In this episode 74 protocols
▶ 12:40 Avoid activities outside your natural structural predisposition Behaviors “Not everybody can play offensive tackle and not everybody can be a gymnast or not everybody can simply tolerate sitting in a chair being a computer operator.” ▷ 28:59 Build musculature around the spine Behaviors “The answer is yes, but it's a very limited yes. So if I can set the stage and give some context here... every system in the body requires stress for optimal health... But you cannot cross what's known as the tipping point.” ▷ 29:00 Stay below the tipping point of stress Behaviors “Every system in the body requires stress for optimal health... But you cannot cross what's known as the tipping point. Because if you do, you start building cumulative trauma of some form.” ▷ 41:42 Use provocative testing to identify pain triggers Behaviors “Then we go and assess them and it begins with what we call provocative testing. I'm purposefully provoking their pain. If I can provoke their pain, I've nailed the mechanic. If I can't provoke it, it's not mechanical.” ▷ 45:32 Remove exercises that replicate symptoms Behaviors “That was triggering his pain. So we took out the Palloff press, which for him right now is replicating his symptoms.” ▷ 46:55 Avoid movements that trigger pain Behaviors “Every person that comes to us comes with back pain. So initially we avoid it.” ▷ 47:48 Desensitize pain by not repeatedly provoking it Behaviors “If we keep creating pain on that toe, it will never get better. So we have to start a desensitization wind down, which is tissue based, but it's also neurologically based as well.” ▷ 48:28 Sit upright instead of slouched Behaviors “When they sit upright, their pain goes away.” ▷ 48:30 Lumbar Support Tools “So I will give them a lumbar support, which I'm just happening to use now. I had to sit on an airplane for five hours yesterday coming to see you. And this allows me to not get back pain on the airplane while I'm sitting.” ▷ 49:10 Practice spine hygiene Behaviors “First of all, know the cause and try and eliminate it. So we'll teach them, you know, we spend a lot of time with spine hygiene.” ▷ 49:36 Baby Crawl Behaviors “We teach them how to do a baby's crawl, which eliminates the torso twisting, which in their current state will offend the sensitized pain trigger.” ▷ 1:05:55 Control training volume near pain triggers Behaviors “So it isn't a matter of selecting the exercise sometimes as much as it is controlling the volume and then having a period of time off or a deload or whatnot.” ▷ 1:06:43 Limit end-range spine mobility in jiu-jitsu training Behaviors “Jujitsu requires a lot of spine mobility. And typically, jujitsu athletes get pain when they use too much spine mobility. What we do is we limit their training... they don't need to push the end range every day.” ▷ 1:07:54 Train consistently and reasonably hard while avoiding injury Behaviors “One of the best ways to get and stay in excellent shape your entire life is to train consistently, train reasonably hard. And we can talk about what his recommendation is. I'd love your thoughts, but as best as one can to not get hurt.” ▷ 1:10:13 Protect your joints during training Behaviors “The key to long life is don't mess up your joints. You can train hard and build muscle, but muscle is adaptive and resilient. Joints are not so much.” ▷ 1:11:06 Use mostly submaximal training intensity Behaviors “His suggestion, and by the way, this is not for competitive athletes, this is just for exercisers, if you will, is to make 85% of one's workouts across the year at about 85% of maximal intensity and output.” ▷ 1:11:41 Use occasional high-intensity training Behaviors “To make 10% of one's workouts across the year at somewhere between 90 to 95% intensity of what one could generate that day.” ▷ 1:11:57 Use very rare all-out training Behaviors “And then 5% or even less of their workouts all out. Everything you could possibly give, quote unquote, leaving it all on the mat.” ▷ 1:13:35 Increase rest days with age Behaviors “You try doing that to a 65-year-old and you'll find that they don't recover as quickly. They need many more deload and rest days.” ▷ 1:34:41 Follow a post-surgical-style rest protocol for severe back pain Behaviors “Tomorrow, your first post-surgical recovery day, you're going to lay in bed, relax, get up for a pee every two or three hours, have short little shuffles. The next day we'll add a little bit more, etc.” ▷ 1:35:51 Rest from compulsive exercise when pain is severe Behaviors “Surgery works in a lot of cases because it's forced rest. Surgery for that exercise addict forced them to have rest and allowed them to desensitize.” ▷ 1:38:18 Use tools that allow pain-free movement Behaviors “They know the counterpoints, what actually are beneficial for their pain. And they begin this life of having as little pain as possible.” ▷ 1:38:39 Do not cross the pain tipping point early in rehab Behaviors “But in the beginning, we cannot cross the tipping point... We know where that tipping point is and we keep building the training capacity of being pain-free until we have a margin of safety.” ▷ 1:41:59 McGill Big Three Behaviors “The bird dog, the roll up and the side plank. Right. Designed to build strength and stability around the spine and to stave off back pain or in some cases rehabilitate back pain” ▷ 1:46:00 Walk more in multiple short bouts Behaviors “I might just say, walk more, but not in a single dose... instead of walking an hour in one dose have three 20-minute walks.” ▷ 1:47:01 Lay prone and let the low back sink into the table Behaviors “Maybe laying on their tummy. As they exhale, they allow the low back to sink into the table, increasing the lordosis, which is, we measured this in the lab, if they have a posterior disc bulge with an open fissure... that maneuver vacuums in the disc bulge.” ▷ 1:47:24 Manual leg traction while prone Behaviors “If that immediately reduces the pain down their leg, I would say, lay prone and have someone pull on your legs along the plane of the table, five or six pounds per leg.” ▷ 1:49:38 Avoid cobra pose if it aggravates your back Behaviors “The cobra doesn't work for everybody, but it is a powerful vacuuming in of certain types of disc bulges. So I'm glad it works for you and you found it and it will work for some others, or it will make the pain worse than some others.” ▷ 1:50:16 Use lumbar support during sitting and travel Behaviors “Don't forget to use your lumbar on the airplane.” ▷ 1:52:16 Walk three or four times per day Behaviors “It's quite fine. That's not your problem. But we still want you to walk three or four times a day.” ▷ 1:52:21 Do not walk into pain Behaviors “Don't walk to pain. So if your tipping point is 40 minutes, you can't go and for a 40-minute walk. You've just guaranteed that you will be unsuccessful in having a pain-free day.” ▷ 1:53:07 Change posture frequently during the day Behaviors “So the key for their daily regimen is to keep changing posture.” ▷ 1:53:07 Sit-Stand Desk Tools “So something like a sit-stand desk at work would be a really good idea.” ▷ 1:53:34 Walk after meals Behaviors “In my own life, it's a habit. I walk after every meal.” ▷ 1:53:43 Walk before bed Behaviors “I walk before I go to bed and that's my time with my wife and my dog.” ▷ 1:55:02 Avoid training too hard at the gym if you want pain-free sitting Behaviors “They are probably going far too hard in a short period of time with too much intensity, and they're creating a little bit of microtrauma. So now they just made sitting painful.” ▷ 1:56:21 Use deadlifts only as a goal-specific tool Behaviors “At the highest level, every exercise is a tool, and it's a tool to reach a specific goal.” ▷ 2:03:01 Pull from blocks or pins instead of the floor Behaviors “We will elevate the bar and put it on blocks... they pull off pins. In other words, we're matching the height of the pole to their biomechanical optimum in the beginning.” ▷ 2:04:06 Walk backwards uphill Behaviors “Why don't we walk backwards up a hill in a monster walk style and you will feel the quads burning.” ▷ 2:04:26 Walk forwards uphill after backward uphill walking Behaviors “Then walk down to the bottom of the hill and walk forwards up the hill. The brain says, I'm perceiving exhausted quads, let's go get the next in the hierarchy, your glutes.” ▷ 2:05:52 Glute Ham Raise Behaviors “It's exactly the same answer that I gave you for deadlifts. A, it depends, and B, is it the best tool to reach the goal. That is an auxiliary exercise.” ▷ 2:11:38 Rear-Foot-Elevated Split Squat Behaviors “As alternatives, a rear leg elevated split squat, you can do it just with body weight... Interlace your fingers, put them behind your head, become a peacock, lift your chest up. Now do the split leg rear elevated squats.” ▷ 2:12:25 Goblet Squat Behaviors “You could do a goblet squat, hold it in front. Now the whole body takes a more upright attitude. It's more knee load. If you want more knee load and less back and hip load.” ▷ 2:12:35 Back Squat Behaviors “Or a back squat, you add more hip and low back load and you take some off the knees.” ▷ 2:12:40 Band the knees during squats Behaviors “So you can band the knees. We can really play jazz on this to optimize the best variant to get optimal reward with minimal risk.” ▷ 2:13:01 Single-Leg Step-Up Behaviors “Single leg step-ups would be another example. Now you've added a balance challenge.” ▷ 2:18:06 Biblical Training Week Behaviors “There's six days to train in its basic form two days a week i strength train two days a week i work on the things that are a bit sticky and not moving very well... two days a week, I work on my ticker, cardiovascular system.” ▷ 2:19:23 Keep a regular sleep schedule Behaviors “Another thing that suits me well is routine. I try and go to bed at the same time, get up at the same time.” ▷ 2:19:48 Swimming Behaviors “In the summertime I will swim, kayak, canoe, but I'll put a bit of beef into it, a bit of effort.” ▷ 2:19:48 Kayaking Behaviors “In the summertime I will swim, kayak, canoe, but I'll put a bit of beef into it, a bit of effort.” ▷ 2:19:48 Canoeing Behaviors “In the summertime I will swim, kayak, canoe, but I'll put a bit of beef into it, a bit of effort.” ▷ 2:20:15 Cross-country skiing Behaviors “In the winter, I cross-country ski.” ▷ 2:23:28 Inversion Table Tools “I've measured that. Yes. It will increase disc height for 15 minutes.” ▷ 2:23:28 Anti-Gravity Boots Tools “I've measured that. Yes. It will increase disc height for 15 minutes.” ▷ 2:28:19 Bird Dog Behaviors “I don't lift the leg so much. I push the heel away. And it really causes you to lock the core to create the proximal stability. And then pushing the heel away really engages the glutes and hamstrings.” ▷ 2:30:34 Side Plank Behaviors “So I will then do side planks, rolling side planks.” ▷ 2:30:40 Glute Bridge Behaviors “I will do a variety of abdominal exercises, the modified abdominal curl that you're familiar with, and I'll do some glute bridges. Then I'll do them one-legged and I'll get the arm involved and cross body.” ▷ 2:30:52 Kettlebell Tools “I may put a kettlebell on my belly and do some hip thrusts that way.” ▷ 2:31:10 Push-Up Behaviors “I'll go over and do pushes. Now, consider a pushup, which rather than me load heavy with a bench press or something like that, I'll do pushups, you know, the clapping pushup where you dynamically explode up, clap, and go down.” ▷ 2:31:37 Inverted Row Behaviors “Then I'll do some pulls. Uh, I probably won't do a row with a barbell, but I'll do an inverted row pulling on a TRX, pronated grip, pulling into hammer grip, power breathing and exploding.” ▷ 2:31:41 TRX Tools “I'll do an inverted row pulling on a TRX.” ▷ 2:32:25 Heel-Elevated Squat Behaviors “I've broken my ankle. I do heel elevated squats, usually with a banded knee.” ▷ 2:33:20 Train the neck Behaviors “Keep your neck strong. It's important for me.” ▷ 2:33:57 Avoid neck bridges unless specifically adapted to them Behaviors “Jeff Cavalier from Athlete Necks has a great set of videos on this where he really spells out the dangers of things like neck bridges. They can be done, but there's a risk there that probably outweighs the potential benefits for most people.” ▷ 2:35:21 Sword Play Behaviors “People laugh at this. I call it sword play... I take an iron bar... and I'll put maybe a two pound weight on the end. And then I grab it and I do figure eights over here, over here, over here, around there.” ▷ 2:40:01 Load the distal limbs cautiously Behaviors “I really think there's something to this loading of the distal limbs cautiously, right? Properly. But there's something there in terms of keeping the neural pathways healthy and alive.” ▷ 2:40:36 Use your non-dominant hand for daily tasks Behaviors “I try and do things with my opposite hand. So today I'm just going to brush my teeth, comb my hair with my opposite hand.” ▷ 2:40:55 Use a staggered stance during standing resistance exercises Behaviors “Certainly when I resistance train, if I'm doing anything standing, I make it a point to stagger my stance.” ▷ 2:42:38 Thoracic spine extension work Behaviors “Given my history, I do thoracic spine extension.” ▷ 2:42:38 Hip mobility work Behaviors “Given my history, I do thoracic spine extension. I do a little bit of neck work, hip mobility.” ▷ 2:42:50 Move every joint through its range without load Behaviors “And then once I've done the targeted ones, I just go through the motion of every joint and don't add load.” ▷ 2:42:55 Shadow Boxing Behaviors “And then I will do the footwork. So with my background, I'll do a little bit of shadow boxing. I'll play traditional southpaw, et cetera.” ▷ 2:43:19 Stationary Bike Tools “If it's winter time and I, for some reason, couldn't go for a cross-country ski that day or whatnot, I will ride a stationary bike in the clinic.” ▷ 2:43:34 Cycling Behaviors “If it's summertime, I'm riding outside... If it's winter time and I, for some reason, couldn't go for a cross-country ski that day or whatnot, I will ride a stationary bike in the clinic.”