WEBVTT 00:00:07.011 --> 00:00:09.096 stage again here 00:00:09.096 --> 00:00:14.066 uh... is a man that just got his bachelor's degree last year from seventh 00:00:14.066 --> 00:00:19.033 in solely university and is also working on is phd_'s gonna talk about 00:00:19.033 --> 00:00:24.021 high-intensity exercise the lower back give them a round of applause and james 00:00:24.021 --> 00:00:31.041 feel sick it say 00:00:31.041 --> 00:00:35.015 purple 00:00:35.015 --> 00:00:41.006 uh... nelson 00:00:41.006 --> 00:00:55.004 uh... 00:00:55.004 --> 00:00:59.091 rick 00:00:59.091 --> 00:01:01.012 here 00:01:01.012 --> 00:01:03.079 finance and 00:01:03.079 --> 00:01:09.004 okay guys right uh... i'm hoping that this focusing aborted its image as a bit 00:01:09.004 --> 00:01:12.019 of apprehensive about talking about this topic 00:01:12.019 --> 00:01:15.005 she does is big interests of my obviously and in my phd_ and i've been 00:01:15.005 --> 00:01:16.032 a lot of 00:01:16.032 --> 00:01:19.003 intensive research on it 00:01:19.003 --> 00:01:22.049 so to me is very interesting and so i think quite 00:01:22.049 --> 00:01:26.046 quite a lot about how to relate to you guys ab 00:01:26.046 --> 00:01:28.034 i'm radio 00:01:28.034 --> 00:01:32.084 i kind of full of al have more to talk about how happen 00:01:32.084 --> 00:01:34.069 apartments 00:01:34.069 --> 00:01:36.329 you how unpretentious the nature of 00:01:36.329 --> 00:01:39.859 clinic by back pain is i mean like that do his 00:01:39.859 --> 00:01:43.021 had back pain got back i know some of that time 00:01:43.021 --> 00:01:44.003 that's 00:01:44.003 --> 00:01:47.006 only about eight thirty which or sponsor 00:01:47.006 --> 00:01:50.027 research biggest quite interesting 00:01:50.027 --> 00:01:53.046 but they had just risk i give you an introduction of how our cargo in 00:01:53.046 --> 00:01:57.071 circuses allotted boss that i would say you know has again to back pains 00:01:57.071 --> 00:02:00.007 that we've 00:02:00.007 --> 00:02:02.082 like these that i i just finished my 00:02:02.082 --> 00:02:06.001 basses uh... degree in applies for science and 00:02:06.001 --> 00:02:11.219 before start that i was very interested in complex eisenhower relates that uh... 00:02:11.219 --> 00:02:13.092 health and fitness despite a shady and 00:02:13.092 --> 00:02:15.019 definitions and 00:02:15.019 --> 00:02:18.088 and the fact that excise can have on on the body so i i wanted in the floods 00:02:18.088 --> 00:02:23.849 both sides agree with uh... with my main focus being on excise physiology and 00:02:23.849 --> 00:02:27.169 at that time i was getting introduced a kind of concepts of high intensity 00:02:27.169 --> 00:02:31.779 training and show you guys are aware of what today doug mcgrath uh... 00:02:31.779 --> 00:02:32.919 off the jones 00:02:32.919 --> 00:02:37.079 and i i was reading the bear works as read my menses works at the time 00:02:37.079 --> 00:02:38.539 uh... hands 00:02:38.539 --> 00:02:43.029 kunkel incidently wedding bill two seven two so it's not my degrade 00:02:43.029 --> 00:02:46.098 uh... one of my lectures that was involved with them 00:02:46.098 --> 00:02:49.629 some research using that uh... medics equipment 00:02:49.629 --> 00:02:52.599 we specifically had at medics lumbar extension machine there 00:02:52.599 --> 00:02:55.999 and that is quite interesting that i was just reading boulevard today's but some 00:02:55.999 --> 00:02:59.069 time and i kind of a ride to the university and was like max max that 00:02:59.069 --> 00:03:01.019 would i know that name from 00:03:01.019 --> 00:03:03.068 out aliya opportunism in the back 00:03:03.068 --> 00:03:07.169 and i got involved in the research in a kind of stem from their redevelopment 00:03:07.169 --> 00:03:11.119 houston high intensity training went back with all the research um... 00:03:11.119 --> 00:03:14.098 as for the convinced by the evidence supporting and then move free kind of 00:03:14.098 --> 00:03:18.048 the same way off the progress from high intensity training grover norquist's and 00:03:18.048 --> 00:03:23.006 i'm leaving for it's a sent testing and then rehabilitation fill up back in the 00:03:23.006 --> 00:03:25.109 other possibility as well 00:03:25.109 --> 00:03:28.479 looking for the researchers orlow big holes 00:03:28.479 --> 00:03:30.073 in understanding of um... 00:03:30.073 --> 00:03:35.939 that probably what might be the main causative factor back pain 00:03:35.939 --> 00:03:39.067 and potentially how we can try and tree that i'm trying to be either prevent it 00:03:39.067 --> 00:03:42.054 or rehabilitated 00:03:42.054 --> 00:03:46.939 for people who do safra so today's talk i'm gonna try and zach 00:03:46.939 --> 00:03:50.269 kind of a personal decision of what will be why karva that will 00:03:50.269 --> 00:03:53.539 what was it you guys and you go part time 00:03:53.539 --> 00:03:56.329 yet 00:03:56.329 --> 00:03:58.119 exactly 00:03:58.119 --> 00:04:02.379 genesis says said united is really really annoying let's just have this 00:04:02.379 --> 00:04:04.579 chronic pain 00:04:04.579 --> 00:04:07.829 s around you at the whole time we're currently in a minute popping up up and 00:04:07.829 --> 00:04:08.042 down 00:04:08.042 --> 00:04:12.014 it's really annoying and you hirings are things in the conference is well if you 00:04:12.014 --> 00:04:17.039 go about backing that poster don't look so tracked it doesn't really convey 00:04:17.039 --> 00:04:19.109 kind message you want states to 00:04:19.109 --> 00:04:23.229 maybe women or other other people you china at the relationships of 00:04:23.229 --> 00:04:24.025 three to talk about 00:04:24.025 --> 00:04:26.729 it was important to care about it 00:04:26.729 --> 00:04:30.999 living in a discuss maybe maybe what you know why is it separate prevalent unit 00:04:30.999 --> 00:04:33.075 so if you've got a semi people of color 00:04:33.075 --> 00:04:36.043 the figures are really high 00:04:36.043 --> 00:04:39.349 if it's a hard as they'll be something that's that's causing as something 00:04:39.349 --> 00:04:42.389 that's having a real impact on and something that's meaning that it's going 00:04:42.389 --> 00:04:45.869 to you know that it's kind of time in society 00:04:45.869 --> 00:04:50.046 cynicism light my guide is uh... and based on my reading around the lectures 00:04:50.046 --> 00:04:52.459 of what remains of like 00:04:52.459 --> 00:04:55.419 associations of low about paying off 00:04:55.419 --> 00:04:58.569 and what i think has the most influencing factor a wide the majority 00:04:58.569 --> 00:05:00.979 of people suffer from it 00:05:00.979 --> 00:05:02.919 but any other kind of cupboard 00:05:02.919 --> 00:05:06.459 ni what you can actually do about it because it is so well in the pain this 00:05:06.459 --> 00:05:07.429 is causing it 00:05:07.429 --> 00:05:11.087 all of this might be causing is me the main factor 00:05:11.087 --> 00:05:13.013 now with a day 00:05:13.013 --> 00:05:15.069 it's good to have some information of the how can you talk about how can you 00:05:15.069 --> 00:05:18.539 do with that how can you do something about how can you bring the situation 00:05:18.539 --> 00:05:20.999 because this is the main reason while you guys again 00:05:20.999 --> 00:05:22.075 getting information and learning how to 00:05:22.075 --> 00:05:26.069 apply and improve unite your life basically 00:05:26.069 --> 00:05:30.259 i'm gonna spend the time just just kind of going over what what i'm doing in and 00:05:30.259 --> 00:05:32.032 uh... the impact i kind of envisage 00:05:32.032 --> 00:05:37.229 of my research is going to have until june bit about 00:05:37.229 --> 00:05:41.879 what specific areas on looking at one looking at them and how that kind of 00:05:41.879 --> 00:05:46.021 like is involved with with and about henry and then we'll connect they must 00:05:46.021 --> 00:05:47.033 be tough questions 00:05:47.033 --> 00:05:52.179 uh... just in case any of you on the web alone racial messed it up 00:05:52.179 --> 00:05:54.979 mats the love that 00:05:54.979 --> 00:05:59.006 the bond five rumbled up and that's when my main area of intro testers 00:05:59.006 --> 00:06:03.279 so anyone's go questions above that well below that 00:06:03.279 --> 00:06:07.018 i want to step outside my area of expertise sat ideally i can give you an 00:06:07.018 --> 00:06:11.129 opinion barefoot and i'll tell you i don't know uh... and style of the above 00:06:11.129 --> 00:06:12.949 the question benefiting 00:06:12.949 --> 00:06:16.022 inbetween those five that a bright 00:06:16.022 --> 00:06:19.011 i've probably got to know is i can give you did you get on some 00:06:19.011 --> 00:06:23.015 site jain sadie questions to something relevant 00:06:23.015 --> 00:06:26.109 i guess the why care about love at 00:06:26.109 --> 00:06:29.239 will first thing that there is to get back on the definition 00:06:29.239 --> 00:06:31.036 yet what is back pain 00:06:31.036 --> 00:06:34.909 if we don't have to ask tackle something and you know why isn't it important to 00:06:34.909 --> 00:06:36.062 care about it we need to kind of 00:06:36.062 --> 00:06:39.072 defined and i know what it means i campaigned saying yesterday uh... some 00:06:39.072 --> 00:06:41.199 words in some definitions 00:06:41.199 --> 00:06:42.062 lost many of the answer 00:06:42.062 --> 00:06:46.001 to tackle probably need to be up to define it and no what the problem that 00:06:46.001 --> 00:06:47.949 she is 00:06:47.949 --> 00:06:49.069 by planes used to describe 00:06:49.069 --> 00:06:53.026 as a kind of tension or so and insults stiffness their lease kind of words that 00:06:53.026 --> 00:06:54.065 used to describe 00:06:54.065 --> 00:06:57.044 what is a sense it over arching kind of condition 00:06:57.044 --> 00:06:59.089 in the lower back 00:06:59.089 --> 00:07:02.073 mike say any of these are the things then she sort of stiffness 00:07:02.073 --> 00:07:05.071 sharp pains anything about it can be annoying them and they have an impact on 00:07:05.071 --> 00:07:07.459 our lives 00:07:07.459 --> 00:07:08.062 we'll say five 00:07:08.062 --> 00:07:12.012 categorize our back payments a in surveys difference of what's up 00:07:12.012 --> 00:07:13.069 categories 00:07:13.069 --> 00:07:15.879 acute pain 00:07:15.879 --> 00:07:21.139 what we will be considered social time paints a lasting erupts ovr twelve weeks 00:07:21.139 --> 00:07:25.289 accutane would usually be involved with united an injury maybe sports injury may 00:07:25.289 --> 00:07:27.063 be tripped and says well you know anything 00:07:27.063 --> 00:07:29.639 that this should back out 00:07:29.639 --> 00:07:34.039 so to speak anne's and causing pain usually in the majority of cases acute 00:07:34.039 --> 00:07:38.002 pain kind of resolves itself almost kind of naturally 00:07:38.002 --> 00:07:41.025 even the research suggests that it doesn't really matter what you doing the 00:07:41.025 --> 00:07:45.047 actual pain will tend to go away after bouts of at most 00:07:45.047 --> 00:07:50.149 near upset so salt lamps are supposed to meet 00:07:50.149 --> 00:07:52.389 out that's of light line is a two week period 00:07:52.389 --> 00:07:53.031 the problem is 00:07:53.031 --> 00:07:54.099 is when the paint doesn't go away 00:07:54.099 --> 00:07:56.849 profits periods 00:07:56.849 --> 00:08:00.269 is tenzin said what we've encountered rises sub-acute pain 00:08:00.269 --> 00:08:03.279 and eventually develops into chronicling 00:08:03.279 --> 00:08:07.369 aykroyd has anything that any pain has lasted for a for a long period in twelve 00:08:07.369 --> 00:08:07.789 weeks 00:08:07.789 --> 00:08:09.199 and usually in those cases 00:08:09.199 --> 00:08:13.024 it's way develops in thirty years under some people who are involved in my 00:08:13.024 --> 00:08:14.052 research allied 00:08:14.052 --> 00:08:16.369 i'd been testing and and 00:08:16.369 --> 00:08:20.000 uh... rehab with to uh... some of them in our time 00:08:20.000 --> 00:08:23.095 for thirty years billy had spent the whole life in pain basically 00:08:23.095 --> 00:08:27.809 and i think there's no way to lead your life unit 00:08:27.809 --> 00:08:31.469 happy them suffering 00:08:31.469 --> 00:08:34.909 one of the other kind of problems that and i was speaking to and 00:08:34.909 --> 00:08:36.279 gentleman editor about it 00:08:36.279 --> 00:08:38.042 is a very differences come on 00:08:38.042 --> 00:08:41.005 uh... is very difficult to m 00:08:41.005 --> 00:08:43.759 give back pain in aloft cases 00:08:43.759 --> 00:08:47.073 a diagnosis i mean that we will go on for a second but there are a lot of 00:08:47.073 --> 00:08:50.039 different things associated with backpacking 00:08:50.039 --> 00:08:52.017 that 00:08:52.017 --> 00:08:55.249 maybe or may not be causing pain 00:08:55.249 --> 00:08:58.889 then maybe you'll may not be affecting the joints by mechanics and then having 00:08:58.889 --> 00:09:01.051 something impact on how the structures which may 00:09:01.051 --> 00:09:03.085 illicit a pain response 00:09:03.085 --> 00:09:07.082 or unit in may or may not be expecting um... functions are out how the joined 00:09:07.082 --> 00:09:09.055 by metaxas function 00:09:09.055 --> 00:09:14.579 so it all the time is very difficult to say right you you have back pain anne's 00:09:14.579 --> 00:09:17.061 this is causing your back pain or all of this is causing the pain that you're 00:09:17.061 --> 00:09:19.051 experiencing unanimity 00:09:19.051 --> 00:09:22.085 uh... nerve impingement and maybe uh... 00:09:22.085 --> 00:09:26.042 baghdad's degenerate correction this instance since causation 00:09:26.042 --> 00:09:29.099 and what you know it could be ligaments execute the must it could be actual 00:09:29.099 --> 00:09:32.699 unanimously saying elan's right 00:09:32.699 --> 00:09:33.002 uh... 00:09:33.002 --> 00:09:36.008 then the majority of cases diagnosis comes up 00:09:36.008 --> 00:09:40.052 so people labeled is nonspecific can go part time 00:09:40.052 --> 00:09:43.015 method and ideals 00:09:43.015 --> 00:09:46.014 most cases is very difficult then say oh if we don't know i fear what's causing 00:09:46.014 --> 00:09:49.007 it happened how harry's personnel to do about it 00:09:49.007 --> 00:09:52.005 and this is where the majority of my kind of like researchers involved with 00:09:52.005 --> 00:09:55.046 his dealing with 00:09:55.046 --> 00:09:57.035 is poorly causing that 00:09:57.035 --> 00:10:01.089 non-specific aspirate because it is and eighty five percent of 00:10:01.089 --> 00:10:02.097 people with chronic low back pain 00:10:02.097 --> 00:10:06.044 how this non-specific kasri given to them 00:10:06.044 --> 00:10:08.095 israel so by fifteen percent uh... 00:10:08.095 --> 00:10:11.096 you can say you know you know you've got this problem you've got the specific 00:10:11.096 --> 00:10:12.078 policy 00:10:12.078 --> 00:10:15.073 the specific conditions of our buttons that nichols in time 00:10:15.073 --> 00:10:19.098 so i'm focusing on conflict how can we figure out what's causing apple what may 00:10:19.098 --> 00:10:23.129 be the predominant because of that is non specific cases 00:10:23.129 --> 00:10:25.028 and how can we address 00:10:25.028 --> 00:10:28.082 so when i talk about uh... old previously lbp and 00:10:28.082 --> 00:10:30.067 in uh... the rest of the un 00:10:30.067 --> 00:10:31.051 but the slides 00:10:31.051 --> 00:10:34.012 unfocused specifically about nonspecific 00:10:34.012 --> 00:10:35.076 chronic low back pain 00:10:35.076 --> 00:10:39.008 says back pain without specific diagnosis that's lasting in a long and 00:10:39.008 --> 00:10:40.088 twelve weeks in 00:10:40.088 --> 00:10:42.759 and maybe the car rental unit 00:10:42.759 --> 00:10:50.007 people's pain perceptions change that 00:10:50.007 --> 00:10:53.099 said just a quick diagram for you and this is just a complex at the same for 00:10:53.099 --> 00:10:59.047 my research unwilling back to the kind of lay-up 00:10:59.047 --> 00:11:03.087 these guys im leave leaning lian lian lian 00:11:03.087 --> 00:11:04.071 uh... 00:11:04.071 --> 00:11:07.082 they've actually done a lot of research a lot of at reviews on the time i think 00:11:07.082 --> 00:11:09.057 really act and dysfunction 00:11:09.057 --> 00:11:13.054 and i put together this kind of uh... integrated model to say like 00:11:13.054 --> 00:11:18.046 well in in non specific cases uh... with unusual school function as as a as an 00:11:18.046 --> 00:11:19.459 outcome measure 00:11:19.459 --> 00:11:22.029 which is very difficult to say all i can try to um... 00:11:22.029 --> 00:11:25.011 for specific something specifically wrong with this 00:11:25.011 --> 00:11:29.019 structure altadena something is causing painewebber's nervous eleven 00:11:29.019 --> 00:11:33.035 and sony's function like the function of the joint joined by mechanics 00:11:33.035 --> 00:11:35.034 as an outcome measure 00:11:35.034 --> 00:11:37.072 blood as a taken this kind of kind of approach that they've use in the 00:11:37.072 --> 00:11:38.095 categories are used 00:11:38.095 --> 00:11:40.053 and adapted it said 00:11:40.053 --> 00:11:41.819 be applied to lie back 00:11:41.819 --> 00:11:45.139 so we've got got as cargo at that time as a kind of like entity as a kind 00:11:45.139 --> 00:11:46.001 concept 00:11:46.001 --> 00:11:51.018 and function as the outcome measure all functions as the perhaps rehabilitation 00:11:51.018 --> 00:11:51.909 go 00:11:51.909 --> 00:11:52.072 so 00:11:52.072 --> 00:11:55.054 one looking at is whether or not we can improve function 00:11:55.054 --> 00:11:57.054 we can definitely improved 00:11:57.054 --> 00:11:58.097 all these other 00:11:58.097 --> 00:12:02.014 areas uh... associating with 00:12:02.014 --> 00:12:06.059 may not necessarily because it is but certainly associated with caught up at 00:12:06.059 --> 00:12:09.036 night 00:12:09.036 --> 00:12:10.839 one thing i a m day 00:12:10.839 --> 00:12:14.004 is focusing on the physical characteristics involvement 00:12:14.004 --> 00:12:15.036 that's love dot 00:12:15.036 --> 00:12:18.649 section then psychological and so i can say show 00:12:18.649 --> 00:12:19.086 instances 00:12:19.086 --> 00:12:23.002 my resistance and the folks in alexander come from the excise physiology 00:12:23.002 --> 00:12:24.007 backgrounds and 00:12:24.007 --> 00:12:26.057 sold out 00:12:26.057 --> 00:12:30.017 there is a psychological impact acts like a social impact to stress impacts 00:12:30.017 --> 00:12:32.839 on pain perception which i'll discussed briefly 00:12:32.839 --> 00:12:34.002 and mind as well 00:12:34.002 --> 00:12:36.002 main focus of my recession might 00:12:36.002 --> 00:12:37.076 efforts are looking at 00:12:37.076 --> 00:12:40.013 what the actual physical symptoms are 00:12:40.013 --> 00:12:42.093 is the school said he said to tell whether or not 00:12:42.093 --> 00:12:46.057 dislike us at the psychological stress is causing the plane or whether or not 00:12:46.057 --> 00:12:48.001 it's 00:12:48.001 --> 00:12:49.093 causing psychological distress 00:12:49.093 --> 00:12:51.053 united services hall 00:12:51.053 --> 00:12:55.093 association doesn't necessarily imply causation 00:12:55.093 --> 00:12:58.077 unthinking his motherland on fixing the physical characteristics the more 00:12:58.077 --> 00:13:03.024 specifically in my research i'm thinking of fixing on things like range of motion 00:13:03.024 --> 00:13:05.044 you know if this generation 00:13:05.044 --> 00:13:09.004 the act actual atrophy if they uh... lumbar extensor musculature 00:13:09.004 --> 00:13:11.094 as the looking a bit sort of ad 00:13:11.094 --> 00:13:16.031 uh... skilled specific bomb attacks when we come up on the tax uh... if you guys 00:13:16.031 --> 00:13:18.089 are where pala build us a man's world 00:13:18.089 --> 00:13:20.022 most of you who are about 00:13:20.022 --> 00:13:23.008 seems videos threat 00:13:23.008 --> 00:13:27.048 fuzz it up yet ok ever anyone read my mail access 00:13:27.048 --> 00:13:29.529 yeah ok kitty co but left 00:13:29.529 --> 00:13:31.069 bill talks a lot of our time 00:13:31.069 --> 00:13:35.035 by mechanics that has as a an overarching sold like uh... 00:13:35.035 --> 00:13:36.028 subject 00:13:36.028 --> 00:13:39.096 uh... by metaxas display and so there are certain things that we we 00:13:39.096 --> 00:13:43.081 wet when bill talks about bond cactus talking specifically about uh... 00:13:43.081 --> 00:13:46.319 rolled from what governments works is um... 00:13:46.319 --> 00:13:49.007 joint structure anatomy function in a 00:13:49.007 --> 00:13:51.009 what i had some people michael functional kese ology 00:13:51.009 --> 00:13:56.003 uh... the bomb attacks also incorporates skills specific movements as well so 00:13:56.003 --> 00:13:59.096 free my plus full size three that we one-week were looking at buying tax we 00:13:59.096 --> 00:14:02.032 look at basically so what the physics of how 00:14:02.032 --> 00:14:06.044 particular movements uh... whether that elaborate so much support skills work on 00:14:06.044 --> 00:14:06.097 up 00:14:06.097 --> 00:14:10.007 and one of the senate things is looking and was cool gate which is basically you 00:14:10.007 --> 00:14:11.035 unit 00:14:11.035 --> 00:14:14.969 look for mostly commission's web describing an you like to mention 00:14:14.969 --> 00:14:17.909 and report back pains and have discovered variable datetime which 00:14:17.909 --> 00:14:18.047 doesn't 00:14:18.047 --> 00:14:22.096 fee the normal time which we see people hey that got back pain 00:14:22.096 --> 00:14:25.024 so that's just tell us that the saying an 00:14:25.024 --> 00:14:25.093 of 00:14:25.093 --> 00:14:29.084 what i'm looking at and why i think is an important to look at 00:14:29.084 --> 00:14:33.046 and we're going back to the family aside more determined to research and doing 00:14:33.046 --> 00:14:37.018 and why do you get so much important things that you know the results on 00:14:37.018 --> 00:14:48.076 huntington 00:14:48.076 --> 00:14:50.052 okay 00:14:50.052 --> 00:14:52.159 what's the as a senator 00:14:52.159 --> 00:14:53.028 quite low back pain 00:14:53.028 --> 00:14:54.093 really prevalent 00:14:54.093 --> 00:14:57.065 really unpretentious than a foot is in his word 00:14:57.065 --> 00:15:00.085 recently i think i might use their 00:15:00.085 --> 00:15:04.005 the kind of thing with the about me up on the time you want to mention dot com 00:15:04.005 --> 00:15:08.037 if this is unpretentious condition there that is everywhere everyone has their 00:15:08.037 --> 00:15:10.006 normal talks about it 00:15:10.006 --> 00:15:12.073 you know it is not laptop kind of scary you know 00:15:12.073 --> 00:15:17.018 as necessary killeen blaze interestingly in some cases that i've read uh... case 00:15:17.018 --> 00:15:20.056 there is an examples of people who've been slice of the stress 00:15:20.056 --> 00:15:23.039 by that i know that yet i felt suicidal 00:15:23.039 --> 00:15:26.075 hands and may be that goes back to the whole used business-like is a 00:15:26.075 --> 00:15:30.004 psychological stress causing pain or is the pain caused the psychological sts 00:15:30.004 --> 00:15:30.097 distress 00:15:30.097 --> 00:15:33.052 some interesting points 00:15:33.052 --> 00:15:36.027 but yet because this is kind of unpretentious unknown really kind of 00:15:36.027 --> 00:15:37.015 like 00:15:37.015 --> 00:15:38.093 thinks as a massive impact 00:15:38.093 --> 00:15:40.027 on society 00:15:40.027 --> 00:15:41.035 uh... 00:15:41.035 --> 00:15:42.299 it doesn't really get 00:15:42.299 --> 00:15:46.179 a lots of press shall we say on my things like cancer heart disease 00:15:46.179 --> 00:15:50.075 analysts at the city 00:15:50.075 --> 00:15:54.055 is definitely one of the most prevalent medically soul is in fact the world 00:15:54.055 --> 00:15:57.062 health organization did a big survey at 00:15:57.062 --> 00:16:00.006 as a love like uh... and in the nineteen nineties 00:16:00.006 --> 00:16:05.051 and zag actually ranked low back pain is the second most prevalent 00:16:05.051 --> 00:16:06.075 disorder 00:16:06.075 --> 00:16:10.279 uh... in uh... in that survey be anything that was interesting and called 00:16:10.279 --> 00:16:10.709 me 00:16:10.709 --> 00:16:15.589 and i have it was m unforeseen amiably and low back pain right-wing prevalence 00:16:15.589 --> 00:16:18.072 higher than almost everything out to clean your heart please cancel these are 00:16:18.072 --> 00:16:19.056 things 00:16:19.056 --> 00:16:23.075 and so i uh... it's a real problem and dan 00:16:23.075 --> 00:16:28.019 here's some of the estimates are that sixty to eighty percent of of adult 00:16:28.019 --> 00:16:31.051 we'll will suffer from back link so you need a new guys who have miss everybody 00:16:31.051 --> 00:16:32.064 paying now 00:16:32.064 --> 00:16:35.013 will have an expense in pain in the past 00:16:35.013 --> 00:16:38.065 it may come point you lots where it was very likely that you can suffer from 00:16:38.065 --> 00:16:42.048 back pain is gonna really cause you some problems 00:16:42.048 --> 00:16:43.006 anos a 00:16:43.006 --> 00:16:47.058 one interesting things is is the cost of back pain 00:16:47.058 --> 00:16:51.036 it may not have a massive impacts in the interest of like uh... 00:16:51.036 --> 00:16:52.489 severe 00:16:52.489 --> 00:16:53.075 impact 00:16:53.075 --> 00:16:57.025 that on all of our lives of some illnesses and conditions date 00:16:57.025 --> 00:17:00.089 but intends it costs it costs shit load of money 00:17:00.089 --> 00:17:05.069 every year some of the estimates are it costs about ten thousand a 00:17:05.069 --> 00:17:08.043 won the most recent estimates for the uk musicals they call me and direct 00:17:08.043 --> 00:17:11.309 and indirect costs about ten point six 00:17:11.309 --> 00:17:12.011 that ten 00:17:12.011 --> 00:17:14.169 point six thousand million 00:17:14.169 --> 00:17:16.037 sanders a billion 00:17:16.037 --> 00:17:18.074 about about ten million pounds a year 00:17:18.074 --> 00:17:23.007 lessen the direct and indirect costs last reunited cost of healthcare 00:17:23.007 --> 00:17:26.031 posterity and i i i'm one of these problems is the treatments that that 00:17:26.031 --> 00:17:28.036 utilized by people with back pain 00:17:28.036 --> 00:17:32.025 and assistant director of student if people go back on the part of the work 00:17:32.025 --> 00:17:35.009 than that both of those weapons they missed limits now i'm getting money for 00:17:35.009 --> 00:17:35.659 it 00:17:35.659 --> 00:17:38.078 working and provide value for that company in that companies or say missing 00:17:38.078 --> 00:17:39.023 out 00:17:39.023 --> 00:17:41.056 on the web at providing for them 00:17:41.056 --> 00:17:44.095 so there's all these complex lost involve all venice is big spiral that 00:17:44.095 --> 00:17:48.024 just keeps continuing costing more and more money and the way the kind of 00:17:48.024 --> 00:17:50.051 economy is going on the mine with rates inflation 00:17:50.051 --> 00:17:54.063 buzzing scott b skyrocketing even more 00:17:54.063 --> 00:18:02.309 big problem 00:18:02.309 --> 00:18:06.004 if i'm pain is so prevalent like if that is going to some reasons why it's 00:18:06.004 --> 00:18:11.071 prevalent in what's causing what is having an impact on it to make its such 00:18:11.071 --> 00:18:14.096 prevalent conditional society when we look 00:18:14.096 --> 00:18:18.064 epidemiologically sex which is a study of sort of like m 00:18:18.064 --> 00:18:24.006 epidemics of disease oval the political political 00:18:24.006 --> 00:18:27.047 we look at the school respect as we look at things are socially within that we 00:18:27.047 --> 00:18:31.007 can generate hypotheses about word and maybe is a is act was in 00:18:31.007 --> 00:18:35.037 it wasn't such a very uh... what link doesn't have to the actual conditions 00:18:35.037 --> 00:18:37.059 so we look at things cool risk factors 00:18:37.059 --> 00:18:40.004 and in fact i mean they're kind of mainly cell-free 00:18:40.004 --> 00:18:43.088 trains a full and kind of categories what types of respect this 00:18:43.088 --> 00:18:44.079 all 00:18:44.079 --> 00:18:46.067 responsible 00:18:46.067 --> 00:18:54.088 the conditions that that we say 00:18:54.088 --> 00:19:00.049 so one of these ab prospectuses these environmental and work-related expenses 00:19:00.049 --> 00:19:03.016 ansel played out latest pictures i see that i was just following and i don't 00:19:03.016 --> 00:19:05.559 really realize that soft or click on that site 00:19:05.559 --> 00:19:09.529 but but that they're supposed to have backpacks andrea 00:19:09.529 --> 00:19:14.027 you can't find him 00:19:14.027 --> 00:19:17.034 something which i remember this morning which i a m needs to remove told you 00:19:17.034 --> 00:19:20.026 about was that rice farmers interestingly 00:19:20.026 --> 00:19:24.035 uh... undergo close the while back has been a kind of interest of mind looking 00:19:24.035 --> 00:19:26.149 answer at back pain in 00:19:26.149 --> 00:19:28.046 but traditional indigenous of coaches 00:19:28.046 --> 00:19:29.989 also what alienated 00:19:29.989 --> 00:19:32.061 bike there and and evolutionary reasoning new unit 00:19:32.061 --> 00:19:34.009 is m 00:19:34.009 --> 00:19:38.067 between paul and i think in anytime lab spective of uh... the human sciences or 00:19:38.067 --> 00:19:43.012 any kind of like uh... biological sciences in exercises 00:19:43.012 --> 00:19:48.025 so he did just as a kind of like a example of people and have decided that 00:19:48.025 --> 00:19:51.005 working conditions and therefore carbide pollsters and that sort of thing that we 00:19:51.005 --> 00:19:54.019 experience during a work with libya 00:19:54.019 --> 00:19:57.074 extended seating fighting month five office jobs accenture 00:19:57.074 --> 00:20:00.096 will come by lifting that we experienced and doesn't really like a man who worked 00:20:00.096 --> 00:20:02.065 the last five a 00:20:02.065 --> 00:20:04.002 bustles sorts of things 00:20:04.002 --> 00:20:05.074 maybe lengths to 00:20:05.074 --> 00:20:07.083 high prevalence of backpacking 00:20:07.083 --> 00:20:09.077 unloaded tonight so with that 00:20:09.077 --> 00:20:12.046 you know you can ingi back lifting something hedley 00:20:12.046 --> 00:20:16.002 or lifting anything for that matter of fact if you lifting and stupid way 00:20:16.002 --> 00:20:17.077 if you've seen in a way that 00:20:17.077 --> 00:20:21.033 excessively loads perhaps the passage structures robin the muscles taken the 00:20:21.033 --> 00:20:22.045 like 00:20:22.045 --> 00:20:24.003 so you know i'm not denying that 00:20:24.003 --> 00:20:27.064 you can hurt your back doing stupid stuff at work or or in whatever 00:20:27.064 --> 00:20:28.082 environment you're in 00:20:28.082 --> 00:20:30.059 but interestingly 00:20:30.059 --> 00:20:34.019 i was looking at it and some research in thailand slickers and see whether or not 00:20:34.019 --> 00:20:38.098 they prevalence of back pain was as high in thailand as it is in 00:20:38.098 --> 00:20:40.022 other cultures in the world 00:20:40.022 --> 00:20:43.649 and the kind of that prevalence of pieces it is it's very difficult 00:20:43.649 --> 00:20:47.057 skylight link things the government draw direct comparisons 'cause methodologies 00:20:47.057 --> 00:20:48.069 are always different 00:20:48.069 --> 00:20:51.055 indifference studies which is was a problem when you try and uh... in 00:20:51.055 --> 00:20:53.087 separate them 00:20:53.087 --> 00:20:57.067 but one interesting thing was an analytical the acid oakley who teaches 00:20:57.067 --> 00:21:01.036 law about pollster and thinks it's very important 00:21:01.036 --> 00:21:05.002 highlighted to me that uh... innovative i watched uh... 00:21:05.002 --> 00:21:06.084 fingerboard chests not uh... 00:21:06.084 --> 00:21:09.044 gava resident americans were back in a fast 00:21:09.044 --> 00:21:13.009 uh... their posters on the bending lifting is these brilliant to keep 00:21:13.009 --> 00:21:14.289 neutral spine 00:21:14.289 --> 00:21:18.929 intended the hips an extended hours and hours a day spent and that poster bend 00:21:18.929 --> 00:21:19.077 down 00:21:19.077 --> 00:21:23.057 picking up or checked checked sounds and she says his picture and 00:21:23.057 --> 00:21:27.067 which outcome regret nothing on it now but i am of these what these women with 00:21:27.067 --> 00:21:29.001 his wonderful pasta 00:21:29.001 --> 00:21:31.047 spending hours a day and that posture and yet 00:21:31.047 --> 00:21:33.058 seem to have no at that time 00:21:33.058 --> 00:21:36.058 and she kind of used as a burst of like uh... 00:21:36.058 --> 00:21:39.065 eye-catching tool to cut my heart like uh... i like this 00:21:39.065 --> 00:21:43.035 so full of claims they saw that on the ground is a symptom of a resurgence in 00:21:43.035 --> 00:21:46.046 pictures and an offense interesting picture when i was looking to try and 00:21:46.046 --> 00:21:47.029 prevalence 00:21:47.029 --> 00:21:51.046 of uh... so much promise and rice farmers in in thailand in an abrasion 00:21:51.046 --> 00:21:54.019 country you can expect too much of the same job is spent 00:21:54.019 --> 00:21:55.046 than the day's bent down 00:21:55.046 --> 00:21:59.068 but here i sit in that mocha you know whatever is the kind of war he feels 00:21:59.068 --> 00:22:01.001 that way 00:22:01.001 --> 00:22:04.097 ands and interestingly that that you found showed the unit 00:22:04.097 --> 00:22:07.022 well half of the people in the picture you have this 00:22:07.022 --> 00:22:09.037 perfect posture newt respon 00:22:09.037 --> 00:22:10.062 bending of the hips 00:22:10.062 --> 00:22:14.098 and you know i reloading the spine in the mouth of the that these conflict and 00:22:14.098 --> 00:22:17.023 schools of thought would want you to bullies 00:22:17.023 --> 00:22:21.169 and the idea of a half of them had relief ship upstate new york hunched 00:22:21.169 --> 00:22:21.096 revolt 00:22:21.096 --> 00:22:26.659 bending down and using a standing hours a day in that position 00:22:26.659 --> 00:22:29.039 so much so therefore you know that's quite interesting considering that she's 00:22:29.039 --> 00:22:35.075 also saying that the rates of back pain in thailand quite loves wealth 00:22:35.075 --> 00:22:39.058 along the lines my foot much of the full of why i think is the time 00:22:39.058 --> 00:22:42.489 could only the causative factor although maybe 00:22:42.489 --> 00:22:45.037 the majority of almost irresponsible 00:22:45.037 --> 00:22:48.073 is that i was on for a second is one of the physical characteristics of the 00:22:48.073 --> 00:22:49.081 lumps popping 00:22:49.081 --> 00:22:51.004 and was that 00:22:51.004 --> 00:22:54.085 bless those odds you study done with ross thomas he found that 00:22:54.085 --> 00:22:57.009 rice farmers with lower 00:22:57.009 --> 00:23:01.026 strength levels in that lumber expenses actually had a high rate of back pain 00:23:01.026 --> 00:23:05.049 and that was the factor that was most associated with it now doesn't so imply 00:23:05.049 --> 00:23:06.629 causation 00:23:06.629 --> 00:23:08.062 but it's interesting that 00:23:08.062 --> 00:23:12.025 the actual working conditions didn't really have a big impacts 00:23:12.025 --> 00:23:14.001 weber all they have backpacking 00:23:14.001 --> 00:23:18.015 so what we can usually says if there is no association is quite like me that's 00:23:18.015 --> 00:23:19.079 probably know causative 00:23:19.079 --> 00:23:24.007 so it is very difficult complex a lena is definitely the majority of people are 00:23:24.007 --> 00:23:27.042 getting back pain because that spending time than i ever lisp and science flash 00:23:27.042 --> 00:23:29.559 in the states will sign opposition the web 00:23:29.559 --> 00:23:32.539 because they're new situations just on consistent 00:23:32.539 --> 00:23:35.009 they're all over the place in the may be affected by methodologies in the 00:23:35.009 --> 00:23:36.058 populations in the catholic 00:23:36.058 --> 00:23:39.036 and thus the consistent is very difficult to say yet definitely that 00:23:39.036 --> 00:23:44.073 message russell what's happened so we need to 00:23:44.073 --> 00:23:49.041 comeback as of today the psychological family swings back into the hallway m 00:23:49.041 --> 00:23:57.039 work-related stuff and uh... work-related stress is 00:23:57.039 --> 00:24:01.025 other said mahmud focuses isn't probably on uh... and so i thought processes 00:24:01.025 --> 00:24:04.096 associates is melissa nicholson associated with back pain 00:24:04.096 --> 00:24:07.799 and i want to step out of my bounds uh... that 00:24:07.799 --> 00:24:11.002 and cognitive behavior therapy is is a very sort of like prevalent that 00:24:11.002 --> 00:24:14.679 treatment options and i and the you're the research is trying to be pretty 00:24:14.679 --> 00:24:15.078 successful 00:24:15.078 --> 00:24:18.093 and in terms of an leading people's pain 00:24:18.093 --> 00:24:21.046 section but im 00:24:21.046 --> 00:24:22.074 interestingly 00:24:22.074 --> 00:24:25.008 and some of the research that i've looked at looks at has with the fact 00:24:25.008 --> 00:24:28.039 that the soldiers in chicago i stress the soldiers and and psychological 00:24:28.039 --> 00:24:29.084 sensitivity 00:24:29.084 --> 00:24:31.669 and and found that 00:24:31.669 --> 00:24:33.019 injury cases they're not 00:24:33.019 --> 00:24:34.087 necessarily associative 00:24:34.087 --> 00:24:37.049 with the prevalence of le backpacking 00:24:37.049 --> 00:24:41.021 they affect the degree of love acting cell asserted that the intensity of the 00:24:41.021 --> 00:24:42.054 plane experience 00:24:42.054 --> 00:24:45.082 so it's not the kind of like four to me that suggests well 00:24:45.082 --> 00:24:46.729 maybe 00:24:46.729 --> 00:24:50.083 psychological stress and most of the things all having you know the director 00:24:50.083 --> 00:24:53.000 of direct impact on howell 00:24:53.000 --> 00:24:56.085 much background people all how prevalent back pain is certainly one of the story 00:24:56.085 --> 00:24:59.002 be the main causative factor 00:24:59.002 --> 00:25:01.095 it's also by holistic approach to the 00:25:01.095 --> 00:25:05.059 they can have an impact on the penny to safety preserves the perception that 00:25:05.059 --> 00:25:09.052 uh... it's it's considering that it's time to see the brain 00:25:09.052 --> 00:25:10.509 hands and 00:25:10.509 --> 00:25:13.989 any kind of stress is not necessarily have an impact on what the sections you 00:25:13.989 --> 00:25:17.063 have of that and response 00:25:17.063 --> 00:25:22.015 was important it's monastery myers focused and attendance of think it's 00:25:22.015 --> 00:25:25.093 unit remains hoping plays an important thing to consider perhaps 00:25:25.093 --> 00:25:27.049 in an 00:25:27.049 --> 00:25:31.049 addressing people's pain perceptions 00:25:31.049 --> 00:25:35.049 and lastly won the race as a respect as we look at 00:25:35.049 --> 00:25:38.064 uh... these physical acceptance that when we talk about his work at respect 00:25:38.064 --> 00:25:40.259 as we're talking about times and 00:25:40.259 --> 00:25:43.086 but demographic characteristics and i like height weight 00:25:43.086 --> 00:25:47.004 below the only things that i'm uh... people's physical 00:25:47.004 --> 00:25:48.419 characteristics 00:25:48.419 --> 00:25:51.096 and some of these things are we looking at like uh... join structures join 00:25:51.096 --> 00:25:52.077 function 00:25:52.077 --> 00:25:55.069 uh... how how the joint actually physically functions like i say no 00:25:55.069 --> 00:25:59.009 they're going to function of the joint and so you know that could be in the 00:25:59.009 --> 00:26:03.046 love acted to strengthen lumber expenses that you feel that well but that's the 00:26:03.046 --> 00:26:05.072 anil diagram and 00:26:05.072 --> 00:26:09.015 petty from one of our jags but uh... just showing a lumbar extension 00:26:09.015 --> 00:26:10.076 and sent uh... 00:26:10.076 --> 00:26:14.075 and his lodi vanfleet looking at things like range of motion as well and that 00:26:14.075 --> 00:26:19.093 the check i might grow strong regulation and on the stage a specific number 00:26:19.093 --> 00:26:24.001 dimension which we talk about that alonso 00:26:24.001 --> 00:26:32.035 excuse me 00:26:32.035 --> 00:26:37.009 okay so i could send association doesn't necessarily imply causation 00:26:37.009 --> 00:26:41.075 started clover is difficult to say also if something's associated with it was 00:26:41.075 --> 00:26:45.066 really causing it liberalize just may be simply unite maybe something else is 00:26:45.066 --> 00:26:46.085 underlying it 00:26:46.085 --> 00:26:49.045 and when this thing has an impact on a campaign 00:26:49.045 --> 00:26:50.033 is prevalent 00:26:50.033 --> 00:26:53.043 and something else is provided as well these kind of a conditions because very 00:26:53.043 --> 00:26:57.429 difficult i'd like to say i'm what's causing wall 00:26:57.429 --> 00:26:59.072 in the majority of cases 00:26:59.072 --> 00:27:02.098 found at the same opinion is as researchers likes to have a gala benefit 00:27:02.098 --> 00:27:06.073 you've you've had it is his name is quite big names alone about 00:27:06.073 --> 00:27:09.039 uh... by mechanics and rehabilitation 00:27:09.039 --> 00:27:10.077 uh... 00:27:10.077 --> 00:27:13.429 even if you know i mean in general agreement with him 00:27:13.429 --> 00:27:16.036 that in the jury cases pain has an organic 00:27:16.036 --> 00:27:17.019 souls 00:27:17.019 --> 00:27:20.056 okay and injury or some sort this function of the joint 00:27:20.056 --> 00:27:27.005 because it is what initially causes move sequence of events that leads to 00:27:27.005 --> 00:27:31.006 he fixes along harrel and very stiff physical characteristics of columbus 00:27:31.006 --> 00:27:35.045 find have an impact on injury uh... thresholds and and and the injuries that 00:27:35.045 --> 00:27:36.067 you've infects 00:27:36.067 --> 00:27:38.041 and dan 00:27:38.041 --> 00:27:41.064 usa distinctions between where for all of the uh... 00:27:41.064 --> 00:27:47.799 yet acute injuries all chronic injuries as well netware broadband 00:27:47.799 --> 00:27:51.006 you know yesterday like an acute chiseled like sprain or 00:27:51.006 --> 00:27:53.052 high-impact an injury a liberal that 00:27:53.052 --> 00:27:55.038 anne anne 00:27:55.038 --> 00:27:56.088 these words right now 00:27:56.088 --> 00:28:02.034 uh... a repressive injury at for example like maximize get the texas rangers 00:28:02.034 --> 00:28:06.039 people get reports of injuries which can develop in c chronic back pain the lungs 00:28:06.039 --> 00:28:08.429 spine as well you know it's a really 00:28:08.429 --> 00:28:12.022 get tackle from behind the rugby of whatever so quickly backed out 00:28:12.022 --> 00:28:15.048 it may be sustained loading and sustained injury 00:28:15.048 --> 00:28:20.029 very small small small just builds up a discount like running response 00:28:20.029 --> 00:28:23.058 and what does that mean is off to a injury a series of events happens which 00:28:23.058 --> 00:28:25.399 leads to spot of high response 00:28:25.399 --> 00:28:29.069 the actual at peripheral nervous systems or data structures and uh... person in 00:28:29.069 --> 00:28:31.419 their structures become sensitizing come really 00:28:31.419 --> 00:28:35.016 sensitive to pangs anymore compass simulations as joy they structures 00:28:35.016 --> 00:28:37.008 willis eaten for the pain response 00:28:37.008 --> 00:28:40.055 and some of the things that you know if you can get directness and pension 00:28:40.055 --> 00:28:43.046 because of a with joined by mechanics because of the function 00:28:43.046 --> 00:28:47.074 uh... and discs and other tissues as well facet joints it's just easier to 00:28:47.074 --> 00:28:52.051 handle it and it seems fine that date that's right and had to have muscular 00:28:52.051 --> 00:28:55.019 and ligaments officially they will have no supplies 00:28:55.019 --> 00:28:57.023 so they can all feel kind of any kind like 00:28:57.023 --> 00:29:00.053 alterations that by the tax may be something that's responsible for 00:29:00.053 --> 00:29:01.096 sensitizing those 00:29:01.096 --> 00:29:02.749 nerves 00:29:02.749 --> 00:29:06.279 and then subsequently sitting up a series of n since i was the rest of the 00:29:06.279 --> 00:29:09.014 uh... same response 00:29:09.014 --> 00:29:15.075 says maybe white white paint private developments mccormick condition as well 00:29:15.075 --> 00:29:18.008 you know one thing i just want to point out is something interesting laid out in 00:29:18.008 --> 00:29:27.929 a again how made what you guys followed local yukon abilities but does 00:29:27.929 --> 00:29:31.062 well the big he cannot hide real of research and i really love lots of out 00:29:31.062 --> 00:29:34.038 of the book the great source of information such as you can find good 00:29:34.038 --> 00:29:35.509 blogs from bike 00:29:35.509 --> 00:29:37.094 interesting and and 00:29:37.094 --> 00:29:42.036 and critical correctly thinking and russian peoples uh... are full of logs 00:29:42.036 --> 00:29:43.031 written by 00:29:43.031 --> 00:29:45.799 and very species and doctors center 00:29:45.799 --> 00:29:49.799 and but why does a is was a full is a guy called photography bro's vocal 00:29:49.799 --> 00:29:54.014 better movement and he's over so blood brain senses approach on um... 00:29:54.014 --> 00:29:56.074 pain and and and he is uh... 00:29:56.074 --> 00:29:59.076 questions for back pain 00:29:59.076 --> 00:30:03.041 and interestingly uh... heated up a couple of studies that show was aware of 00:30:03.041 --> 00:30:04.084 announcing of the stories where 00:30:04.084 --> 00:30:08.088 some people who have abnormalities in the lower back 00:30:08.088 --> 00:30:12.058 discount haitians of exposing myself think 00:30:12.058 --> 00:30:15.016 shows no pain symptoms 00:30:15.016 --> 00:30:19.549 so alarm people cause like jumps on top and wagon to say 00:30:19.549 --> 00:30:23.052 you know if if that's not being as they go back problem but not all time 00:30:23.052 --> 00:30:29.002 then maybe that's not responsible for paying the first place 00:30:29.002 --> 00:30:33.009 but i think i'm set said like injury cases pain does seem to have an organic 00:30:33.009 --> 00:30:36.003 kind of like like souls icon stimulates appetite 00:30:36.003 --> 00:30:39.099 and one of things as an impact on my sisters their tv injury as well 00:30:39.099 --> 00:30:42.088 when you can't look at these have studies which metabo malfeasance 00:30:42.088 --> 00:30:44.013 incidents 00:30:44.013 --> 00:30:48.008 tends to find that the actual and degree of injury 00:30:48.008 --> 00:30:51.087 if for example we looking at the disks of dust can begin to degenerate make and 00:30:51.087 --> 00:30:53.058 then softball which 00:30:53.058 --> 00:30:56.084 and they couldn't center at that point stop pressing on earth and causing pain 00:30:56.084 --> 00:30:57.058 response 00:30:57.058 --> 00:31:00.078 or they they could have a completely within which case you know they can 00:31:00.078 --> 00:31:04.044 cause a real slow like impingement on that uh... nervous tissue would need to 00:31:04.044 --> 00:31:05.082 move down into the 00:31:05.082 --> 00:31:07.889 actual blood-brain units stimulators 00:31:07.889 --> 00:31:11.087 inflammatory cascade of events that that can cause a racial painful response 00:31:11.087 --> 00:31:14.047 and it seems to me that that the majority of links 00:31:14.047 --> 00:31:19.011 and between abnormalities in pain for a lot more satiated with at the severity 00:31:19.011 --> 00:31:20.001 of them 00:31:20.001 --> 00:31:22.019 so the ratio of light 00:31:22.019 --> 00:31:24.027 lotus verity and injuries 00:31:24.027 --> 00:31:29.059 uh... abnormalities when necessary it's highly associated with um... back pain 00:31:29.059 --> 00:31:32.029 the thing to do is come by at least this state's response relationship between 00:31:32.029 --> 00:31:36.002 how badly injured the spinal how badly deteriorated wars 00:31:36.002 --> 00:31:39.039 and the extent of pain experienced 00:31:39.039 --> 00:31:41.051 so maybe they even when we see an abnormality 00:31:41.051 --> 00:31:46.309 it may not necessarily be sufficient enough to cause the pain response yet 00:31:46.309 --> 00:31:50.179 also we've got an examples with some people have since in some people say 00:31:50.179 --> 00:31:52.001 they experienced pain 00:31:52.001 --> 00:31:53.669 the scan showed 00:31:53.669 --> 00:31:54.084 nighttime soap 00:31:54.084 --> 00:31:56.079 also no amounts itself 00:31:56.079 --> 00:31:58.094 am 00:31:58.094 --> 00:32:01.063 and this is this is interesting as well because a lot people may become a little 00:32:01.063 --> 00:32:02.047 erica 00:32:02.047 --> 00:32:04.929 whether it's a caring 00:32:04.929 --> 00:32:09.045 evidence uh... sorry and absence of evidence to main evidence of absence 00:32:09.045 --> 00:32:14.003 side is this whole inmates in the senate as uh... a phrase it that they use and 00:32:14.003 --> 00:32:16.034 which is 00:32:16.034 --> 00:32:20.085 sorry absence of evidence doesn't indicate evidence absence faces hold you 00:32:20.085 --> 00:32:24.005 com prove the non-existence of something godlike and that's what we're talking 00:32:24.005 --> 00:32:28.639 about his family entertainment 00:32:28.639 --> 00:32:30.019 it's 00:32:30.019 --> 00:32:33.679 is a logical jumped that i'm a logical jumps i'd say that just because you can 00:32:33.679 --> 00:32:37.016 see something on this particular scan 00:32:37.016 --> 00:32:39.025 there's nothing that the festive season 00:32:39.025 --> 00:32:42.072 am so that you had the scam i hadn't made mister ouagadougou lawsuit estate 00:32:42.072 --> 00:32:46.007 using and i just like laugh as well now i'm not docking station said his 00:32:46.007 --> 00:32:50.096 admonition lines up that incident of of reason the research 00:32:50.096 --> 00:32:53.049 yet not not not the thing i missed something 00:32:53.049 --> 00:32:55.419 or perhaps the abnormality was there 00:32:55.419 --> 00:32:57.749 desensitized and create a kind response 00:32:57.749 --> 00:33:01.026 as potentially alleviate itself it's rotten lousy but 00:33:01.026 --> 00:33:03.038 tangling it because of the same size asian 00:33:03.038 --> 00:33:06.073 it's very difficult scott venues ease diagnostic tests to stay on the air 00:33:06.073 --> 00:33:09.023 power how worthwhile actually offered 00:33:09.023 --> 00:33:12.083 and zambia's any refers to the use of these tests in the country who was then 00:33:12.083 --> 00:33:17.002 that that clinicians like arafat's visit is that you can see contact 00:33:17.002 --> 00:33:21.036 this small number of people with that was an accurate diagnosis in most cases 00:33:21.036 --> 00:33:25.085 is no usually that useful 00:33:25.085 --> 00:33:29.063 this whole idea of how dangerous verity then conference on the side there's an 00:33:29.063 --> 00:33:31.000 injury fractals 00:33:31.000 --> 00:33:32.005 and 00:33:32.005 --> 00:33:36.045 in most cases when injury fresh fruit is exceeding along the lines plastered 00:33:36.045 --> 00:33:37.389 mcgill thinking 00:33:37.389 --> 00:33:41.799 it you'd kill joy structural have a particular um... level of of loading and 00:33:41.799 --> 00:33:44.024 i can't sustain before 00:33:44.024 --> 00:33:48.021 it's it breaks basically is like any kind of like engineering aspect it will 00:33:48.021 --> 00:33:49.039 be up to sustain 00:33:49.039 --> 00:33:53.429 uh... and start consented to have loading beforehand as boom 00:33:53.429 --> 00:33:56.689 and amber expand that made a spectacular failure 00:33:56.689 --> 00:33:58.049 and they all collapsed 00:33:58.049 --> 00:34:01.012 or but like an accused of a severe injury impact injury 00:34:01.012 --> 00:34:04.051 or maybe a sustained pat stipulating that may cause an injury i a verdict 00:34:04.051 --> 00:34:08.024 that period of time but as an injury fresh felt and they're gonna be things 00:34:08.024 --> 00:34:09.159 that impact 00:34:09.159 --> 00:34:11.149 how well you can 00:34:11.149 --> 00:34:14.002 opened to that'll how well you can sustain and 00:34:14.002 --> 00:34:18.349 leading before you actually and gets injury 00:34:18.349 --> 00:34:30.999 excuse me walter 00:34:30.999 --> 00:34:33.025 and his own mind refresh alerting them 00:34:33.025 --> 00:34:36.519 one important things in certainly coming from a uh... 00:34:36.519 --> 00:34:39.025 mciver excise phase that background is 00:34:39.025 --> 00:34:43.053 and be submitting a joint can't take is usually to be dependent upon the extent 00:34:43.053 --> 00:34:44.589 of 00:34:44.589 --> 00:34:48.639 resistance that the musculature holding the joined together can actually 00:34:48.639 --> 00:34:51.219 withstands 00:34:51.219 --> 00:34:53.619 if you've got week musculature 00:34:53.619 --> 00:34:56.799 that's joins dot is not to be out with stands much loading 00:34:56.799 --> 00:35:00.609 is going to be up to that you may have led injured mergers lefty 00:35:00.609 --> 00:35:02.019 characteristics as well 00:35:02.019 --> 00:35:05.869 uh... and strength and endurance you know the not separate things they go 00:35:05.869 --> 00:35:09.489 hand in hand if any of you familiar with the kind of opportunism analogies on 00:35:09.489 --> 00:35:10.339 that 00:35:10.339 --> 00:35:13.219 if for example you implement strength training program 00:35:13.219 --> 00:35:17.005 accessory any exciting east offer a little with a at maximum 00:35:17.005 --> 00:35:20.003 former max it as a hundred ql you improve 00:35:20.003 --> 00:35:22.859 increase that to syndicators 00:35:22.859 --> 00:35:25.919 and stuff so you can do one red mexicans killers 00:35:25.919 --> 00:35:27.038 and things to do 00:35:27.038 --> 00:35:28.075 eight reps with 00:35:28.075 --> 00:35:30.009 excuse 00:35:30.009 --> 00:35:33.089 can increase that you one red max two indicators 00:35:33.089 --> 00:35:36.489 then people began to get to do about a breadth of hasn't sixty hitler's 00:35:36.489 --> 00:35:38.059 interested person 00:35:38.059 --> 00:35:40.149 so your actual endurance 00:35:40.149 --> 00:35:43.949 the amount of rhetoric and to we've aggressive loans going up to some 00:35:43.949 --> 00:35:47.399 dangerous enormous you know if you previous championship reviewed your your 00:35:47.399 --> 00:35:48.042 insurance as well 00:35:48.042 --> 00:35:50.939 so there's no time like training for one or the other 00:35:50.939 --> 00:35:53.589 anne's doesn't have an impact on how well you can 00:35:53.589 --> 00:35:57.085 yet uh... withstand impact injuries no se sustained writing as well 00:35:57.085 --> 00:35:59.219 and dan 00:35:59.219 --> 00:36:02.459 twelve impacts on the visit the injury severity and then the impact that has on 00:36:02.459 --> 00:36:05.269 paying the sponsor 00:36:05.269 --> 00:36:08.519 interestingly and one of the most consistent things you find in in the in 00:36:08.519 --> 00:36:10.098 the lecture looking on on summation of studies 00:36:10.098 --> 00:36:13.098 is small populations into large-scale studies looking at least physical 00:36:13.098 --> 00:36:16.189 characteristics 00:36:16.189 --> 00:36:18.599 a lot of things associated with um... 00:36:18.599 --> 00:36:22.589 the actual number extensive musculature minimal two-fisted rectus finally muscle 00:36:22.589 --> 00:36:23.022 groups 00:36:23.022 --> 00:36:24.119 uh... 00:36:24.119 --> 00:36:25.071 shave in people with back pain 00:36:25.071 --> 00:36:27.489 they usually very weak 00:36:27.489 --> 00:36:28.099 and they're very agitated 00:36:28.099 --> 00:36:33.039 and they unit uh... compared to an older population of people without back tag 00:36:33.039 --> 00:36:37.044 packing that colin able to withstand is much stratton 00:36:37.044 --> 00:36:42.489 unloading as as the people who are suffering from that 00:36:42.489 --> 00:36:44.839 all of these and these things like that to fade 00:36:44.839 --> 00:36:45.073 the uh... 00:36:45.073 --> 00:36:48.099 lumbar extension strength 00:36:48.099 --> 00:36:52.179 lumber extensive activation is usually lauren s toward native people of back 00:36:52.179 --> 00:36:52.969 pain 00:36:52.969 --> 00:36:54.039 and we actually get 00:36:54.039 --> 00:36:56.569 interestingly as well 00:36:56.569 --> 00:36:59.889 is that people who have the q injuries 00:36:59.889 --> 00:37:03.509 tend to have innocent have associated lumbar muscle atrophy as well 00:37:03.509 --> 00:37:06.989 so certainly in the in the most if that's the people come into a with an 00:37:06.989 --> 00:37:10.859 acute injuries though you know that was done by uh... heights and click 00:37:10.859 --> 00:37:12.939 something 00:37:12.939 --> 00:37:15.053 and uh... the people who came in with acute injuries 00:37:15.053 --> 00:37:16.579 founder 00:37:16.579 --> 00:37:17.809 they had 00:37:17.809 --> 00:37:21.021 lumbar muscle wasting his well they didn't know follow-up study as well and 00:37:21.021 --> 00:37:24.058 also did some studies looking at people coming out of injuries up 00:37:24.058 --> 00:37:25.053 and found that 00:37:25.053 --> 00:37:28.033 the degree of the improvement in the back pain was actually related to the 00:37:28.033 --> 00:37:31.076 degree of improvement in the lumber mill musculature as well as the amount we 00:37:31.076 --> 00:37:32.073 actually 00:37:32.073 --> 00:37:37.579 uh... itouch stage in the amount of and improvement act financing 00:37:37.579 --> 00:37:38.909 says interesting that 00:37:38.909 --> 00:37:42.007 first-time and certainly the impact on whether it becomes chronic or not 00:37:42.007 --> 00:37:44.659 is also related to how 00:37:44.659 --> 00:37:52.189 strong and how lab well-developed the actual on the musculature is 00:37:52.189 --> 00:37:57.569 when i was in the stuff 00:37:57.569 --> 00:38:01.109 and it's not rush for the next time that sent on the phone sir 00:38:01.109 --> 00:38:04.519 wine okay 00:38:04.519 --> 00:38:07.619 but is it briefly just such a down on the indigenous populations that 00:38:07.619 --> 00:38:11.000 i have this kind of idea that well if it's a physical characteristic that is 00:38:11.000 --> 00:38:12.004 not necessary to be 00:38:12.004 --> 00:38:15.067 uh... environmental cause it causes all you know that holds online 00:38:15.067 --> 00:38:19.269 westernization you know what else is in the lift anything to win 00:38:19.269 --> 00:38:21.229 having impact supple 00:38:21.229 --> 00:38:23.799 i'm going to have a look 00:38:23.799 --> 00:38:24.091 western prostitutes 00:38:24.091 --> 00:38:28.089 with uh... i am indigenous in traditional population sea while the 00:38:28.089 --> 00:38:31.319 rates of back pain are and then see where they had a hearing to traditional 00:38:31.319 --> 00:38:32.024 pain you know 00:38:32.024 --> 00:38:34.025 final lifestyle but one of the our caller 00:38:34.025 --> 00:38:38.004 and actually unite reduce the rate at that time we see and all the times like 00:38:38.004 --> 00:38:41.289 and traditional populations are confined and 00:38:41.289 --> 00:38:43.059 literature on research on 00:38:43.059 --> 00:38:46.399 count me in the race with justice high in some cases higher 00:38:46.399 --> 00:38:48.009 than about time we have to get 00:38:48.009 --> 00:38:52.039 in um... western populations fish in the it doesn't really matter whether you 00:38:52.039 --> 00:38:55.859 convert hitting tradition diet lifestyle whatever 00:38:55.859 --> 00:38:58.032 you seem to seems to be back pain everywhere we go 00:38:58.032 --> 00:39:01.092 out the question honestly rule tide is because of that discrepancies in some of 00:39:01.092 --> 00:39:03.319 the research but 00:39:03.319 --> 00:39:04.021 on the whole 00:39:04.021 --> 00:39:09.059 is very very prevalent regardless of what you get it 00:39:09.059 --> 00:39:10.319 avodon 00:39:10.319 --> 00:39:13.092 a slight here with some of my recent forced us to quickly go either 00:39:13.092 --> 00:39:15.014 now if that's the case 00:39:15.014 --> 00:39:18.199 before the potentially there must be some sort of evolution reasoning for 00:39:18.199 --> 00:39:19.389 walleye 00:39:19.389 --> 00:39:24.219 we've got a high prevalence of back pain and to some sort structural 00:39:24.219 --> 00:39:29.959 btwn compromise perhaps uses the word to use that badly she's had to make uh... 00:39:29.959 --> 00:39:30.609 elation 00:39:30.609 --> 00:39:35.038 resulted in that means that we fuji dot we care about muscles than than we 00:39:35.038 --> 00:39:37.599 really need 00:39:37.599 --> 00:39:40.088 and i'll be right that i did everything since a m trying to book list i'm 00:39:40.088 --> 00:39:43.819 working a series of the moment 00:39:43.819 --> 00:39:46.309 which will be fascism 00:39:46.309 --> 00:39:50.047 just looking at how probable on the spot is involved in howell diane us all links 00:39:50.047 --> 00:39:54.011 if my research and have strengthened the lumber accents among muscles 00:39:54.011 --> 00:39:57.071 actually links back to that somehow there is an evolution basis for week 00:39:57.071 --> 00:40:00.119 lumber expenses 00:40:00.119 --> 00:40:02.889 just as a kind of power backup background 00:40:02.889 --> 00:40:06.369 holidays uses and the cat 00:40:06.369 --> 00:40:09.889 uh... what's the global market basically all twelve monkeys is generally 00:40:09.889 --> 00:40:12.088 absolutely representative of early 00:40:12.088 --> 00:40:16.939 hate bury my sanity sense of before the pain in the thick area and in the early 00:40:16.939 --> 00:40:18.399 nineteen when we left 00:40:18.399 --> 00:40:19.038 all boreal 00:40:19.038 --> 00:40:25.239 quarter panel four-legged opm trees will and locomotive dan 00:40:25.239 --> 00:40:29.099 and what we what we have those need to have a very long so sixty seven number 00:40:29.099 --> 00:40:31.999 that's right 00:40:31.999 --> 00:40:36.019 what then happened is is we kind of involved in the short back terrestrial 00:40:36.019 --> 00:40:42.419 have on the ground grounds and and branched and swing uh... 00:40:42.419 --> 00:40:45.749 and what's what's coming up more was never quite shortening of the land of 00:40:45.749 --> 00:40:46.409 right 00:40:46.409 --> 00:40:47.409 because 00:40:47.409 --> 00:40:50.629 using what's called regulation which got swinging between the trees requires a 00:40:50.629 --> 00:40:53.549 stable platform from which to break it from 00:40:53.549 --> 00:40:58.349 this is this is actually uh... andy and image of chimpanzees and 00:40:58.349 --> 00:41:02.549 uh... spinal sent his pelvis inconceivable in the spines school 00:41:02.549 --> 00:41:03.083 dramatically 00:41:03.083 --> 00:41:06.018 and what's also happened is the iliac crest 00:41:06.018 --> 00:41:07.209 have come up 00:41:07.209 --> 00:41:11.249 elongated and they cause like an entrapment of the lungs spine so what 00:41:11.249 --> 00:41:15.369 happens is is we've gone from big long spines really short spine with a lot of 00:41:15.369 --> 00:41:18.689 passive rigidity and all of passive uh... 00:41:18.689 --> 00:41:20.589 structural integrity of that 00:41:20.589 --> 00:41:23.059 so will subsequently happens 00:41:23.059 --> 00:41:28.039 is over that period of time we've gone from having a relatively massive strong 00:41:28.039 --> 00:41:32.069 erect respond i was involved in involved heavily in our locomotion 00:41:32.069 --> 00:41:35.359 touting a relatively small 00:41:35.359 --> 00:41:38.509 one in eight times a cross-section i ran across that you have a muscle as an 00:41:38.509 --> 00:41:40.989 impact on the actual math forced generate 00:41:40.989 --> 00:41:42.899 site smaller muscles 00:41:42.899 --> 00:41:46.709 jim remain weak muscles 00:41:46.709 --> 00:41:49.017 icahn says an evolution basis for y 00:41:49.017 --> 00:41:50.279 potentially 00:41:50.279 --> 00:41:52.369 a lot of people have got week back muscles 00:41:52.369 --> 00:41:54.099 and his wife seriously when i get people into testing 00:41:54.099 --> 00:42:00.109 in the lumber extension shame which of the freemen as well 00:42:00.109 --> 00:42:01.098 in that case what can you do about it 00:42:01.098 --> 00:42:06.629 where two different i'd like to methods of treatment as a passive treatments 00:42:06.629 --> 00:42:11.029 rashad payne absence of relief and this is one of the reasons why 00:42:11.029 --> 00:42:14.032 the costs of it's freezing back pain at the site hard 00:42:14.032 --> 00:42:17.016 is because a lot of treatment options focus on relieving the symptoms 00:42:17.016 --> 00:42:20.005 relieving the pain that the focusing on what the actual 00:42:20.005 --> 00:42:22.259 underlying causal factors 00:42:22.259 --> 00:42:25.719 so things like bed rest in a a depression pain killers that something's 00:42:25.719 --> 00:42:28.089 sarge they'll focus on pain relief 00:42:28.089 --> 00:42:29.349 and actually 00:42:29.349 --> 00:42:31.369 removing the perception of pain relief 00:42:31.369 --> 00:42:34.519 spirits as the great on the short time 00:42:34.519 --> 00:42:35.959 really painful 00:42:35.959 --> 00:42:38.949 but then she comes back because they haven't dealt with the coles and that 00:42:38.949 --> 00:42:44.179 would watch at actually the mechanism which is actually stimulating the times 00:42:44.179 --> 00:42:47.002 the value of the cells treatments and there is somebody 00:42:47.002 --> 00:42:50.058 is in terms of uh... the severity to frighten people really bad pain and you 00:42:50.058 --> 00:42:53.038 need to begin active treatment program 00:42:53.038 --> 00:42:56.779 sometimes the social treatments can be very useful indicating that process it 00:42:56.779 --> 00:42:58.012 is hard to accompany 00:42:58.012 --> 00:43:01.599 and get involved with the program 00:43:01.599 --> 00:43:06.849 in that respect we should be immediately dismissed as being completely deceitful 00:43:06.849 --> 00:43:09.109 that is of a role for the ms nine wall 00:43:09.109 --> 00:43:11.999 role they should play a treatment program 00:43:11.999 --> 00:43:14.859 and yet for three years and years and years doctors we recommend that 00:43:14.859 --> 00:43:16.999 breastfed back pain but 00:43:16.999 --> 00:43:21.299 that's done to realize now that doesn't really 00:43:21.299 --> 00:43:23.679 so stupid 00:43:23.679 --> 00:43:25.000 the next time area 00:43:25.000 --> 00:43:27.249 is abt active 00:43:27.249 --> 00:43:30.469 active on uh... treatment options which it would she have physical treatment 00:43:30.469 --> 00:43:33.002 options aimed at trying to address the actual course 00:43:33.002 --> 00:43:34.039 but at that time 00:43:34.039 --> 00:43:37.089 and that the traditional primaries in looking at physiotherapy sick physical 00:43:37.089 --> 00:43:38.669 manipulation of the joints 00:43:38.669 --> 00:43:40.169 and um... 00:43:40.169 --> 00:43:43.199 you know that there's a really long history of using uh... manipulation 00:43:43.199 --> 00:43:46.069 techniques such as mackenzie stuff and they've been very useful way in in 00:43:46.069 --> 00:43:47.064 research and adding 00:43:47.064 --> 00:43:50.005 in clinical practice in introducing pain outcomes 00:43:50.005 --> 00:43:51.719 and improving 00:43:51.719 --> 00:43:54.769 functional outcomes improving function of the of the joys of the uh... and 00:43:54.769 --> 00:43:57.759 physiotherapist manipulating 00:43:57.759 --> 00:43:59.075 well the problems that we had with it is 00:43:59.075 --> 00:44:03.095 and zan it's unfortunately lee just a a problem with the technique and therefore 00:44:03.095 --> 00:44:06.022 the cuff is effective for the writing is just that 00:44:06.022 --> 00:44:08.081 the technique relies on a subjective so flight 00:44:08.081 --> 00:44:12.069 uh... clinically wisdom if you like a third of the physiotherapists is very 00:44:12.069 --> 00:44:13.859 difficult to provide verse of like 00:44:13.859 --> 00:44:16.047 yet objectives and and valid measurement 00:44:16.047 --> 00:44:19.007 of what the joints actually doing so they can be useful is very difficult to 00:44:19.007 --> 00:44:20.069 that 00:44:20.069 --> 00:44:24.049 gets old white baseline measurement that you know is accurate and provide 00:44:24.049 --> 00:44:24.099 progressive 00:44:24.099 --> 00:44:29.091 intervention to try and solve tackle and every measure again get accurate results 00:44:29.091 --> 00:44:33.829 and thinking you know i definitely know that that's great 00:44:33.829 --> 00:44:37.139 so one things you can do instead is actually apply progressive sobai 00:44:37.139 --> 00:44:40.429 exercise prior program and not necessarily focus also but physical 00:44:40.429 --> 00:44:41.055 manipulation which 00:44:41.055 --> 00:44:43.059 to extend involves a 00:44:43.059 --> 00:44:47.339 uh... the combination of subjective sold like uh... interpretation and also the 00:44:47.339 --> 00:44:52.029 com wisdom of the actual physiotherapist 00:44:52.029 --> 00:44:55.589 now their free time i a reserve an excise indicate that we can look at 00:44:55.589 --> 00:44:57.419 which the lipstick admits that 00:44:57.419 --> 00:45:01.469 well in this kind of general activity which is basically decide their own 00:45:01.469 --> 00:45:04.039 get on with with it if you go back and get on with it just 00:45:04.039 --> 00:45:08.079 the active do what you can can you confirm run good do whatever take on a 00:45:08.079 --> 00:45:09.679 class 00:45:09.679 --> 00:45:13.299 and and some areas of research had focused on this new edition rows of the 00:45:13.299 --> 00:45:15.599 good outcomes in terms of payment spawns 00:45:15.599 --> 00:45:18.269 the problem is very difficult to say 00:45:18.269 --> 00:45:22.259 that they're holy affected because they don't necessarily houston and the 00:45:22.259 --> 00:45:23.119 phillies geez 00:45:23.119 --> 00:45:25.559 objective measures of function 00:45:25.559 --> 00:45:28.689 site it's very difficult to objectively say 00:45:28.689 --> 00:45:32.209 functional outcomes and improved pain meds were just for whatever reason maybe 00:45:32.209 --> 00:45:34.001 because of a conscious general 00:45:34.001 --> 00:45:35.043 outcome of the excise 00:45:35.043 --> 00:45:38.779 but it's very difficult to jets every validate that 00:45:38.779 --> 00:45:42.719 the second robot school of foreign zones of excise whole idea of stability trying 00:45:42.719 --> 00:45:46.499 them out of control training and it is very big in the complex pulls 00:45:46.499 --> 00:45:47.093 performance areas 00:45:47.093 --> 00:45:51.001 answer is a very big in rehab and areas as well 00:45:51.001 --> 00:45:51.009 and 00:45:51.009 --> 00:45:55.047 there are a number of problems that with this approach i failed uh... in terms of 00:45:55.047 --> 00:45:56.409 the actual 00:45:56.409 --> 00:45:59.299 controlled trials downstate look is the fact that this again 00:45:59.299 --> 00:46:01.649 it does show improvements 00:46:01.649 --> 00:46:05.529 outcome measures such pain and disability and that sort of thing 00:46:05.529 --> 00:46:09.559 the problem is on a theoretical basis is underlying um... 00:46:09.559 --> 00:46:13.679 premises very for very flawed it seems to be that in general 00:46:13.679 --> 00:46:17.979 it's probably just a generalized excise effect from doing the activities that 00:46:17.979 --> 00:46:19.819 having an impact on it 00:46:19.819 --> 00:46:23.169 physics behind them 00:46:23.169 --> 00:46:25.429 sinking 00:46:25.429 --> 00:46:28.289 so it was a little bit of the the whole motor control fit for a few dozen 00:46:28.289 --> 00:46:31.929 familiar with the hine says hiv_ lecture and certainly but we also have 00:46:31.929 --> 00:46:34.209 the political science 00:46:34.209 --> 00:46:39.359 they discussed in quite detailed yet how fast iv transpacific scalia's decline 00:46:39.359 --> 00:46:41.819 kal bounce around swiss for whatever 00:46:41.819 --> 00:46:45.079 these specific skills and and question the answer transference about scaling 00:46:45.079 --> 00:46:46.019 the actual 00:46:46.019 --> 00:46:49.469 muscle recruitment plans are you saying that stuff over activities 00:46:49.469 --> 00:46:50.409 site 00:46:50.409 --> 00:46:54.549 on that basis during these motor control instability exercises 00:46:54.549 --> 00:46:57.239 it's is very ten years to suggest that 00:46:57.239 --> 00:46:58.024 is the actual 00:46:58.024 --> 00:47:01.008 motor control has been transferred to them reduced pain and injury right 00:47:01.008 --> 00:47:05.039 reason improve disability it's probably just a general 00:47:05.039 --> 00:47:09.025 adaptation the actual masterchief rothman proven transference 00:47:09.025 --> 00:47:12.009 of the kind of skills involved 00:47:12.009 --> 00:47:16.046 another level as well as recent research at has focused on time 00:47:16.046 --> 00:47:19.064 news the white techniques of measuring at range of motion an actual joint 00:47:19.064 --> 00:47:20.439 mission 00:47:20.439 --> 00:47:21.909 into segments early 00:47:21.909 --> 00:47:25.017 sit on the spinal cancer that is not a five to four vote right 00:47:25.017 --> 00:47:28.048 and what a lot of research recently is fixed on is how those individuals are 00:47:28.048 --> 00:47:32.005 brand new even how the muscles surrounds those individual that a break 00:47:32.005 --> 00:47:33.989 control dot 00:47:33.989 --> 00:47:37.799 mind is that for the actual facets of the the whole matter controller syria 00:47:37.799 --> 00:47:41.099 and misinterpretation of that skill transparency 00:47:41.099 --> 00:47:43.339 but one of the problems of aids 00:47:43.339 --> 00:47:47.159 the to the studies of lots of people with back pain suggested ah... 00:47:47.159 --> 00:47:51.039 people with partner about backpacking have a lot of variability in the uh... 00:47:51.039 --> 00:47:55.119 sp into segments to movement of and that's a bright 00:47:55.119 --> 00:47:56.589 but the problem is 00:47:56.589 --> 00:47:58.299 so does everyone 00:47:58.299 --> 00:47:59.021 decision get 00:47:59.021 --> 00:48:00.229 above 00:48:00.229 --> 00:48:04.049 the solve love that's a bright with a majority of movement actually 'cause it 00:48:04.049 --> 00:48:05.229 seems to be that 00:48:05.229 --> 00:48:08.929 the movement is very into individual you've taken population of of healthy 00:48:08.929 --> 00:48:11.057 divisions and fun last variability between 00:48:11.057 --> 00:48:15.095 individuals so it makes it quite hard to then say well how is definitely 00:48:15.095 --> 00:48:17.076 that which is causing an impact 00:48:17.076 --> 00:48:21.045 on uh... united that show uh... function of the lungs spot because the majority 00:48:21.045 --> 00:48:22.949 movement because 00:48:22.949 --> 00:48:24.809 and the lower levels of uh... bright 00:48:24.809 --> 00:48:28.609 and a majority that movement is produced by the larger uh... musculature 00:48:28.609 --> 00:48:29.779 externally 00:48:29.779 --> 00:48:34.329 and compress images is provided by internal musculature again 00:48:34.329 --> 00:48:36.289 them out of control theory 00:48:36.289 --> 00:48:40.349 it's not necessarily training that particular skills particular skills and 00:48:40.349 --> 00:48:41.289 help 00:48:41.289 --> 00:48:44.329 so what we then move on to decide their progress strengthening and and in 00:48:44.329 --> 00:48:47.509 particular high-intensity sector 00:48:47.509 --> 00:48:50.013 without going into detail because on the web time 00:48:50.013 --> 00:48:53.037 of yet high intensity training principles and everybody was times beach 00:48:53.037 --> 00:48:56.899 read a little too literature in the area uh... 00:48:56.899 --> 00:48:59.079 and other lucrative mention actually there 00:48:59.079 --> 00:49:02.039 uh... i'm not sure toll-free paperwork done at the moment so hopefully i'll be 00:49:02.039 --> 00:49:02.919 have 00:49:02.919 --> 00:49:07.729 publishes some point you guys got to meet up to the crime scene 00:49:07.729 --> 00:49:08.053 buddy right yet 00:49:08.053 --> 00:49:10.299 progressive strengthening site 00:49:10.299 --> 00:49:14.629 resistance excise this could be 00:49:14.629 --> 00:49:16.539 one question mark side 00:49:16.539 --> 00:49:18.859 and is 00:49:18.859 --> 00:49:21.799 do these exercises trying the lumber extensive musculature 00:49:21.799 --> 00:49:23.269 through the dead lift 00:49:23.269 --> 00:49:25.549 good morning brian and share right 00:49:25.549 --> 00:49:28.499 generic insists i dot 00:49:28.499 --> 00:49:30.539 back extension excised 00:49:30.539 --> 00:49:33.299 one of the problems with all these excise is is 00:49:33.299 --> 00:49:34.007 they involve 00:49:34.007 --> 00:49:35.064 hip extension as well 00:49:35.064 --> 00:49:39.048 say there is movement of the hips as well as movement have the uh... 00:49:39.048 --> 00:49:41.739 outlook on the spot 00:49:41.739 --> 00:49:45.379 and when we're looking at a time kind of movements and so like rest compound 00:49:45.379 --> 00:49:46.229 movements 00:49:46.229 --> 00:49:48.689 the bollywood seem to find a way of 00:49:48.689 --> 00:49:52.799 making things efficient and making things things and and incision in terms 00:49:52.799 --> 00:49:54.015 of energy expenditure 00:49:54.015 --> 00:49:57.092 so when we looking excised involve movement around the hits 00:49:57.092 --> 00:50:02.062 larger and stronger muscles of the group at the if the and please and hamstrings 00:50:02.062 --> 00:50:05.015 fans do the majority of the like that 00:50:05.015 --> 00:50:06.048 now studies have been done 00:50:06.048 --> 00:50:07.739 to look at it 00:50:07.739 --> 00:50:10.289 activation of the lumbar extensor musculature 00:50:10.289 --> 00:50:14.659 in these various excise is in fact and we we uh... one of the students is just 00:50:14.659 --> 00:50:17.369 uh... compares the fact that lessons and 00:50:17.369 --> 00:50:18.529 traditional deadliest 00:50:18.529 --> 00:50:20.409 and you know the lumber stance is definitely 00:50:20.409 --> 00:50:21.629 active 00:50:21.629 --> 00:50:25.709 insensitive using a election on the fee which measures the image cracked version 00:50:25.709 --> 00:50:26.759 of the muscles 00:50:26.759 --> 00:50:31.159 and during it sizes bosses excise is being done 00:50:31.159 --> 00:50:34.399 that doesn't ask anything other than their activities and tell us the extent 00:50:34.399 --> 00:50:39.579 of activation accounting for their very schools involved with the technique 00:50:39.579 --> 00:50:44.269 lewis's their active uh... sending him out my number expenses are active 00:50:44.269 --> 00:50:48.949 but doesn't this lean mean that they're getting sufficient stimulus 00:50:48.949 --> 00:50:51.259 uh... produce an adaptive response 00:50:51.259 --> 00:50:53.699 they need to be loaded sufficiently 00:50:53.699 --> 00:50:57.024 and city sufficiently trashy produced and that the response 00:50:57.024 --> 00:50:58.097 boom of all of these excise is is 00:50:58.097 --> 00:51:01.319 they allow hit extension 00:51:01.319 --> 00:51:05.419 and they allow the collision hamstrings and the majority of the load bearing 00:51:05.419 --> 00:51:07.289 studies looking at comparing 00:51:07.289 --> 00:51:10.509 at traditional back extension chains with what we want to insect which is the 00:51:10.509 --> 00:51:13.109 lumber extension seem pretty fanatics 00:51:13.109 --> 00:51:16.026 both is that he's looking at and comparing the um... 00:51:16.026 --> 00:51:17.075 raymond share exercise 00:51:17.075 --> 00:51:20.369 to the lumber extension shea showed up 00:51:20.369 --> 00:51:22.479 as long as he picks engines allowed 00:51:22.479 --> 00:51:25.959 lowell insulated lumbar extension strength is an increased because of on 00:51:25.959 --> 00:51:30.499 the musculature presumably isn't loaded sufficiently interested sufficiently 00:51:30.499 --> 00:51:34.479 also am james fish in a guy's gonna be coming on sunday as well to the exiles 00:51:34.479 --> 00:51:35.799 intrusion kunin 00:51:35.799 --> 00:51:37.003 as just finished and 00:51:37.003 --> 00:51:39.849 a city he's been doing comparing this to think that left with the lumber 00:51:39.849 --> 00:51:42.018 extension chain and interestingly 00:51:42.018 --> 00:51:43.799 stiff but their lives 00:51:43.799 --> 00:51:46.969 that really improve your lumber extensive rammstein 00:51:46.969 --> 00:51:49.719 a couple of people grew the lumber extension straight 00:51:49.719 --> 00:51:55.279 not a significant agreeing on the whole most people didn't 00:51:55.279 --> 00:51:57.049 so what can we do we do that 00:51:57.049 --> 00:52:01.149 so if you've got guys maybe you know that all have access to quit my like 00:52:01.149 --> 00:52:04.789 this study in those cases yet 00:52:04.789 --> 00:52:08.009 how many of you from london actually 00:52:08.009 --> 00:52:09.829 ecology 00:52:09.829 --> 00:52:12.789 you guys will have access to the equipment 00:52:12.789 --> 00:52:16.016 back and then i think it is a facility cookies a training 00:52:16.016 --> 00:52:19.249 they have a full range of medics training equipment 00:52:19.249 --> 00:52:22.039 and they have a medical version lumbar extension chain here 00:52:22.039 --> 00:52:24.679 i think that an excise division as well 00:52:24.679 --> 00:52:28.069 legend is that they equipment we've got a university which has all the testing 00:52:28.069 --> 00:52:29.469 facilities on as well 00:52:29.469 --> 00:52:31.033 and the main principle behind it 00:52:31.033 --> 00:52:33.589 is the stress-strain systems 00:52:33.589 --> 00:52:37.066 so what is the changes in st is basically what the pelvis in place 00:52:37.066 --> 00:52:41.629 pipeline forced down on the theme is by the man 00:52:41.629 --> 00:52:46.759 uh... five-story mistresses kind of life opens to the point 00:52:46.759 --> 00:52:50.659 the football that applies force out the lower legs which hit three 00:52:50.659 --> 00:52:51.939 fema restraint 00:52:51.939 --> 00:52:55.709 which then combustible backwards the famous what doesn't really holds the 00:52:55.709 --> 00:52:59.639 pelvis down back against the spelled with a straight ahead 00:52:59.639 --> 00:53:01.079 and what happens then it 00:53:01.079 --> 00:53:05.096 is no movement forth and back actually athletes conf calf in the pelvis 00:53:05.096 --> 00:53:07.022 sony flexion 00:53:07.022 --> 00:53:08.499 extension 00:53:08.499 --> 00:53:10.069 movement that because 00:53:10.069 --> 00:53:12.879 just because of the lumber lunberg senses 00:53:12.879 --> 00:53:14.017 so we can do it 00:53:14.017 --> 00:53:17.077 as we can more effectively loaded at going back to the the evolution of the 00:53:17.077 --> 00:53:18.006 uh... 00:53:18.006 --> 00:53:21.259 perspective 00:53:21.259 --> 00:53:25.109 one of the reasons perhaps that we've got stronger lilac gleason hamstrings 00:53:25.109 --> 00:53:28.059 is because of the way out date patterns has evolved when we kind of like 00:53:28.059 --> 00:53:29.099 compaq children's 00:53:29.099 --> 00:53:34.024 we went sizzled has been hit sent me and katelyn if you think it how much of that 00:53:34.024 --> 00:53:35.035 these gorillas live 00:53:35.035 --> 00:53:39.013 and that involved a heavier influence of heavy involvement of the grease 00:53:39.013 --> 00:53:40.021 enhancing sec 00:53:40.021 --> 00:53:42.859 potentially there's a there's a powerful e dash away 00:53:42.859 --> 00:53:46.599 because we have changed again massively powerful must be strong 00:53:46.599 --> 00:53:50.098 and now in this position would go a long dated lumber uh... lumbar spine again 00:53:50.098 --> 00:53:56.089 to allow bipedal movement to to for example a two-legged walking 00:53:56.089 --> 00:53:57.004 and we've got his legacy of 00:53:57.004 --> 00:54:01.029 big strong voice and sing but we can spon muscles which creates its just 00:54:01.029 --> 00:54:01.065 uh... 00:54:01.065 --> 00:54:03.349 recipe for dan 00:54:03.349 --> 00:54:06.069 hi levels of the whole high prevalence of back pain 00:54:06.069 --> 00:54:07.075 so we can do is we can isolate it 00:54:07.075 --> 00:54:12.063 and effectively test in isolation attesting isolation is important because 00:54:12.063 --> 00:54:15.909 anne of the previous tests it that re says he's looking at 00:54:15.909 --> 00:54:16.072 extension 00:54:16.072 --> 00:54:18.909 to exit trump extension 00:54:18.909 --> 00:54:20.052 they've got it uh... 00:54:20.052 --> 00:54:24.829 the dispensing testing fantasy machine and not skip elvis so it's very 00:54:24.829 --> 00:54:26.429 difficult for them to say 00:54:26.429 --> 00:54:30.979 that with us and love back because the hips and and uh... hits the extension is 00:54:30.979 --> 00:54:32.095 involved in prison hamstrings involved 00:54:32.095 --> 00:54:35.054 to the actual measurements they take you to be a combination of all of those 00:54:35.054 --> 00:54:36.329 factors 00:54:36.329 --> 00:54:39.005 yukon in allies like that one factor 00:54:39.005 --> 00:54:43.019 was machine does is isolates that allows us to get varied objective invalid 00:54:43.019 --> 00:54:45.048 picture of lumbar spine function 00:54:45.048 --> 00:54:48.071 and we can measure for a full range of motion we can produce and and look at 00:54:48.071 --> 00:54:51.789 what i think uh... books like 00:54:51.789 --> 00:54:53.259 in general 00:54:53.259 --> 00:54:57.066 they would back pain since before we even below the top one or more range of 00:54:57.066 --> 00:54:58.489 strength 00:54:58.489 --> 00:55:01.249 when we look at things we have this common bell curve in the middle is the 00:55:01.249 --> 00:55:05.279 average some people release on some people over a three-week the most people 00:55:05.279 --> 00:55:06.015 back time 00:55:06.015 --> 00:55:07.189 tend to have 00:55:07.189 --> 00:55:08.068 really low levels 00:55:08.068 --> 00:55:10.046 of love of lumber extensions right 00:55:10.046 --> 00:55:11.094 they can't afford to let the norms 00:55:11.094 --> 00:55:16.819 will sally and just make it up to the ball range 00:55:16.819 --> 00:55:18.809 just to finish up at one of my thing 00:55:18.809 --> 00:55:23.259 so it's been like this um... dot and the military's top 00:55:23.259 --> 00:55:26.169 flaunt they're doing is looking at some research 00:55:26.169 --> 00:55:30.039 using the lumber extension james caan plug some of the gaps 00:55:30.039 --> 00:55:33.099 the number extension shames rehabilitation uh... and and and 00:55:33.099 --> 00:55:36.079 strengthening using high-intensity excise 00:55:36.079 --> 00:55:36.879 others 00:55:36.879 --> 00:55:39.789 cool just wrapping up 00:55:39.789 --> 00:55:41.027 what what is allows the war 00:55:41.027 --> 00:55:44.749 the majority of rescission is in a hell of a lot of research mechanic says that 00:55:44.749 --> 00:55:49.639 one yet improves lumbar extension center improves isolated lunberg lumber spon 00:55:49.639 --> 00:55:50.043 from chin 00:55:50.043 --> 00:55:52.499 right wheaton objectively measure that 00:55:52.499 --> 00:55:55.869 research shows that we know that works 00:55:55.869 --> 00:55:57.689 increased pain outcomes 00:55:57.689 --> 00:56:02.038 massive studies are studies have been got done using the uh... medics machine 00:56:02.038 --> 00:56:06.018 all the studies done in people with back pain should improve pain outcomes 00:56:06.018 --> 00:56:09.017 along with improved function prove number extension strength 00:56:09.017 --> 00:56:12.209 'cause reprieve strengthening prove joint function we've got a nice 00:56:12.209 --> 00:56:15.239 objective measure that would find pains reduced moved to file a disability 00:56:15.239 --> 00:56:18.639 levels nation using technical glitches 00:56:18.639 --> 00:56:19.091 amber improved as well 00:56:19.091 --> 00:56:22.013 two great we know that it works in terms of 00:56:22.013 --> 00:56:24.059 improving function an improving pang 00:56:24.059 --> 00:56:28.022 and if you've got guys can get access to the case of facilities you guys and 00:56:28.022 --> 00:56:31.579 access to it as well and if you've got and you can 00:56:31.579 --> 00:56:33.729 uh... take time incident 00:56:33.729 --> 00:56:37.419 fancy and an teas that strength in your muscles 00:56:37.419 --> 00:56:38.057 but the thing is 00:56:38.057 --> 00:56:43.029 coming back to these complex sensitive factors involved with back pain 00:56:43.029 --> 00:56:45.999 my fourth on on these are the potentially the most symptoms often 00:56:45.999 --> 00:56:47.519 causes 00:56:47.519 --> 00:56:49.959 to be interesting to see whether or not 00:56:49.959 --> 00:56:51.739 before addressing the 00:56:51.739 --> 00:56:56.039 potentially ultimate calls and uses the word ultima arash review familiar jack 00:56:56.039 --> 00:56:59.169 diamonds but dungeons and still uses live there 00:56:59.169 --> 00:57:02.409 proximal causes an ultimate courses 00:57:02.409 --> 00:57:07.619 yeltsin of course big what causes these things these extra proximal causes which 00:57:07.619 --> 00:57:09.529 then have an impact on the 00:57:09.529 --> 00:57:12.289 you know lax images like paying disability and that's ok 00:57:12.289 --> 00:57:14.249 and if we if we consider 00:57:14.249 --> 00:57:18.469 potentially week lumbar extension muscles of what's happening impact 00:57:18.469 --> 00:57:20.095 and causing these of uh... ishi's 00:57:20.095 --> 00:57:24.048 but limited range of motion degenerate fiske's indicate very that series of a 00:57:24.048 --> 00:57:26.429 physical symptoms 00:57:26.429 --> 00:57:28.043 what we might see is if we address that 00:57:28.043 --> 00:57:29.879 ultimate kalos 00:57:29.879 --> 00:57:33.249 we might see an impact on these of a possible causes well ease tension 00:57:33.249 --> 00:57:34.006 simpson's 00:57:34.006 --> 00:57:36.409 well my research is looking at 00:57:36.409 --> 00:57:40.209 physically improve lumbar extension strength 00:57:40.209 --> 00:57:44.109 we improve pain withdrew bridges pampered disability right 00:57:44.109 --> 00:57:45.389 week and we'll say 00:57:45.389 --> 00:57:46.639 with you decided 00:57:46.639 --> 00:57:50.039 of improving range of motion as well to solicit some of the research looking at 00:57:50.039 --> 00:57:51.829 has improved regulation 00:57:51.829 --> 00:57:53.699 one interesting thing is 00:57:53.699 --> 00:57:57.319 is most people back i have a limited range of motion to begin with 00:57:57.319 --> 00:58:00.339 so clinicians employees limited range of motion 00:58:00.339 --> 00:58:01.859 intervention 00:58:01.859 --> 00:58:05.075 now bill phyllis and i and talks a lot of our islands of regulation excised 00:58:05.075 --> 00:58:09.529 and the theoretical basis of why he suggests avoiding 00:58:09.529 --> 00:58:12.819 streams of the range of motion sensor for the lumber extensions can be 00:58:12.819 --> 00:58:15.041 extremes inflection extremes of extension 00:58:15.041 --> 00:58:18.059 is because in those positions the muscles on necessarily 00:58:18.059 --> 00:58:19.789 what's being loaded 00:58:19.789 --> 00:58:23.319 it may be the patent issues attendance ligaments lines they're gonna be what 00:58:23.319 --> 00:58:24.869 load as well 00:58:24.869 --> 00:58:27.066 so what what we're looking at doing is saying whether or not 00:58:27.066 --> 00:58:28.065 we can actually 00:58:28.065 --> 00:58:32.072 on the medics take the exercise limited to a very small range of motion avoiding 00:58:32.072 --> 00:58:36.319 those extremes of the world are still produces full range functional outcomes 00:58:36.319 --> 00:58:38.499 as if that still produces improvements in 00:58:38.499 --> 00:58:43.249 it's associates in tune with limited range of motion 00:58:43.249 --> 00:58:44.809 secondly within the kit 00:58:44.809 --> 00:58:46.022 in a very busy as well 00:58:46.022 --> 00:58:49.075 should admit when he came up to the lab we've got i was gonna buy consistent 00:58:49.075 --> 00:58:51.045 that's actually a freidy 00:58:51.045 --> 00:58:52.049 imaging system 00:58:52.049 --> 00:58:56.749 well and if any does he have high level of the rings is put together 00:58:56.749 --> 00:58:59.939 when they picked all the mystical these little night that ping-pong balls will 00:58:59.939 --> 00:59:00.054 ever end 00:59:00.054 --> 00:59:03.009 and he just doesn't list off the cameras recorded essentially the same system for 00:59:03.009 --> 00:59:04.619 too much 00:59:04.619 --> 00:59:08.869 and symbolic invaded as i can take distance ed and i can 00:59:08.869 --> 00:59:10.329 marketable up 00:59:10.329 --> 00:59:13.659 film than using these ten freidy cameras in the reconstruct that have an 00:59:13.659 --> 00:59:18.009 animation see exactly how their lungs spine is moving relative to that elvis 00:59:18.009 --> 00:59:21.064 well several king so i can see how very police to begin with 00:59:21.064 --> 00:59:25.026 and then look to see what impact strengthening those muscles has on 00:59:25.026 --> 00:59:28.078 improving the way they walk as well as britain is kind of extra simpson 00:59:28.078 --> 00:59:32.509 this is listed below that time 00:59:32.509 --> 00:59:34.129 and lastly as well 00:59:34.129 --> 00:59:36.209 we're going to look at 00:59:36.209 --> 00:59:39.279 effect looting has actually only 00:59:39.279 --> 00:59:41.005 numbers on the discs as well 00:59:41.005 --> 00:59:42.829 we know that you know 00:59:42.829 --> 00:59:47.319 progresses high-intensity strength training most the muscles improves must 00:59:47.319 --> 00:59:51.053 must papers like the increases have purchased a increases strength 00:59:51.053 --> 00:59:52.359 we know that 00:59:52.359 --> 00:59:56.289 increases bone mineral density in fact you know the status of that uh... 00:59:56.289 --> 00:59:59.819 what effect the lumber extension she has available by mineral density of the the 00:59:59.819 --> 01:00:01.949 strength and taken to the actual that's right 01:00:01.949 --> 01:00:04.042 and fowler increases by mineral density as well 01:00:04.042 --> 01:00:07.091 one thing i mean the time you see any structure the in the love that the that 01:00:07.091 --> 01:00:09.839 you know it has an impact on that 01:00:09.839 --> 01:00:12.002 i'd like to see whether actually has an effect on 01:00:12.002 --> 01:00:15.069 improving discount 01:00:15.069 --> 01:00:18.749 most people people about that time due to some extent especially as you get 01:00:18.749 --> 01:00:22.779 older they get unit fifty generation which concerns herniation bolting accept 01:00:22.779 --> 01:00:23.429 it 01:00:23.429 --> 01:00:26.259 and some people got this idea 01:00:26.259 --> 01:00:27.048 the more you move 01:00:27.048 --> 01:00:31.026 the more he creates variances impression across that says you ben folds back was 01:00:31.026 --> 01:00:32.579 the discs basically 01:00:32.579 --> 01:00:35.799 and gets washed and extending either side 01:00:35.799 --> 01:00:39.529 so it's not extension movements creatives 01:00:39.529 --> 01:00:41.046 squeeze mechanism is listing 01:00:41.046 --> 01:00:42.029 sundance 01:00:42.029 --> 01:00:47.449 and to increase hydration subdesc why one of the time the cap was well 01:00:47.449 --> 01:00:50.969 may be that that works in terms of physiotherapy what i'll be effective at 01:00:50.969 --> 01:00:53.053 the same time i does load have an effect on it 01:00:53.053 --> 01:00:57.159 and may well day because the study that that uh... 01:00:57.159 --> 01:00:59.459 uh... but you know that's the family 01:00:59.459 --> 01:01:01.229 the changes in 01:01:01.229 --> 01:01:04.779 but it was named traveled on the soft so but by no means area which is very 01:01:04.779 --> 01:01:08.024 closely associated with the disc alphas well as discs degenerate 01:01:08.024 --> 01:01:10.599 that since the generators muslim aviall inc 01:01:10.599 --> 01:01:12.719 that i could potentially have in effect 01:01:12.719 --> 01:01:16.299 ambitions well recent study was published uh... big city in germany 01:01:16.299 --> 01:01:17.119 found that 01:01:17.119 --> 01:01:18.014 uh... 01:01:18.014 --> 01:01:21.002 the heavy overloading of exercise because the people give weight lifting 01:01:21.002 --> 01:01:25.069 and that's all things and have better itself that people we do things like 01:01:25.069 --> 01:01:26.589 long distance running as well 01:01:26.589 --> 01:01:30.016 uh... leading of parcel of that the fat 01:01:30.016 --> 01:01:32.019 repetitive um... 01:01:32.019 --> 01:01:34.319 sports center in america running 01:01:34.319 --> 01:01:38.539 that triathlons bingo about aren't very good feedback health 01:01:38.539 --> 01:01:42.039 so there there's a potential link that whereby wife we ask that question we 01:01:42.039 --> 01:01:45.072 employ uh... employs invention the mud yeltsin effect 01:01:45.072 --> 01:01:47.053 on all these different outcomes 01:01:47.053 --> 01:01:50.809 and see whether or not in terms of the holistic approach 01:01:50.809 --> 01:01:56.079 this intervention can have in effect on all with the contacts that's about time 01:01:56.079 --> 01:01:59.092 so that that's the whole idea and hopefully i can 01:01:59.092 --> 01:02:03.009 i what provide some benefit you get uh... if anyone who gets back thank for 01:02:03.009 --> 01:02:06.043 the main time you know the research said he does suggest 01:02:06.043 --> 01:02:10.989 that anyone gets back pain should really be employing discarding intervention is 01:02:10.989 --> 01:02:12.048 very strongly supported 01:02:12.048 --> 01:02:17.033 and it's far more objective uh... method of uh... treatment than any other kinds 01:02:17.033 --> 01:02:21.359 of currently existing treatment 01:02:21.359 --> 01:02:25.019 thirteen blue 01:02:25.019 --> 01:02:28.069 just a summary of kind of what we call free that today 01:02:28.069 --> 01:02:29.909 consciously aware of the time 01:02:29.909 --> 01:02:35.709 so uh... if any questions 01:02:35.709 --> 01:02:38.989 to liberty at all 01:02:38.989 --> 01:02:42.549 yet 01:02:42.549 --> 01:02:48.079 um... so you mentioned in some cases the actual uh... 01:02:48.079 --> 01:02:53.279 if pain may not necessarily be the in which is simpson is 01:02:53.279 --> 01:02:55.629 little-noticed 01:02:55.629 --> 01:02:58.389 has your system of receiving it 01:02:58.389 --> 01:03:00.949 suggests is a correlation between 01:03:00.949 --> 01:03:04.479 loans at issue c of battlefield 01:03:04.479 --> 01:03:08.999 uh... on the list is not something that by specifically focused on this and i 01:03:08.999 --> 01:03:15.969 like him and uh... point of the at the beginning 01:03:15.969 --> 01:03:21.009 is not all wooden ones there come a step outside my area of expertise and says he 01:03:21.009 --> 01:03:24.299 is not something that i'm uil aware of whether or not there is a correlation 01:03:24.299 --> 01:03:27.739 and by the not looked extensively incidence of the research said that 01:03:27.739 --> 01:03:29.569 there may be that may not be at 01:03:29.569 --> 01:03:34.619 allied i'm not gonna show 01:03:34.619 --> 01:03:35.669 calm 01:03:35.669 --> 01:03:40.199 seems to me like uh... you weeks oldies usta medics machine 01:03:40.199 --> 01:03:41.139 uh... 01:03:41.139 --> 01:03:44.639 he said he had a way to smoke i don't think everyone else most people will 01:03:44.639 --> 01:03:48.299 have access to and uh... you know that you're absolutely right and and at 01:03:48.299 --> 01:03:51.389 assess as an idol in his it sounds 01:03:51.389 --> 01:03:55.989 of thinking sands of the way off by structures is an 01:03:55.989 --> 01:03:58.329 certainly the best waste it 01:03:58.329 --> 01:04:02.319 but it may not necessarily be the anyway 01:04:02.319 --> 01:04:05.042 some you could be any extras i went for it to begin with 01:04:05.042 --> 01:04:09.089 they do activate and loads of love back 01:04:09.089 --> 01:04:13.109 and in some cases though provide a stimulus fa 01:04:13.109 --> 01:04:15.019 producing adaptation in them 01:04:15.019 --> 01:04:19.319 and doug would have had to run for a few excise on on a few videos of potential 01:04:19.319 --> 01:04:21.091 access which you could use to local outback 01:04:21.091 --> 01:04:26.004 and that any reductions i have with excise lie that is already activated 01:04:26.004 --> 01:04:29.001 is very difficult because the research hasn't looked at it 01:04:29.001 --> 01:04:34.299 zero var less efficiently and loaded to produce an adaptation 01:04:34.299 --> 01:04:37.489 it looked like a scene with albrecht sizing a gem writes of jesus home but 01:04:37.489 --> 01:04:42.609 uh... control course ability and train assaulting improves out outcome measures 01:04:42.609 --> 01:04:44.109 such as pain 01:04:44.109 --> 01:04:48.109 is likely that there is something general adaptation so although the 01:04:48.109 --> 01:04:51.679 loading may not be sufficient to produce the degree of results that you season 01:04:51.679 --> 01:04:54.659 something is as uh... advanced medics mission 01:04:54.659 --> 01:04:58.219 um... is probably worth doing as long as you can do them appropriately in safe in 01:04:58.219 --> 01:05:03.039 united news i'm using falling satellite hines instant principles and venue 01:05:03.039 --> 01:05:04.042 you'll likely see and 01:05:04.042 --> 01:05:05.779 effect from them 01:05:05.779 --> 01:05:09.289 but if you want that's results diesel to best accomplish use the the best 01:05:09.289 --> 01:05:10.809 equipment available 01:05:10.809 --> 01:05:13.709 but yet it if you've not got access to them 01:05:13.709 --> 01:05:18.979 anza this is one of the reasons why i'm doing the research is well because a m 01:05:18.979 --> 01:05:23.739 just draw contrasts would fully and then x avonex website has a uh... as a 01:05:23.739 --> 01:05:26.094 facility like i said say is anyone buzznet equipment 01:05:26.094 --> 01:05:28.739 sensei then 01:05:28.739 --> 01:05:31.759 loaded uh... you have reached that would be a website annual concerts where 01:05:31.759 --> 01:05:32.769 facilities 01:05:32.769 --> 01:05:34.109 uh... in the uk 01:05:34.109 --> 01:05:35.769 there are five facilities 01:05:35.769 --> 01:05:39.529 and i think that's likely to no one's there six cities in the uk 01:05:39.529 --> 01:05:43.089 uh... which i have a medic slumber extension should content to just the 01:05:43.089 --> 01:05:44.048 florida area undecided 01:05:44.048 --> 01:05:45.075 which has about fifty ps 01:05:45.075 --> 01:05:47.719 seven facilities in dc 01:05:47.719 --> 01:05:51.459 say yahoo there loads 01:05:51.459 --> 01:05:56.329 have a lot of american life that is very complex hands at that time surrealism 01:05:56.329 --> 01:06:00.005 and edge investors but it but as the along war access available 01:06:00.005 --> 01:06:04.005 as a long time typing as it is so in this country people are aware of that 01:06:04.005 --> 01:06:05.859 dividend any options available 01:06:05.859 --> 01:06:08.689 although it's very sparse i think impolite 01:06:08.689 --> 01:06:11.869 doing the research at presenting a academic conferences and making 01:06:11.869 --> 01:06:14.039 precipitous inclinations more aware of it 01:06:14.039 --> 01:06:17.002 and showing how effective it potentially could be 01:06:17.002 --> 01:06:20.068 will hopefully make people's ours i think that warmed up pocket we need to 01:06:20.068 --> 01:06:23.047 get the sacrament we need to make it more variables that we can 01:06:23.047 --> 01:06:27.239 you know we can get that treatment option gehring hands at 01:06:27.239 --> 01:06:30.139 get sorted patients come in and use that 01:06:30.139 --> 01:06:33.919 but yeah i think i think i'm you can get benefit from of rec sizes but 01:06:33.919 --> 01:06:35.029 sorry 01:06:35.029 --> 01:06:38.299 so maybe has been the season 01:06:38.299 --> 01:06:39.008 that okay 01:06:39.008 --> 01:06:43.779 and has a guys if any of you go expressions tom bradley outfits 01:06:43.779 --> 99:59:59.999 isozyme