Lower Back Pain | Discussion & Treatment | Full Length HD

Subscribe on Youtube: http://t21c.com/W5AZ1g
Subscribe by e-mail: http://www.the21convention.com
Follow on Twitter: http://twitter.com/beachmuscles

James Steele (or James Steele II as he is known online and through his blog) is a 23 year old Lecturer and PhD Research Student at Southampton Solent University in the UK. James is an exercise scientist by profession having gained a first class honours degree in Applied Sport Science and during his time of study working with a wide range of elite athletic populations including; international Ironman triathlete's, Paralympic wheelchair basketball and rugby, semi professional muay thai fighters and professional football (soccer). In addition he has worked with non-athletic populations including the elderly, diseased and a population that he is currently conducting research with; sufferers of chronic low back pain.

James is active as an academic pursuing his PhD research into chronic low back pain, its multifactorial symptoms and the effects of isolated resistance exercise for the lumbar extensors in treating it. He has also recently had a paper published with his colleagues, on which he was second author, presenting the scientific literature of resistance training and suggesting recommendations for its optimal implementation based upon the current evidence.

Despite his clear academic focus in the area of exercise science, James also has many other areas of interest on which he occasionally writes when the time permits at jamessteelii.blogspot.com, one of these topics being philosophy. James has always taken an interest in the nature of the universe and man's relationship to it yet never had a conceptual framework for which to understand it.

A few years ago whilst reading Mike Mentzers books on High Intensity Training James was introduced to a philosophical perspective on exercise based around reason and logic. It was from here that he was introduced to philosophy as a subject to study and more specifically Ayn Rand's Objectivism. Since then James has dedicated time in his personal life to further his knowledge on all areas of philosophy, and specifically Objectivism, providing himself with an armchair philosopher's perspective on the universe, man and life.

Visit James at http://jamessteeleii.blogspot.com/

stage again here

uh... is a man that just got his
bachelor's degree last year from seventh

in solely university and is also working
on is phd_'s gonna talk about

high-intensity exercise the lower back
give them a round of applause and james

feel sick it say

purple

uh... nelson

uh...

rick

here

finance and

okay guys right uh... i'm hoping that
this focusing aborted its image as a bit

of apprehensive about talking about this
topic

she does is big interests of my
obviously and in my phd_ and i've been

a lot of

intensive research on it

so to me is very interesting and so i
think quite

quite a lot about how to relate to you
guys ab

i'm radio

i kind of full of al have more to talk
about how happen

apartments

you how unpretentious the nature of

clinic by back pain is i mean like that
do his

had back pain got back i know some of
that time

that's

only about eight thirty which or sponsor

research biggest quite interesting

but they had just risk i give you an
introduction of how our cargo in

circuses allotted boss that i would say
you know has again to back pains

that we've

like these that i i just finished my

basses uh... degree in applies for
science and

before start that i was very interested
in complex eisenhower relates that uh...

health and fitness despite a shady and

definitions and

and the fact that excise can have on on
the body so i i wanted in the floods

both sides agree with uh... with my main
focus being on excise physiology and

at that time i was getting introduced a
kind of concepts of high intensity

training and show you guys are aware of
what today doug mcgrath uh...

off the jones

and i i was reading the bear works as
read my menses works at the time

uh... hands

kunkel incidently wedding bill two seven
two so it's not my degrade

uh... one of my lectures that was
involved with them

some research using that uh... medics
equipment

we specifically had at medics lumbar
extension machine there

and that is quite interesting that i was
just reading boulevard today's but some

time and i kind of a ride to the
university and was like max max that

would i know that name from

out aliya opportunism in the back

and i got involved in the research in a
kind of stem from their redevelopment

houston high intensity training went
back with all the research um...

as for the convinced by the evidence
supporting and then move free kind of

the same way off the progress from high
intensity training grover norquist's and

i'm leaving for it's a sent testing and
then rehabilitation fill up back in the

other possibility as well

looking for the researchers orlow big
holes

in understanding of um...

that probably what might be the main
causative factor back pain

and potentially how we can try and tree
that i'm trying to be either prevent it

or rehabilitated

for people who do safra so today's talk
i'm gonna try and zach

kind of a personal decision of what will
be why karva that will

what was it you guys and you go part
time

yet

exactly

genesis says said united is really
really annoying let's just have this

chronic pain

s around you at the whole time we're
currently in a minute popping up up and

down

it's really annoying and you hirings are
things in the conference is well if you

go about backing that poster don't look
so tracked it doesn't really convey

kind message you want states to

maybe women or other other people you
china at the relationships of

three to talk about

it was important to care about it

living in a discuss maybe maybe what you
know why is it separate prevalent unit

so if you've got a semi people of color

the figures are really high

if it's a hard as they'll be something
that's that's causing as something

that's having a real impact on and
something that's meaning that it's going

to you know that it's kind of time in
society

cynicism light my guide is uh... and
based on my reading around the lectures

of what remains of like

associations of low about paying off

and what i think has the most
influencing factor a wide the majority

of people suffer from it

but any other kind of cupboard

ni what you can actually do about it
because it is so well in the pain this

is causing it

all of this might be causing is me the
main factor

now with a day

it's good to have some information of
the how can you talk about how can you

do with that how can you do something
about how can you bring the situation

because this is the main reason while
you guys again

getting information and learning how to

apply and improve unite your life
basically

i'm gonna spend the time just just kind
of going over what what i'm doing in and

uh... the impact i kind of envisage

of my research is going to have until
june bit about

what specific areas on looking at one
looking at them and how that kind of

like is involved with with and about
henry and then we'll connect they must

be tough questions

uh... just in case any of you on the web
alone racial messed it up

mats the love that

the bond five rumbled up and that's when
my main area of intro testers

so anyone's go questions above that well
below that

i want to step outside my area of
expertise sat ideally i can give you an

opinion barefoot and i'll tell you i
don't know uh... and style of the above

the question benefiting

inbetween those five that a bright

i've probably got to know is i can give
you did you get on some

site jain sadie questions to something
relevant

i guess the why care about love at

will first thing that there is to get
back on the definition

yet what is back pain

if we don't have to ask tackle something
and you know why isn't it important to

care about it we need to kind of

defined and i know what it means i
campaigned saying yesterday uh... some

words in some definitions

lost many of the answer

to tackle probably need to be up to
define it and no what the problem that

she is

by planes used to describe

as a kind of tension or so and insults
stiffness their lease kind of words that

used to describe

what is a sense it over arching kind of
condition

in the lower back

mike say any of these are the things
then she sort of stiffness

sharp pains anything about it can be
annoying them and they have an impact on

our lives

we'll say five

categorize our back payments a in
surveys difference of what's up

categories

acute pain

what we will be considered social time
paints a lasting erupts ovr twelve weeks

accutane would usually be involved with
united an injury maybe sports injury may

be tripped and says well you know
anything

that this should back out

so to speak anne's and causing pain
usually in the majority of cases acute

pain kind of resolves itself almost kind
of naturally

even the research suggests that it
doesn't really matter what you doing the

actual pain will tend to go away after
bouts of at most

near upset so salt lamps are supposed to
meet

out that's of light line is a two week
period

the problem is

is when the paint doesn't go away

profits periods

is tenzin said what we've encountered
rises sub-acute pain

and eventually develops into chronicling

aykroyd has anything that any pain has
lasted for a for a long period in twelve

weeks

and usually in those cases

it's way develops in thirty years under
some people who are involved in my

research allied

i'd been testing and and

uh... rehab with to uh... some of them
in our time

for thirty years billy had spent the
whole life in pain basically

and i think there's no way to lead your
life unit

happy them suffering

one of the other kind of problems that
and i was speaking to and

gentleman editor about it

is a very differences come on

uh... is very difficult to m

give back pain in aloft cases

a diagnosis i mean that we will go on
for a second but there are a lot of

different things associated with
backpacking

that

maybe or may not be causing pain

then maybe you'll may not be affecting
the joints by mechanics and then having

something impact on how the structures
which may

illicit a pain response

or unit in may or may not be expecting
um... functions are out how the joined

by metaxas function

so it all the time is very difficult to
say right you you have back pain anne's

this is causing your back pain or all of
this is causing the pain that you're

experiencing unanimity

uh... nerve impingement and maybe uh...

baghdad's degenerate correction this
instance since causation

and what you know it could be ligaments
execute the must it could be actual

unanimously saying elan's right

uh...

then the majority of cases diagnosis
comes up

so people labeled is nonspecific can go
part time

method and ideals

most cases is very difficult then say oh
if we don't know i fear what's causing

it happened how harry's personnel to do
about it

and this is where the majority of my
kind of like researchers involved with

his dealing with

is poorly causing that

non-specific aspirate because it is and
eighty five percent of

people with chronic low back pain

how this non-specific kasri given to
them

israel so by fifteen percent uh...

you can say you know you know you've got
this problem you've got the specific

policy

the specific conditions of our buttons
that nichols in time

so i'm focusing on conflict how can we
figure out what's causing apple what may

be the predominant because of that is
non specific cases

and how can we address

so when i talk about uh... old
previously lbp and

in uh... the rest of the un

but the slides

unfocused specifically about nonspecific

chronic low back pain

says back pain without specific
diagnosis that's lasting in a long and

twelve weeks in

and maybe the car rental unit

people's pain perceptions change that

said just a quick diagram for you and
this is just a complex at the same for

my research unwilling back to the kind
of lay-up

these guys im leave leaning lian lian
lian

uh...

they've actually done a lot of research
a lot of at reviews on the time i think

really act and dysfunction

and i put together this kind of uh...
integrated model to say like

well in in non specific cases uh... with
unusual school function as as a as an

outcome measure

which is very difficult to say all i can
try to um...

for specific something specifically
wrong with this

structure altadena something is causing
painewebber's nervous eleven

and sony's function like the function of
the joint joined by mechanics

as an outcome measure

blood as a taken this kind of kind of
approach that they've use in the

categories are used

and adapted it said

be applied to lie back

so we've got got as cargo at that time
as a kind of like entity as a kind

concept

and function as the outcome measure all
functions as the perhaps rehabilitation

go

so

one looking at is whether or not we can
improve function

we can definitely improved

all these other

areas uh... associating with

may not necessarily because it is but
certainly associated with caught up at

night

one thing i a m day

is focusing on the physical
characteristics involvement

that's love dot

section then psychological and so i can
say show

instances

my resistance and the folks in alexander
come from the excise physiology

backgrounds and

sold out

there is a psychological impact acts
like a social impact to stress impacts

on pain perception which i'll discussed
briefly

and mind as well

main focus of my recession might

efforts are looking at

what the actual physical symptoms are

is the school said he said to tell
whether or not

dislike us at the psychological stress
is causing the plane or whether or not

it's

causing psychological distress

united services hall

association doesn't necessarily imply
causation

unthinking his motherland on fixing the
physical characteristics the more

specifically in my research i'm thinking
of fixing on things like range of motion

you know if this generation

the act actual atrophy if they uh...
lumbar extensor musculature

as the looking a bit sort of ad

uh... skilled specific bomb attacks when
we come up on the tax uh... if you guys

are where pala build us a man's world

most of you who are about

seems videos threat

fuzz it up yet ok ever anyone read my
mail access

yeah ok kitty co but left

bill talks a lot of our time

by mechanics that has as a an
overarching sold like uh...

subject

uh... by metaxas display and so there
are certain things that we we

wet when bill talks about bond cactus
talking specifically about uh...

rolled from what governments works is
um...

joint structure anatomy function in a

what i had some people michael
functional kese ology

uh... the bomb attacks also incorporates
skills specific movements as well so

free my plus full size three that we
one-week were looking at buying tax we

look at basically so what the physics of
how

particular movements uh... whether that
elaborate so much support skills work on

up

and one of the senate things is looking
and was cool gate which is basically you

unit

look for mostly commission's web
describing an you like to mention

and report back pains and have
discovered variable datetime which

doesn't

fee the normal time which we see people
hey that got back pain

so that's just tell us that the saying
an

of

what i'm looking at and why i think is
an important to look at

and we're going back to the family aside
more determined to research and doing

and why do you get so much important
things that you know the results on

huntington

okay

what's the as a senator

quite low back pain

really prevalent

really unpretentious than a foot is in
his word

recently i think i might use their

the kind of thing with the about me up
on the time you want to mention dot com

if this is unpretentious condition there
that is everywhere everyone has their

normal talks about it

you know it is not laptop kind of scary
you know

as necessary killeen blaze interestingly
in some cases that i've read uh... case

there is an examples of people who've
been slice of the stress

by that i know that yet i felt suicidal

hands and may be that goes back to the
whole used business-like is a

psychological stress causing pain or is
the pain caused the psychological sts

distress

some interesting points

but yet because this is kind of
unpretentious unknown really kind of

like

thinks as a massive impact

on society

uh...

it doesn't really get

a lots of press shall we say on my
things like cancer heart disease

analysts at the city

is definitely one of the most prevalent
medically soul is in fact the world

health organization did a big survey at

as a love like uh... and in the nineteen
nineties

and zag actually ranked low back pain is
the second most prevalent

disorder

uh... in uh... in that survey be
anything that was interesting and called

me

and i have it was m unforeseen amiably
and low back pain right-wing prevalence

higher than almost everything out to
clean your heart please cancel these are

things

and so i uh... it's a real problem and
dan

here's some of the estimates are that
sixty to eighty percent of of adult

we'll will suffer from back link so you
need a new guys who have miss everybody

paying now

will have an expense in pain in the past

it may come point you lots where it was
very likely that you can suffer from

back pain is gonna really cause you some
problems

anos a

one interesting things is is the cost of
back pain

it may not have a massive impacts in the
interest of like uh...

severe

impact

that on all of our lives of some
illnesses and conditions date

but intends it costs it costs shit load
of money

every year some of the estimates are it
costs about ten thousand a

won the most recent estimates for the
uk musicals they call me and direct

and indirect costs about ten point six

that ten

point six thousand million

sanders a billion

about about ten million pounds a year

lessen the direct and indirect costs
last reunited cost of healthcare

posterity and i i i'm one of these
problems is the treatments that that

utilized by people with back pain

and assistant director of student if
people go back on the part of the work

than that both of those weapons they
missed limits now i'm getting money for

it

working and provide value for that
company in that companies or say missing

out

on the web at providing for them

so there's all these complex lost
involve all venice is big spiral that

just keeps continuing costing more and
more money and the way the kind of

economy is going on the mine with rates
inflation

buzzing scott b skyrocketing even more

big problem

if i'm pain is so prevalent like if that
is going to some reasons why it's

prevalent in what's causing what is
having an impact on it to make its such

prevalent conditional society when we
look

epidemiologically sex which is a study
of sort of like m

epidemics of disease oval the political
political

we look at the school respect as we look
at things are socially within that we

can generate hypotheses about word and
maybe is a is act was in

it wasn't such a very uh... what link
doesn't have to the actual conditions

so we look at things cool risk factors

and in fact i mean they're kind of
mainly cell-free

trains a full and kind of categories
what types of respect this

all

responsible

the conditions that that we say

so one of these ab prospectuses these
environmental and work-related expenses

ansel played out latest pictures i see
that i was just following and i don't

really realize that soft or click on
that site

but but that they're supposed to have
backpacks andrea

you can't find him

something which i remember this morning
which i a m needs to remove told you

about was that rice farmers
interestingly

uh... undergo close the while back has
been a kind of interest of mind looking

answer at back pain in

but traditional indigenous of coaches

also what alienated

bike there and and evolutionary
reasoning new unit

is m

between paul and i think in anytime lab
spective of uh... the human sciences or

any kind of like uh... biological
sciences in exercises

so he did just as a kind of like a
example of people and have decided that

working conditions and therefore carbide
pollsters and that sort of thing that we

experience during a work with libya

extended seating fighting month five
office jobs accenture

will come by lifting that we experienced
and doesn't really like a man who worked

the last five a

bustles sorts of things

maybe lengths to

high prevalence of backpacking

unloaded tonight so with that

you know you can ingi back lifting
something hedley

or lifting anything for that matter of
fact if you lifting and stupid way

if you've seen in a way that

excessively loads perhaps the passage
structures robin the muscles taken the

like

so you know i'm not denying that

you can hurt your back doing stupid
stuff at work or or in whatever

environment you're in

but interestingly

i was looking at it and some research in
thailand slickers and see whether or not

they prevalence of back pain was as high
in thailand as it is in

other cultures in the world

and the kind of that prevalence of
pieces it is it's very difficult

skylight link things the government draw
direct comparisons 'cause methodologies

are always different

indifference studies which is was a
problem when you try and uh... in

separate them

but one interesting thing was an
analytical the acid oakley who teaches

law about pollster and thinks it's very
important

highlighted to me that uh... innovative
i watched uh...

fingerboard chests not uh...

gava resident americans were back in a
fast

uh... their posters on the bending
lifting is these brilliant to keep

neutral spine

intended the hips an extended hours and
hours a day spent and that poster bend

down

picking up or checked checked sounds and
she says his picture and

which outcome regret nothing on it now
but i am of these what these women with

his wonderful pasta

spending hours a day and that posture
and yet

seem to have no at that time

and she kind of used as a burst of like
uh...

eye-catching tool to cut my heart like
uh... i like this

so full of claims they saw that on the
ground is a symptom of a resurgence in

pictures and an offense interesting
picture when i was looking to try and

prevalence

of uh... so much promise and rice
farmers in in thailand in an abrasion

country you can expect too much of the
same job is spent

than the day's bent down

but here i sit in that mocha you know
whatever is the kind of war he feels

that way

ands and interestingly that that you
found showed the unit

well half of the people in the picture
you have this

perfect posture newt respon

bending of the hips

and you know i reloading the spine in
the mouth of the that these conflict and

schools of thought would want you to
bullies

and the idea of a half of them had
relief ship upstate new york hunched

bending down and using a standing hours
a day in that position

revolt

so much so therefore you know that's
quite interesting considering that she's

also saying that the rates of back pain
in thailand quite loves wealth

along the lines my foot much of the full
of why i think is the time

could only the causative factor although
maybe

the majority of almost irresponsible

is that i was on for a second is one of
the physical characteristics of the

lumps popping

and was that

bless those odds you study done with
ross thomas he found that

rice farmers with lower

strength levels in that lumber expenses
actually had a high rate of back pain

and that was the factor that was most
associated with it now doesn't so imply

causation

but it's interesting that

the actual working conditions didn't
really have a big impacts

weber all they have backpacking

so what we can usually says if there is
no association is quite like me that's

probably know causative

so it is very difficult complex a lena
is definitely the majority of people are

getting back pain because that spending
time than i ever lisp and science flash

in the states will sign opposition the
web

because they're new situations just on
consistent

they're all over the place in the may be
affected by methodologies in the

populations in the catholic

and thus the consistent is very
difficult to say yet definitely that

message russell what's happened so we
need to

comeback as of today the psychological
family swings back into the hallway m

work-related stuff and uh...
work-related stress is

other said mahmud focuses isn't probably
on uh... and so i thought processes

associates is melissa nicholson
associated with back pain

and i want to step out of my bounds
uh... that

and cognitive behavior therapy is is a
very sort of like prevalent that

treatment options and i and the you're
the research is trying to be pretty

successful

and in terms of an leading people's pain

section but im

interestingly

and some of the research that i've
looked at looks at has with the fact

that the soldiers in chicago i stress
the soldiers and and psychological

sensitivity

and and found that

injury cases they're not

necessarily associative

with the prevalence of le backpacking

they affect the degree of love acting
cell asserted that the intensity of the

plane experience

so it's not the kind of like four to me
that suggests well

maybe

psychological stress and most of the
things all having you know the director

of direct impact on howell

much background people all how prevalent
back pain is certainly one of the story

be the main causative factor

it's also by holistic approach to the

they can have an impact on the penny to
safety preserves the perception that

uh... it's it's considering that it's
time to see the brain

hands and

any kind of stress is not necessarily
have an impact on what the sections you

have of that and response

was important it's monastery myers
focused and attendance of think it's

unit remains hoping plays an important
thing to consider perhaps

in an

addressing people's pain perceptions

and lastly won the race as a respect as
we look at

uh... these physical acceptance that
when we talk about his work at respect

as we're talking about times and

but demographic characteristics and i
like height weight

below the only things that i'm uh...
people's physical

characteristics

and some of these things are we looking
at like uh... join structures join

function

uh... how how the joint actually
physically functions like i say no

they're going to function of the joint
and so you know that could be in the

love acted to strengthen lumber expenses
that you feel that well but that's the

anil diagram and

petty from one of our jags but uh...
just showing a lumbar extension

and sent uh...

and his lodi vanfleet looking at things
like range of motion as well and that

the check i might grow strong regulation
and on the stage a specific number

dimension which we talk about that
alonso

excuse me

okay so i could send association doesn't
necessarily imply causation

started clover is difficult to say also
if something's associated with it was

really causing it liberalize just may be
simply unite maybe something else is

underlying it

and when this thing has an impact on a
campaign

is prevalent

and something else is provided as well
these kind of a conditions because very

difficult i'd like to say i'm what's
causing wall

in the majority of cases

found at the same opinion is as
researchers likes to have a gala benefit

you've you've had it is his name is
quite big names alone about

uh... by mechanics and rehabilitation

uh...

even if you know i mean in general
agreement with him

that in the jury cases pain has an
organic

souls

okay and injury or some sort this
function of the joint

because it is what initially causes move
sequence of events that leads to

he fixes along harrel and very stiff
physical characteristics of columbus

find have an impact on injury uh...
thresholds and and and the injuries that

you've infects

and dan

usa distinctions between where for all
of the uh...

yet acute injuries all chronic injuries
as well netware broadband

you know yesterday like an acute
chiseled like sprain or

high-impact an injury a liberal that

anne anne

these words right now

uh... a repressive injury at for example
like maximize get the texas rangers

people get reports of injuries which can
develop in c chronic back pain the lungs

spine as well you know it's a really

get tackle from behind the rugby of
whatever so quickly backed out

it may be sustained loading and
sustained injury

very small small small just builds up a
discount like running response

and what does that mean is off to a
injury a series of events happens which

leads to spot of high response

the actual at peripheral nervous systems
or data structures and uh... person in

their structures become sensitizing come
really

sensitive to pangs anymore compass
simulations as joy they structures

willis eaten for the pain response

and some of the things that you know if
you can get directness and pension

because of a with joined by mechanics
because of the function

uh... and discs and other tissues as
well facet joints it's just easier to

handle it and it seems fine that date
that's right and had to have muscular

and ligaments officially they will have
no supplies

so they can all feel kind of any kind
like

alterations that by the tax may be
something that's responsible for

sensitizing those

nerves

and then subsequently sitting up a
series of n since i was the rest of the

uh... same response

says maybe white white paint private
developments mccormick condition as well

you know one thing i just want to point
out is something interesting laid out in

a again how made what you guys followed
local yukon abilities but does

well the big he cannot hide real of
research and i really love lots of out

of the book the great source of
information such as you can find good

blogs from bike

interesting and and

and critical correctly thinking and
russian peoples uh... are full of logs

written by

and very species and doctors center

and but why does a is was a full is a
guy called photography bro's vocal

better movement and he's over so blood
brain senses approach on um...

pain and and and he is uh...

questions for back pain

and interestingly uh... heated up a
couple of studies that show was aware of

announcing of the stories where

some people who have abnormalities in
the lower back

discount haitians of exposing myself
think

shows no pain symptoms

so alarm people cause like jumps on top
and wagon to say

you know if if that's not being as they
go back problem but not all time

then maybe that's not responsible for
paying the first place

but i think i'm set said like injury
cases pain does seem to have an organic

kind of like like souls icon stimulates
appetite

and one of things as an impact on my
sisters their tv injury as well

when you can't look at these have
studies which metabo malfeasance

incidents

tends to find that the actual and degree
of injury

if for example we looking at the disks
of dust can begin to degenerate make and

then softball which

and they couldn't center at that point
stop pressing on earth and causing pain

response

or they they could have a completely
within which case you know they can

cause a real slow like impingement on
that uh... nervous tissue would need to

move down into the

actual blood-brain units stimulators

inflammatory cascade of events that that
can cause a racial painful response

and it seems to me that that the
majority of links

and between abnormalities in pain for a
lot more satiated with at the severity

of them

so the ratio of light

lotus verity and injuries

uh... abnormalities when necessary it's
highly associated with um... back pain

the thing to do is come by at least this
state's response relationship between

how badly injured the spinal how badly
deteriorated wars

and the extent of pain experienced

so maybe they even when we see an
abnormality

it may not necessarily be sufficient
enough to cause the pain response yet

also we've got an examples with some
people have since in some people say

they experienced pain

the scan showed

nighttime soap

also no amounts itself

am

and this is this is interesting as well
because a lot people may become a little

erica

whether it's a caring

evidence uh... sorry and absence of
evidence to main evidence of absence

side is this whole inmates in the senate
as uh... a phrase it that they use and

which is

sorry absence of evidence doesn't
indicate evidence absence faces hold you

com prove the non-existence of something
godlike and that's what we're talking

about his family entertainment

it's

is a logical jumped that i'm a logical
jumps i'd say that just because you can

see something on this particular scan

there's nothing that the festive season

am so that you had the scam i hadn't
made mister ouagadougou lawsuit estate

using and i just like laugh as well now
i'm not docking station said his

admonition lines up that incident of of
reason the research

yet not not not the thing i missed
something

or perhaps the abnormality was there

desensitized and create a kind response

as potentially alleviate itself it's
rotten lousy but

tangling it because of the same size
asian

it's very difficult scott venues ease
diagnostic tests to stay on the air

power how worthwhile actually offered

and zambia's any refers to the use of
these tests in the country who was then

that that clinicians like arafat's visit
is that you can see contact

this small number of people with that
was an accurate diagnosis in most cases

is no usually that useful

this whole idea of how dangerous verity
then conference on the side there's an

injury fractals

and

in most cases when injury fresh fruit is
exceeding along the lines plastered

mcgill thinking

it you'd kill joy structural have a
particular um... level of of loading and

i can't sustain before

it's it breaks basically is like any
kind of like engineering aspect it will

be up to sustain

uh... and start consented to have
loading beforehand as boom

and amber expand that made a spectacular
failure

and they all collapsed

or but like an accused of a severe
injury impact injury

or maybe a sustained pat stipulating
that may cause an injury i a verdict

that period of time but as an injury
fresh felt and they're gonna be things

that impact

how well you can

opened to that'll how well you can
sustain and

leading before you actually and gets
injury

excuse me walter

and his own mind refresh alerting them

one important things in certainly coming
from a uh...

mciver excise phase that background is

and be submitting a joint can't take is
usually to be dependent upon the extent

of

resistance that the musculature holding
the joined together can actually

withstands

if you've got week musculature

that's joins dot is not to be out with
stands much loading

is going to be up to that you may have
led injured mergers lefty

characteristics as well

uh... and strength and endurance you
know the not separate things they go

hand in hand if any of you familiar with
the kind of opportunism analogies on

that

if for example you implement strength
training program

accessory any exciting east offer a
little with a at maximum

former max it as a hundred ql you
improve

increase that to syndicators

and stuff so you can do one red mexicans
killers

and things to do

eight reps with

excuse

can increase that you one red max two
indicators

then people began to get to do about a
breadth of hasn't sixty hitler's

interested person

so your actual endurance

the amount of rhetoric and to we've
aggressive loans going up to some

dangerous enormous you know if you
previous championship reviewed your your

insurance as well

so there's no time like training for one
or the other

anne's doesn't have an impact on how
well you can

yet uh... withstand impact injuries no
se sustained writing as well

and dan

twelve impacts on the visit the injury
severity and then the impact that has on

paying the sponsor

interestingly and one of the most
consistent things you find in in the in

the lecture looking on on summation of
studies

is small populations into large-scale
studies looking at least physical

characteristics

a lot of things associated with um...

the actual number extensive musculature
minimal two-fisted rectus finally muscle

groups

uh...

shave in people with back pain

they usually very weak

and they're very agitated

and they unit uh... compared to an older
population of people without back tag

packing that colin able to withstand is
much stratton

unloading as as the people who are
suffering from that

all of these and these things like that
to fade

the uh...

lumbar extension strength

lumber extensive activation is usually
lauren s toward native people of back

pain

and we actually get

interestingly as well

is that people who have the q injuries

tend to have innocent have associated
lumbar muscle atrophy as well

so certainly in the in the most if
that's the people come into a with an

acute injuries though you know that was
done by uh... heights and click

something

and uh... the people who came in with
acute injuries

founder

they had

lumbar muscle wasting his well they
didn't know follow-up study as well and

also did some studies looking at people
coming out of injuries up

and found that

the degree of the improvement in the
back pain was actually related to the

degree of improvement in the lumber mill
musculature as well as the amount we

actually

uh... itouch stage in the amount of and
improvement act financing

says interesting that

first-time and certainly the impact on
whether it becomes chronic or not

is also related to how

strong and how lab well-developed the
actual on the musculature is

when i was in the stuff

and it's not rush for the next time that
sent on the phone sir

wine okay

but is it briefly just such a down on
the indigenous populations that

i have this kind of idea that well if
it's a physical characteristic that is

not necessary to be

uh... environmental cause it causes all
you know that holds online

westernization you know what else is in
the lift anything to win

having impact supple

i'm going to have a look

western prostitutes

with uh... i am indigenous in
traditional population sea while the

rates of back pain are and then see
where they had a hearing to traditional

pain you know

final lifestyle but one of the our
caller

and actually unite reduce the rate at
that time we see and all the times like

and traditional populations are confined
and

literature on research on

count me in the race with justice high
in some cases higher

than about time we have to get

in um... western populations fish in the
it doesn't really matter whether you

convert hitting tradition diet lifestyle
whatever

you seem to seems to be back pain
everywhere we go

out the question honestly rule tide is
because of that discrepancies in some of

the research but

on the whole

is very very prevalent regardless of
what you get it

avodon

a slight here with some of my recent
forced us to quickly go either

now if that's the case

before the potentially there must be
some sort of evolution reasoning for

walleye

we've got a high prevalence of back pain
and to some sort structural

btwn compromise perhaps uses the word to
use that badly she's had to make uh...

elation

resulted in that means that we fuji dot
we care about muscles than than we

really need

and i'll be right that i did everything
since a m trying to book list i'm

working a series of the moment

which will be fascism

just looking at how probable on the spot
is involved in howell diane us all links

if my research and have strengthened the
lumber accents among muscles

actually links back to that somehow
there is an evolution basis for week

lumber expenses

just as a kind of power backup
background

holidays uses and the cat

uh... what's the global market basically
all twelve monkeys is generally

absolutely representative of early

hate bury my sanity sense of before the
pain in the thick area and in the early

nineteen when we left

all boreal

quarter panel four-legged opm trees will
and locomotive dan

and what we what we have those need to
have a very long so sixty seven number

that's right

what then happened is is we kind of
involved in the short back terrestrial

have on the ground grounds and and
branched and swing uh...

and what's what's coming up more was
never quite shortening of the land of

right

because

using what's called regulation which got
swinging between the trees requires a

stable platform from which to break it
from

this is this is actually uh... andy and
image of chimpanzees and

uh... spinal sent his pelvis
inconceivable in the spines school

dramatically

and what's also happened is the iliac
crest

have come up

elongated and they cause like an
entrapment of the lungs spine so what

happens is is we've gone from big long
spines really short spine with a lot of

passive rigidity and all of passive
uh...

structural integrity of that

so will subsequently happens

is over that period of time we've gone
from having a relatively massive strong

erect respond i was involved in involved
heavily in our locomotion

touting a relatively small

one in eight times a cross-section i ran
across that you have a muscle as an

impact on the actual math forced
generate

site smaller muscles

jim remain weak muscles

icahn says an evolution basis for y

potentially

a lot of people have got week back
muscles

and his wife seriously when i get people
into testing

in the lumber extension shame which of
the freemen as well

in that case what can you do about it

where two different i'd like to methods
of treatment as a passive treatments

rashad payne absence of relief and this
is one of the reasons why

the costs of it's freezing back pain at
the site hard

is because a lot of treatment options
focus on relieving the symptoms

relieving the pain that the focusing on
what the actual

underlying causal factors

so things like bed rest in a a
depression pain killers that something's

sarge they'll focus on pain relief

and actually

removing the perception of pain relief

spirits as the great on the short time

really painful

but then she comes back because they
haven't dealt with the coles and that

would watch at actually the mechanism
which is actually stimulating the times

the value of the cells treatments and
there is somebody

is in terms of uh... the severity to
frighten people really bad pain and you

need to begin active treatment program

sometimes the social treatments can be
very useful indicating that process it

is hard to accompany

and get involved with the program

in that respect we should be immediately
dismissed as being completely deceitful

that is of a role for the ms nine wall

role they should play a treatment
program

and yet for three years and years and
years doctors we recommend that

breastfed back pain but

that's done to realize now that doesn't
really

so stupid

the next time area

is abt active

active on uh... treatment options which
it would she have physical treatment

options aimed at trying to address the
actual course

but at that time

and that the traditional primaries in
looking at physiotherapy sick physical

manipulation of the joints

and um...

you know that there's a really long
history of using uh... manipulation

techniques such as mackenzie stuff and
they've been very useful way in in

research and adding

in clinical practice in introducing pain
outcomes

and improving

functional outcomes improving function
of the of the joys of the uh... and

physiotherapist manipulating

well the problems that we had with it is

and zan it's unfortunately lee just a a
problem with the technique and therefore

the cuff is effective for the writing is
just that

the technique relies on a subjective so
flight

uh... clinically wisdom if you like a
third of the physiotherapists is very

difficult to provide verse of like

yet objectives and and valid measurement

of what the joints actually doing so
they can be useful is very difficult to

that

gets old white baseline measurement that
you know is accurate and provide

progressive

intervention to try and solve tackle and
every measure again get accurate results

and thinking you know i definitely know
that that's great

so one things you can do instead is
actually apply progressive sobai

exercise prior program and not
necessarily focus also but physical

manipulation which

to extend involves a

uh... the combination of subjective sold
like uh... interpretation and also the

com wisdom of the actual physiotherapist

now their free time i a reserve an
excise indicate that we can look at

which the lipstick admits that

well in this kind of general activity
which is basically decide their own

get on with with it if you go back and
get on with it just

the active do what you can can you
confirm run good do whatever take on a

class

and and some areas of research had
focused on this new edition rows of the

good outcomes in terms of payment spawns

the problem is very difficult to say

that they're holy affected because they
don't necessarily houston and the

phillies geez

objective measures of function

site it's very difficult to objectively
say

functional outcomes and improved pain
meds were just for whatever reason maybe

because of a conscious general

outcome of the excise

but it's very difficult to jets every
validate that

the second robot school of foreign zones
of excise whole idea of stability trying

them out of control training and it is
very big in the complex pulls

performance areas

answer is a very big in rehab and areas
as well

and

there are a number of problems that with
this approach i failed uh... in terms of

the actual

controlled trials downstate look is the
fact that this again

it does show improvements

outcome measures such pain and
disability and that sort of thing

the problem is on a theoretical basis is
underlying um...

premises very for very flawed it seems
to be that in general

it's probably just a generalized excise
effect from doing the activities that

having an impact on it

physics behind them

sinking

so it was a little bit of the the whole
motor control fit for a few dozen

familiar with the hine says hiv_
lecture and certainly but we also have

the political science

they discussed in quite detailed yet how
fast iv transpacific scalia's decline

kal bounce around swiss for whatever

these specific skills and and question
the answer transference about scaling

the actual

muscle recruitment plans are you saying
that stuff over activities

site

on that basis during these motor control
instability exercises

it's is very ten years to suggest that

is the actual

motor control has been transferred to
them reduced pain and injury right

reason improve disability it's probably
just a general

adaptation the actual masterchief
rothman proven transference

of the kind of skills involved

another level as well as recent research
at has focused on time

news the white techniques of measuring
at range of motion an actual joint

mission

into segments early

sit on the spinal cancer that is not a
five to four vote right

and what a lot of research recently is
fixed on is how those individuals are

brand new even how the muscles surrounds
those individual that a break

control dot

mind is that for the actual facets of
the the whole matter controller syria

and misinterpretation of that skill
transparency

but one of the problems of aids

the to the studies of lots of people
with back pain suggested ah...

people with partner about backpacking
have a lot of variability in the uh...

sp into segments to movement of and
that's a bright

but the problem is

so does everyone

decision get

above

the solve love that's a bright with a
majority of movement actually 'cause it

seems to be that

the movement is very into individual
you've taken population of of healthy

divisions and fun last variability
between

individuals so it makes it quite hard to
then say well how is definitely

that which is causing an impact

on uh... united that show uh... function
of the lungs spot because the majority

movement because

and the lower levels of uh... bright

and a majority that movement is produced
by the larger uh... musculature

externally

and compress images is provided by
internal musculature again

them out of control theory

it's not necessarily training that
particular skills particular skills and

help

so what we then move on to decide their
progress strengthening and and in

particular high-intensity sector

without going into detail because on the
web time

of yet high intensity training
principles and everybody was times beach

read a little too literature in the area
uh...

and other lucrative mention actually
there

uh... i'm not sure toll-free paperwork
done at the moment so hopefully i'll be

have

publishes some point you guys got to
meet up to the crime scene

buddy right yet

progressive strengthening site

resistance excise this could be

one question mark side

and is

do these exercises trying the lumber
extensive musculature

through the dead lift

good morning brian and share right

generic insists i dot

back extension excised

one of the problems with all these
excise is is

they involve

hip extension as well

say there is movement of the hips as
well as movement have the uh...

outlook on the spot

and when we're looking at a time kind of
movements and so like rest compound

movements

the bollywood seem to find a way of

making things efficient and making
things things and and incision in terms

of energy expenditure

so when we looking excised involve
movement around the hits

larger and stronger muscles of the group
at the if the and please and hamstrings

fans do the majority of the like that

now studies have been done

to look at it

activation of the lumbar extensor
musculature

in these various excise is in fact and
we we uh... one of the students is just

uh... compares the fact that lessons and

traditional deadliest

and you know the lumber stance is
definitely

active

insensitive using a election on the fee
which measures the image cracked version

of the muscles

and during it sizes bosses excise is
being done

that doesn't ask anything other than
their activities and tell us the extent

of activation accounting for their very
schools involved with the technique

lewis's their active uh... sending him
out my number expenses are active

but doesn't this lean mean that they're
getting sufficient stimulus

uh... produce an adaptive response

they need to be loaded sufficiently

and city sufficiently trashy produced
and that the response

boom of all of these excise is is

they allow hit extension

and they allow the collision hamstrings
and the majority of the load bearing

studies looking at comparing

at traditional back extension chains
with what we want to insect which is the

lumber extension seem pretty fanatics

both is that he's looking at and
comparing the um...

raymond share exercise

to the lumber extension shea showed up

as long as he picks engines allowed

lowell insulated lumbar extension
strength is an increased because of on

the musculature presumably isn't loaded
sufficiently interested sufficiently

also am james fish in a guy's gonna be
coming on sunday as well to the exiles

intrusion kunin

as just finished and

a city he's been doing comparing this to
think that left with the lumber

extension chain and interestingly

stiff but their lives

that really improve your lumber
extensive rammstein

a couple of people grew the lumber
extension straight

not a significant agreeing on the whole
most people didn't

so what can we do we do that

so if you've got guys maybe you know
that all have access to quit my like

this study in those cases yet

how many of you from london actually

ecology

you guys will have access to the
equipment

back and then i think it is a facility
cookies a training

they have a full range of medics
training equipment

and they have a medical version lumbar
extension chain here

i think that an excise division as well

legend is that they equipment we've got
a university which has all the testing

facilities on as well

and the main principle behind it

is the stress-strain systems

so what is the changes in st is
basically what the pelvis in place

pipeline forced down on the theme is by
the man

uh... five-story mistresses kind of life
opens to the point

the football that applies force out the
lower legs which hit three

fema restraint

which then combustible backwards the
famous what doesn't really holds the

pelvis down back against the spelled
with a straight ahead

and what happens then it

is no movement forth and back actually
athletes conf calf in the pelvis

sony flexion

extension

movement that because

just because of the lumber lunberg
senses

so we can do it

as we can more effectively loaded at
going back to the the evolution of the

uh...

perspective

one of the reasons perhaps that we've
got stronger lilac gleason hamstrings

is because of the way out date patterns
has evolved when we kind of like

compaq children's

we went sizzled has been hit sent me and
katelyn if you think it how much of that

these gorillas live

and that involved a heavier influence of
heavy involvement of the grease

enhancing sec

potentially there's a there's a powerful
e dash away

because we have changed again massively
powerful must be strong

and now in this position would go a long
dated lumber uh... lumbar spine again

to allow bipedal movement to to for
example a two-legged walking

and we've got his legacy of

big strong voice and sing but we can
spon muscles which creates its just

uh...

recipe for dan

hi levels of the whole high prevalence
of back pain

so we can do is we can isolate it

and effectively test in isolation
attesting isolation is important because

anne of the previous tests it that re
says he's looking at

extension

to exit trump extension

they've got it uh...

the dispensing testing fantasy machine
and not skip elvis so it's very

difficult for them to say

that with us and love back because the
hips and and uh... hits the extension is

involved in prison hamstrings involved

to the actual measurements they take you
to be a combination of all of those

factors

yukon in allies like that one factor

was machine does is isolates that allows
us to get varied objective invalid

picture of lumbar spine function

and we can measure for a full range of
motion we can produce and and look at

what i think uh... books like

in general

they would back pain since before we
even below the top one or more range of

strength

when we look at things we have this
common bell curve in the middle is the

average some people release on some
people over a three-week the most people

back time

tend to have

really low levels

of love of lumber extensions right

they can't afford to let the norms

will sally and just make it up to the
ball range

just to finish up at one of my thing

so it's been like this um... dot and the
military's top

flaunt they're doing is looking at some
research

using the lumber extension james caan
plug some of the gaps

the number extension shames
rehabilitation uh... and and and

strengthening using high-intensity
excise

others

cool just wrapping up

what what is allows the war

the majority of rescission is in a hell
of a lot of research mechanic says that

one yet improves lumbar extension center
improves isolated lunberg lumber spon

from chin

right wheaton objectively measure that

research shows that we know that works

increased pain outcomes

massive studies are studies have been
got done using the uh... medics machine

all the studies done in people with back
pain should improve pain outcomes

along with improved function prove
number extension strength

'cause reprieve strengthening prove
joint function we've got a nice

objective measure that would find pains
reduced moved to file a disability

levels nation using technical glitches

amber improved as well

two great we know that it works in terms
of

improving function an improving pang

and if you've got guys can get access to
the case of facilities you guys and

access to it as well and if you've got
and you can

uh... take time incident

fancy and an teas that strength in your
muscles

but the thing is

coming back to these complex sensitive
factors involved with back pain

my fourth on on these are the
potentially the most symptoms often

causes

to be interesting to see whether or not

before addressing the

potentially ultimate calls and uses the
word ultima arash review familiar jack

diamonds but dungeons and still uses
live there

proximal causes an ultimate courses

yeltsin of course big what causes these
things these extra proximal causes which

then have an impact on the

you know lax images like paying
disability and that's ok

and if we if we consider

potentially week lumbar extension
muscles of what's happening impact

and causing these of uh... ishi's

but limited range of motion degenerate
fiske's indicate very that series of a

physical symptoms

what we might see is if we address that

ultimate kalos

we might see an impact on these of a
possible causes well ease tension

simpson's

well my research is looking at

physically improve lumbar extension
strength

we improve pain withdrew bridges
pampered disability right

week and we'll say

with you decided

of improving range of motion as well to
solicit some of the research looking at

has improved regulation

one interesting thing is

is most people back i have a limited
range of motion to begin with

so clinicians employees limited range of
motion

intervention

now bill phyllis and i and talks a lot
of our islands of regulation excised

and the theoretical basis of why he
suggests avoiding

streams of the range of motion sensor
for the lumber extensions can be

extremes inflection extremes of
extension

is because in those positions the
muscles on necessarily

what's being loaded

it may be the patent issues attendance
ligaments lines they're gonna be what

load as well

so what what we're looking at doing is
saying whether or not

we can actually

on the medics take the exercise limited
to a very small range of motion avoiding

those extremes of the world are still
produces full range functional outcomes

as if that still produces improvements
in

it's associates in tune with limited
range of motion

secondly within the kit

in a very busy as well

should admit when he came up to the lab
we've got i was gonna buy consistent

that's actually a freidy

imaging system

well and if any does he have high level
of the rings is put together

when they picked all the mystical these
little night that ping-pong balls will

ever end

and he just doesn't list off the cameras
recorded essentially the same system for

too much

and symbolic invaded as i can take
distance ed and i can

marketable up

film than using these ten freidy cameras
in the reconstruct that have an

animation see exactly how their lungs
spine is moving relative to that elvis

well several king so i can see how very
police to begin with

and then look to see what impact
strengthening those muscles has on

improving the way they walk as well as
britain is kind of extra simpson

this is listed below that time

and lastly as well

we're going to look at

effect looting has actually only

numbers on the discs as well

we know that you know

progresses high-intensity strength
training most the muscles improves must

must papers like the increases have
purchased a increases strength

we know that

increases bone mineral density in fact
you know the status of that uh...

what effect the lumber extension she has
available by mineral density of the the

strength and taken to the actual that's
right

and fowler increases by mineral density
as well

one thing i mean the time you see any
structure the in the love that the that

you know it has an impact on that

i'd like to see whether actually has an
effect on

improving discount

most people people about that time due
to some extent especially as you get

older they get unit fifty generation
which concerns herniation bolting accept

it

and some people got this idea

the more you move

the more he creates variances impression
across that says you ben folds back was

the discs basically

and gets washed and extending either
side

so it's not extension movements
creatives

squeeze mechanism is listing

sundance

and to increase hydration subdesc why
one of the time the cap was well

may be that that works in terms of
physiotherapy what i'll be effective at

the same time i does load have an effect
on it

and may well day because the study that
that uh...

uh... but you know that's the family

the changes in

but it was named traveled on the soft so
but by no means area which is very

closely associated with the disc alphas
well as discs degenerate

that since the generators muslim aviall
inc

that i could potentially have in effect

ambitions well recent study was
published uh... big city in germany

found that

uh...

the heavy overloading of exercise
because the people give weight lifting

and that's all things and have better
itself that people we do things like

long distance running as well

uh... leading of parcel of that the fat

repetitive um...

sports center in america running

that triathlons bingo about aren't very
good feedback health

so there there's a potential link that
whereby wife we ask that question we

employ uh... employs invention the mud
yeltsin effect

on all these different outcomes

and see whether or not in terms of the
holistic approach

this intervention can have in effect on
all with the contacts that's about time

so that that's the whole idea and
hopefully i can

i what provide some benefit you get
uh... if anyone who gets back thank for

the main time you know the research said
he does suggest

that anyone gets back pain should really
be employing discarding intervention is

very strongly supported

and it's far more objective uh... method
of uh... treatment than any other kinds

of currently existing treatment

thirteen blue

just a summary of kind of what we call
free that today

consciously aware of the time

so uh... if any questions

to liberty at all

yet

um... so you mentioned in some cases the
actual uh...

if pain may not necessarily be the in
which is simpson is

little-noticed

has your system of receiving it

suggests is a correlation between

loans at issue c of battlefield

uh... on the list is not something that
by specifically focused on this and i

like him and uh... point of the at the
beginning

is not all wooden ones there come a step
outside my area of expertise and says he

is not something that i'm uil aware of
whether or not there is a correlation

and by the not looked extensively
incidence of the research said that

there may be that may not be at

allied i'm not gonna show

calm

seems to me like uh... you weeks oldies
usta medics machine

uh...

he said he had a way to smoke i don't
think everyone else most people will

have access to and uh... you know that
you're absolutely right and and at

assess as an idol in his it sounds

of thinking sands of the way off by
structures is an

certainly the best waste it

but it may not necessarily be the anyway

some you could be any extras i went for
it to begin with

they do activate and loads of love back

and in some cases though provide a
stimulus fa

producing adaptation in them

and doug would have had to run for a few
excise on on a few videos of potential

access which you could use to local
outback

and that any reductions i have with
excise lie that is already activated

is very difficult because the research
hasn't looked at it

zero var less efficiently and loaded to
produce an adaptation

it looked like a scene with albrecht
sizing a gem writes of jesus home but

uh... control course ability and train
assaulting improves out outcome measures

such as pain

is likely that there is something
general adaptation so although the

loading may not be sufficient to produce
the degree of results that you season

something is as uh... advanced medics
mission

um... is probably worth doing as long as
you can do them appropriately in safe in

united news i'm using falling satellite
hines instant principles and venue

you'll likely see and

effect from them

but if you want that's results diesel to
best accomplish use the the best

equipment available

but yet it if you've not got access to
them

anza this is one of the reasons why i'm
doing the research is well because a m

just draw contrasts would fully and then
x avonex website has a uh... as a

facility like i said say is anyone
buzznet equipment

sensei then

loaded uh... you have reached that would
be a website annual concerts where

facilities

uh... in the uk

there are five facilities

and i think that's likely to no one's
there six cities in the uk

uh... which i have a medic slumber
extension should content to just the

florida area undecided

which has about fifty ps

seven facilities in dc

say yahoo there loads

have a lot of american life that is very
complex hands at that time surrealism

and edge investors but it but as the
along war access available

as a long time typing as it is so in
this country people are aware of that

dividend any options available

although it's very sparse i think
impolite

doing the research at presenting a
academic conferences and making

precipitous inclinations more aware of
it

and showing how effective it potentially
could be

will hopefully make people's ours i
think that warmed up pocket we need to

get the sacrament we need to make it
more variables that we can

you know we can get that treatment
option gehring hands at

get sorted patients come in and use that

but yeah i think i think i'm you can get
benefit from of rec sizes but

sorry

so maybe has been the season

that okay

and has a guys if any of you go
expressions tom bradley outfits

isozyme