Episode 154: Take Home Messages From Our Back Pain Workshop This Past Weekend
Jul 15, 2024
Jenni
Can understanding the root causes of back pain transform your life? Join us as Dr. Jake Berman and Jenni Berman, PA, reveal the secrets they shared during their recent back pain workshop. Learn how to replace fear with confidence by addressing fundamental issues such as glute weakness and pelvic instability, rather than simply treating symptoms. Discover practical tips for pain relief and prevention, and embark on a journey toward becoming anti-fragile, embracing activities you once thought were out of reach.
In this episode, we delve into the often overlooked muscular inefficiencies that contribute to chronic back issues, particularly for those over 60 but also affecting younger individuals. By understanding and strengthening these weak areas, you can shift from feeling like a victim to taking proactive steps towards a pain-free life. We also tackle the mental barriers that hold you back from enjoying hobbies like skiing or golfing due to a "bad back." With expert guidance from Dr. Jake and Jenny Berman, reclaim your quality of life and become the resilient, strong individual you aspire to be. Be sure to connect with us on social media and visit www.bermanpt.com for more resources on achieving physical and mental wellness.
Check Us Out On Social Media - Facebook: @bermanwellness , @physicaltherapynaples, @Berman Golf Instagram: @berman_wellness, @bermanphysicaltherapy , @Berman Golf Youtube: Berman Golf, Berman Physical Therapy TikTok: Bermangolf, Bermanwellness
Email us - drberman@bermanpt.com jenni@bermanwellness.com
Check out our website - www.bermanpt.com www.bermanpt.com/wellness www.bermangolf.com
Can understanding the root causes of back pain transform your life? Join us as Dr. Jake Berman and Jenni Berman, PA, reveal the secrets they shared during their recent back pain workshop. Learn how to replace fear with confidence by addressing fundamental issues such as glute weakness and pelvic instability, rather than simply treating symptoms. Discover practical tips for pain relief and prevention, and embark on a journey toward becoming anti-fragile, embracing activities you once thought were out of reach.
In this episode, we delve into the often overlooked muscular inefficiencies that contribute to chronic back issues, particularly for those over 60 but also affecting younger individuals. By understanding and strengthening these weak areas, you can shift from feeling like a victim to taking proactive steps towards a pain-free life. We also tackle the mental barriers that hold you back from enjoying hobbies like skiing or golfing due to a "bad back." With expert guidance from Dr. Jake and Jenny Berman, reclaim your quality of life and become the resilient, strong individual you aspire to be. Be sure to connect with us on social media and visit www.bermanpt.com for more resources on achieving physical and mental wellness.
Check Us Out On Social Media - Facebook: @bermanwellness , @physicaltherapynaples, @Berman Golf Instagram: @berman_wellness, @bermanphysicaltherapy , @Berman Golf Youtube: Berman Golf, Berman Physical Therapy TikTok: Bermangolf, Bermanwellness
Email us - drberman@bermanpt.com jenni@bermanwellness.com
Check out our website - www.bermanpt.com www.bermanpt.com/wellness www.bermangolf.com
Speaker 1:
This is the Berman Method podcast, featuring Dr Jake Berman and physician assistant Jenny Berman. We are here to treat problems and not symptoms. Disclaimer this podcast is for entertainment purposes only and not to treat anyone or to give medical advice. If you are interested in any information that we are giving and would like to use this for yourself, we recommend that you contact your primary care physician or reach out to us and ask us questions about yourself specifically. Enjoy.
Speaker 2:
And we're back with the Berman Method podcast, where we're focused on treating problems and not symptoms. Dr Jake Berman, here with my lovely co-host.
Speaker 1:
Jenny Berman, physician assistant.
Speaker 2:
What is happening? How is everybody doing?
Speaker 1:
Happy Monday. Hope everybody had a nice weekend.
Speaker 2:
Yes, I love asking that question, like I'm going to get responses.
Speaker 1:
About their weekend.
Speaker 2:
Yeah, how's everybody doing?
Speaker 1:
Yeah, we're all doing great Jake. I can answer for you. If you want, I could be the peanut gallery.
Speaker 2:
How's everybody doing?
Speaker 1:
We're all doing great, Jake. Thanks for asking. We had a great weekend. How about you? I?
Speaker 2:
actually had a great weekend. Saturday was our back pain workshop. We had a workshop that we had, that we were advertising it for a few weeks, and the purpose of the back pain workshop was for you to come in and, primarily, figure out what was the real cause of your back pain.
Speaker 1:
Right.
Speaker 2:
And then after that, some simple tips on how you could reverse it and get going in the right direction and, ultimately, what is the plan of attack, what is the roadmap to become anti-fragile?
Speaker 1:
Okay, explain anti-fragile a little more.
Speaker 2:
Anti-fragile is this thing that I've been saying a lot lately, or I've been saying it over the years, but lately I've heard more and more healthcare providers using it. I'm not saying they got it from me, I think it's becoming a buzzword kind of thing. We're anti-fragile where you're getting older and you're not scared to do X, to do Y, to walk across uneven surfaces, meaning like walking across the yard or bending over to pick up a box, getting your grandkids out of a crib, playing flag football with your kids I mean just doing anything. Jumping off a boat at the beach.
Speaker 1:
Right, or even getting on a boat.
Speaker 2:
Getting on a boat.
Speaker 1:
We've had some family members that won't even come on our boat because they're afraid of the getting on and getting off process.
Speaker 2:
Yeah, and think about that. I mean, there's a lot of people listening to this right now in their 30s, 40s and 50s where you can't even imagine being so scared to get on and off a boat that you're saying, okay, I'm not going to go on the boat period.
Speaker 1:
Right.
Speaker 2:
I'm just going to give up this whole opportunity to have a great day out on the water because I'm not confident that I can get on the boat and off the boat again without hurting myself.
Speaker 1:
Right. So anti-fragile you're not just meaning like you're not going to break a hip, but just having more confidence to be able to do things without the fear of injuring yourself.
Speaker 2:
Yes, Breaking a hip is an extreme. The fear of injuring yourself is the most driving factor there. Though I don't know if I'm going to slip and fall, I'm not really concerned that I might break a hip, but I'm concerned that I will injure myself or I will be really embarrassed that I can't do it on my own. I'll be really embarrassed if I think that I'm going to do it on my own and I start doing it on my own. Then I can't do it on my own and then somebody has to help me.
Speaker 1:
Right, right. Or the amount of times I've heard clients say oh, I can't do that because I might throw my back out. That's something. I can't go on that walk, or I can't do that lifting class, or I can't go to that aerobics class because I might throw my back out.
Speaker 2:
I might die today. I mean, what kind of might is that? What does that even mean? What is the threshold of? Okay, I'm going to be safe here If I do X, y, z, I'm safe. But as soon as I go to ABC I might throw my back out, like what kind of life is that? How do you know that you're okay or not okay? What's the gray area?
Speaker 1:
Well, that's where we get increasingly more fearful and we start doing less and less and less, because we just we have that thought in our head about one thing, and then that cascades down to even simpler tasks we end up being afraid of.
Speaker 2:
Yeah, so that was. The ultimate goal of this workshop was first, to identify what is the real cause of back pain. Second of all, what are some things that you can start doing right here, right now, today, to start alleviating it? And third of all, what is the roadmap to becoming anti-fragile? What do we have to do to get to a point to where I don't care about having to move a box, I'm not concerned about getting on and off a boat again, because I can freaking do it? I mean, how many clients do we have that are in their mid 80s that I would never, ever look at them and say you're definitely not in your mid 80s. They'd be jumping on and off our boat without any problem at all. And then, at the same time, we've got clients that are in their early 60s and I'm going oh no, you are not coming on my boat.
Speaker 1:
Right right.
Speaker 2:
Anti fragile right.
Speaker 1:
Or they are fragile but we want them to become anti fragile.
Speaker 2:
Yes, so I just want to do a real quick recap on the workshop, because I think it's really, really important the amount of relief that these people had on their faces by the time they left my office Saturday morning. It was night and day. You could see it. People were walking into the office with this look of uncertainty on their face, fear, not knowing what the future had in store for them. Were they going to have to live with back pain for the rest of their life? Were they ultimately going to have to have surgery? Are they going to have to be reliant on pain pills and injections? So there's just a look on somebody's face and then, 90 minutes later, once you know exactly what the problem is and a roadmap on how to get out of it, how to solve it, you could just see a look of relief.
Speaker 1:
Right, they're like oh, this is starting to make sense, I don't have to live in fear oh, this is starting to make sense.
Speaker 2:
I don't have to live in fear, and that was the most rewarding part of the whole morning was being able to communicate it on a level where it's like, oh, wow, now I actually understand it. So real quick recap. Well, I say quick, it's not gonna be quick. Nothing's ever quick whenever I do anything. You guys know this by now, right? Yeah, the first thing that we went over is what is the true cause of back pain, and when I ask this question, it's always the same response. When I ask the audience what causes back pain, whenever I'm giving a talk, they always say the same thing Herniated disc that's what I was going to say. Bulging disc Right. Spondylolisthesis Right, degeneration slip disc all of these things that only show up on an MRI. Some of them might show up on an X-ray. Majority of them only show up on an MRI.
Speaker 1:
Okay.
Speaker 2:
Right, yeah, you look like you're thinking right now.
Speaker 1:
I was, but I was going to let you finish your statement before I interrupted you.
Speaker 2:
The thing that I will go on record time and time again saying that herniated discs do not cause pain. They don't. They can't cause pain or they can. I'm sorry I shouldn't say it that way. Herniated discs do not cause pain there, or they can. I'm sorry I shouldn't say it that way. Herniated discs do not cause pain. Herniated discs can be correlated with pain, and the way that I can say that is that over the years they've done more and more studies where they're looking at asymptomatic people people over the age of 40 who have no pain at all and doing an MRI with them, and over 60% of people over the age of 40 who have no pain at all have some type of bulging disc, herniated disc, degenerated joint that shows up on their MRI.
Speaker 1:
Right. So it's showing up on their MRI, but they're not having pain.
Speaker 2:
Exactly so. You cannot say that a herniated disc causes pain, because 60% of people over the age of 40 have a herniated disc that shows up on their MRI and they don't have any pain.
Speaker 1:
Right.
Speaker 2:
It can be correlated, but it doesn't cause it.
Speaker 1:
Okay, got it. So there's the difference can be correlated. Does not actually cause the pain, so you can have back pain along with having a herniated disc, but it is not the cause of your pain.
Speaker 2:
Exactly A herniated disc is a symptom of a bigger problem, and the bigger problem 99.9999% of the time. With all of the people that I've worked with over the years, thousands of them that have back pain, had back pain right Past tense, don't have it anymore. Glute weakness, weak ass syndrome.
Speaker 1:
Right.
Speaker 2:
And specifically one glute is weaker than the other.
Speaker 1:
For majority of the population.
Speaker 2:
All of them.
Speaker 1:
Including us.
Speaker 2:
Yeah, all of them. I've never met anybody that didn't with back pain. I never met anybody that had back pain who didn't have one glute that was significantly weaker than the other glute.
Speaker 1:
And why does that happen? Why does one glute get weaker than the other one?
Speaker 2:
It's something along the way, something over the years. You start favoring one side more than the other. It could go back to childhood. I've had lots of people where they injured themselves way back in childhood and they just favored one side more than the other over the years. Stella, for example how old was she when she had that hip fracture?
Speaker 1:
18 months probably 18 months.
Speaker 2:
We don't know how it happened, but it showed up on x-ray and it was her right side and still to this day she favors her left side. Whenever she's down on the ground, she gets up with her left side every single time. And when she first started climbing stairs she would only go up with her left leg and I had to get on her every single time and I'd say switch legs, right side, right side. And still to this day I'm still having to remind her to use her right leg. Still to this day, I'm still having to remind her to use her right leg. So if I don't do this, if she doesn't get to the point to where she uses both legs equally again, 40, 50 years from now, it will be a problem.
Speaker 1:
Right, and we've seen that with myself as well. I had surgery on my left leg. Two surgeries when I was very young One I was seven years old on my left leg. Two surgeries when I was very young one I was seven years old, one when I was eight years old and was on crutches for a fair amount of time each time that I had the surgery and to this day, my left glute is by far weaker than my right. Consistently. It's something that I always have to work towards, and even after that. So I had those two injuries. And then the seventh grade I injured my left knee. In college I had surgery on my left hip. It was like my left side kept getting injured because it was naturally weaker the whole time. But even now I definitely notice that my left hip will bother me, or my back will bother me if I'm getting loose on focusing on my left side glute activating.
Speaker 2:
Exactly the biggest challenge that we have as humans is we're too subjective to be objective, meaning that if you don't, if Jenny doesn't ask Jake to check her out and say which muscles are or are not working, then she would never know. She'll be in the gym focusing on what she thinks she should be focusing on, and it, most of the time, is not exactly the right thing. And then that just snowballs over one year, five years, 10 years, 20 years, until ultimately something breaks. It's a straw that breaks the camel's back and that's what happens. And we end up in the orthopedic surgeon's office and they do an MRI and it's like oh, here's your problem, right here.
Speaker 1:
Right and I'm gonna add to that is just looking at someone doesn't always give us the whole picture. So if you have a personal trainer that's just watching you rather than actually feeling if your muscles are activating appropriately, that may not be enough. Or if you're taking videos and watching yourself, yes, sometimes we can see discrepancies where on our squat we're not squatting evenly and we're off center, but it doesn't always show that on the videos. A lot of times we need somebody actually touching us and feeling if we're seeing a difference.
Speaker 2:
Exactly, and you just have to have somebody else check it out. You have to have somebody else test it to show or feel what is and what is not doing its job. So to come back full circle, the number one cause of back pain that I've found over years of specializing and working with people with back pain of all ages, primarily 60 plus, so 60 year olds plus, but I've been working with people with back pain in their teenage years. I just got off the phone with somebody virtually in Texas. She's 17 years old with back pain. Same thing is true, though. One glute's not doing its job. Pelvis was unstable, creating transitional pain, and you just got to figure it out, get the muscles working the way that they should be working. So sorry, lost my train of thought.
Speaker 2:
We've got the kids up here today, so we're bouncing back and forth the pressing pause, pressing play, pressing pause, pressing play. Vera's running around screaming, drinking her bottle, screaming, drinking her bottle, knocking on the door. Stella can't open up her doctor kit. It's like Stella, you have 3,800 toys out here. Why can't you play with something else? Why does it have to be this one freaking?
Speaker 1:
toy. We need the doctor kit right now. It's urgent.
Speaker 2:
My baby is sick so right now I'm holding vera while she's drinking her bottle. We'll see how long this lasts, oh my gosh. So back on track.
Speaker 2:
Herniated disc, bulging disc things that show up on MRI rarely ever are the primary cause of your back pain. They can be highly correlated with back pain. However, they are not the cause of back pain. Glute weakness, pelvic instability, inefficiencies of the core and the glute those are the things that cause more stress to be placed on your lumbar spine and, ultimately, herniated disc. However, the disc herniation itself is not the problem. So you can't just go have surgery on your disc, a disectomy and say, okay, fix the problem, because it will come back. One of our good friends, a lady I grew up with, she had this issue where herniated disc ended up having surgery, disectomy, cut the disc out and now she's got chronic back pain because the real problem was never addressed.
Speaker 2:
So the biggest thing that I want everybody to know is that whatever shows up on your x-ray or your MRI, that's nine times out of 10, not the real cause of your back pain. Nine times out of 10, it is inefficiencies of the core, the glutes, the way that you're loading and not loading your lower quarter when you're doing, bending, lifting, twisting things. So once you know that, oh wow, that's not what's causing my pain, it's this glute weakness. I have that right. There is enough to give a lot of people instantaneous relief, because what shows up on your MRI is surgical instantaneous relief, because what shows up on your MRI is surgical Glute weakness. That's in your power. You can do something about glute weakness. All you have to do is strengthen it.
Speaker 1:
Right, right, and so that adds to the feeling of not being so fragile, if you know that it's not an actual diagnosis, but yet it's a weakness that you can continue to work towards, and that gives us that boost of confidence that we're really not that fragile. We just have to get stronger.
Speaker 2:
Yeah, I think it's even deeper than that Maybe fragile might not be the right word for that as much as victim, where you might feel like a victim because what shows up on your MRI is not your fault, right? So you kind of take on a victim mentality, versus when you know that glute weakness is what's causing your back pain core weakness, glute weakness. Now you can raise the red flag and be on the attack. You can go, do whatever you need to do and you don't have to be a victim. You can do what you need to do and go on the offense and go on the offense.
Speaker 1:
Yeah, I like that sense of it too, and it's just like you said, a different mentality of knowing whether you can make improvements yourself or you want to believe that you can't. Right 99% of the time, you can make a difference.
Speaker 2:
Good, moving on to feeling like you have a bad back. I don't want to do X, y, z, because I might throw my back out again. I don't know if I'll ever be able to golf again. I don't know if I'll ever be able to go skiing again. I don't know if I'll be able to do these things because I now have a bad back. That in itself is one of the biggest thieves of quality of life, because now you quit doing the things that you love doing.
Speaker 2:
I cannot tell you how many times I've met clients over the years where they just lived for snow skiing. They lived for golfing, they lived for playing tennis. They lived for walking on the beach. One of the main reasons why they moved to Naples, florida, to retire was so that they could walk on the beach every single day. And they just give it up because they now have a quote unquote bad back. And it just doesn't have to be that way. I've worked with thousands and thousands of people over the years where don't get me wrong they have been in some really bad shape. However, they had a ton of weaknesses and I can honestly say that it is such a small fraction of the population that really needs to give up those things that it's not even worth mentioning.
Speaker 2:
For example, I just had somebody this past season where she had a shift, a lateral shift, so the pelvis was going one way, the back was going the other way, and it's bad. The only way you can fix that is with surgery. She had to have surgery and the thing that we focused on was what muscles were weak. We focused on strengthening those weak muscles so that she could ultimately have the surgery. Should be actually this month. She had it in June or end of June, I'm sorry, end of July coming up. Should be end of this month, but anyways. So after she has a surgery she can bounce back faster than ever and get back to living the life that she loves. So that is less than 1% of the population that actually needs to have that. The vast majority, everybody else.
Speaker 2:
You just need to work on strengthening your weaknesses. I always love the saying of Arnold Schwarzenegger I think it's in his Six Keys to Success, or Seven Keys to Success, whatever it is, and one of them is I'm paraphrasing now he goes you've got to find your weaknesses, then you've got to strengthen your weaknesses, you've got to make your weaknesses strengths. That way, you have no more weaknesses. It's so true. It is so true you know you've got.
Speaker 2:
If you hate doing squats, if you hate doing leg day, it's because you're weak. It's that simple. It's very rare that people hate exercising things that they're good at doing. It's very rare that people hate exercising things that they're really strong at. It's just rare. So what you have to do is you have to have a mental shift that is like, oh wow, I hate leg day.
Speaker 2:
This was me personally 15 years ago or 10 years ago. I used to hate leg day All through college. I didn't even know what a squat was. It was upper body all day, every day breakfast, lunch and dinner, bench press, bench press, bench press. Oh man, it was the strongest I ever was, maxed out at 315 pounds bench press. I'm like, yeah, but I couldn't squat anything to save my life because I hated it, absolutely hated it, because it was so weak compared to my chest. So I avoided it and then I'll ultimately just quit doing it, period. Until I hurt my back 10 years ago. Come to find out you really need your glutes. You can't just work out upper body. So it was around that time when I made a promise to myself. I said that's it.
Speaker 2:
I'm shifting my mindset from hating leg day to looking forward not loving, but looking forward to leg day, because every single time I go and I do work out my legs I know that I'm preparing myself to avoid that horrific back pain that I experienced when I was laying on the ground. My back was. It was a 12 out of 10. If I did not know what I know about physical therapy in the body, I would have called 911 to come take me to the emergency room. It was excruciating and I had clients tell me this over for years that, yeah, I called 911. My back was so bad and I used to think how could your back possibly be that bad that you call 911 and the paramedics show up and take you out on a stretcher? I never understood it until I experienced it. Once I experienced it, I'm like, oh wow, I get it now. So every single day that is leg day.
Speaker 2:
Wednesdays are my leg day, heavy leg day or primary focus leg day. On Wednesday, I think about avoiding that sensation, that pain, that experience. Every single Wednesday morning when I wake up I'm like, okay, let's go do this, and it completely shifts everything from a mental state and now I look forward to it. I don't love it, I do look forward to it, and at the end of my workout I'm going hell. Yeah, that was a success. That is going to help me avoid that horrific pain again. So, in summary, jenny hasn't been here for probably five minutes now. She ended up having to take Vera out. She was not cooperating, so I'm going to wrap everything up for us.
Speaker 2:
In summary, your x-rays and MRIs, 99.9% of the time, are not the real cause of your back pain. They are a symptom of why it's there in the first place. Most of the time, it's because of glute and core weakness. It's that simple. I don't care if you're 15 years old or 95 years old. The best thing that you need to take away from this is that weakness is in your control. You do not have to rely on a surgeon. You don't have to rely on medication. You don't have to rely on anybody else except yourself. Hold yourself accountable and make your weaknesses strengths. Do like Arnold says identify your weaknesses, strengthen your weaknesses, make your weaknesses strengths. That way, you have no more weaknesses. It's that simple. It is not that easy. It is that simple.
Speaker 2:
So I think we have a recording of that workshop that we just did this past Saturday. If you want a recording of the workshop, make sure you email me, drberman at bermanptcom, and I will put that recording. I'll link it somehow in the email and get it out to you, or I'll send it to a friend or a family member that really needs to hear and see other people just like them and get the insight that you don't have to be a victim, you don't have to sacrifice quality of life, you don't have to be somebody that has a bad back. Take your life back, get your ass stronger again and start living your life again. Make sure you like and subscribe to this and share this episode with somebody that needs to hear it. Thank you for bearing with us. I know I was back and forth a little bit there, dad, life All right Till next time.
Speaker 1:
Thank you for subscribing on your social media and podcast platforms to the Berman Method Dr Jake Berman with Berman Physical Therapy and Jenny Berman, Physician Assistant with Berman Health and Wellness. You can find more information on our website wwwbermanptcom for physical therapy. Wwwbermanptcom forward slash wellness for the health and wellness. You can also find us on social media, Facebook, Instagram, and on your podcast platform, so be sure to follow us, like us, subscribe to us and, if you would like any further information, definitely visit our website and reach out to us. You may also find our free reports on the websites as well, where you can download this free information for yourself. Have a great day.
