MannaLife Podcast 1 Back Pain

Welcome back, friends. Uh, we hope you're doing well today. Hope that you're blessed. And, uh, if there are struggles or challenges you're facing at the moment, we pray that, um, God will meet you in those and that we can be encouraging as well here in what we're doing. Um, I'm glad to be back with my compadres, Dr. John King, Dr. Ryan Nordell. Uh, these are some great men and just frankly fun and, uh, friendly. You know, it's just been lovely to hang out with them. It's very easy, and it's great to be able to partner together and providing world-class health and wellness information to you guys. I wanted to have Dr. Ryan Nordell in particular comment and pick up on a theme that he mentioned in a previous podcast. He has a background in physical training, orthopedics, you know, advanced-level fitness solutions for people. And, you know, he started to talk briefly about the concept of core strength. And so I want to have him back today to amplify on that a little bit and talk through that, maybe some case studies, examples. I know I could share some from my side and stuff. So welcome back, Ryan. It's good to see you, brother.

Yeah, you too. John, doing okay? Yeah, doing wonderful, man.

Good to see you.

I mean, I'm fascinated by this. Yeah, it's good. It's good. Well, you know, it's a great question because we started talking about what are the most common, you know, ailments and issues that people deal with. And one of them that's got to be at the top of the list is low back pain, right? For males, it hits us as we get older, we get out of shape, whatever it is. We put a little, a few too many pounds on our tummy on the front. And then, what it does mechanically is it shifts our hips forward and then gives us sore lower back. For females, same thing. We get older, we get out of shape, or maybe it's childbearing and all the hormonal changes and the changes to the ligaments around that area and that kind of thing. A huge percentage of the population when they're filling out a health questionnaire or something, it's like, yeah, my back hurts, or I wake up and it's sore. And that's just getting older. And I'd really love to argue that point with them and say it's not getting older. It's core stabilization. I think that that's something that as a practitioner, I refuse to accept that as an answer for myself personally and for my clients.

That's good, man.

To say, You know, I'm not just going to say, well, I'm 45. In fact, I turn 45 next week. I'm not just going to say I'm 45. So, you know, some low back pain is to be expected. Some, you know, whatever you want to pick on. I can't do this activity that I used to do as much because I'm just getting older. And we've been, you know, brainwashed maybe as a society and as a culture to think that our trajectory is, you know, this and then this, and then we spend our last days in a an assisted living or a nursing home and we deteriorate Alzheimer's and we're weak and all this stuff.

No.

Yeah. I don't subscribe to that.

No way.

The very first thing that— and at the crux of this, and Dr. Turner and I talked about it last time a little bit, it's your core stabilization because everything works from the outside in. And so, whether you're dealing with You know, a shoulder issue or hand or you're doing whatever movement you're doing, you could pick any sport, right, that you're going to do, whether it's golf or baseball or football or whatever. Sure, there's specific skill things that are related to that, but balance and core stability are what is needed at the foundation for all of that. And what I find that most of my clients, probably 98% of people have never heard of this. But it's these muscles called the transverse abdominis and the multifidus. And what happens, or anatomically how those muscles work, is that the transverse abdominis is the deepest anteriorly, so on the front of the spine, and then the multifidus is the deepest muscle posteriorly on the back of the spine. And those 2 muscles form a corset together to stabilize the spine. And I like to provide this analogy because when we think about doing core strength or core training, Most of us think about our 6-pack muscles, and most of the exercises that we do are for our 6-pack muscles. And that's actually called our rectus abdominis and then our obliques, which are on the side. And really what happens is when you train those stronger muscles, the rectus abdominis and the obliques, the transverse abdominis actually says, oh, the big guys are here, I'm just going to shut down. So we think we're training our core, but really— Well, that's cool. That transverse abdominis, if we don't know how to fire it, we don't know how to keep it on. And if we don't do that as a baseline. And so, starting there is almost every program that I incorporate with people and we're overcoming pain or we're looking to reach this specific goal or whatever it is, we almost always start with looking at transverse abdominis, looking at how that works. And then, for low back pain too, I'd love to get into it and hear your story a little bit, Dr. Turner, because it's just right in line with this.

Yeah.

Because you probably did a lot of the things that I'm teaching on a day-to-day basis and that kind of stuff. But it's just really interesting because we're so— you can get an MRI report and just because that MRI says one thing, I have a herniated disc or bulging disc or whatever it is, all this stuff, that doesn't necessarily mean that I'm debilitated and I have pain. My body is resilient. That word resiliency keeps coming up to us, right? From a mental health standpoint and from a physical standpoint and everything.

Yeah.

I love it. But my body is resilient. It wants to be self-healing. I just have to coach it along, give it the right tools, put it in the right posture and the right framework, and move about the right way. But strengthening the core is paramount for foundation. And so, with my strength, with my mobility, with overcoming injury, with injury prevention, that's something that I love to talk about is like, hey, let's not be reactive as a society and as a medical culture.

Yeah.

In our country, we're very health reactive, right? I get sick, so I go take this pill. I get hurt, so I go do this or have this surgery.

Good.

It's like, what if we could flip the script and be proactive on all that?

Yes.

And stay strong and stay healthy and take the vitamins and the supplements and eat a nutritious diet that I need to do so that I don't, you know, get to that point where now I have to have reactive healthcare. That's good, mate. So, yeah. So, share, share with me maybe your story, Dr. Turner, about your back. Talk about it a little bit, um, because it's, it's really key.

Yeah, well, so at the time I was working at the hospital in a neuroscience center. So I did non-surgical care for back pain, neck pain of all different kinds, and other neurologic conditions. And I've always been aggressive in the gym. And interestingly enough, all of my injuries are self-inflicted in the gym. I've never actually had a proper sport injury. I've only had— Oh my gosh. And I'm an overachiever and, you know, perfectionist and a hard worker.

Really? Really? I would never— no, really?

Yeah, some people just get that vibe. I don't know why.

Because we all have it.

Yeah. So my exercise philosophy used to be pretty hard driving, and this is a bit of a turning point for me at this time. So I remember my workout that day was really heavy deadlifts and then alternating with going to the rowing machine and doing like a 1:30 500-meter pace.

Wow.

Which is, which is strong. I mean, you're putting out like— there's smoke coming off the chain on the rowing machine. Yeah, yeah, for sure. Anyway, so it was power-packed, uh, and I'm, I'm lifting up near some, some strong deadlift weights, and the thought goes through my mind You need to back off or else you're gonna tear a disc and pinch a nerve in your back. And then I put the weight down. I was like, come on, stay positive. I was like, where'd that thought come from? Like, come on, you know, you gotta stay dialed in. Lock in, lock in.

I got 2 more reps.

I can't be thinking about my back blowing up. Come on. So I do, I do the second rep. It's kind of effortful, but I got it. The same thought comes through my mind again. You better—

Oh, man.

You're gonna blow up a disc, you're gonna pinch a nerve in your back. I'm like, come on, come on, stay positive, lock it in, finish this set, right? That 3rd lift, it's like somebody took a hatchet and just swung it down and it hit my spine and then they left it there. That's the only way I can describe it. They just left the hatchet just hanging in the base of my spine.

Wow.

I couldn't straighten up. at all because there's a hatchet sitting there and just sharp pain all kind of into my left glute area and stuff. I'm like, oh my gosh.

Wow, bro.

Yeah. So, I lean over and I find the nearest bench. And, you know, my man pride, I don't want to display that I've just hurt myself lifting too much weight.

Rub some dirt on it. I'm all right.

Exactly. So, I'm leaning awkwardly off this bench Pretending like I'm stretching, but I'm trying to find that. Yeah, John guilty there, brother.

Yeah, yeah.

I'm trying to find some position that'll take the hatchet out of my spine and enable me to walk to the locker room. Okay, and I'm literally stranded on the gym floor for about twenty minutes, like fake stretching, like trying to get it together. Go locker room. I go to the locker room. It's all I can do. I sit down on a bench in the locker room. I can't even get up to open my locker. I'm another 20 minutes on the bench, like trying to get it together, figure out how am I gonna stand balanced without this hatchet, you know, doing a number. This whole thing, this goes on. Fast forward, about a week later, I'm in my very own office at the Neuroscience Center at the hospital in a wheelchair, getting wheeled past my office that's now vacant 'cause I'm on short-term disability.

Dang.

I go right past my office. I go to the office of my friend, the neurosurgeon, Dr. Matthew Fuel. I'm like, Matt, you got to do something about my back, man. I mean, surgery is never the first resort, but here we are, and this thing is not getting better, da-da-da. I've been in the ER. I've gotten shots. Nothing's working. My leg doesn't work, all that stuff. So, I had back surgery. I had a discectomy.

And it was amazing.

It was amazing. The moment I got out of the operating room in the recovery room, the hatchet was out of my back for the first time in weeks. And so, it was just extraordinary. That began this journey of I had to rehab myself. I had to take my own medicine, right? So, I'm definitely lifting all this weight and doing all this stuff, and now I'm just with a back brace on in the swimming pool at my gym.

With the little pink dumbbells. Yes.

Yeah. But, resiliency, and I had to fight back. Yeah, that's good. Yeah. So today, I'm back, I'm strong, I'm fit, I can run, I can do box jumps, I can do squats and things.

Wow.

But I know my limits and I don't push.

Yeah. You know, one of the biggest things kind of along those lines are that I preach this to people because I see it over and over and over again is that as our body is aging, it wants to do this, right? It wants to decline. How many health statistics are there around, you know, what our hormones do and what our metabolism does and all this stuff, you know, that's constantly wanting to take us downhill? into this weak, feeble, injury-prone kind of state of our body. And so, to combat that, we have to change what we're doing. Our mindset has to change about what we're doing. And so, as we're getting older and we're trying to do this and our body's trying to do this, I have to change, okay, what does my routine look like? So, flexibility becomes more important, right? Core stabilization becomes more important. Lifting for endurance-type muscles becomes more important than 1 or 3 rep maxes or something like that. Balance becomes more important. And, these are all things that we know as we're looking at longevity protocols and we're looking at our healthspan versus our lifespan, right? For our audience—

Good.

Your lifespan is chronological, right? It's just how many years old am I going to live to be, 95, 85, whatever it is. But, your healthspan is how healthy am I within those years? And, I'm much more concerned around our healthspan. I don't care less if I live to be 110, but the last 40 years of my life are decrepit or relying on someone to pick me up and transfer me into my wheelchair or whatever. So, our healthspan becomes important.

Yeah.

And, that's where core strength and core stabilization really, really pay dividends for us when we focus on those things. So, I'm focusing in the gym on being healthy, not necessarily looking at my physique or how much weight can I lift. And certainly, we have metrics, right?

Yeah.

That tell us, hey, my grip strength or my dead hangs and stuff like that. We have metrics around these things that say, hey, for a male at this age, for longevity metrics, you should probably be about right here. But, one of the most common kind of things that I talk to people about is this is that they've been out of the gym for a while, they want to go back in or something and they say, oh, well, I got to get a gym membership and I got to do that. And, I said, no, you don't have to because you can do— well, and right here behind me is my little biohacking kind of area of my house that I do this stuff. And, with a few simple pieces of equipment and bodyweight exercises, and appropriate instruction and appropriate posture, you can really do a lot of the things that you need to do to maintain that healthspan and to maintain your strength and to maintain your balance and to do all the things that are important to us as we age. You can really do all those things at home.

Yeah.

And, I love doing that because the gym membership and stuff, it creates barriers, right? I want to preach to people and talk to you about doing these things, But eliminating all the excuses.

Okay.

So, if I have a gym membership but it's raining that day, I was like, oh, I don't want to drive to the gym. I got to get out of my car. I'm going to get wet, whatever. Okay. So, I didn't work out that day because I have to go to the gym, right? Or I'm in a rough spot financially. I'm going to cancel my gym membership. I can't afford it right now. Okay. Well, I don't even have a gym membership, so I can't go to the gym, right? But if I change my mindset into thinking, okay, I can do this stuff at home. I mean, I personally do like to go to the gym. I mean, I like the social aspect of it. I go sometimes. I don't have to though. I can do things here and I oscillate between going and staying and that kind of thing. But if I change my mindset into just thinking about, okay, what can I do to just live a healthy lifestyle that's easy, convenient, social? That's another big thing. It's like, hey, find a group or do it with your spouse or whatever it is when you're walking and when you're lifting weights or doing fun activities with your kids that might be plyometric in nature and stuff. We just started playing in my family, we started playing spikeball. Have you guys ever played spikeball?

No.

Played that? You know what that—

Seen it.

Okay. So, so my kids are all teenagers and I'm trying to keep up with them, right? And doing a, doing a good job, I think. But then you go play spikeball and you're hitting this ball on this net and then you've gotta like quickly move over here and hit the ball back. And, and it's like all this plyometric stuff. And I'm thinking about it and I'm like, man, I love this because what it's doing is it's keeping my body resilient. It's keeping me— it's working on my balance, is working on—

Good.

Which muscle fibers and movements and things. And it's fun. You know, it's fun. It's something that I like to do or playing pickleball or whatever it is. You know, lots of things that you like to do. But those are some of the things that I like to talk about around people as we're looking at healthspan versus lifespan and we're looking at, hey, core strength and stability, why is that so important? And the reason why, all the things that we talked about, you know, we kind of branch from there out on everything. And man, I love to just educate people around that and build programs for people around that stuff.

So that's great.

Yeah.

So let's tell the people, speaking of transversus, what's maybe one top exercise people could be doing to help with their transversus? Which, if you recall, Dr. Nordell said is one of the deepest muscles, and it's kind of on the front side of your spine. And then on the backside, we have the multifidi. So, maybe give us one exercise for each of those that people could think about.

Yeah. So, the most foundational exercise that I do for transverse abdominis is just an isometric contraction because until you learn how to just turn that muscle on and contract it and hold it, then you do all these other things where you do a Valsalva maneuver where you're just— and you're holding your breath and you're like, okay, I'm contracting everything here, and you're not really doing it. And so, the key thing to me is I'm taking people through and instructing on this is learning how to palpate it. And, it's really easy to do and you can do it as you're watching this podcast or sitting in a chair, standing up, or whatever. Here we go. Here we go. Let's do it. You're going to find those 2 pointy bones right on the fronts of your hips. So, right around your waistline. Yep. You have them on either side. Those are called your ASIS, your anterior superior iliac spine. And then, as you're palpating and finding those 2 pointy bones, you just bring your fingers off and in towards your belly button just about an inch, maybe even half an inch. So now, I'm kind of in my belly and my tummy right there. So now, I'm palpating over what's called the transverse abdominis. And then, to contract it, what I'm thinking about doing is drawing my navel, drawing my belly button down and in, so towards the back of my spine. The easiest way to do it is if you're laying down on your back and you're doing this thing because you're relaxed and that kind of stuff. But, as we're sitting here and doing it, That's what you're thinking about doing. And then, I'm going to just hold. I'm going to do an isometric contraction, which means I'm going to hold and just stay in that position. I'm not moving. It's a static contraction is what that's called as well. And, I'm going to hold it for 3 seconds and then I'm going to turn it off. So, stop contracting. And then, I'm going to reengage and hold it for 3 seconds again. And then, I'm going to stop contracting. And, that's the number one exercise. I just— when I'm starting with anybody, they have low back pain or not, it's simple but it's really, really pivotal. And, the reason why it's pivotal is because these muscles that we're talking about for stabilization, they're endurance muscles. That means that I don't want them to be able to lift a lot of heavy weight 5 or 10 times or something. I want them to stay on all day long and protect my back whenever I'm bending over to do this thing or I'm playing spikeball with my kids or whatever it is. That's good, man. That's really good. And so, when your mindset kind of goes in that manner and says, okay, Maybe my bicep, I want to be able to lift something heavier quickly or whatever it is. You may train that in a different way. But, these endurance muscles like your postural muscles and the transverse abdominis and the multifidus, I want to do high reps. So, I'm going to be doing isometric contractions for 20 or 30 or 40 reps. But then, what I'm going to do is I'm going to start with that foundational transverse abdominis contraction and then I'm going to do something else like a hip adduction movement where I'm now engaging some of my adductor magnus and my hamstrings. Hamstring muscles and things like that.

Very good.

So, yeah, that's what I like to talk about. And then, for the multifidus one, you've got to do stuff where I'm getting into extension. So, I like to lay down on my tummy and do a simple arm raise like this and that starts to fire those posterior muscles on your back. I will caution our audience as you're doing this stuff, if you do have existing low back pain, then you need to get it checked out before you just start doing these exercises. There's a proper sequence and a right time and a right place to do that stuff. And like Dr. Turner just said, his case was surgical, you know, and sometimes that's the answer. You know, my platform, you know, that I kind of advertise and I talk about a lot is that I do nonsurgical, nonpharmaceutical pain management. But sometimes there is the time and the place for surgery, right? Dr. Turner, of all people, you would have known if, okay, this is something I got to surgically fix or not.

Yeah.

So, so I always advise you make sure you're talking to a healthcare practitioner, an expert around this stuff before we just start doing these exercises that could potentially make our situation worse. But yeah, what else do you guys want to know around that? I love talking about it. I talk about it all day. You know, I talk to my kids about it too. My daughters are running track and cross-country in high school now and, and kind of following dad's footsteps. And, you know, they may or may not do a good job of that stuff in training, you know, with their coaches and stuff.

Mm-hmm.

And so, I make them do it, you know, and I explain to them and so that they understand, man. It's injury prevention, you know, when you've got a strong core that really helps you to not get injured in the future no matter what sport you're doing. And so—

Very good.

Taking the time to do it. Well, I'm kind of convicted. I've got 2 mates that are the world's best at what they do.

And like, you know, I'm starting to make appointments for you guys.

So, When can we launch this app so I can go on and get all the free stuff? Yeah, yeah, I know, I know. I can't wait to see— you get to see all your stuff.

Warning, John, I am selective about who I work with.

Yeah, you're right. Thanks very much, Turner.

You gotta, you gotta screen your potential customers really closely.

Oh, you're right.

Oh man, you know, if you come off too much of a head case, I just— I might have to— Bro, I'm crazy.

I've got a certificate that says I'm crazy, man. Like, what's your point? Well, now, now we have a place for that, John. We can send everybody to John. Yeah.

Wow.

Great, great. The crazy guy.

That's awesome.

Yeah. Yeah. That's good. Good stuff.

Yes, it is. Here we are, uh, friends. We hope you're doing well. We hope this was encouraging. Uh, yeah. Yeah. And, uh, just lighthearted and, uh, inspiring, educational all at the same time. We're, we're loving working together. We're the 3 amigos. We're bringing you manalife.app, and, uh, we're going to continue these kinds of discussions. So have a blessed day. Take care.