BPL20: When “Correcting” Posture Causes Pain

by | Mar 21, 2019

 

SHOW NOTES

When “correcting” posture causes pain.

Like most people with back problems, you’ve probably tried to improve your posture by sitting or standing up straight.

The problem with doing this, is that it feels wrong; unnatural and strained.

You can’t hold it and you return to your old ways.

You wonder “Why does my back hurt when I sit up straight?”

The trick is to have an upright posture while also being properly relaxed. This takes a bit of practice.

According to today’s guest. Dr. Senastian Gonzales

Ideally, you want to have the least amount of effort possible to hold a good posture”

Excerpts from the Show

This is the fourth of 4 episodes with Dr. Sebastian.

Now is your chance to win an audiobook copy of I Will Beat Back Pain: Getting Into A Winning Mindset For Recovery

 

Today’s Guest

Founder of Performance Place sports injury specialists, and author of I Will Beat Back Pain: Getting Into A Winning Mindset For Recovery, Dr Sebastian Gonzales.

Live Pain-free Eliminate Chronic Pain without Drugs or Surgery

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Click the play button to listen to this episode now

When “Correcting” Posture Causes Pain

Why does good posture hurt?

The risk is that we are so determined to hold ourselves upright, that we brace with too much muscular tension.

In reality, this isn’t good posture

 

  • It’s funny when people come in, and all of a sudden  – they know I’m looking at stuff – they’ll sit up, right? And they sit upright for a while, and they get tired of it and the slouch again
  • Sitting is not the devil. It’s just bad when it’s too much. And the same thing with a lot of other things, too. We just happen to sit a lot
  • Get up and walk around every 15 to 20 minutes or so
  • If you cue them into having really solid posture, they’re going to end up with upper back issues
  • People who are pretty resilient and who’ve done the right training, they’ll tolerate these positions longer. Not that they’re great to have
  • I would suggest build your supports, rather than just focus on the position all the time.

 

Hi, I’m Iain Barker creator of Back Pain Liberation.

I got back pain young and it got worse over time. Like many others in this situation, I saw plenty of doctors and therapists – all to no avail.

In the end self-help worked best – it often does for bad backs. Now I train regularly, focus on what works, and don’t get back pain.

My goal is to share what I learned. To help you find a more effective way when treatment doesn’t hit the spot.

 

Belly Breathing Benefits

Sebastian likens the torso to a beer keg. The internal pressure keeping the keg strong and in good shape.

He talks about the benfits of deep belly breathing vs chest breathing.

 

  • Imagine two coke cans. I’m going to pop the top of one. The other one is going to be as it is. Which one can you stand on? … the one with the pressure in it … it’s just like a bike tire, it’s supportive
  • So if you’re breathing really highly into your chest, then you deflate … what goes along with this, a lot of times is hollowing. So they’re kind of coupled together

 

You can use visualisation for your deep belly breathing technique

  • So if you breathe deep into – although this is not possible – breathe into your hips. It’s just a lower centre of focus, or breathe into your flanks
  • There’s what we call internal versus external cueing
  • So the further the attention is, or the further the thing is away from your centre of direction, the better the response is out of the person
  • That it’s better to say … break the yoga pants versus saying expand your belly

 

360°  belly breathing – essential core exercise

 

  • 360°, in general, is what you want
  • Breathing doesn’t mean a change of posture or position. It means breathing. And we’re just changing the direction of the breathing
  • We’re trying to improve breathing into, I’ll say ‘belly region’
  • Sometimes when you say belly, people expand their belly, like a beer belly, and I don’t want that either

I Will Beat Back Pain: Getting into a Winning Mindset for Recovery

Dr. Sebastian says that the most important aspect of recovering from back pain is your mindset.

People are more willing to believe a treatment will fix their problem than to get working themselves – with help from a trainer.

On a former patient who recovered from back problems

 

  • And so she sees her colleagues … and they have back pain and she tries to tell them about MRIs and how they’re not always seeing the whole picture and how all you need to do is a handful of things and you’ll directly get better and you don’t need surgery all the time… And she cannot get them to do it
  • And so the book is intended for cases just like that
  • We all really want to help people but they don’t always take the solution
  • And I’m sure they don’t realize it yet. And their intentions are good. But they’ve been fed misinformation. And they have a lot of fear
  • it’s very normal to think, that when something hurts, ‘what is it and what needs to be fixed’. And usually when something’s fixed that means something’s damaged or broken. And it’s not the case a lot
  • I want people to find the book intriguing enough to do something
  • I want them to get one-on-one attention from someone who knows what they’re doing. And then they’re going to feel amazing, it’s going to be life-changing for them.

Back Pain Rehabilitation through Exercise

Sebastian refers to the hips as the engine of the body

 

  • Well, I like to give them what they want and what they’ve asked for. And if they’re only asking for pain relief, I’ll educate them on the reasons why we should try the other things
  • My responsibility is to educate them about a more responsible stopping point
  • Most people if they just want to live a normal life and not even do athletics and not even run or any of that stuff like the marathons and so on they need to acquire the engine that’s just the simple fact of it
  • If people are going to do things in a poor way, I have the responsibility to show them. And, as long as they’re paying attention, and they do it, they don’t need to be shown twice
  • Most people can get through the entire process into loading, which is therapeutic for them, usually within about like, four or five times
  • So learning the foundational stuff is really important because it cuts through all the time and we get to the nitty-gritty. I think everyone has to realize that, that is what’s intended, and you need to do your due diligence as well
  • I think that a lot of us tend to forget about what other people are feeling around us

Biomechanics of the Spine

  • If you guys have not read Stuart McGill’s stuff, he’s the leading expert in spine biomechanics like literally anywhere in the world
  • He’s got so much research and he’s the nicest guy and he presents it in a very easy way to people. I’ve referred his book for a solution for people many times. That one’s called Back Mechanic in case you’re interested
  • The McGill Big Three is like the foundation building – high reward, low risk, endurance based core activity

 

  • His analogy is that  ‘I’m going to hand you a pound of butter in your hand, and I want you to hold it there.’ At some point your arms are going to get very tired and very painful. What’s the solution to get rid of this? And the answer is to take the butter away. Or,  instead of holding the butter up like a like a bicep curl, put the butter by your thigh and hold it like you’re holding a suitcase. It won’t hurt anymore. And there’s nothing wrong with the structure,  nothing wrong with the bicep. There’s nothing wrong with the elbow or the shoulder. There’s no MRI findings on that. It’s a simple take the load away, give it a break, give it a chance to recover. The pain will dissipate very quickly, right. So that’s basically the model that that I propose that people try first before they try other stuff

Back Pain Red Flags

  • So there are visceral organs that can refer to the back. There are malignancies which can refer to the back. There’s benign tumors, which can refer to the back. I mean, shoot, it could be menstrual cramps. So there’s a lot of different reasons
  • I know everyone’s kind of looking for a fix. Like a stretch or exercise. But really, from a healthcare perspective, our first thing is to rule out what we call red flags, or red flag conditions
  • Everyone has to realize that that your due diligence as a human is take care of yourself first. And that just comes down to being responsible with ruling out things that are serious. And that doesn’t take too long. It’s a simple thing

Thanks for Listening!

 

What inspires you to get training and improve the health of your back? To share your experience, leave a comment below.

To help out the show, click a link to iTunes, Stitcher or TuneIn:

  • Subscribe.
  • Leave an honest review.

Thanks to Dr Sebastian Gonzales for joining me this time and talking through the issues of trying to improve posture; as well as all the other good stuff he shared with us.

Best,

Iain

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Full Transcript BPL20

Iain Barker
So Myth number 11. poor posture while sitting has no effect on back pain.

Sebastian Gonzales
Yeah, so you already hit on that one. Similarly, though, if people are standing too long, it’s gonna bother certain things too. So I put out a bunch of YouTube videos. And one guy – he was funny. So I talked about the book in the video. But I started with a back flow, a movement flow. And so this guy (it’s funny how strong people get with their words when there’s no profile attached to their comments). So he says, something to the effect of ‘Yeah, that’s really cool. Tell people to get better with their back, but then make it worse, with sitting and reading a book.’ My answer was ‘Well, I have an audio version. But sitting is not the devil. It’s just bad when it’s too much. And same thing with a lot of other things, too. We just happen to sit a lot.

 

Iain Barker
We do, it’s what I’m doing right now.

Sebastian Gonzales
I am too. I keep changing positions though.

 

Iain Barker
Well, this is good, isn’t it? So how would you describe poor posture while sitting

Sebastian Gonzales

Well, it’s going to be dependent upon the problem – I’ll clean that up – ideally I think you want to have the least amount of effort possible to hold a good posture. It’s funny when people come in, and all of a sudden – they know I’m looking at stuff – they’ll sit up, right? And they sit upright for a while, and they get tired of it and the slouch again.
When you’re attentively trying to hold a posture, it’s going to hurt something else . So I tend to tell them it’s like a Leaning Tower of Pisa. Just put your hips below and use a little bit of a lean. And that lean is kind of on that same concept of learning to deadlift or hinge. The hinging pattern. So if you can stack things really well you can usually stay there pretty well. It’s kind of like the game – You guys have Jenga over there? You guys probably made it?

 

Iain Barker
I don’t know about that but – we have it. Yeah.

Sebastian Gonzales

So Jenga, you can leave it there forever. And it’s not going to fall over. But if you tilt it a little bit, and stack them kind of weird, then it takes a lot of effort. Just the wind will blow, and it will fall over. So I tend to have people just sit off the end of the table and change and to get up and walk around every 15 to 20 minutes or so, Drink a lot of water, go to the bathroom, it’s going to force you, you won’t be able to hold it. So that’s probably the easiest because if you if you cue them into having really solid posture, they’re going to end up with upper back issues.
And the easiest thing is just to get them a little bit more resilient and stiff.
If you do the right programming, core stuff, and hip stuff for ’em. I think you’d be surprised. People who are pretty resilient and who’ve done the right training, they’ll tolerate these positions longer. Not that they’re great to have.
But they’ll just tolerate them more. They’re just more robust as a human body. So I think you can train for that.

 

Iain Barker
Yeah, military posture, shoulders pulled back and chest puffed out. I guess it looks alright. But, I think that ties into what you’re saying about getting upper back pain.

Sebastian Gonzales
Yeah, a lot of people that have back pain, slouching is going to bother them. So, it’s very natural to go into the other. But if you think of your spine like a coat hanger – bending in both directions aggressively and frequently. (I’ll put a disclaimer on this, this is a, this is a generic explanation, because you can bend your spine.) But at some point, the coat hanger starts to wear. And it gets it gets really tiring, with changing posture backwards, and forwards, usually forward is is painful, and they go backwards, and that’s painful, then they go forward again. And sometimes it’s progressive over the course of months. And, it’s very frustrating. So one of the easier things is, you just build that system there, you leave a keg there’s not going to go anywhere. It’s pretty solid, right? It’s true. So I would suggest build your supports, rather than just focus on the position all the time.

 

Iain Barker
Makes sense. So Myth number 12, the way you breathe has no effect on back pain. And that ties into the ‘keg’ system that you were talking about?

Sebastian Gonzales

Yeah, I usually do an example with people. Imagine two coke cans right there. I’m going to pop the top of one the other one is going to be as it is. Which one can you stand on? Without greater risk of it crumbling? Most people answer the one with the pressure in it. Because of the pressure in it, it’s just like a bike tire, it’s supportive. So if you’re breathing really highly into your chest, then you deflate, we can generally say, and also what goes along with this, a lot of times, is hollowing. So they’re kind of coupled together. So if you breathe deep into – although this is not possible – breathe into your hips. It’s just a lower center of focus, or breathe into your flanks. Sometimes people will put a band, like a hair band, around the belly, and the key was expand the band. So it’s more of a 360 fashion.

 

Iain Barker
I read about this, in the book. 360 degree belly breathing.

Sebastian Gonzales

Right. So that little belt has little nubbies on it. But it’s basically an elastic band with little, imagine golf balls. So they stab you, and then you recognize they’re there. So you breathe to expand them away.
But you could do it with…
I had people do with fingers, people do it with yoga pants – expand the yoga pants. So it doesn’t necessarily have to be that tool It was helpful to me, and I use it on occasion with patients. But I find that anytime you can get away from a brace or a tool like that;, it’s better for the person in the long run. Yeah, that’s the core 360 belt you referencing.

 

Iain Barker
Well, I read the term, 360 degree belly breathing …. but that is using the belt.

Sebastian Gonzales

I used the belt, a little bit, in my own rehab. I think that’s what I thought. And I wrote about it in there, because it was part of the story.

 

Iain Barker
But you actually visualize, sorry to interrupt you, you visualize breathing all the way down to the hips.

Sebastian Gonzales

This is a whole big tangent topic. But there’s what we call internal versus external cueing. And if you imagine I’m attempting to get someone to raise their arm. I can say, ‘Well, I want you to shrug your shoulder, and extend your hand and then contract your tricep’ And eventually they go up in the air and raise their hand. Or I can just say ‘Reach for the stars!’ And it’s a little simpler. So if you say ‘Reach over your head’. They might not know how high; but I really want them to reach high. So I can say ‘Reach for the ceiling’. But even better ‘the stars’. They’re further away. Get up there! So the further the attention is, or the further the thing is away from your center of direction, the the better the response is out of the person. And they’ve done some good research on that. That it’s better to say breathe into the hips, something like that, or break the yoga pants versus saying expand your belly. Because the belly still part of you. Notice the other two things are well, the hips are still part of you. So I’d probably say breathe into your shoes. Or something further away. And it’s not part of you. So you can affect it.

 

Iain Barker
Yeah, that’s interesting.

Sebastian Gonzales

That’s a whole other topic, though. But yeah, 360 in general’s what you want. Most times I cue people from the sides. I put my fingers onto their sides, like they’re points, and tell them to expand my fingers. And that usually gets the job done

 

Iain Barker
And can people visualize as well, breathing out towards the back, either side of the spine.

Sebastian Gonzales

They can. it’s a little harder.
Just one thought is that, a lot of times, when people attempt back there, they’ll actually slouch. And, to be clear, breathing doesn’t mean a change of posture or position. It means breathing. And we’re just changing the direction of the breathing. And we’re trying to improve breathing into, I’ll say ‘belly region’. Because sometimes when you say belly, people expand their belly, like a beer belly, and I don’t want that either. I think the words that we use are pretty important when we’re trying to improve movement, you know.

 

Iain Barker
So I noticed that you said that in over nine years of practice. You’ve only referred one case for surgery?

Sebastian Gonzales

Yeah, she needed a fusion. She was an impact one. She fell on driveway. She fared very well. So when surgery’s needed it, it’s needed. I know she won’t mind me talking about it. She’s passionate about telling people about her recovery. Because she’s just a living breathing version of someone who … she went to an orthopedic surgeon and they said to her ‘You need a fusion. You need rods.’ and she’s like ‘Well, I don’t want to do that.’ and they said to her ‘Don’t worry, when you’re ready come back.’ and she’s perfectly normal today. And it’s funny, by the way this is not bashing orthopedics, it was just her experience. The interesting thing with her today – so she has a few of my books now – And so she sees her her colleagues, her co workers and they have back pain and she tries to tell them about MRIs and how they’re not always seeing the whole picture and how all you need to do is a handful of things and you’ll directly get better and you don’t need surgery all the time. and blah, blah, blah. And she cannot get them to do it. And so the book is intended for cases just like that. The intention is good, I think we all really want to help people but they don’t always take the solution.

 

Iain Barker
No, it’s difficult

Sebastian Gonzales

And I’m sure they don’t realize it yet. And their intentions are good. But they’ve been fed misinformation. And they have a lot of fear. You know.

 

Iain Barker
Yeah totally. And I think there’s also a bit of a disbelief. I’ve got this really bad pain can I really affect it by doing something simple, like doing some training in on a regular basis? They just find it hard to believe that there is not some kind of structural cause?

Sebastian Gonzales

Yeah, well I think it’s very normal to think, that when something hurts, ‘what is it and what needs to be fixed’. And usually when something’s fixed that means something’s damaged or broken. And it’s not the case a lot. Stuart MacGill has a really good example that he typically talks about it’s an example of biomechanical loading. By the way, if you guys have not read Stuart McGill’s stuff, he’s the leading expert in spine biomechanics like literally anywhere in the world. He’s got more research on back pain like fracturing the spine and figuring out like he’s got he’s got so much research and he’s the nicest guy and he presents it in a very easy way to people. I’ve referred his book for a solution for people many times. That one’s called back mechanic in case you’re interested.

 

Iain Barker
I’m interested Yeah, I don’t know this book. Obviously I’ve heard of Stuart McGill. People talk about the McGill Big Three.

Sebastian Gonzales

That’s what he’s really known for. But it’s much more than that. The McGill Big Three is like the foundation building – high reward, low risk, endurance based core activity. His analogy is that ‘I’m going to hand you a pound of butter in your hand, and I want you to hold it there.’ At some point your arms are going to get very tired and very painful. What’s the solution to get rid of this? And the answer is to take the butter away. Or, instead of holding the butter up like a like a bicep curl, put the butter by your thigh and hold it like you’re holding a suitcase. It won’t hurt anymore. And there’s nothing wrong with the structure, nothing wrong with the bicep. There’s nothing wrong with the elbow or the shoulder. There’s no MRI findings on that. It’s a simple take the load away, give it a break, give it a chance to recover. The pain will dissipate very quickly, right. So that’s basically the model that that I propose that people try first before they try other stuff.
But again, getting people to that model is a cumbersome thing. That’s why I’m focusing more on the book, because I want people to go see, there’s mention, of a course, by the way, in the book, because when I said in the beginning that the book was a course. And I get questions from the book like ‘Hey, what is diaphragmatic breathing?’ I say ‘Great question. It’s in the course’ because I don’t have time to answer them all. But what I really want is, I want people to find the book intriguing enough to do something. And I want them to go from one-on-one attention to someone who knows what they’re doing. And then they’re going to feel amazing, it’s going to be life changing for them.

 

Iain Barker
And so the course – is that available on your website?

Sebastian Gonzales
It is. it’s under its under courses. But actually, it’s intended to be I think I wrote Part Two on it, because it’s intended for people to read the first one first, it’s like I said, it was an entire manual there, a lot of the foundational ideas are not repeated in that second part, because in theory, they already read them, you know.

 

Iain Barker
Okay, so can they get access to both of these courses on your website? If someone was interested in doing these courses, how would they go about enrolling ?

Sebastian Gonzales

So you can go on the website, that’s p to sports care, and you’ll see courses and so it’s right in there. Right now we have it hosted on Vimeo, that one’s a little higher price. I don’t know what it is right now. I believe in meeting people where they’re at. And again, this is why the the book is what the book is. And that’s why the course is what the course is. Somewhere in the middle, there’s people who don’t want to spend money. So my thought with those people is that I created, I call it a mini guide. And it’s very basic, honestly, I wrote the thing in in a couple hours. And I took videos from colleagues who taught stuff well, and it’s some of the very foundational things that people are going to want to try when they’re ready to try something. It’s not an end all it’s a baby step. And if they find that that’s something they want to continue, then they go see someone a little bit more, who’s gonna help them one on one or they just go and check the course. You know, so, but I know not everyone’s ready to invest in something like that. It’s scary to think that you’re going to have to pay forever to go to someone, but you don’t. Most of you find someone good, you won’t. Yeah, I’ve seen back cases that resolved and they’re on their own within four or five times.

 

Iain Barker
So yeah, as you say, some doctors are quite happy to have someone keep coming back. But that’s not your goal.

Sebastian Gonzales

Well, I like to give them what they want and what they’ve asked for. And if they’re only asking for pain relief, I’ll educate them on the reasons why we should try the other things. Maybe they want us to start it, they want to be skeptical they want to do first aid. That’s okay. My responsibility is to educate them about a more responsible stopping point. And I tend to think most people if they just want to live a normal life and not even do athletics and not even run or any of that stuff like the marathons and so on they need to acquire the engine that’s just the simple fact of it. That’s going to take that’ll probably take a few months of training. I remember this one time this guy came, and he was the only person I’ve ever met who … so I programmed a clean in his homework, and he said ‘A clean – got it’ I said ‘You know what? Show me your clean’. because he’s very confident he had it. And he had the best clean I’ve ever seen. It was perfect. And he’s the only person ever so.

 

Iain Barker
Sorry to interrupt you. This is a weightlifting, term? This is when you lift the weight up to shoulder height. Is this a clean?

Sebastian Gonzales

Right. It’s like a quick movement that it lands on your shoulders. And so that was part of this program. But he’s the only person I’ve ever met, with that one movement, that I felt comfortable saying, ‘Yes, go home and do that’. Most other people, I remember this one lady. And like, I’ve seen her on and off over the years and she’s sweetest lady. But she used to come in only four steps one and two. Finally, she was mentally ready for some type of level three, four type of thing, some strength thing. So she said ‘What kind of rehab should I do?’ And our time was kind of out for that day. And I said, ‘Well, why don’t you do…’ (it was for her shoulder) I said ‘Why don’t we just do a row then?’ And so we kept talking a little bit. And she said, finally ‘A row. So is that the one where you just kind of pulling backwards and like you’re seated?
And I said ‘Look, let me do this. Next time, let’s only do strength conditioning suggestions. So you can do it well.’
So your comment about I don’t like to keep people for a long time. There’s little steps where, if people are going to do things in a poor way, I have the responsibility to show them. And, as long as they’re paying attention, and they do it, they don’t need to be shown twice. Most people can get through the entire process into loading, which is therapeutic for them, usually within about like, four or five times. But if they want to stay later and learn more stuff, it’s totally up to them. So they’re the boss.

 

Iain Barker
Okay.

Sebastian Gonzales

But yeah, they should be feeling better pretty quickly, though. That’s the moral the story.

 

Iain Barker
Okay. I guess there’s always more to learn.

So chapter nine, you talk about reasons for back and hip pain that are not from the muscular skeletal system. So I guess this is the kind of scary stuff which is rare but something that we kind of need to be aware of.

Sebastian Gonzales

Yeah. So maybe everyone should consider heart attacks, right? If you have hand pain or arm pain. It’s not always the arm. So there are visceral organs that can refer to the back. There are malignancies which can refer to the back. There’s benign tumors, which can refer to the back. I mean, shoot, it could be menstrual cramps. So there’s a lot of different reasons. And I know everyone’s kind of looking for a fix. Like a stretch or exercise. But really, from a healthcare perspective, our first thing is to rule out what we call red flags, or red flag conditions. And these are them. I’m sure there’s a lot of healthcare providers where, sadly, they’ve had some of these walk into their office and they caught them or they didn’t catch then. Or maybe the person didn’t follow up, or they jumped care to somebody else. And there wasn’t enough time to have a rapport built to really get into the nitty gritty. So everyone has to realize that that your due diligence as a human is take care of yourself first. And that just comes down to being responsible with ruling out things that are serious. And that doesn’t take too long. It’s a simple thing.

 

Iain Barker
So, from a practical point of view, if someone’s got back pain, the first thing to do is go see a doctor and make sure it’s not some very scary condition. And once that’s been ruled out, then maybe you’re kind of looking at some kind of physical training rehabilitation program, is that right?

Sebastian Gonzales

Right. And then so encompassed in that there might be blood work, they might do advanced imaging, and they might do an MRI. But again, the MRI is going to show things that are scary, that are not really that relevant. They’re looking for other things. So I think there’s no substitute for seeing someone in person. And I know everyone has these online things and so on, and they’re great. And the intention is to guide people where there’s no help. But when at all possible, you come in, you see someone that knows what they’re doing. I’ve had people come in that, one of the foundational ones with McGill is the bird dog. And they they come in doing a bird dog, the bird dog is pretty good, but maybe the tension is poor. Or they have a little pain with it. And so we do a minor tweak and all of a sudden they’re like ‘Oh, that didn’t hurt at all’ and then they can progress and just do it. So learning the foundational stuff is really important, because it cuts through all the time and we get to the nitty gritty. I think everyone has to realize that, that is what’s intended, and you need to do your due diligence as well.

 

Iain Barker
That makes total sense. And chapter 10 is called how my story ends. And I’ve just got a little excerpt from that where you say, ‘I hope this book has assisted you in getting into a healing mindset, practice telling yourself, I’m a back pain survivor.’

And that’s how I think of myself, actually. Yeah, exactly that – a back pain survivor, I think I’m always going to be prone to it, you know. Always need to be aware of it, always needs to try and keep my back healthy. But yeah, I’m a survivor. You know, I’ve, I’ve survived it.

Sebastian Gonzales

Yeah, when you hear people that have survived cancer, and all these other things, obviously there are different types of conditions. But it’s a it’s very inspiring for other people to hear. I think that a lot of us tend to forget about what other people are feeling around us. And, when I wrote this book, hopefully my story is an inspiration to you to try something. Your story is going to be an inspiration to somebody else. So hear it – you know.

 

Iain Barker
well, really, that is the, the main point of this podcast. Yeah, that’s what it’s all about.

Sebastian Gonzales

Nice.

 

Iain Barker
So we’ve come to the end of all the chapters in your book, we’ve been talking for over two hours!

Sebastian Gonzales

Yeah, it’s been fun.

 

Iain Barker
It has. Yeah. I’m going to get a few episodes of this, because I’m not going to do a single podcast episode of two hours. So I’m going to split it up.

Before we go, you’ve got your website. What was the address again, for that?

Sebastian Gonzales

There’s a P the letter, like Paul, two the number – sports is plural – care.com. That is, that’s the easiest way to find everything. I try to make it very seamless. But you’re looking for a mini guides, they’re in the store. If you’re looking for courses. They’re in there. The book should be front and center but it’s distributed through Amazon.

 

Iain Barker
Yeah. So I’ll put a link to your site. I saw I was looking at your site today, I saw that there were several social media icons. So I can I can link to all of those from the blog post as well. And your book … we talked about doing giveaway, didn’t we? And you mentioned that you’d be happy to give away three copies of the audio book. That’s right, wasn’t it?

Sebastian Gonzales

Yeah so these would be these would be mp3 version. They, they take about four and a half hours to listen to. I would give away Amazon ones, but I don’t have control of those. So I’m gonna make sure everyone’s clear that the, the quality that comes from that, or the usability, is not as good as Amazon, because Amazon’s just a beast. But if you can play an mp3, you can play this thing. So I’ll just share it this way.

 

Iain Barker
I think that would be quite a good thing for someone to win. A nice audio book, yeah, they can listen to, when they’re in the car, or whatever it is they’re doing, I think that’d be great.

I didn’t have time to read your book in absolute detail, because it’s quite long. And it’s packed with really useful information. And it was interesting reading your personal story as well. Your personal experience about pain.

I know that you understand, because you’ve been through it, that kind of personal experience, I think, is quite an important. So yeah, it’s a good read. And I’m going to revisit it actually, at my leisure. Because, there was some good information and I enjoyed reading it. So I think the audio book, I think that would be a great prize for someone to win. So yeah, I think that’s fantastic.

Sebastian Gonzales

Yeah, and I read it myself too. Just so everybody knows.

 

Iain Barker
I was going to ask you that. It’s your voice is it? Yeah, good-oh!

I was looking at Amazon today. And I saw that the book had a hundred percent five star reviews from I think it was 16 reviews. You must be pleased with that.

Sebastian Gonzales

I am pleased. But then I see the other books I’m like, ‘I have to get 1000!’

 

Iain Barker
Well, quality not quantity, I guess. Of the reviews that you’ve got. Everyone’s given it a five star rating. Well, you can’t beat that can you?

Sebastian Gonzales
Yeah, I’m happy with the reviews so far. And all the feedback I’ve gotten. I’m very attentive to it to make sure that I’m making the best experience I can for everybody. And actually, there was there was one, there’s actually a bad review on Audible that I saw. So it inspired me to add a part to the book. It was something to the effect of, it was like a two star three star. It was like ‘This is terrible. It’s an infomercial.’ And I’m like, ‘Oh, that’s sad.’ Because I do mention the course in there a couple times. But if I do a percentage, it was like 2% or less of the entire book is me saying that. But it’s like, ‘If you’re interested in what I did, here’s why I did this on that’ and then I just continue, so then I decided that I believe in good communication with everybody. So I put a section there, I said, I’m framing something for everybody to make sure that my clear call to action is not necessarily to buy that course. It’s to go see somebody and to get motivated. So I wanted to make sure that no one had that experience again with it. Because there’s a lot of good stuff, I think, in the book, that can help people.

 

Iain Barker
That certainly wasn’t my impression. I could tell that you had put an awful lot of work. And, you know, it’s no easy thing, writing a book. And I thought it was very well written, it reflected your experience and your knowledge. And, you know, it’s thought provoking. So, yeah, that was my experience,

Sebastian Gonzales
That’s all I can ask. I hear it’s an honor to get your first one star review. That means you’re actually a published author.

 

Iain Barker
Good for you. Fantastic. Yeah.

Sebastian Gonzales

So I’m still waiting on that one.

 

Iain Barker
I don’t understand, you’ve got all those five star reviews on Amazon already.

Sebastian Gonzales

I know. But I need a one star.

 

Iain Barker
Oh, sorry. I didn’t understand what you meant. Right? Okay.

Sebastian Gonzales

They say you finally made it when you have a 1 star

 

Iain Barker
Someone tells you that you really suck.

Sebastian Gonzales

Right. Yeah.

 

Iain Barker
Okay. Well, good luck with that.

Right. I think we’ve kind of come to the end

Sebastian Gonzales

Right on. Yeah, that was fun. Thanks for having me on.

 

Iain Barker
My pleasure. Thanks for appearing as a guest on the Back Pain Liberation Podcast. 2 hours has gone by, I thought, quite quickly. There was no fluff in there. I think we covered a lot of great stuff. And I think this is going to be a great few episodes, I think are going to come from this.

Sebastian Gonzales
Nice. Yeah. I love to see the feedback and if anyone gets inspired, and just tries something. So let me see the action steps on this.

 

Iain Barker
Okay. Let’s see what I can do about that to try and get some feedback. I’m going to think about that. Okay. Well, lovely talking to you, Sebastian. It’s been good.

Sebastian Gonzales
Then we’ll email a little bit after

 

Iain Barker
Yeah, we’ll sort out the details.

Sebastian Gonzales
Right on. Okay. Thank you so much.

 

Iain Barker
Thank you. Appreciate it. All the best now. Cheers. Bye bye.

Transcribed by https://otter.ai

BPL20: When “Correcting” Posture Causes Pain

by | Mar 21, 2019

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When “correcting” posture causes pain.

Like most people with back problems, you’ve probably tried to improve your posture by sitting or standing up straight.

The problem with doing this, is that it feels wrong; unnatural and strained.

You can’t hold it and you return to your old ways.

You wonder “Why does my back hurt when I sit up straight?”

The trick is to have an upright posture while also being properly relaxed. This takes a bit of practice.

According to today’s guest. Dr. Senastian Gonzales

Ideally, you want to have the least amount of effort possible to hold a good posture”

Excerpts from the Show

This is the fourth of 4 episodes with Dr. Sebastian.

Now is your chance to win an audiobook copy of I Will Beat Back Pain: Getting Into A Winning Mindset For Recovery

 

Today’s Guest

Founder of Performance Place sports injury specialists, and author of I Will Beat Back Pain: Getting Into A Winning Mindset For Recovery, Dr Sebastian Gonzales.

Live Pain-free Eliminate Chronic Pain without Drugs or Surgery
Click the play button to listen to this episode now

When “Correcting” Posture Causes Pain

Why does good posture hurt?

The risk is that we are so determined to hold ourselves upright, that we brace with too much muscular tension.

In reality, this isn’t good posture

 

  • It’s funny when people come in, and all of a sudden  – they know I’m looking at stuff – they’ll sit up, right? And they sit upright for a while, and they get tired of it and the slouch again
  • Sitting is not the devil. It’s just bad when it’s too much. And the same thing with a lot of other things, too. We just happen to sit a lot
  • Get up and walk around every 15 to 20 minutes or so
  • If you cue them into having really solid posture, they’re going to end up with upper back issues
  • People who are pretty resilient and who’ve done the right training, they’ll tolerate these positions longer. Not that they’re great to have
  • I would suggest build your supports, rather than just focus on the position all the time.

Belly Breathing Benefits

Sebastian likens the torso to a beer keg. The internal pressure keeping the keg strong and in good shape.

He talks about the benfits of deep belly breathing vs chest breathing.

 

  • Imagine two coke cans. I’m going to pop the top of one. The other one is going to be as it is. Which one can you stand on? … the one with the pressure in it … it’s just like a bike tire, it’s supportive
  • So if you’re breathing really highly into your chest, then you deflate … what goes along with this, a lot of times is hollowing. So they’re kind of coupled together

 

You can use visualisation for your deep belly breathing technique

  • So if you breathe deep into – although this is not possible – breathe into your hips. It’s just a lower centre of focus, or breathe into your flanks
  • There’s what we call internal versus external cueing
  • So the further the attention is, or the further the thing is away from your centre of direction, the better the response is out of the person
  • That it’s better to say … break the yoga pants versus saying expand your belly

 

360°  belly breathing – essential core exercise

 

  • 360°, in general, is what you want
  • Breathing doesn’t mean a change of posture or position. It means breathing. And we’re just changing the direction of the breathing
  • We’re trying to improve breathing into, I’ll say ‘belly region’
  • Sometimes when you say belly, people expand their belly, like a beer belly, and I don’t want that either

 

Hi, I’m Iain Barker creator of Back Pain Liberation.

I got back pain young and it got worse over time. Like many others in this situation, I saw plenty of doctors and therapists – all to no avail.

In the end self-help worked best – it often does for bad backs. Now I train regularly, focus on what works, and don’t get back pain.

My goal is to share what I learned. To help you find a more effective way when treatment doesn’t hit the spot.

 

I Will Beat Back Pain: Getting into a Winning Mindset for Recovery

Dr. Sebastian says that the most important aspect of recovering from back pain is your mindset.

People are more willing to believe a treatment will fix their problem than to get working themselves – with help from a trainer.

On a former patient who recovered from back problems

 

  • And so she sees her colleagues … and they have back pain and she tries to tell them about MRIs and how they’re not always seeing the whole picture and how all you need to do is a handful of things and you’ll directly get better and you don’t need surgery all the time… And she cannot get them to do it
  • And so the book is intended for cases just like that
  • We all really want to help people but they don’t always take the solution
  • And I’m sure they don’t realize it yet. And their intentions are good. But they’ve been fed misinformation. And they have a lot of fear
  • it’s very normal to think, that when something hurts, ‘what is it and what needs to be fixed’. And usually when something’s fixed that means something’s damaged or broken. And it’s not the case a lot
  • I want people to find the book intriguing enough to do something
  • I want them to get one-on-one attention from someone who knows what they’re doing. And then they’re going to feel amazing, it’s going to be life-changing for them.

Back Pain Rehabilitation through Exercise

Sebastian refers to the hips as the engine of the body

 

  • Well, I like to give them what they want and what they’ve asked for. And if they’re only asking for pain relief, I’ll educate them on the reasons why we should try the other things
  • My responsibility is to educate them about a more responsible stopping point
  • Most people if they just want to live a normal life and not even do athletics and not even run or any of that stuff like the marathons and so on they need to acquire the engine that’s just the simple fact of it
  • If people are going to do things in a poor way, I have the responsibility to show them. And, as long as they’re paying attention, and they do it, they don’t need to be shown twice
  • Most people can get through the entire process into loading, which is therapeutic for them, usually within about like, four or five times
  • So learning the foundational stuff is really important because it cuts through all the time and we get to the nitty-gritty. I think everyone has to realize that, that is what’s intended, and you need to do your due diligence as well
  • I think that a lot of us tend to forget about what other people are feeling around us

Biomechanics of the Spine

  • If you guys have not read Stuart McGill’s stuff, he’s the leading expert in spine biomechanics like literally anywhere in the world
  • He’s got so much research and he’s the nicest guy and he presents it in a very easy way to people. I’ve referred his book for a solution for people many times. That one’s called Back Mechanic in case you’re interested
  • The McGill Big Three is like the foundation building – high reward, low risk, endurance based core activity

 

  • His analogy is that  ‘I’m going to hand you a pound of butter in your hand, and I want you to hold it there.’ At some point your arms are going to get very tired and very painful. What’s the solution to get rid of this? And the answer is to take the butter away. Or,  instead of holding the butter up like a like a bicep curl, put the butter by your thigh and hold it like you’re holding a suitcase. It won’t hurt anymore. And there’s nothing wrong with the structure,  nothing wrong with the bicep. There’s nothing wrong with the elbow or the shoulder. There’s no MRI findings on that. It’s a simple take the load away, give it a break, give it a chance to recover. The pain will dissipate very quickly, right. So that’s basically the model that that I propose that people try first before they try other stuff

Back Pain Red Flags

  • So there are visceral organs that can refer to the back. There are malignancies which can refer to the back. There’s benign tumors, which can refer to the back. I mean, shoot, it could be menstrual cramps. So there’s a lot of different reasons
  • I know everyone’s kind of looking for a fix. Like a stretch or exercise. But really, from a healthcare perspective, our first thing is to rule out what we call red flags, or red flag conditions
  • Everyone has to realize that that your due diligence as a human is take care of yourself first. And that just comes down to being responsible with ruling out things that are serious. And that doesn’t take too long. It’s a simple thing

Thanks for Listening!

 

What inspires you to get training and improve the health of your back? To share your experience, leave a comment below.

To help out the show, click a link to iTunes, Stitcher or TuneIn:

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Thanks to Dr Sebastian Gonzales for joining me this time and talking through the issues of trying to improve posture; as well as all the other good stuff he shared with us.

Best,

Iain

 

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Full Transcript BPL20

Iain Barker
So Myth number 11. poor posture while sitting has no effect on back pain.

Sebastian Gonzales
Yeah, so you already hit on that one. Similarly, though, if people are standing too long, it’s gonna bother certain things too. So I put out a bunch of YouTube videos. And one guy – he was funny. So I talked about the book in the video. But I started with a back flow, a movement flow. And so this guy (it’s funny how strong people get with their words when there’s no profile attached to their comments). So he says, something to the effect of ‘Yeah, that’s really cool. Tell people to get better with their back, but then make it worse, with sitting and reading a book.’ My answer was ‘Well, I have an audio version. But sitting is not the devil. It’s just bad when it’s too much. And same thing with a lot of other things, too. We just happen to sit a lot.

 

Iain Barker
We do, it’s what I’m doing right now.

Sebastian Gonzales
I am too. I keep changing positions though.

 

Iain Barker
Well, this is good, isn’t it? So how would you describe poor posture while sitting

Sebastian Gonzales

Well, it’s going to be dependent upon the problem – I’ll clean that up – ideally I think you want to have the least amount of effort possible to hold a good posture. It’s funny when people come in, and all of a sudden – they know I’m looking at stuff – they’ll sit up, right? And they sit upright for a while, and they get tired of it and the slouch again.
When you’re attentively trying to hold a posture, it’s going to hurt something else . So I tend to tell them it’s like a Leaning Tower of Pisa. Just put your hips below and use a little bit of a lean. And that lean is kind of on that same concept of learning to deadlift or hinge. The hinging pattern. So if you can stack things really well you can usually stay there pretty well. It’s kind of like the game – You guys have Jenga over there? You guys probably made it?

 

Iain Barker
I don’t know about that but – we have it. Yeah.

Sebastian Gonzales

So Jenga, you can leave it there forever. And it’s not going to fall over. But if you tilt it a little bit, and stack them kind of weird, then it takes a lot of effort. Just the wind will blow, and it will fall over. So I tend to have people just sit off the end of the table and change and to get up and walk around every 15 to 20 minutes or so, Drink a lot of water, go to the bathroom, it’s going to force you, you won’t be able to hold it. So that’s probably the easiest because if you if you cue them into having really solid posture, they’re going to end up with upper back issues.
And the easiest thing is just to get them a little bit more resilient and stiff.
If you do the right programming, core stuff, and hip stuff for ’em. I think you’d be surprised. People who are pretty resilient and who’ve done the right training, they’ll tolerate these positions longer. Not that they’re great to have.
But they’ll just tolerate them more. They’re just more robust as a human body. So I think you can train for that.

 

Iain Barker
Yeah, military posture, shoulders pulled back and chest puffed out. I guess it looks alright. But, I think that ties into what you’re saying about getting upper back pain.

Sebastian Gonzales
Yeah, a lot of people that have back pain, slouching is going to bother them. So, it’s very natural to go into the other. But if you think of your spine like a coat hanger – bending in both directions aggressively and frequently. (I’ll put a disclaimer on this, this is a, this is a generic explanation, because you can bend your spine.) But at some point, the coat hanger starts to wear. And it gets it gets really tiring, with changing posture backwards, and forwards, usually forward is is painful, and they go backwards, and that’s painful, then they go forward again. And sometimes it’s progressive over the course of months. And, it’s very frustrating. So one of the easier things is, you just build that system there, you leave a keg there’s not going to go anywhere. It’s pretty solid, right? It’s true. So I would suggest build your supports, rather than just focus on the position all the time.

 

Iain Barker
Makes sense. So Myth number 12, the way you breathe has no effect on back pain. And that ties into the ‘keg’ system that you were talking about?

Sebastian Gonzales

Yeah, I usually do an example with people. Imagine two coke cans right there. I’m going to pop the top of one the other one is going to be as it is. Which one can you stand on? Without greater risk of it crumbling? Most people answer the one with the pressure in it. Because of the pressure in it, it’s just like a bike tire, it’s supportive. So if you’re breathing really highly into your chest, then you deflate, we can generally say, and also what goes along with this, a lot of times, is hollowing. So they’re kind of coupled together. So if you breathe deep into – although this is not possible – breathe into your hips. It’s just a lower center of focus, or breathe into your flanks. Sometimes people will put a band, like a hair band, around the belly, and the key was expand the band. So it’s more of a 360 fashion.

 

Iain Barker
I read about this, in the book. 360 degree belly breathing.

Sebastian Gonzales

Right. So that little belt has little nubbies on it. But it’s basically an elastic band with little, imagine golf balls. So they stab you, and then you recognize they’re there. So you breathe to expand them away.
But you could do it with…
I had people do with fingers, people do it with yoga pants – expand the yoga pants. So it doesn’t necessarily have to be that tool It was helpful to me, and I use it on occasion with patients. But I find that anytime you can get away from a brace or a tool like that;, it’s better for the person in the long run. Yeah, that’s the core 360 belt you referencing.

 

Iain Barker
Well, I read the term, 360 degree belly breathing …. but that is using the belt.

Sebastian Gonzales

I used the belt, a little bit, in my own rehab. I think that’s what I thought. And I wrote about it in there, because it was part of the story.

 

Iain Barker
But you actually visualize, sorry to interrupt you, you visualize breathing all the way down to the hips.

Sebastian Gonzales

This is a whole big tangent topic. But there’s what we call internal versus external cueing. And if you imagine I’m attempting to get someone to raise their arm. I can say, ‘Well, I want you to shrug your shoulder, and extend your hand and then contract your tricep’ And eventually they go up in the air and raise their hand. Or I can just say ‘Reach for the stars!’ And it’s a little simpler. So if you say ‘Reach over your head’. They might not know how high; but I really want them to reach high. So I can say ‘Reach for the ceiling’. But even better ‘the stars’. They’re further away. Get up there! So the further the attention is, or the further the thing is away from your center of direction, the the better the response is out of the person. And they’ve done some good research on that. That it’s better to say breathe into the hips, something like that, or break the yoga pants versus saying expand your belly. Because the belly still part of you. Notice the other two things are well, the hips are still part of you. So I’d probably say breathe into your shoes. Or something further away. And it’s not part of you. So you can affect it.

 

Iain Barker
Yeah, that’s interesting.

Sebastian Gonzales

That’s a whole other topic, though. But yeah, 360 in general’s what you want. Most times I cue people from the sides. I put my fingers onto their sides, like they’re points, and tell them to expand my fingers. And that usually gets the job done

 

Iain Barker
And can people visualize as well, breathing out towards the back, either side of the spine.

Sebastian Gonzales

They can. it’s a little harder.
Just one thought is that, a lot of times, when people attempt back there, they’ll actually slouch. And, to be clear, breathing doesn’t mean a change of posture or position. It means breathing. And we’re just changing the direction of the breathing. And we’re trying to improve breathing into, I’ll say ‘belly region’. Because sometimes when you say belly, people expand their belly, like a beer belly, and I don’t want that either. I think the words that we use are pretty important when we’re trying to improve movement, you know.

 

Iain Barker
So I noticed that you said that in over nine years of practice. You’ve only referred one case for surgery?

Sebastian Gonzales

Yeah, she needed a fusion. She was an impact one. She fell on driveway. She fared very well. So when surgery’s needed it, it’s needed. I know she won’t mind me talking about it. She’s passionate about telling people about her recovery. Because she’s just a living breathing version of someone who … she went to an orthopedic surgeon and they said to her ‘You need a fusion. You need rods.’ and she’s like ‘Well, I don’t want to do that.’ and they said to her ‘Don’t worry, when you’re ready come back.’ and she’s perfectly normal today. And it’s funny, by the way this is not bashing orthopedics, it was just her experience. The interesting thing with her today – so she has a few of my books now – And so she sees her her colleagues, her co workers and they have back pain and she tries to tell them about MRIs and how they’re not always seeing the whole picture and how all you need to do is a handful of things and you’ll directly get better and you don’t need surgery all the time. and blah, blah, blah. And she cannot get them to do it. And so the book is intended for cases just like that. The intention is good, I think we all really want to help people but they don’t always take the solution.

 

Iain Barker
No, it’s difficult

Sebastian Gonzales

And I’m sure they don’t realize it yet. And their intentions are good. But they’ve been fed misinformation. And they have a lot of fear. You know.

 

Iain Barker
Yeah totally. And I think there’s also a bit of a disbelief. I’ve got this really bad pain can I really affect it by doing something simple, like doing some training in on a regular basis? They just find it hard to believe that there is not some kind of structural cause?

Sebastian Gonzales

Yeah, well I think it’s very normal to think, that when something hurts, ‘what is it and what needs to be fixed’. And usually when something’s fixed that means something’s damaged or broken. And it’s not the case a lot. Stuart MacGill has a really good example that he typically talks about it’s an example of biomechanical loading. By the way, if you guys have not read Stuart McGill’s stuff, he’s the leading expert in spine biomechanics like literally anywhere in the world. He’s got more research on back pain like fracturing the spine and figuring out like he’s got he’s got so much research and he’s the nicest guy and he presents it in a very easy way to people. I’ve referred his book for a solution for people many times. That one’s called back mechanic in case you’re interested.

 

Iain Barker
I’m interested Yeah, I don’t know this book. Obviously I’ve heard of Stuart McGill. People talk about the McGill Big Three.

Sebastian Gonzales

That’s what he’s really known for. But it’s much more than that. The McGill Big Three is like the foundation building – high reward, low risk, endurance based core activity. His analogy is that ‘I’m going to hand you a pound of butter in your hand, and I want you to hold it there.’ At some point your arms are going to get very tired and very painful. What’s the solution to get rid of this? And the answer is to take the butter away. Or, instead of holding the butter up like a like a bicep curl, put the butter by your thigh and hold it like you’re holding a suitcase. It won’t hurt anymore. And there’s nothing wrong with the structure, nothing wrong with the bicep. There’s nothing wrong with the elbow or the shoulder. There’s no MRI findings on that. It’s a simple take the load away, give it a break, give it a chance to recover. The pain will dissipate very quickly, right. So that’s basically the model that that I propose that people try first before they try other stuff.
But again, getting people to that model is a cumbersome thing. That’s why I’m focusing more on the book, because I want people to go see, there’s mention, of a course, by the way, in the book, because when I said in the beginning that the book was a course. And I get questions from the book like ‘Hey, what is diaphragmatic breathing?’ I say ‘Great question. It’s in the course’ because I don’t have time to answer them all. But what I really want is, I want people to find the book intriguing enough to do something. And I want them to go from one-on-one attention to someone who knows what they’re doing. And then they’re going to feel amazing, it’s going to be life changing for them.

 

Iain Barker
And so the course – is that available on your website?

Sebastian Gonzales
It is. it’s under its under courses. But actually, it’s intended to be I think I wrote Part Two on it, because it’s intended for people to read the first one first, it’s like I said, it was an entire manual there, a lot of the foundational ideas are not repeated in that second part, because in theory, they already read them, you know.

 

Iain Barker
Okay, so can they get access to both of these courses on your website? If someone was interested in doing these courses, how would they go about enrolling ?

Sebastian Gonzales

So you can go on the website, that’s p to sports care, and you’ll see courses and so it’s right in there. Right now we have it hosted on Vimeo, that one’s a little higher price. I don’t know what it is right now. I believe in meeting people where they’re at. And again, this is why the the book is what the book is. And that’s why the course is what the course is. Somewhere in the middle, there’s people who don’t want to spend money. So my thought with those people is that I created, I call it a mini guide. And it’s very basic, honestly, I wrote the thing in in a couple hours. And I took videos from colleagues who taught stuff well, and it’s some of the very foundational things that people are going to want to try when they’re ready to try something. It’s not an end all it’s a baby step. And if they find that that’s something they want to continue, then they go see someone a little bit more, who’s gonna help them one on one or they just go and check the course. You know, so, but I know not everyone’s ready to invest in something like that. It’s scary to think that you’re going to have to pay forever to go to someone, but you don’t. Most of you find someone good, you won’t. Yeah, I’ve seen back cases that resolved and they’re on their own within four or five times.

 

Iain Barker
So yeah, as you say, some doctors are quite happy to have someone keep coming back. But that’s not your goal.

Sebastian Gonzales

Well, I like to give them what they want and what they’ve asked for. And if they’re only asking for pain relief, I’ll educate them on the reasons why we should try the other things. Maybe they want us to start it, they want to be skeptical they want to do first aid. That’s okay. My responsibility is to educate them about a more responsible stopping point. And I tend to think most people if they just want to live a normal life and not even do athletics and not even run or any of that stuff like the marathons and so on they need to acquire the engine that’s just the simple fact of it. That’s going to take that’ll probably take a few months of training. I remember this one time this guy came, and he was the only person I’ve ever met who … so I programmed a clean in his homework, and he said ‘A clean – got it’ I said ‘You know what? Show me your clean’. because he’s very confident he had it. And he had the best clean I’ve ever seen. It was perfect. And he’s the only person ever so.

 

Iain Barker
Sorry to interrupt you. This is a weightlifting, term? This is when you lift the weight up to shoulder height. Is this a clean?

Sebastian Gonzales

Right. It’s like a quick movement that it lands on your shoulders. And so that was part of this program. But he’s the only person I’ve ever met, with that one movement, that I felt comfortable saying, ‘Yes, go home and do that’. Most other people, I remember this one lady. And like, I’ve seen her on and off over the years and she’s sweetest lady. But she used to come in only four steps one and two. Finally, she was mentally ready for some type of level three, four type of thing, some strength thing. So she said ‘What kind of rehab should I do?’ And our time was kind of out for that day. And I said, ‘Well, why don’t you do…’ (it was for her shoulder) I said ‘Why don’t we just do a row then?’ And so we kept talking a little bit. And she said, finally ‘A row. So is that the one where you just kind of pulling backwards and like you’re seated?
And I said ‘Look, let me do this. Next time, let’s only do strength conditioning suggestions. So you can do it well.’
So your comment about I don’t like to keep people for a long time. There’s little steps where, if people are going to do things in a poor way, I have the responsibility to show them. And, as long as they’re paying attention, and they do it, they don’t need to be shown twice. Most people can get through the entire process into loading, which is therapeutic for them, usually within about like, four or five times. But if they want to stay later and learn more stuff, it’s totally up to them. So they’re the boss.

 

Iain Barker
Okay.

Sebastian Gonzales

But yeah, they should be feeling better pretty quickly, though. That’s the moral the story.

 

Iain Barker
Okay. I guess there’s always more to learn.

So chapter nine, you talk about reasons for back and hip pain that are not from the muscular skeletal system. So I guess this is the kind of scary stuff which is rare but something that we kind of need to be aware of.

Sebastian Gonzales

Yeah. So maybe everyone should consider heart attacks, right? If you have hand pain or arm pain. It’s not always the arm. So there are visceral organs that can refer to the back. There are malignancies which can refer to the back. There’s benign tumors, which can refer to the back. I mean, shoot, it could be menstrual cramps. So there’s a lot of different reasons. And I know everyone’s kind of looking for a fix. Like a stretch or exercise. But really, from a healthcare perspective, our first thing is to rule out what we call red flags, or red flag conditions. And these are them. I’m sure there’s a lot of healthcare providers where, sadly, they’ve had some of these walk into their office and they caught them or they didn’t catch then. Or maybe the person didn’t follow up, or they jumped care to somebody else. And there wasn’t enough time to have a rapport built to really get into the nitty gritty. So everyone has to realize that that your due diligence as a human is take care of yourself first. And that just comes down to being responsible with ruling out things that are serious. And that doesn’t take too long. It’s a simple thing.

 

Iain Barker
So, from a practical point of view, if someone’s got back pain, the first thing to do is go see a doctor and make sure it’s not some very scary condition. And once that’s been ruled out, then maybe you’re kind of looking at some kind of physical training rehabilitation program, is that right?

Sebastian Gonzales

Right. And then so encompassed in that there might be blood work, they might do advanced imaging, and they might do an MRI. But again, the MRI is going to show things that are scary, that are not really that relevant. They’re looking for other things. So I think there’s no substitute for seeing someone in person. And I know everyone has these online things and so on, and they’re great. And the intention is to guide people where there’s no help. But when at all possible, you come in, you see someone that knows what they’re doing. I’ve had people come in that, one of the foundational ones with McGill is the bird dog. And they they come in doing a bird dog, the bird dog is pretty good, but maybe the tension is poor. Or they have a little pain with it. And so we do a minor tweak and all of a sudden they’re like ‘Oh, that didn’t hurt at all’ and then they can progress and just do it. So learning the foundational stuff is really important, because it cuts through all the time and we get to the nitty gritty. I think everyone has to realize that, that is what’s intended, and you need to do your due diligence as well.

 

Iain Barker
That makes total sense. And chapter 10 is called how my story ends. And I’ve just got a little excerpt from that where you say, ‘I hope this book has assisted you in getting into a healing mindset, practice telling yourself, I’m a back pain survivor.’

And that’s how I think of myself, actually. Yeah, exactly that – a back pain survivor, I think I’m always going to be prone to it, you know. Always need to be aware of it, always needs to try and keep my back healthy. But yeah, I’m a survivor. You know, I’ve, I’ve survived it.

Sebastian Gonzales

Yeah, when you hear people that have survived cancer, and all these other things, obviously there are different types of conditions. But it’s a it’s very inspiring for other people to hear. I think that a lot of us tend to forget about what other people are feeling around us. And, when I wrote this book, hopefully my story is an inspiration to you to try something. Your story is going to be an inspiration to somebody else. So hear it – you know.

 

Iain Barker
well, really, that is the, the main point of this podcast. Yeah, that’s what it’s all about.

Sebastian Gonzales

Nice.

 

Iain Barker
So we’ve come to the end of all the chapters in your book, we’ve been talking for over two hours!

Sebastian Gonzales

Yeah, it’s been fun.

 

Iain Barker
It has. Yeah. I’m going to get a few episodes of this, because I’m not going to do a single podcast episode of two hours. So I’m going to split it up.

Before we go, you’ve got your website. What was the address again, for that?

Sebastian Gonzales

There’s a P the letter, like Paul, two the number – sports is plural – care.com. That is, that’s the easiest way to find everything. I try to make it very seamless. But you’re looking for a mini guides, they’re in the store. If you’re looking for courses. They’re in there. The book should be front and center but it’s distributed through Amazon.

 

Iain Barker
Yeah. So I’ll put a link to your site. I saw I was looking at your site today, I saw that there were several social media icons. So I can I can link to all of those from the blog post as well. And your book … we talked about doing giveaway, didn’t we? And you mentioned that you’d be happy to give away three copies of the audio book. That’s right, wasn’t it?

Sebastian Gonzales

Yeah so these would be these would be mp3 version. They, they take about four and a half hours to listen to. I would give away Amazon ones, but I don’t have control of those. So I’m gonna make sure everyone’s clear that the, the quality that comes from that, or the usability, is not as good as Amazon, because Amazon’s just a beast. But if you can play an mp3, you can play this thing. So I’ll just share it this way.

 

Iain Barker
I think that would be quite a good thing for someone to win. A nice audio book, yeah, they can listen to, when they’re in the car, or whatever it is they’re doing, I think that’d be great.

I didn’t have time to read your book in absolute detail, because it’s quite long. And it’s packed with really useful information. And it was interesting reading your personal story as well. Your personal experience about pain.

I know that you understand, because you’ve been through it, that kind of personal experience, I think, is quite an important. So yeah, it’s a good read. And I’m going to revisit it actually, at my leisure. Because, there was some good information and I enjoyed reading it. So I think the audio book, I think that would be a great prize for someone to win. So yeah, I think that’s fantastic.

Sebastian Gonzales

Yeah, and I read it myself too. Just so everybody knows.

 

Iain Barker
I was going to ask you that. It’s your voice is it? Yeah, good-oh!

I was looking at Amazon today. And I saw that the book had a hundred percent five star reviews from I think it was 16 reviews. You must be pleased with that.

Sebastian Gonzales

I am pleased. But then I see the other books I’m like, ‘I have to get 1000!’

 

Iain Barker
Well, quality not quantity, I guess. Of the reviews that you’ve got. Everyone’s given it a five star rating. Well, you can’t beat that can you?

Sebastian Gonzales
Yeah, I’m happy with the reviews so far. And all the feedback I’ve gotten. I’m very attentive to it to make sure that I’m making the best experience I can for everybody. And actually, there was there was one, there’s actually a bad review on Audible that I saw. So it inspired me to add a part to the book. It was something to the effect of, it was like a two star three star. It was like ‘This is terrible. It’s an infomercial.’ And I’m like, ‘Oh, that’s sad.’ Because I do mention the course in there a couple times. But if I do a percentage, it was like 2% or less of the entire book is me saying that. But it’s like, ‘If you’re interested in what I did, here’s why I did this on that’ and then I just continue, so then I decided that I believe in good communication with everybody. So I put a section there, I said, I’m framing something for everybody to make sure that my clear call to action is not necessarily to buy that course. It’s to go see somebody and to get motivated. So I wanted to make sure that no one had that experience again with it. Because there’s a lot of good stuff, I think, in the book, that can help people.

 

Iain Barker
That certainly wasn’t my impression. I could tell that you had put an awful lot of work. And, you know, it’s no easy thing, writing a book. And I thought it was very well written, it reflected your experience and your knowledge. And, you know, it’s thought provoking. So, yeah, that was my experience,

Sebastian Gonzales
That’s all I can ask. I hear it’s an honor to get your first one star review. That means you’re actually a published author.

 

Iain Barker
Good for you. Fantastic. Yeah.

Sebastian Gonzales

So I’m still waiting on that one.

 

Iain Barker
I don’t understand, you’ve got all those five star reviews on Amazon already.

Sebastian Gonzales

I know. But I need a one star.

 

Iain Barker
Oh, sorry. I didn’t understand what you meant. Right? Okay.

Sebastian Gonzales

They say you finally made it when you have a 1 star

 

Iain Barker
Someone tells you that you really suck.

Sebastian Gonzales

Right. Yeah.

 

Iain Barker
Okay. Well, good luck with that.

Right. I think we’ve kind of come to the end

Sebastian Gonzales

Right on. Yeah, that was fun. Thanks for having me on.

 

Iain Barker
My pleasure. Thanks for appearing as a guest on the Back Pain Liberation Podcast. 2 hours has gone by, I thought, quite quickly. There was no fluff in there. I think we covered a lot of great stuff. And I think this is going to be a great few episodes, I think are going to come from this.

Sebastian Gonzales
Nice. Yeah. I love to see the feedback and if anyone gets inspired, and just tries something. So let me see the action steps on this.

 

Iain Barker
Okay. Let’s see what I can do about that to try and get some feedback. I’m going to think about that. Okay. Well, lovely talking to you, Sebastian. It’s been good.

Sebastian Gonzales
Then we’ll email a little bit after

 

Iain Barker
Yeah, we’ll sort out the details.

Sebastian Gonzales
Right on. Okay. Thank you so much.

 

Iain Barker
Thank you. Appreciate it. All the best now. Cheers. Bye bye.

Transcribed by https://otter.ai

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