"Pain Free" by Pete Egoscue

Frank Silbermann · Nov 18, 2012

I have the book now and am reading it. He teaches that the mis-alignments which cause wear and pain are cost by improper or inadequate movement, which leads to inadequate muscles, which leads to misuse of the body.

My only complaint is that there doesn't seem to be any recognition that some people's bones simply may not be ideally formed or shaped. For example, is it even possible for someone such as Pancho Segura (who suffered from rickets as a child) to walk forward properly using his knees and hips while his feet point straight ahead? What if a bone that should be straight is bent or twisted to a greater or lesser degree?

Povl Carstensen · Nov 19, 2012

Interesting book. I have used some of his exercises for the back and foot (plantar fasciitis). His chapter on shoes is also interesting reading concerning minimal shoes. He basically says, concerning shoes, less is more.

charliefedererer · Nov 19, 2012

There will always be exceptions.

So yes, specialized therapy would be required for someone with rickets.

How many people do you actually know who suffer from rickets?

How many people do you actually know abnormally shaped bones?

"When all you have is a hammer, everything looks like a nail."

Pete Egoscue's advice will not apply to all.

Some may say that makes his advice wrong.

I'll bet his books and therapy have helped a lot - probably most.

And probably not harmed very many.

Hopefully Posture Guy, who is an Egoscue therapist who frequently posts here will weigh in.

Posture Guy · Nov 19, 2012

saw this thread through a google alert. Gotta love technology.

Charlie hit the nail on the head. And the OP's point is sound. Some people DO have congenital or trauma-related deviations from the postural blueprint. I'm an example. I was in a near fatal car accident back in 1992. Went form 70 mph to 0 in less than a second. Fractured several bones in my spine, my sternum, lots of soft tissue damage, and on it goes. There is a segment of my spine that is supposed to articulate at least a little bit and does not move at all. So there are some of our exercises where when I do them, it ain't pretty.

The goal with EVERYONE is to bring them back to as close to the postural and functional blueprint as their situation permits. No one has perfect posture, everyone has 'their stuff', but the question is, can it get better? I've yet to meet the person where the answer was no.

Sometimes in people's heads, perfection is the enemy of better. I'm a big fan of better.

Frank Silbermann · Nov 20, 2012

Posture Guy said:
..Some people DO have congenital or trauma-related deviations from the postural blueprint. ...The goal with EVERYONE is to bring them back to as close to the postural and functional blueprint as their situation permits. No one has perfect posture, everyone has 'their stuff', but the question is, can it get better? I've yet to meet the person where the answer was no.

Sometimes in people's heads, perfection is the enemy of better. I'm a big fan of better.

Well, that makes much more sense. In fact, quite a few people do have bowed legs, knock-knees, feet that are angled in the direction of clubfoot but not so much that they are unable to pronate the sole to the floor -- not from neglect, but since infancy. But often those led to accommodations that are less than optimal.

vegasgt3 · Nov 21, 2012

I do some egoscue stretches and they have eliminated my knee pain.

Posture Guy · Nov 22, 2012

Frank....yes.

And what I've found is that let's take someone, for example, with bowledggedness (varus knee stress). What tends to happen is over time, it gets more pronounced as their motion patterns "feed" the muscles that are already over-engaged in supporting this posture, thus amplifying it. We'll see folks with bowledggedness or knock knees (valgus knee stress) where it will get significantly better through corrective exercises, as we're now able to strip away the layer of it that is NOT congenital, but is instead lifestyle-driven. And the more neutral a position we can get the knee in, the longer that knee will last and the more it will be able to do.

sixftlion · Nov 30, 2012

I love Pete Egoscue's stuff. I read his books long time ago, tried many exercises in my training and eventually adopted some of it into my style. The majority of my clients get great relief with some of the simple exercises, too.

PostureGuy is correct that a lot of the "born with" stuff is just something that was very mild sometimes long time ago and that with time and incorrect movement grew into something huge. It's never too late to start correcting things. It can take longer if the person has had the problem for long time, but any improvement is better than nothing. Patience and discipline to do the work is the key. Sometimes people give up way too early.

Povl Carstensen · Dec 1, 2012

I have done the same. "Lifted" some exercises that seem to work for me. In one sense the exercises can seem a bit different and difficult, so I can understand that some people work as instructors in it. On the other hand, the great thing is that they mostly are different than your regular stretches and so forth, so it is a inspiring supplement to more conventional exercises.

Posture Guy · Dec 1, 2012

One piece of advice: if you're doing stuff from the book, do the exercises in order. Don't treat them as a 'buffet'. One sets you up for the next, etc... They're not just thrown together, but have a method to their madness, so to speak.

And sixftlion, thanks for chiming in! And I haven't forgotten about you, I'm gonna get you that article. Just had an 'interesting' year. Had an accident in May, tore some stuff up in my right (dominant) shoulder, had surgery in July but they found some stuff in the shoulder they had not obtained consent to optimally deal with while they were in there, things they didn't expect, so we tried to work around it but no joy. Getting cut on again in a couple of weeks. Will get back to you shortly after that.

And the moral of that long story is try not to get into accidents while doing high speed racing go karts.

Fee · Dec 1, 2012

Might be time for me to check out the book and the woman's book from the library again. My right shoulder and neck is acting up again, no one ever really told me what was wrong with it the last time.

akind · Dec 2, 2012

Thank you for sharing the info. Looks like a really good book. I will let my friend (who has severe tendonitis) know about it... the ebook is not that expensive!

robbyh · Dec 18, 2012

I hurt my hip this fall playing tennis. It was kind of odd because it felted real deep in the muscle but I could still play tennis. the league is over and I have been using the egoscue method to try and straighten out my body but when I do those exercises they do not hurt but hours later my hip will start hurting. Should I quit doing those exercises or is the hurting means it is working?
Thanks for any advice.

vin · Dec 20, 2012

Frank Silbermann said:
What if a bone that should be straight is bent or twisted to a greater or lesser degree?

I think the best you can do is to become as familiar as possible with the limitations and potential consequences imposed by whatever structural deviations you might have. This may simply mean fine tuning your technique and/or fitness training, or depending on the severity of your issue, perhaps even evaluating the risk/reward ratio of even playing a physically demanding sport like tennis.

One thing I would pay particular attention to is if the structural deviation predisposes to overuse of any particular muscles as this is something that you have control over.

If possible, find someone with a good understanding of functional anatomy and movement dysfunction to help you through this. If you're brave enough to dig in yourself, Diagnosis and Treatment of Movement Impairment Syndromes by Shirley Sahrmann would be a good place to look. It's not easy reading, though. Especially if your anatomy knowledge is limited.

tennis forlife · Dec 21, 2012

The book helped me with osteoarthritis pain in big toe. I do the general routine daily and the tennis one twice a week. The air-bench is brutal, but I never give up and after feel like steel all day. Currently, I need help with a low-intensity shoulder pain that came out of nowhere. It doesn't bother me when I play. It hurts to raise my arm palm-up about two feet from my body. Can anyone help?

tennis forlife · Dec 21, 2012

Sorry. I meant palm-down. If I have my arm at my side and lift straight out slowly, at about 2" there is a pretty sharp pain, in addition to a constant sort of low pain. HELP!

Chas Tennis · Dec 22, 2012

tennis forlife said:
Sorry. I meant palm-down. If I have my arm at my side and lift straight out slowly, at about 2" there is a pretty sharp pain, in addition to a constant sort of low pain. HELP!

2 inches or 2 feet as in your first reply?

If your palms are down and you get pain when you raise your arm one common possibility is impingement. Rotating the shoulder internally - upper arm bone rotates around it axis - as you are doing and raising the arm causes less clearance under the acromion because a bony attachment on the upper arm squeezes shoulder structures such as the supraspinatus tendon.

Search TW for recent threads and especially see the Ellenbecker video on shoulder anatomy and impingement.

See a Dr for a diagnosis. I believe, but do not know, that the shoulder can experience impingement damage without much early pain.

danix · Dec 23, 2012

Just got wind of the egoscue thing and am going to check it out. Might be too late for me, but maybe not.

corbind · Dec 28, 2012

danix said:
Just got wind of the egoscue thing and am going to check it out. Might be too late for me, but maybe not.

Is it working?

danix · Jan 1, 2013

Haven't found the book yet, will have to order it off amazon.

TennisCJC · Jan 3, 2013

tennis forlife said:
Sorry. I meant palm-down. If I have my arm at my side and lift straight out slowly, at about 2" there is a pretty sharp pain, in addition to a constant sort of low pain. HELP!

I have had this condition in a severe form twice in 35+ years of tennis. My right arm was basically dangling from the shoulder. Place it by my side while standing and it was impossible to raise the arm to the side. Doctor said tendinitis in the rotator cuff area - I can feel acute pain on the upper front of the joint where the arm connects to the shoulder. Both times, pregnizone 6 day pack helped where you take 6 pills the first day, then 5, then 4, and so on for 6 days fixed the acute pain. Now, I do shoulder strenghtening and streching to avoid acute issues but still get a bit of soreness at the top front of the joint if I play a lot.

I use the following exercies:

1. wrist curls: forward, backward and rotate L to R with ball of 5 lb dumbell in hand.
2. bicep curls
3. tricep pull overs and sometimes kick backs
4. chest flys
5. back flys
6. chest press
7. back rows
8. push ups
9. shoulder lifts - arms at side with thumbs up and dumbell in hand - raise arm up and slightly to outside
10. streches for front of shoulder and back of shoulder

Search "throwers 10 exercies" and you'll get examples of most of these plus a few more. I use light weights 5, 8, 10, 12 lb dumbells and hi-reps 2x15 or 3x10.

Roforot · Jan 10, 2013

Posture Guy said:
One piece of advice: if you're doing stuff from the book, do the exercises in order. Don't treat them as a 'buffet'. One sets you up for the next, etc... They're not just thrown together, but have a method to their madness, so to speak.
<edit>

I'm not the OP but I did get the book. It's very interesting when he talks about racquet sports, he says something to the effect that these sports aren't hard on the arm or elbow but actually unmasks symptoms in those of us who have postural imbalances. It was an interesting perspective I hadn't considered given how much attention we take to racquets and strings.

Correspondingly, his elbow chapter actually focusses more on the shoulders and hips... That being said, I feel improved. Full disclosure, I am also doing wrist/forearm stretches and just started using the red flexbar.

I'm wondering though about adding other "body parts" to the list as some exercises are repeated. If I also have a sore neck, do you do the full menu of exercises for the elbow in order then do the neck? Or if I did the Gravity drop for the elbow, can I leave that one off when I do the neck routine?

Posture Guy · Jan 20, 2013

My apologies for not being around of late to answer questions on the thread. Had an accident that tore up my right shoulder (and yes, I'm right handed) and had to have shoulder surgery. To say shoulder surgery sucks is an understatement. Hope to be back on the court in March.

In any event, if anyone has specific questions about the book or this type of therapy in general, I'm happy to answer them. Feel free to either post here, or if you'd like to discuss something privately, feel free to email me at rickATegoscueDOTcom. I'm the clinic director of the Egoscue Clinic in Austin, TX.

r2473 · Jan 20, 2013

Sorry to hear about your shoulder Posture. What happened?

boramiNYC · Jan 20, 2013

hey PostureGuy,

Ever since I found out and practiced the Alexander Technique, I came to the same conclusion what Mr Egoscue is saying about a lot of the musculoskeletal disorders. Do you know about the Alexander Technique? If so what's your opinion?

Posture Guy · Jan 27, 2013

r2743....it was dumb. Was at a team building event doing K1 go kart racing. In the middle of a really tight turn with my shoulder fully loaded, another kart crashed into me really hard and pushed my shoulder in a direction it didn't want to go. Tore the labrum. And was pretty sure I tore the labrum. Weird thing was, I could still play tennis without pain except for serving, had to serve side handed but other than that could play full out. So I pursued the surgical side of things, getting the MRI, etc..., but kept playing because I knew surgery was coming. Then the last day I played, I was at the net and had to reach out and behind me for a backhand volley and when I made the shot I heard something in my shoulder pop, and my shoulder pain escalated dramatically. At that point I knew I was really screwed. What we think happened was the initial accident tore the labrum, which then created some instability in the joint. Then the tennis shot rotated the humerus into a weird angle and it lost positional integrity because of the labral tear, and I knocked a big piece of cartilage off the head of the humerus.

Had surgery in July to fix the labral tear and that's when they found the cartilage defect. Said it was weird, my shoulder looked like a 30 year old shoulder (i'm 51) except for the damaged stuff. Rotator cuff, glenoid, all looked great. So she repaired the labrum and smoothed out the cartilage as best she could, but predicted it would become an issue and it did. So in December we did something called 'hemi cap', basically a humeral head resurfacing. Hope to be back on the court in march doing light hitting.

BoraminNYC....re the Alexander technique, I know it at a very passing depth. My view of it is very positive and I've had a number of clients who have used both to good effect.

Chas Tennis · Jan 27, 2013

Posture Guy- After your first accident on the go kart - Any injury is not that well know - its exact structure and the tissue/cartilage strength are not know from an MRI. That structure and strength depends on where splits are in the cartilage. These splits can be difficult to see in MRIs. With a labrum tear why should a person expect that it would function for tennis which is stressful to the shoulder?

In 2011, I kept playing when I knew my knee was having joint issues. I left the courts a few weeks later from sudden pain unable to play - a meniscus injury. That was my turn for a dumb move in order to play tennis.

If someone has a labrum tear how should they interact with their Dr and, in your opinion, what should they do about playing tennis?

Reference Labrum Injury -
http://www.hopkinsortho.org/labrum_tear.html

Posture Guy · Jan 28, 2013

Chas_Tennis.....i'm a big fan of "if it hurts, don't do it. If it doesn't hurt, chances are doing it is ok."

If I just went out and did light hitting on the court with no overhead motions, then I don't think I would've made anything worse. But honestly, I'm neither that bright nor disciplined. I love the game and love to compete. I knew a surgery was coming so I kept playing my ladder matches and would go after shots I should've let pass.

How should a person interact with their physician? If you suspect you have an injury you should consult with a qualified physician promptly and follow their advice. Do not engage in any movements or activities that provoke pain.

I did most of that, but would occasionally reach for a shot I shouldn't have, or toss my serve more upright than I should've. Just HATED serving side armed.

Basically, try to use a bit more common sense than I did. But I'll tell you what. The last match I played, the one where I felt the shoulder pop? After it popped I KNEW I was done. But it was the second set against a guy I had never beaten. And I REALLY wanted to beat him. So I kept playing, lol. And actually played pretty well. Looking back on it, I'm not sure how the shoulder kept functioning. Must've been adrenaline. In fact, on match point, I was up 40-15, served him wide in the deuce court, rushed the net, took his return and hit a sharp cross court volley for a clean winner. Man that felt good. I've been living off that match and shot for a few months now.

When I got home I iced the shoulder down, figured "well maybe I just tweaked it". When I was done icing it I couldn't lift it over my shoulder, was completely useless with what doctors call "the big sign that you have an issue" painful popping and a feeling of significant instability.

But I won, dammit!

corbind · Jan 29, 2013

I hear you on playing even know you should not. The drive to win or have fun exceeds the pain. That is until the pain becomes greater than the expected joy of playing.

heycal · Feb 19, 2013

sixftlion said:
I love Pete Egoscue's stuff. I read his books long time ago, tried many exercises in my training and eventually adopted some of it into my style. The majority of my clients get great relief with some of the simple exercises, too.

PostureGuy is correct that a lot of the "born with" stuff is just something that was very mild sometimes long time ago and that with time and incorrect movement grew into something huge. It's never too late to start correcting things. It can take longer if the person has had the problem for long time, but any improvement is better than nothing. Patience and discipline to do the work is the key. Sometimes people give up way too early.

Posture Guy said:
One piece of advice: if you're doing stuff from the book, do the exercises in order. Don't treat them as a 'buffet'. One sets you up for the next, etc... They're not just thrown together, but have a method to their madness, so to speak.

Are there a few key exercises you folks can recommend for a 50 year old guy suffering from low back pain for about a year? Any specific do's and dont's?

Chas Tennis · Feb 19, 2013

heycal said:
Are there a few key exercises you folks can recommend for a 50 year old guy suffering from low back pain for about a year? Any specific do's and dont's?

Many years ago I played often with player who developed serious back pain. He was in his 30s. He went to see a Dr. The Dr treated him by having him do exercises. The exercises were painful and the general pain continued.

After about a year, he had imaging done on his back. The Dr then said that the exercises could not have helped his back problem and might even had made it worse.

He has not played since then.

If you have a slip-disc or other back problem doing exercises is risky. Find a well qualified Dr.

-------------------------
FYI - Link to back treatment for vertebrae osteoporosis. No personal experience but a player that I know says that his mother did very well with this procedure, kyphoplasty, performed on two different surgeries.

http://www.spine-health.com/video/kyphoplasty-osteoporosis-fracture-treatment-video

Povl Carstensen · Feb 19, 2013

heycal said:
Are there a few key exercises you folks can recommend for a 50 year old guy suffering from low back pain for about a year? Any specific do's and dont's?

Here is a thread that might interest you: http://tt.tennis-warehouse.com/showthread.php?t=447310
I recommend doing exercises that bend the back backwards. Like lying on the floor and push your upper body up, so that you flex in the back. You can google McKenzie exercises.
(This is of course different than Egoscue, but pretty well credited I think).

Posture Guy · Feb 28, 2013

Chas Tennis said:
Many years ago I played often with player who developed serious back pain. He was in his 30s. He went to see a Dr. The Dr treated him by having him do exercises. The exercises were painful and the general pain continued.

After about a year, he had imaging done on his back. The Dr then said that the exercises could not have helped his back problem and might even had made it worse.

He has not played since then.

If you have a slip-disc or other back problem doing exercises is risky. Find a well qualified Dr.

-------------------------
FYI - Link to back treatment for vertebrae osteoporosis. No personal experience but a player that I know says that his mother did very well with this procedure, kyphoplasty, performed on two different surgeries.

http://www.spine-health.com/video/kyphoplasty-osteoporosis-fracture-treatment-video

I have a different prespective. It's not that doing exercises is risky. Doing the wrong exercises is risky. That said, I'll bet that the person in question here got ample feedback from his body that the exercises he was doing were not constructive, and he most likely ignored that feedback thinking "well, the doctor told me to do it." Always trust your instincts. If something feels destructive instead of constructive, it probably is.

Working with people with bulging or herniated discs is the most common thing we do in our clinic and it's one of the easier things we deal with in terms of helping the client get symptom relief. The body NEEDS motion, but it needs complementary motion. Take the advice of doing McKenzie stuff above. It's mostly extension based. Well, if you have someone who has a bulging disc because their spine lacks extension, they might happen to do very well with that protocol. If they have a bulging disc because their spine has too much extension, that protocol will likely send them to the surgical table in screaming pain.

Where is the body out of balance, and what does it need to come back to balance? That's the question.

Bulging discs are not a big deal if you deal with them intelligently and listen to your body as you do so.

Chas Tennis · Feb 28, 2013

Posture Guy said:
I have a different prespective. It's not that doing exercises is risky. Doing the wrong exercises is risky. That said, I'll bet that the person in question here got ample feedback from his body that the exercises he was doing were not constructive, and he most likely ignored that feedback thinking "well, the doctor told me to do it." Always trust your instincts. If something feels destructive instead of constructive, it probably is.

Working with people with bulging or herniated discs is the most common thing we do in our clinic and it's one of the easier things we deal with in terms of helping the client get symptom relief. The body NEEDS motion, but it needs complementary motion. Take the advice of doing McKenzie stuff above. It's mostly extension based. Well, if you have someone who has a bulging disc because their spine lacks extension, they might happen to do very well with that protocol. If they have a bulging disc because their spine has too much extension, that protocol will likely send them to the surgical table in screaming pain.

Where is the body out of balance, and what does it need to come back to balance? That's the question.

Bulging discs are not a big deal if you deal with them intelligently and listen to your body as you do so.

Those are good points after a firm diagnosis.

In my reply to heycal - asking for back exercises apparently without a diagnosis - I was pointing out the need for a Dr and imaging in a diagnosis. For example, if the bone itself of the vertebra is starting to deteriorate or is deteriorated how could that be known without imaging? I believe that a firm diagnosis for the back and other joints requires imaging such as MRI. I'm not sure what imaging technology was available at the time that my friend had his back injury or condition. He probably got an X ray.(?) Perhaps the other imaging of the spine available at that time was very invasive (?) so that imaging had considerable risk. ? My friend did complain to the Dr of the pain he experienced when doing the corrective exercises. As soon as he got the imaging the treatment changed.

Posture Guy · Feb 28, 2013

I have zero problem with a client getting imaging. I do think imaging diagnostics like MRIs are overused, especially in cases of minor to moderate pain. If a client is worried and fretting about the condition of their spine, I encourage them to get an MRI and find out.

But if they ask me if the results of the MRI will change my work with them, the answer is no. The MRI doesn't show the problem. It shows the RESULT of the problem. The problem is the spine has become fundamentally mispositioned. The discs wouldn't displace otherwise. So in case, I have two fundamental objectives:

1. Prescribe the appropriate corrective exercises to bring the body back to postural and functional balance.

2. Listen to the client's instincts and allow their wisdom to drive the process.

If I give a client an exercise that is posturally indicated but causes a mild increase in their symptom, that's their body telling me it's not ready to do that movement or position yet. We listen to that and find another way to get where we want to go.

My bottom line, if a client asks me if they think they should get an MRI, I tell them there are two fundamental circumstances in which I think that's absolutely appropriate:

1. Given the symptom presentation there is a distinct possibility of an issue that requires immediate medical or surgical intervention. When we're talking about mild to moderate back pain, that is beyond rare.

2. If the client is so mentally wrapped around the axle that they just "have to know". If it gives them peace of mind, great.

Chas Tennis · Feb 28, 2013

When it comes to diagnosing an injury or chronic condition I believe in imaging. Without imaging there is usually hardly any certain information on the damaged part of the body. I believe that the statistics of false positives and false negatives with imaging, when added to the other diagnostic information, gives the best probability for an accurate diagnosis.

heycal · Feb 28, 2013

Posture Guy said:
I have zero problem with a client getting imaging. I do think imaging diagnostics like MRIs are overused, especially in cases of minor to moderate pain. If a client is worried and fretting about the condition of their spine, I encourage them to get an MRI and find out.

But if they ask me if the results of the MRI will change my work with them, the answer is no. The MRI doesn't show the problem. It shows the RESULT of the problem. The problem is the spine has become fundamentally mispositioned. The discs wouldn't displace otherwise. So in case, I have two fundamental objectives:

1. Prescribe the appropriate corrective exercises to bring the body back to postural and functional balance.

2. Listen to the client's instincts and allow their wisdom to drive the process.

If I give a client an exercise that is posturally indicated but causes a mild increase in their symptom, that's their body telling me it's not ready to do that movement or position yet. We listen to that and find another way to get where we want to go.

My bottom line, if a client asks me if they think they should get an MRI, I tell them there are two fundamental circumstances in which I think that's absolutely appropriate:

1. Given the symptom presentation there is a distinct possibility of an issue that requires immediate medical or surgical intervention. When we're talking about mild to moderate back pain, that is beyond rare.

2. If the client is so mentally wrapped around the axle that they just "have to know". If it gives them peace of mind, great.

Chas Tennis said:
When it comes to diagnosing an injury or chronic condition I believe in imaging. Without imaging there is usually hardly any certain information on the damaged part of the body. I believe that the statistics of false positives and false negatives with imaging, when added to the other diagnostic information, gives the best probability for an accurate diagnosis.

I'm of the paranoid school, so I did get the imaging, which showed this:

MRI OF THE LUMBAR SPINE

Spondylitic changes L5-S1, with a left paracentral annular tear and small associated posterocentral disc herniation. Mild diffuse degenerative facet hypertrophy. No stenosis demonstrated.

I've tried McKenzie, doing it everyday for a month. While both the extension and flexion exercises felt good while doing them and for a very short time after, no real benefits long term.

Now I've got the Egoscue book. And the McKenzie book is still lying around. And two other books on back pain and a sheet of exercises recommended by a PT. There is TOO much information and too many exercies to choose from now, too many paths to try (some of them conflicting) leaving me confused and frustrated after a year of persistant back pain.

What to do? When? How often? Oh, how I wish there was one clear path to take, even if it was a hard one.

tennis forlife · Feb 28, 2013

Thanks for the reply about my shoulder and I apologize for being gone for so long. I was buried under with work. Anyway, the good news is the shoulder pain disappeard, thank goodness. Perhaps, it was due to my religiously performing the Egoscue e-cises.

However, I need help for my wife. She believes she has a ganglion at the top of the inner leg below the buttock. She is forever asking me to feel it, which I can't really. She visited a doctor who took an x-ray which revealed nothing wrong with the bone and no relief. Can anyone provide any advice, insight or help? Thanks in advance.

Povl Carstensen · Mar 1, 2013

heycal said:
I've tried McKenzie, doing it everyday for a month. While both the extension and flexion exercises felt good while doing them and for a very short time after, no real benefits long term.

I think you should remember to only do extension untill the back feels good. Flexion is more for "maintenance" once the back is ok, imo. Too much or wrong flexion is often what causes the problem.

heycal · Mar 1, 2013

Povl Carstensen said:
I think you should remember to only do extension untill the back feels good. Flexion is more for "maintenance" once the back is ok, imo. Too much or wrong flexion is often what causes the problem.

This seems somewhat at odds with most other back programs, yes? It seems to me that there are many, many exercises that include some form of flexion in various 'help your back' routines, including yoga.

Disregard all that in your opinion?

Posture Guy · Mar 1, 2013

The whole "extension is good/flexion is bad" thing is looking at this wrong. Neither is intrinsically good or bad. If we're talking about a bulging disc, for example, it's about WHY the disc has bulged. In what plane has the spine lost its normal position such that this level of the spine is getting sufficient dysfunctional torque to cause a disc to bulge. I've had clients with bulging discs who were stuck in flexion and needed more extension in their lumbar spine. And just yesterday I had a new client, college kid who is very athletic, with back pain. Doesn't have any MRIs but my guess is he has a small bulging disc. His problem is that his pelvis and lumbar spine have completely lost their ability to flex. He is stuck in lumbar extension.

The spine is designed to move in both directions, and when at rest to occupy a neutral middle ground.

In response to the post above expressing exasperation about what to do with so many options, that was me as a client years back. I got this book and after using it for a month or so I realized two things: first, I probably wasn't doing the exercises correctly, and second, I likely wasn't doing the exercises I specifically needed to be doing for my unique postural issues. So I started going to the clinic in San Diego (only one west of the Mississippi at that time) to get personal instruction and coaching. My attitude was "help me understand WHY I hurt, map out the action plan of what I need to do to remedy it, help me understand how that action plan will remedy it, and then I'll do the work."

Some people can do very well working from a book. Others, like me, need more individualized assistance.

mark999 · Mar 1, 2013

heycal said:
I'm of the paranoid school, so I did get the imaging, which showed this:

MRI OF THE LUMBAR SPINE

Spondylitic changes L5-S1, with a left paracentral annular tear and small associated posterocentral disc herniation. Mild diffuse degenerative facet hypertrophy. No stenosis demonstrated.

I've tried McKenzie, doing it everyday for a month. While both the extension and flexion exercises felt good while doing them and for a very short time after, no real benefits long term.

Now I've got the Egoscue book. And the McKenzie book is still lying around. And two other books on back pain and a sheet of exercises recommended by a PT. There is TOO much information and too many exercies to choose from now, too many paths to try (some of them conflicting) leaving me confused and frustrated after a year of persistant back pain.

What to do? When? How often? Oh, how I wish there was one clear path to take, even if it was a hard one.

been reading this book
http://www.amazon.com/Steps-Pain-Fr...e=UTF8&qid=1362167140&sr=1-1&keywords=gokhale
should be able to find it at the local library
been doing the exercises for 3 days and i already have had positive results. had lower back pain and sciatica for over a year with no relief from doctors and PT. good luck.

heycal · Mar 1, 2013

Posture Guy said:
In response to the post above expressing exasperation about what to do with so many options, that was me as a client years back. I got this book and after using it for a month or so I realized two things: first, I probably wasn't doing the exercises correctly, and second, I likely wasn't doing the exercises I specifically needed to be doing for my unique postural issues. So I started going to the clinic in San Diego (only one west of the Mississippi at that time) to get personal instruction and coaching. My attitude was "help me understand WHY I hurt, map out the action plan of what I need to do to remedy it, help me understand how that action plan will remedy it, and then I'll do the work."

Some people can do very well working from a book. Others, like me, need more individualized assistance.

I'm not sure if I'm the book or need instruction type. Of course, one needs to decide WHICH school of thought to follow before worrying about whether to follow the book or get one on one instruction. Yoga? McKenzie? Egoscue? Foundation? The one book this last poster just recommended? Or one of the other ones?? And of course, most of them claim they are the very best way, or the only way...

That to me is the first issue/problem here, and one I find very vexing...

mark999 said:
been reading this book
http://www.amazon.com/Steps-Pain-Fr...e=UTF8&qid=1362167140&sr=1-1&keywords=gokhale
should be able to find it at the local library
been doing the exercises for 3 days and i already have had positive results. had lower back pain and sciatica for over a year with no relief from doctors and PT. good luck.

Thanks for the tip.

Povl Carstensen · Mar 2, 2013

heycal said:
This seems somewhat at odds with most other back programs, yes? It seems to me that there are many, many exercises that include some form of flexion in various 'help your back' routines, including yoga.

Disregard all that in your opinion?

No, it is just that from what I know the problem and bulging is very often because of flexion (the buldge is "backwards"), and the treatment is exercises that focus on extension (and correction of posture, both sitting and in general). For general strengthening, prevention and so on, ofcourse different exercises are cool.

Posture Guy said:
The whole "extension is good/flexion is bad" thing is looking at this wrong.

Yes, but as I wrote "Too much, or wrong flexion is OFTEN the problem".

boramiNYC · Mar 2, 2013

Posture Guy,

Reading his book, I got an impression Mr. Egoscue emphasizes feet pointing straight forward as something very important in posture. Could you please share your view on this?

Posture Guy · Mar 8, 2013

weird, sometimes I get email notifications of new posts on this topic, but usually I don't. So sorry about the delay in responding.

Povl....i completely agree, excessive time in flexion is the cause of a LOT of spinal issues for people, no question.

Heycal...i feel your pain. I'm not a fan of anyone or anything that purports to be "the only way". I think Egoscue is a great tool but there are a lot of great tools out there. This is absolutely a case where pretty is as pretty does. I also refer out to other practitioners freely when I think it will benefit the client. My bottom line: trust your instincts. Let them guide you to what you should be doing. If, for example, you read the first 3 chapters of Pain Free and your response is "meh, I don't think there's much here for me", then put it down and go find something that resonates. That is likely to be where your solution lays.

re the post about Gokhale, it's funny, I just posted on their forums. I think the Gokhale Method is great and can be of significant benefit to people. Ms Gokhale looks at the body in a very similar fashion to the way we do, and I think her method is very complementary to ours.

heycal · Mar 8, 2013

Posture Guy said:
Heycal...i feel your pain. I'm not a fan of anyone or anything that purports to be "the only way". I think Egoscue is a great tool but there are a lot of great tools out there. This is absolutely a case where pretty is as pretty does. I also refer out to other practitioners freely when I think it will benefit the client. My bottom line: trust your instincts. Let them guide you to what you should be doing. If, for example, you read the first 3 chapters of Pain Free and your response is "meh, I don't think there's much here for me", then put it down and go find something that resonates. That is likely to be where your solution lays.

I guess one way to approach the problem is just too go through the various methods and give 'em all a fair try, tedious as it may be, and hope one works. For instance, I did a month of McKenzie and didn't notice a change. Now perhaps I should try a month of soley Egoscue, and then so on. I often end up doing a mish mash of various exercises from various methods, and maybe that's not the best way.

Posture Guy · Mar 8, 2013

BoramiNYC....yes, foot position is one of many indicators of what is going on with the body posturally and functionally. Feet and knees are designed to point straight, not out to the sides as most people's are.

Heycal....that approach is one way to try to cut through the haze. For me, I would endeavor to find the approach that made the most intuitive sense, and then commit to that for a period of time (1-3 months).

One thing you might want to try is doing Egoscue at a licensed clinic if one is near you, or with a therapist from a licensed clinic via skype if one isn't. All clinics guarantee their work so you could "do Egoscue" for a month, have a few visits, and if you're better, then awesome. If you're not, politely tell your therapist you appreciate their help but you didn't improve and would like a full refund, and they'll give you all your money back. It's standard policy at every Egoscue clinic.

Just a thought.

Povl Carstensen · Mar 8, 2013

heycal said:
I guess one way to approach the problem is just too go through the various methods and give 'em all a fair try, tedious as it may be, and hope one works. For instance, I did a month of McKenzie and didn't notice a change. Now perhaps I should try a month of soley Egoscue, and then so on. I often end up doing a mish mash of various exercises from various methods, and maybe that's not the best way.

But you should be correcting posture at the same time. Otherwise it just cancel each other out.

boramiNYC · Mar 8, 2013

Posture Guy said:
BoramiNYC....yes, foot position is one of many indicators of what is going on with the body posturally and functionally. Feet and knees are designed to point straight, not out to the sides as most people's are.

I agree foot position is a very important indicator about posture and function. However, in my experience and studies about form and posture, I cannot agree that feet and knees are designed to point straight forward. Instead, in any activity where critical balance is essential to be able to react quickly in any directions like in tennis and dance, I find the feet pointing outward achieves the best functionality. The only instance where the feet are supposed to point forward is when the weight is being propelled straight forward.

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