How to make PROGRESS while in Back Pain
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, doctor 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 answered 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. This week's topic is on making progress or progressing your exercise routine or whatever it is, your journey toward pain-free while experiencing
pain. And so how to navigate those waters. And it's, you know, it's always going to be uncharted territory because you're always going to be in a place that you've never been before, whether your pain is getting better and you've made some
progress but still having pain or maybe a setback and possibly experiencing worse pain than before. And so we can come up with some general rules, general guidelines for how to progress through this journey that we're on and be dealing with
pain at the same time. That's the topic for today. I'm going to do a lot of talking and just sharing my insight and then we're going to get into kind of a practical example. There's been several questions. One of the most common questions I
get about one of the lessons in core balance training is about the front anchors. It's an unusual exercise. It's not something you would see in a normal program and it's a kind of an abstract concept. So we're going to go into a practical
example with the front anchors awareness exercise, how to potentially just do that exercise if it's a little bit painful and also just answer some questions about the exercise to offer clarity about what it actually is and what you're doing
in the front anchors awareness and how to progress that in the front anchors awareness part two which is the next lesson and then also in the front anchors progression which is one of my favorites. So we'll get right into it. So basically the
topic, how to progress when having pain. We're going to be referring back to the topic that I spoke about several weeks ago of the most valuable skill, the most important skill for reversing chronic pain and that is going to be listening to
your body. And so to develop that skill is going to be part of this process of navigating this uncharted territory of, you know, how much can I do? How far do I go? How intense do I go when doing an exercise and also experiencing pain at the
same time? Is it potentially, am I hurting myself? Or if I push it harder, will I get more benefit? Will I be better tomorrow? Where do you draw the line? It's understandable that a lot of people would have questions about where that line is
and so we're going to try and draw that line today and try and make it as clear as possible and we're going to be using the skill of what I believe is the most valuable skill that you can develop, that anybody can develop of listening to your
body. It requires reflection. It's not something that you're doing in the exact moment all the time where your body, you know, the easiest example is you're having pain and you can feel it. And that's an example of listening to your body.
Sometimes listening to your body is more beneficial when you reflect backwards in time, what you did before. So it's going to be thinking about, so how do I feel right now? And how can I relate that to what I did earlier in the day or yesterday
or that I've just done? Because the body often has a delayed reaction. And so we're going to use that skill of listening to your body both in the moment and reflecting back to learn if, you know, the goal with listening to your body is to learn
the things, the activities, the methods, the ways that you use your body that increase the pain and we want to avoid those things. And then the things that you do with your body that decrease the pain or make you feel better, whether it's later
that day or the next day. And we want to do more of those things. And so that's kind of a prerequisite. We're going to dive a little bit deeper into that skill and then how to apply it while you're doing exercise. If you're experiencing pain
during that exercise, how far do you go and how to progress despite the pain? All right. So that's the kind of the topic introduction. And the first thing I kind of want to start with is the idea that when you are experiencing pain, it's
important to differentiate the type of pain. Pain is not black and white. Pain is not on or off. Pain is a scale or a spectrum. And on that same scale, on the other end of the scale, is good feelings that your body gives you when you do the
right thing or when you've done the right thing recently. And so if you're practicing this skill, this is something you can do every day of your life and continue to build on this skill over a lifetime and get really good at it and get to
know your body really well. And it just takes a little bit of reflection time. For example, if your back is really tight or really sore, being able to think back to what you did earlier that day or what you're doing right now. Maybe you've
been sitting in a chair for three hours and be able to associate those two activities. That's the most obvious one, right? Sitting. Prolonged sitting. And then be able to learn and respond by doing less of that or changing the way that you sit,
changing the variety of the surfaces that you sit on, adding standing rest breaks, stuff like that. We're going to try and differentiate the type of pain. And what I want to try and differentiate is good pain versus bad pain. Okay, this is an
important topic for anybody who's experiencing pain, specifically chronic pain. And it doesn't matter what part of the body it is. Sometimes you have to be able to know that the pain that you're experiencing is going to be more beneficial to
push through. And sometimes the pain that you're experiencing, the type of pain, is going to be what I call bad pain, something you want to avoid completely altogether. So how do you differentiate between good pain, what I call the pain that
would be okay to push through and maybe even beneficial to push through, versus the type of pain that you want to absolutely avoid, what I call bad pain. Pain that you want to absolutely avoid, you're definitely not helping yourself by pushing
through this type of pain. One of the things that I teach to guide people on this type of differentiation is using your intuition. So your intuition knows, just as it does with lots of things in life, it speaks to you. And it's not necessarily
through conscious thoughts, but through just gut feelings. And so using that as a guide when you are experiencing pain, when you're doing an exercise or doing a movement or an activity, maybe it's your favorite activity and you're wondering,
man, should I keep doing this today? Should I keep playing golf today? Or will I hate myself tomorrow because I didn't stop right now? So letting your intuition speak to you about that and just kind of quiet your mind and go, okay, what's my
feeling? What's my gut feeling? This doesn't feel good. Or based on my experience, this feels like I should stop. Or is it like, well, maybe it doesn't seem so bad. Yes, it's pain, but it just kind of seems like it's just sore, like stiffness.
And if I push through it, it actually warms my body up and starts to feel better. So Chris, we got a contribution here from you. Sharp pain seems like bad pain. Absolutely nailed it on the head. So sharp pain is the most obvious form of bad
pain. Easy to distinguish. By obvious, I mean easy to distinguish. If you ever experience sharp pain, stop immediately. Muscle soreness after cardio or weightlifting seems like good pain. Okay, excellent, Chris. So what if the pain is not after?
Because muscle soreness or delayed onset muscle soreness, what you get after weightlifting, is expected. And yeah, that's good pain. I mean, it's like you broke down your muscles by lifting weights and your muscles are now repairing. So it's a
good pain. What if it's during the movement or the exercise? So maybe you're doing core balance training and you're doing, you know, one of the movements that seems to bother people is the front anchors awareness exercise. And you're doing this
front anchors awareness, you're doing the push away, you're lifting your legs and you feel pain in your back. But it's not necessarily bad pain. So how would we be able to describe something that may not be bad pain? We know that sharp pain
is avoid at all costs. I mean, it's like you break your bone or you're about to tear your ligament or you're getting electrical shocks from a nerve compression, anything that is like zap or like comes on instantly and strong, avoid at all costs.
Intense pain would be another one. So if it's intense, like excruciating or somewhere in the 7, 8, 9, maybe let's put it at 8, 9, 10 range, it doesn't matter what kind of pain it is. It's too intense. So even if it's not sharp pain, we want
to avoid that. That's bad pain. And another one. So we've got sharp, we've got intense. The other one is the hardest one to interpret. And that's the one where I say just you intuitively feel like it's not a good pain. And so like something is
wrong type pain. That could be different types of pain. There's many different adjectives to describe pain. So that would just be the third kind of umbrella category is it's a type of pain and intuitively it's just like, no, I don't like that.
So that's going to be the third one. OK. Sharp, intense or intuitively feels wrong like don't do it. Now, good pain while doing the exercise is potentially going to be the most obvious one for me is muscle stiffness. OK, so this happens to
everyone. If you haven't moved your body in a while, the most easy example and the most obvious example would be a long car ride. You've been in a car for hours, you get out, your legs hurt to stand up. They're really sore and they're stiff
and it's painful, but it's good because that's what your body wants. It needs to move. The reason you are in pain is because you haven't moved. And so it's beneficial to you to push through that. And so that's an example of good pain. And that
happens pretty much to anybody that has that drives in cars. So now we have like this area, this area of where it's not obvious, it's not sharp, it's not muscle stiffness from riding in a car. We're like kind of near the center of the scale or
the spectrum where it's a little harder to differentiate. We're not at the ends of the scale. We're trying to find that line. Like, where do you draw the line? Good pain versus bad pain. So I find it easiest to use another example. We'll do a
front anchors awareness. So we're in the front anchors position and we're just laying there. We're in the starting position, breathing. And then we go to lift our legs. And remember, I'm using the term lifting. I don't like using that term
because it's more of a push away and we're going to dive deep into that. But you lift your legs and you get some pain in your lower back. How do you know if you should stop or if it's something that you should push through? My best way to
differentiate when we're near this line, this middle of the spectrum, is does it feel like muscular pain? OK, muscular pain would include something like stiffness, stiff pain, or pain that is a result of a lack of oxygen or blood flow or muscle
tension. Or does it feel like something deeper in the spine? And so it's not going to be so much the type of pain. That will be a factor. I mean, you're going to want to take everything into account. If it's not intense, it's somewhere in the
middle, like a 3 or 4 or 5. And it's not sharp. It's more dull. And now we're going to go to location. Is it deep in the spine or is it superficial on the surface? So if you can guess, deep pain is going to be something we want to pay more
attention to. And surface pain, superficial pain in the muscles, is going to be something that, unless you have a torn muscle, which I think that most people don't, you know, with chronic back pain, the cause is not typically a torn muscle.
That's something that we can be able to push through. Because if you think about it, the leg pain that we get from sitting in a car and not moving our legs happens only after a matter of hours of not moving our legs. That's how often our legs
want to move. And so if we have joints in our spine that are really stiff, and they don't move very much, which is extremely common. I'm not going to point out specific joints or spinal vertebrae, but it happens. And then we go to move them.
There's going to be pain. We know that the body loves movement and motion is lotion. So you can expect there to be pain around those joints. The muscles that move those joints may not be functioning very much. And so this would be a type of
pain that may happen regularly in the beginning while you're loosening up your body and working on improving your mobility. And so to avoid that pain at all costs would have a negative impact on you. And so this is the type of pain we want to
push through. And it's expected because it's a stiff part of the body. It doesn't move very much. The muscles aren't moving. They're not getting their blood flow and their oxygen. And there's stagnant fluids in them. And so muscular pain is
typically more superficial. And if it's deep pain, then we want to do a little bit more investigation. Okay. It feels deep. It's not intense. It's not sharp. And it doesn't feel muscular. Now I have to go to my intuition. Does it feel like
I should, like, does it feel wrong? Like, no, I shouldn't do this. Or does it feel like, you know what, it's okay. Like, it feels to me a little bit like I just got out of the car and I haven't moved and it just needs to move a little bit for
that pain to go away. So you're going to use your intuition and your judgment. And so I appreciate you always giving the updates. Okay. So we're doing an exercise. We're doing the front anchors awareness. And we have pain. And this applies
to any exercise.Okay. So this is not just this exercise. This is all exercises. We're experiencing pain and we need to change our approach because we've determined that the pain is bad pain. Okay. It just feels too deep. It feels in the spine.
It feels like I'm pressing on my herniated disc or my nerve or I got a little zap in my leg. It just feels too sharp for whatever reason that it's not good pain and we need to avoid it. How do we now navigate this so that we can continue to
make progress in our journey so that we don't have to stop at a roadblock and not proceed or turn around and go back. We want to continue making progress. And so my guideline, my practical what to do scenario is go up to the point of the bad
pain. Remember, if it's good pain, we can push through it a little bit. And that doesn't mean that good pain can't turn into bad pain. So this can apply to good pain too. We're going to go up to the point of bad pain, but not into it. So say we
have an arc of motion. I'll use my shoulder for an example. So right there, I get bad pain. Ouch. It's an impingement. So instead of going past it, I'm going to go right up to right before, oh, I feel it's about to start to come on. I'm going
to stop. And then I will go around that sharp pain instead of doing a full circle. I did a little swoop around that point of impingement of pain and then continued the motion. And so we're going to go up to the point of bad pain. And if you
need to stop there and return back, great. Or if it's more of an arc motion like you can do with your arm, then you can go around the pain and back, not through. Around and then return. If it's like the bridge and you have pain, it's not an
arc, but you're coming up and back down, you would go up to the point of pain and return back, but not go into the bad pain. And so that's the general rule. And the most challenging thing, I believe, for most students is the 10% rule or keeping
the intensity low. Because it's our natural tendency to want to think that doing more will result in more benefits. And so there's several different reasons why that I'm not going to get into, especially in core balance training. It's more
beneficial to keep the intensity low because of the muscle grips that we are trying to access. They operate at a low intensity. But the one that applies to this lesson is that potentially pushing through or doing more when there's bad pain
could set you back and just not allow you to progress and maintain you at this problem area. And so by going up to the pain but not into it and working right at that threshold, what happens with the body is there's this amazing benefit where
the body will have benefits in a 10% range above and below the range of motion that you are doing. So you can gain benefits 10% further into the range that you went into for those muscles and nerves without going into that pain. So if that
makes... I'll try to say it in a different way. If you go up so high into the bridge but not all the way and you stop because of bad pain and you work right at that edge, you will get benefits as if you went 10% higher in the neuromuscular
system. And so what that does is it allows you to push the threshold a little bit, a little bit, a little bit without aggravating the pain, without aggravating the problem. And the goal over time is to, well, is to make progress, is to push
your threshold. And so this is the hardest thing for people mindset-wise is to sometimes it's beneficial to do less and to fight our natural tendency as humans who want to make progress just in general in our lives in the world, to fight that
tendency to correlate more, doing more, and pushing harder with gaining more and receiving more benefits. And so that's the mindset piece. So let's go through this exercise. We do have some questions so I got to save time for that. So one of
the most abstract concepts and lessons in core balance training is the push away. And especially when it comes to the front anchors. And so I'm going to try and explain it. This is the lesson video in the program, but I'm going to do my own
talking now. And I just have to keep this one on mute. So what we're trying to do here, actually, I'm going to start with a really important part of the lesson that I believe is probably skipped over often is just the starting position.
I believe it's very important and valuable and beneficial to spend some time in the starting position without applying the push away and just lay down face down just like this and just relax into it and breathe. Breathe into your back. Just
send your breath down low because the floor provides a barrier which will help the breath be sent into your back. And just breathing and relaxing in this position offers fantastic benefits. It's a position that if you're not in core balance
training you don't get into very often. And just relax and let gravity operate on your body in this way. So spend a couple minutes in this position just relaxing and breathing because I would hope that the relaxed position isn't causing pain.
So it's a way to get benefits from the front anchors without the pain if this is an exercise that causes you pain. Once you, and I will digress one moment here, is if it is painful for you to just lay prone then that is a probably tight hip
flexors. And so what I would recommend you do is before you get into this position you do a good five minutes of the bridge to open up the front of your hips, lengthen your hip flexors, and prepare you and just kind of warm up your muscles and
prepare you to get into this position without having those ropes yank on your lumbar spine causing pain. So that was just a quick digression. We'll go back to doing the exercise. So a couple minutes just breathing and relaxing, meditating,
feeling your breath go into your back, and just feeling all your muscles relax into the floor. It's belly time. Once you've done that, and you can see that I'm, you know, we're a minute and a half into the lesson and I'm still in that phase
of just relaxing into the position. I haven't even started the push away yet. So once you've done that then my assumption is that if people are experiencing pain with this exercise it's most often from the lumbar spine muscles, the paraspinals,
contracting in order to lift. The intention of lifting either the legs or the head. And so those muscles are contracting and compressing the lumbar spine.And so I think it's my opinion, and I got down on the floor earlier today and tried this,
it's my opinion that happens more so, at least for me, when doing the upper front anchor push away. And so I would recommend for people, if that's true for you, to separate the upper and the lower push aways and do start with the one that is
not causing as much muscle contraction or pain. And so for me that would be the legs. I would consider doing the lower first if this one causes more muscle contraction in the lumbar spine muscles and or bad pain. Let's go to the lower.
So what are we actually doing in this exercise? I tell people to push away and that's what causes the legs to lift. And I think that's what we want the intention to be. But I want people to know that it's going to require a little more than
just the abdominals to cause this to happen. Because the abdominals don't attach to the legs, they attach to the pelvis.And so it would be impossible for the abdominals to pull the pubic bone into the floor and push further into the floor and
cause the legs to lift up. There must be glute involvement. That's what causes the legs to lift up because the glutes attach to the legs. And so what I would hope for the intention to be is connect the pubic bone using the abdominals and once
it's connected bring in the glutes and you can squeeze them and then that action of pushing the glute, you know, pushing the pubic bone further into the floor, the pubic bone is anchored to the floor. And that's important. The name of the anchor
s was not a random selection and we're going to get further into why these are called anchors in a minute. And that becomes a fulcrum. The pubic bone becomes a fulcrum and the glutes further contract and this doesn't move so the other attachment
must move and the legs elevate. But it is not the lower back muscles that are causing the motion of the legs. It's the squeezing of the glutes and the pressing, the pushing or pressing of the pubic bone further into the floor but the pubic bone
does not actually move because the is there. And so there's an equal and opposite reaction and what must move is the other end of the lever and that's the legs lifting. Now let's switch over to the front anchors and then I'm going to then I will
talk about joining them together. So the front anchor, the upper front anchor is the bottom of the ribcage that is also anchored to the floor and does not move. And so if we have the pubic bone anchored to the floor and the ribcage anchored to
the floor and neither of them move, then you could suspect that the area between these two anchors also does not move. And so that is the purpose behind the name anchors.Is they anchor to the floor. And when the floor is not there, they are
still your anchor. They are the thing that is the foundation for the other parts of your body around them to move.So they don't move, but the limbs do move. And especially when you join them together in the anchor triad, that becomes a stable
foundation. And so you can move your upper spine, you can move your hips, and the spine stays stable.So the goal, you know, the goal with the lower front anchor is to get more hip extension, more movement in the hips in this backward bending
direction, because that's what's often lacking in lower back pain population. The goal with the upper front anchor is to get more movement in this stiff part of the spine. And there may be pain in this part of the spine because it doesn't move
very much, and this exercise actually gets it to move.But we need to make sure that not only is the upper front anchor anchored, but even when you're doing the upper push away, this upper push away where your head floats off the ground, that
the pubic bone is still anchored to the floor. And I believe I teach this in the lesson, but I'm emphasizing it much more right now, that it is critical that the pubic bone stays anchored to the floor when we are doing the upper front anchor
push away, when the head floats up off the floor. Because the fact or the act of maintaining the pubic bone and the front of the ribcage anchored helps ensure that there's no movement between these two anchors.They don't move, and so nothing
between them moves. So that was an important point that I just wanted to make. Pubic bone stays connected even when doing the upper.And there will be lower back muscle contraction when doing the upper front anchor push away because these
muscles are attached to, you know, their paraspinals, they kind of go up the whole length of the spine. There are tons of tiny different muscles as well that are not connected, but there are some long ones that go up a large portion of the
spine. And so there will be muscle contraction, but the goal is that even though the muscles contract, the spine is not being pulled on because it's an isometric contraction.Because we're keeping the pubic bone anchored and the ribcage anchored,
even though we're doing the upper, we can't forget about this. The lower, you know, doing it this morning, I don't think it's as big of a concern to, I don't think it's as necessary for the lower back muscles to contract because the movement
of the elevating of the legs happens from the glutes and not the lower back muscles. So if you're having pain in the lower back from pressing the pubic bone into the floor, so first we do it with the abdominals, we connect it to the floor by
pulling it into the floor with the abdominals, then we bring the glutes in to push away further and create the elevation of the legs or the floating up of the legs.And you're still having pain and you're doing it, what you feel is the right way,
it only can come down to turn down the intensity to the rule we established earlier, which is go up to the point of pain, if it's bad pain, and not further. And work that threshold so you can get that 10% benefit on either side of where you're
working. So that's the strategy I would recommend that you employ.If there's any more questions about this, feel free to ask. Otherwise, I'm going to go into the Q&A, which is going to start with Chris's question here from the chat, and then
we'll go into some other student questions that came through in the comments, etc. So Chris says difficulty with the anchor triad.So all three anchors in standing and the lower back feels tight and weak. So the first thing I want to tell you,
Chris, is that the anchor triad is difficult for everyone in the beginning. No exceptions.I knew that this would be the case. I tried introducing the anchor triad earlier in the program and telling people, you don't have to get this now, but
I want to show you where we're going, because it's going to take you like two weeks to actually get it. And so by the time I need you to have it, like a little more confidence with it, you'll be ready.That strategy worked OK, but it was
stressful for people to not have really nailed all the anchors individually before knowing what we're going to do with them with the anchor triad. So I've gone back to introducing it in month two, phase two, and there's no real easy way around
it. It's a challenging, abstract concept where there's like intangibles.You're removing your primary source of biofeedback, which is the floor, and you're expected to be able to push away from these anchors in the same way without anything to
push away from. And so I just wanted to let you know, Chris, that it's OK and expected if you're struggling with it, because every single person does. But once you get it, and there will be a day when you get it, and it kind of happens like
this, it's almost like two nerve endings where I've been close, and then finally one day they touch, and the connection is made, and it flows.And that day is a breakthrough. First, I'm just going to encourage you to keep working at it until
you get to that breakthrough. And it might feel like a plateau until you get there.It might feel like there's no progress and this is pointless. But what happens a lot in progress with a lot of different things is one day, and it may be one
of those days where you're really tired too, it goes boom. And then you get to benefit from all that hard work you did during the plateau.Now let's get some practical advice for you. Definitely if you're feeling lower back tightness, then it's
beneficial to warm up. However that looks for you.If that's going through the warm-up routine, which I think we've established by then, is just front anchor, back anchor. And I think the challenge is just get those muscles moving. And I don't
necessarily recommend static stretching.So if you want to stretch your lower back muscles to allow you to get that connection a little stronger, I like doing the back anchor progression because it's a form of lengthening those lower back muscles
by kind of curling up the pelvis, but it's an active stretch. And so it has more long-term benefits. So potentially do some back anchor progression to get a little lengthening of those lower back muscles.And one of the things that I believe why
people feel that their lower back muscles are weak is not because they're actually weak, but they're tired. And they're tired because we overuse them. And the superficial lower back muscles are not meant to be used all the time.By being
superficial, by definition, they are mover muscles. They're designed to be moved. But when we lack stability in the deep core, they turn on all the time as a compensation for that stability.And so they just hold. And they get tired from that
because that's not their design. It's not their genetic makeup.There are muscles that have different genetics, different types of cells, that make them more just better performers under different scenarios. And one of the major differentiating
factors is a postural all-day long type muscle or is it a movement muscle for power. So, I don't know that your lower back muscles are weak.They're probably overworked. That's more, in my opinion, more common. One of the things you can do is,
through the warm-up, is just really focusing on activating those abdominals.And you can just send your focus and your imagination into the abdominals and really working them. And if you feel the lower back muscles turning on, then back off. And
so that's your threshold.It's a different kind of threshold. It's the same concept as good pain, bad pain threshold, but it's more for like 10% rule. Where do we stop so that we know we are working those deeper muscles that we want to turn on?
So, there's a lot to be said about the warm-up.If you're in Module 5, I'm wondering, Chris, if you've done the Anchor Triad marching. Because sometimes it's easier to do the Anchor Triad marching than Anchor Triad itself because the movement all
ows you to feel things better. And so try the Anchor Triad marching and see if it's easier for you.A 10% rule applies here too. In the beginning, it's going to be easier to do it with more intensity to feel it. But when it comes to applying it
to real life, you know, you're just standing here in line at the grocery store.This has got to be posture. It's got to be 10%. It's got to be subtle.And so that's a big recommendation I have is to remember that this is not powerlifting. This is
standing. I'm going to reread your question.So, applying the Push Away concept in standing. Lower back tight and weak. So, warm-up and definitely doing the Front Anchor and Back Anchor awareness right before so you can have those muscle
memories fresh in your mind and your muscles right before you get up off the ground and then apply it.And then be patient because it takes weeks for that one day to come where you're like, I got it. But I can promise you when you do get it
and you start applying it to things like the Hip Hinge, just looking at the feedback I've gotten from students, it's kind of life-changing because it applies to everything you do. And so, be patient.Stick with it. Keep working at it. And
basically, you're just applying the same Push Away.The rib cage does not move. The pubic bone does not move. The parts of the body above the rib cage and below the pubic bone are what move.And so, when you are getting that Push Away connection
the goal is for all the movement to happen outside of that range. And the Back Anchor, too, is extremely relevant. So, it's abstract stuff.It's tough. What we're teaching is feelings in your body. And it's always been tough for me to put these
things into words and describe.It's like, describe the color red to me. Describe the taste of food to me. Like, without comparing it to something else.Like, what does an apple taste like? Without comparing it to something else. Just describe it.
It's kind of like that.It's really hard for me to put these feelings into words. And so, it's going to be a lot about repetition over time. And I hope that's helpful to you, Chris.I'm going to constantly forever be thinking about how I can
better explain these things. And if I figure it out, I'll go public with it to all the students. I'm going to switch into some student questions.I'll just read. I believe this is Kaylee. Since we've spoken, I've basically rested every day and
stretched.Iced my knee. Did some lateral movements with a band. And focused on the first two modules.And also did laser therapy and a sports massage. And for an x-ray was fine. No major diagnosis.By the way, this is the person who we did the
case study on last week. So, this is a follow-up. She's done a lot of resting, ice, some light stuff, and massage, x-ray, laser therapy.In the meantime, I somehow had the willpower to climb Mount Baker. Eight miles round trip with 8,000 feet
of elevation gain and a pack. Remember, she's a mountain climber.I did use some K-Tape on the way down and brought the knee camp more laterally. And honestly, it helped a bunch. Brought the knee camp more laterally.Maybe that's a brace. I'm not
really sure. But I do recommend people, when they're doing functional movements, to keep your knees lateral, not medial.Keep them out. My knee felt good the way up. Felt not good the way down.That's very typical. Going downhill hurts more than
going up for the knees. And just normal aches and pains from trips like this.The next day, I wasn't as sore as I thought I would be. Wednesday, I did another six-mile round trip hike. Steep snow climb. Again, surprisingly felt good and fine. I
did pull my left hip flexor a bit, unfortunately. And, of course, today, Thursday, my left knee is bothersome again.My back's still a bit sore, but it seems like it's manageable for the time being. I plan to continue ice, rest, laser, core
balance, and continue with the ibuprofen and prophylactic, maybe? Probiotic enzymes, maybe? I also had a steroid pack last week, which I felt really helped with the back and knee. If this is also an inflammatory process, I'm not sure what the
next steps are because I can't continue to take steroids.But that is a question for the nurse practitioner. Thank you again so much for everything. I moved on to Module 3 after finally feeling the front anchors click.All right. That's what I
was talking about earlier. So someday, it's like a click.It's like a light switch. Like something happens. The two nerves that were getting real close and all that work you were doing, one day they touch and something clicks.And that is a
breakthrough. So she felt it click, and that's great. Honor you for sticking with it, Kaylee.I still think I struggle with both at the same time, but a bit. But time a bit, but I'll keep working. All right.So I thought that was a question, but
we're just sharing the follow-up from last week, so that's super relevant. I'm going to try and search through these for the actual questions. I think I found one that's kind of a questionI'm still slowly working through the program. This is
from Adam. But very busy with daily life.Since determining that most physical training does not aggravate my pain, but rather make it go away temporarily because of the increased blood flow, I have been able to vastly increase my amount of
physical training over the past two to three months, and now have reached about 30 miles a week of running, three to four days of weight training, a few days of indoor rock climbing per week, and various other sports and activities as they
come up. That being said, the more inactive I am, the more pain I find myself in. The left lower back tightness and sharp left glute pain are still extremely present, especially in the mornings and when I am in a relaxed state, driving, sitting,
standing, reading, et cetera, as well as during any straight-legged hinging motion done with my left leg hip.I am learning from your program, still lost as to where the root cause of my pain is. Okay, Adam. So we'll dive into this.It's not an
actual question, but I can just help you a little bit figure out where the root cause of the pain is. So one of the things I just want to mention, Adam, is that it is easy to find yourself getting... It's all... I hate using the word because it'
s not exactly... It's not exactly this, but it's kind of an addiction to movement. And so what you're experiencing is you feel good with movement, so you do more of it, but you say that you're actually... When you don't move now, you feel even
worse with a lack of movement.And so it's kind of like a dependency on movement to feel good, and that, like anything else, the dependency can grow. And so we want to get to the point where we feel good in moderation. And it sounds like being
in a relaxed state for you is not comfortable, and the pain that you feel is in your left lower back and sharp left glute pain.And so oftentimes when it's one-sided and sharp, there could be a nerve involvement. And so it may potentially be a
lumbar spinal nerve. And in that case, I would recommend the protocol of the program.But that's not going to get better through higher intensity, high, you know, extreme activity. What we need to do is bring the body back towards balance. And
part of what's inherent in balance is just like, you know, moderation.And so my recommendation is stick with the program. It may take longer than you think, but I don't think that the strategy of constantly increasing activity is a winning
strategy because you will reach a, you will pass a threshold where it becomes too much. And so the foundations of the program are designed for someone that's having nerve impingement, whether that be the piriformis compressing the sciatic nerve
in the glute itself where you feel the pain, or if the compression is happening farther up the nerve in the lumbar spine.The protocol of the program will help. And so, you know, if I were you, I would commit more to the lower intensity protocol
of the program and really learning how to create balance in my body and my muscles through doing the bridge and connecting to the anchors and gradually, not abruptly, but gradually reduce your, I don't know, maybe if it's not causing you any
harm, then the amount of activity you're doing is fine. But if it starts causing you increased muscle tension and stiffness and soreness when you're not moving, then it might be something to, you know, back off for a little bit and then ramp
back up.If you love that lifestyle, ramp back up when your body is in more balance and you feel more comfortable at rest. So that's my advice to you. And I think I'm going to move on.Chris, I see you shared some more questions. Let's go
straight to you. We'll prioritize the live attendees.So it says, I've had tightness in the back of my right knee ever since I began experiencing back pain last October. How is this connected to back pain? Okay. And then it says, my MRI
indicated two bulging discs between L4-5 and L5-1 along with stenosis.My knee feels tight when extending my leg. Okay. So I kind of need a little more information about the knee.So does the knee tightness and pain go up and down depending on
what you do? Or is it relatively constant no matter what you do? That's question number one that I have for you, Chris. And then my question number two is just can you describe the knee pain, the type of knee pain that you feel? I know that
you said it feels tight and pain. The back of the knee tightness is pretty consistent throughout the day.Okay. And your MRI was of your back and not your knee. So I'm going to start by saying that I don't actually have a strong answer.I think
that there may be a correlation between your back and your knee, especially if it's a nerve, potentially like a nerve impingement in your back that could be causing the pain in the back of the knee, which is very possible. But the fact that
you said it's pretty consistent throughout the day makes that less likely. If it was more like, well, it happens at the end of the day, more so after I've been sitting at my computer all day, then I would say, okay, well, that seems like it
could be a result of a nerve impingement or if it happens every time you do this thing.But if it's pretty consistent, then it could potentially be a large variety of things. One thought that comes to my head is a lot of times people feel pain
and tightness in the back of their knee from a Baker's cyst. So that's a possibility.I don't know that it's not that. It's a fluid buildup in the back of the knee and it becomes painful and tight. So I can't give you like a clear assumption or
speculation.The other thing that comes to my mind is that just like back pain is not a back problem. Back pain is a full body problem. So the same muscle imbalances that could be causing your knee pain could be or back pain could be the same
ones causing the knee pain.And so just generally bring your body back towards balance could help both. The hard stuff is when it's consistent. If the pain is consistent, you know, no matter what you do, it doesn't get better or worse from
changing activity.And so that's when you point to something more physiological or pathological. And a Baker's cyst, I believe it's a medical, the medical term is I believe it's a popliteal cyst. The Baker's cyst is like the common name.That
would fall under that category. So let's get into a couple questions from the lessons. Karen, it's not really a question, but I'll just read it.It says, I feel I've made some improvement after completing the first module. However, a lot of my
pain comes from my sacral area and down into my tensor fascia lata and into my hand sprint strings. I love that name for ham, ham, hamstrings.You confuse me on the name now. Hand sprint strings. So tensor fascia lata and hamstrings are painful.
I'm hoping as I strengthen the transverse abdominis that I will be able to relieve pain. I hope so too, Karen. I believe that that would be a good strategy.We don't, we don't isolate or single out the transverse abdominis in this program because
it's only one muscle of a vast number of muscles that are part of the deep core. That muscle gets a lot of attention. It's pretty much famous for being a deep core muscle, but it doesn't work alone.It actually alone is very incompetent. It
relies on many muscles that form basically a spherical chamber or cylindrical, sorry, cylindrical chamber. And they all work together to provide compression, increasing interabdominal pressure and stability in the spine.So lots of muscles.
There's, you know, four layers of abdominals and also hundreds of muscles in the deep spine and kind of like the lower, like the back region. So we want to strengthen all of those and not just strengthen them, but also, you know, more accurately
, I would say we want to increase their activity in our daily movement and our daily life and their endurance so that they can go all day long because that's what they're designed for.Thank you for sharing, Karen. And I agree with you that
getting your deep core stronger and more balanced and more active will provide some decompression for the spine and should help the sacrum and that referred pain that's going down into your legs. OK, Angela says, I practiced the push away today
and I'm understanding it better.It seems like it would help our core gain strength because there is not so much effort involved and we're not using our arms and legs. I love that, Angela. And thank you for sharing.That is more true than it even
seems. It's more true than you may even know. The fact that we're not using our arms and legs is huge.It's monumental in the push away concepts because the pattern of movement, of dysfunctional movement that we tend to fall into is we overuse
the arms and legs. And so even with sitting, people tend to really like lean on their arms one way or the other. Or let's say you're in like a movie theater seat and you're like resting on your elbows.Well, that's a lot of work for the arms and
the shoulder muscles. But the core can be just completely turned off. And so we're perpetuating the problem by not using the core and making it even weaker.And so to trust the spine, to have confidence in the core muscles that they can do the
job and to use them more, not less, it's counterintuitive. We have an injury to something so we want to use it less, but not chronic lower back pain. We want to use those muscles around the spine more so they get stronger to a degree.And then
that's part of what this entire stream is about. So if you're just hopping in now, go back to the beginning of the stream and we dive deep into to what degree can we push it and use and do exercises if we're experiencing pain. OK, Kaylee.OK,
here is a question from Kaylee. This is the mountain climber. So we updated on her earlier.And this is in the front anchors challenge. So module three, I believe. It's interesting because I do a lot of bird dog for erector spinal muscles.But
I guess I never felt my core so much as I did with this. So bird dog is pretty much the same movement as the front anchors challenge. But with the front anchors challenge, we have an entirely different intention, mindset, focus of staying
connected to your anchors and we're not focused on the arms and legs.And so it completely changes the exercise and turns it much more into a core exercise. And so you get different benefits. So that makes sense, Kaylee.Definitely a bit of a
challenge when the core is engaged to lift the extremities. Yes, particularly my left leg. So that's a good reflection, Kaylee.Work on the left leg. We want to work on general rule. Just work on the things that we have more trouble with and
even them out.Even though I'm not lifting the leg much, I can feel things shifting almost off balance. So two questions. OK, so yeah, side to side shifting.And when you do shift from one leg to the other, there's a shift in your core, in your
abdominal core. And it's kind of like, it's like kind of abrupt, like left leg, right leg. And those muscles shift to stabilize with a different lever pulling on them.And so, yeah, you are going to feel a shift. Here's your question. In a bird
dog, would I normally try to keep the pelvis level and stable while lifting the opposite arm and leg to make adjustments that way? Am I doing the same thing as far as shifting to make sure the pelvis is stable and low back isn't dripping,
dropping, I'm assuming you say, with this? So I'm much less focused on the side to side of the pelvis, Kaylee, than I am the staying connected to the anchors.So side to side would be kind of like a transverse plane stability. We're not there
yet in the program. We're going to get to that later in the program.What we need to establish and develop before we'd work on other planes of motion is sagittal plane, front to back. And so the anchors, front of the body, back of the body
stability. And so staying connected to the anchors, you know, with this one it's the front anchors, but you can also think about the back anchor and just maintaining that connection while breathing.And I don't really care what you do with the
arms and legs. You can lift the right. You can lift the left.You can alternate. You can do whatever. But staying connected throughout is the most important thing.The side to side tilting of the pelvis is not wrong. It's okay. It happens in
natural movement, but we want to be stable in the sagittal plane while doing these movements.And we don't let the lower back drop, right, or collapse is the term that I like to use. Because I find the legs creating that unevenness but seems
more challenging to neutralize, that was part of the first question. Okay with the unevenness side to side.Number two, with a wrist issue I usually need to be on my fists for this position. Does this pose a problem posture wise for CBT? Sometime
s in yoga I may put a little something under the hands and I can keep my hands on the ground. Totally okay, Kaylee.Totally fine. Fists are okay and also if you put something under your hands to reduce the angle of your wrist. The focus is not
the arms, legs, wrists.It's on staying connected to the anchor. So great questions. And just sharing this one, Heidi, who's in unilateral anchor triad.She's pretty far into the program. She says, I'm thankful that I'm really strong and stable
standing on one foot. Everything seems level and connected to my anchor triad.Awesome job, Heidi. I don't know if you're going to see this, but love it, love hearing it. Patrick Harris, I can honestly say that I feel a difference.I have suffered
for so long with lower back, hip, groin issues. I notice getting up and down off the floor feels different. I'm excited to keep progressing.Thank you. Thank you, Patrick. That is amazing.Glad you shared. We have a question here from Marcy.
Is there a flow to doing multiple squats? Yes, there is a flow.So we'll get into that in a second. You hinge and lean your butt back, correct. When you come back up, do you stand up straight? You can, but you don't need to.What's more important
than the amplitude of movement, how far down you go and how far straight you stand back up is staying connected to the anchors. Once you feel confident staying connected to the anchors within a certain range, then you can expand that range,
stand up taller, squat down lower, and progress your ability to stay connected through a larger range of motion. But there's no right or wrong to how far you stand up because it's relative to where you're at at this point in your training and
fitness, Marcy.It seems awkward to me. I'll keep working on it. So standing up all the way seems awkward to you, then don't stand all the way up because it's important that things feel good, so that's my advice to you, Marcy.Do what feels good,
and if standing up all the way doesn't feel good, you want to just stop short of that and go back into a flow of squatting back down and back up and turn it into like a little bit of like a flow, then do that, and maybe that'll be, maybe
that'll change later and it will feel less awkward in the future at some point to stand all the way up, so yeah, cool. Ed McGill, I've had a breakthrough by combining this course with isometric training focused on my core and therapy stretching,
this course is the key to learn how to connect with the right core muscles for the first time in two years. I played golf yesterday, pain-free and without restriction.Whoa, that's amazing, Ed. I love hearing that. Congratulations.I honor you
for sticking with it. I honor you for staying committed to your body and to your sport, to golf. I hope that you continue to stick with it because there's a lot more.It looks like you just finished module two. There's a lot more to be gained,
not to say to speed ahead, this first module and second module are like, are the most valuable life-changing foundational building blocks and everything that comes next is cherries on top, but you can't have what's next without mastering the
anchors, so keep going and don't forget about what got you to make this post, module one or module two, remember them, stick with them, and also I look forward to you to keep progressing through the program because if you're already having this
much progress, then I'm just excited for you to see what comes next for you. Okay, Debbie asked a question before about sleeping and this is a follow-up question.She says, wow, great answer. Thank you. I also worried about fetal position, that
eight hours in that position would shorten my hip flexors even more.But what I'm hearing is that the resting position will not undo my good work. So I shouldn't worry, right? And so confirming with me something I had said in my previous answer
to her. And she says, thank you.You're very welcome, Debbie. Thank you for the gratitude. And I'm so glad you asked because I'd like to expand on my previous answer.What I had said was that sleeping is not going to undo, the original question
was like, I have anterior pelvic tilt, I can feel it when I'm sleeping, when I'm laying down in bed, is that sleeping for eight hours a night with anterior pelvic tilt going to undo the work that I've done to lengthen these muscles and create,
you know, strive for muscular balance? And my answer was no, it's not going to undo. And I said, if you feel like the discomfort with the anterior pelvic tilt while you're sleeping, then I gave some recommendations, bolster under the knees,
or if you don't have a bolster, a bunch of pillows piled up. And I said, the sleeping on the side naturally would reduce that anterior pelvic tilt when you're sleeping.And she said, yeah, because it's kind of like the fetal position. And I kind
of worried that that would undo, it would shorten my hip flexors. And so Debbie, there is something to be said about that, about sleeping in the fetal position, contributing to heightened, shortened hip flexors.And so what I had said earlier
is with a disclaimer, and I didn't put that disclaimer in my message, so I'm glad you followed up and I will put the disclaimer here, I recommend that you only come up into say your side sleeping. You only come up into the fetal position as much
as you need to take the pressure off the spine. And don't go further into the fetal position.Don't sleep curled up in a ball and don't lift your legs. If you're sleeping on your back with a bolster much higher than you need just to take that
tension off the spine from the hip flexors because there may be an argument to be said that over-shortening those muscles and sleeping for that long can train them to rest in a shortened position. So we're going to prioritize comfort and taking
the tension off the spine so that we can reduce our back pain.And then secondarily, next priority is don't over-shorten the hip flexors. Don't curl up beyond what you need in the fetal position or raise your legs higher than you need. Just go
to where you need.And so we're going to minimize any potential shortening of those muscles that might happen. All right. So we have the last question of the day and it comes from William.It says, Dr. Peebles, I'm struggling with the front
anchor concept. Are we still contacting the core? I think you mean contracting the core to push away from the front anchors? Yes. The answer is yes, William.We're engaging the abdominals to bring the pubic bone to the floor. We're pulling the
pubic bone into the floor using the abdominals, abdominal contraction, and then when we're pushing away from the floor to cause the legs to float up off the floor, we're maintaining that abdominal contraction engagement and we're adding in the
glutes and the glutes are going to be what actually causes enough push away force to fulcrum off of the pubic bone and cause the legs to elevate. This caused me some pain in the lumbar region.I talked a lot about this. Actually, a lot of this
stream, William, was about exactly this issue. So we need to make sure to keep both anchors securely anchored to the floor.And so there's no movement or extension in the lumbar spine. And thank you for being here. I'm going to go move my body
because I've been in front of a computer for hours.And I hope you do the same. You know, if you're doing core balance training, then I encourage you to stop after this stream and get down on the floor and do some CBT and connect to your anchors
and, you know, give some love to your body that does so much for you. Super grateful.And until next time, I will see you in the course. All right. Take care.
