Posture Correction

The stress bucket model of chronic pain

Dr. Wohlfert explains how physical stresses like poor posture, hunching over phones, and prolonged sitting fill a "stress bucket" in the brain until it overflows as chronic pain.

"Every stress, not just mental stress or negative thought that we have, but also physical type stressors, accidents that we've been in, poor posture, hunched over our phones, hunched over our watching TV, sitting down too much."

Hyperkyphotic posture and 15-year lifespan loss

Research from the Spine Journal and American Journal of Geriatrics shows hyperkyphotic posture can lead to up to a 15-year reduction in healthspan and lifespan by compressing organs and stretching the spinal cord.

"So in this posture that has been shown to lead to up to a 15 year loss of health span and lifespan. And this has been spine journal, American journal of geriatrics."

Posture affects every physiologic function

Dr. Wohlfert cites the American Journal of Preventative Medicine showing posture affects breathing, hormone production, blood pressure, pulse, lung capacity, and mood.

"Posture affects and moderates every physiologic function from breathing to hormone production, spinal pain, headache, mood, blood pressure, pulse, and lung capacity are among the functions most easily influenced by your posture."

Practical chin tuck and shoulder retraction exercise

Dr. Wohlfert demonstrates his top posture correction exercise: clasp hands behind head, pull elbows back, tuck chin into hands, hold 5-10 seconds. Repeat every 15 minutes for best results.

"If you can't do that, then you might have to keep them separated somewhat, but I'll show you the, the, the ideal way to do it. So here you take the elbows back. So it's like your chest is going out a little bit. Take your head out."

Hinging and posture for back pain resolution

Dr. Nickelston identifies hip hinging as the second essential daily habit alongside breathing for resolving chronic back pain, noting that combining both makes recovery reflexive over time.

"But you'll also, when you have what they call dysfunctional breathing, which I hate that word dysfunctional, I just think it's not optimal, is that with the over-breathing, the person breathes with the mouth open, not in and out through the nose. The tongue is usually resting on the floor of the mouth, not the roof of the mouth."

Egoscue method treats pain through posture alignment

Brian Bradley discusses the Egoscue method (now PostureRx), a movement-based approach that resolves chronic pain by correcting posture.

"thought process that we want the human body to have its most efficient way of moving around and just living the most compelling life. I think it's important for us to kind of support each other and the people that are"

Your symptom location rarely matches the cause

Chronic pain in any joint traces back to postural dysfunction, not the painful area itself.

"I don't care what symptom shows up. CrossFit didn't hurt you. You showed up broke. You just didn't have enough awareness to understand that."

How the Upright Go 2 trains better posture through buzzing

Ross and Carrie explain the Upright Go 2's training mode, where it vibrates after 3 seconds of forward lean, and how Ross quickly reduced his slouch time from 20% to low single digits just through increased awareness.

"I feel like I did notice a difference because I was becoming more aware of it and trying to sort of game the system. This is all very good for people who love gamification. It gives you little charts afterwards and you can see a little pie chart of like how long you were upright versus how long you weren't."

Upright Go's health benefit claims examined

The hosts review Upright Go's claimed benefits including boosted testosterone, lowered cortisol, improved breathing, and increased oxygen to the brain. They find the breathing and oxygen claims reasonable but are skeptical about the hormone claims.

"An upright posture boosts testosterone production and lowers cortisol levels in the body and brain, making you feel ready to take on any challenge. Upright posture also helps your lungs to take in more oxygen giving your body what it needs to naturally relax."

The honest verdict on posture correction devices

After weeks of testing, both hosts give the Upright Go a lukewarm review -- useful as a posture awareness tool but neither kept using it after the trial. They note it would be most valuable for people whose bodies are central to their work, like models or actors.

"You know what? I would need some kind of service that would kind of figure all this out for me. Exactly. And you know what that service is? What is it? Ship Station. Oh, Ship Station. Yeah. And I just realized, oh, my God, this is so funny that we'd be talking about this. Ship Station is actually one of the sponsors of this episode. What? Yes. I know. What? Are you serious? Yeah, I'm serious. Aren't they the service that brings all of your orders into one simple interface, whether you're selling on Amazon or Etsy or your own website? Yes, it is. And you know, folks are adapting to this changing world, right? We're all buying stuff online and there's all this delivery culture. And ShipStation works with all the major carriers like the ones I mentioned, right? USPS, FedEx, UPS, even Amazon Fulfillment and Jerry's shipping service, JSS. So you can compare and choose the best shipping solution for you and your customer right inside the system. They even offer big discounts on shipping costs. So now any business can access the same postage discounts that are usually reserved for larger Fortune 500 companies. Oh, boy. You'll always know that you're getting the best deal. Oh, man, that's good stuff. And right now, Oh No Ross and Carrie listeners can try ShipStation for free for 60 days. Yes, when you use the offer code OHNO. Oh, then they'll know that we sent you. Exactly. So make sure your business is ready to meet the demands of delivery culture. Get started at shipstation.com today. Click on the microphone at the top of the homepage and type in, oh no, O-H-N-O. That's shipstation.com and then enter offer code oh no. Shipstation.com. Make ship happen."

Play expands prefrontal cortex flexibility

Play releases endogenous opioids that let the prefrontal cortex explore new contingencies and expand creativity.

"Play is really about exploring things in a way that feels safe enough to explore, expanding our catalog of potential outcomes."

Low Back Pain Is a Symptom, Not a Diagnosis

Dr. Shirley Sahrmann, a legend in physical therapy with 60+ years of experience, explains that low back pain is merely a symptom -- the real diagnosis should name the movement that consistently causes the symptoms. She argues that identifying and changing that movement can reduce or eliminate pain, a fundamentally different approach from treating symptoms after a doctor's structural diagnosis.

"The one big objective in it, I've actually been a physical therapist for over 60 years. And during all of that time, I've been through different eras of changes in physical therapy. And where I've sort of gotten to is how movement basically induces pathology. And part of that, trying to explain that and how it works, is also developing diagnostic categories that direct physical therapy treatment. So what this book was about was a first attempt to really put together diagnostic categories that are based on movement and movement as an inducer of musculoskeletal problems. Also kind of working on the background of what are the tissue adaptations that contribute to this. So it really was an organizational attempt to identify for, in the first book, we covered the back and the shoulder and the hip. And so I guess the shoulder is one of the things that he must have been particularly interested in if he's dealing with pitchers. And the shoulder is really quite complex because you've got that shoulder blade as well as the glenohumeral joint. And it's not as easy as muscles just turn on or turn off appropriately. They've got to really be well-coordinated. So I think that putting together this kind of information in a way that could be understood by a whole variety of people. In fact, I was so slow in getting it out that I was grateful that there was the internet and Amazon selling things because if it would have only been sold in medical bookstores, no one like Eric would have ever found it. So that was one of the advantages of being a slow writer. And of course, I learned more while all of that was happening too. How did that attempt, or maybe not attempt, how did that organizational approach and also the maybe reframing of movement in the way that you just described differ from what came before or what was predominant at the time? To be perfectly honest with you, Tim, it's not like this insight has been taken over by even the large majority of the people in my profession. It's still a bit of a struggle to have people move in this direction for a whole variety of reasons. But typically, and even though I wasn't there when physical therapy was first started, I wasn't too far behind. But typically, the role of the physical therapist was the doctor figured out what the problem was, made the diagnosis, and the physical therapist really provided treatment for what I think could fairly be called the symptoms or the consequences of that problem. In fact, I am old enough that I actually saw polio patients. The vaccine had just come out about when I was entering physical therapy school. So we had a role in providing the therapy for the doctor's identified condition. And that's very different than what I'm proposing or have proposed with this book. And I think the other thing that's so important about all this, and I'm sure you are a reflection of this, is in the old days, no one thought lifestyle had anything to do with your health. I always like to point out this story. My family cooked with so much Crisco, I don't know how my blood flows. And if the green beans were too healthy, we had bacon grease to put on them. But I was very fortunate. I worked with a physician for a while who was really leading the way and showing about the role of exercise and nutrition. he did what's really called translational research showing the cellular changes in animals and then also running studies in older people. And it was like an amazing insight for me to realize that your lifestyle had something to do with it. So I think that's behind what's slowly emerging as seeing movement play a different role. I think what I'm like to get across to people, it's not inevitable what's going to happen to you, that you can do things by a lifestyle to improve what your outcome's going to be. I would love to come back to, I believe, and I don't want to misquote you, but something you said, which is the treatment of symptoms. So many offices are treating symptoms, perhaps not root causes. And I have read, and you can't believe everything you read on the internet, so please correct me if I'm getting this wrong. I said a new saying. Yeah. Wow. That you've described low back pain as not a diagnosis, but a symptom. And could you just speak to that? Because I, as someone who currently for the last maybe six to nine months has had a very perplexing constellation of symptoms that I describe as low back pain, this I think will resonate with many people who are listening. So would you mind elaborating on low back pain as a symptom and not a diagnosis? Well, I mean, just what you're saying. You're saying it's low back pain. You're just telling me that you've got pain and you're telling me where you've got pain. That is clearly a symptom. Yeah, right. I am from Long Island, so sometimes I ask the silliest of questions, but got to start with the basics. Well, the nice part is you can actually get reimbursed for making that big, clever diagnosis, even without an MD degree. But where I would be looking at that problem, and I have an idea of what your problem is. Wow. Okay, already. Just because we can talk about that. Okay. I mean, I don't want to sound too glib about it, but what I would be doing is naming your low back pain by the movement that most consistently causes your symptoms, and by changing that movement, reduces or eliminates your symptoms. Then I'm talking to you about a real cause of the problem. Now, it's not going down to the tissue level and saying, well, you know, it's a disc or a facet joint or any of the rest of it. But here again, in some ways, when you have a problem like that, you can't say in the back that one tissue's at fault because a lot of tissues have to change if you're having pain coming from your back region. So the expertise of a physical therapist needs to be what is the movement that's either causing or exacerbating that problem. So I'm curious to, well, maybe we can dive into, you you thought you might know what my, my issue is. That's because I know you're a big exerciser. I, yes, yes, indeed. And do you want me to just give you a ballpark idea? I do. Okay. Absolutely. Well, because would you believe that abdominals can get to be too much, like overdeveloped?"