#24 - Root Causes of Back Pain

Chronice BAck Pain Explained

Summary

• How did you find your niche market? 0:02
  • Average of five hours and 20 minutes of deep sleep.
  • Ayurveda and chinese medicine.
  • Niche market comes from personal experiences and frustration.
  • Chronic pain is an interesting topic.
• Moxibustion for pain relief. 4:18
  • Pain medications after rock climbing accident.
  • Moxibustion, a game changer for joint pain.
  • Paracetamol as a source of red and infrared light.
  • How par acetamol works.
• Medications for inflammation and pain. 8:48
  • Medications for pain, inflammation and neuropathic pain.
  • Chronic pain and addiction to pain medications.
  • Cortisone shots and the placebo sham.
  • Steroids and osteoporosis in a joint.
  • Nervous system, spinal cord, thalamus and reticular formation.
  • Reticular formation and habituation.
• Habituation and chronic back pain. 15:56
  • Chronic back pain is a four out of 10.
  • Two options for chronic pain.
  • The bottom-up and top-down signals of pain.
  • The first step to change pain.
• The false sense of safety that comes with passive treatments. 20:27
  • Having a false sense of safety from passive therapy.
  • Habits, beliefs and behavior.
  • Low-hanging fruit, tools to change.
  • Clear intention with elevated emotion.
  • Back pain and Russian twists.
  • Investing in the tools to build a better body.
• Money is energy and energy is energy. 26:54
  • Mentoring from a similar group of people.
  • Money is energy, physical, chemical and emotional elements to pain.
  • Physical discomfort comes from blockage or inflammation.
  • Three points of discomfort for back pain.
• The three muscle groups of the hip. 31:03
  • The three muscles of the iliopsoas muscle group.
  • The iliacus and the lumbar rector.
  • Tension, mobility and strength in the psoas.
  • How to get started with stretching.
• Groin pain in front of the hip. 34:16
  • Groin pain in the front of the hip.
  • Changing the leverages to improve strength.
  • Pop in the front hip. Rest for two weeks.
  • Tear in the left side.
  • Gaining tension in the right muscles.
  • Why all back pain is psychological.
• Psychosomatic Medicine. 40:12
  • Psychosomatic medicine in the US vs somatic medicine in Germany.
  • Psychological elements to pain back pain.
  • Immuno-psychiatry and finding biomarkers for mood and emotional issues.
  • How the field is moving in the right direction.
• The need for change in the healthcare system. 44:05
  • The change has to come from within the system.
  • Upcoming events in the future.

Transcript

Richard Aceves: 0:58

We are back this time. Yeah, I got the i don't know i That's an understatement to an average of five hours and 20 minutes

Dr Ed: 1:12

for me as much as I am these days, but it's

Richard Aceves: 1:15

up to five hours and 20 minutes, but my deep sleep is three hours and a half an hour of run.

Dr Ed: 1:26

I mean, that's pretty good quality. Yeah.

Richard Aceves: 1:28

Well, cuz I'm exhausted by it

Dr Ed: 1:34

just had a conversation with somebody to go off on another tangent. I was being kind to my work colleagues and I was going around with the

Richard Aceves: 1:43

with ice lollies nice.

Dr Ed: 1:46

And one said, No, I'm not doing cold at the moment. And I was like, oh, that's I've never heard that one before. It's interesting. Like Ayurveda. Yeah, we're big on Chinese medicine doesn't they don't have a normal doctor. They have a Chinese medicine doctor. And it got me thinking like, there's so many ways to approach healing and health. Yeah. Which is kind of where we found a niche. And I suppose we both came to that niche through initially starting with physical pain.

Richard Aceves: 2:21

Right, I think. Yeah, I mean, for me, it was it. I think we came to the niche, because we were frustrated by a system that failed us. Right? I mean, I sought out every type of methodology to get out of my hip pain and my back pain and my foreign pain and you know, ranging from massage therapists and mind you they all had their I learned a lesson from each one of them. So and it added to my tool belt, because it got me interested as the as the discomfort started to go away. But yeah, I think I think the niche, niche, niche market always comes from your own experiences and kind of what you're going through. And so my niche market was, you know, just frustration of the system failing me. The symptoms were, you know, pain and discomfort to my back, it would take me 45 minutes to get out of bed. wanting to do more than just being average, and sedentary and boring and life and just not wanting to be a victim of of the pain and discomfort that I suffered. And so I think you have similar story if I'm wrong.

Dr Ed: 3:40

Yeah, well, I mean, I, I developed right sided back pain when I started medical school, or actually, when I started going to medical placement. So when I was in hospital, watching what was going on, I didn't know at that time, that it was my frustration at the outside environment that was triggering my right side and lower back pain. And not being able to express that. But at least that's my perception of what caused that there was no injury per se to my back. Right? There were movement patterns over time, but it got really bad. And then I was so interested in pain, I ended up going to do a little placement at a chronic pain clinic. And my chronic pain consultant told me Well, if it's been there for longer than six months, you'll have it for the rest of your life. So that's, that's somebody who gets paid like 600 pounds an hour to do private work and coordinate pain. And that's the view. So it really depends who you go to is what answers you're going to get and what outcomes you're going to have. I suppose I think this pain is an interesting topic, because there's so many facets to it. You can see it through so many lenses. Yeah. From the nervous system perspective, we have I mean, it's medicine. I don't know if you were offered that you must have been given pain medication when you had your accident and after it. I know you didn't use it so much.

Richard Aceves: 5:14

Yeah. So right after the accident. I mean, they were giving me I would say like close to lethal doses. Yeah. I was taking anything and everything I could. They gave me a super strong opioid that made me have just the worst trip. And so from that point, I was like, I'll try and find other ways. Which was interesting. My brother had similar issues. He had back pain from playing tennis. And he actually went to Mexico and studied Reiki and did that type of energy work and he's extremely heavy science based kind of person. And then worked for him and he became a practitioner and he was at my side after my rock climbing accident. And that was actually, I would say, more powerful than the pain medications. And I don't I don't remember much of what he did. I remember laying in the hospital bed and him having me breathe. And you know, visualize. I remember I was like, visualize an eagle, and you're an eagle flying above, you had like this overview and it was interesting, because it's it was, you know, something that felt more powerful than the, you know, gnarliest pain medications that they were trying to give me at the at the hospital. But yeah, once I started to learn to walk and everything, I had, you know, the capacity to get into oxy oxy cotton and Xanax and all that, but now, I was just like, No, I don't need it.

Dr Ed: 6:49

And a one point you got moxibustion like charcoal. Yeah, those things are awesome. Those Was that was that early on, or later on?

Richard Aceves: 7:01

Yeah, so that came for my acupuncturist, which I came across her from the stand up paddling community, and it was a friend of a friend. And we made contact and she was, I mean, she really helped me out because I was at the time where I was like, going balls deep into CrossFit. And wanting to open up my own place and a trying to say fuck you to the doctor that told me that I shouldn't do anything for the rest of my life. So I was training really hard, but I was having like crazy back spasms and knee spasms and everything was hurting. But you know, the will to push forward his cause big, and she came up and she started doing the acupuncture work. And she suggested the Moxa sticks and gave me a couple, she would give me a couple of attempts to come see me. And I mean, that was that was a game changer for for joint pain. And for my hip. It released just so much. And for people who don't know what it is like a think of like a thick, strong made out of charcoal and you light on one side, and then you put it like, you know, three centimeters to five centimeters from the skin. And then if you really want to have a good time, you have somebody blow on the other side of it, which is like basically just does like gnarly amounts of heat into the body. And it kind of goes into the muscles and the fascia and everything, it just kind of creates a massive amount of blood flow is would be my, my

Dr Ed: 8:32

way, obviously. I mean, I talk a lot about light. And it's essentially a source of red and infrared light, directly targeted. So it's an it's an early form of like a local red light therapy or sauna therapy or heat therapy, which is going to allow the mitochondria to produce energy more efficiently, which will then draw oxygen to it and which will then create blood flow to the area. So it's a super cool idea. In conventional medicine, we have various medications that we aim at pain, and they're mostly licensed for acute pain. So we've got things like paracetamol which would be I mean, a super fan or whatever you guys call it and in the US, acetaminophen was get it the wrong way

Richard Aceves: 9:15

around today's price. Everybody understands paracetamol, I think yeah.

Dr Ed: 9:19

And then it always astounds me like they don't know how it works. Like there's no very specific mechanism that paracetamol works on. But we do know that it depletes glutathione. So eventually taking it for a long period of time is not going to be that great fuel labor and taking a lot of it very quickly is obviously not good fuel other people do that when they get upset. So we have medications that are just for pain, in inverted commas, which kind of you would think about your normal opiates. And then there's there's medications for inflammation, which are like a non steroidal anti inflammatories, which try to deal with the inflammation side, but we know that the inflammation is kind of important for the healing process too. So whether the use of those is good are not remains to be seen. We know that they can cause cardiovascular issues and some of them have been taken off the market because they cause heart attacks and deaths and that kind of thing. And then we have the I always laugh because these medications are designed for neuropathic pain, ie pain related to nerves. So the first set of drugs don't work on neuropathic pain. Which is interesting because in theory, all pain comes from the nerve, eventually first

Richard Aceves: 10:38

set of medications so paracetamol works on taking away the inflammation.

Dr Ed: 10:45

So and there's some theories that they might work similarly to the the anti inflammatories may influence the Cox pathways Which again, they're involved in anti inflammatories, but there's no one mechanism by which they're supposedly supposed to work. But again, opiates can worsen neuropathic pain. And it goes to show like, you're not supposed to use pain medications chronically because your body's sending you a signal. And the idea is that you respond to the signal by changing something. So if you keep blunting the signal by taking the signal away by taking medication over time, you need more medication. And eventually, you need too much medication that that signal is just going to get louder and louder and louder, which is what the issue with chronic pain and addiction to pain medications leads to, which is unfortunate. And that's clear, a lot of the work that we do is aimed at breaking that cycle of needing medications in the first place, because there's a realization that at least from a movement perspective, it's the way that you're moving. that's causing the pain. It's not the pain itself.

Richard Aceves: 11:56

Yeah, for sure. And then, of course, where does the cortisone shots and all of that come into play? I have an assessment coming up in a couple of weeks with a guy that's gotten. He was about to take his fourth cortisone shot. He was like, This isn't right. The doctor asked me after two, I'd be good to go. And now he's on the sport. So they can change directions.

Dr Ed: 12:21

I mean, there's, there's some I mean, so in a lot of studies they use, if there's an injection or procedure involved, there's, they have this thing called the placebo Sham. So there's studies where, for example, if you damage a knee meniscus, they do things like they go in and trim the meniscus. Or if you just put somebody to sleep, but don't actually do the operation on the knee, we pretend to make them up, they get the same outcomes as if you actually go in and do the trimming of the meniscus. So I think part of the benefit of having these shots into joints is actually just sticking a needle into the joint, which promotes blood flow to it through healing. And then there can be some benefits that I don't think chronically using steroids in a joint is helpful. Because steroids, we know long term use of steroids causes osteoporosis, so it directly impairs bone healing. Okay, so if you're giving it to a joint, you can liquefy it eventually, I think,

Richard Aceves: 13:22

essentially just making it lazy, right? Like, why should I function want to have this super fluid coming in?

Dr Ed: 13:28

You should I mean, your body should deal with the issue in a way that it knows if you just disrupt that and

Richard Aceves: 13:34

my body, just my body's just visualizing it my mind visualizing as a cartoon, sorry. Just the joint, we're like, I'm lazy guys, I'm out.

Dr Ed: 13:44

I mean, there might be some cases where it's helpful if there's a really, really nasty inflammation that just won't settle. And maybe it can figure that but to use it multiple times, without helping, then obviously, that's not the solution. Right. And I wanted to get into so the nervous system carries pain signals up the spinal cord, and what is known as the spinal syllabic tract. So it goes from the spine to the thalamus, which is this thing that takes in all of our sensations. But that tract has various destinations. So the the tract I mentioned to the thalamus tells you kind of where the pain is. And interestingly, it also carries thermal stimuli. So that might also be a reason why your Moxie Bhushan can work to break the cycle, because you're replacing pain with heat with heat, right? And it just gives your body something like Okay, so maybe it's not still in pain.

Richard Aceves: 14:44

In order to change that perception, you need heat, rays and blood pressure, and something else, right and intense discomfort,

Dr Ed: 14:52

intensity. And that goes into the other two, so that the system also feeds up to the reticular formation, which changes your level of alertness and arousal. So, like, when you hurt yourself, you you want that response to come. So you're like, oh, what's going on, and then you you can make a decision to run a hide or a tackle or move. And then the other one is actually feeds directly into the head and the eyes. So that's something you're probably more familiar with than I am because the eyes and the face is something that you're constantly watching when you're working with somebody in pain. Yeah. And you gives you a window into what the nervous system is. Feeling,

Richard Aceves: 15:40

I suppose. Yeah. I mean, now that you see all this, it kind of goes into how I start to intuitively coach. You know, because essentially what I'm doing is I'm creating heat in the area, right? Yeah, by forcing muscles To activate and move and create blood flow in the area, which then sends the signals up. There's the unconscious facial expression that you make automatically based on how you're perceiving that intensity. And that's when I know if I should keep pushing the person forward, bringing in the back, making sure that they're present understanding if they want to basically play dead, right? So are they fleeing the problem? Are they playing dead from the problem? Are they attacking the problem? Or are they actually starting to find comfort in that in that discomfort, which then allows us to change the belief system or the perception of what that intensity is?

Dr Ed: 16:33

Exactly. And what's interesting is the, the second one, so the reticular formation, the one that controls arousal also receives input from motor control, cardiovascular control, sleep, consciousness, and also controls habituation. So these people that like I always remember you in assessments where they kind of say, Oh, yes, just like a chronic, like four out of 10. Yeah, but you're always like, well, it's, it's become a four out of 10. But when it started, it was like a 10, or worse, and you've just like, got used to waking up with that pain day in and day out. And now it's become something that you can tolerate, but it's still there screaming at you in the background. Right.

Richard Aceves: 17:18

Yeah. That's a I mean, those cycles, right, it's a, the habituation aspect of it is. When I feel like I've noticed that with the it become normal to have back pain, until it's not and you start to actually get into the I'm frustrated at at the system, I'm frustrated myself or not. I feel that there's two options, right, you become the victim that needs to constantly prove that they have the issue that nobody can solve. And we've said this, which again, becomes that habit, or you start to get frustrated. And that frustration comes once the habitual pain starts to become higher than three or four. Because when people aren't like a to like, it's just it's normal pain, I can deal with it, it's not a big deal. So the the discomfort, the intensity, the pain, whatever word you want to put to, it needs to be higher than like three or four on a daily basis for somebody to actually want to, because that's a point where it's like, it's just uncomfortable, nonstop. You can't just like a, like a level two point of discomfort like my arm here. Like if I don't pay attention to it. It's constantly numb because of some nerve damage. So all of this is like, always explained, like if you sit in the toilet and it gets watching the video, like my pinky and my, I don't know what the other finger next up he has but raised finger, the ring finger, there we go. So these two fingers going down all the way into the owner and the forearm flexors are constantly numb, like when you sit in the toilet for too long, and your leg has pins and needles. But it's been 15 years like that. So I've I've habitually just disregarded it because it said a one and a half to two of discomfort on a regular basis. But it wouldn't you start to go into like a four or a five. mean, that's like just constant discomfort. And so I think that that's where the frustration comes to want to find the change.

Dr Ed: 19:12

Exactly. So from from my perspective, that we have these, the bottom up signals, we also have the top down signals. And kind of the gate between those two is the autonomic nervous nervous system. So your your balance between the sympathetic and the parasympathetic. Well, the state you're in IE flow, fight flight freeze. So when we approach pain with kind of a long term view, it's about can we change the state, and that can be in the nervous system and the autonomic nervous system in the cell where the actual danger was sensitive initially. So that that kind of brings in these ideas of energy and the cell danger response? Essentially, Can we reverse the changes that have now happened at the molecular level at the biochemical level in order to protect you and not waste too much energy dealing with the stressor? And then also, can we change the environment and the belief system because, as you said, you you become the person who's in pain. And then you begin to tell the story to yourself, but also to the people around you and you live your life in a way where your environment around you reinforces the narrative that you are the person with pain, right? So we have to change the inside of you, we have to change outside of you. And then we can start to change how you feel. But I think the first the first step, I mean, we You spoke to us in the last episode, and you've worked with some clients recently is with that initial trust, which can either be there already, or you can build it by making that radical switch during a session. And then it's like, okay, like, it wasn't, it's not a constant thing. It's the state that I'm in and the environment that I'm in. And that's changed. And now, I know that it can. It's not me, it's an external thing. Right? For Yeah.

Richard Aceves: 21:25

And that's the, you know, again, I feel like I say this a whole lot. But having a false sense of safety comes through these passive applications of getting rid of the pain or discomfort, because you're not changing anything, you're sending false signals of safety to the body, which then make you feel that you are safer when you are not. So you know, if you have a cortisone shot, to get rid of your discomfort, but you don't start to become more active, if you don't start, you know, we take away the pain, cool. If there's not a plan, after taking away the pain, no habits are going to change. So therefore, why should the pain not come back? There's no easy fix in that scenario. And so that's why it requires a lot of work, whether it's, you know, not whether I mean, it requires a change of environment internally, which the doctor does by giving you the shot, or, you know, the passive therapy, massage, acupuncture, all of this, but then it requires a change of your external environment. So it can match your internal environment, which means you should be getting stronger, which means that you should be doing more activities, which means you should be changing your movement patterns, if you're somebody that goes to the gym constantly, you know, I mean, like, all of these things need to start to change. So then it can all match up when you go back to your regular base, because at the end of the day, when you do get medication, or any of even if you go in and they shave off a herniation or you know, or a bullet or they're fixing, or they're fusing a disc. It's still only treating the symptom, if you go back to doing exactly what you're doing before. How do you not expect to come back to the same problems?

Dr Ed: 23:08

Right, and that concept of your thoughts, habits and beliefs and behaviors, they create your personality, and your personality creates your personal reality, which in turn feeds your habits, behaviors and thoughts. So yeah, it's what what we do is, through a proper assessment, we give you the, the low hanging fruit, so the tools to change. Yeah, it's up to you, if you want to change will

Richard Aceves: 23:42

always right. I mean, it's I'm not a magic. I'm not a magic shaman, you know what I mean? Like, it requires work on on both parties, and a lot of dedication, but the, the changing factor is so simple, you know, it's, I have, but not easy. No, it's not easy, because you need to be there presently, right. And so I have people that have discomfort, don't have the money or the time or this or that to want to make the change, I give them the tools for free, and they still don't do it. So if if there's not a true want for change, then you can't expect better results.

Dr Ed: 24:27

Yeah, I'm starting to be very conscious about being clear with the person that there needs to be a clear intention of what they want, the 100% and that I stole this from Joe Dispenza. But the clear intention with an elevated emotion. So that's why I think movement, the way you that you coach, it is very helpful as a tool because you can change very quickly because you can allow it to elevate your emotion, it can either be like a strong aggressive response, or it can be a very joyful response, or it can be a mixture of both in some cases, or somewhere in between, you know, all around the spectrum. But yeah, it's, it's, there's no, I think that's the issue that's come from his medication, which when somebody is in a lot of pain, very useful, but when they're using it as a crutch, to not do anything about the reason that they're in pain. Then issues come,

Richard Aceves: 25:35

right. Yeah. And it's, uh, you know, I can always tell who's really invested into making the change not by how much they're paying me, but by following directions. Now because what I ask of you is not easy. It's simple. But you know, for example, I have a client with with back pain, and I said, Do Russian twists, but don't go to it back, right I give the breathing cues, I give everything they need, and I send them a 10 and a half minute video. They don't watch the video, I know because I do unlisted and I send it only to them. So nobody else has seen the video has zero views. And they say they're doing the exercise zero views. And then I check up on them two weeks eras how's it going? Like, I tried the Russian Twist, I got no results. And I was like, that's interesting. I haven't seen it open up the YouTube channel to watch the video that I spent 12 minutes recording for you. So your investment is not the money, your investment is putting the time into the tools that I'm giving you. So you can actually learn to build a better body. And so like, that's the you know, that's always one of my conversations is I charge a lot of money, because I'm hoping that that money forces you to dedicate time to build your own toolset. You know, I'm doing that right now. I don't I know I suck at structuring things. I know that I speak like a crazy person. And I maybe don't, I can't relate how I would like to for mass population. So I hired coaches that have the proper tool set to help me grow my business. It's the same thing I understand where I'm lacking. That's a that's a pain point in my business and my personal life and my professional life. So I find people that are their best at it. So they can help help me grow. And so when people come to see me, it's the same thing, like I'm giving you the tools so that you can grow. Because once you understand what I'm teaching you, you don't need a personal trainer or a coach. I mean, you get one because you enjoy their company, or you know what I mean? Like you enjoy the structure they have whatever it may be, but in reality, you know exactly what you need to do to stay healthy, and to optimize your life on the physical, mental and emotional level.

Dr Ed: 27:49

Exactly. Yeah. And I mean, we both had mentoring business mentoring from similar group of people, it's out to them. It's, I mean, we're offering value. So our prices are fairly high, I could argue that they should be higher, because we provide value that others cannot provide. So again, if people think they're paying us for their fix, no, we're paying us for the value that we provide in giving them the tools that they need to apply.

Richard Aceves: 28:25

Right, anyway. And every time that I tried to do things had a deal, or X, Y, and Z, the work never gets done. And then it makes me look like shit that I can't provide the results, which I'm not supposed to provide the results. I provide the tools in the solutions. You give yourself the results. But it's it's still frustrating, because there's still such a big time investment dump on on my part, at least.

Dr Ed: 28:48

Yeah, I think that if you perceive, I mean, some people don't agree with this, but money is energy. And that's the if you have the intention, and you have the elevated emotion, which is the raised energy, which is the money that we're putting down, then that is like that's part of the healing processes. I'm investing in this because this is my intention. For sure. Yeah, so I mean, I guess in summary, you kind of use the words that I probably shouldn't use right at the start, but there's physical, chemical, mental and emotional out elements to pain. We haven't even got into the emotional causes of pain. Whether it whether it's for this episode or another. I don't know. That's up to you.

Richard Aceves: 29:36

I do have a couple of calls I have to get on. But what time is it? Quarter past 12? Okay, we're good. Yeah, I mean, I think the, you know, the, you know, the physical pain, let's go really quickly. So, the physical discomfort comes when there is a blockage or inflammation, right. So

Dr Ed: 29:58

the lack of energy, or lack of energy imbalances and deficiencies in the cell system, right.

Richard Aceves: 30:05

Yeah. And so when I'm looking at the, at the body, like, you know, you feel the discomfort in your mid back or you feel your discomfort in your lower back or in the front of the hip. The biggest thing is, is look at what's inflamed, and then look around it and one of the bigger structural muscles that aren't working. I mean,

Dr Ed: 30:21

so, for the shoulder, B, the shoulder and B, the pec major and the lats. Yeah, and for the hip.

Richard Aceves: 30:30

Glue, simple, that transverse abdominus maybe there's some different things going in there. Right. But for the most part, if those aren't working, then you're gonna have other muscles that are gonna be taken over into you get to very small, very tiny muscles that send massive amounts of intensity signals to the brain that turn out to be very painful and spasms and, you know, the nerves start to start to scream quite loudly. But what can you

Dr Ed: 30:55

give for people? Like, for example, they're suffering from back pain? And like maybe three specific points of discomfort that you've seen or two, I don't know how many you have. And what might they suggest?

Richard Aceves: 31:11

Yeah, so the first one, the kind of common one would be sciatic thing, right. So you have a right at the lumbar, between L four L, five s, one that has like nerve shooting pains down to the knees with the ankles, sometimes you have numbness going that way, have you have spasms, we can barely touch your knees, XYZ. So there's a lot of discomfort coming straight centralized into the spine. What are we going to do, go to my YouTube channel, look up the SWAMI session, do Swami intentionally and presently, for 20 to 30 minutes and make an you'll see that you'll have a big change, and how much discomfort will be relieved from the low back. Second one would be your feeling the pain kind of either the left or the right, that's usually the iliac is doing more work than the so as major. So again, the iliopsoas muscle group, there's three of them. So as major, which helps you stand up, right, it's one of the biggest muscles that connects the lower body and the upper body, then you have this. So as minor, which is what helps you kind of go into crawling situations, some humans don't have a sauce minor anymore, because we all crawl, we're not chimpanzees anymore. And then you have the iliacus. And it's kind of like a fan based muscle that sits on the inside of the hip. And essentially, from a practical standpoint, I started to realize that when people can no longer stay standing, because they're so as as weak, or they're just weak, because they don't exercise or do any sort of strength training, they start to arch their back. And as they start to arch their back, the iliacus starts to help in that stabilization of that standing or the walking. So along with that arching, you also start to see the people start to walk more like ducks. And they'll start to change their their torque chain pattern into more of a squat than a hinge movement pattern. And so again, if you have that, you'll also start to see that the arch will start to happen more and more. And then you're gonna start to go to certain physios osteopaths, chiropractors, and they're gonna start to tell you that one femur is longer than the other, which is not true, it just means that one, so as is stronger than the other. And that means that either the lumbar Rector or the iliacus is overworking on that painful side.

Dr Ed: 33:19

My recommendation in that situation is to not get them to relax or lengthen or stretch or so as with manual therapy does not help.

Richard Aceves: 33:30

It just makes it worse and worse and worse. And if you're out there, and you're laughing right now, it's because it's happened to you, when you massage it, you're just relaxing a muscle that's already under worked. And you're basically sending again, false signals of safety to the body. And therefore you start to use more and more of the iliacus or the lumbar erector until it does become a structural issue. So again, solution for that. Yeah, just to jump

Dr Ed: 33:55

in the there's a few people who, before they come for an assessment with me, they say, Yeah, I just, I haven't really been stretching as much as I should, or I've started stretching and that seems to help. But it's still not where I want it to be. Like, I know that's a ticking time bomb, too. Okay, so we need to get some tension and mobility and strength in the psoas. Otherwise, everything's going to come back with a vengeance.

Richard Aceves: 34:24

Right? Yeah, for sure. Again, simple fix for that, at least to get started your YouTube channel, look up Swami do Swami for 2030 minutes, at least to gain awareness. And then from there, you can start to do so as races. Again, do exercises, find exercises, go on chatty PT or go on bodybuilding.com. And just look up exercises for so as major look up exercise for the glute max, and do the exercises only focusing on working for those muscles not to complete a range of motion that was dictated by whoever's teaching the exercise. So focus on the connection to those muscles and you'll see the elbow get better. I have my own tips and tricks, but that's cost extra. Yeah. Right. And then you have the like, the trickier ones that I've had lately, is usually like groin pain in the front, kind of like what Terry was having when there's like the click happening more on the front of the hip towards the groin, at the at the hinge, the criss cross of the hip. And it gets achy gets Poppy gets cracking. And so this is again going to be more than likely the permit Dallas starts to get overworked with starts to send high signals and that has to go towards the emotional side. You can have a slight tear in the groin or overuse or underuse of the groin. You know, we can have certain things that are kind of happening there in the front of the hip. Again, if we can start to get a little bit of activation going to the so as major, you're going to see so much of that discomfort go away right away. And the other one that you'll start to see when you start to have those sorts of issues, especially when you talk about like strength and conditioning, or functional fitness is that they're going to start to put a plate so that you could do kind of like the knees over toes, guys. So you can kind of track that to be Alice correctly. For me, that's a very dangerous situation, because you're not strengthening the soul. So therefore, you're not building the hinge movement pattern. And all you're doing is you're sending a false sense, or adding more mobility and more tension to the vastus intermedius. That's the middle strain of the quadricep. And if you continue to push that and add load, you're going to essentially, and I've seen it happen a few times, where you need to get a patella tear, or you'll get the vastus intermedius MaryAlice tear completely from the origin. Because it's so tight,

Dr Ed: 36:49

what the what exercise you're talking about.

Richard Aceves: 36:53

When they start when you can't have like, when people are wanting to get you to squat below depth, under the heels. Yeah, so they'll put like a plate underneath the heels. And they'll they'll do like the low let the knees track over the toes, they're essentially leveraging their body better without having the capacity to create better tension in the right muscles. All right, so the reason that you're not getting the depth is because you have a tightness of either hamstrings, or usually the vastus intermedius. And so when you start to change the leverages, all you're doing is you're allowing more load to the improper muscles. You push that long enough that discomfort will end up coming back, boil shift to the lower back. And then again, some structural damage will happen. It'll be your fault for doing stupid training.

Dr Ed: 37:41

Yes, no, I think when I was when How old was I 17. I was doing squats and trying to go lower than I probably could and got a pop in the front of my left hip. And never I've never really worked out what that was, but that probably was that. Yeah. And I don't know if it was a full tech that never bruised or anything. But again, I went to a GP at that time. And at that time, I had a lot of respect for the medical world. And they said to rest two weeks. If it doesn't get better to come back and use anti inflammatory medication. There you go. Not speaking as medical advice. But if that was me now, I would not do that.

Richard Aceves: 38:30

Did it get better with the rest for two weeks? I mean, the rest for two weeks.

Dr Ed: 38:34

I never I never went back to squatting after that for years, probably until I came to the seminar to see you five, six years later. I mean, I did. But never it was never comfortable.

Richard Aceves: 38:43

Right? Yeah. And so that could be one of two things right? When you feel the pop? Yeah, it could be the I've seen people that tear their their groin, and their pyramidalis. And there's very little blood flow to that region. So it doesn't really heal all that well. So you have to be kind of careful what's actually my pyramidalis on my left side is torn, because I didn't listen to doctors when I should have listened to doctors. Because I just gotten my screws out of my pubic area. And so it was basically like a, it was a third C session type surgery that had to be done in my lower abs. And they told me to rest and I was an asshole and didn't rest. And so now my permit Dallas, I don't have basically lower abs on my left side whatsoever. So that's a fun. Now, you know, fact listen to the doctor sometimes.

Dr Ed: 39:40

Yeah, it's also true.

Richard Aceves: 39:44

But yeah, so that's, you know, again, that all comes down to making sure that we're gaining tension in the right muscles. So if you want to help your lower back, find tension and you're so as major don't leverage it. So you can get more tension, just even if it is, excuse me, even if it's a small amount of tension, find and understand how to contract you're so as major your glutes, your hamstrings, you're going to see that 99% of those issues are going to be gone. Obviously, there's structural damage as far as like herniations, bulging discs, things like that, that requires a little bit more extra care than when you start looking at how the transverse abdominus is working and everything else right. So now it'd be the physical part. Which then leads towards the mental part, which is, you know, there's I forgot who it is, but he says that all back pain is psychological.

Unknown: 40:38

And it's at some to some effect it is right but it is because it's a feedback loop. There's back pain because your body doesn't feel safe to move. And you don't want to listen to it. You move in correctly, your back hurts. So yeah, it is psychological, but the way to change that is by not saying, Oh, it's all in your head get over yourself is by teaching them to move correctly, so that we can show that the body is safe to move, which will then give the feedback loop to the brain, which will then give it confidence to start performing or everyday tasks.

Dr Ed: 41:07

Yeah, this is the thing. So if something is considered to have a psychological element, it does not mean that the solution has to be psychotherapy or like a psychological treatment. We were talking about this actually at the institute yesterday. In Germany, there's a branch of medicine, which is a true medical specialty called psychosomatic medicine. Yeah. In the US, there's a psychosomatic somatic Medical Society, which is one of the longest standing societies in the US but it gets really bad press because people don't like to be told that their condition is under the umbrella of psychosomatic right. It's the words people don't like to hear.

Richard Aceves: 41:48

Right. Particularly gonna have an assessment with one of them on August 19. Glad to have him on the podcast. Keep going. Sorry. Yeah. Well, I

Dr Ed: 41:58

mean, it's just interesting, like the words that you use. So there are absolutely psychological elements to pain, back pain, potentially more, so I don't know. But yeah, it doesn't mean that the, the therapy that you choose has to be psychological therapy and movement Iosco is a great example of that is that the therapy can be initially a physical movement practice. Right? Yeah, for sure.

Richard Aceves: 42:28

I think we're gonna start to see a big shift in in how psychology is, is being ran. You know, what I mean? Like, I feel like now you're starting to see a big blend of, of methodologies and of of specializations. You know, what, like, Uberman coming out with so much stuff. And yeah, you know, Jack crews trying to get bigger and, you know, functional medicine starting to take a big effect, because nobody trusts Big Pharma anymore.

Dr Ed: 42:59

Well, even my own field, like, so I work in immuno psychiatry, so we see patients that have chronic inflammation with psychiatric problems that aren't solved by conventional psychiatric medications. And even the work I'm directly doing, we're trying to find biomarkers things that we can measure in the body in the blood in the brain, that correspond to mood and affective issues. So once they become in use, then I think hopefully the stigma of you have a psychological problem we'll drop in, if you can measure it in the blood, then is it a psychological problem? Or is it just like, it's an ecosystem problem? It's a human problem. Right? We need human solutions for

Richard Aceves: 43:50

Yeah, exactly. Yeah. So I think we're moving in the right direction. I think we still for sure. You know, but I think the rest of the world is starting to catch up. I mean, again, I think that the having the amount of communication of anxiety and depression and leading a more towards movement, and exercise is starting to change a lot. And it's interesting, saying, you know, have great conversations with people and when they go talk to their doctors, or they go talk to their specialists. Because, you know, if I work with a crazy case, I want to make sure that the whole team is on board. And they're always on board with what I'm doing. And they're excited to see the results. You know, I sent you the message today about what one of the guys said with one of the clients that I'm working with. So I think that the field is starting to become more and more open, especially as more and more information and knowledge is being put out there on the internet. And you can just research so much stuff that you're interested in. So when you don't see the results, that's when, you know, you start to look for other options.

Dr Ed: 45:01

Yeah, and I think that's, I mean, that's sort of the important thing that Jack Cruz said to me on podcast is that the change has to come from the patient or the client come from within the system. So you're welcome to ask your doctor or whoever the questions and they can answer you to the best of your abilities. You don't have to just ask one, you can ask different ones, you can go to different fields. There's nothing to stop you doing that. Right. And I think that's the way that again, it's the the active approach, as opposed to going to one person who gives you one solution, and then you do what they tell you. Like that's that's passive. If you agree with it, and it makes sense to you then that's more active. Right? Because you've done your due diligence on Oh, yeah, that makes sense. So yeah, cool.

Richard Aceves: 45:53

I like what we got through the the physical and the mental, I think

Dr Ed: 45:57

emotional. Well, they all kind of flow. Yeah. I mean, they're all interconnected. They're all connected. And we will probably do a new webinar at some point too on emotional mapping. Yeah. That's so cool to catch. Get some more people talking about it.

Richard Aceves: 46:15

I dig it. Alright guys. Well, thank you very much. What do we have coming up? I have a seminar in Iceland in October. I have a workshop this weekend. I don't know if I'm gonna have this up this weekend. In Netherlands I have movement. I have Wasp in Australia. But I think I only have like four spots left. So if you're going to be in Australia, November, hurry up and book it November. We should set up some sort of August workshop in the UK. I've been getting a lot of questions.

Dr Ed: 46:44

Yeah, definitely. Maybe we could. I'll speak to my little farm. Yeah, it'd be we could host it. Be cool to

Richard Aceves: 46:51

do something. Oh, that's true. Let's make that happen. That'd be great. And yeah, if you guys want more information, or if you would like to work with Dr. Adonai, send us a message. We're not that scary. We're very friendly. Actually. You can head over to Richard sevens.com. Fill out the questionnaire. I'm trying to get pretty booked. So I'm going to start having a waiting list in the next three days. Because I'm capacity with one on one clients. It's a lot of work.

Dr Ed: 47:18

I will say I'm at capacity with people messaging me if I can send them a paper on cholesterol. And what just tell their doctors. Cholesterol is a complex topic. If you disagree with your doctor on something, go and find another one. Yeah. It's not up to me to convince you to convince your doctor.

Richard Aceves: 47:43

Find a new doctor. Yeah. Beautiful. Alright guys, thank you very much for listening. We'll keep you guys posted. We'll catch you guys in the next episode. See everyone