put your hands on them and-

Jarlo: Yeah. Absolutely.

JJ: … facilitate.

Jarlo: Absolutely.

JJ: But this has forced me to really hone in better and revalue the importance of that exercise piece. Before COVID, I would see people like once a week and I would give him like three to five exercises because I felt like that’s all they would do on their own anyway, just to-

Jarlo: Right.

JJ: “Okay. For the next two weeks, you’re going to focus on these three moves and that’s it.” And that worked. I mean, people did great, but with COVID now, I’m like, “I think people’ll get better even faster if I can give them this program.” You know?

Jarlo: Right.

JJ: In addition.. so, we’ll see.

Jarlo: Yeah. I totally agree. I think that’s a big point here, it’s like now you’re forced or you know what I mean? To really evaluate how you’re communicating with someone and not even just like the talking kind of thing, but when you say how to do an exercise, you give them cues, right? You try and get them to feel it in the right way. Now, you have to be really precise, right?

Jarlo: And careful with the language, but also adapt it. So, if you know this cue works for all the people you worked with before, high percentage, but it’s not working for this person right now, you have to change it right away, or you’re just not-

JJ: Yeah.

Jarlo: You can’t just be hammering away too. So, yeah. I like that a lot. It the same way, like, “Man, I can give three things if I’m lucky with this patient. Two. One” But now we have to be more creative and figure out a way for like, can they do this all and how can I help them to do it all. Jenn, you mentioned, you don’t do manual work, manual meaning hands-on and type of stuff.

Jarlo: I know for me initially, the draw of it was, I liked being able to put hands on and fix things, right? Whack. Right? “Oh, look at that.” And it works, but thankfully I got away from that probably within the first 10 years or so, but really, later on I realized what manual work was helping that connection. So, anytime you have that touch and then you have it from someone that, as a therapist, you create that alliance and then you convinced, and that’s what it is.

Jarlo: You convinced this person that you’re able to help them, the manual work really amplifies that, and I think JJ, you can speak to that too. It was like someone’s handling you with care and handling you with competence, and then that threat goes down.

Jenn: Mm-hmm (affirmative).

Jarlo: I’ve seen that. It’s the same thing even, and why like needling, because it seemed faster. Well, it’s also cool. It’s like, “Oh Man, I can do this.” Right? But that’s another way too. It’s like, it’s really direct interface with the nervous system and even more.

Jenn: Yeah.

Jarlo: Right. And so I think it fits there with what you were saying, Jenn, about connections and some would argue it’s faster. I think it’s faster. I don’t know. I’m always going to go back to that, but is it completely necessary? No, of course not. It doesn’t have to be.

JJ: And I think, I guess from a devil’s advocate perspective, it is faster short term, but I think if you don’t tie it into the piece-

Jarlo: Right. Oh, yeah.

JJ: It could be a hindrance, and that’s what I’ve noticed. I think, like my patients, I treat one-on-one, that’s why I don’t sweat when I talk about the time I have with patients, but patients like that quick, like you were talking about-

Jarlo: Yeah.

JJ: Quick response, and they can sometimes get, I don’t know if addicted is the right word, but they-

Jarlo: No, it’s true. Absolutely true.

JJ: They, not just crave that, but for us to fix this, we really need the piece that Jenn is focusing on, the piece that we’re focusing on from that exercise integration perspective, and so that’s, I think that’s… so sometimes the manuals could be a hindrance in that perspective, if you don’t move it past that point-

Jarlo: Right.

JJ: Right?

Jarlo: No, I totally agree. I’ve made that mistake way too much over the years and created dependencies where there shouldn’t have been.

JJ: Oh, we all have. Yeah.

Jarlo: Yeah. Right. And more and more, even if we go into like evidence-based and research and all of that, the movement is key. It is key. You cannot just have someone come in, whack, and then, “I’ll see you later.” Unless you want to create a nice steady income stream. Well, there you go.

Jarlo: So, this is another thing, if we’re going to go on and rant. So, it’s all right. There’s clinics that I knew of, I didn’t work at thankfully, where they had anniversaries for people, patient anniversaries. Yeah. Yeah. “Oh man. Look at this. I’ve been here a year now.”

JJ: Oh my God, are you serious?

Jarlo: Yeah. So bad, and then you wonder why insurance and payouts and all of that stuff isn’t a pendulum and people are complaining about, “I’m not getting paid for any of this stuff.” Well, because look what happened in the ’80s and ’90s or even 2000s, right?

JJ: Yeah.

Key Takeaways

Jarlo: Oh, I love this. We could talk forever on this, and actually this is something that if people are interested and depending on the feedback and all of that, I’d love to talk more about this and even have some specifics, but I really wanted this to be a nice intro for people, hopefully helpful, and if there was one thing we could take away or you want to give to someone, what would you say? Let’s start with JJ.

JJ: Pelvic-wise? We’re talking-

Jarlo: Yeah.

JJ: Basically, and we said this, but not in this way. Just that, my phone’s ringing in the background, I’m sorry. Just that the pelvis is the bridge, right? So, you think about, do you want to walk on a crickety, wobbly bridge? That’s in the middle of the woods, and hasn’t even seen daylight in a long time, or do you want to walk on a nice, solid sturdy bridge with lots of reinforcing beams around it?

Jarlo: Yeah. That’s a good one. Jenn, what do you think?

Jenn: Well, I really like what JJ said. That was very well put. So, nice work. I’m sorry, I’m following that up, but the pelvis is, of course, as Jarlo mentioned earlier, it’s how we transmit force throughout our entire body. So, if you are having issues with your pelvis, think about how you’re using your feet, think about how you’re using your ribs. Start to see if you can find both strength and softness in those areas and see what happens. You might be surprised.

Jarlo: Oh that’s really good. I love it.

JJ: That is good.

Jarlo: Yeah.

JJ: When you said that, I had this vision of a trampoline, like I’m like, it’s a bridge, but it’s also a trampoline, what’s it going to put out for you, you know? How high are you going to jump? That’s awesome.

Jenn: I like that. You’re good with the analogies, JJ.

JJ: I don’t know. I had a lot of coffee.

Jarlo: No, it was good. I think that’s huge and important, again, for my takeaway is I want people to think about this as the more information and the less mysterious it is, and I think analogies like that, bridges and trampolines are massive. What can we do to help people get it, and so it clicks a little bit more?

Jarlo: Maybe you don’t have to get it right away, but a lot of stories and analogies and anecdotes are so helpful because it can be different from person to person. So, I hope that whoever’s listening here tapped into some of that, and if you have any questions, [email protected] is our email. You can email us any time.

Jarlo: Comment on the socials. We are here for you, we have a lot of great support staff. Also, they can forward it to me or Jenn or JJ if you have specific things and we’ll get it to them. Well, thank you both for this. I had a lot of fun.

JJ: I did too.

Jarlo: I hope you did too.

JJ: Yes.

Jarlo: Well, thank you, everybody.

Jenn: Thanks Jarlo.

JJ: Thanks Jarlo, thanks Jenn.

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