The spine is needed in every movement we do, which is why we get more questions about back pain and back issues than almost anything else.
In this two part series, Jarlo and Rose look at the spine and answer some of the most-asked questions.
In Part 1, we cover:
- basic anatomy and actions of the spine
- why so many people have back pain and spine issues
- protective mechanisms, how our brains perceive threats and produce pain to protect us
- nocebos, how anxiety and fear perpetuates the pain cycle
- how new sensory inputs can dampen pain and help us keep moving
In Part 2, we cover:
- why chronic pain happens more frequently in the thoracic and neck
- how posture and ergonomics actually affect pain
- how to figure out your “directional preference” to be more comfortable and get more done in your day
Spinal Health Part 1 – Low Back
- How to Maintain Your Spine Health
- Overcoming Chronic Pain with Exercise
- Hip Mobility FAQs
- Todd Hargrove – Better Movement
Spinal Health Part 2 – Thoracic
Transcript for Part 1 – Low Back
Jarlo: Hey, everybody. This is the GMB Fitness podcast. My name is Jarlo Ilano. I’m one of the co-founders of GMB Fitness. I’m here with my friend, Rose Calucchia. She is a lead GMB trainer for us, also on staff. And we’re here to talk about … What are we going to talk about today, Rose?
Rose: We are going to talk about the spine specifically the lower back.
Jarlo: To the lower back, yeah. We’re going to go over, I think through the first half of this GMB Fitness podcast. GMB Fitness of course stands for Grapes, Melons and Berries. That’s Grapes, Melons, and Berries Fitness. The first half we’re going to come and do a general overview of the spine and then do the low back specifically. And actually this is part one or either going to do a two and a three or just a second one on the neck and upper back. But I think it’s really important that we have a good overview of the spine in general and talking about the troubles we can have with it and pain, because super important.
Jarlo: Rose was just saying about 90% of the emails and the comments we get from people that have problems are spine problems. And that actually really fits in with, correlates with just in general, like back pain is a billion dollar industry. The statistics are wild. It’s something like 80% of us are going to have back pain at some point of our lives. And unfortunately, a great percentage of that is chronic and people having it for years and years and years. And we’re going to talk a little bit about that.
Spine Anatomy Overview
Jarlo: I don’t want to go into a massive anatomy and physiology thing, but just in general, we can talk about the spine. When we talk about the spine there’s the vertebrae. It’s divided into cervical, thoracic and lumbar. Cervical is the neck for seven vertebrae there. Then we’ve got thoracic, which is upper, mid-back. There’s 12 vertebrae there. And then the low back, which is lumbar into the sacrum coccyx tailbone, we got five vertebrae, sometimes six. Then you’ve got the sacrum tailbone. The reason most say healthcare professionals talk about it like that is because bones are easy. Your bone just got your skeleton and it’s easy to divide things that way. And then also you can help people with understanding of what they have there, whether it’s the spine, spinal column protects the spinal cord.
Jarlo: The spinal cord is all the movement from your brain to the spinal cord, all movement and sensation our nervous system. And so that’s one of the reasons why we have the bones there, it’s a protective housing for that. Now, also think about all the things that we have to do in our body. We have to turn ourr head, we have to rotate our torso. We got to bend forward. We got to go bend backwards and side, all of these things. That’s why between each vertebrae there’s … No, this is really complicated. Joints. There’s the joint that they call the intervertebral joint, which is between the bones and you have the discs and you have all that fluid. That’s a joint, but then you also have the sides. On the sides of the joint, the facets and all of these things. I’m not going to say the technical term, but so that you can move side to side. You can move rotation wise, you can bend forward and back.
Jarlo: And then the reason we also have those is because they have attachment points to lots of muscles, like small muscles, bigger muscles all across to the ribs. It’s super complicated. It’s super complicated. And that’s also why that leads into why people have lots of trouble and lots of pain with it. And because it’s complicated and then also, because it’s complicated when some like a doctor or therapist, or any healthcare provider tries to explain it to you like that, you don’t get it. How can you get it? I just tried to tell you this, in the last five minutes, but had to undergrad, grad school, continuing education. You’re going to go into your doctor’s office and he or she’s going to try to explain it to you in like 10 minutes, like I just did. You’re not going to get it. So, it makes it worse.
Rose: Right. I was going to say like, there’s probably a lot of us who maybe got a little glazed over just now listening to all those things because it’s really complicated.
Jarlo: That’s the interesting thing too, because I have been doing a lot of pain science research over the years, but I’m taking it as a formal class. And one of the aha moments for me was the presenter or the professor talking to us says. “When you educate patients, we’re really used to describing anatomy, describing all these things, but that’s wrong. You shouldn’t be telling because you’re actually making it worse for them because it’s hard to understand.” One analogy is like when you go to your mechanic, do you want to know the vagaries of the internal combustion engine, exactly what’s wrong with it? No, you want to get your car fixed.
Rose: Just fix it.
Jarlo: Right. We should be educating our people about pain and why you might be having it, what you can do about it versus, “Oh, here, look. The spine got the disc and got the zygapophyseal joints, got facet joints. Some other joints you have in the neck, but you don’t have in the low back, all that kind of stuff. That’s not helpful. That’s not helpful. That’s why like in these series of podcasts that go really general about it, but it’s important I think because right now we’re just trying to learn about it and then you can go and you can look more of it. But I think my point here with saying it, is that it is so complex and it takes a long time to learn.
Jarlo: Just knowing the basics is good enough. And then actually going drilling down is very important, if you’re a surgeon. It’s very important if you’re trying to do things with it, but it’s less important when you’re having pain and you’re trying to figure out what to do. The strategies are more important than the actual anatomy and mechanics of it.
Causes of Low Back Pain
Rose: Okay. That’s good to know. And from there, can we talk about the things that go wrong? Like why do so many people suffer with lower back pain? What are things … We’ve talked in previous podcasts about the difference between repetitive strain versus overuse. We can talk a little bit about that, but we also hear herniation, bulges, SI joint pain, like all of these things. What are the causes behind some of these stuff?
Jarlo: Sure. Well, and this is important, but it also requires a history of it. And it sort of makes sense because when we talk about things like that, you even mentioned the SI and discs, you would think, and it’s common sense or just intuitive that there are pain generators. You sprained a ligament, you strained a muscle, your disc bulges, and that’s true. It’s true. It’s the nail in your foot analogy. You step on a nail. Yeah. Pretty sure that’s the nail making this a problem. But the thing is, is that injury and even like bad injury, even like tearing a muscle or breaking a bone, the pain isn’t correlated with the severity of the injury.
Rose: What’s it correlated with?
Jarlo: It’s correlated with how your brain filters that input as a threat. It depends on what your brain thinks is a threat to you. You have all of these stories that you’ve heard of people not knowing they were hurt or injured until later on.
Rose: Right. Or even you hear that certain people you’ll give MRIs to and they have all kinds of herniation or bulges, but they have no pain. And then somebody else has like one little one and is in a ton of pain.
Jarlo: Right. And that’s not to say that that pain isn’t real for that person.
Rose: Right, it’s totally real.
Jarlo: It’s totally real, but there’s something in their system. And again, this is really complicated where their brain perception of that threat is dialed up higher. And there’s a lot of things going on with that. The environment of when you got injured, your state of mind when that happens, your overall body condition. But a lot of it, this is to say that it’s not all in your head, but what it is, is that it’s more complicated than just, I got a herniated disc. Well, I’m glad you brought that up because that is massive to actually see an MRI of all these problems like, oh yeah. I can look at that. Look at that. And look at that bulge, look at that tear.
Jarlo: You can actually see it and you’re not even a trained radiologist. You can see it. And you’re like, “Oh man, that’s why I’m in pain.” It’s something that it makes sense, we want to know why. But then it’s also good to know that you can see that thing and like, “Oh, this is another person.” Looks like yours, it’s bad. Yeah. You can see it. It’s bad. And it’s like, “Oh, they don’t have pain.” Then you can go, “Oh, it should be empowering.” Or like, “Oh, there’s something there.” This is kind of rambling, but this is what it is. It makes sense that you’re just like, “Oh, there’s pain generators. You broke your bone. That’s a big one.” Yeah, man, that hurts. It’s massive. Of course it hurts. Of course it hurts. The trouble is after it heals, some people, it still hurts. Some people it’s done, you don’t hurt anymore.
Jarlo: What’s the difference there, it’s not tissue damage. The initial stuff, the nail in the foot hurts. You take the nail out, heals up. It’s better. Some people later on still feels like the nails still in their freaking foot.
Rose: Right. We get emails all the time from people who are like, “I did this, I had this injury, but everything’s healed now, but I’m still in pain.”
Jarlo: Right. You know the whole Phantom limb pain thing? That’s a massive clue. Just a little bit of background. This Phantom pain is when say amputees, people that had limbs amputated, either surgically removed or traumatically removed, they have pain still. Some of them still have pain where their hand was, where their foot was. It can’t be like a damage thing, because that’s gone, it’s gone.
Rose: Right. It’s got to be neurological in some way.
Jarlo: Right. And that’s another thing too. This is such a complicated topic, but you can’t just go, “Oh yeah. It’s just nerves.” It is nerves for sure. And it’s the brain and all that, but it’s everything around it. That’s the thing with the spine. Again, it’s so complex. There’s so many things going on with it. And it’s also in everything we do is involved. You can’t lie down unless we’re talking about this and like in a float tank, totally submerged, everything’s affecting you as soon as you sit up. As soon as you sit up, it’s not like you sprained your wrist and you’re like, you can’t use that wrist. I’ll brace it up. I’ll splint it. That’s cool. It doesn’t work that way for your neck, your mid-back, your lower back.
Rose: Right. There’s always forces on it.
Jarlo: Yeah. And so like the pain generating things. Let’s bring it back to that. What is it? Well, it goes back to this thing of what is your brain perceiving as a threat? And I think we talked about this a little bit before, but a lot of the times we’re amped up. It’s sort of like allergies. Everyone’s has allergies right now because it’s spring. That’s the immune system thinking this allergen is a threat. Then that messes you up because you’re sneezing. It’s worse than to think. It wasn’t that much of a threat. That little bit of pollen wasn’t going to kill you. But that’s the same thing with your brain and pain as a protective mechanism. It’s like, “Oh, you overstretched your back a little bit.”
Jarlo: But maybe you’ve had pain before. Maybe it reminds your mind, reminds your brain again off something where it “had a really bad time with,” and so it just flipped that on. It just goes, “Okay. Oh, that’s it, don’t move now.” You get these spasms. Everyone, hope not everyone, but I’ve had them where your back just goes oh. And then just gradually just cramps up and you can’t move.
Rose: It’s like a vice grip, yeah.
Jarlo: Right. Your brain is just trying to put a cast on it. You sprain your ankle, it swells up. Your brain perceives pain in the back. Well, it’s going to splint it. That’s why it causes a lot of problems is because again, it’s complex, get all of these things, got all these small muscles along the side, and you got all the big ones around there. It’s an involvement in everything you move, but your brain says, “Oh, don’t move.” That’s why you have a lot of it. And so when we look at it and you go to the doctor, you go to your therapist and you go to whoever you go to. Then they do some tests and then they do all these things. They’re like, “Oh yeah.”
Jarlo: They want something to point at to tell you, “Oh, it’s your disc. It’s probably your facet. Maybe it’s because your muscles are like this.” Because they want to help you and you want to know, so they’ll tell you that. And maybe it is, but it’s not the whole thing. It was sort of like the trigger.
Rose: Right. Exactly. And that might not be why you’re having such extreme pain.
Jarlo: Exactly. And then also, why would that trigger such pain in you, but somebody else could have the same thing and it’s like no big deal.
Rose: Right. Totally. Okay. We could geek out on pain all day. You and I can talk about this forever, but-
Pain and When to See a Doctor
Rose: Forever, but let’s talk about some concrete things that people can take away from this who are maybe in pain right now and want to be getting out of pain. First of all, let’s just start with, how do you know when to see a doctor? And I know we’re recording this in the time of a pandemic when all of us are sheltering in place. And so it’s not easy to go out and access healthcare at this time. In general, when is it a good idea to see a doctor versus when can you self-treat at home?
Jarlo: Right. And so this is super important, especially now. And here’s a little bit of a tangent. With the whole COVID thing we’ve be reading about is younger people having strokes because of this. Have you heard of that?
Jarlo: Well, first of all, it’s bad, but also one of the reasons why it’s that bad is because when you’re younger, you don’t think there’s going to be a stroke. You’re in your 30s and 40s. These signs of when the stroke is happening, you either ignore or you don’t know. Like weakness, facial weakness or just body weakness on one side. Slurring. All of that stuff that are signs of a stroke. And then if you were 60, 70, 80 either you or someone with you would go, “Oh man.” And they call 911, but they’re not doing that. And so that’s worse. That’s a good example of these red flags. Red flags for pain are not just numbness, but complete loss of sensation. Not like when someone says, “Oh, it feels a little numb.”
Rose: Or tingling.
Jarlo: Yeah. That’s not what we’re talking about, like straight up loss of sensation. Straight up weakness, meaning you’re dragging your foot. This is low back here oriented. You’re dragging your foot. Foot drop means you can’t lift your foot up. Your toe stops-
Rose: Can’t flex it.
Jarlo: Can’t flex it, can’t lift it. That’s massive foot drop because that means there’s nerve occlusions and impingement. That there’s something happening there. Okay. Also, and this seems while I’m saying, but like bowel and bladder problems either incontinence or pain in there. I’m pretty sure you would be calling someone right away if you have that, but those types of things. Also pain that is just straight up unrelenting fully. Like doesn’t go down at all. Now, sometimes that’s the reaction and some people have it and again, not related to something that’s really bad, but I don’t think you can decide that in the morning.
Rose: Yeah, better be safe.
Jarlo: Better to be safe. Those types of things. It has to be pretty massive.
Pain and When To Move
Rose: Okay. Then if we don’t need to see a doctor, which I would say a lot of people probably don’t based on those symptoms, we typically think that like we have pain and we need to stop doing everything. Especially when it comes to like the back, the spine. I have a long history with neck stuff. Don’t worry, we’ll talk all about that in then the next one. I can jump in on it. So, I understand. And I’ve had back stuff happen before. I understand how stressful it can be and how panicky you can feel when stuff happens. And you’re just like, you want to freeze up and not do anything. And is that the right way to go? When is movement appropriate?
Jarlo: Right. And I think with what you just said, that’s something important to talk about is like the pain itself creates stress and anxiety, but also too, that stress and anxiety can create more pain. So, it becomes this loop and it’s not just psychological. Even if there was a just psychological thing, stress, anxiety, all of those things are accompanied by hormonal changes. Cortisol increases, noradrenaline, all of that stuff. And it’s fully proven that those hormonal changes increase your pain. They do. It’s a physiological thing. Your nerves get more sensitive in that chemical mix. And also too, when that chemical mix or these kinds of inflammatory chemicals, all of this stuff that people talk about with swelling and all of that stuff too, that also creates more pain in itself.
Jarlo: Or creates that perception of threat to the brain because there’s actual nerve changes. So, imagine there’s signals to the brain that aren’t pain signals really. There are no straight up pain signals. What they are is information. It’s information to the brain. But if it’s flooded with all this bad information, then it’s going to think of a threat. Right. This is a long way of saying that what can we do right away? Well, we don’t want to say, “Just move and bear with it and just fucking go through it.” Because that’s not good. That’s not right. That’s just creating more of this bad information, bad news to the brain.
Rose: Okay. Let’s stop there for one second, because I feel like this is really key for everyone to hear about the whole work through pain. If it’s not that bad, keep going. Why is it so important not to do that, based on what you just said?
Jarlo: Because it becomes this loop of associating pain with movement. And if you associate pain with movement, then it becomes this sort of body memory and your brain is like, well, that movement always creates pain. It’s going to think that, if we’re going to answer from our side of the brain and go, it thinks, if you over and over again, this movement is associated with pain. Why wouldn’t it think that?
Rose: By stopping to do the thing that like pushing through the pain if you scale back, stay and safe ranges of motion, we know about brain neuro-plasticity. We can actually like change that-
Jarlo: Right. And that’s a super important empowering thing because it’s not just work through the pain and you’ll manage it and you’ll get through it. And then it won’t bother you as much. No, it’s actually, if you move within a certain range and give something, my friend Todd Hargrove calls, good news. Todd Hargrove, he wrote Better Movement, Move Better, all these books. Great. We’ll put it in the show notes. But he had a really good phrase that I liked, and it says, “You have to give your body good news.” And continue to give it good news with lots of reps, so it pushes away that association of pain with movement. And so one of the things there is, okay, so you’re saying I should move, but I have to rest. And I think that’s one of the thing there too is you should do as much as you can, as pain free as possible.
Jarlo: Now, if there, and we’ve talked a little bit about that, say when a person says, “But I’m always in pain.” So, there’s your baseline there. You move as much as you can, until it goes up past a bit, then you stop. Let’s say you’re always at a four out of 10 pain. I’m always in pain then and I should never move. No, it’s like, you should start doing things. But if that creeps up into a five and a six and you stop, let it go down, try again. But as soon as you move, it jumps up right away, then that’s it, you stop. There’s also this thing, and I don’t know if it has to be done with everybody or everyone should do it called graded motor imagery where you think about moving.
Jarlo: There’s lots of studies on visualization and motor control and all that stuff. And I think we even, you can see them in some of the popular literature. If you’re thinking about moving and you’re thinking about doing things, your body actually, some muscles are activated. You have some neuro input of even just practicing a movement in your head.
Rose: I feel like I’ve experienced this because I teach so many like-
Jarlo: That’s a good one.
Rose: … hand stand and tumbling classes that I’ve been able to pick up some moves that I don’t touch for years because I’m watching them happen all the time.
Jarlo: Yeah, watching them. And then going through with them in your head. This could be another podcast, but there was a lot of studies. One of the classic ones was basketball free throw shooting. They put a group of, I think it was kids. Might’ve been college, college age people that actually physically practice the free throw. Then they taught this other group to visualize it. And they had nearly the same progress.
Rose: Yeah. That’s crazy.
Jarlo: Yeah. And it’s not just, again, not just in your head and visualization, your body actually does things. When we talked a little bit about these postural muscles, like the transverse abdominis and the tinnitus, all of those things. There’s research saying that before we move, before we actually reach our hand out or put our leg out, those muscles fire, as soon as you think about it. Actually kind of woo-woo, but it seems like before you even think about it because it’s subconscious. There’s always the delay. Our brains are always on the delay. We think we’re thinking about it in this millisecond, but no, it was actually something that happened even before. When I first came across it, I was like, “Eh, thinking about movement, whatever.” But if you’re in serious pain and you can’t move at all, that’s awesome to know that you can do these visualizations and thinking about the imagery of moving can be helpful. It’s massive and empowering.
Rose: Okay. Something that you just said I want to branch off from which you talked about, like you’re about to move something and your muscles and your core start to fire. A big thing with people with low back pain, we hear all the time is that they’re told their core is weak. They need to strengthen their core to support their back. Is it like we can just do crunches and planks and that’s going to solve the problem. Can you talk about that relationship between the core and the back and like what that really means to-
Jarlo: Yeah. Again, this is part of the thing that seems like common sense. So, we have these small muscles in our backs and multifidus that are in the groove and the spine transverse abdominis, which is below your six pack, wraps around your spine like a corset. That’s the one where you breathe out or your brace. I remember back in the early ‘90s and through there, this was big and therapy and then went over into the personal training world. It’s like, “oh, you got to work on your core. That mean transverse abdominis, bracing, multifidus.” And sort of makes sense because of, yeah, we can brace all those areas in our spine, then we can protect it.
Jarlo: Yeah. Well, the research is yes, that motor control is off. When you have pain and you look at people who have low back pain, it seems like that stuff is not firing correctly is not firing before, like this speed forward like it should. Yeah, let’s train it. Let’s train it. But the research later on, it’s like, we got flipped. You have poor motor control and these things aren’t firing well, and these muscles aren’t working well because you have pain. It’s not that it’s not the either/or. It’s not like you have weakness and then that’s causing pain.
Rose: Right. That’s what we always think, is your core is not working. Your core is weak. That’s why you have back pain.
Jarlo: Right. But that’s also not to say that you shouldn’t work on it because you should. It’s supposed to happen. The reasoning behind it now isn’t that you fix this, you’re going to fix your pain. Is that you have pain and this is correlated with it. And it’s not the way it should be. You should work on it because it’s going to decrease all the bad news that’s going your spine. It’s also going to help the way you move in general. You’re supposed to have a good core strength and stability to be able to move and do things. Does that make sense?
Jarlo: It’s just reframing it. Don’t think, “Oh, I got to do lots of crunches and clenches and side planche.” Planks, not planche, if you can do planche, that’s pretty good. You have to do this and get strong. There’s lots of strong freaking people with pain. And I’m not saying I’m like, I’m super strong, but I was like that for a long time too. Again, this is the nuance. We’re not saying, “Don’t work on your core. Don’t work on anything.” We’re saying, “Realize what you’re doing, what you’re doing it for.” You’re doing it for so that you can move better because it’s really important to have that. You can see that. Would you rather have a floppy torso and would you rather have that or would you want it to be nice and strong and solid when you need it to so that you can do other things. That’s why we’re training it.
Jarlo: And then that correlates to improved decreased pain because now you’re able to move more and move well, move better and do more of that. Then you’re replacing all that bad news with the good news of movement. That’s one of the things.
Disc Bulge and Herniation
Jarlo: Let’s go back to a little bit more like the specifics. Say you have a disc bulge or someone told you, you have a disc bulge.
Rose: Or a herniation.
Jarlo: Or a herniation, or a slip disc, all these bad things. That’s another thing too, so much nocebo out there. Nocebo means the words that actually harm you because this information that as soon as someone tells you that, then you have this, “Aw man.” That’s what nocebo is. It’s not like we want to lie to people and say, “Oh, you don’t have a herniated disc.” But you want to tell them what it really means. What it really means is that in some positions there’s going to be more say stress or more inputs to your brain that comes from that area. We’re talking about the herniated disc, but let’s just talk about something that’s maybe a little bit more common for everyone to figure, you broke a bone. We’re not saying, “Oh, that broken bone is just all in your head and that pain doesn’t exist.” No, we’re saying you have to take stress off of that area leave it alone for a bit and let it heal and then do as much movement as you can.
Jarlo: The same thing with a herniated disc. The position there that could bother it more where you have less tolerance for, and we’ll talk a little bit more about tolerance later, is sitting, bending over, lifting, prolonged sitting in the car where your legs are up. That’s why driving is the worst for disc stuff because you’re sitting in a bad most, yeah we’re going to have to talk about ergonomics, but most cars you’re in this position that puts so much intra-abdominal pressure. And your leg is out, which also stretches those nerves out and creates even more. Your tolerance is low and then you’re putting yourself in this the worst place. That’s why it’s good to have that kind of information about herniated disc or if you have a stress fracture, that’s another thing too. That’s actually more common than you would think in the low back. You’ve worked with a lot of kids and teenagers. They’re really prone to that. Runners, gymnast all of that stuff, acrobats it’s just because that’s a straight up overuse thing there. Right?
Jarlo: That’s why it can be important to know these things, but also it should be tempered with, that doesn’t mean that you’re going to be in pain forever. And it doesn’t mean you’re screwed because the body does heal.
Rose: Right. And it doesn’t necessarily mean that your course of treatment is going to change. Like if you have a herniation or you just have some pain in your back but there’s no herniation, you’re probably going to treat it similarly.
Jarlo: And that’s the thing that people also think, “Well, if I have this, then I have to have this really specific course of therapy or rehab or exercise.” And actually most of it looks the same and you would think of it – It shouldn’t look the same, because it’s all different, but that’s not true what it is, yes those injuries and all of these things are different. But the reason why the good treatment, good therapy, good rehab, good movement looks the same. It’s because that’s what we want. We want to improve how you move your whole body, not just this one area, because all of that is what decreases your pain gets you more tolerant because that’s,
Jarlo: I think let’s talk a little bit more about tolerance now. They’re going back to, in therapy and especially when I went to school and got out of it, really like area focus. It’s this low back problem that’s caused by this facet and then I have to do this, this, this, and this.
Jarlo: Not saying it doesn’t work, it does, especially if you have a good patient therapist relationship, you’re doing all these other things, you’re doing what you need to do. But also later on, we got away from that and we talk more about movement tolerances and stuff like that. For the low back, especially it seemed very simple, but some people don’t tolerate flection, bending over, sitting that well. And then some people don’t tolerate extension, meaning standing up tall, walking, bending backwards. And so that led us to go. It doesn’t mean don’t do those things, but it means you have to find a way to gradually improve how they can do it or how they can handle it.
Jarlo: If you know your flexion intolerant, that means you have to set yourself up in a good way where if you know, you got to be sitting for a long time, well, adjust the chair and you do the ergonomic things so that you can sit in it and do your work and not kill yourself. Right. If you know your extension tolerant, that means, well, if you’re standing up … So this is the whole thing like, “Oh, you should stand instead of sit.”
Jarlo: Maybe. More important it’s better to not stay in one position.
Rose: Right exactly.
Jarlo: That’s the thing.
Rose: Move around.
Jarlo: So, if you know, you have trouble standing. That’s why there’s perching, perching is when you’re on a bar stool.
Rose: Mm-hmm (affirmative).
Jarlo: Perching, it’s that halfway or midway or three quarter way between sitting and standing or also why some people have, if they have standing desks, they also have a stool or something where they can put their foot up just a little bit. Those types of things, and I was that was a revelation. Its like, “Oh, we can really focus on what’s you’re less tolerant for.” So, we acknowledge that. It doesn’t mean we get rid of it, but we find ways that you can tolerate it more and then gradually build it up. That’s the thing we’re trying to gradually build up what you can do over time, that’s the key. And exercise does that, movement does that, exercise builds your tolerance.
Rose: Wait, wait, wait. This is the gold moment of this podcast right here people.
Jarlo: Is it?
Rose: Yes. Say that again. Say what exercises.
Jarlo: Yeah exercise builds your tolerance. It builds your ability to be resilient and handle all of these things that before was or maybe currently is perceived as a threat by your brain and the trouble is. And again, we can talk more about pain all the time, but in chronic pain people what’s happening is that tolerance is lower. Now, it’s not this whole pain threshold thing, which I hate because I have a high pain threshold or this person must have a low pain threshold. That’s not what it is. What it is, is there’s a certain level of activity either it’s sitting, walking, lifting weights, whatever locomotion, right exercise or if you go to it and beyond it, your brain thinks that’s a threat there’s pain there.
Jarlo: And then people that have chronic pain, that ceiling is lower. You have to be really aware the best thing and the most empowering thing to know is you can raise that ceiling, the brain by neuroplasticity, the brain changes, growth. That’s totally true. It just takes time, repetition, patience where you can, is this an actual thing where you can decrease your pain, improve your tolerance. It’s not just in your head. But if you have a herniated disc, you have this, you have that. It’s a little bit harder to deal with.
Rose: Right. But I really like that, that we often think about exercises, getting in shape or being fit or all these things, which are true. But also it makes our bodies more tolerant for everything.
Jarlo: This the whole exercise, the fountain of youth thing because it totally is the best medicine. We’ve talked about this all the time. The difference between someone that’s 60 years old, which is not that old can’t move, can’t get up and down. I’m not blaming their lifestyle or anything like that, but compare them and I’ve seen this. This is not just like made up story. 90-year-olds in hospitals who the only reason they’re in there is because they fell and broke something. Otherwise they’re spry and a lot of that is how active they were and continued to be. It is, man. If there’s a magic pill, it’s exercise.
Rose: Okay, so let’s-
Jarlo: Or movement. Everybody is like, “I hate exercise, hate the word exercise.” All right call it movement then. Jesus Christ.
Answers to Common Questions
Rose: You need to move. Let’s talk about the movement component for a second. I’m on the support staff at GMB. I get a lot of emails from people who are either in pain or had injuries or are currently dealing with injuries. And I want to kind of go through some of the questions that we get which I think your answers will help a lot of people.
Jarlo: Hit me.
Rose: And the first being, we talked about planks and crunches before, but why does something like locomotion? Our bear, our monkey, our frogger, the movements that are in our elements program and are now in our new mobility program as well. Why are these so helpful, almost more so than just a basic core program like that is like planks and sit ups and that stuff. Why are locomotion movements so helpful in back pain?
Jarlo: Right. Well, we talked about this a little bit earlier. It’s because it’s not just that one core muscle or two core muscles or three core muscles that are the cause of your pain. And that right there is the answer. It’s if it was then all you’d have to do is crunch. Like you said, then they wouldn’t even be looking for other things to do. Because, the emails that go all man I’ve been doing crunches and planks and all of these things for months and it’s not helpful. And so the distinction there is locomotion, you’re actually moving around and it’s good information for your brain. That’s the whole thing, replacing bad news with good news. We’re replacing those associations of pain with movement, with movement that is new novel. That’s another thing, a lot of research and actually good trainers and good systems out there realizing that it’s new movement that’s really helpful.
Jarlo: That’s why the worst thing before was all of this balance ball stuff. Remember when they were like, “You got to do all of these,” you’re standing in a ball or you’re squatting, people throwing balls at you and all that stuff that’s the extreme of this sort of novel movement. It doesn’t have to be like that. But it can be as simple as say doing the bear, say you’re on all fours, you got your butt up in the air and you’re moving around. And then you’re thinking about how I’m shifting weight side to side. You’re moving forward. That’s new information for the brain because we don’t walk around, chances are we all don’t walk around on hands and feet all day unless you’re a baby. That’s one thing is this new information. And if it’s done in a way, again that doesn’t have a lot of pain or maybe you start with pain and the best things, you start with pain, you do it. And it decreases. That’s the best.
Rose: We all want that. We all want that.
Jarlo: Right. As you do it, not even like, “Oh the day after,” but say we start it and it improves. That’s why I always say in our programs, the warm up,t’ the 10th repetition of it should feel better that your first then you know what you’re doing right. And flexibility work are saying the same thing for doing some dynamic contractions should feel better at the end. The same thing with the locomotion, if you’re doing it. And you’re like, “Oh, this is a little weird.” And we get lots of feedback from it. Like, “Oh, I started it. And then 10 seconds later it’s better.” That’s that new information that you want to give to your brain. That’s sort of the big answer to why locomotion, like bear, monkey, frogger and all this stuff seem to really help people almost right away.
Rose: And is it okay for people who have previous injuries to their back, current injuries, they’re recovering from, are our programs safe for them to use? Like our Mobility program or our Elements program, which is probably where we recommend you start.
Jarlo: Right. It’s a good question. And the answer for a lot of it is yes because not just the exercises themselves, but also our method as to how we tell you to do it. We don’t go no pain, no gain or work through it. We always say there’s adjustments to be made. You should continue to move and do the things and if you there’s a pain with it or have any bad sensations, you adjust it. Either you stop, do less and do sets of it where you have breaks in between. That’s one of our things we always say, “You know what you should do? You should put a timer, you should put a three minute timer, do what you can within it. Let the timer go when you have to rest, don’t be like, “Oh, I’ll pause.”
Rose: Right, just let it run.
Jarlo: Let it run. Do your things move because some days you’ll be able to do more. Some days you won’t be able to do more, you’ll be doing less, but that doesn’t change how you’re doing. That’s to me is really freeing. And what it’s really meant by when Ryan says, “Don’t worry about sets and reps.” It’s not that you don’t do sets and reps. It’s not that you don’t do repetitions of things, is that you be really mindful of what’s happening while you do it and don’t be restrained with, “Oh, I got to do three sets of 10 today. I got to do it. I got to do it.”
Rose: No matter what, even if-
Jarlo: No matter what. Well, what if you’re feeling great? Why don’t you do more? So, let’s think about that way. Let’s think about it as if it could be limiting, but also why force yourself to do three steps of 10. If that day is not good, why do you want to make yourself worse? It actually does make yourself worse. It’s the method of our programs and the GMB Method that makes this most likely safe for you to do, not just the exercises.
Rose: Because you’re talking about what we call autoregulation, which is paying attention to how you feel and making adjustments off of how you feel. And this is what you talked about earlier in that, if you feel pain, you don’t want to reinforce that pain pattern. And why stopping, changing what you’re doing, taking a break, doing less will reinforce that good information coming in, which will hopefully move you forward and out of that pain.
Jarlo: Correct. This is another thing too. We’re not saying don’t work hard or as soon as you break a sweat or feel fatigued, stop. No, we’re talking about pain. There’s a difference and you know, there’s a difference. We all know there’s a difference. We’re not saying don’t work hard. That’s another thing too. We’re not pushing it where you’re not improving. Because another reason with exercise building tolerance is that you do push yourself when you can, you should push yourself when you can, you should. But say it again, you should push yourself when you can. This is why it’s really important to understand what pain is. Pain isn’t like discomfort, burning muscles, breathing hard. That’s not pain. Oh, man. I’m on the new, I told you the other day, I’m on a rowing program. If I would stop whenever discomfort I wouldn’t even last five minutes.
Rose: That’s the same with most people in running.
Rose: Just so uncomfortable in the beginning.
Jarlo: Running there’s a big difference within your running and then you have this sharp pain in your foot and you just keep going or you’re running and it’s freaking hard to breathe and you’re like, “Crap.” And you’re on the six mile and you got another two to go and you just want to stop. That’s not pain. Come on now. Let’s just get that out of the way. And I think let’s give the benefit of the doubt to people that do say things like no pain, no gain. That’s what they’re really talking about. If you’re talking about does this person really trying to help you. They’re saying that. Hopefully they’re not saying, “Oh yeah, I don’t care if you hurt your shoulder, keep going.”
Rose: Right. Exactly. It’s exercise at some level when you’re pushing yourself is going to be uncomfortable.
Jarlo: Yes and it should be. That’s how you grow. That’s how you grow more tolerant. But pain is something different. Pain is something different.
Rose: Okay. With thinking about locomotion exercises, we have to talk about the squat and there’s a lot of, talk in the fitness industry and even within our client base about what is a good squat? When I squat my back is really round. Is that okay? If I’m squatting with a load on my back, like I’m back squatting with a barbell, how low should I be going? What if there’s a butt wink? There’s just so much around the squat. Can we talk a little bit about what is good for the low back with squatting and what’s not.
Jarlo: I’m going to repeat this again and again, it’s tolerance. And we’ve talked about this a little bit before with the back wink and as your back is rounded out, if you are on the bodyweight, squat and your back rounds out. You’re probably fine. The problem is if you’re just getting used to squatting and squatting that low and your back rounds out and you keep going too much, that’s the problem. That’s the tolerance thing. And that’s why we always talk about auto regulation and being really mindful. For me, how many years or for you. That’s the thing too. I’m flexible enough and my back very rarely rounds out at the bottom of a squat, but that’s not-
Rose: I was going to say.
Jarlo: That doesn’t mean that’s why I can do it and do it for a long time. It’s because I’m used to it. Even if my back did round that more and it does. What is that thing where this is squat, where your butt is fully on the ground, but your feet are still fully on the ground?
Rose: Mm-hmm (affirmative).
Jarlo: Right. It’s hard to do. Not a lot of people can do that. My back has to round at that. It fucking has to.
Rose: But if you all looked at our squats, Jarlo and I next to each other, we have completely different squats. Jarlo is able to get really low with his back flat. I’m able to get pretty low. My back probably never going to be flat and I’m okay with that, but I can do 20 minutes of locomotion without stopping and my back does not bother me.
Jarlo: Because you’re used to it. You’re tolerant. And so that’s another thing with like, people say, there’s just starting our programs. And they say, “I like it. It’s great.” But then I do these squats or do these locomotion and I feel it. It’s not a lot of pain.
Rose: It’s sore or tight.
Jarlo: It’s sore. That’s perfectly normal, man. It’s the whole thing of I’m using muscle I didn’t know I have type of thing its cause it’s new for you. It’s straight up new for you. Let’s go back to this whole butt wink thing with loaded squats. It can be bad if you’re not used to it also too uou’re probably going to lose a little bit of power because you don’t have that kind of good alignment. But let’s look at Olympic weightlifters and it doesn’t even matter if they’re like amateur or world class, straight up Olympic Games. And they are putting themselves with there at the bottom of the snatch and bottom of a clean, they are fully rounded out with hundred pounds over their head. I’m not saying that they are a hundred percent perfect, but they can do that and they’re not dead. That’s going to tell you something right there. It’s tolerance. It’s tolerance. What can your body do? It’s why we build calluses. It’s why bones heal. Exercise builds tolerance, movements build tolerance. That’s all it is.
Rose: Okay. Another question about tolerance for our lifters out there because we do have quite a few people who come to us who they lift weights in some way, whether it’s Olympic lifting or just lifting at the gym for their workouts. What about things like weight belts? I see a lot of fellow trainers and people at the gym who use belts when they’re either dead lifting or squatting. What do you think about that?
Jarlo: Well, I use a belt. I use a belt, when I’m really lifting heavy. Because it does help you lift heavier weights. You can’t deny it. Does it help back pain or does it help you not get injured?
Rose: Does it protect you? Yeah.
Jarlo: Right. Probably not. Unless, and this is the whole thing you really feel it does. If you have it in your head, that I have to wear this belt or I’m going to get hurt, well yeah.
Rose: You should probably wear it then.
Jarlo:You should probably wear it. I’m not making fun of people because I was one of those. I was religious. I’m like, “I need my belt.” I have a lever belt. A lever belt is a power lifting belt, has a thick lever and has a lever. You just put the hooks in and then you lever it shut. If you don’t know it, it’s the best thing in the world. Because I don’t have to put the prongs in. I had that for … When did I buy it? I was in PT school in 1996. I’ve had this belt probably older than some of the people listening. I love that thing. I love it. If I went to the gym, I didn’t have it. I drove back home. And it’s probably not as helpful as you think.
Rose: Got it. Okay. Why does stretching or doing flexibility work on your hips often help with low back pain?
Jarlo: That’s a good one. And as part of that whole, what type of sensations and news is going towards your back. Now, if your hips are tight, that means you’re going to have to move. That’s the whole thing. It’s the chain, the chain link thing. If you’re stiff and all of these links of the chain, the rusted and the rusted here then the one that can move, get overworked, overuse there and then they become less tolerant or they aren’t as tolerant as all of that, those inputs. If you can have flexible hips, strong hips, you’re taking away the stresses to your back. That’s just as simple as that.
Rose: So, a great tool for a lot of our clients who have low back pain is our hip mobility sequence.
Jarlo: Yeah because-
Rose: A lot of people feel a difference from that.
Jarlo: That will help until your back can get all these inputs and gradually improve its tolerance. That’s why right away it helps because you’re taking away some of that stress. It’s sort of like this magic thing was like, “Oh, why is that helping my back so much. I only did a few times.” It’s cause one you’re moving, movement is great, but two is yeah, you’re decreasing all of those kind of bad inputs or not bad, but you know what I’m saying?
Jarlo: And then you’re allowing yourself now that it feels better, you’re probably walking more, you’re probably doing more and you’re doing more with less pain and that’s a positive feedback loop. Or as before you do something and it hurts, then you got this negative feedback loop. It’s not something where like, “Oh, I figured out the magic thing.” Just do this exercise and you’re going to feel better. There’s a lot to it.
Rose: Last question because we have a lot of desk jockey, we have a lot of people who sit for a majority of the day. I mean, at this point, you and I sit a lot for a lot of the day, we’re on the computer a lot. We hear a lot about like, “Oh, I need to set up my desk ergonomically.” And we kind of talked about that with the standing versus sitting desk. How important are ergonomics really relative to just getting up and moving more and not being sitting somehow.
Jarlo: If it’s relative to getting up and moving more, then there’s no question. Don’t even worry about it. If you can get up and move more, that’s it. That’s the thing. The trouble is a lot of people can’t, so that’s the trouble and even though people are well meaning like, “Yeah, get up and move, man. Just move, set the timer,” of course. But there’s some people in jobs, they can’t, they literally can’t either you’re a truck driver. You’re long haul. How are you going to do that? It’s easy for someone to say only drive a few miles and then get out. This person has to get their work done. Even the same thing in like offices. You’re working, you can’t disrupt it. You can’t disrupt it every five minutes of every hour, you can’t. That’s where ergonomics is super important.
Jarlo:So, ergonomics is sort of this external way of improving your tolerance because you’re all set up. That’s why posture, when we say posture is important because posture good, bad, whatever doesn’t create pain. It doesn’t. But can you remain in these postures that you need to have happen for your work, for your activities? Then yes posture is important. Does that make sense?
Rose: Yeah. We’ll touch on that more with the upper back and neck.
Jarlo: Yeah. We’re going to do, that’s why we have to … There’s so much, that could be like three hours, but that’s where ergonomics is super important. And I have a few friends, therapists that, that’s a big part of their work and I’m sure they’ll say the same thing. It’s like, “Yeah we could tell this people, oh, don’t worry about it. Just move around go up and down. But you can’t.” To just say that is just being disingenuous. And then just trying to project your own things to people, that’s like saying get a different job. Thanks for saying that.
Rose: Right. Not helpful.
Jarlo: Not helpful, not helpful at all. Was that good? That was a lot.
Rose: Yeah. The low back is a lot.
Jarlo: And that’s why I kind of wanted to separate this out. Have this pain conversation again. We have an article on GMB that I wrote a few years ago on pain and it’s really good. I’m probably going to update it and actually because of a little bit more research, but it helps. We have our spine article, lower back. We have all these things, the hip one that you mentioned, we’ll put this in the show notes. But I think this was really good to trying to help people understand where it’s coming from and what they can do about it. That’s the thing. What can you do about it? I don’t want to just give an anatomy lecture for an hour. That’s not helpful at all. These questions we did and I think we’re really good.
Rose: Yeah. And if people still have more questions or they’re working with our programs and they need help, they’ve got pain, they’re trying to work with it and you can always email us at firstname.lastname@example.org and we can see if we can help you.
Jarlo: Awesome. Well, thanks so much, everybody. Hope that was useful. Yeah, like Rose said, if you have any questions or comments or even praise for us, please write us and drop us an email. Facebook comment, Instagram, all that stuff. Well, thanks a lot. Thank you, Rose.
Rose: Thank you.
Transcript for Part 2 – Thoracic
Jarlo: Hello, everybody. Welcome to the GMB fitness podcast. My name is Jarlo Ilano, I’m the co-founder of GMB Fitness. Here again with my friend and GMB lead trainer, Rose Calucchia. Hello Rose.
Jarlo: So in this GMB Fitness Podcast, and again, GMB for those who are just tuning in, stands for Glue My Boots. That’s Glue My Boots Fitness. I think that’s what it is.
Jarlo: So Rose, what are we going to talk about today?
Rose: We are doing our second installment of the spine today. So we’re going to be talking about the upper back, the thoracic spine and the neck, the cervical spine.
Jarlo: Yeah. So the last one, if you guys have… And women, sorry, this gender normative stuff, it’s just so hard to break for you. It’s just terrible. If you guys saw our, listened to it before, we did a good hour, it was a general overview of the spine and then more specifically about the low back, a lot on pain and a lot of trying to dispel a lot of myths about it and hopefully empower people. Because low back pains, spine pains, so prevalent. The percentages are ridiculous, 80% of everyone.
Jarlo: It would have been too much to include the upper back, mid back and neck, cervical and thoracic spine. So we had decided to have a second part and also this part, we’ll go over a review a little bit of what we said last time in terms of the pain response and the output of it and perception of it. But we’re going to do a lot more actionable things of answering, why does it hurt? So what can I do about it? And more specific kinds of things, talking about posture, ergonomics and all of that.
Overview of Upper Back
Jarlo: So for the neck and the upper back, cervical spine, neck, from the base of your skull, seven vertebrae to the traps, right? That’s basically those seven points, C one two, three, four, five, six, seven. Then it turns into thoracic spine has 12 vertebrae. The thing with this and why it causes so much trouble or is perceived as causing so much trouble, is whether you’re sitting or you’re lying down or you’re doing things, you’re reaching overhead. You’re twisting, you’re looking around. I mean, I can’t imagine anything that you do during the day that doesn’t involve your spine, especially your neck, especially your upper back, your thoracic.
Jarlo: Then there’s always that thing where along with that, you have this bowling ball, you have this eight to 12 pound, right? Bowling ball on the top of your spine. To me, that’s always kind of facetious because yeah, we have it, but we also had it since we were born. So it’s not going to be… It’s not a thing where all of a sudden you have a bowling ball on top of your spine. You should be used to it by now. That’s the whole thing. But it’s true though, because it magnifies thing. The leverage is there. If you have something where you hurt your neck or you’re hurt your upper back, having to haul your head around with it, doesn’t help.
Rose: It is really hard.
Jarlo: It’s really hard. But at the same time, you shouldn’t be lying down all the time. So there’s that then there’s also what position do you have to take during the day? We talked about this a little bit. Should you have a standing desk? Should you be sitting? What’s the optimal position for you when you’re working? And there really isn’t one. It’s better to move around, right? It’s better to get up and move around every a half hour. Whatever feels best for you. But for a lot of us, that’s just not possible, right? It would disrupt your work that you have to do so much that it would… Not even about productivity and doing all these things, but you simply have to do your work, you have to do things. You have to live your life.
Jarlo: So there has to be different ways to adapt for yourself. Okay. Now let’s have the example of a truck driver or someone who works in delivery. That’s happening a lot now, right? Everyone’s getting stuff delivered. Say it takes 30 minutes to go somewhere, but you have problems within five minutes, 10 minutes. Are you supposed to stop at 10 minutes, get out of the car and move around? It’s not feasible, it’s not feasible. So that’s another thing too, is why these issues… And if you have problems and they can seem to last a long time and they do last a long time, it’s because we are supposed to do stuff or we have to do stuff. We have responsibilities.
Jarlo: So it’s much better to give people options and information so that they can understand that versus, “Oh, you have to sit this way. Everything got to be at eye level, right? 90 degrees here, 90 degrees there.” That’s the misconception about ergonomics and people that are really well trained in ergonomics… There’s specialists in that and then they go and… The really good ones aren’t going to say that. No way. That’s just wrong, man. Right? But it could be what people perceive is that. Right? Especially if they read a blurb here that, sitting is the new smoking, type of thing. Sure.
Jarlo: So I just want kind of get that out of the way and also too some of the things with, why is it an issue for a lot of people? Is the protective mechanism that we talked about in the last one. What your brain perceives as a threat is going to cause pain and other reactions, because pain really is a reaction. It’s your body, it’s your brain’s way of trying to help the situation. Right? Pain is actually a good thing, right? It’s the overreaction and overprotection that causes the problem, right? The classic example is you want to have pain when say you touch a hot stove.
Jarlo: If you didn’t have a paint response, then you’re really going to hurt yourself. Right? But, a lot of things, the body, can say it overreacts. Because it wants to be protective and all of that. One of the things in the spine, that’s because of all the small muscles around it, all the connections, right? The groove of the spine, the small muscles and then they have to connect to the ribs and everything. Those small muscles can guard and spasm up. I think Rose you brought up the example when you wake up in the morning and you have the crick in your neck.
Rose: Yeah. You can’t turn your head.
Jarlo: You can’t turn your head. You didn’t injure yourself in the night sleeping, that’s… Well, maybe you could have, but I think that’s very rare. What probably happened is that your body got into position where you’re sleeping and the receptors there, the sensation of the nerves, it had something that either you had a history of it… That’s another thing. If you have a history of injury, neck pain, upper back pain, low back pain, that was significant, right? Maybe you were in a car accident, that’s a huge one. It’s traumatic, right? It was sudden, right? It’s not so much the woowoo thing of your body holds a memory of it. But you can say that, but it’s more like it got sensitized to it. Right?
Jarlo: Got sensitized to it, especially in car accidents where there’s that overstretched whiplash kind of thing. Right? And your joints kind of move more than they should. Your muscles get that speed of unexpectedness. Okay. I think one of the theories, and I think it’s a good one, is that when you sleep, everything’s relaxed. Right? But you’re in a position where it gets overstretched. Right? You get out of this support, a neutral zone where your body thinks it’s okay. Then you get out of it, then how is your body going to react? It’s going to react like you got injured, but you didn’t really get injured. And so what is the reaction? The spasming, the guarding, that whole thing of, “Look, my back is out of place.” That’s the thing. That’s-
Rose: Right. Or I threw my back out or I threw my neck out.
Jarlo: Yeah. Threw my neck out, threw my back out. Those are the things that people say and maybe people told them that. And what it feels like to you too, it feels like it.
Rose: Right. It feels injured. It feels like a big deal.
Jarlo: Right. And it’s not, we’re not saying it’s not real, because it absolutely is real, but it’s not an injury. Right?
Rose: Okay. So before we talk about what’s going on and how to fix it, can you talk a little bit about… Especially in the thoracic spine, is this kind of unknown area of our backs where our shoulders kind of connect and sit and then the relationship between our neck and our upper back, if they’re closely linked. So could you just talk a little bit about how that whole area kind of works together for the shoulders and everything else.
Rose: In the training world for a long time, we’ve been fixated on the thoracic spine and getting the thoracic spine moving better, because it helps with shoulder mobility and all these things. Could you just talk about that for a little bit and then we can talk about what goes wrong.
Jarlo: Yeah. I think it’s really easy to get into the weeds of it, but one of the things and with these connections to be sure… One of the kind of controversies in the past, probably 20 years or so is the whole posture thing. Here’s a plug. So, my friend Steven Low, he wrote Overcome Gravity and does all these things, a couple of years ago he approached me and we got together and we made Overcoming Poor Posture, this book. That was funny too, because even the title got people just freaking into fits. Posture doesn’t matter, posture isn’t related to pain and yeah, we say that in the book. They immediately judged it based on the title.
Jarlo: But anyway, yeah. Posture and all of that, isn’t related to pain. It isn’t, but it is related to function and performance and how you can do things. Right? Okay. This goes back to, what we said a little bit in the last one, is disregarding pain or even all of these things. Most of us have what they call a directional preference, especially in terms of… This comes from the whole pain thing. When you have low back pain, when you have certain kinds of things, is when we see these most of the time, they have a preference for what feels good and what feels bad.
Jarlo: So a directional preference reflection means you feel better when you’re sitting, you feel better kind of when you’re curled up, you don’t feel good when you’re trying to arch back or walk or stand. Right? Do bridges. If we go into the training aspect, overhead presses, that’s all kind of extension stuff that bothers you. It bothers you because like we said, you can’t tolerate it, you got to build up to it. Having an extension preference is the other way where you feel better when you’re standing, walking, doing tons of stuff like that. Dead-lifts bending over, even squatting to some extent, isn’t great and if you do too much of that, you’re going to have problems.
Jarlo: So that’s clearly the connection there and kind of a roundabout way of saying this for the neck and upper back. What are the connection to the shoulders? What are the connection to your arms? Right? To your legs and everything else. Is because that’s part of it. How our spine is… And I’m not saying you have to be neutral and you have this perfect posture, but it affects everything else because how you move and the muscular attachments and all of these things with a joint position, how you move in your arms and your legs is directly related to the position that you want to be in, in your spine. Right?
Jarlo: If you are hunched over and we can… This is a really classic thing. Okay. Everyone sit up, sit up tall, wherever you’re at or stamp and reach up, keep your chest up, reach up. Okay. So see how much you can do it. You should probably do pretty well. Now when you sit, sit down, hunch really round your back out, fold your chest over, just being what they call the worst posture, slumped posture, then lift up. Immediately you’ll see that you can’t reach up as far.
Jarlo: It’s just a structural thing. Right? Now imagine that you are trying to do things like put weight overhead or even as simple as reach up into a cabinet and put a few plates up there.
Rose: Right. Put your suitcase up.
Jarlo: Right. Put your suitcase. The whole overhead bin thing.
Jarlo: Which maybe people aren’t doing as much right now.
Rose: Right. Are they even… I was reading this article, Sea–Tac, Seattle Tacoma airport is down 75% or whatever. I’m like, “Why are people even flying anyway?” I don’t even get it anyway. But that’s the thing is you can even look at it and just physics. It’s a structural thing. You just can’t. Or you can do it, but it’s way more uncomfortable because it’s just not… You’re not in a good position.
Rose: That’s when it’s related to performance and maybe pain because imagine yourself doing that and you’re not used to it already, or you already have a little bit of pain, you already have some issues. Then that’s compounding it. That’s where we talk about the importance of ergonomics and posture, not that isn’t directly related to pain, but it does affect it. Because if you can’t move in the-
Jarlo: Right, if you can’t move in the way you want to move or it’s uncomfortable, then yeah, your brain is going to perceive it as a threat. This makes sense. That’s probably the best way to think about it. Because otherwise, if you want to know a big discussion on why everything is connected, then got to talk about nerve roots. You got to talk about referred pain. You got to talk about all kinds of things. I think one of the best ways to think about it is the position of your spine and your ability to move it, right? It’s choices. So having, we talked about this a little bit in the posture book and all throughout our writings, posture and all of that and mobility and flexibility and fitness in general just gives you more options to move.
Jarlo: So it seems pretty common sense to think… If you have less options in your ability to move, stretch, be flexible, be mobile, then you’re limiting yourself to only certain amount of actions. Any time you have to do things or want to do things that are outside of that set of reactions or a set of actions, then you’re going to have a hard time.
Jarlo: I think that’s the simplest way to do it and that’s why I’ve always said for flexibility, it’s simply flexibility work, simply a way for you to find how to get more motion in the things you want to do.
Rose: It gives you more options.
Jarlo: “Stretching doesn’t work.” What do you mean stretching doesn’t work?
Rose: Oh, we could have whole podcast episode of that.
Jarlo: Right. I think we will because you pass that out. Stretching doesn’t work. For what? What do you mean by, it doesn’t work? Right? It doesn’t mean anything to me when you say that. All right. So I think that’s kind of a roundabout way, but maybe let’s think about that way we’re affected in all of our… Through all our body by what our spine can do, just because of the limitation of choices and myths that happen because you can’t do certain things or you’re not tolerating certain things. That’s the thing that we want to talk about.
Rose: Right. We’re going to get into that.
Jarlo: You can change this. Right? You can change this.
Rose: Yeah. We’re going to get into that.
When to See a Doctor
Rose: But before we get to that, can you talk about when? Okay, so for example, we talked about the waking up with a stiff neck thing where you can’t turn your head. And even though it feels like an injury, it’s probably not a real injury. It’s just a protective mechanism, your body is guarding. But how do you know when to see a doctor? We talked about this for lower back, but with the upper back or the neck, how do you know when it’s bad enough to go see somebody?
Jarlo: Right. Well, one of the things, and I’m not sure if we specifically said this, but one of the obvious things is there was a trauma, you fell down, right? I think we need to say that. You fell down, right? You hit yourself, something hit you. Right? There’s pain there. It’s not getting any better. That’s for sure. Right? Trauma. It’s the same thing for your neck or your upper back as your elbow. You fell down, right? You bang your elbow. It’s swollen, super hard, super much and you have trouble moving it. I’m pretty sure you’re going to go see somebody. Right? Um, But this is another thing. It’s like yeah, you’ll get an x-ray, broken blah, blah, blah. The thing is getting imaging for the spine. Right? MRIs. And x-rays. That’s a whole other can of worms, right?
Jarlo: Usually, yeah. But there’s that, then also there’s… If there’s a trauma there, that makes sense. There’s also, if you get pain that seems outrageous and comes out of nowhere, right? Come down out nowhere, maybe wakes you up in the middle of the night. Those are the red flag things that could be saying it’s coming from something else. It’s coming from something else. And this is also the thing of pain as a protective mechanism.
Jarlo: When it’s working correctly is absolutely necessary. Because then now you’re talking about things and this is really difficult to say, and always the worst case scenario, Google your symptoms. Right? Then you have cancer, you have tumors, you have all of these things, but sometimes it happens. That’s why it’s always really risky to say, “Oh, you don’t need to go see a doctor.” Again, this is why most people will disclaim everything they say with, “You should go see a doctor.” Because, they want to cover themselves.
Rose: Right. And I mean, even on support on GMB, when we answer emails. So people ask, “This is what’s going on with me. What do you think?” It’s like, “Well, I can’t really tell you, because I’m not a doctor and I’m not even seeing you in person, but here’s some things you could try.” But it’s always a good idea if you’re concerned to go see-
Jarlo: Oh yeah, absolutely. And it’s more just like, “Oh, we have to cover our ass.” It’s always a disclaimer. It’s just true.
Jarlo: It’s just true. But there’s also… We can’t just do that and never answer anything.
Jarlo: Then the worst thing is to say, “Oh, I can’t help you here. You got to go see a doctor.” And then don’t give any kind of other options. We don’t want to do that. Definitely this podcast would be five minutes long.
Jarlo: Here’s all the things wrong with you. Go see a doctor.
Rose: Good luck.
Jarlo: Good luck.
Rose: Okay. That makes a lot of sense. I hear a lot of times where people will say things like with respect to a pain in their upper back like, “Oh, I think I have a rib out of place.” Or with their neck like, “Oh, I must have pinched a nerve.” Is that what’s really happening? Or is it just the guarding that’s usually happening?
Jarlo: Yeah. Most likely that’s not what’s happening. But these things get introduced into the culture from a lot of times, either well-meaning people or maybe that’s just sort of the way it was thought of before. Right? The whole back out of place. And yeah, kind of came from bone setters, chiropractors, that type of thing. Plus that’s what it feels like.
Rose: Right. It’s a good descriptor.
Jarlo: It’s a good descriptor. That’s another thing that I kind of want to talk about is when you are listening to people, talk about pain, talk about why you might have pain. There’s lots of good analogies and metaphors out there and stories that seem right. Right? The back out of place, all of these things, and that’s why people hold on to it. Because they’re like, “Yeah, that perfectly describes what’s happening.” You listen more and you kind of hold onto it.
Jarlo: So the purpose of this podcast and all the writings in this, all the kind of pain science education that’s happening and over the last 20 odd years is giving it more of a real scientific basis. Right? And kind of, I won’t say replacing, but giving better analogy. So people kind of understand and more empowering stuff. So let’s talk about the back or your neck or your rib out of place. That implies that you have to put it back in place.
Jarlo: Can you do that yourself? Or do you got to go find somebody? Blah, blah, blah. Right? Knowing that, that’s probably not the case 99% of the time, not the case, I think is empowering because that means you can do something for yourself. It also means that, that’s not something that’s just happening to you. Right? But I think the main thing is that it feels right. It makes sense. And so you’re going to listen to it. That’s a whole nocebo thing that we talked about a little bit. If people are telling you, “Well, that means you have the arthritis because you’re 46 now.” Or, “You’re 47 now.” Or whatever. “Your discs are dry. Right? You have this low height. Your vertebrae is slightly out of place. So it’s a messing up your whole spine.” That’s bad information, in my opinion. That’s not good information for you. Because, that implies you got to get fixed.
Rose: Right. That there’s something wrong.
Jarlo: There’s something wrong with you. If you don’t get it fixed in the right way, then you’re going to have problems forever. That’s the nocebo, right? Now I’m not saying you go to a particular person, this happened with something we talked about before, with you and your wrist and you got some work done on it. Right? And perhaps the person said this thing that wasn’t totally correct.
Rose: Right. It wasn’t moving quite right.
Jarlo: Right. Or the bones and this and the bones. Nothing, sit there, just kind of an example. But you improved, you got better and it helped you to move better and it helped you to get back into exercise and it helped. I would to be just as bad to say, “Oh, that’s not right. You didn’t get helped.”
Jarlo: Yeah, you did. And so that’s the other extreme of people talking about this. Like, “Oh, all everyone is quacks unless they do this certain thing. Oh, they’re just trying to get your money unless they do this exact thing that was in this study.”
Rose: Right. “This technique is good. This technique is bad”-
Jarlo: Right, this technique.
Jarlo: Right. That’s the other extreme. But I think as long as the intent is right, as long as it’s not making this person, this patient kind of dependent on something and it’s not making them feel bad and less empowered, then yeah. You should listen to this person that was trying to help you. The main thing is all of those things of these treatments, these initial things, this goes… Everyone that’s in healthcare, professional fitness thing, will tell you how do people get out of pain and manage it? Well, not just manage it, but actually feel better and do things if they incorporated exercise into their treatment and they continue to do that for their lives. That’s it. Everything else sort of helps you get to that.
Jarlo: This is also what we’re going to talk about. That doesn’t mean no pain, no gain. “Oh you got to exercise, even though it hurts.” That’s not what we’re saying, either. You have to find your ways to get moving, to feel better about it and then gradually improve the tolerance thing.
What We Can Do Ourselves
Rose: Okay. So let’s start, let’s now shift into what we can do for ourselves. So we’re recording this in the time of COVID, we can’t really get to doctors or physical therapists easily right now. Right? So let’s say okay, tomorrow, one of us wakes up and our neck is really stiff or we can’t turn her head or it’s really sensitive or something’s tight in our upper back. When we take a deep breath, it feels like a pinching or pulling. What are some things that we can do right now at home to sort of self-treat? Are you supposed to not move at all? Should you move? How much should you move?
Jarlo: Right, exactly. The not moving at all thing is probably the worst thing you can do, I think. Right?
Rose: Why do you think that?
Jarlo: Because it sort of gets you into this cycle of, “I’m not going to move because it hurts. If I move this much, it hurts. So I’m not going to move at all. What you’re doing is you’re narrowing that choice that you have and you get into this vicious cycle of, “Okay, I’m not moving this way. I’m not moving at all.” And then that range of motion decreases. It could be really slow over time, but it’ll eventually get to where you can’t move. You feel like you can’t move at all without any kind of pain at all. That’s why it’s bad. Right?
Jarlo: Research after research and even anecdote after anecdote is if you move as much as you can, within this pain-free or just a little bit discomfort, blood flow improves, right? You got these natural endogenous chemicals that are pain relievers in themselves, right? The runner’s high thing, the feeling good of exercising, the blood flow of improved oxygen, all of these things, circulation. You’re flushing out those inflammatory, if there are, if there was inflammatory chemicals there, if there are those sorts of chemical things there. If you’ve had swelling and all of that, swelling.
Jarlo: So now we’re kind of mixing up examples, but I think this is a good one. Say you have some swollen ankle, you’ll have a swollen wrist or whatever that stops you from moving your body. Thinks it’s broken. Right? Within that swelling are actual chemicals that irritate the nerves and cause pain and blah, blah, blah, right? Blood flow, moving, flushes those out. It’s the same thing to a lesser extent in the spine. You probably don’t see a big bulged swelling.
Jarlo: But likely those chemicals are there. Right. So that’s why not moving at all, is bad.
Rose: But you want to stay within ranges of motion that aren’t super painful.
Jarlo: The majority of the time. So this is another thing we want to talk about. It’s just like training. Strength training. Flexibility training, skill training. You have to get some kind of adapt… The only way to get some kind of adaptive stimulus is to go past a certain point, right? So you should, for the example of the crick in your neck, you should move as much as you can with that pain-free motion, much as you can, many reps can, just do it. And sometimes go past that a little bit. So say you have there’s zero to 10. 10 out of 10 pain is the worst. Zero is nothing.
Jarlo: You shouldn’t be at the zero or one or two. You should probably be at around a three or four occasionally. Right? Because you want to move as much as you can, give your body good news. Occasionally it’s… I don’t want to say test it, but yeah, go out and try and do a little bit more, but don’t bang your head against it, bang your head against the wall over and over. That’s worse too. Let’s go back to the exercise analogy, right? Yeah. You want to work out, be uncomfortable, but then you want to back off, don’t want to do too much. Three sets is good, oh five sets, six sets, seven sets. It’s better. Not if you’re not used to it. That’s the whole thing. With pain it’s the same thing. You want to go above it a little bit, drop down. Go above it a little bit, drop down. So that it improves that there’s that adaptive stimulus.
Jarlo: So thinking about that, I think helps how much movement do you do, it is right there. You sort of do as much as you can. Pain-free as much as you can. Right? And then it starts to bother you. That’s good. Then you back off. Right? Then you try again, but you don’t just start banging into it. Bang, bang. That’s too much. So now we’re at the extreme of you did too much versus you did nothing at all.
Upper Back Issues and Training
Rose: Right. Okay. So let’s take a training example since we’re going in that direction. So if people have pain that they’re working with right now, we can put in the show notes, we have a great neck routine, have all kinds of articles on the spine, routines for back stuff so that people can start working on those types of movements. But let’s talk about like bigger movements, like training movements. A lot of what we do at GMB, it’s time on our hands, handstands, different locomotions, where we’re in an overhead position, in our vitamin and Mobius programs, we have rolling, which a lot of adults don’t do regularly.
Rose: A lot of people say, “I shouldn’t do any overhead movement. It’s really bad for me. It’s compression on my neck. It’s kind of too much compression on my upper back.” Or, “I shouldn’t be rolling because it’s going to hurt my neck or it does hurt my neck.”
Rose: So how can we start training these things? First of all, are they bad for us? Second of all, if they’re not, how do we train them in a way that doesn’t hurt, basically?
Jarlo: Right. Well, first of all, most of the time, they’re not bad for us. They can be bad for us when, just like what we said, you can’t tolerate them and you overdo it. Right? That’s common sense. The thing that I think we’re really asking ourselves is what does overdoing it mean? The only way you can decide or you can figure that out is if you have a baseline. Right? When someone says, let’s do the rolling, for example, “Every time I do these rolling, it hurts.” Okay. So let’s break that down. How many times did you do it? What did you do? Right? Did you try something else? All of these things… You need more information-
Rose: What variation did you do?
Jarlo: Right. What variation did you do? How much weight did you do? How much risk did you have? So you need a baseline. We’re not saying that you are not experiencing pain or discomfort or having issue and you should just deal with it. That’s not what you’re saying. We’re saying you should get as much information about it so that you can find out where your tolerance level is and then we can plan from it. So this is our whole thing in our GMB method of the five Ps, where at the end, there’s that ponder. Being really mindful of what you’re doing rather than, oh, if the program says, “I want to do this for three minutes.” So I’m going to do it. Right? I’m going to do it for three minutes because that’s what the program says.
Jarlo: That’s not what we’re saying. This is being pondering, thinking about it, being mindful is what’s going to help and what’s going to help you too. The easiest thing to do is to say, when someone says, “Rolling, it’s really bothering me every time I do it, I get hurt. It’s like this, I feel this.” The easiest thing to do is to say, “Well, don’t do it.”
Jarlo: Don’t do it. But how helpful is that? That’s not helpful because they’re obviously interested in doing it because they’re doing the program. They’re asking about it, right? So this requires a little bit of effort. It’s only a little bit because it’s not that hard. You’re already doing the thing. You try to do it. So you write down what’s happening. Okay. I’m having trouble. I did this roll where I did a forward roll, I put my hand down and I put my head down and I feel that right there. Before I even roll over, that’s great information for you and for us, that’s trying to help you, then we can go. Okay. How about halfing that movement out? You put your hand down, you just barely put your head there, then you’ve kind of noticed.
Rose: Tuck your head.
Jarlo: Yeah. Tuck your head down. Then you notice, how much are you flexing your neck, right? How much are you tucking it in? How much weight are you putting on it? Is it anything at all? Right? That’s the next step. Then you go, “Oh, I think I’m putting…” The first time I put a lot of weight on it, but then I listened to what you said and I’m just mindful of it. I realized I can put about 25% of that and I’m fine. Then you’re like, “Oh man, that’s great. Perfect.” Write that down. Okay? Write that down. How many times can you do it? Were you able to hold it there for a bit and feel good? And you spent a couple of minutes on it. There’s your baseline? Awesome.
Jarlo: So, that gives us the information there. Now. That’s why I have trouble with things like progressions and regressions and advanced. Because to me it’s all exercise, it’s all movement and it’s all, how can we figure out what you can tolerate and tolerate not just in terms of pain, but also tolerate in terms of getting that adaptive stimulus to get better.
Rose: Right. So variations might be a better word.
Jarlo: Yeah. Variations or just you’re trying to adapt it for yourself.
Rose: So with this example, will you talk about adaptive threshold more? Because I feel like the rolling is a really good example for people to understand what that means.
Jarlo: Yeah. Well, the adaptive threshold is… Okay. So if we say you shouldn’t have any pain at all or you shouldn’t have any discomfort at all, or it shouldn’t feel hard at all when you exercise. Right? Aside from some of the aerobic benefit, right? The aerobics, the cardiac output in your heart.
Jarlo: Right. Maybe that’s a little different, but if you are there and we talked a little bit about this in the last podcast and you don’t get any kind of discomfort at all, you don’t push into anything at all, you’re not going to improve. You’re just not. How could you? You’re not providing your body the stimulus to want to adapt. So that’s another kind of thing that lots of people say, and maybe it’s true or not. It’s like the body goes through the path of least resistance. Why should it expend energy to build muscle, to loose fat. Whatever. Build bone. Why should it expend that energy if it doesn’t have to? It’s pretty miserly. And it should, because we’ve got other things to do. Got other stuff to do, man. Right? So the same thing with learning something new and having some discomfort and all of that. Is you have to at least some of the time go into and provide an adaptive stimulus. Right.
Rose: So what does that mean? What does adaptive stimulus mean?
Jarlo: So say you have a threshold of… Maybe we can put a chart in the show notes where there’s a line, right on the graph. And that’s your threshold of, if you expend the energy and you go above it, that your body reacts with like, “Oh, I better get better.” Right?
Rose: Because I’m asking more of my body than I was-
Jarlo: Yeah. You’re asking more of it. You’re doing all these things. So your body’s going to go, “Oh, I’m going to give you a little bit more strength there. Because, you’re telling me you want to do this.” Right? So the whole thing, since we’re talking about pain and all of that stuff is if you go way past that, this is my whole bang your head against the wall or rolling in this case over and over again. Then your pain just gets worse and worse and you just feel bad, you get dizzy, all of these things. There’s another thing too. For me, an example, dizziness.
Jarlo: I do too much right away. I get dizzy. I could have just stopped. I won’t do it. I did that for a long time, but I’ve found ways to kind of go up into it and back down and I’m better now. So, that’s what it is. You can go way too far. Right? Then you don’t want to do it again. But you can also do way too little and not improve at all. So the trick, and this is art as much as science is knowing to go up into it a little bit, go down, go up above it, go down. Give yourself time to recover, within the session, as well as throughout the week, months, years. That’s the art of physical adaptation and improving tolerance.
Rose: That sort of reminds me of our 5P framework because our practice is practicing at that really high level that we’re trying to get better, we’re trying to improve. We always say at GMB, that’s where you do one rep, make it as beautiful as you can and then take a rest and then do it again. But we’re not banging out like rep after rep.
Rose: That’s in our push section where we’re kind of dropping back a little bit.
Jarlo: Right. And so that’s the nuance. You want to… People say, “Well, how do I get better at this, so I can just do it kind of effortlessly and play with it? That’s why we have the practice, push and play. Right? With practice, that’s when you’re really kind of trying to develop your skills. You’re trying to push yourself a little bit. Meaning you’re trying to do a little bit more, right? But you’re not just going full tilt at it. You’re deciding, “I’m going to try this.” Because, you know your baseline. That’s another thing about the whole thing of assess where your baseline is, assess where you’re uncomfortable. I’m going to do this three, four times, because that’s my baseline. Right? I’m going to maybe do it five times, right? Today.
Jarlo: If I feel good about it. Right? That’s autoregulation. Then once you go to what most people consider the workout section is you do something that you know you can do. It doesn’t give you any trouble at all and you do lots of repetitions on it. You set the timer, “I’m going to do 10 minutes of this and it’s going to feel good.” You know it. Right? And then what you’ve done there is that over time, your threshold in the practice part is going to improve.
Jarlo: It’s just going to have to. Right? Maybe it’ll take longer than you want. And it probably will, because we’re all impatient. But to me, it’s empowering to even know that you’re going to improve. Right? And you’re going to be able to do it. That’s the adaptive threshold thing. That’s what really the whole no pain, no gain should be.
Jarlo: Right? But that’s just kind of a bad phrase.
Rose: You’ll have some discomfort.
Jarlo: Right. That’s just kind of a bad phrase because then that’s just lumping all pain into pain, pain, pain. Doesn’t matter, rather than being kind of nuanced about it. I mean, you have to have a little bit of discomfort to grow. That doesn’t mean a lot.
Rose: Right? Like soreness is technically pain, but we have interpreted it differently. It’s not bad pain.
Jarlo: Yeah. Totally. Right. You know there’s a difference between a bad pain and a good pain. Well, maybe you need to be told that. Because, I’ve actually had patients ask me that. So what’s the bad pain and good pain. Or bad pain is sharp unrelenting… Yeah, you have it in your head like, “Oh man, what the hell is this?” That’s a bad pain versus exercise, good exercise pain where it’s kind of burning. You’re breathing a little bit harder. Maybe in your head, you’re like, “Oh man, this is not…” I’d rather be laying down on the couch kind of thing.
Rose: Right. I don’t want to do one more rep.
Jarlo: I want to do one more rep. Well, I think I should. Even in your head, it’s like, “Oh, I think I should. And I think I can.” That’s probably good pain. Right?
Jarlo: So again, it’s really rambling and it’s hard to give really specific things, but that’s what it is. You find your baseline, you find ways to go a little bit above it, again and again, right? In the session as much as can, without being too much and you’ll know that. Then over a week period or over two weeks, three weeks, this is the whole periodization thing, cycling. Right? And having this steady up and down, but still upward progression.
Jarlo: Did that help?
Rose: Yeah. No, that was very helpful on explaining that. For people who are currently in pain, we have resources.
Jarlo: Yeah. We’ve got the neck. We do have some good upper back routines, back routines, all of that stuff. Is there anything specific to the neck and to the upper back that you want to talk about?
Common Program Questions
Rose: No, I think we covered a lot of it. I think a lot of the questions that we get through support at GMB about neck stuff is… Oh, here’s a good one. I have been diagnosed with a herniated disc or a disc bulge or I had some going on in my cervical spine or my thoracic spine. I’ve had some sort of trauma. I have been diagnosed with a thing, but I’m better now, but can I use your programs? Is it safe to use your programs?
Jarlo: Right. I think the key thing there is, if they say, “Well, I’m better now.” Or, “I’m a year out.” Or, “I’m six months out.” Right? Versus, “I just had this car accident last week.” That’s an extreme, but really when you’re talking about months out or you’re talking about, they’ve gone through some therapy and rehab or whatnot and they’re ready to go.
Rose: If people are still having some pain, even though they’ve been cleared for exercise, it’s probably still okay-
Jarlo: Oh yeah. I think I’m very confident in saying that. Right? I would say that too. Yes, there should be… But then now we’re talking about this whole dynamic, that we just talked about for the last 20 minutes, right? Finding your baseline, finding the threshold, going up into it and the programs… Yeah, we can toot our own horn, but our programs it’s built into it. It absolutely is. We talk about autoregulation from the beginning, we talk about how to practice from the beginning. Also we have a great support staff and our coaches being able to help you. But in general, for the most part, this is the hard part, right? You always have the disclaimers. If you had an injury or a trauma, but you’re cleared by a doctor or your therapist or it’s been several years later yeah, we should try our stuff out.
Rose: Right. And if you need help with modifications, you can always email us. We can help.
Jarlo: Right. And not just our stuff. You should be trying different things out now. You’re not going to hurt yourself more unless you do too much right away. That’s when you can hurt someone. But even then you’re not hurting yourself more. You’re just sort of not helping yourself. Right? It’s the only way you’re going to injure yourself more is if you do something really bad.
Rose: Right. Way too much.
Jarlo: Way too much. Or you’re just like something you know you shouldn’t be doing, come on now.
Jarlo: Give yourself a little bit of credit for knowing that you shouldn’t do this. Yeah. So that’s that.
Rose: Cool. If people have further questions or they’re wanting some more information about our programs or how they could help, or if you have concerns at all, you can always email us at email@example.com.
Jarlo: Yeah man, we do good. And we answer it within a day.
Rose: Yeah. You might even hear from me.
Jarlo: Yeah. Even from Rose. Not so much me, unless they forward it to me. Yeah. I hope that was helpful. If you have any questions about this in particular, you can email us or you can comment on the Facebooks or the Instagrams, whatever. But we’ll do more of these, if you like it. We’ve done a bunch now, Rose.
Rose: We have.
Jarlo: Yeah. I hope you liked it. Thank you, everybody. Really appreciate you tuning in as they say. I hope everybody has a great rest of their day, evening, night, wherever you are. Thank you.
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