What is your shape? Lordosis? Kyphosis? Scoliosis? Learn about the structures that “shape” the spine. Other clinicians, Cera and Jackie have shared their trauma. Find out what Shermain has experienced on this podcast!
That’s great. Most of the regions in the thoracic and the cervical regions, you would need to have much much more mobility. Although that said some parts where it’s hypo mobile mean meaning that is not moving right or moving too little.
Isn’t that saying your body’s a temple but a lot of people are, you know, probably, you know, treating their bodies like public libraries, maybe I don’t know.
They will commonly describe it like, Oh, hey, I’m, I’m generally okay. I could have back pain. I feel like an old person from sitting to standing. I can’t really do it properly. And on this train, I feel like it’s really really aching aching so badly I cannot tolerate this.
Dr Shermain Wong is a seasoned chiropractor with particular expertise in Sports Medicine and a passion for the benefits of in ‘Active Release Technique™ (an advanced Soft Tissue Technique developed by Chiropractors). She is professionally trained in ART and has a Masters in Clinical Chiropractic from RMIT University. Dr Wong has provided chiropractic and movement rehabilitation services at international sporting competitions, and provided rehabilitation and training for professional dancers, professional football players and professional athletes.
She can be found at https://www.jurmainehealth.com.au/dr-shermain-wong/
Episode 024: Low back pain part 3
Podcast brought to you by Jurmaine Health
This is Jurmaine Health, the center to help you achieve wellness in both your brain and body. We endeavor to encourage cross communication between health professionals for your health and well being. We bring you topics on neuro psychology, neuro behavior, neuromusculoskeletal, neurogastro, movement is well being metabolism and microbiome, which are also some of the services that we provide. And today's podcast is the fourth and final in our low back pain series. We're talking about the shape of the spine and how it may affect the whole person. I've Dr. Shermain along with me today, so say hello, Shermain.
So, the topics that we are introducing to you today or speaking about with you today, and then continuing on later with relation to scoliosis, kyphosis and lordosis. So where should we start Shermain?
is the most common thing.
Lordosis and kyphosis, and scoliosis are all different where we talk about as different curves in the spine lordosis and kyphosis and natural curves that occur. It's when we refer to him as being of a concern we refer to them as being hypo or hyper, whether it's lordotic or kyphotic scoliosis and it's obvious in different curvature. Again, most people do have a slight scoliosis where the spine kinks around the spine. And again, most people also don't have any issues with their scoliosis itself, it doesn't really present as any problematic issue Shermain apart from a radiology, radiological, finding, in most cases, but occasionally it can be if it's not monitored and picked up at a young age, it can become a problematic situation. The scoliosis issue usually occurs more so in the thoracic spine so up higher in your mid back, but can occasionally happen in lumbar spine, I'd be saying in your low back again, and again be contributing to higher up levels going back to the lordotic and kyphotic curves there in the sagittal plane isn't it? So sagittal plane. So if you're looking at a person, it's the front and back sort of plane that we're looking at, in this case, your neck and your low back, have natural lordotic curves. Your mid back, which is your thoracic spine has normally a natural kyphotic curve. So when we're talking about the lordotic curve, it means that you've sort of got a concave situation happening. If you're looking at your kyphotic curve, it's a convex situation happening. So it's your spine is sort of a tripolis best way that I can describe it.
to say, with scoliosis itself. It's a huge topic. So in and of itself. We have got to speak about that
Yeah, it will be coming as a series later down the track.
Yes. If you're talking about low back pain, sometimes some people would have things like fusion hmm in that area and it loses its kyphosis. Sorry, it loses lordosis. So we are right. And when that happens, everything else changes up the spine. When we have changes up the spine that way, what can normally happen is the degeneration process starts much faster and earlier and more aggressive sometimes, largely because of how we are using our bodies every single day.
Compensatory movements, so previously a natural movement, as well as trying the body's way of trying to get around the fusion segment in itself.
Absolutely. However, the vertebrae of the L5-S1, that's got to be really stable. So in that sense, fusion in that area makes very significantly less issues and it gives rise to significantly less issues as compared to other parts of the body,
Especially the higher ones, anyway, it becomes even more problematic.
That's great. Most of the regions in the thoracic and the cervical regions, you would need to have much more mobility. Although that said some parts where it's hypo mobile mean meaning that is not moving right or moving too little. Then we are looking at having to have other aspects means that if let's say if it's a fusion, but it was no fusion, then we would have got to mobilize alpha as one on that. No, no, most people overly adjusted in the L5S1 or L4L5S1. So there you go.
So regardless of what you have, they just go on, they will just adjust your neck area.
Especially, if it's chiropractor does the following seven, it's included in the following seven.
It's not all the time that you need to be adjusted in an area. It's not all the time that you need to not move the air. At the same time. You also do need stability in that area it's a very fine line. And that's something that even we as clinicians cannot judge for ourselves with our own bodies. We will need another technician to do that.
Point to help, point out will help guide us in the right direction.
That's right. Sometimes it's a matter of just an engagement issue, and engagement between the L3 L4 L5 and the pelvic floor. If people can't engage
or recognize, yeah, there's movement or no movement some people don't even recognize that they let's just say that they've completely locked down the lumbar spine to their pelvis so that we truly using one whole unit that we just moving from, say, their pelvis, and let's see, it's pretty much like a flat back or just a legs, and nothing else, and they can't figure it out.
Or if they have a disc issue in that area, then what that could mean if you are not looking at one segment and it's not so bad, that is not too bad, then it doesn't translate upwards or downwards. It's quite okay. You're very localized. There's no neural tension upwards or downwards the body and the spinal cord. I mean, on the other hand, we are looking at sometimes what I see sometimes, you know, if we give people exercises to do and they can't exercise can't do it. Sometimes it's not a matter of them not for the lack of trying. They do it and they are conscientious but they still cannot. So what normally happens in that scenario is that it's not just spine it may not be just find that's an issue, it can be the tissues anterior to the spine, that is an issue and that's quite common as well. Tissues like your hip flexors. Or it's not so much the psoas itself as an issue, but the inner psoas that the left has to see is the muscle that wraps around the pelvic room that can be inflamed or overused, or any one of those
tugging on the pelvic bone
Yeah or any one of those effects and that will be holding on so badly to the duty is very tightly and badly to the inner psoas. As is stopping extension from happening.
So what you're going to be looking at is like you've got a slight flexion through yourself with a slight bend forward. As opposed to being able to trying to extend yourself.
Oh yeah. And this happens a lot in cyclists. Sometimes swimmers runners. Are you looking at the jitsu people to wrestling farmers and trainees farmers and trainees Judo.
Any sports that have a lot of hunched over forwards positions in society especially sustained position? Yeah, hockey definitely. Soccer is relatively fine if you've got a long, fair bit of extension nibbles points, you've got a fair bit of extension that's around cricket. If you're especially if you're a batter or a wicket keeper well that would do it again. And they are the ones not so much for fielding.
One interesting sport would be basketball. Even in basketball, I find that they tend to strain their inner psoas a lot,
I can see that.
Yeah, because of the way they checking each other.
Checking or jumping as well. When they're trying to get some elevation.
They will commonly describe it like, Oh, hey, I'm generally okay. I could have back pain. I feel like an old person from sitting to standing. I can't really do it properly. And on this train, I feel like it's really aching so badly I cannot tolerate this. So that's quite common to
I know ones that are more likely than not to have a hyper lordosis as well where it's slightly decreased as opposed to what it should be.
Sometimes if you're like, their tailbone aches their tailbone aches their groin area aches.
So they have, they might have groin issues, constipation, or frequent urination or matriculation. Yeah, I think that's a word. I think it's because of my degeneration in my c4 to c7.
Yes Shermain had her X ray done today. She got classified as an old granny by me.
Oh, yes, that's the like medical terminology. You have. You are an old granny, you look like a turtle you have a chicken neck
For the record. This was the positions that she was putting herself into, while we were trying to figure out how best to stabilize and mobilize her neck. So she was putting herself into a very interesting position that did, in fact, make her look like a turtle. And the chicken reference in my defense again, was how she actually moves from it. I was trying to explain that instead of the flexion extension that she shouldn't be having through her neck which is limited, hence the degeneration really, or vice versa. I'm not controversial which way it came first regardless. But what I was saying was, it was the way she moves. I said, she translate. So she goes forwards and backwards, but in a straight line versus in a curved line. So I said the best way to look at it is like a chicken. So she sort of got cold and rainy, and a chicken.
I'm like, I am like a hybrid homunculus.
Thanks, Jackie. I love you too. Happy Valentine's Day.
Okay, back to spine and spinal things.
We got lordosis, those were on to kyphosis now. So, kyphosis is a curve that's predominantly or should be, to an extent, prominent in your thoracic spine. So it's the one that reach in your mid back?
Well, yes. Also in the we can have kyphosis in the low back too
in the sacrum to the L5 L3 L4 L5 L4 L3.
Ankylosing spondylitis. Okay, we'll close that. Thanks.
I was talking about natural kyphosis. I was talking about the natural curve and this
well if there's a pathology that happened,
that's a pathology. That's not a natural thing.
I'm not sure what it is. It's a natural pathology. Yes. And if the ALL gets stuck ALL is anterior ligamentum ligamentis. Also about to say that the long ligament anteriorly in front. Then what right? Yeah, that one? Yeah, the one that runs at the front of your spine. That's right, that would cause a kyphosis and you don't want to have kyphosis of the lumbar spine, you really don't want that to happen. So because when that happens, there's a possibility that your entire spine becomes a C shape. So your long C shape from the tailbone all the way up to the �
first presents itself as a hypo lordosis and then as it progressed, it would then make itself into a kyphosis.
That is right, and the thing about spoilers is,
you know, it would be that would be what would be classified as an abnormal kyphosis. It's not supposed to be present in the lumbar spine it's curve that shouldn't be present in the lumbar spine. That's why it's an abnormality,
think about spines, so people think that the spine is a strong nerve. You know, the C 1 to L5 most of the time.
they're missing another eight to nine segments. Yes including the, you know, the sacrum and the coccyx. Those form your spine too, by the way. Yeah, yep. Okay, people � those are your little tailbone guys, that's the full spine. Yep. Not just your like Shermain just said not your cervical to your lumbar.
And then this suddenly stops no it doesn't. It goes all the way. And how do you how the brain transmits all the information is through the brain itself, and it exits through the brainstem, through your nerves from C1, right and this right under the skull and all the way down to maybe about L2, L3, L4 and then they exit. Now they're still supplying the S1 S2 S3 But what he does is that they all exits around the area and then orms a big nerve called your sciatic nerve and at the back and in front it is a femoral nerve. And then it branches out into little like little streets, right and it supplies the lower part of your body. Yeah, it supplies the lower part of your body everywhere and everywhere. If you think about it like a network of nerves, this will be much easier.
It'd be much easier for how you guys will be hearing it.
It's not just for one it's a network like showing just said yes.
That's right and you have got Yeah, so and you have got you know, it's like terminals, right? The terminals at some places such as you are not talking about terminals that ending terminals we are talking you think about you know, those big train stations, central stations that's opening You have got at least about 1233 Hmm. So it's the sacral plexus. Yeah. The Solar Plexus and the brachial plexus. Yeah, I think that's a lumbosacral.
So you've got three big, you know, like central stations in your body, and spleen, the brain itself. So that's a lot. And we are still not talking about you know, we have got now what is why are these things three two brains has gut brain and the brain and the gut brain and the brain can be functioning separately.
And a lot of the time now.
Yes, that's right. So you've got three central stations two headquarters. It's like it's a bit like Sydney, Melbourne, Canberra.
Melbourne and Sydney are always fighting to be like the capital. But no, they have got to put Canberra in the middle of nowhere all right. And that is where all the big decisions
like that, okay? So for you guys for listening to this podcast, I think that you know, it makes it a bit easier for you guys to do that. So we were talking about low back pain now once we speak a bit more about the entire spine and some people have been asking me some lifters have been asking me how do you keep your spine healthy. Here�s how we do that to make your spine healthy generally most people are bored of healthy your spines Unless you have had trauma like for example myself I had several traumas in my in my body. I fell in a drain once back first, head first when I was younger,
I fell off the slide.
Sorry you fell the slide. Yeah, and I fell off a boat from like, it's like you know many stories really steep stairs, yeah and hit my tailbone.
Into on it. Sorry, totally not into the water. He fell from a boat from a level on the boat to another level about yeah
okay all the way down right so it was my tailbone
Did you fall and if you slide down list you just try sliding down list you
No I slipped and fell.
So there's that. I have many kicks to the head because I was I do a lot of martial arts I did a lot of martial arts when I was younger. Two or three years ago I fell off the bike onto the tram track. So in and of itself, I have had personally you know, physically I have many lash like symptoms. So I do have a flat spine or middle military spine, how does what they are going to describe it as and we will speak about that a bit later. But generally if a person is healthy or getting towards healthier, a healthier body, they generally will have got a good and healthy spine. What that also means is that if the person is able to have good strength or if a person doesn't have good strength, they will have to practice until they get good strength. If the person has got good stroke, Australia that's about beginners level, you know, fresh practices, right. And they're obviously, they're working hard. So what maybe one day we'll have got to do first is to, you know, have mobility and flexibility. So people have asked me what is the biggest thing you need to have in weightlifting, to you're talking about newbies, I said to them, it's not so much about muscles. It's about a strong nervous system, because there are people who do not have muscles musculature, they are still very really strong, they can they are able to carry 2.5 times lift 2.5 times their very weight. And that's very strong nervous system. And if a person has got a strong nervous system, and on class on top of that they've got good hypertrophy of musculature. Not just hypertrophy that we are talking about, you need to have that muscle type is that a fit endurance muscle type, endurance and strength instead of speed and power in weightlifting then they would have a lot of longevity in a sport they will have very good and strong spine for a very long time. What people mistake there is as if they are training as if they are like power people. But the thing is that when they are doing a ballistic movement because power means speed times strength, not speed plus strength it's speed times strength. So and if you have power, but if you have got, you know, this you've strength, but you're and then after that you've got speed, well you don't have the nervous system strength for that nervous system injuries for that. For that spot. You're not gonna have a really strong spine No. And also a lot of people mistake flexibility for mobility. And when and then they, they become too mobile, but not flexible, or they can be too flexible, but not mobile, then we have trouble. And then on top of that, they are training, their training regime says to them, hey, you look strong, so we are going to give you more hypertrophy with our power, and it throws the technique up. Once it throws the technique up by that what I mean is that the body is compensating around the bar as compared to the body is strong and stable and above moves around the body, and then we'll have a better lift overall. So if a person do is move the body around the bar, it's likely we are going to have a lot of compensation. By the time me the weight lends on a person, it crushes the spine almost. So the spine itself cannot dissipate that load into the route that load and the pressure needs to go somewhere. And if it doesn't go somewhere it is going to go to your hips is going to be your knees, your ankles, your shoulders, your elbow somewhere, you know somewhere, and then it crushes you. Right crushes the body, and people go what do I not have you know, why do I have elbow issue? Knee issue. Some, you know, an issue, any issue usually by the time they are doing power moves for lifting. They're going to get hip issues. Most of them are going to get hip issues here. Then it's a technical fault. If the hip is the issue, but then the spine is free to do what it does so your mind works very hard for you guys,
as we did with a bit on this, you know,
Ideally you want to treat with respect, don't try to look after as best as you can. Yeah.
Isn't that saying your body's a temple but a lot of people are, you know, probably, you know, treating their bodies like public libraries, maybe I don't know.
I'm trying to figure out these public libraries concept.
Well, now, you
Now, a lot of people are doing the whole I might as well run with you're gonna die anyway. So I might as well run my body into the ground. It's no point you're gonna go into the ground anyway.
not necessarily die young, but he might as well go out
But YOLO you only live once.
I'm trying to not say that.
So people. Also to keep a healthy spine. That's one way to do so.
Pilates. Do they have healthy spines?
Sometimes they do. Sometimes they don't, it depends on what you're working on. Depends on what they're working on. It depends on the instructor.
Depending on the explanations as well, that's right, this person understands or not, we see too many injuries presenting themselves with pretty much been an explanation situation where the person just didn't understand the explanation that was given to them. This tends to happen with breathing. So breathing is a big one that a lot of people have issues with engage in a call versus breathing. Because a lot of instructors say bring your naval into your spine, but don't explain how to do it. And a lot of people do it by trying to suck their tummy in. Yes, and that's where everything goes downhill all the time from there.
So we have had quite a number of people, people coming in from pilates, and then they go like, but I do pilates. Why do you look so locked down and you look like you are so stiff and you cannot move but you're flexible? And they go like but I do pilates. It's like, Well, can you do Can you touch your toes? No, I can't. Can you control your core? No, I can't. What? What else is happening? Oh, my hip hurts. Yeah, so exactly why are you paying for right? So but I'm not saying that all penalties are not good. There are some people that we sent to. And usually when we send these people there, they understand movement really well as compared to a three day physio thing. I'm not bagging physios. But there are a lot of people going for pilates session of physio who has attended a three day workshop, okay. And to go further, to do pilates what you need to do have about 10,000 hours to be actually good at it to be actually no I'm not good at good at it. Just understanding it
that provides some basic level novice level.
Yes. And I started when I was 18. So it's like and that was a very long time ago. So the only people I like working with and if they're dancers, that's one if they were ex dancers and a very high level dancers as well. And if they don't place the person into a template form, there's some people that are dancers fantastic well and good but they still place people into a template form. And so I've asked some of their interns to show up to say, hey, show me if you use his or his or her complaint that you've seen and try on those patients, try it, see what happens and they almost and the patient almost always goes, I'm still in pain. So template format is not necessarily a good way to go. It's a very convenient way and efficient way for clinics and studios to place you into
The gyms as well. The same but majority of the time we are seeing that out of like five people who are going to come in and do come in and we refer them for pilates we are likely to refer three of them to one person, or maybe two of them to one person another two to another and one for generic pilates class because their body can't tolerate that. For some people, we know you shouldn't even go just do it. So there are reasons for that. And we don't do it lightly. We don't do it without thought, when we are doing it for a lot of times for longevity. Yeah, for you. So, I mean, a lot of times and sometimes something like well, you can do it and for short term and temporary term to do it and do it really quickly, aggressively and fast. And that's because you want to speed up the process of healing and then after that you need to back off. So in short, does that support your spine, it doesn't quite work on the spine. It supports only all the muscles and tissues and ligaments around the spine. So in that sense, and also, people must understand. And it's not so it's not a bad thing. It really accentuates and refines the spinal movement and a certain situation and articulation. Fantastic. All those things are very good, works to below the neck and not anywhere above the neck. Yes. Okay. So when that happens, is that useful or not? It's debatable. At least you're healthy. Yeah. All right. Sometimes I think that yoga some forms of yoga will fit a person much more accurately and sustainably and efficiently for a person for a particular person type as compared to anything any pilates? So it depends. Yeah, I mean you sometimes to resolve tension just normal tension. It could be a sitting type yoga, some people need a moving type yoga, some people need a sustain in one position kind of yoga, I don't know the names of yoga because there's so many according
according to a lot of our Indian patients and
patients from India. So do you do Ayurveda? And you know Shermain we don't. It's just like so. So who do them? Not us?
Yeah, we're like, oh, so you guys don't know. No, we don't.
Think of it. I can actually see that you don't see or hear very much. I like to just say whether they are Indian or orient around those areas. Don't actually hear about them doing yoga, you know, dancing Yes. Then a lot of them do their traditional dancing but no you don't see
you don't do yoga you don't hear them go
ayurveda no nothing
How about meditation, meditating yoga, meditate no? Isn't it funny? Yeah, but let's
Get out of the country, were they not? It's not a dominant thing in the country.
No. So that's what we found quite fascinating too.
And, and that's what I have to say for spinal strength. Also, to roll out your back all the time, was fine on foam roller on your spine. That's not great. Okay, that's like just mobilizing everything.
It's also compressing every tissue that you're pressing on.
So you're mobilizing your entire spine and you are ironing the
tissues, the tissues just next to it.
Like why are you doing this? It defeats the purpose. Not unless you are lying on it for an insane sustain extension in your thorax for a long time
or yours cervical like your neck, like when decided that Shermain's going to be doing.
Yeah, that will be in a horizontal plane, right? Yeah. Because I need that lordosis. Yes, I heard.
SPEAKER 3 [30:28]
Yeah, I'm just trying to think of horizontal plane. What were you talking about? the horizontal? That's what I heard you lying a horizontal line?
SPEAKER 3 [30:40]
Exactly. What are we doing?
I'm just I'm just taking I'm taking a mental break.
SPEAKER 3 [30:45]
I realize that you're overwhelmed by being called a homunculus.
Are you calling yourself horn killers? Variety of other names.
Right I'm a multivariable species alright okay.
Okay, at least, call me a Phoenix. Or something like that, Chicken.
Why Phoenix, Phoenix have a spine. They have a nice curve to them.
It's called feathers and tail.
The next day, they just strike. Okay. That's why they do the whole that motion. All right.
We'll ask to meet Seen Lee, Seen Lee loves chickens.
SPEAKER 3 [31:32]
Google pictures of chicken book. Yes, we have a picture book of chickens,
chickens surely. Anyway, we digress. I hope that clears out some air about
low back issues about things that you've been experiencing and was giving you some information about things that you may have been feeling or pretty much experiencing is one thing, or thinking that you may be in that boat, I guess would probably be the other one feeling like you're alone would be the other. The other part of to hear that it's all about experiences that even us in the clinic experience similar problems sometimes or have gone through similar issues.
It's lived, not imagined.
So we can. Sometimes we can relate. So hopefully that helps you guys feel more comfortable with us as well. We can relate to you on a personal level with regards to injuries, pains and niggles.
So share this podcast with someone because it's quite integral I think for especially if a person who's lifting and they start having spinal issues so they're unsure of whether they should do yoga, pilates, you know, running whatever you have anything, any sport any conflicting sport. For their body or that they are going to start preparing your body for some for an event, give us a yell or otherwise we will be seeing you in the next podcast.
Yep, we'll be continuing our discussion on lordosis in the next podcast, and that's where we'll be introducing the cervical spine, the neck pain and headaches. That'll be our next series that will be coming up. So guys, if you like what we're presenting, please give us a thumbs up a like or share it with one of the person you may think we may be able to help. For those of you who are coaches, dancers or athletes, and may find difficulty with expressing or executing movement patterns. Please do connect with us on our website www.JURMAINEHEALTH.com.au and JURMAINEHEALTH is spelled J U R M A I N E H E A L T H. Please socialize with us on Facebook, which is also in JURMAINEHEALTH and on Instagram which is JURMAINEHEALTH body guys, said you can jump onto jurmainehealthbody Instagram, which can also guide you in the direction of our embodied athlete page. Whether it would be fitting for you and whether you'd like to be involved can also share that around to your friends and family that you may know that would be interested. And last but not least, since this podcast is made for you, our clients, patients and fans, do let us know what else you might like to hear about. And that's us for today guys, see you bye.
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