WEBVTT
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stage again here
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uh... is a man that just got his
bachelor's degree last year from seventh
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in solely university and is also working
on is phd_'s gonna talk about
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high-intensity exercise the lower back
give them a round of applause and james
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feel sick it say
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purple
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uh... nelson
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uh...
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rick
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here
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finance and
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okay guys right uh... i'm hoping that
this focusing aborted its image as a bit
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of apprehensive about talking about this
topic
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she does is big interests of my
obviously and in my phd_ and i've been
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a lot of
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intensive research on it
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so to me is very interesting and so i
think quite
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quite a lot about how to relate to you
guys ab
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i'm radio
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i kind of full of al have more to talk
about how happen
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apartments
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you how unpretentious the nature of
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clinic by back pain is i mean like that
do his
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had back pain got back i know some of
that time
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that's
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only about eight thirty which or sponsor
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research biggest quite interesting
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but they had just risk i give you an
introduction of how our cargo in
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circuses allotted boss that i would say
you know has again to back pains
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that we've
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like these that i i just finished my
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basses uh... degree in applies for
science and
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before start that i was very interested
in complex eisenhower relates that uh...
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health and fitness despite a shady and
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definitions and
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and the fact that excise can have on on
the body so i i wanted in the floods
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both sides agree with uh... with my main
focus being on excise physiology and
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at that time i was getting introduced a
kind of concepts of high intensity
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training and show you guys are aware of
what today doug mcgrath uh...
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off the jones
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and i i was reading the bear works as
read my menses works at the time
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uh... hands
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kunkel incidently wedding bill two seven
two so it's not my degrade
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uh... one of my lectures that was
involved with them
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some research using that uh... medics
equipment
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we specifically had at medics lumbar
extension machine there
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and that is quite interesting that i was
just reading boulevard today's but some
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time and i kind of a ride to the
university and was like max max that
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would i know that name from
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out aliya opportunism in the back
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and i got involved in the research in a
kind of stem from their redevelopment
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houston high intensity training went
back with all the research um...
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as for the convinced by the evidence
supporting and then move free kind of
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the same way off the progress from high
intensity training grover norquist's and
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i'm leaving for it's a sent testing and
then rehabilitation fill up back in the
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other possibility as well
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looking for the researchers orlow big
holes
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in understanding of um...
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that probably what might be the main
causative factor back pain
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and potentially how we can try and tree
that i'm trying to be either prevent it
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or rehabilitated
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for people who do safra so today's talk
i'm gonna try and zach
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kind of a personal decision of what will
be why karva that will
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what was it you guys and you go part
time
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yet
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exactly
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genesis says said united is really
really annoying let's just have this
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chronic pain
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s around you at the whole time we're
currently in a minute popping up up and
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down
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it's really annoying and you hirings are
things in the conference is well if you
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go about backing that poster don't look
so tracked it doesn't really convey
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kind message you want states to
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maybe women or other other people you
china at the relationships of
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three to talk about
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it was important to care about it
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living in a discuss maybe maybe what you
know why is it separate prevalent unit
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so if you've got a semi people of color
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the figures are really high
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if it's a hard as they'll be something
that's that's causing as something
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that's having a real impact on and
something that's meaning that it's going
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to you know that it's kind of time in
society
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cynicism light my guide is uh... and
based on my reading around the lectures
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of what remains of like
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associations of low about paying off
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and what i think has the most
influencing factor a wide the majority
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of people suffer from it
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but any other kind of cupboard
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ni what you can actually do about it
because it is so well in the pain this
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is causing it
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all of this might be causing is me the
main factor
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now with a day
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it's good to have some information of
the how can you talk about how can you
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do with that how can you do something
about how can you bring the situation
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because this is the main reason while
you guys again
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getting information and learning how to
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apply and improve unite your life
basically
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i'm gonna spend the time just just kind
of going over what what i'm doing in and
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uh... the impact i kind of envisage
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of my research is going to have until
june bit about
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what specific areas on looking at one
looking at them and how that kind of
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like is involved with with and about
henry and then we'll connect they must
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be tough questions
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uh... just in case any of you on the web
alone racial messed it up
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mats the love that
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the bond five rumbled up and that's when
my main area of intro testers
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so anyone's go questions above that well
below that
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i want to step outside my area of
expertise sat ideally i can give you an
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opinion barefoot and i'll tell you i
don't know uh... and style of the above
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the question benefiting
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inbetween those five that a bright
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i've probably got to know is i can give
you did you get on some
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site jain sadie questions to something
relevant
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i guess the why care about love at
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will first thing that there is to get
back on the definition
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yet what is back pain
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if we don't have to ask tackle something
and you know why isn't it important to
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care about it we need to kind of
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defined and i know what it means i
campaigned saying yesterday uh... some
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words in some definitions
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lost many of the answer
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to tackle probably need to be up to
define it and no what the problem that
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she is
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by planes used to describe
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as a kind of tension or so and insults
stiffness their lease kind of words that
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used to describe
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what is a sense it over arching kind of
condition
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in the lower back
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mike say any of these are the things
then she sort of stiffness
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sharp pains anything about it can be
annoying them and they have an impact on
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our lives
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we'll say five
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categorize our back payments a in
surveys difference of what's up
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categories
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acute pain
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what we will be considered social time
paints a lasting erupts ovr twelve weeks
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accutane would usually be involved with
united an injury maybe sports injury may
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be tripped and says well you know
anything
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that this should back out
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so to speak anne's and causing pain
usually in the majority of cases acute
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pain kind of resolves itself almost kind
of naturally
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even the research suggests that it
doesn't really matter what you doing the
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actual pain will tend to go away after
bouts of at most
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near upset so salt lamps are supposed to
meet
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out that's of light line is a two week
period
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the problem is
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is when the paint doesn't go away
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profits periods
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is tenzin said what we've encountered
rises sub-acute pain
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and eventually develops into chronicling
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aykroyd has anything that any pain has
lasted for a for a long period in twelve
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weeks
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and usually in those cases
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it's way develops in thirty years under
some people who are involved in my
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research allied
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i'd been testing and and
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uh... rehab with to uh... some of them
in our time
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for thirty years billy had spent the
whole life in pain basically
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and i think there's no way to lead your
life unit
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happy them suffering
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one of the other kind of problems that
and i was speaking to and
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gentleman editor about it
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is a very differences come on
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uh... is very difficult to m
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give back pain in aloft cases
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a diagnosis i mean that we will go on
for a second but there are a lot of
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different things associated with
backpacking
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that
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maybe or may not be causing pain
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then maybe you'll may not be affecting
the joints by mechanics and then having
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something impact on how the structures
which may
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illicit a pain response
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or unit in may or may not be expecting
um... functions are out how the joined
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by metaxas function
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so it all the time is very difficult to
say right you you have back pain anne's
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this is causing your back pain or all of
this is causing the pain that you're
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experiencing unanimity
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uh... nerve impingement and maybe uh...
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baghdad's degenerate correction this
instance since causation
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and what you know it could be ligaments
execute the must it could be actual
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unanimously saying elan's right
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uh...
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then the majority of cases diagnosis
comes up
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so people labeled is nonspecific can go
part time
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method and ideals
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most cases is very difficult then say oh
if we don't know i fear what's causing
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it happened how harry's personnel to do
about it
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and this is where the majority of my
kind of like researchers involved with
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his dealing with
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is poorly causing that
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non-specific aspirate because it is and
eighty five percent of
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people with chronic low back pain
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how this non-specific kasri given to
them
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israel so by fifteen percent uh...
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you can say you know you know you've got
this problem you've got the specific
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policy
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the specific conditions of our buttons
that nichols in time
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so i'm focusing on conflict how can we
figure out what's causing apple what may
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be the predominant because of that is
non specific cases
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and how can we address
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so when i talk about uh... old
previously lbp and
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in uh... the rest of the un
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but the slides
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unfocused specifically about nonspecific
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chronic low back pain
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says back pain without specific
diagnosis that's lasting in a long and
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twelve weeks in
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and maybe the car rental unit
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people's pain perceptions change that
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said just a quick diagram for you and
this is just a complex at the same for
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my research unwilling back to the kind
of lay-up
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these guys im leave leaning lian lian
lian
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uh...
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they've actually done a lot of research
a lot of at reviews on the time i think
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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
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outcome measure
00:11:19.459 --> 00:11:22.029
which is very difficult to say all i can
try to um...
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for specific something specifically
wrong with this
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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
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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
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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
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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