Back pain steals your freedom. Core connection, and healthy movement, bring it back.
So before we get started, I want you to strap your walking shoes on, or better yet, no shoes at all.
Grab your headphones and get your body moving while you listen to the insights that helped me climb out of a decade long struggle of debilitating lower back pain and led to the creation of Core Balance training, which has helped thousands of people climb out of the back pain spiral for good.
Welcome to the Back Pain Podcast by Core Balance where we share practical insights to address back pain at its root.
I'm your host, Dr. Ryan Peebles, DR of Physical Therapy, specializing in spine and core rehabilitation.
Each episode brings you a recording of one of my live sessions with my students.
We start with a focused topic on back pain, then move into a live Q&A where I answere real questions in real time.
My hope is that these episodes get you on the path to climbing out of the back pain spiral for yourself so you can live life the way that you want to.
Let's dive in.
I debated whether or not to start this first podcast episode with my very first live stream back in 2022 because, well, let's just say my skills weren't very refined yet, but in the end I decided to go with it because, well, you'll get to see my skills develop over time.
And this first episode topic is what is core balance training?
And I do start out talking about what is the problem of muscular imbalance that we are solving with core balance training.
So it's a good introduction to our philosophy here.
And in future episodes you'll get more specific topics like chiropractic or how stress relates to pain, how do MRIs help with back pain or not?
And other diagnoses such as SI, joint pain, degenerative disc disease stenosis, spondylolysis, and so on.
So why don't we get right into it, and here we go.
What tends to happen?
Over our lifetime, through modern lifestyle and the positions that we put our body in on a daily basis, we tend to get out of balance.
In more ways than one, but specifically our muscles tend to get out of balance.
And so I dare to say that muscle imbalances are the root cause of nearly all chronic conditions of lower back pain and lots of hip pain and knee pain too.
There's a lot of conditions and pain that result from muscle imbalances, but at the root of these conditions is this predictable pattern.
And if you stick around, we can get a little bit deeper into.
What I mean by all this, so I have some goals for this first ever live stream that I'm doing.
I hope that alumni start showing up and can tell their stories of their experience in core balance training.
The successes they've had.
We just had so many inspiring success stories over these last few years that it's incredible. Their lives have been permanently altered by the lessons that are taught in the program.
It's not gonna be one specific exercise that healed them.
It's integrating a new way of relating to your body.
We'll get very deep into that kind of stuff.
So let's talk a little bit about the goals that I set for today's first session.
It's gonna be driven, hopefully by the questions, but I will come prepared each week with a topic just in case there's not a lot of questions.
And so today's topic is, what is core balance training?
I actually received that question this week and I thought, wow, what a fantastic question.
I probably should address that on the live stream.
So that's what I'm gonna start out with.
I already introduced that it's not just an exercise program, it's much more than that.
It doesn't give credit to the exercises for the healing.
Because it doesn't matter what exercise you're doing.
It matters how you're doing it.
It matters how you're moving your body, how you're relating to your body while doing that exercise.
And so someone in my profession, I'm a physical therapist.
Often gets questions, what's the best exercise for fill in the blank?
And I always have a hard time answering that question because you could do an exercise, say the bridge for example.
So the bridge is an excellent exercise for lower back pain.
But if I were to tell you, go do the bridge and tell you nothing else, you might watch a YouTube video or you might already know the bridge from yoga class or whatever, and go do it.
And it could actually make your back pain worse, and that might be because you are using your compensatory muscles, your leg muscles.
These imbalances that we have in our body, what they really are are certain muscles that we overuse and other muscles that we underuse, we don't use them enough.
And so when we go and do an exercise, we tend to favor the muscles that we overuse, those are the ones that take over.
So you could go do the bridge, and you're doing the bridge using, often it's the quads and hamstrings, maybe even the glutes are involved, but the core could be completely turned off.
And so what you're doing is you're strengthening the imbalance, you're strengthening the muscles that you already overuse.
The underactive muscles may be completely turned off during that exercise, and so the bridge wouldn't be a perfect exercise for lower back pain.
It actually is worsening the problem.
It's strengthening the imbalance.
What core balance training tries to do, and this applies to all exercises.
It could be a squat.
It could be a deadlift, it could be, you name it.
It doesn't matter what the exercise is, it matters how you are connecting to your body and relating to your body.
To do that exercise.
And so that's what Core Balance training aims to do is teach you how to connect to your body in a healthy way to connect to your core and the deeper muscles of the core, the ones that tend to be underactive.
Once you learn how to activate those muscles, the deep core muscles as I call them, those are the ones that support your spine.
Those are the ones that provide stability to your core and to your spine so that there's no shearing force and you're not causing friction and you're not injuring the tissues and your spine.
They're stabilized, and once you learned how to activate those, then you can go ahead and apply that skill to any movement you want.
And that movement can become good for you.
A movement that used to be bad for you.
The very same movement could become good for you depending on how you are doing it, how you're relating to your body, and how you're connecting to your body while you're doing it.
So that's the long answer.
For what is Core Balance training?
And the short answer is it's a movement retraining program in a nutshell.
It helps you to connect with your core, with your deep core, and it gives you a new perspective on your body.
It gives you a new way, a new sense, a new awareness of how to go about your day and your day-to-day life.
It doesn't have to be exercise.
It could be doing the dishes or yard work or picking up your child or your grandchild.
It could be anything that you want.
In the beginning, it's a strong awareness that you are intending to apply, but over time, after you've done the program and after you've integrated the skills into your body, it becomes a much more subtle awareness.
It becomes more part of you.
Part of the core balance training philosophy is that you are the one that has to heal your back, and it's actually impossible.
For anyone else to do it for you.
And I would argue having worked in the profession now and seeing hundreds and hundreds of back patients, that even surgery is not the solution.
Not only because the success rate is extremely low.
Surgery can be a very valuable tool and a very valuable thing that's necessary in some cases.
It really matters what you do after the surgery that's gonna help determine your outcome.
So surgery, yes, is necessary and some people absolutely need it.
But the success rate for surgery, highly dependent on what you do before and after.
That's my belief.
After seeing a lot of both successful and failed surgeries, the next part of today's goal was to answer questions and I came prepared.
Got a question from a very valuable moderator.
It says you probably get this as a frequently asked question, but to correct the muscle imbalances, why wouldn't it work to just do lots of crunches?
To tighten abs and lots of toe touches to lengthen the low back muscles.
I spent years trying to do this and I wrote that in my answer to him, and at the same time, you know, the stretching was one thing, but I also tried doing exercise just to strengthen my abs, whether that be sit ups or planks, these exercises like a sit, sit-up, or Mike mentions crunches could actually exacerbate the problem and I would feel, well, I know that I need to strengthen my abdominals.
I'm gonna do sit ups, and then that night or the next day, my back would be even more sore.
So why does that happen?
Why can't you just correct the muscle imbalances that I talk about in the masterclass where you know your lower back muscles get tight, abdominals get lengthened.
There's a lot more muscles involved that we see on the surface.
Like the glutes, they get lengthened.
Hip flexors tend to get tight.
It is called cross posture syndrome.
It's very well known in the industry.
It was made popular by Vladimir Yonda, who was a pioneer of physical medicine. He coined the term cross posture syndrome.
It's a term to describe the predictable pattern of muscle imbalances that we see. I talk about it in the masterclasses is not new.
This information is founded upon this research of geniuses, I just explained it in the masterclass in a way that's digestible by people who may not be a medical professional.
And so this question probably came from that.
We have these muscles that are out of balance.
Some are tight, some are lengthened.
Why can't we just tighten the ones that are lengthened and stretch the ones that are tight?
If you've ever tried it, you have your answer experientially that.
This just does not last, and it requires me to go into a deeper explanation of what muscle imbalances really are and why they happen.
To be able to give this answer of why it doesn't work to do this.
What we see on the surface, this cross posture syndrome of certain muscles being tied is only what is happening on the surface, and there's something happening much deeper, pun intended in the body. That is the root of this.
You have to be aware of that and be able to grasp and conceptualize that to be able to understand this answer.
The surface muscles are tightening.
The protective ones are tightening because they're protecting something wrong, and what's wrong is the deep muscles in the body tend to become underactive.
We tend to become disconnected from them.
We get disconnected from our core through our lifestyle, through modern lifestyle.
As I sit here on a computer and then spent the whole morning on a computer, I am doing exactly what is wrong with our modern lifestyle.
Lots of sitting, lots of inactivity, lots of repetitive trauma where I don't need to be using my core to sit here sinking down lower and lower.
And so this is a good reminder to reset, take a breath, and connect to my anchors.
Right?
So we disconnect from these deep muscles.
There's hundreds of them.
And we name them in groups.
For example, the Multifidi, tens and dozens of muscles in the spine. We call them the multifidi.
They're some of the ones that tend to shut down and turn off.
And we know from research, I learned this in PT school, that they don't spontaneously return after they start to shut down and they actually begin to atrophy and get smaller and eat themselves and go away.
They don't spontaneously come back unless we target them.
And that's just one group.
There's literally hundreds of tiny little muscles in our spine, and then layers of muscles around the front.
We've got four or five, depending on how you look at it.
Layers in the front.
And when we do sit ups, when we do crunches, we're really only targeting this one muscle here called the rectus abdominis.
It's on both sides.
This muscle is designed to move these muscles on the sides that wrap all the way around and the muscles in the back that attach to the spine, and there's lots of much smaller ones.
These ones are designed to stabilize the spine and create stability.
These ones here are designed to create pressure like a corset.
They're designed to squeeze, and when you squeeze and increase the pressure inside the abdomen, that increases the stability of that chamber.
You could do a sit up with these movement muscles here, the six pack abs, and these could be completely shut off and the spine not stabilize.
That could be causing friction and damage in the spine, and it could lead to any number of conditions.
The resulting outcome could be a herniated disc, or it could be stenosis, or it could be, you name it.
It could be spondylolisthesis, which is very common one.
In athletes, the outcome is just the result of lack of stability, lack of support.
We want to support our spine.
The goal is to be able to do the exercise with these turned on and to reactivate these muscles and learn how to use them.
When we are doing the exercise, that's the imbalance.
We tend to overuse our thigh muscles and our leg muscles, and our six pack abs and our chest muscles.
These are all the surface muscles of the body and the imbalance is between these surface muscles.
And the deep muscles we were just looking at, those are the ones that tend to shut down.
We don't really need to use them all the time in our society, and so the goal is to reactivate them and try and narrow the imbalance, try and get the deep muscles stronger without strengthening these superficial muscles.
Once you have that understanding that the imbalance is not really just between muscles on the surface, but the true source of the imbalance is the deep muscles versus, or the imbalance between the deep muscles and the superficial muscles, then we can begin to answer this question.
The weak muscles that you wanna strengthen are the ones that get no attention.
They're the deep ones inside your core.
And once you can strengthen those.
Learn how to use them in your day-to-day life.
Then the lower back muscles, the tight superficial muscles, the hip flexors, the chest muscles, the neck muscles that tend to get high, those ones can begin to let go and relax and stop protecting.
It doesn't even require you to stretch them.
They simply can just let go of their grasp on the body that's trying to protect the body.
Because something is wrong.
Let's go to the next one.
Alice says, seeking simple stretches.
Exercise for tight, lower back for elders.
Which is really appropriate because I work with elders all the time on a weekly basis here in Santa Barbara where I live, and so I'm very familiar with your population.
She says something feels stuck, but she can bend over without pain.
This is actually a really common set of symptoms.
I fell into this category where I could always bend over and touch my toes, touch the ground.
I wasn't like super flexible, but my point is that bending forward never hurt if always felt good.
In some cases, there's a perception from people that people with back pain shouldn't bend over or could hurt themselves.
But in the cases, if somebody has stenosis, which is the closing down of the discs and the vertebrae in the back, bending over is a good thing.
It feels good.
It opens up those vertebrae and gives space into the discs.
Anyway, to answer your question, Alice, simple stretches for a tight lower back.
This kind of leads me to go down a path where I'm gonna talk more about why Core Balance Training exists.
When someone has back pain, there's some underlying cause.
One of the results of that cause is muscles tighten up.
That's a protective mechanism.
So for a lot of people, those muscles that tighten up are the lower back muscles.
We have tight, lower back muscles, and you can stretch those muscles and that will feel good.
It will offer relief.
And then I'm sure you've experienced this, that within a matter of hours they will tighten back up.
And that's because they're tight for a reason.
They are tightening for a reason.
If the goal is to have a more long-term result.
And to not have tight, lower back muscles, then we have to address the root of the problem.
Why do those lower back muscles want to be tight?
Because clearly they want to be tight, and I would argue that they're not tight, simply because you are not stretching them.
Because there's a lot of people that don't have to stretch their back or don't have to do therapeutic exercises, and they don't have back pain.
So the reason that they're tight is something deeper than a lack of stretching them.
In core balance training, what we do is we address the root of the problem.
So Alice, if you're here, I would suggest in a more long-term sense that you want to start targeting the muscles that support the spine, the ones that are deeper than those lower back muscles.
And once you can turn those on and get those engaged.
The lower back muscles which are protecting will feel safe to relax and let go.
If you haven't seen the masterclass, I talk about that in there.
There's probably a link to the masterclass in the notes below the video, and anybody that hasn't seen the masterclass, I would strongly suggest.
Taking a look at that just to get a better idea of what I'm talking about and bring you up to a level of knowledge where I can say some higher level things and may make sense.
So yeah, this question is a very good reflection of why Core Balance Training was created.
If you don't know, I have a personal history of chronic lower back pain of over 10 years, and I spent years addressing these muscle imbalances that occur in our bodies.
On the surface, I stretched the tight muscles and I tried to strengthen.
The weak muscles, and what I noticed was the tight muscles that I stretched would always tighten back up.
In the beginning they would last for a day at the most, but after a while of getting to this daily routine of becoming dependent on my stretches, they would just start tightening back up in a matter of hours.
And so like two hours later, my muscles, I'd spend hours on my body every day in the gym, and within hours they would return, you know, it was almost pointless.
But I had become dependent on that pattern of just doing that to try and stay out of pain.
So I got a question just now coming through from Kimberly.
Dry needling is kind of like acupuncture, but in a more orthopaedic approach.
It has a purpose.
It has a role.
I did my thesis for my DPT on dry needling actually, and its effectiveness for knee pain.
Basically, when the kneecap tends to track laterally or get out of the groove and starts to rub on one side of the knee, it causes pain.
That's the number one cause of.
Physical therapy patients going to pt.
It's the number one cause of knee pain.
It's called lateral tracking, or patello femoral pain syndrome.
I did my thesis on using needling or dry needling for treating this syndrome, and what I found was that it was very effective.
I had this syndrome at one point in my life and I got to be also a patient of dry needling.
I did my internship in New Zealand where dry needling is legal for physical therapists to do, and very popular.
I worked in a clinic where they used it all the time and I got to use it on myself.
So yes, it's effective for anybody that has no clue what it is.
Like I said, it's kind of like acupuncture.
They use needles, they stick 'em into your muscle, and the goal is to hit what's called a trigger point and create the muscle to relax.
So the trigger point is a knot.
It's the same thing as when you have a knot in your muscle.
Everybody has one like right around here, unless you're perfect.
And this knot or trigger point is basically a ball of stagnant electricity.
We have electricity running through our bodies and it's just trapped in there.
The needle can go in and it just like instantly releases this knot as much, much more effective than massage.
Trigger point massage, which could take potentially like five hour long sessions to get a nod out where this trigger point therapy through dry needling can do it instantaneously.
It sounds not believable, but it's, that's what happens.
It releases the electricity and so very effective for that.
And at the same time, it would be want to be combined with other treatments, especially the strengthening.
Activating side because remember in the same way that we have tight muscles, like our lower back muscles, they are tight for a reason.
They are protecting, right?
And we can stretch them, but they're gonna tighten back up.
Well, we have to think about dry needling in the same way.
So if you have a trigger point, it formed for a reason.
If you have a knot in your muscle, it forms for a reason.
Simply releasing that knot or the trigger point is great and very effective, but it's going to return unless we address the reason why it formed.
Typically, the reason why muscles tighten up is to protect because some other muscle is not doing its job.
This muscle is overworking to compensate for an underactive muscle that is underactive underworking and not doing what it's supposed to be doing.
If you can address that imbalance by activating the muscle that's not doing its job and teaching it how to do its job in conjunction with the dry needling, then that trigger point or that knot may not return.
It doesn't have a reason to come back.
That would be the role that I see for needling and other treatments and modalities in general, like chiropractic and most modalities, they all have a role.
They all have a place where they wouldn't exist.
To say that something like chiropractic doesn't work is not true.
It's not accurate.
It does work.
It's very effective for doing the thing that it does, but it's not the full picture.
And it's not the full solution.
Use it for what it's needed for and complete the picture by addressing the root of the problem and not just trying to correct the result of the problem.
Kim says you started receiving it on your traps and the suboccipital muscles.
I'm guessing is it neck pain or headaches?
Potentially that you are receiving it for.
Let me know if you have had any results from it.
Has it helped?
I'm curious to know.
So you're not doing a bad thing.
Dry needling I mentioned is legal in New Zealand.
Dry needling is not legal for physical therapists to perform on patients in California.
So in the state in which I live, the acupuncturists have a strong grip on using needles for therapy.
They are understandably protecting their own profession, and it's in the law that they are the only ones that can do it and PTs can't.
But if I were to go to Nevada or Arizona, I could use my PT license to treat patients with dry needles.
That's just an interesting fact and reflection of our legal system.
It would be great for us to be able to use here.
Like I said, it's really effective.
It's kind of magical how fast this can happen.
The traps are really painful though.
You mentioned you're getting it on your traps.
I hope you are tolerating that quite well.
The traps are just one trigger point that almost everybody has is usually extremely dense.
And the dry needling may not release that one completely in one treatment, but does release other trigger points like in your quads, like the ones that would be contributing to the patello femoral pain syndrome in the knee.
Those ones for me could be released instantly.
You have Jenny, I see your chat.
It says, in which sequence?
Best to combine core balance exercises.
Bodybuilding and muscle release.
For example, foam roller, dry needling, massage guns.
Okay, that's a really good question, Kim.
I see that you said it didn't work in one treatment.
Yeah, the upper trap one is gonna take a few sessions 'cause it's probably been there for, depending on how old you are.
It's been there for decades and yeah, it's hard to reverse something like that in seconds.
So sequence you have Jenny, so I see Core Balance, bodybuilding, and then we'll call that muscle release as a group.
Yeah.
I would say core balance is like the base you would want to start with just activating your deep core.
Even if you're gonna go stretch or do the foam roller next, you would want your deep core to be active.
You would want to be connected to those deep core muscles while rolling yourself out on the foam roller.
It's almost like doing side planks at times, and you would want your core to be functioning optimally while doing that foam rolling and so.
Core balance, you know, phase one first, and then bodybuilding is pretty much core balance, phase two and three, if you're gonna be doing squats and deadlifts where you're just gonna apply more weight to core balance training, squat and deadlift.
I think you may have named it in the order that I would suggest if you had.
Specific issue with a muscle that's not letting go, then you could potentially address that before getting into the bodybuilding because bodybuilding is high level, it's high exertional, high demand on the muscles, and you would want them to be functioning optimally for.
Bodybuilding, but it's also good to do some cool down stretching type things after the bodybuilding.
So I would say core balance, then you're clarifying.
I mean, if I do it repetitively, each of them over time, I don't know exactly what you mean by that.
If it were all in one session, I would start out with some core balance, back anchor, front anchor, activate the core, and then I would address any major stuck or tight muscles with a foam roll.
Then I would do the bodybuilding, and then I would do a cool down, which would also involve some stretching and stuff like that.
I'll talk a little bit about your examples.
So massage gun is not gonna be part of your workout.
I think of a massage gun as a nighttime type thing.
I wouldn't do it before a workout.
I would do it either after or not even part of the workout.
It's almost like getting a massage.
You wouldn't get a massage right before a workout and you could get a massage right after a workout, but.
It doesn't really intuitively make a lot of sense.
You get benefits from the workout.
You want to feel those endorphins and move around after your workout, and then maybe the massage would be later on or another day.
So I would treat the massage gun in the same way.
Dry needling is something that would be ideal to do before it gets the muscles in a more natural state.
I would do it before workout, or if you're talking now, I'm gonna answer it a little differently.
If you're talking consecutive days, you're saying doing them repeatedly over and over, over time, I would say dry needling could be Monday.
Do a little workout that day, later that day.
But if you have a full on workout, you would wanna do that the next day.
Let a little healing to take place because you are causing some micro trauma with the needles.
Totally worth it.
But that is what's happening.
So the dry needling would come before the workout, the massage, potentially after.
And core balance you could do every day.
Core balance is how you get to the gym.
Core balance is how you get to the physical therapist, how are you sitting in your car, how are you getting out of your car, how are you walking to into the clinic.
Even the most highest level athletes, the vast majority of their time and their life is spent doing movements that are in this category, non-exercise related movements.
Sitting, walking, standing.
Reaching, doing things just to get from point A to point B or just sitting in point C like I've been doing for the last hour.
And so this is core balance.
It's the blue.
And so the answer is core balance is before you get to the gym, after you get to the gym.
And all the time, but I know Jenny, you're an alumni and I know that you're referring to specific, the back anchor connection.
The front anchor connection would be great to do right before a workout, Kim.
I totally agree.
Movement is medicine.
Motion is lotion is another one.
One of my favorites is if you keep moving, they can't throw dirt on you.
Which means it's a kind of a morbid statement, but never stop moving. 'cause the day you stop moving, you're done.
We do that like even in my age group, even younger, we are just like spending too much time not moving.
Uh, and if you think back into history before screens, we probably moved all the time unless we were reading or writing before.
Reading and writing.
If you believe in that, we were still here then I don't know when we weren't moving.
And that's how our bodies developed through a movement, so keep moving.
I appreciate everybody that was here for this first ever live stream.
I hope that you got something out of it.
If you want to come back, you can hit subscribe and we will be coming on every Wednesday.
Hopefully that's the goal for Without Pain Wednesday.
Keep coming back and I'm super grateful for all of you.
I'm grateful for the alumni that continued through the program and had life-changing success.
I'm grateful for current students that are here.
Testing out this new weird thing called Core Balance Training, and I'm especially grateful for the people who have not yet experienced or discovered core balance training because we were all there and I was there for so many years.
At a certain point, I reached the point where it was half of my life.
I remember going, man, half of my life I've been suffering for back pain.
And that's where I was.
The curiosity to learn and to grow.
Keep going.
You will find if you don't stop.
If you don't give up, you will find your solution.
And maybe it's this, the best thing I can tell you to do is watch the masterclass if you haven't, and if you have and you're still curious, then do the free trial.
We offer a free trial.
It's a seven day trial and it's $0.
We do require a credit card to protect us from being taken advantage of, but it's completely free and you can discover.
What Core Balance Training is about through doing it and experiencing it and seeing if it's a good fit for you.
If it is, you can continue, and if not, you can cancel the trial and keep searching.
One thing I can say is for the people that have stuck with it, man, I am.
Impressed beyond all my expectations, the amount of success people have had.
So thank you, all of you for being here.
Hey, Mitch.
Good to see you, Mitch.
Here's another alumni.
Mitch, I remember you, thank you for this.
Your approach solved my issues, and I've been pain free for two years now.
So that kind of thing is what drives me to keep going forward.
This is not my comfort zone.
This is not what I think of myself wanting to do and put myself out there and go live, but it's people like you, Mitch, that you stuck with the program and you have the results and the the messages like that give me goosebumps.
And I know there's a lot more to come.
It's my calling to put this out there more, but we're starting to reach out to people and let people know about this movement that's happening.
It's really cool to see.
The amount of people that are being helped.
Thank you Dana as well for being here.
Signing off.
Everyone, have a great day.
Have a great evening or morning wherever you are, and I hope to see you again.
