stage again here
uh... is a man that just got his bachelor's degree last year from seventh
in solely university and is also working on is phd_'s gonna talk about
high-intensity exercise the lower back give them a round of applause and james
feel sick it say
purple
uh... nelson
uh...
rick
here
finance and
okay guys right uh... i'm hoping that this focusing aborted its image as a bit
of apprehensive about talking about this topic
she does is big interests of my obviously and in my phd_ and i've been
a lot of
intensive research on it
so to me is very interesting and so i think quite
quite a lot about how to relate to you guys ab
i'm radio
i kind of full of al have more to talk about how happen
apartments
you how unpretentious the nature of
clinic by back pain is i mean like that do his
had back pain got back i know some of that time
that's
only about eight thirty which or sponsor
research biggest quite interesting
but they had just risk i give you an introduction of how our cargo in
circuses allotted boss that i would say you know has again to back pains
that we've
like these that i i just finished my
basses uh... degree in applies for science and
before start that i was very interested in complex eisenhower relates that uh...
health and fitness despite a shady and
definitions and
and the fact that excise can have on on the body so i i wanted in the floods
both sides agree with uh... with my main focus being on excise physiology and
at that time i was getting introduced a kind of concepts of high intensity
training and show you guys are aware of what today doug mcgrath uh...
off the jones
and i i was reading the bear works as read my menses works at the time
uh... hands
kunkel incidently wedding bill two seven two so it's not my degrade
uh... one of my lectures that was involved with them
some research using that uh... medics equipment
we specifically had at medics lumbar extension machine there
and that is quite interesting that i was just reading boulevard today's but some
time and i kind of a ride to the university and was like max max that
would i know that name from
out aliya opportunism in the back
and i got involved in the research in a kind of stem from their redevelopment
houston high intensity training went back with all the research um...
as for the convinced by the evidence supporting and then move free kind of
the same way off the progress from high intensity training grover norquist's and
i'm leaving for it's a sent testing and then rehabilitation fill up back in the
other possibility as well
looking for the researchers orlow big holes
in understanding of um...
that probably what might be the main causative factor back pain
and potentially how we can try and tree that i'm trying to be either prevent it
or rehabilitated
for people who do safra so today's talk i'm gonna try and zach
kind of a personal decision of what will be why karva that will
what was it you guys and you go part time
yet
exactly
genesis says said united is really really annoying let's just have this
chronic pain
s around you at the whole time we're currently in a minute popping up up and
down
it's really annoying and you hirings are things in the conference is well if you
go about backing that poster don't look so tracked it doesn't really convey
kind message you want states to
maybe women or other other people you china at the relationships of
three to talk about
it was important to care about it
living in a discuss maybe maybe what you know why is it separate prevalent unit
so if you've got a semi people of color
the figures are really high
if it's a hard as they'll be something that's that's causing as something
that's having a real impact on and something that's meaning that it's going
to you know that it's kind of time in society
cynicism light my guide is uh... and based on my reading around the lectures
of what remains of like
associations of low about paying off
and what i think has the most influencing factor a wide the majority
of people suffer from it
but any other kind of cupboard
ni what you can actually do about it because it is so well in the pain this
is causing it
all of this might be causing is me the main factor
now with a day
it's good to have some information of the how can you talk about how can you
do with that how can you do something about how can you bring the situation
because this is the main reason while you guys again
getting information and learning how to
apply and improve unite your life basically
i'm gonna spend the time just just kind of going over what what i'm doing in and
uh... the impact i kind of envisage
of my research is going to have until june bit about
what specific areas on looking at one looking at them and how that kind of
like is involved with with and about henry and then we'll connect they must
be tough questions
uh... just in case any of you on the web alone racial messed it up
mats the love that
the bond five rumbled up and that's when my main area of intro testers
so anyone's go questions above that well below that
i want to step outside my area of expertise sat ideally i can give you an
opinion barefoot and i'll tell you i don't know uh... and style of the above
the question benefiting
inbetween those five that a bright
i've probably got to know is i can give you did you get on some
site jain sadie questions to something relevant
i guess the why care about love at
will first thing that there is to get back on the definition
yet what is back pain
if we don't have to ask tackle something and you know why isn't it important to
care about it we need to kind of
defined and i know what it means i campaigned saying yesterday uh... some
words in some definitions
lost many of the answer
to tackle probably need to be up to define it and no what the problem that
she is
by planes used to describe
as a kind of tension or so and insults stiffness their lease kind of words that
used to describe
what is a sense it over arching kind of condition
in the lower back
mike say any of these are the things then she sort of stiffness
sharp pains anything about it can be annoying them and they have an impact on
our lives
we'll say five
categorize our back payments a in surveys difference of what's up
categories
acute pain
what we will be considered social time paints a lasting erupts ovr twelve weeks
accutane would usually be involved with united an injury maybe sports injury may
be tripped and says well you know anything
that this should back out
so to speak anne's and causing pain usually in the majority of cases acute
pain kind of resolves itself almost kind of naturally
even the research suggests that it doesn't really matter what you doing the
actual pain will tend to go away after bouts of at most
near upset so salt lamps are supposed to meet
out that's of light line is a two week period
the problem is
is when the paint doesn't go away
profits periods
is tenzin said what we've encountered rises sub-acute pain
and eventually develops into chronicling
aykroyd has anything that any pain has lasted for a for a long period in twelve
weeks
and usually in those cases
it's way develops in thirty years under some people who are involved in my
research allied
i'd been testing and and
uh... rehab with to uh... some of them in our time
for thirty years billy had spent the whole life in pain basically
and i think there's no way to lead your life unit
happy them suffering
one of the other kind of problems that and i was speaking to and
gentleman editor about it
is a very differences come on
uh... is very difficult to m
give back pain in aloft cases
a diagnosis i mean that we will go on for a second but there are a lot of
different things associated with backpacking
that
maybe or may not be causing pain
then maybe you'll may not be affecting the joints by mechanics and then having
something impact on how the structures which may
illicit a pain response
or unit in may or may not be expecting um... functions are out how the joined
by metaxas function
so it all the time is very difficult to say right you you have back pain anne's
this is causing your back pain or all of this is causing the pain that you're
experiencing unanimity
uh... nerve impingement and maybe uh...
baghdad's degenerate correction this instance since causation
and what you know it could be ligaments execute the must it could be actual
unanimously saying elan's right
uh...
then the majority of cases diagnosis comes up
so people labeled is nonspecific can go part time
method and ideals
most cases is very difficult then say oh if we don't know i fear what's causing
it happened how harry's personnel to do about it
and this is where the majority of my kind of like researchers involved with
his dealing with
is poorly causing that
non-specific aspirate because it is and eighty five percent of
people with chronic low back pain
how this non-specific kasri given to them
israel so by fifteen percent uh...
you can say you know you know you've got this problem you've got the specific
policy
the specific conditions of our buttons that nichols in time
so i'm focusing on conflict how can we figure out what's causing apple what may
be the predominant because of that is non specific cases
and how can we address
so when i talk about uh... old previously lbp and
in uh... the rest of the un
but the slides
unfocused specifically about nonspecific
chronic low back pain
says back pain without specific diagnosis that's lasting in a long and
twelve weeks in
and maybe the car rental unit
people's pain perceptions change that
said just a quick diagram for you and this is just a complex at the same for
my research unwilling back to the kind of lay-up
these guys im leave leaning lian lian lian
uh...
they've actually done a lot of research a lot of at reviews on the time i think
really act and dysfunction
and i put together this kind of uh... integrated model to say like
well in in non specific cases uh... with unusual school function as as a as an
outcome measure
which is very difficult to say all i can try to um...
for specific something specifically wrong with this
structure altadena something is causing painewebber's nervous eleven
and sony's function like the function of the joint joined by mechanics
as an outcome measure
blood as a taken this kind of kind of approach that they've use in the
categories are used
and adapted it said
be applied to lie back
so we've got got as cargo at that time as a kind of like entity as a kind
concept
and function as the outcome measure all functions as the perhaps rehabilitation
go
so
one looking at is whether or not we can improve function
we can definitely improved
all these other
areas uh... associating with
may not necessarily because it is but certainly associated with caught up at
night
one thing i a m day
is focusing on the physical characteristics involvement
that's love dot
section then psychological and so i can say show
instances
my resistance and the folks in alexander come from the excise physiology
backgrounds and
sold out
there is a psychological impact acts like a social impact to stress impacts
on pain perception which i'll discussed briefly
and mind as well
main focus of my recession might
efforts are looking at
what the actual physical symptoms are
is the school said he said to tell whether or not
dislike us at the psychological stress is causing the plane or whether or not
it's
causing psychological distress
united services hall
association doesn't necessarily imply causation
unthinking his motherland on fixing the physical characteristics the more
specifically in my research i'm thinking of fixing on things like range of motion
you know if this generation
the act actual atrophy if they uh... lumbar extensor musculature
as the looking a bit sort of ad
uh... skilled specific bomb attacks when we come up on the tax uh... if you guys
are where pala build us a man's world
most of you who are about
seems videos threat
fuzz it up yet ok ever anyone read my mail access
yeah ok kitty co but left
bill talks a lot of our time
by mechanics that has as a an overarching sold like uh...
subject
uh... by metaxas display and so there are certain things that we we
wet when bill talks about bond cactus talking specifically about uh...
rolled from what governments works is um...
joint structure anatomy function in a
what i had some people michael functional kese ology
uh... the bomb attacks also incorporates skills specific movements as well so
free my plus full size three that we one-week were looking at buying tax we
look at basically so what the physics of how
particular movements uh... whether that elaborate so much support skills work on
up
and one of the senate things is looking and was cool gate which is basically you
unit
look for mostly commission's web describing an you like to mention
and report back pains and have discovered variable datetime which
doesn't
fee the normal time which we see people hey that got back pain
so that's just tell us that the saying an
of
what i'm looking at and why i think is an important to look at
and we're going back to the family aside more determined to research and doing
and why do you get so much important things that you know the results on
huntington
okay
what's the as a senator
quite low back pain
really prevalent
really unpretentious than a foot is in his word
recently i think i might use their
the kind of thing with the about me up on the time you want to mention dot com
if this is unpretentious condition there that is everywhere everyone has their
normal talks about it
you know it is not laptop kind of scary you know
as necessary killeen blaze interestingly in some cases that i've read uh... case
there is an examples of people who've been slice of the stress
by that i know that yet i felt suicidal
hands and may be that goes back to the whole used business-like is a
psychological stress causing pain or is the pain caused the psychological sts
distress
some interesting points
but yet because this is kind of unpretentious unknown really kind of
like
thinks as a massive impact
on society
uh...
it doesn't really get
a lots of press shall we say on my things like cancer heart disease
analysts at the city
is definitely one of the most prevalent medically soul is in fact the world
health organization did a big survey at
as a love like uh... and in the nineteen nineties
and zag actually ranked low back pain is the second most prevalent
disorder
uh... in uh... in that survey be anything that was interesting and called
me
and i have it was m unforeseen amiably and low back pain right-wing prevalence
higher than almost everything out to clean your heart please cancel these are
things
and so i uh... it's a real problem and dan
here's some of the estimates are that sixty to eighty percent of of adult
we'll will suffer from back link so you need a new guys who have miss everybody
paying now
will have an expense in pain in the past
it may come point you lots where it was very likely that you can suffer from
back pain is gonna really cause you some problems
anos a
one interesting things is is the cost of back pain
it may not have a massive impacts in the interest of like uh...
severe
impact
that on all of our lives of some illnesses and conditions date
but intends it costs it costs shit load of money
every year some of the estimates are it costs about ten thousand a
won the most recent estimates for the uk musicals they call me and direct
and indirect costs about ten point six
that ten
point six thousand million
sanders a billion
about about ten million pounds a year
lessen the direct and indirect costs last reunited cost of healthcare
posterity and i i i'm one of these problems is the treatments that that
utilized by people with back pain
and assistant director of student if people go back on the part of the work
than that both of those weapons they missed limits now i'm getting money for
it
working and provide value for that company in that companies or say missing
out
on the web at providing for them
so there's all these complex lost involve all venice is big spiral that
just keeps continuing costing more and more money and the way the kind of
economy is going on the mine with rates inflation
buzzing scott b skyrocketing even more
big problem
if i'm pain is so prevalent like if that is going to some reasons why it's
prevalent in what's causing what is having an impact on it to make its such
prevalent conditional society when we look
epidemiologically sex which is a study of sort of like m
epidemics of disease oval the political political
we look at the school respect as we look at things are socially within that we
can generate hypotheses about word and maybe is a is act was in
it wasn't such a very uh... what link doesn't have to the actual conditions
so we look at things cool risk factors
and in fact i mean they're kind of mainly cell-free
trains a full and kind of categories what types of respect this
all
responsible
the conditions that that we say
so one of these ab prospectuses these environmental and work-related expenses
ansel played out latest pictures i see that i was just following and i don't
really realize that soft or click on that site
but but that they're supposed to have backpacks andrea
you can't find him
something which i remember this morning which i a m needs to remove told you
about was that rice farmers interestingly
uh... undergo close the while back has been a kind of interest of mind looking
answer at back pain in
but traditional indigenous of coaches
also what alienated
bike there and and evolutionary reasoning new unit
is m
between paul and i think in anytime lab spective of uh... the human sciences or
any kind of like uh... biological sciences in exercises
so he did just as a kind of like a example of people and have decided that
working conditions and therefore carbide pollsters and that sort of thing that we
experience during a work with libya
extended seating fighting month five office jobs accenture
will come by lifting that we experienced and doesn't really like a man who worked
the last five a
bustles sorts of things
maybe lengths to
high prevalence of backpacking
unloaded tonight so with that
you know you can ingi back lifting something hedley
or lifting anything for that matter of fact if you lifting and stupid way
if you've seen in a way that
excessively loads perhaps the passage structures robin the muscles taken the
like
so you know i'm not denying that
you can hurt your back doing stupid stuff at work or or in whatever
environment you're in
but interestingly
i was looking at it and some research in thailand slickers and see whether or not
they prevalence of back pain was as high in thailand as it is in
other cultures in the world
and the kind of that prevalence of pieces it is it's very difficult
skylight link things the government draw direct comparisons 'cause methodologies
are always different
indifference studies which is was a problem when you try and uh... in
separate them
but one interesting thing was an analytical the acid oakley who teaches
law about pollster and thinks it's very important
highlighted to me that uh... innovative i watched uh...
fingerboard chests not uh...
gava resident americans were back in a fast
uh... their posters on the bending lifting is these brilliant to keep
neutral spine
intended the hips an extended hours and hours a day spent and that poster bend
down
picking up or checked checked sounds and she says his picture and
which outcome regret nothing on it now but i am of these what these women with
his wonderful pasta
spending hours a day and that posture and yet
seem to have no at that time
and she kind of used as a burst of like uh...
eye-catching tool to cut my heart like uh... i like this
so full of claims they saw that on the ground is a symptom of a resurgence in
pictures and an offense interesting picture when i was looking to try and
prevalence
of uh... so much promise and rice farmers in in thailand in an abrasion
country you can expect too much of the same job is spent
than the day's bent down
but here i sit in that mocha you know whatever is the kind of war he feels
that way
ands and interestingly that that you found showed the unit
well half of the people in the picture you have this
perfect posture newt respon
bending of the hips
and you know i reloading the spine in the mouth of the that these conflict and
schools of thought would want you to bullies
and the idea of a half of them had relief ship upstate new york hunched
revolt
bending down and using a standing hours a day in that position
so much so therefore you know that's quite interesting considering that she's
also saying that the rates of back pain in thailand quite loves wealth
along the lines my foot much of the full of why i think is the time
could only the causative factor although maybe
the majority of almost irresponsible
is that i was on for a second is one of the physical characteristics of the
lumps popping
and was that
bless those odds you study done with ross thomas he found that
rice farmers with lower
strength levels in that lumber expenses actually had a high rate of back pain
and that was the factor that was most associated with it now doesn't so imply
causation
but it's interesting that
the actual working conditions didn't really have a big impacts
weber all they have backpacking
so what we can usually says if there is no association is quite like me that's
probably know causative
so it is very difficult complex a lena is definitely the majority of people are
getting back pain because that spending time than i ever lisp and science flash
in the states will sign opposition the web
because they're new situations just on consistent
they're all over the place in the may be affected by methodologies in the
populations in the catholic
and thus the consistent is very difficult to say yet definitely that
message russell what's happened so we need to
comeback as of today the psychological family swings back into the hallway m
work-related stuff and uh... work-related stress is
other said mahmud focuses isn't probably on uh... and so i thought processes
associates is melissa nicholson associated with back pain
and i want to step out of my bounds uh... that
and cognitive behavior therapy is is a very sort of like prevalent that
treatment options and i and the you're the research is trying to be pretty
successful
and in terms of an leading people's pain
section but im
interestingly
and some of the research that i've looked at looks at has with the fact
that the soldiers in chicago i stress the soldiers and and psychological
sensitivity
and and found that
injury cases they're not
necessarily associative
with the prevalence of le backpacking
they affect the degree of love acting cell asserted that the intensity of the
plane experience
so it's not the kind of like four to me that suggests well
maybe
psychological stress and most of the things all having you know the director
of direct impact on howell
much background people all how prevalent back pain is certainly one of the story
be the main causative factor
it's also by holistic approach to the
they can have an impact on the penny to safety preserves the perception that
uh... it's it's considering that it's time to see the brain
hands and
any kind of stress is not necessarily have an impact on what the sections you
have of that and response
was important it's monastery myers focused and attendance of think it's
unit remains hoping plays an important thing to consider perhaps
in an
addressing people's pain perceptions
and lastly won the race as a respect as we look at
uh... these physical acceptance that when we talk about his work at respect
as we're talking about times and
but demographic characteristics and i like height weight
below the only things that i'm uh... people's physical
characteristics
and some of these things are we looking at like uh... join structures join
function
uh... how how the joint actually physically functions like i say no
they're going to function of the joint and so you know that could be in the
love acted to strengthen lumber expenses that you feel that well but that's the
anil diagram and
petty from one of our jags but uh... just showing a lumbar extension
and sent uh...
and his lodi vanfleet looking at things like range of motion as well and that
the check i might grow strong regulation and on the stage a specific number
dimension which we talk about that alonso
excuse me
okay so i could send association doesn't necessarily imply causation
started clover is difficult to say also if something's associated with it was
really causing it liberalize just may be simply unite maybe something else is
underlying it
and when this thing has an impact on a campaign
is prevalent
and something else is provided as well these kind of a conditions because very
difficult i'd like to say i'm what's causing wall
in the majority of cases
found at the same opinion is as researchers likes to have a gala benefit
you've you've had it is his name is quite big names alone about
uh... by mechanics and rehabilitation
uh...
even if you know i mean in general agreement with him
that in the jury cases pain has an organic
souls
okay and injury or some sort this function of the joint
because it is what initially causes move sequence of events that leads to
he fixes along harrel and very stiff physical characteristics of columbus
find have an impact on injury uh... thresholds and and and the injuries that
you've infects
and dan
usa distinctions between where for all of the uh...
yet acute injuries all chronic injuries as well netware broadband
you know yesterday like an acute chiseled like sprain or
high-impact an injury a liberal that
anne anne
these words right now
uh... a repressive injury at for example like maximize get the texas rangers
people get reports of injuries which can develop in c chronic back pain the lungs
spine as well you know it's a really
get tackle from behind the rugby of whatever so quickly backed out
it may be sustained loading and sustained injury
very small small small just builds up a discount like running response
and what does that mean is off to a injury a series of events happens which
leads to spot of high response
the actual at peripheral nervous systems or data structures and uh... person in
their structures become sensitizing come really
sensitive to pangs anymore compass simulations as joy they structures
willis eaten for the pain response
and some of the things that you know if you can get directness and pension
because of a with joined by mechanics because of the function
uh... and discs and other tissues as well facet joints it's just easier to
handle it and it seems fine that date that's right and had to have muscular
and ligaments officially they will have no supplies
so they can all feel kind of any kind like
alterations that by the tax may be something that's responsible for
sensitizing those
nerves
and then subsequently sitting up a series of n since i was the rest of the
uh... same response
says maybe white white paint private developments mccormick condition as well
you know one thing i just want to point out is something interesting laid out in
a again how made what you guys followed local yukon abilities but does
well the big he cannot hide real of research and i really love lots of out
of the book the great source of information such as you can find good
blogs from bike
interesting and and
and critical correctly thinking and russian peoples uh... are full of logs
written by
and very species and doctors center
and but why does a is was a full is a guy called photography bro's vocal
better movement and he's over so blood brain senses approach on um...
pain and and and he is uh...
questions for back pain
and interestingly uh... heated up a couple of studies that show was aware of
announcing of the stories where
some people who have abnormalities in the lower back
discount haitians of exposing myself think
shows no pain symptoms
so alarm people cause like jumps on top and wagon to say
you know if if that's not being as they go back problem but not all time
then maybe that's not responsible for paying the first place
but i think i'm set said like injury cases pain does seem to have an organic
kind of like like souls icon stimulates appetite
and one of things as an impact on my sisters their tv injury as well
when you can't look at these have studies which metabo malfeasance
incidents
tends to find that the actual and degree of injury
if for example we looking at the disks of dust can begin to degenerate make and
then softball which
and they couldn't center at that point stop pressing on earth and causing pain
response
or they they could have a completely within which case you know they can
cause a real slow like impingement on that uh... nervous tissue would need to
move down into the
actual blood-brain units stimulators
inflammatory cascade of events that that can cause a racial painful response
and it seems to me that that the majority of links
and between abnormalities in pain for a lot more satiated with at the severity
of them
so the ratio of light
lotus verity and injuries
uh... abnormalities when necessary it's highly associated with um... back pain
the thing to do is come by at least this state's response relationship between
how badly injured the spinal how badly deteriorated wars
and the extent of pain experienced
so maybe they even when we see an abnormality
it may not necessarily be sufficient enough to cause the pain response yet
also we've got an examples with some people have since in some people say
they experienced pain
the scan showed
nighttime soap
also no amounts itself
am
and this is this is interesting as well because a lot people may become a little
erica
whether it's a caring
evidence uh... sorry and absence of evidence to main evidence of absence
side is this whole inmates in the senate as uh... a phrase it that they use and
which is
sorry absence of evidence doesn't indicate evidence absence faces hold you
com prove the non-existence of something godlike and that's what we're talking
about his family entertainment
it's
is a logical jumped that i'm a logical jumps i'd say that just because you can
see something on this particular scan
there's nothing that the festive season
am so that you had the scam i hadn't made mister ouagadougou lawsuit estate
using and i just like laugh as well now i'm not docking station said his
admonition lines up that incident of of reason the research
yet not not not the thing i missed something
or perhaps the abnormality was there
desensitized and create a kind response
as potentially alleviate itself it's rotten lousy but
tangling it because of the same size asian
it's very difficult scott venues ease diagnostic tests to stay on the air
power how worthwhile actually offered
and zambia's any refers to the use of these tests in the country who was then
that that clinicians like arafat's visit is that you can see contact
this small number of people with that was an accurate diagnosis in most cases
is no usually that useful
this whole idea of how dangerous verity then conference on the side there's an
injury fractals
and
in most cases when injury fresh fruit is exceeding along the lines plastered
mcgill thinking
it you'd kill joy structural have a particular um... level of of loading and
i can't sustain before
it's it breaks basically is like any kind of like engineering aspect it will
be up to sustain
uh... and start consented to have loading beforehand as boom
and amber expand that made a spectacular failure
and they all collapsed
or but like an accused of a severe injury impact injury
or maybe a sustained pat stipulating that may cause an injury i a verdict
that period of time but as an injury fresh felt and they're gonna be things
that impact
how well you can
opened to that'll how well you can sustain and
leading before you actually and gets injury
excuse me walter
and his own mind refresh alerting them
one important things in certainly coming from a uh...
mciver excise phase that background is
and be submitting a joint can't take is usually to be dependent upon the extent
of
resistance that the musculature holding the joined together can actually
withstands
if you've got week musculature
that's joins dot is not to be out with stands much loading
is going to be up to that you may have led injured mergers lefty
characteristics as well
uh... and strength and endurance you know the not separate things they go
hand in hand if any of you familiar with the kind of opportunism analogies on
that
if for example you implement strength training program
accessory any exciting east offer a little with a at maximum
former max it as a hundred ql you improve
increase that to syndicators
and stuff so you can do one red mexicans killers
and things to do
eight reps with
excuse
can increase that you one red max two indicators
then people began to get to do about a breadth of hasn't sixty hitler's
interested person
so your actual endurance
the amount of rhetoric and to we've aggressive loans going up to some
dangerous enormous you know if you previous championship reviewed your your
insurance as well
so there's no time like training for one or the other
anne's doesn't have an impact on how well you can
yet uh... withstand impact injuries no se sustained writing as well
and dan
twelve impacts on the visit the injury severity and then the impact that has on
paying the sponsor
interestingly and one of the most consistent things you find in in the in
the lecture looking on on summation of studies
is small populations into large-scale studies looking at least physical
characteristics
a lot of things associated with um...
the actual number extensive musculature minimal two-fisted rectus finally muscle
groups
uh...
shave in people with back pain
they usually very weak
and they're very agitated
and they unit uh... compared to an older population of people without back tag
packing that colin able to withstand is much stratton
unloading as as the people who are suffering from that
all of these and these things like that to fade
the uh...
lumbar extension strength
lumber extensive activation is usually lauren s toward native people of back
pain
and we actually get
interestingly as well
is that people who have the q injuries
tend to have innocent have associated lumbar muscle atrophy as well
so certainly in the in the most if that's the people come into a with an
acute injuries though you know that was done by uh... heights and click
something
and uh... the people who came in with acute injuries
founder
they had
lumbar muscle wasting his well they didn't know follow-up study as well and
also did some studies looking at people coming out of injuries up
and found that
the degree of the improvement in the back pain was actually related to the
degree of improvement in the lumber mill musculature as well as the amount we
actually
uh... itouch stage in the amount of and improvement act financing
says interesting that
first-time and certainly the impact on whether it becomes chronic or not
is also related to how
strong and how lab well-developed the actual on the musculature is
when i was in the stuff
and it's not rush for the next time that sent on the phone sir
wine okay
but is it briefly just such a down on the indigenous populations that
i have this kind of idea that well if it's a physical characteristic that is
not necessary to be
uh... environmental cause it causes all you know that holds online
westernization you know what else is in the lift anything to win
having impact supple
i'm going to have a look
western prostitutes
with uh... i am indigenous in traditional population sea while the
rates of back pain are and then see where they had a hearing to traditional
pain you know
final lifestyle but one of the our caller
and actually unite reduce the rate at that time we see and all the times like
and traditional populations are confined and
literature on research on
count me in the race with justice high in some cases higher
than about time we have to get
in um... western populations fish in the it doesn't really matter whether you
convert hitting tradition diet lifestyle whatever
you seem to seems to be back pain everywhere we go
out the question honestly rule tide is because of that discrepancies in some of
the research but
on the whole
is very very prevalent regardless of what you get it
avodon
a slight here with some of my recent forced us to quickly go either
now if that's the case
before the potentially there must be some sort of evolution reasoning for
walleye
we've got a high prevalence of back pain and to some sort structural
btwn compromise perhaps uses the word to use that badly she's had to make uh...
elation
resulted in that means that we fuji dot we care about muscles than than we
really need
and i'll be right that i did everything since a m trying to book list i'm
working a series of the moment
which will be fascism
just looking at how probable on the spot is involved in howell diane us all links
if my research and have strengthened the lumber accents among muscles
actually links back to that somehow there is an evolution basis for week
lumber expenses
just as a kind of power backup background
holidays uses and the cat
uh... what's the global market basically all twelve monkeys is generally
absolutely representative of early
hate bury my sanity sense of before the pain in the thick area and in the early
nineteen when we left
all boreal
quarter panel four-legged opm trees will and locomotive dan
and what we what we have those need to have a very long so sixty seven number
that's right
what then happened is is we kind of involved in the short back terrestrial
have on the ground grounds and and branched and swing uh...
and what's what's coming up more was never quite shortening of the land of
right
because
using what's called regulation which got swinging between the trees requires a
stable platform from which to break it from
this is this is actually uh... andy and image of chimpanzees and
uh... spinal sent his pelvis inconceivable in the spines school
dramatically
and what's also happened is the iliac crest
have come up
elongated and they cause like an entrapment of the lungs spine so what
happens is is we've gone from big long spines really short spine with a lot of
passive rigidity and all of passive uh...
structural integrity of that
so will subsequently happens
is over that period of time we've gone from having a relatively massive strong
erect respond i was involved in involved heavily in our locomotion
touting a relatively small
one in eight times a cross-section i ran across that you have a muscle as an
impact on the actual math forced generate
site smaller muscles
jim remain weak muscles
icahn says an evolution basis for y
potentially
a lot of people have got week back muscles
and his wife seriously when i get people into testing
in the lumber extension shame which of the freemen as well
in that case what can you do about it
where two different i'd like to methods of treatment as a passive treatments
rashad payne absence of relief and this is one of the reasons why
the costs of it's freezing back pain at the site hard
is because a lot of treatment options focus on relieving the symptoms
relieving the pain that the focusing on what the actual
underlying causal factors
so things like bed rest in a a depression pain killers that something's
sarge they'll focus on pain relief
and actually
removing the perception of pain relief
spirits as the great on the short time
really painful
but then she comes back because they haven't dealt with the coles and that
would watch at actually the mechanism which is actually stimulating the times
the value of the cells treatments and there is somebody
is in terms of uh... the severity to frighten people really bad pain and you
need to begin active treatment program
sometimes the social treatments can be very useful indicating that process it
is hard to accompany
and get involved with the program
in that respect we should be immediately dismissed as being completely deceitful
that is of a role for the ms nine wall
role they should play a treatment program
and yet for three years and years and years doctors we recommend that
breastfed back pain but
that's done to realize now that doesn't really
so stupid
the next time area
is abt active
active on uh... treatment options which it would she have physical treatment
options aimed at trying to address the actual course
but at that time
and that the traditional primaries in looking at physiotherapy sick physical
manipulation of the joints
and um...
you know that there's a really long history of using uh... manipulation
techniques such as mackenzie stuff and they've been very useful way in in
research and adding
in clinical practice in introducing pain outcomes
and improving
functional outcomes improving function of the of the joys of the uh... and
physiotherapist manipulating
well the problems that we had with it is
and zan it's unfortunately lee just a a problem with the technique and therefore
the cuff is effective for the writing is just that
the technique relies on a subjective so flight
uh... clinically wisdom if you like a third of the physiotherapists is very
difficult to provide verse of like
yet objectives and and valid measurement
of what the joints actually doing so they can be useful is very difficult to
that
gets old white baseline measurement that you know is accurate and provide
progressive
intervention to try and solve tackle and every measure again get accurate results
and thinking you know i definitely know that that's great
so one things you can do instead is actually apply progressive sobai
exercise prior program and not necessarily focus also but physical
manipulation which
to extend involves a
uh... the combination of subjective sold like uh... interpretation and also the
com wisdom of the actual physiotherapist
now their free time i a reserve an excise indicate that we can look at
which the lipstick admits that
well in this kind of general activity which is basically decide their own
get on with with it if you go back and get on with it just
the active do what you can can you confirm run good do whatever take on a
class
and and some areas of research had focused on this new edition rows of the
good outcomes in terms of payment spawns
the problem is very difficult to say
that they're holy affected because they don't necessarily houston and the
phillies geez
objective measures of function
site it's very difficult to objectively say
functional outcomes and improved pain meds were just for whatever reason maybe
because of a conscious general
outcome of the excise
but it's very difficult to jets every validate that
the second robot school of foreign zones of excise whole idea of stability trying
them out of control training and it is very big in the complex pulls
performance areas
answer is a very big in rehab and areas as well
and
there are a number of problems that with this approach i failed uh... in terms of
the actual
controlled trials downstate look is the fact that this again
it does show improvements
outcome measures such pain and disability and that sort of thing
the problem is on a theoretical basis is underlying um...
premises very for very flawed it seems to be that in general
it's probably just a generalized excise effect from doing the activities that
having an impact on it
physics behind them
sinking
so it was a little bit of the the whole motor control fit for a few dozen
familiar with the hine says hiv_ lecture and certainly but we also have
the political science
they discussed in quite detailed yet how fast iv transpacific scalia's decline
kal bounce around swiss for whatever
these specific skills and and question the answer transference about scaling
the actual
muscle recruitment plans are you saying that stuff over activities
site
on that basis during these motor control instability exercises
it's is very ten years to suggest that
is the actual
motor control has been transferred to them reduced pain and injury right
reason improve disability it's probably just a general
adaptation the actual masterchief rothman proven transference
of the kind of skills involved
another level as well as recent research at has focused on time
news the white techniques of measuring at range of motion an actual joint
mission
into segments early
sit on the spinal cancer that is not a five to four vote right
and what a lot of research recently is fixed on is how those individuals are
brand new even how the muscles surrounds those individual that a break
control dot
mind is that for the actual facets of the the whole matter controller syria
and misinterpretation of that skill transparency
but one of the problems of aids
the to the studies of lots of people with back pain suggested ah...
people with partner about backpacking have a lot of variability in the uh...
sp into segments to movement of and that's a bright
but the problem is
so does everyone
decision get
above
the solve love that's a bright with a majority of movement actually 'cause it
seems to be that
the movement is very into individual you've taken population of of healthy
divisions and fun last variability between
individuals so it makes it quite hard to then say well how is definitely
that which is causing an impact
on uh... united that show uh... function of the lungs spot because the majority
movement because
and the lower levels of uh... bright
and a majority that movement is produced by the larger uh... musculature
externally
and compress images is provided by internal musculature again
them out of control theory
it's not necessarily training that particular skills particular skills and
help
so what we then move on to decide their progress strengthening and and in
particular high-intensity sector
without going into detail because on the web time
of yet high intensity training principles and everybody was times beach
read a little too literature in the area uh...
and other lucrative mention actually there
uh... i'm not sure toll-free paperwork done at the moment so hopefully i'll be
have
publishes some point you guys got to meet up to the crime scene
buddy right yet
progressive strengthening site
resistance excise this could be
one question mark side
and is
do these exercises trying the lumber extensive musculature
through the dead lift
good morning brian and share right
generic insists i dot
back extension excised
one of the problems with all these excise is is
they involve
hip extension as well
say there is movement of the hips as well as movement have the uh...
outlook on the spot
and when we're looking at a time kind of movements and so like rest compound
movements
the bollywood seem to find a way of
making things efficient and making things things and and incision in terms
of energy expenditure
so when we looking excised involve movement around the hits
larger and stronger muscles of the group at the if the and please and hamstrings
fans do the majority of the like that
now studies have been done
to look at it
activation of the lumbar extensor musculature
in these various excise is in fact and we we uh... one of the students is just
uh... compares the fact that lessons and
traditional deadliest
and you know the lumber stance is definitely
active
insensitive using a election on the fee which measures the image cracked version
of the muscles
and during it sizes bosses excise is being done
that doesn't ask anything other than their activities and tell us the extent
of activation accounting for their very schools involved with the technique
lewis's their active uh... sending him out my number expenses are active
but doesn't this lean mean that they're getting sufficient stimulus
uh... produce an adaptive response
they need to be loaded sufficiently
and city sufficiently trashy produced and that the response
boom of all of these excise is is
they allow hit extension
and they allow the collision hamstrings and the majority of the load bearing
studies looking at comparing
at traditional back extension chains with what we want to insect which is the
lumber extension seem pretty fanatics
both is that he's looking at and comparing the um...
raymond share exercise
to the lumber extension shea showed up
as long as he picks engines allowed
lowell insulated lumbar extension strength is an increased because of on
the musculature presumably isn't loaded sufficiently interested sufficiently
also am james fish in a guy's gonna be coming on sunday as well to the exiles
intrusion kunin
as just finished and
a city he's been doing comparing this to think that left with the lumber
extension chain and interestingly
stiff but their lives
that really improve your lumber extensive rammstein
a couple of people grew the lumber extension straight
not a significant agreeing on the whole most people didn't
so what can we do we do that
so if you've got guys maybe you know that all have access to quit my like
this study in those cases yet
how many of you from london actually
ecology
you guys will have access to the equipment
back and then i think it is a facility cookies a training
they have a full range of medics training equipment
and they have a medical version lumbar extension chain here
i think that an excise division as well
legend is that they equipment we've got a university which has all the testing
facilities on as well
and the main principle behind it
is the stress-strain systems
so what is the changes in st is basically what the pelvis in place
pipeline forced down on the theme is by the man
uh... five-story mistresses kind of life opens to the point
the football that applies force out the lower legs which hit three
fema restraint
which then combustible backwards the famous what doesn't really holds the
pelvis down back against the spelled with a straight ahead
and what happens then it
is no movement forth and back actually athletes conf calf in the pelvis
sony flexion
extension
movement that because
just because of the lumber lunberg senses
so we can do it
as we can more effectively loaded at going back to the the evolution of the
uh...
perspective
one of the reasons perhaps that we've got stronger lilac gleason hamstrings
is because of the way out date patterns has evolved when we kind of like
compaq children's
we went sizzled has been hit sent me and katelyn if you think it how much of that
these gorillas live
and that involved a heavier influence of heavy involvement of the grease
enhancing sec
potentially there's a there's a powerful e dash away
because we have changed again massively powerful must be strong
and now in this position would go a long dated lumber uh... lumbar spine again
to allow bipedal movement to to for example a two-legged walking
and we've got his legacy of
big strong voice and sing but we can spon muscles which creates its just
uh...
recipe for dan
hi levels of the whole high prevalence of back pain
so we can do is we can isolate it
and effectively test in isolation attesting isolation is important because
anne of the previous tests it that re says he's looking at
extension
to exit trump extension
they've got it uh...
the dispensing testing fantasy machine and not skip elvis so it's very
difficult for them to say
that with us and love back because the hips and and uh... hits the extension is
involved in prison hamstrings involved
to the actual measurements they take you to be a combination of all of those
factors
yukon in allies like that one factor
was machine does is isolates that allows us to get varied objective invalid
picture of lumbar spine function
and we can measure for a full range of motion we can produce and and look at
what i think uh... books like
in general
they would back pain since before we even below the top one or more range of
strength
when we look at things we have this common bell curve in the middle is the
average some people release on some people over a three-week the most people
back time
tend to have
really low levels
of love of lumber extensions right
they can't afford to let the norms
will sally and just make it up to the ball range
just to finish up at one of my thing
so it's been like this um... dot and the military's top
flaunt they're doing is looking at some research
using the lumber extension james caan plug some of the gaps
the number extension shames rehabilitation uh... and and and
strengthening using high-intensity excise
others
cool just wrapping up
what what is allows the war
the majority of rescission is in a hell of a lot of research mechanic says that
one yet improves lumbar extension center improves isolated lunberg lumber spon
from chin
right wheaton objectively measure that
research shows that we know that works
increased pain outcomes
massive studies are studies have been got done using the uh... medics machine
all the studies done in people with back pain should improve pain outcomes
along with improved function prove number extension strength
'cause reprieve strengthening prove joint function we've got a nice
objective measure that would find pains reduced moved to file a disability
levels nation using technical glitches
amber improved as well
two great we know that it works in terms of
improving function an improving pang
and if you've got guys can get access to the case of facilities you guys and
access to it as well and if you've got and you can
uh... take time incident
fancy and an teas that strength in your muscles
but the thing is
coming back to these complex sensitive factors involved with back pain
my fourth on on these are the potentially the most symptoms often
causes
to be interesting to see whether or not
before addressing the
potentially ultimate calls and uses the word ultima arash review familiar jack
diamonds but dungeons and still uses live there
proximal causes an ultimate courses
yeltsin of course big what causes these things these extra proximal causes which
then have an impact on the
you know lax images like paying disability and that's ok
and if we if we consider
potentially week lumbar extension muscles of what's happening impact
and causing these of uh... ishi's
but limited range of motion degenerate fiske's indicate very that series of a
physical symptoms
what we might see is if we address that
ultimate kalos
we might see an impact on these of a possible causes well ease tension
simpson's
well my research is looking at
physically improve lumbar extension strength
we improve pain withdrew bridges pampered disability right
week and we'll say
with you decided
of improving range of motion as well to solicit some of the research looking at
has improved regulation
one interesting thing is
is most people back i have a limited range of motion to begin with
so clinicians employees limited range of motion
intervention
now bill phyllis and i and talks a lot of our islands of regulation excised
and the theoretical basis of why he suggests avoiding
streams of the range of motion sensor for the lumber extensions can be
extremes inflection extremes of extension
is because in those positions the muscles on necessarily
what's being loaded
it may be the patent issues attendance ligaments lines they're gonna be what
load as well
so what what we're looking at doing is saying whether or not
we can actually
on the medics take the exercise limited to a very small range of motion avoiding
those extremes of the world are still produces full range functional outcomes
as if that still produces improvements in
it's associates in tune with limited range of motion
secondly within the kit
in a very busy as well
should admit when he came up to the lab we've got i was gonna buy consistent
that's actually a freidy
imaging system
well and if any does he have high level of the rings is put together
when they picked all the mystical these little night that ping-pong balls will
ever end
and he just doesn't list off the cameras recorded essentially the same system for
too much
and symbolic invaded as i can take distance ed and i can
marketable up
film than using these ten freidy cameras in the reconstruct that have an
animation see exactly how their lungs spine is moving relative to that elvis
well several king so i can see how very police to begin with
and then look to see what impact strengthening those muscles has on
improving the way they walk as well as britain is kind of extra simpson
this is listed below that time
and lastly as well
we're going to look at
effect looting has actually only
numbers on the discs as well
we know that you know
progresses high-intensity strength training most the muscles improves must
must papers like the increases have purchased a increases strength
we know that
increases bone mineral density in fact you know the status of that uh...
what effect the lumber extension she has available by mineral density of the the
strength and taken to the actual that's right
and fowler increases by mineral density as well
one thing i mean the time you see any structure the in the love that the that
you know it has an impact on that
i'd like to see whether actually has an effect on
improving discount
most people people about that time due to some extent especially as you get
older they get unit fifty generation which concerns herniation bolting accept
it
and some people got this idea
the more you move
the more he creates variances impression across that says you ben folds back was
the discs basically
and gets washed and extending either side
so it's not extension movements creatives
squeeze mechanism is listing
sundance
and to increase hydration subdesc why one of the time the cap was well
may be that that works in terms of physiotherapy what i'll be effective at
the same time i does load have an effect on it
and may well day because the study that that uh...
uh... but you know that's the family
the changes in
but it was named traveled on the soft so but by no means area which is very
closely associated with the disc alphas well as discs degenerate
that since the generators muslim aviall inc
that i could potentially have in effect
ambitions well recent study was published uh... big city in germany
found that
uh...
the heavy overloading of exercise because the people give weight lifting
and that's all things and have better itself that people we do things like
long distance running as well
uh... leading of parcel of that the fat
repetitive um...
sports center in america running
that triathlons bingo about aren't very good feedback health
so there there's a potential link that whereby wife we ask that question we
employ uh... employs invention the mud yeltsin effect
on all these different outcomes
and see whether or not in terms of the holistic approach
this intervention can have in effect on all with the contacts that's about time
so that that's the whole idea and hopefully i can
i what provide some benefit you get uh... if anyone who gets back thank for
the main time you know the research said he does suggest
that anyone gets back pain should really be employing discarding intervention is
very strongly supported
and it's far more objective uh... method of uh... treatment than any other kinds
of currently existing treatment
thirteen blue
just a summary of kind of what we call free that today
consciously aware of the time
so uh... if any questions
to liberty at all
yet
um... so you mentioned in some cases the actual uh...
if pain may not necessarily be the in which is simpson is
little-noticed
has your system of receiving it
suggests is a correlation between
loans at issue c of battlefield
uh... on the list is not something that by specifically focused on this and i
like him and uh... point of the at the beginning
is not all wooden ones there come a step outside my area of expertise and says he
is not something that i'm uil aware of whether or not there is a correlation
and by the not looked extensively incidence of the research said that
there may be that may not be at
allied i'm not gonna show
calm
seems to me like uh... you weeks oldies usta medics machine
uh...
he said he had a way to smoke i don't think everyone else most people will
have access to and uh... you know that you're absolutely right and and at
assess as an idol in his it sounds
of thinking sands of the way off by structures is an
certainly the best waste it
but it may not necessarily be the anyway
some you could be any extras i went for it to begin with
they do activate and loads of love back
and in some cases though provide a stimulus fa
producing adaptation in them
and doug would have had to run for a few excise on on a few videos of potential
access which you could use to local outback
and that any reductions i have with excise lie that is already activated
is very difficult because the research hasn't looked at it
zero var less efficiently and loaded to produce an adaptation
it looked like a scene with albrecht sizing a gem writes of jesus home but
uh... control course ability and train assaulting improves out outcome measures
such as pain
is likely that there is something general adaptation so although the
loading may not be sufficient to produce the degree of results that you season
something is as uh... advanced medics mission
um... is probably worth doing as long as you can do them appropriately in safe in
united news i'm using falling satellite hines instant principles and venue
you'll likely see and
effect from them
but if you want that's results diesel to best accomplish use the the best
equipment available
but yet it if you've not got access to them
anza this is one of the reasons why i'm doing the research is well because a m
just draw contrasts would fully and then x avonex website has a uh... as a
facility like i said say is anyone buzznet equipment
sensei then
loaded uh... you have reached that would be a website annual concerts where
facilities
uh... in the uk
there are five facilities
and i think that's likely to no one's there six cities in the uk
uh... which i have a medic slumber extension should content to just the
florida area undecided
which has about fifty ps
seven facilities in dc
say yahoo there loads
have a lot of american life that is very complex hands at that time surrealism
and edge investors but it but as the along war access available
as a long time typing as it is so in this country people are aware of that
dividend any options available
although it's very sparse i think impolite
doing the research at presenting a academic conferences and making
precipitous inclinations more aware of it
and showing how effective it potentially could be
will hopefully make people's ours i think that warmed up pocket we need to
get the sacrament we need to make it more variables that we can
you know we can get that treatment option gehring hands at
get sorted patients come in and use that
but yeah i think i think i'm you can get benefit from of rec sizes but
sorry
so maybe has been the season
that okay
and has a guys if any of you go expressions tom bradley outfits
isozyme