Edinburgh Deep Tissue Massage

I often see my pal Colin when I need some kinks working out of my back. As a body worker - massage with some of Tom Myer's Anatomy Trains approaches - he really know his stuff.

He is currently using facebook to post interesting bits and pieces of remedial exercises and ideas on injury treatment.

Go over to his page on facebook, and click "like" so that you can keep up with the stuff he is writing. (Also visit his blog)

Here is the latest post (which accurately describes my back problems!):

When I get a new client one of the more common problem areas they come to me with will be their lower back. There’s also a pretty good chance that they spend most of the day sitting down so the source of the problem can, in some respects, be easy to identify. [edit - by the way there is an interesting piece on sitting here] Aside from poor posture and its associated problems one of the biggest contributory factors are the gluteals and gluteus medius in particular.

When we are sitting the gluteals are being stretched which over time causes them to become inactive, weak and, from a fascial point of view, tight. The primary role of glute medius is to stabilise the pelvis when we walk or run the loss of the ability of gluteus medius to do it’s job properly obviously will then cause a reduction of stability in the pelvis as we move.

This instability causes muscles in the torso such as the obliques and quadratus lumborum to have to work harder to stabilise the torso as they lack the base of a stable pelvis. This is compounded by the fact that the the increased fascial tension moves through what Tom Myers would call the lateral line from the gluteals and into the obliques and as a result affecting the back. While there is more to it all than what I’ve outlined above it would turn this short post into a much longer and not necessarily any more informative post so let’s get onto how to help fix it.

We want to try to activate and strengthen the glutes so this is a great exercise to do just that and comes with a great explanation from Dr Bill Booker. It is also a great exercise to include in any athlete’s warm up protocol .

Doug McGuff on Lower Back Training

A couple of videos from Dr Doug McGuff, on how to train the lower back:

First the physiology:



then the exercises:



hat tip

An unreal lower back

Rif pointed this out. Look at this guy's lower back musculature. Absolutely amazing.

McGill Exercises

In discussing back pain, some people - including Bill De Simone - have recommended that I look at McGill;s exercises. Here is a video of him looking at his ideas which are also described here:

Back Pain...TMS or Z...or both?

I've posted some stuff in the past about back pain, particularly looking at TMS - the pain being real but a physical manifestation of something going on psychologically. Your mind creating real pain in your body to distract you from subconscious worries and anger and other emotions. Your mind is giving you real physical pain to distract you from what is really stressing you....

My interviews with Monte and Adam explain this all in more detail.

Then I was at that workshop with mc last week and she was talking about how the body reacts unconsciously to threat....health is about threat modulation....Emotions effecting, causing something physical.....now something physical can affect emotions.....

Things connect...that there are emotional factors at play, even at an unconscious level.


In my interview with Frank Forencich he alluded to something similar:

Depression is epidemic. The World Health Organization forecasts that, by 2020, “depression will be second only to heart disease in terms of disability or disease burden.”

To me, this is even more shocking than our epidemics of heart disease, obesity and diabetes. This is a disease state that’s psychospiritual as well as physical. There are many explanations, but I like the work of Kelly Lambert. She’s a neuroscientist who’s traced reward centers in the brain. She’s discovered a strong association between areas that coordinate movement and those that deliver a sense of satisfaction. I call this “the ancestral reward system.”

mc has discussed back pain more in a new post:

Thoughts on Low Back Pain

The big take away seems to be that especially chronic low back pain is frequently not about the joints - pain is way more interesting and intriguing it seems than that, but it does make sense that the low back is where so much chronic pain gets filtered.

Mind-Body Conditioning...

Last week I posted an interview with Monte Hueftle, a runner and writer who specialises in running injuries generated by emotional factors, following in the teaching of Dr John Sarno

There are other writers that have traced their own pain to emotional factors too. This is a guest post from one of them - Adam Rostocki. Adam is a martial artist who has battled with pain and finally conquered it through following Sarno's approach. I am convinced that much pain is emotional at its root.

Mind Body Conditioning

Physical Conditioning vs Psychological Conditioning

I welcome the opportunity to speak to you about conditioning.

As a serious martial artist for over 34 years I am well aware of the demands we all place on our bodies. In the course of training, I learned to use physical conditioning to make my body strong and increase my endurance and overall physical abilities. However, the type of conditioning I want to share with you today has nothing at all to do with the body. Instead, I would like to share some thoughts on psychological conditioning, specifically how it relates to physical performance and especially the generation of pain. A tremendous amount has already been written on this topic, so I hope to provide some intimate knowledge on the subject by relating my own personal experiences on how the mind can cause physical pain.

A Student of Chronic Pain

I am a student of chronic pain. I suffered from a variety of physical ailments as a child and teen, including wrist pain (blamed on my fanatical pursuit of drumming perfection), headaches and an ultra-sensitive stomach. None of these conditions were really more than annoyances, but they were ever present in my young life. I was a sensitive and independent child, the product of a broken home and I became a vegetarian at age 4, despite the protests of my family. Doctors had no real explanation for why these painful symptoms never went away, but I was too concerned with being a kid to care much about them…
The beginning

At 16, I was working hard in school, with my band and in a part time job. My family was poor and I felt that stress terribly as I readied myself for college. I knew I needed a full scholarship or I was simply out of luck. Within a few months, I developed horrific back pain completely out of the blue. The symptoms were in the lumbo-sacral junction and were linked to movement of my neck. I could not sit at all without burning, searing pain. Being completely naïve to the ways of medical and complementary medicine at this point, I visited a chiropractor after weeks of suffering and was diagnosed with degenerative disc disease, muscle imbalances and scoliosis. I entered treatment and so began my 18 years of tortuous agony with chronic back pain…

I suffered with recurrent bouts of acute back spasms and continued to suffer stomach concerns for my entire young adult life. None of these symptoms stopped me from doing what I wanted, since I was an extremely driven, perfectionistic, stoic, self-critical and achieving person. If I was in misery, I just coped with it. My love for martial arts led me to achieve various degrees of black belt ranking in 4 separate styles of Karate, Judo and Jiu-Jitsu, as well as instructor certification in Tai Qi Quan. I developed my own system under my instructor’s tutelage and opened my own martial arts school. However, as I got older, my pain became worse and worse, evolving into a chronic pattern of daily torment.

Nothing worked…then hope!

To make a long story short about my back pain experience, I tried virtually everything to cure the suffering. I was treated with chiropractic, injection therapy, pharmaceutical therapy, TENS, acupuncture, massage, physical therapy, Traditional Chinese medicine, Reiki, traction, dietary therapy and activity addition and avoidance. I was recommended as an ideal candidate for surgery by many doctors and was even threatened with my continuing functionality if I did not acquiesce to surgical intervention by at least several noted orthopedic surgeons. Eventually, I began to discover the same path that other incredibly frustrated back pain sufferers find as a last hope…knowledge therapy.

Dr. Andrew Weil was my first exposure to a medical practitioner using the mind as a causative explanation for physical maladies. His brilliant writings led me to explore further, leading me to Dr John Sarno, Dr. Candace Pert, Dr. Marc Sopher and others. I never would have even considered the idea that my back pain, as well as all the other chronic physical concerns I endured, were the result of a mindbody process. They just seemed so physical and had structural anatomical explanations provided to me by my trusty care givers. This was my mistake and is also the number one reason why people DO NOT recover from chronic pain.

The beginning of recovery

As I became well versed in mindbody medicine, I realized how much it all made sense. I had studied the mindbody connection my entire life and was an expert in certain aspects of it, but was completely ignorant about others. I learned that the mind could make my body do incredible things in martial arts training. I could literally will my body to perform anatomically impossible tasks using internal energy. I just never realized that this ability also reflected the subconscious mind’s capacity to make the body do what it wanted, as well. I knew who I was personality wise, but did not realize the effects my very nature had on my body. The way I was wired emotionally made me particularly susceptible to mindbody conditions which stem from emotional issues, but are expressed in the physical body. This was the beginning of my recovery…

It is obvious to all that the mind controls the body in many ways. Hypnosis, sexual arousal, fear, fight or flight response, anxiety, stress and happiness all cause noticeable reactions in our bodies. However, even though these facts are well documented and accepted in medical literature, doctors still do not credit the mind for being able to cause pain in the body. Instead, they blame a plethora of structural scapegoats throughout the anatomy. When it comes to back pain, the spine is the typical target pariah. Doctors will be happy to do a battery of diagnostic testing and tell you all the seemingly horrible abnormalities you have in your spine. However, they will not tell you that practically everyone has these same issues, including themselves, but not everyone suffers pain from them. Scientific evidence clearly shows that there is little relationship between the most common spinal diagnoses, including degenerative disc disease, herniated discs, osteoarthritis and spinal stenosis, and the occurrence of chronic pain.

Conditioning

So, finally, we come around to conditioning… Conditioning occurs constantly in our minds. We perceive events and relate them to feelings and experiences we have. This is life. However, when it comes to pain, we rely heavily on conditioning. Our drives to succeed and our inner desires to avoid sensitive and painful emotional issues place a huge burden on our subconscious. The subconscious fears the conscious acknowledgment of these emotional concerns and pressures, so it looks for a way out. Physical pain is the answer.

The subconscious uses the autonomic system, and other bodily systems, to create pain anywhere in the physical body. However, statistics clearly show that the mind will target areas known to be sites of former injury or regions with an obvious and known abnormality, in order to make the pain seem more “physical”, more convincing, if you will. We are conditioned to accept the structural nature of these aches and pains every time we experience them in conjunction with an otherwise innocent activity, such as sitting or bending. These are typically things our bodies have done countless times in the past, but are now agonizing and it is no surprise that these painful activities are most often linked to things we MUST do for work or family responsibility…

We never even consider the source of the pain as being anything except the part of our body which hurts. We also do not question our diagnosis, even if the symptoms presented do not correspond exactly with the expectations from a particular diagnosed condition. I encourage all of you to discount the body as the cause of most chronic pain. Consider that fact that medicine is extremely efficient and successful at curing structural issues with the body. If you have not enjoyed relief from ANY chronic bodily pain, despite a wide range of seemingly appropriate treatments, there is a very good chance that the source of your discomfort is not residing in our body, but instead, in your mind.

It is up to you to cure yourself

This simple philosophy literally saved my life and has put me on a new path. I have dedicated my life to helping others see the truth about how the mind and body are equal parts of the human entity and work together to create ALL conditions of health and disease. I have written exhaustively about this topic in my books, articles and websites and encourage interested readers to continue to study these ideas in order to find true health and comfort in life. The mind can make the body feel pain logically or illogically. The subconscious mind will also use its influence over the consciousness to make you think and believe the pain is anatomical. It is up to you to learn why the scientific model of chronic pain DOES NOT make sense. It is up to you to investigate how and why millions have recovered from disabling pain syndromes, including dorsopathy, fibromyalgia, TMD, carpal tunnel syndrome and plantar fasciitis, using only emotional and psychological therapies. It is up to you to cure yourself.

Knowledge Therapy

I leave you with a final thought… Many doubt the theory of how the mind can enact pain. Objectively, medical science is adamant in their Cartesian beliefs, but abysmal in their curative results. Knowledge therapy is highly effective and flexible in application. Would you rather follow the accepted norm and continue believing in a myth while in pain or embrace the truth and find relief? After all, the world was flat for thousands of years…

Sensei Adam Rostocki is the author of 3 books and maintains of huge database of dorsopathy information on his Back Pain website, Cure-Back-Pain.Org. Interested readers are encouraged to find all of Sensei’s writings by searching Google using his name. Sensei would like to thank Chris Highcock for this opportunity to share this article with his readers.

Running Pain - An interview with Monte Hueftle

In a recent post I talked about my back pain and about the idea that much of it is not due to physical injury, but to emotional factors (TMS or Tension Myoneural Syndrome as the originator of the theory - Dr Sarno - now calls it). It is still real physical pain – not imaginary – but the cause is emotional. Public speaking can make you blush – a real physical reaction – but the cause is emotional. Physical pain can be the same thing.

In this post I interview a guy called Monte Hueftle, a long distance runner who has also battled back pain. He explains where his pain came from, how he finally identified the cause and - crucialy - how he has managed to cure it.


I first read Monte’s book – Get Rid of the Pain in your Butt Now! – a few years ago when my own back was playing up. My pain has returned recently and I have gone back to Monte’s book and one or two others. You may find this stuff a bit challenging and but I’d urge you to read and consider what Monte is proposing. I thoroughly recommend his book.



Monte can you give the readers a little bit of background on you as an athlete: what is your record as a runner?

Sure. I have been running since cross country in high school. I mainly focus on the longer distances. I have run 6 marathons with a PR of 2:42, 8 half-marathons – PR of 1:16:50. Haven’t run a 10 in a couple of years and that was around 36:10

Are you still competing?

Yes, I’ll be 49 in December, can’t wait to get to the 50-54 age group though. I train about 75 miles per week and have my sights set on running a new PR in the half early next year. One of my goals is to continue to set PR’s.

Most of the readers of this blog are fairly serious amateur athletes. We may not be that good, but we enjoy our training and love the sheer pleasure of movement and exercise. We take it seriously and it is a big part of our lives. As an athlete do you understand the frustration that many of us feel when we are unable to train or compete because of injury?

Absolutely I relate. Running was and probably is still the most important part of my life. When I had piriformis for 3 years it was the most depressing/frustrating time of my life. And this carries over into work life and your relationships. When you can’t do something you love and can’t completely figure out what is going on with the body it’s not much fun.

What sort of pain were you experiencing at its height?

I had chronic lower back pain from about the time I was 18 years old. I would get back spasm about 3 or 4 times per year and chronic stiffness in the legs and back. Incredible inner knee pain that came totally out of the blue but it was the piriformis and sciatica that just make running and life in general miserable. I had non-stop piriformis for 3 years.

Your book explains that you went through a whole series of treatments – physical therapy, massage, yoga. Did it help?

I got absolutely no relief from chiropractic, massage, nerve stimulation, orthotics, lower back brace, specific exercises to strengthen, acupuncture, relaxations exercises and knee brace.

How did you finally work out what was causing the pain?

I found Dr. Sarno’s book on healing back pain. The book described my physical condition, my Type-A personality and stated that the pain was caused by psychological dynamics like inner stress and tension. It also stated that the biggest key to healing the pain was to Think Psychological. This means that you must stop treating the pain/injury with physical treatments and that the pain symptom is always a signal to reflect on your thoughts and your emotions---what and how you are feeling.

How quickly did you manage to conquer the pain?

My chronic stiffness and back pain were gone within weeks—at least 90% of it. The piriformis and sciatica I had to work on myself a little more. It took me about another 7-8 months to be fully pain free. Much of that was due to learning how my thoughts and behaviours were generating inner tension and then on how to reverse or change those patterns. That was the hard part and this is why I have written three books on how to permanently end this pain disorder.

At first did you think that this approach – the emotional aspect of pain - was all a bit too “alternative” / hippy / weird stuff or did it make sense?

Two things about this:

1. When you have tried everything and are at a loss you are probably going to be more open to an alternative diagnosis.

2. I earned a degree in clinical hypnotherapy and had studied the mind body connection for quite a few years, so I was very open to it from the beginning. This is quite important to understand. A person must accept the mind body diagnosis in order to begin to think psychological and stop all the physical treatments. This is the biggest challenge for people and especially athletes who are really conditioned to treat any pain as an over-use or muscle imbalance injury.

Does you pain ever recur? How would you / how do you cope if it does?

Never like before. I have not had one spasm in nine years. The low back pain has never reoccurred. On occasion I will feel the sciatica or piriformis sensations. They are like a reminder to make sure you are paying attention. The key to coping is to always, always, always Think Psychological. The biggest key to remaining pain free is paying attention to your thoughts and behaviours. A person knows when they are creating inner tension or losing energy to a person or situation. When you monitor the psychological aspects of yourself and then change or redirect when you are creating lots of inner stress you can keep the pain disorder from coming back.

I must admit that I am pretty convinced by the argument that you and Sarno and others advocate. It seems obvious to me that mental and emotional issues have very real physical impacts on the body. An example I think of - which I suppose reveals my base nature – is sexual arousal. An image – even a mental image – that is explicit can easily cause a physical change in the body – an erection or whatever. Something wholly mental has an impact on the physical body. Does that make sense?

Yes, perfectly. Also people accept for example the tension headache or the ulcer caused by stress. Scientist have now shown us that emotions have physical locations in the body. The challenge is accepting this for chronic soreness, back and knee pain or piriformis, especially when you are an active person and you can associate the pain with activity.

How would you explain your approach to pain to - say - a recreational athlete struggling with persistent / intermittent back pain?

First, take a look at your history of pain and of treatments. Have you been able to successfully heal these pain symptoms or injuries? Also does it appear that you win certain battles of pain but then always seem to be fighting a new one, a new injury or a new pain symptom or location? It is important to take this type of investigation so that you can open your mind to looking at a completely different diagnosis as the cause of the pain.

Next I would want to make the association that people have with a tension headache and stress in their life or an upset stomach and stress. We all in some way are able to identify stress with affecting our body in some way. I would then ask this person if they identify themselves with the Type A personality behaviours—Striving, People Pleasing, Perfection, Highly competitive. Do they consider themselves the type of person that worries a lot and is being self-conscious and/or do them seem to hold their feelings inside. I would then explain that it is common for people with many of these qualities to generate a tremendous amount of inner tension and that there is a chronic pain disorder that is caused by this generation of inner tension. I would explain that this is real pain and it closely resembles the pain sensations felt by physical injuries.

Next I believe it is important for people to understand the biochemical event taking place in the body that is manifesting the pain. When our autonomic nervous system becomes overloaded with inner tension it will automatically constrict blood vessel walls. This means less oxygen is making its way to muscle and nerve tissue. When these tissues have their oxygen supply restricted the result is a variety of pain symptoms—burning, soreness, spasm, stiffness, shooting, burning, tightness and numbness.

While understanding the argument, I still struggle with back pain myself, particularly at stressful times of my life. I do my best to “think psychological” as Sarno prescribes, but sometimes I’m left more frustrated. I am aware of some of the things that stress me out – work, a relationship – but thinking about them doesn’t seem to get rid of the pain. Where could I be going wrong?

You just explained the major struggle most people have and why they remain stuck to some degree in this pain disorder.

For some, at least initially being aware of this pain disorder caused by psychological factors is enough to reverse the pain. However, I have discovered that usually just being aware of the stress-pain relationship and knowing that stress is the cause is not enough to reverse this disorder. Here is why. This is a chronic pain disorder caused by our daily, moment to moment, chronic behaviours and thoughts. So a person will be aware that they are in a striving, people pleasing mode, and they know that this is generating inner tension and then pain, but they don’t do anything else!

My work in this pain disorder is focused on helping people understand that they must begin to change their chronic behaviours and thoughts that generate inner tension. If a person doesn’t stop generating inner tension/stress they are not going to stop this pain disorder. It is significant to understand that a person in worry or being very self-conscious or holding in anger is doing two things:

1. Generating new inner tension and

2. Repressing emotional energy or holding it down, which also generates inner tension.

Awareness is where you must start, but once you are aware that you are generating tension/stress, you must learn how to change or redirect out of those patterns.

I admit that I still get a regular massage. Most of the time it is purely for relaxation but when I have a back spasm or cramp I do submit to their treatment. Could this be an issue – me still looking for a physical cause?

I am extremely anal when it comes to physical treatments. The short answer is that if you are doing anything to treat your body in the hope that it is going to somehow fix or cure your pain/injury, you are breaking the number rule on how to heal from this disorder. This is the crux of Think Psychological. It means that every communication that you make back to the body/pain/injury is psychological. In the beginning a person must be this anal about getting or even thinking about physical treatments. This may sound quite knit picky, but I am telling you it is a big, huge deal. If you can truly go and get a massage because it makes you feel good and by no means do you believe it is going to fix your body then yes, have at it. You must be completely honest with yourself here though.

Thinking psychological is also hard work! It is not easy to dwell on things that are painful / frustrating and disappointing to me. I sometimes feel that I am fighting my own mind.

Yes, in the beginning, it is mentally exhausting. For maybe the first time in our life we are actually paying attention to what we are thinking and then we are analyzing it and then trying to change it. But this becomes much easier and then it actually begins to give you more energy. At first you need to listen in on your inner conversations so that you are aware of what you are thinking. Once you are aware of your thoughts, the chronic ones become a signal for you to change or redirect out of that thought.

Here is what I mean. Let’s say you are a big worrier. You know that this worry generates tension and anxiety within you. The next time you catch yourself in these worry thoughts you make the choice to deliberately think a new thought, one that is not so much in worry, and then you built on that thought with another one. It is a process and it takes discipline and practice.

When we make the decision to stop generating inner tension so that we can stop manifesting pain we find the inspiration and energy to continue on. Because suddenly we begin to feel the results in our body and then we go “wow” this is fun, this is working and we keep moving forward with it.

How much pain do you think is caused by mental factors? Is it the predominant cause of pain and disability in our society?

I believe it is easily 90% and probably higher. My own case as an example. I’m 48 and I have averaged running about 50 miles per week for the past 30 years. I have had all sorts of back, neck, leg, piriformis, itbs and sciatica pain. Chronic stiffness and soreness and probably 25 back spasms. I can say that 100% of this pain has been due to psychological factors creating inner stress/tension. For the past 5 years I have been consulting with chronic pain patients and it is phenomenal to hear the success stories of people who have been in physical pain for half of their life, tried every treatment known to man and when they begin to apply the principles of treating chronic pain caused by inner stress/tension and anxiety, their pain goes away. It is absolutely astounding!

You seem to take quite a “spiritual” approach. Other writers working from the same premises seem to be a bit more into positive thinking. Fred Amir for example focuses very much on goal setting, rewarding his “inner child” and mental imagery. Does this just reflect your different personalities or are your approaches really similar?

Everyone at the core practices "Think Psychological". This always means the pain is a signal to think about how you are being/thinking and not to think physical injury or treatment.

I am 100% confident that this disorder is caused by inner stress/tension/anxiety, as are all TMS doctors. I take the approach of then getting to the core of how a person is generating this inner tension in order to reverse the effects. Everyone is generating inner tension through behaviours and thoughts. Period!

I was fortunate enough to experience my pain subside greatly though a very physical power yoga practice. What I realized though, it was not so much the physical exercise as it was the tremendous amount of mindful focus that it took to breath, hold locks, stay balanced, count your breaths and change postures that was the transformational healing force. Understand that it is impossible to be in angry or worry thoughts when you are counting breath #3, contracting your perineal muscle, holding in your abdominals, breathing closed mouth, while keeping your balance in a position that is stretching legs, arms and everything else.

It is impossible to be generating inner tension when you are being so mindful. So I began to apply this mindful focus to simple mindless activities like: eating, taking a shower, brushing your teeth, walking up steps. When you do this or I should say be this way you are not in your dominant chronic behaviours and thoughts that generate inner tension. Having been a certified, clinical hypnotherapist, I believe that imagery and hypnosis are very beneficial in helping a person understand their psychological make-up. I have been fortunate to be pain-free for the past 8 years.

The reason for this is three-fold:
1. Understanding that you must Think Psychological and not physical.
2. Realizing that you must change the unique ways that you create inner tension through your thoughts and behaviours.
3. Implementing an on-going practice: of paying attention, being mindful, having a focused practice like power yoga and utilizing different practices like guided imagery and journaling that help keep you in check and balance mentally-physically and emotionally.

One thing that I have thought of - prompted a little by Scott Sonnon is the idea that if the mind/emotions can affect the body, can the body also affect the mind/emotions? Are there physical things we can do that can prompt certain mental states?

Sure.

I love what Dr. Elmer Green, the great Mayo physician and biofeedback expert stated.

"Every change in the physiological state is accompanied by an appropriate change in the mental emotional state, conscious or unconscious, and conversely, every change in the mental emotional state, conscious or unconscious, is accompanied by an appropriate change in the physiological state"

Physical exercise is the best example right. Go out for a high tempo 10 miler and experience the runners high. Do a highly focused 45 minutes of power yoga and you will feel emotionally and mentally clean. Practice guided imagery. Image energy or light moving through your body. Do it slowly at first and then have it move at the speed of light. Do this for 3-5 minutes and you and have changed the chemistry of your body and of your mind/emotions.

One of the themes of this blog is that I am very much sympathetic to the evolutionary fitness approach / primal blueprint. There are a number of writers now proposing diet and fitness approaches that start from the premise that we are still basically hunter gatherers and as such our activity patterns and diet should be those of hunter gatherers to promote health. We are still physically cavemen but we are living in a world that is very different form the one for which we were designed. One aspect of this approach that I think is underappreciated is the psychological. In his essay Evolutionary Fitness Art DeVany states:

Modern life leaves our minds restless and under utilitized because we are confined, inactive, and comfortable. That is why we restlessly seek stimulation and sensory satisfaction. Some find it in entertainment (an industry that could not exist but for the extraordinarily stimulating environment of our ancestors) in the form of television, movies, or novels. Others seek it in simulated adventure like mountain climbing or dangerous sports (like me). We cannot be satisfied with more and more, because we are evolved for another lifeway in which material goods do not matter. The result is that we are deeply unsatisfied with modern life and don’t know why.

Do you think primitive man – or even present day hunter gatherers – experience the sort of chronic emotionally induced pain that seems to dominate our societies?

Sure. Anyone anywhere that is competing and being self-conscious or striving to please or judging, comparing and complaining, holding in resentment, anger, guilt from the past or wishing for the future to arrive and not living in the present moment is susceptible to generating inner tension. When this becomes a chronic way of being it manifest into chronic pain.

For any of us struggling with chronic intermittent pain and stiffness, what would be the first step that we should take in tackling it?

Think Psychological and not physical.

Check how you are being, what you are thinking, where is your focus.

Who or what are you giving thought energy to.

Go into this psychological mode while totally stopping the physical treatments and thinking. Look at your past struggles and determine if the physical treatment approach has worked. Be open to an alternative cause of pain and then trust your intuitive self.

If readers wanted to learn more, what would you recommend that they should do?

Find a TMS book to read. Sarno has 4 or 5 out there. (That is Dr John Sarno)



I’m a little biased as I believe that my most recent book and cd program, The Master Practice, gives people the tms knowledge they need but more importantly the “how to” knowledge needed to reverse this pain disorder. There is a tremendous amount of free information at my site: www.runningpain.com

Monte – thanks for taking the time to answer these questions. I have enjoyed and benefited from your books and hope that other people might learn something from this too.

It was my pleasure to share this information. Thank you.

Contact Monte at monte@runningpain.com

Pain in your back or in your heart? The impact of emotions…..

You may have picked up from reading this blog over the years that I have – occasionally - a bad back. Pain that ranges form stiffness after sitting for a while, to tightness that distorts my posture through to extreme spasms that will grip with great force and pain literally stopping me in my tracks and bringing me to me knees. Debilitating and depressing stuff for someone like me for whom exercise is fun, rewarding and an escape from life stresses.

I first remember hurting my back after deadlifting, not a maximum weight by any means, but just before I was to give up my job to return to university. Ever since the back has been there. Sometimes – for months at a time there is no pain and I’ll train, run and climb mountains – sometimes it returns with a vengeance and sees me floored, carried out of the office and taken home. Hence my interest in keeping my back healthy, in mobility, in posture….

However as I’ve also hinted here a few times, I am personally convinced that stress and emotional factors have a huge impact on my back pain. Often my back pain correlates very clearly with stressful episodes professionally or personally.

To me it makes clear sense that your emotions and mental state can have impacts on your physical body and on your health. You enter an embarrassing situation and you blush. It is the morning before an exam and you get the shits. You see something sexually arousing and get an erection. Totally abstract mental events have a very physical impact.

This is incidentally one aspect of the whole Primal Blueprint / Evolutionary Fitness approach that is under appreciated – that of mental outlook and stress. Mark Sisson in his excellent new book – the Primal Blueprint – does touch on the topic and Devany has also mentioned it. We talk about living primal – in a way that suits your genes in terms of diet and exercise, but we neglect what is going on in our heads - our psychology, our spirituality. To be honest I think our psychology can have a massive impact on our health, trumping diet and exercise.

I’ve pointed previously to the theories of John Sarno. Much back pain, he would contend, is not derived from any physical injury or abnormality. Rather it is a physical phenomenon caused by the brain - like a blush or an erection. But in the case of pain, the brain is causing the pain – probably due to restricting the blood flow to the muscles and nerves. Why? He would explain that it is a method used by the brain to distract you from really painful and frightening emotions – anger, frustration.

The brain is protecting you. When you have the pain you are not thinking about the stressful painful issues – relationships, work stress, pressure from family etc.

It might all sound a bit weird but the more I think about this and read about it the more it makes sense to me. I can see in my own life how my back plays up when other stresses are at their worst at work or in my relationships. The pain comes and goes and moves around. It will move from the back to the buttocks, from the lower back to the upper back, with no explanation. It can be terrible first thing but then improve.

OK it all sounds a bit wacky, but I’ve got an interview coming with a guy who has written a book on his experiences with this type of pain.

Perspective...back pain

I've had a bad back the last week or so. Work has been busy recently and I've been doing 10-12 hour days over the last few weeks. Lots of sitting and lots of stress too.

The lower back was getting very tight but it would always loosen off quite quickly when I started moving. Then last week we were out for lunch at a pub in the country and afterwards while walking round the loch I decided to climb a tree (!) and I got this massive back spasm that I've been recovering from all week.

I've had episodes of back pain over the last 15 or so years and am used to it but each time it really makes me appreciate basic health and fitness.

When you cannot move due to intense muscle spasms literally immobilising you, when you cannot put your own socks on or wipe your own arse then all this health and conditioning discussion seems a bit stupid.

It is only when you are injured that you truly appreciate what it is to be fit, mobile and healthy. Of course when you are well, you soon forget to appreciate what you have.

I coudl blame it on tight hip flexors but part of my back pain I am sure is about stress and I am really sympathetic to the whole Sarno approach - the idea that sometimes the pain is derived from your subconscious - your mind is giving you the pain to distract you from what is really stressing you. Emotional factors are really important for lots of pain and illness.

Sonnon's mobility stuff is related to all this too. His mobility booklet and the full book - Free to Move - talk about the impact of emotional factors e.g.:

Common mental and emotional issues faced as a result of the lower back not being Free to Move:

• Feeling unsupported
• Feeling insecure
• Lacking stability
• Lacking community development

I think there is more to it - massage really helps me too. Maybe it is just a placebo, but it works. I'm always looking for other placebos or course - hence some of the things I refer to in this blog.....

Art Devany has remarked before that the body is the subconscious. I think posture has something to do with it as well. When you are weighed down mentally, your posture collapses too.

There is a good interview with Sarno here.

And another is below:

Floating Bones

Floating Bones posted a really good comment on my post on Tensegrity.

Anatomytrains.com has a 20-page summary of the first edition

There are several very good papers on biotensegrity.com why the compression-based model is fundamentally inadequate to explain our musculoskeletal system. Levin has been studying this for his whole career as a MD.

Model-maker Tom Flemons has some great models on his site: tinyurl.com/toms-models .

I talk about floating compression models on my website floatingbones.com. Part of what I add to the structural conversation is the impact of our nervous system on our structure.

High Intensity - one set is enough

That interview with Doug McGuff got me thinking quite a bit about the whole High Intensity thing.

Here is a study which says that - for resistance training aimed at combating low back pain - there is no point in doing more than one set of an exercise. (Incidentally the same as was found in this review - The preponderance of resistance-training studies shows no difference in the gains in muscular strength, hypertrophy, power, or endurance as a result of performing a greater number of sets. )


Randomized trial comparing the effects of one set vs two sets of resistance exercises for outpatients with chronic low back pain and leg pain.

AIM: Progressive resistance exercises (PRE) are prescribed to reverse the deconditioning associated with chronic back pain. The spine rehabilitation program has utilized 2 sets of progressive resistance exercises during each session, with increased resistance between sets, and with successive sessions. Exercise literature has challenged the need for multiple sets of resistance exercises, with a single set producing similar functional benefits. The authors studied whether completing 1 versus 2 sets of resistance exercises would affect strength, pain and disability outcomes in subjects with chronic low back pain (CLBP).
METHODS: The study randomly assigned subjects with CLBP to perform either 1 set or 2 sets of progressive resistance exercises during otherwise identical spine rehabilitation programs. The patient sample included 100 subjects (36 male patients, 64 female patients, mean age 46 years) with chronic back pain referred to spine rehabilitation. Primary outcomes were back strength and progressive isoinertial lifting evaluation (PILE) at discharge. Secondary outcomes were Oswestry disability (0-100) and pain scores (0-10). Exercises consisted of Cybex back extension, rotary torso, pull downs, and multi-hip; lifting of crates from floor-to-waist (lumbar) and waist-to-shoulder (cervical) heights. The maximum levels of exercises were determined using a four repetition to maximum protocol, and the PILE.
RESULTS: At discharge, there was no significant difference in strength, disability or pain measures between subjects completing 1 versus 2 sets of resistance exercises.
CONCLUSION: These findings suggest that there were no added benefits for completing a second set of resistance exercises during therapy sessions for patients with CLBP.

Free back pain relief exercises

Here is one for you - a nice little free booklet of exercises to assist in correcting anterior pelvic tilt, a common cause of back pain.

I know that stretching out the psoas can often relieve my back pain and this booklet explains why a tight psoas can be a problem, tugging your pelvis out of position.

Mobility work is another route to loosening our muscles of course (as in Scott Sonnon's booklet). Anyway, check out the booklet:

4-essential-strategies-for-the-correction-of-anterior-pelvic-tilt

The guy that wrote that has some good free videos on Youtube too, for example

Esther Gokhale - posture explained

A couple of weeks or so ago I posted about Esther Gokhale's book - 8 steps to a pain free back. I know that a few of you found that a useful post.

Here is a lecture from Esther talking about her approach to posture.

Back Rehab

This is (another) interesting video from Rob's Mountain Athlete.


It shows Coach Corrin Berg doing some post-rehab work with someone who has a lower back injury.


The exercise is one I've seen in Gray Cook's Athletic Body in Balance book. Download some of his articles here.

Posture, Functional Training and the B Squat....

A bad back

For the past 16 years or so I've had a "bad back". I originally strained something doing deadlifts and there have been repeated bouts of back spasms ever since. Sometimes they have been severe, leaving me on the floor and almost unable to move. On other occasions it is more of a continual minor ache. Sometimes I'll be OK for months on end and capable of some relatively good athletic performances - big walks in the hills, demanding met con circuits even - when I did more lifting - some heavy deadlifts.

That is context for this post. You see I'm always on the look out for thoughts about back health. I get a regular sports massage and have learned that trigger point therapy and stretching the glutes and psoas is really important for me - just to relieve the effects of sitting all day at a desk. I have learned much from Rif for example.

In addition to the physical side, I must also say that I believe that there is a big psychological element to my back spasms - when I'm stressed my back pain is always worse. In fact I have a lot of sympathy for Dr Sarno's approach to and understanding of back pain. He talks about TMS - effectively back pain being a tactic that your mind/body uses to divert your attention from the things that are really bothering you subconsciously.

While I think stress has a big role, I also think there are physical measures to employ to attack the symptoms and also simply to maintain health.

Esther Gokhale

With this in view, you'll understand that I was interested to read a post on Matt's blog recently about a book he was reading. The post was called Best Back Book and was about a book by Esther Gokhale: 8 Steps to a Pain Free Back

This post is not intended to be a review of the book, but I would agree with Matt that this is a superb volume. He explains:

Judged by the title, you might think is just another back pain book. However, this book is much, much more. It is really an anthropological and evolutionary study of how the human back is supposed to work. Why do traditional cultures have low levels of back pain, yet the rate is skyrocketing in the U.S.? What is the proper way to sit, stand, and walk? These are the questions the author attempts to answer.

I am only part-way through this book, and I learning something new almost every page. For example, many fitness experts state that a "neutral" or flat pelvis is correct posture. Instead, the author makes the case that the natural alignment for the pelvis is to be "tipped forward". She supports this with pictures of babies, young children, and people in traditional cultures who all exhibit a tipped-forward pelvis and none of whom suffer from back pain.

The photographs in the book are fascinating and show just how poor the posture of the average Westerner is. The book is worth buying simply for these photographs which are an indictment of the way so many of us stand, walk, sit and lie.

It is an excellent and challenging book that I wholly recommend. Easy to read and inspiring too.

The Asian / Third World Squat

Basing so much of her argument on trying to what is "natural" I was surprised that Esther did not talk about the squat.

People in developing countries seem to squat all the time. In the absence of chairs it seems the natural way to rest / eat.....and defecate.

Surely if we are to use our backs in their natural positions, we should be squatting lots? Indeed I'd come across this recommended a couple of times as a healthy stretch. Remember Mark Sissons stretching his sprint video? Then the "latrine squat" was recommended here as a glute stretch.

T nation even had an article on this - talking of the Third World Squat

You'll notice that in third-world countries, there will be a lot of situations where people are hanging out or working, and rather than sitting or kneeling down, they squat. They can sit like this comfortably for hours. It seems like a simple thing and can be easily overlooked, but try it some time. The average North American adult can't even get into this position, let alone stay there for any length of time.

There was even the comedy video - with serious points - about the "Asian Squat"




So why did Esther not like the squat?

I emailed her and asked!

Here is her response - basically if you have not grown up squatting like this, it is probably too late to start - you bones will not be built for it. They will have settled into structures which do not easily accommodate the Asian squat.

Here are my musings on squatting.

1. At birth, many of our joints (including the ankles, knees and hips) are not ossified. Instead of bone, we have cartilage in those areas.

2. Each of the above joints has a timetable for when the cartilage ossifies. The hip joint, for example, is made of three parts - the ischeum, ileum and pubis - each pair of which ossifies at a different age (first pair at age 2; last pair at age 16).

3. Once your joints have ossified, they are relatively immutable. Bone does change shape depending on the stresses on it, but it does not change drastically and in particular, the above ossifications are irreversible.

4. If you grow up squatting (on pit toilets, eating on the floor, etc) then the joints ossify differently than if you grew up sitting on chairs and using commodes for toilets. In particular, if you grew up squatting, your joints will ossify in a way that allow you to continue to squat in adulthood. If you did not squat through the years that your ankles, knees, and hips were ossifying, you will probably not be able to do a healthy full squat in adulthood.

5. People who force squats without having he joint architecture to do them tend to round their backs (compressing their spinal discs), pronate their ankles, and stress their knees.

6. Recommendation: don't try to force a squat. In most situations you can do the job equally well with a modified squat (on foot flat on the floor, the other on the ball of the foot). The times squatting does help are childbirth and evacuating your bowels. In these situations I recommend using some extra support under your heels - this makes squatting easy on the ankles and back. For other situations like certain squatting Yoga poses, I recommend not going all the way into the pose.

There you have it! The interesting thing to me though was her recommendation:

In most situations you can do the job equally well with a modified squat (on foot flat on the floor, the other on the ball of the foot).

I'd seen this before! My friend Bryce Lane wrote a piece a few years ago about his experience with this stance of squat.

The B Squat

Bryce came up with this stance while experimenting with positions to get more stability in lifts. The leverage is better apparently. You can read his thoughts here: The B Squat





So there you are.

I like it when different people come up with the same idea from different directions. I'm going to start using the b Squat more myself - the body weight one and maybe even as a goblet squat - hopefully to keep my posture more healthy and efficient.