Heal Yourself From Chronic Pain with Dr. Jen Esquer

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Have you been struggling with chronic pain? That means pain that's been going off and on for three months or more. What if I told you that you could actually heal yourself? Plus you can get a lot more mobility, feel a lot better throughout the day too. Yes, it's true. And oh my gosh, this guest today, I met her at a party at Natalie Jill's house. Dr. Jenna Square, physical therapist, doctor of physical therapy is amazing. You've probably seen her on Instagram. She's got like, I don't know, nearly 700,000 followers. She is an internationally renowned physical therapist who specializes in helping people overcome chronic pain and maximize physical performance. She's created two transformative programs, the Mobility Method and the Optimal Body. And she brings a unique whole body approach to strength, mobility and pain free living. Her easily accessible approach has gathered her more than half a million followers on social media and millions of millions of views on her health and fitness videos. Plus she's been featured all over Shape, Self, Men's Fitness and Muscle and Fitness. And she's been on the COVID of Oxygen. Plus she's been on Good Morning America, CBS and the Rise Podcast with Rachel Hollis and now here. And you are going to love what she has to say. And again, so many of the things she's talking about I was like when I was in school, where was all this information? Well, luckily she questioned it and created these programs and you're going to be able to experience one yourself. She's got a free seven day mobility challenge that you can grab at jjvirgin.com forward/docgenfit d o c J E N F I T and I'll be right back with Doc Gen. Stay with me.

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You to suspicious texts, emails and deep fake videos. Learn more@mcafee.com online protection. I am so excited to unpack this idea that we can actually heal from chronic pain because I know I had it for 30 plus years with a bad knee injury. So this is, this is something that can completely transform your life. So I've got the perfect guest for me. Dr. Jen, I'm so excited to have you here with us today. Thank you so much for joining us.

Thank you for having me honored.

I will tell you, I worked at a physical therapy office early on in my career and I went from being a personal trainer to working in a physical therapy office and it was really challenging because people were really in bad moods because they hurt so much and.

It'S just the setting for a physical therapy place really has to be a positive environment. I think that was. That was honestly my pushback from working in a hospital, too, is that there's so much pain, so much illness, so much negativity. No one wants to get up and move with a therapist. So it's hard. You have to really bring an energy to the profession.

Yeah, I never would have known this had I not worked in that experience and been like, oh, my gosh, you know? So of course I'm intrigued when you say that you can help people heal from chronic pain. First of all, like, how did you get into all of this?

You know, I've always just been fascinated by the body, human movement. I was a gymnast for nine years, and then I just knew that I loved anatomy and biology in high school. So I knew that I wanted to do kinesiology, which is the study of human movement. Didn't necessarily know in college that it was going to be physical therapy, but I just knew I loved movement and the body, and I was fascinated. When I would coach gymnastics, it was like, but why am I taping an ankle? And as I taught Pilates, it was, well, why am I modifying around pain and what more could I do and could I help them? And so it just made sense that physical therapy was going to be the route that I went through because I was so fascinated with learning and seeing the human body and what is possible. And it was just such a cool experience going through school and seeing that people with amputations, cerebral palsy, like other injuries, that I've never surrounded myself with that what is possible within the human body, I think is the one thing that just blew me away.

Well, it also sounds like you question things a lot. And I still remember I was taking some course and they said, well, if someone has back pain, you should do a lot of abdominal work, a lot of flexion, and totally avoid extension. And I remember just kind of head scratcher going. Wouldn't that just make things worse because they get weaker? So, yeah, we needed people out there questioning authority. So let's dig into chronic pain since I know it was. When I was in graduate school, I decided I wanted to focus on spinal biomechanics because it looked like everyone had back pain. So I would imagine chronic pain is pretty prevalent. How does it. What is the definition of chronic pain? How does it develop? You know, walk us through it.

Yeah. When it comes to chronic pain, it's an experience or persistent pain that's been consistent for about over three at Least at least three months, but usually over six, six months to a year. And this doesn't have to mean that it's persistent all the way through. It just means that it continues to pop up over and over and over again and it's something you haven't quite been able to handle. And sometimes, especially with people who deal with chronic pain, it is taking them away from their day to day activities that they really love and enjoy.

All right, so when it happens, like is it usually an acute injury that makes you have chronic pain or is it something that develops over time? I guess it could be all of the above. Like how does it happen?

It really can be all of the above. A lot of times, even if we had an acute incident where something happened and your back kind of feel felt like it gave out, well, now every time you go into that same kind of motion, the brain remembers. So it might not even be something that's physically happening. Every time I bend down, every time I do something and I'm moving forward. So then you blame that movement as my body can't do this anymore because every time I do that, I get pain. When really sometimes we develop what's called neuro tags within our brain and they remember experiences of when your body had to protect itself. And so your body's naturally going to start to go into those protective mechanisms every time it thinks you're going to be in danger again. And when we start to have a different experience with chronic pain, we can understand that it might not just be that physical movement, but it might be the memory that my body has of that movement. And so it could be something repetitive over time and it could be something that the brain is remembering.

Hmm. Well, if it's something that the brain's remembering, does that mean that there's actually something there or is that the big question?

Yeah. In those experiences, typically your body has healed. The body is, is such a great healer, especially when we put it in an environment, whether that's, you know, getting movement in on a daily basis, putting nutrients in our body, getting sleep, all this other stuff that really matters of how your body performs. But when we do that, the body can heal. So physically the tissues usually heal within six months, maybe a year, but it usually doesn't go past that. So if you're having persistent pain after that, a lot of times it's the body and the brain that's remembering into those tissues. And what the brain does is it kind of it wants to always protect you. Your body is always in, you know, survival mode. How Can I make sure that we are the safest that we can be? And so when it's having these experiences of pulling tightness, or think of back spasms, a lot of people who get back spasms, your body is going into a protective mode. And so it's tightening up and it's kind of restricting you from the movement or protecting you from having that experience of pain, which usually leads to more pain. And so it's this chronic and kind of continued experience that the brain is telling the tissues rather than the tissues telling the brain. And I know that's like a. And it doesn't mean that you're crazy. It doesn't mean that you're not experiencing pain. You're clearly experiencing the pain. It's just identifying how that's happening and understanding this on a deeper level. You can actually start to have a relationship with the pain and then really start to move through it.

Okay, so let me see if I've gotten this right. So initially you've got. Let's say you have. I'll just use my knees. So I blew out my acl initially, I had pain there, and the pain was coming from actually the injury site going to my brain. But over time, as that heals, it changes. And my brain is actually signaling the pain, not the joint. Is that correct?

Yeah.

So I just wonder, in situations like that, if you had something real like a bone on bone situation, would that, would that still be something coming from your brain or would that still be something come from the joint or both? Or does it even matter so much? Because it seems like if it was, if your tissues were healed.

Yeah.

And then it's coming from your brain, and now you've gotten yourself so locked into patterning that you start to feel the pain because of that, then you can shift that. Right? And that's what you do.

Yes, yes, you definitely can shift it. And honestly, I think we've. We've learned these terms over time, like bone on bone. But the bone on bone technically isn't the thing that even causes pain. It is the inflammation around the area that causes pain. So how can we start to address the inflammation systemically within my body rather than just locally at the knee? Right. And we develop these patterns of the way that we talk to ourselves too. Like, my disc is blown out, my knee is bone on bone, my hip doesn't move anymore. And we start to tell our brain to literally protect itself because we have these fear mechanisms just from the words that we're saying or the diagnoses that we get. And I think it's so important. This is why I don't always like to see MRI images. They're important, especially if it's something that you've been dealing with chronically. Yeah, we want to see the whole picture of something. However, a lot of people can be walking around with that same MRI and have no pain. So how can we get you to that place that you have no pain, even though you have this disc injury? And I think that's where it's really important to understand that the body doesn't. Just because something is structurally different within your body, that doesn't necessarily mean that it's going to cause pain. And we have study after study that shows this. Now with looking at MRI images, looking at the body, and seeing that people are asymptomatic, meaning they have no pain. So we cannot just blame the image, the issue, or the structure.

Okay, so you have someone walking in and they have. They have this injury, and now they have this chronic pain. And it sounds like a lot of what. What you need to help them do is first, like, you know, they are not their injury. Get rid of that injury identification.

Definitely.

But how do you help them? Basically, it sounds like rewiring their brain. Change their thought processes around this whole thing to stop this.

Well, I think the first thing is addressing why we have the fear of pain. Like, we automatically think that pain is bad when pain is a necessary signal within the body. If we don't have pain, then that's bad. Right. If I don't step on something, feel it sharp, it sends that signal to my brain. Then I don't know if something's going on. So pain is first of all necessary and something important within our body. Just like your stomach grumbling to tell you that you're hungry or just like you're yawning because you haven't been getting a lot of sleep. So if we start to address pain, first of all in a different way, like, thank you for alerting me that something is happening and I get to shift something within my movement, my experience within my body, something has to change. I'm neglecting something. So when we start to appreciate the pain first, I think then we can start to step into, okay, when is it happening? Is there a pattern around when it's happening? I mean, I've sat down with people who believe that it's because they're sitting all day long at work. And then I say, okay, let's talk about that. Are you sitting on the weekends? Are you watching your kid play games? Are you doing different things? So how is it that it suddenly shifts only Monday through Friday, but never on the weekend? Right. And when we start to look at these patterns of when this pain is popping up and what else is happening within my environment, what else am I doing? We can start to make these connections. And I think so journaling is super powerful just to start to understand it. And also acknowledging, okay, if I'm sitting here, am I sitting in other places? And how long does it take for that pain to start to change or start to talk to me? When is it starting to tap in? And are there other stressors that are happening in life? Am I getting sleep? Am I taking care of my health for a nutrient level? Am I getting enough water? Am I surrounding myself with community? Or have I been really lonely and stressed out from work lately? And when we start to tap into these other areas, you might notice that pain is starting to change. Or even if you change the way that you breathe and your pattern of your breath, and all of a sudden your pain changes or it disappears, well, then we might have more of a stressor happening within the body and not necessarily a tissue damage.

Well, it would sound like then, I mean, if you could shift things and your pain would disappear, then it's no longer a tissue problem.

Right?

Right. Mm. Yeah. And it's something super powerful to start to acknowledge.

Wow. How quickly can you help someone shift? I mean, can you get someone who's. Now you acknowledge that it's like they can acknowledge it's not. There's no longer real pain happening at the joint site. And when I say real pain initiating from actually the damage, it's healed, and now it's happening more for their brain. How quickly can you shift that?

It can happen very quickly. Very quickly. I mean, neurologically speaking, we can shift. We can move someone into a different pattern of movement or breath pattern and shift the pain. However, does that mean that's going to stay forever? No. So we have to develop practices that incorporate this on a regular basis if we actually want to change it. And especially if we start thinking of chronic pain. Well, how often has this come up? For me, it's been over a year, it's been two years, five years. It's not going to magically just disappear. So now that I experience that my pain can change, I get to start to add this in on a continual basis. And when we start to add in, whether it's different movements, whether it's the environment, whether it's the breath, whether it's these different practices, then we start to really build in a different wiring into our brain, and it's going to interpret movement different over time. Time.

I just. I've gone to two Dr. Joe Dispenza workshops in the last three months. And so all the things you're saying are these things that he's been teaching that. And it's like, it's so fantastic. It makes me wonder what would have happened had I known this stuff a couple years ago.

Yeah.

So glad other people are hearing about it now. So you talked about some of these practices. What do you see as some of the most therapeutic tools or practices people can use?

One I think is just tapping into, am I in a stress state within my body or am I in a more sympathetic state? And a lot of times we think, okay, take a deep breath and relax. And the first thing that people do is lift up in their chest and take a big inhale. When, if we actually switch that breath pattern, and rather than thinking of an inhale, if we actually just thought of a long, extended, slow exhale, that really elicits that. That parasympathetic that stimulates that. That off switch of relaxing the body, stimulating what's called your vagus nerve in order to get things to rest, relax, and digest. And so one thing that I like to do is rather than putting the hand on the chest and the belly, I actually like to grab the rib cage. And you can even do this by like wrapping a sweater or towel or something around the rib cage and giving it a little squeeze. And rather than thinking of inhaling and lifting those shoulders and the chest, if you inhale and try to the rib cage kind of expand and then exhale and feel everything just melt and drop down so that you should feel that rib cage moving from the sides. And if you can't quite feel that rib cage moving, then there's something that's happening where we're. We're driving the pressure up into our neck and up into this stress response. And every. If we think about it, when someone scares you and you go and everything gets really tight, we take an inhale, we hold our breath, and our shoulders get really tight. So especially people who have chronic headaches, upper trap, upper back, neck pain. This is something that I'm driving in to people is, okay, where are we breathing from? Where's our breath? Initiating. Can we turn off the muscles at the neck? And so sometimes doing this in front of a mirror, so helpful. And can you feel your ribcage move? And just doing that, extending the exhale, getting that rib Cage move, turning off those neck muscles. All of a sudden you will feel an entirely different experience in your body and actually learn to let go. And that's the first place that the body final starts to feel. I am safe. And now we can move into strength or mobility or whatever else we need to.

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One of the things that you can actually really just quickly kind of test is either bend over and try to touch your toes and then go into this five to ten breaths. Or you can try to rotate from your upper back. So if you're just sitting and you try to rotate as much as you can one way, rotate as much as you can the other way, and then try the 5 to 10 breaths, come back and retest that movement pattern. If there's a significant change, which for a lot of people there's a significant change in the range of motion, then your body was having and holding a lot more tension. So you were a little bit more in that stress sympathetic state. And now if we improved your range of motion, we relaxed the muscle tension and we got your body to get back into that parasympathetic that rest, relax, digest. And that's the quickest test that you can do to kind of see where the state of your body is.

That is super cool. And I would imagine especially over this last year, probably most of us are in the stress place like all day, not even checking and thinking about it. You kind of need an app to ping you every hour. Hey, I know beyond the breath, what are some of the other things that you like to use to help people move out of chronic pain?

So I like to address the entire environment. I think it's really important. How much sleep are you getting? What's the quality of sleep that you're getting? How much movement are you getting? And this doesn't have to mean that you're going out and you're doing a heavy workout, but are you walking? Are you getting some activity? Are you breaking a little sweat almost on a daily basis? And again, not from a heavy workout, but just from movement throughout your day. You should be getting some adequate, you know, 30 minutes to an hour of movement on a daily basis. And the last thing I would say is, are you putting your body in positions that it's not in on a regular basis? So this means if I'm sitting all the time, well, have I put myself in a position where I'm lying flat so I can actually get some extension from my back? When is the last time your, your back has actually seen extension? And this could mean just lying on your belly, propping yourself on your elbows. You know, a lot of people who do yoga, you don't necessarily have to do yoga though, if you just come into these opposite positions. So if my foot is in a shoe all the time, well, can I actually put myself my feet out of my sho to interlace the socks between the toes, get some spread. So it's literally how often am I taking my body from the positions that it's used to on a daily basis and shifting that to doing something different? It doesn't have to mean an hour of stretching. It's just doing something different.

Boy, you just made me realize I have to pull out my yoga toes. I went to a body worker last year and he put me in those yoga toes. For people who don't know what those are, they're these toe spreaders. Unbelievably painful. Holy smokes.

Yeah, your body's not used to it.

Oh my gosh. And I remember like I was at a spa speaking at a spa a couple years ago and I had had very carefully avoided yoga at all costs prior to that because it was so difficult. And I just kept going to the gym and doing the same things I always like to do, which is. And I knew that I should not be doing this, you know, I know better. But I did it anyway. And I finally went and did a yoga class and it was so ridiculously hard, this beginner yoga yoga class. I mean, just the things like you talked about, just, you know, lying on your stomach and then doing a cobra lifting your, your chest up.

Crazy.

So it is, we have to get. And that's why I like, even if it's a 15 minute online yoga class, because it's challenging to, to force yourself to do the things that you don't do because you don't do them for a reason.

Exactly. And for Those who do yoga a lot. Are you lifting weights, pulling your body? You know, it's like we need this balance of both.

Yes. I've been preaching cross train your exercise forever. Now I'm in cross train your diet. So it's cross training all those things. And it's just a great reminder that you just said. I mean like two huge things that are so easy to blow off are just the right type of breathing, taking time out and then doing the opposite of what you've been doing. Because that's, that's what will get you to have problems. If you're doing the same stuff, you'll build up all sorts of imbalances. Because I have just one other little question before we jump off. And I know you also have a great, great gift for everybody here, but someone, you're, you're going to go see someone and you know, there's all sorts of different doctors and bodyworkers out there, all sorts of different things that they can do. Like, first of all, how do you know if you're really with the right person? And then what about some of these alternative therapies out there that you can get done?

You know, I think therapy is something to facilitate within the body. So if you're going to someone and expecting them to fix you, well, then that's probably not the best person. Because as magical as our hands can feel, we're facilitating what's possible within your own body. And that is the number one most important thing that you have to remember. No one can fix you unless we're a surgeon literally putting things back together. All we can do is facilitate the pathway for you to heal yourself. So you should be seeing someone who empowers do to learn the exercises or learn the tools within your own body that you can do to help yourself outside of seeing someone else. Whenever we're getting touch, whenever we're getting stimulation, whenever we're getting body work done, it's really, it's talking to our brain through our tissues. It's talking to those mechanoreceptors that respond to touch, vibration, pressure, heat that relax the system. But it's not breaking up scar tissue. It's not manipulating fascia in the way that we think. It's really speaking to the brain. So if we can have that to calm the system and then go do movement, that's going to be the most powerful thing that actually facilitates true healing.

Got it.

That makes so much sense. So tell everyone about the seven day mobility challenge that you're going to be gifting everyone it's going to be@jjvirgin.com docgenfit and that's spelled D O C J E N F I T. Tell us about.

So this was my way of just being able to provide people an insight into their body. It's seven days, ten minutes a day. That's all it takes. And we go through an assessment and then an exercise. So we test. We literally test. Okay, what's your neck range of motion? Okay, here's what you can do for that. Okay, let's look at your back and your hips and your ankles. And we go through these tests from head to toe to see what your body is moving like. And then here are some quick tips that you can add in. And honestly, if you just do that little bit every day, it's going to make a huge difference in how you feel in the long run.

I love the little hinges that swing big doors. Like, I love things that are like 10 minutes and you'll get this great thing that is fantastic. I'm going to be doing that myself because I went to a chiropractor who's like, you have to use this neck thing every day. Which of course I was like, he finally said, how about three times a week? And I go, I can do that. I'm like, come on. You know, and 30 minutes to your day every day. But it was a really eye opening. So super excited about that. You'll be able to get that@jj virgin.com forward/doc genfit. And thank you so much for all of your awesome information. It's such, it's such an important way to look at things because, you know, it feels like what we've been doing again. When I worked in physical therapy, it was literally like putting band aids on things, right?

Yeah, yeah.

Versus what you can do to fix it and heal. So I love your work. Thank you so much.

Thank you.

All right, so make sure you take that mobility challenge with me. It's free. It's 7 days, 10 minutes a day. Jjvirgin.com forward/docgenfit D O C J E N F I T and I'm gonna challenge you on one more thing because, man, I needed to hear this. Interview you today. It's like, do the things that you don't normally do and really do the opposite of the things that you're doing. So again, if you're sitting all the time, go lie down on the floor and do a little back lift, chest lift. Now here's another one. I'm going to give you that's a great one is if you're sitting and you're working on computer. Here's another one so easy to do when you're walking through a door. Do a door jam stretch. Have your elbow closed below your shoulders, put your forearms on the door jamb and then just take a lunging step forward to give you your chest to stretch because that gets super tight when you are sitting all day long and working on that laptop. All right, there you go. If you're in chronic pain now, you've got your lifeline to get on out of it. Thanks for checking in, and if you've not subscribed yet to the show, subscribe to JJ.com will hook you up. See you next time.

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