How to beat pain back pain with Norma Pearson

Knee Pain ? Back Pain ?

Let Norma help you.

Norma is a fitness professional with a big focus on chronic pain.

In this episode Norma explains

🔥Why Core strength is never the fix you need

🔥 How rotation is actually the biggest fix to pain

🔥 Why Planks are not the core strength exercise you need

🔥 Why the focus on Glute training being a newer problem

🔥 Is posture fixing causing you more pain

Follow Norma Here

FB https://www.facebook.com/norma.pearsonfitness

Transcript

SPEAKER_01 0:00

Hello and welcome to the Million Dollar Body Podcast with your host, Greg Feeron. And today I have the awesome Norma Pearson with me who's gonna help you feel like a million dollars. How are you, Norma?

SPEAKER_00 0:14

I am good. How are you, Greg?

SPEAKER_01 0:16

Awesome. And do you want to just give people a little introduction as to who you are? Because we met like like we talked about before during COVID times and stuff. So do you want to just give people an intro to who you are and how you got to where you are?

SPEAKER_00 0:31

Sure. So there were some crazy times, weren't they? Um so my name's Norma Pearson. Um I am by day a group fitness instructor. Um, I have been a personal trainer as well, and I'm currently building up my business outside of the clubs and the leisure centres as a restorative movement coach. Work coming really back full cycle to where I was as a PET, working with chronic pain management, uh, injury rehab, and movement retraining for performance, really, sports performance, everyday performance. So I've been um full-time fitness professional since 2011. Um mostly working with group fitness classes, but my interest with back pain and pain, chronic pain in general, starts from my personal history with pain, having lived with pain for most of my life since I was about 10 years old, and my memories of back pain. And yeah, so my my my interest in pain has been a personal quest as well as a professional one to help my clients and the pe and the people that come to my classes and and and are looking for help and haven't found the answers that they're that they're searching for.

SPEAKER_01 1:50

Awesome. So I think this episode is going to help a lot of people because I think there's a lot of people who have niggles, pain, and they've probably tried physio, they tried chiropractors, they tried osteopaths. And it might go away for a short term, but it always seems to come back. So why does that happen?

SPEAKER_00 2:08

Yeah, and I think this is a very common one, and um, you know, like there are you know, there are amazing physios, osteos, kairos, massage therapists out there that do great work, um, but there always seems to be a missing link between that sort of manual therapy, soft tissue therapy treatment, and then somebody getting back to their full function. And there's always been like I don't think it's newer, there's always been that missing link where people are struggled to make that jump from treatment back to fitness. And that's where I originally started was being that missing link, and then it kind of grew from there. And I think what we need to recognize, and I I've done like mentorship programs and courses with these therapists, so I have an understanding of how they're trained, which is similar to how you and I were trained, biomechanical structural, looking at the body as a series of joints and muscles as mechanical movers, and that's how they're that's how we're all trained. You know, we're trained that this joint does this movement, and that if you if someone reports pain um in a knee joint, then you do a muscle test, you do a range of movement test, and you come up with um that that a range of movement or that muscle being strong or weak. And so, you know, like a lot of these therapists will just go to someone says, I've got knee pain, so they'll look at the knee, or they go, I've got back pain, so they'll look at the spine. And I would say for acute pain, it's awesome. You know, if you, for example, you sprain your ankle, you twist your knee, very, very good at getting them back on their feet. And it for many people that's that's that's no problems that you know it's it's an acute injury and they're back on their feet and they don't have any further issues. The problem comes to people that have chronic pain, pain that's lasted longer than six to twelve months and perhaps no longer has like a definite cause. And for me, it goes, it's now not structural. So I think the fuzzle is the difference between acute pain and chronic pain that not a lot of people are perhaps aware of. Yeah. So like acute pain is where you know, like I think the clear example is you put your hand on like something hot and it hurts, and you take your hand away, and there's that immediate what we call like no susception, that detection of something unpleasant that we need to move away from. And depending on what it is, you might detect it as like heat that's then uncomfortably hot, that is then painful, and it's like a spectrum. Chronic pain is very different. Chronic pain, I would define anything as lasting for longer than three to six months, and then we start to get into the nervous system where we're getting a sensation that's being repeated over and over and over again, and it's being interpreted by the brain as pain. And this is where I think we get into a lot of trouble. Like people then go, so you're telling me it's in my head, and they they feel very personally attacked, and pain, chronic pain is nearly always a product of the nervous system, and it's nearly always an interpretation of the brain. That said, it's a very real experience, but it is often a learned response to a particular trigger. Got it, and you know, so you can, for example, and I like to think it's only almost like it's almost like a PTSD of the muscle and the nervous system, where we can do a movement that reminds our like our limbic system, our amygdala hippocampus on our brain of a movement. So, for example, if I hurt my back doing a squat, it might be a squat, it might be anything my trunk goes slightly forwards that my brain thinks, uh-oh. That's reminiscent to what happened when we first hurt our back and it puts the muscles into spasm, stopping you from doing the movement, and that's what creates the pain, and that's so it's like a learned response.

SPEAKER_01 6:02

Got it. That makes total sense because they're a little bit like habits, right? And so baked in that you don't even realize you're doing them.

SPEAKER_00 6:12

Exactly. So it might seem very random. So it, you know, it might be uh, and it can be something like someone says, like, you know, when you first hurt your back, you know, you might get um of uh like a doctor saying to you, oh, you know, you need to avoid bending forwards while your back is hurting. What that becomes into it is don't bend forwards. Then you get very well-meaning friends and family going, Oh, you shouldn't bend forwards, you should you shouldn't lift that because you're gonna hurt your back. And it becomes this whole narrative that if I bend forwards, I'm gonna hurt my back. But we don't think about it consciously, we're not thinking that we're what we're what happens is the brain stores it away into the subconscious, and then it plays it up like a program so that it becomes like this narrative of if I bend forwards, something bad's gonna happen. So I've got to then brace and stop this from happening, but it's so quick, it's like the you know, it's like the sympathetic coming in. It's like if you see like a grizzly bear, you don't go there and like go, wow, is that a grizzly? Now, do I sit down and run away? What type of bear is it? You don't consider your options. You either, your first instinct is either to throw yourself on the floor and play dead or just run away. You you go with your first instinct, there's no rationale to what you do, it's just and it's and it's the same, it's the nervous system panicking and going, Oh my god, we're gonna we're gonna get hurt, so let's just stop everything from happening.

SPEAKER_01 7:34

And this is why so many people get deconditioned, and then so the thought of maybe doing weight training or some form of resistance training becomes scary because they've been told, Well, don't bend the back. So you'll never do a Romanian deadlift ever, because exactly.

SPEAKER_00 7:53

And then I say to people, so if you're not bending forwards, or I get people that say, Oh, my doctor said don't lift weights. So then I say to them, so then they tell me I can't lift weights, my doctor said so. So I go, So how do you pick up your handbag? How do you pick up your bags of shopping? You know, how do you pick up your basket of laundry? And they go, Well, that's different. And it becomes about context. And so we can get a whole narrative of this, if I do this, then this is going to be painful. So, for example, if we think about the spine, a lot of people associate it like with back pain that bending forwards like a standing forward fold is going to be painful and potentially harmful. But if we that's a spinal flexion movement, we're a spinal flexion movement. So I then will say, okay, so but you like lying on your back and bringing your knees into your chest, and it's the same movement. Okay, it's different because it's not loaded. Yes, but the movement of the spine is essentially the same. Or they say I like to go into hands and knees and do a cat stretch when I round my back to the ceiling. It's the same flexion, so it's not the movement per se. And I do get that obviously with the forward fold, there is a normal loading of the of the trunk coming, but the movement itself, if I break it down, it's not so then all I need to do is then condition the body to load to teach the body, the nervous system once again that flexion is not painful in this context.

SPEAKER_01 9:25

Got it. So this is like another one that comes up for a lot of people, and I guess a lot of the women I work with is knee pain.

SPEAKER_00 9:32

Yeah.

SPEAKER_01 9:33

Um, and you you mentioned earlier about how the structural way we've been taught, right? If there's pain in your knee, it must be your knee. So therefore, I cannot squat or lunge. And actually, oftentimes it's something above, I call it heaven and hell. Now, you're more injured, you'll be better with injuries than me, but I I'm like, well, is the pain, is the issue actually in heaven, which is the hips, or maybe back, or is it down in the feet, which is hell? Because the knees are so are we saying that people still need to start looking beyond where the pain is after it's been chronic pain?

SPEAKER_00 10:11

Absolutely, and I think this is the really big thing, and I think this is where you know, like the more you know, great, the more specialized people become, the more narrow their focus becomes. Um, so you know, anything like that, uh, you know, like our physios and our osteos and cars, they're incredibly well-trained special specialists, and their focus is, you know, typically on that area. And um, and I don't think they, you know, we don't always ask the right questions. You know, I was taught, you know, my training, the questions you ask are really important, what you ask people. So, um, so with knee pain, as you mentioned, you know, it can come from below, we call my bottom up, the feet, the ankles, and it can come from above, typically the pelvis and the hips, but we could go even higher and look at the the ribs, the shoulders, the shoulder girdle, and potentially even the head and the neck. Um, but I always look at the two nearest points above and below, pelvis, hips, uh lumbar, sacral, spine, going down to feet, ankles. And the knee is nearly always the middle man. I would say, unless, you know, like for example, if you've fallen off a mountain and like skiing and you've hurt your knee, it's pretty obvious. But for most people, as you know, Greg, it knee pain is more insidious. It often, like they'll say, well, it started a bit like this, and then it kind of got a bit worse, and then it and it was they can't, but they can't pinpoint a moment when it went pop. Yeah. And so then I look above and below, and um, I was actually I was actually talking to somebody um in the changing rooms, and they've had knee pain for about a year. This is a this was this is a very common conversation I'll have with people, and they were talking about knee pain they'd had for over a year, and then more recently it's gone into the hip. So they've been seeing a physio, and the physios looked at them and said, Yeah, your cord muscles are are wasted, you need to strengthen your quads, do more leg presses in the gym. So they've been doing that for about six months, and the knee pain's still there, and the quad muscles aren't really bulking up as they would like. So then they saw a doctor, and the doctor said, Well, it could be hip displays, or I think we need some x-rays. So, so she's been referred to x-rays, more waiting. So I stood her up and I looked at her and I just said to her, Can you see on your, like the right leg's the normal leg, and it was it's fine, everything's stacked, foot, ankle, knee, hip, all stacked, all point in the same direction, one underneath the other. Really nice. On the left leg, and I said to her, Can you see that your foot's kind of pointing out a little bit, the hip's dead on straight, but the knee is really turning out? Uh, because the knee is going into what we call valga, so the kneecap's turning out, but the actual knee joint is pushing inwards. And so her complaint is a slipping patella. Her pain's coming from the patella slipping to the outside. But I said to her, Do you feel like your weight is not centered? And her whole weight was shifted. I was like a tree leaning to the right. And I just said to her, Have you ever had a fallen injury or surgery on this left side of your body? And she said, Yes, a failed bunion up. And I said, Um, okay. How long ago? She said, two years. And I said, Is your foot still hurting? She said, Yes, very much so. And I said, Did your knee pain predate this bunion up? She said, No. And so my feeling is that unless we get the foot, I don't know if it's the foot definitively, but my feeling is unless we can get her foot to the point where she's happy to stand on it and use it and without worrying about pain, because at the moment I'm so worried it's gonna hurt, I don't use it at all. And I said, I what I think might be happening, this is just a hypothesis until I get into the foot and I actually find out. My work hypothesis is that the patella is being is trying to go back to where it was designed, but the knee is no longer there. The knee is going into quite a strong valgus, so the patella is trying to go back to where it was, but it's slipping, but it's trying to find the knee joint, but the knee joint's gone to the inside, and the hip pain. I potentially think we need to roll out hip displays, we knee must roll it out, so the x-rays are important. But my my feeling potentially is that the hip pain is manifesting through glute medius, trying through the IT band, trying to pull the kneecap out to where it's meant to be, but it's just the knee's no longer there.

SPEAKER_01 14:45

This just reminds me of a client I had when I was doing more in-person, not too long ago, actually. And she couldn't squat without knee pain. And I was like, she said, I've been to the doctors, and she was like, Oh, I've got the because she had some hip problems as well, laboring tears and stuff. And I said, Okay, let's have a look. So I said, Right, take off your your shoes. And I got on the floor, she was like, What are you doing? And I'm like, Let me sit squat for me. So she did two squats, and I'm like you got pain because he said, I put my hand on a big toe. She hesitated because she didn't want pain. Then she then she squatted and she was like, This is not right. There's no pain. I'm like, okay, so I pressed a bit hard, I was like, two five, two five, no pain. And it's actually like, How have you ever injured this toe? Fallen down the stairs, and she's like actually when I was about seven. I fell down the stairs, I broke my toe, I hurt my ankle, there's your problem. I said, right, you're gonna go home and you're gonna really strengthen that foot practice. And I was getting messages because of this looking at different things rather than the one spot. But I guess it's normal because we feel pain.

SPEAKER_00 16:09

Yeah.

SPEAKER_01 16:09

So we think that that is the X marks the spot, as it were, but we forget that everything's connected.

SPEAKER_00 16:16

Absolutely, and it is like you know, when you get like chronic pain, you're all you're gonna get compensation layering on compensation. So, you know, I tend to find that it can often be like peeling away the layers of an onion. So we we have to find somewhere to start, and you know, we were saying before it's about the basics. I was a for me, the basics are are the are the feet functioning, are they level, are they balanced? Because that's our foundations. We can argue about the red, you know, the the the importance of the hierarchy of the pelvis versus the feet, but I was thinking they have to work together, you know, like if your feet aren't engaging with the ground as they should, you've got no foundation. The pelvis has to sit on the feet, it can't do anything but, and the pelvis is like the master, it's the epicenter, it's the master controller of of all movement in the body, everything runs through the pelvis and the spine. So if the pelvis isn't oriented on the hip joints, obviously then you know the muscles that attach onto the pelvis and the spine aren't going to be functioning correctly. Nearly all of our muscles will connect to the spine in some way, directly or indirectly, so we have an immediate channel to all the other parts of the body. So I kind of think, you know, like you have to look at the pelvis and the feet together. Um, you know, I would when I was very early trained, you know, we were taught top down, bottom up, but I think it's a both approach. You've got to have both. So I always look at people, I always my like the basics for me are can someone engage the ground with their feet in a in are their feet level and balance? Are they utilizing the feet to then stack the ankle, knee, and the hip? And then can they feel their pelvis in space? Can they do they have a choice over where their pelvis sits? You know, like can they move the pelvis forwards? Can they move it backwards? Can they feel where the pelvis is? Can they tell me, yes, I'm going forwards, now I'm tilting backwards, now I can feel I'm in the center. And I, you know, like for everybody, center's different, you know. Centre, you know, your neutral isn't like for me a set place. Your neutral in different contexts might be different positions. But I always think, you know, you want to have a you want to feel you want to have a choice. Can I feel where my pelvis is? Do I want it there? Do I not want it there? And if I don't want it there, can I move it? And I think a lot of people it's unconscious, they don't know where their pelvis is, so they have no way of of of changing it, and that's what then causes the problems.

SPEAKER_01 18:40

So there's no connection with the body basically, they haven't got an awareness of how it should feel.

SPEAKER_00 18:45

No, and I think you know, when you've been in chronic pain, you're you're you get a very skewed mind map, you know, like what like you'll not probably see people will swear to you they're straight, you know, like you'll say to them, you're crooked, and or you shift your weight over onto us, you you you know, you can see like they lean into one side, yeah, and you'll tell them straighten up and you'll straighten them up, and you'll say to them, you don't think you're straight, and they go, I'm crooked. I say, No, you stay right where you are, you are straight. And their whole brain has become like, you know, like if you're so used to like leaning over to one side or your shoulders are down, like it becomes normal. And your brain goes, Well, that's normal. So then you get someone's correct, and they go, not straight. And you kind of have to tell them, so when you feel you're straight, correct yourself to where you I put you, where you weren't straight, and you kind of want, and then after a few like more repetition, their brain starts to go, oh okay, and then it starts to feel the difference.

SPEAKER_01 19:41

And you just said a word that I love so much, repetition.

SPEAKER_00 19:47

Absolutely.

SPEAKER_01 19:48

Because that that's the that's the fundamental challenge when it comes to pain management improvement in anything. Repetition, repetition, repetition. And I think that's is that sometimes why people don't necessarily get the release from pain they want because they haven't put enough reps in?

SPEAKER_00 20:05

Absolutely, and I think I think there's two principles. I think the less is more, and the repetition and the basics. Uh, I'm I'm a real one for repeating the basics over and over. And even when you get to be a master, you know, of your body, it's always the basics that make the difference. So I'm a big one for repeat, repeat, and when you know, when we're talking about like what I do, which is basically Poshwed is neural repatterning, the brain learns by repetition. How we learn to ride a bicycle is repetition, how we learn to do any skill, you know, play an instrument, repetition. Um, you know, like play golf, repetition. Everything the brain does, what the brain does frequently, it does well. So if we want to program the brain to do something, we have to A, you know, optimize our patterns. So this is why telling someone to strengthen their quads while their foot isn't functioning, you're just repeating a movement pattern that's causing pain. You're not changing. So I I you know, I say you know, you look at, okay, so we repeat the basics. If it's only changing the foot position, I don't worry about the pelvis for now. I change the foot position, I repeat, I'll repeat, I'll repeat. And then I can get that. Then I can go into something else. You know, and like you know, it's actually training, isn't it, Greg? You know, you don't want to like give someone this amazing program that's so complicated. It looks, you know, it looks fantastic, you know, and and like it looks like amazing, this amazing sequence, but actually they're so complicated that they're just completely lost and befuddled.

SPEAKER_01 21:42

Yeah, but people want complicated, right? They want to see something different, like you said, with the training program. I'm like five to six exercises tops.

SPEAKER_00 21:52

Like, yeah, it's over. And as well, you know, people are time poor. You know, it's like if I give I want someone to master something, if I wasn't To master something, if I want someone to master their foot position, I'm going to give them one or two exercises that I think are going to make the most difference. If I want someone to master how they feel their pelvis, I might give them one or two, maybe three, just to master that so they can spend, instead of spending ten minutes doing six exercises and then only spending a minute and a half on each exercise, if I give them ten minutes and say we do two exercises, that's five minutes and a break. So they they can have a break. And I think people like someone said to me, Who knew? One of my clients said to me, Who knew moving could be so hard? And they barely move. And I think a lot of people think that they've got to do more, you know, they've they've got to like do this bigger, make this hurt more, you know. Like, oh, I I I that's too simple, it's not gonna work. I've got to do this and then I've got to do that, and then and it's not, it's simple.

SPEAKER_01 22:55

Love it, love it. It's funny because I my back I have a background in Chinese martial arts, so my teachers just drill us on certain moves. So when I can do it now, people are like, but Greg, you haven't done Kong Ku properly for like 10-15 years, and like that's because I was drilled on how to do it, as you said. So I've got a question about core training. That's a big bug we're in in the kind of fitness side and also in the restorative side, and people have a perception of core strength. What how do you describe the core strength to people?

SPEAKER_00 23:30

Okay, so this is where I'm I'm a Pilates teacher as well, and this is where I burn Pilates myths. Um, I will literally talk. I'm here for it. I'm here for it. So um I I believe A, core strength and core stability are two different things. I think in terms of everything we do, we must be stable. You know, like for me, stability is at the cornerstone of everything. You you can't stability and mobility are two sides of the coin. You can't be mobile if you're not stable, and you can't be stable if you're not mobile. But we I don't, you know, we must recognize that core strength is something else. You know, it's like you can have a lot of core strength and still not be stable.

SPEAKER_01 24:10

Right.

SPEAKER_00 24:12

So for example, so for example, I get a lot of people saying my core's weak. Well, I'm looking at them and I'm thinking, well, you're standing upright, you're holding yourselves up against gravity, but it's no mean feat. You know, your core is doing just fine as it is. You know, could it be stronger? Well, what do you want to do with it? You know, if you want to go and do Olympic lifting, yes, maybe we make it stronger. But give making it stronger isn't going to give you more stability. That comes down to alignment and stacking and awareness and control. So, in terms of like if we say about back pain, people say, Oh, I need to make more calls stronger. Okay, so you you're gonna you're gonna get stronger. But if you don't have the awareness and the control of that strength, where's it going? You know, and what what what what do you want to make stronger exactly? But I think also as well, we think about pain. Chronic pain comes often from muscles tensing, yes. Muscles bracing. That's often the pain that we feel. Um so if my muscles are tense and bracing, when I train people with back pain, nearly all of them, not one of them, has needed a stronger core. Most of them need to be told, can you relax please and chill out a little bit more? So if we think about bracing the core, typically when I want to brace my core, it's for something like I'm gonna fall, so I need to brace for impact, or I'm doing something like uh maybe I've got a really heavy-loaded barbell squat barbell on my back and I need to brace to stop my spine from being compressed and squashed, or I'm doing a clean impress, then I need to brace my core, absolutely. But I but for everyday movement, when I'm moving through my day, when I'm just going about my everyday job, my everyday routine, I don't need to brace. I I need to move. And if I brace my core, I stop everything in my midsection moving. And then if I stop everything in my midsection moving, my hips stop rotating, my ribs stop rotating, my shoulders, my neck don't rotate. And if we think about walking and running, they're rotational patterns. Yeah, so if I if I'm stopping everything from rotating and everything from moving, I I'm I'm essentially putting myself in a full-body cast, and I'm stopping, and I and I and and this is why finding that you know uh you know, a lot of people saying, Oh, you know, I need to make my core stronger. No, stability is one thing, strength is another, let's not get them confused.

SPEAKER_01 26:33

Yes, I love it. Yeah, I think there's this people like especially the plank is the god exercise of core strength. It's like, well, I can do a plank for three minutes kind of thing. And I'm like, okay, when in real life do you ever have to brace for three minutes? Like, don't get me wrong, it has an application, but but it seems like it's the go-to for most people, probably just because it's been popularized, etc.

SPEAKER_00 27:02

Absolutely. I mean, it's still there, you know. I still get people saying to me, I've been told my core's weak. Uh, I've been told that I've got back pain, so I need to make my core stronger. And I'll uh you know, like so, for example, you know you talked about the plank. Um, I could do like a forearm plank, so hover on elbows, elbows under shoulders, um, on my toes, full forearm plank. Um, I could, I well, never gonna be repeated again, but just for a bit of a giggle, we did like a forearm plank challenge, um, and so it was like a bit of a competition between like the instructors and the trainers, and I managed 17 and a half minutes in full hover. So, you know, you could say that my core is probably stronger than average at that time, but my back pain at that time was also among at its worst. So my core strength, you know, like being able to hold a forearm plank for 17 and a half minutes counted for nothing with managing my back pain. I still had back pain every day. I how strong did I want my how strong did I need my core to be before I got rid of my back pain? And if you know, if if if this was really the answer, I could just send everybody with back pain on a 12-week core strengthening course. I'd magically wave a one and their back pain would go away because their cores would be amazingly strong, they'd never come back to me ever again, and they'd be all be fine.

SPEAKER_01 28:24

And that doesn't happen.

SPEAKER_00 28:26

It does not happen. So I my question is how strong do you need to wear your core before your back pain goes away?

SPEAKER_01 28:32

How you know and even then that strength endurance, not actual strength. And these maybe it's because these terms aren't well explained to the general public, they just see strength as duration, not the ability to move force or to resist force.

SPEAKER_00 28:51

Exactly. And I I think as well, you know, I don't, I don't what I wish people I wish um therapists would stop saying if you've got a weak muscle, you know, it it's not very empowering to somebody, you know, like somebody's already in pain, they're already probably by the time they see a therapist worried enough, because you know, as we know, you know, people don't do anything unless they're really prompted. So by the time they actually seek help, they're probably concerned enough about their well-being. And then to be told, well, you know, like you've got a really weak glute, it that's worrying, you know. Then you're going, oh my god, you know, my body's really weak. And it's very disempowering to somebody to say you've got like a weak muscle. And to be honest, that that's not really, I don't find that that's often the case. Typically, the weak muscle for a lot of people is a fatigued muscle, and it's fatigued because it's working at an involuntary level that they can't feel. So it it if you do a like a maximal voluntary contraction test, it comes off as weak. What they can feel is the voluntary contraction, that's the one they can tap into. But it's but it's smaller because there's an involuntary contraction that's already there that isn't, you know, if it's already there, it's not part of an MVC test. So the test is flawed, the the sensation is flawed, the whole result is flawed.

SPEAKER_01 30:14

Yeah, the weak muscle argument comes up so much. You've got a weak glute. Or you know, what's the the classic one is your glutes don't fire.

SPEAKER_00 30:24

Yeah.

SPEAKER_01 30:24

I'm like, what do you mean? I I can't see smoke. Like, what does that mean? Like, I wanna I wanna understand it. I'm like, okay, can you squat? Can you glute bridge? Yes, okay. So, what do you mean they're not fiery? But like you said, they might be fatigued rather than weak, or the person hasn't got the right movement patterns to engage the muscle fully.

SPEAKER_00 30:45

You know, yeah, and as well, you know, like um if we think about something like sensory emotional amnesia, they often can't feel it. So, you know, like the the brain only has so much hand space. So, for example, if they're using um, say a 10% contraction of the glutes to stabilize their pelvis or their lumbar sacral spine for whatever reason, the glute isn't really meant to perform that function as such. So if that glute is is just on all the time, the brain's just gonna go, you want to leave it to it. I'm not gonna register this anymore, I'm just gonna, you know, it's it's like it's like it's like someone talks all the time and never ever stops. You end up just tuning them out. It's like all the radar one in the background, you just tune it out and the brain stops listening. So they they may not even feel their glutes on, like they'll they'll feel nothing, but the glue is actually firing. And uh I think people sometimes think that that glutes, glutes do more than they do. I think people think they get like fireworks, you know, when the glutes, you know, and it's they're they're a very understated muscle. You know, I do like a really nice one where I get people to like, you know, I get them to align their tummy and they get them just to move their feet in and out and just like swivel the leg and just change the angle of the hip joint from internal external rotation, just think they can feel the tone of the glutes changing. And they're always surprised at how subtle it is, you know, like they don't need to clench, you don't need to clench your buttocks under normal circumstances. That's way, way much. You know, and the glutes are just very you can actually feel the tone change and you know they're on you and you know they're off, but it's not like oh my god, it's seismic, you know, I'm like everything is clenching and squeezing and rising. It it they don't do that, you know. That that's that's way much. I mean, if I was doing like you saying bolt sprinting, they might do that. But under a normal circumstance, if I was really, really doing uh, if I was proper going for it with this with a squat and I was maybe doing like real, you know, concentric squats, like really dry, they might do that. But under normal circumstances, they just they don't do a lot, you know. They they're not a muscle that's like there's there's not like fireworks and explosions and like hello, I've arrived, you know.

SPEAKER_01 32:56

I just had the the phrase that comes to my mind is like people are looking for a glute orgasm. That's the only way to describe. It's like they're looking.

SPEAKER_00 33:06

It's really not. I mean, they're they're just a very, you know, like they're just a very understated muscle, you know. They they they just work in the background, incredibly powerful muscle, but they're not like the hamstrings are a much noisier neighbor. The hamstrings whinge. Uh a lot of people say, Oh, my hamstrings are really tight. And again, I'm always saying, yes, but no muscle wakes up one day and goes, I'm gonna be tight, I'm gonna be weak. They just don't, all that is a sensation. Like one of my mentors, Simon, he would Simon Wellstead, he would say, He he really dislikes these labels of tight and weak and strong, and he's just it's all muscle behavior, you know, it's the muscle telling you it's doing something. Is it meant to be doing that? Is it not meant to be doing that? Is that an you know, is that a normal sensation? Is it a sensation telling you that there's some that there's something, it's doing something it wasn't designed, and so this is what we just look at.

SPEAKER_01 34:00

I think and just and I just want to go back to the glute thing because obviously there's a big rise in people doing lots of glute work, especially women, because they want a nice backside, and I and I watch people doing this thing when they stand up and they squat, and they're really like forcing their pelvis forward to squeeze the glutes. I'm like or they're doing so many hip thrusts, they're almost like I watched a girl in the gym the other day, and the way she was walking, I was like, Is she okay? Like it it no, but she looks like a robot, but that's because I think her glute her like hips and she because she does so many hip thrusts, she's actually put herself in an abnormal position. That makes sense.

SPEAKER_00 34:45

Yeah, yeah. So she's almost is she almost in like that lordotic sway back?

SPEAKER_01 34:49

Yes, yeah, her glutes are stuck out and she's you know, um stomach sticking out almost, and you're just like so her walking, she was like a penguin. I was like, that's not good. She got good great glutes, but she you could she couldn't move properly. It was like uh so is that becoming something you're seeing more of of late, or is that not that not coming to what as much?

SPEAKER_00 35:14

Um probably not to me as much because by the time they get to me, they're pretty far down the line.

SPEAKER_01 35:20

Right.

SPEAKER_00 35:20

Um, but I think that's that's training and imbalance. So um, you know, if like I don't like to say that posture is that there's no evidence that posture is in itself a cause of pain, you know, like um, but I think any posture to an if you the trouble is if you get stuck in a posture, you know, like for example, like if this girl can't get out of that sway back, laudotic, you know, bum out, tummy out type posture, then your muscles get stuck there. You know, you're you're like repetitively training them into that state and you're never let really letting them go. Um I was kind of saying it's like the difference between like, you know, if we like we can squat for longer than a wool sit, you know, you know, you can if you had a bit, you know, if you have a fair amount of strength endurance, you can squat up and down, up and down for a few minutes without fatiguing. Um I would say, you know, like um sustainable I teach body pump, which is a weight class, you know, we might squat with a fairly light to moderate barbell for about five and a half, six minutes, just starting to approach fatigue. But if I were to put you in a wall sit and left you there, you know, you a minute, two minutes, yeah, you know, it after three minutes, you are probably going to kill me. You know, like you know, that that's you know, your Lexus. So it's it's you know, and the muscles get stuck in this sort of pattern, and this is this is the beginning of really chronic pain because the muscles just get stuck in this pattern, and they don't ever come out of that, so they don't ever get a chance to you know relax out of that pattern.

SPEAKER_01 36:53

Got it. And I think there's also this thing about muscle confusion like this needs to stop as well. Like muscles don't get confused, they kind of have a couple of jobs, I guess, but they're not they're not confused about what they have to do, they they do based on the environment they've got, right?

SPEAKER_00 37:13

Yeah, absolutely, and I think it's important to recognize that muscles don't have a brain and they cannot think for themselves. You know, we are the ones that have a brain, and it's the brain's the flight control center. So, you know, it's like and I think as well, you know, going right back to you know, like saying about you know, like therapists, and I think, you know, with with the way with therapists, they're trying to control they're trying to change structure at the level of the joint or the muscle. So they're trying to either change the way the the bones meet or they're trying to change the the physiological state of the muscle with like massage or um shockwave or ultrasound or whatever. But the high but the so muscles move joints, but what controls the muscle ultimately is the central nervous system and the brain. And as you mentioned, they're always responding to the environment, external, internal. So if we really want to get out, if we really want to change the way the muscles are behaving, you know, if if they're if they're staying in contraction or if they're not contracting as we want them to, then it's not we have to go beyond the joint and the muscle, we have to go into this the nervous system and the brain and ultimately change, repattern them, which then alters muscle behavior. Yeah, and that's the only way you're gonna change how the body's how the body really functions.

SPEAKER_01 38:40

So you and this you just brought up a very beautiful point about um environment. So obviously, me and you met through uh mentor Rascliffe World, and we did a lot of stuff on help helping people to actually look at health more holistically. And I think what happens is like you said, we get so focused on that individual joint that we forget all of these other things that are happening, like sleep, stress, what you eat, how you live, all have an impact on the brain, and thus the nervous system, thus you know, how your body has responded to injuries, etc.

SPEAKER_00 39:20

Absolutely, yeah. And certainly when you when you're looking at chronic pain, I mean I would describe chronic pain as a neuroimmunophysiological phenomenon. You know, that there are there's elements of neurology, you know, the brain, the central nervous system, obviously the brain is always taking in inputs from the external environment, from the internal environment. Um you know, then we have the you know the immune system, we we have we have to think about inflammation, we have to think about how the cells, how the cells themselves are functioning. Um, if we're talking about somebody being in a level of involuntary muscle contraction, if that muscle is you know always always active, even if it's only 5 or 10 percent, you know, it's consuming energy, you know, muscle produces contraction, you know, through through glycogen, which then as a byproduct is lactate, which then needs to be flushed out. So then we go into that. Um and as well, I think what is the elephant in the room is people like you know, like with with especially with a long-term injury, you know, like for example, you have a very serious knee injury like you know an ACL or something that's a real long-term injury, there isn't there is definitely a neuro, you know, there is definitely a psychological element where when you lose function, you can you can lose the person that you were pre-injury. So I I think that you know there's always going to be an element that we have to think that there's an element of loss and grief involved with chronic pain that you know again changes neurotransmitters, changes hormone levels, changes um, you know, and all of that feeds into how we feel pain, you know, how we how we perceive pain, how we just perceive our bodies, you know, if we're feeling a little bit down, every sensation that's negative becomes amplified.

SPEAKER_01 41:10

Yep. For sure. I I remember when I tore my Achilles tendon and I thought, and the doctor said to me, Greg, you're never gonna be able to swap again. For about two months, that changed. I I can I know it changed how my injury feeled until I kind of went let's go improv this doctor wrong. I no, hold on, what are you talking about? I know I can do this. Uh I think you're right, and I think one of the big underrated parts of all of this is sleep. And as we were talking about right before the kind of the show kicked off, we were talking about sleep and how important it is.

SPEAKER_00 41:49

Absolutely, and you know, there was um, I think I wrote um there was the I think I wrote my blog there was a really interesting um uh research article um that that looked looked at the relationship between chronic pain and sleep, and it showed that not surprising, I don't think this this was any sort of surprise, but there was a relationship between chronic pain and sleep, in that people with chronic pain had less restorative deep sleep and had less, you know, like worse quality sleep, but also people that had poor sleep patterns tend to have a higher association with chronic pain. So it works both ways. Um, and certainly I think you know, like obviously we know that when you when you don't have enough sleep, you know, you get into the levels of neuroinflammation, you know, like the brain can't detox as it needs to in the in the deeper stages of sleep. So then if the brain is is is in you know there's if there's if there's in sort of pro-inflammatory sort of um proteins circulating around the brain, you know, substance P is is is a neuropeptide that's a really big one in chronic pain. Substance P produced by the spinal neurons is being implicated more and more in lots of cases of chronic pain. So chronic pain syndrome, fibromyalgia, multiple sclerosis, rheumatoid arthritis, it's coming up in more and more and more, um, to some degree osteoarthritis as well. So I I think you know, like sleep is so important. You know, I I think sleep changes mood. We know again, it's no great no great rocket science that when you are when you're tired, um, when you're you know a bit stressed, if you stub your toe, it's like the worst thing in the world. It's like the world has ended.

SPEAKER_01 43:36

Like my toe is broken, it's always never gonna walk again. When you kick your foot against the edge of the bed, that is the worst pain on the earth.

SPEAKER_00 43:44

Oh my god. And and if and if you had like a really crap like sleep, it's like, oh my god, my foot's broken, my toe, I'm never gonna use my and it's like the but if but if you but you know, if you like say for example, you know, you'd won the lottery and you just found out, it'd be like, oh yeah, whatever. You know, it I think I think mood and um you know our our sleep j general health is really underestimated in chronic pain and people just think it's a musculoskeletal issue, but it is and when we get into the world of chronic pain, it is about immune system, it is about physiology, and we know that sleep underpins immune system and physiology.

SPEAKER_01 44:23

So everyone listening, get your sleep sorted, ASAP. Um I wanna leave the podcast with like I think back, I'm trying to think of back pain is the worst, probably the most popular pain that people have right now. And I know you can't give a very specific diagnosis of everybody's back pain who listens to this, but have you got some recommendations that people can start to do differently or do or speak to their physio or whoever's helping them? What can they do differently to make sure they have maybe less back pain?

SPEAKER_00 44:56

So I for me with back pain. Um the the main thing is to recognize with back pain is typically the the worst pain comes when the muscles go into spasm. Yeah, anyone who's ever had back muscle, you know, spasm will know that it literally floors you. Um some people describe it as one of the worst pains in the world. I mean, it if the back muscles really go into spasm, there is you you're on the floor, there's nothing more. I would always say that you know, when like less is more. The exercise that um I I still use now, and it's a very it's one of my foundational exercises, is where we, you know, we we do an exercise called arch and flatten, where it's normally like a pelvic tilt, but we go into the tension in order to make the brain aware of the tension and then release it. So, you know, you you would if you can get on the floor and lie on your back with your knees bent, do that. But if you can't get on the floor, um you can do it seated, you can do it in bed, you can do it in even in four-point kneeling. Some people are sometimes more comfortable on their hands and knees with back pain, oddly enough. Um, and and you would first of all think about the lower back muscles and really think about them in your in your in your mind. And once you're thinking about them, then start to think about contracting them. So you might feel your lower back arching, but if movement is too painful, it's enough just to think about contracting that because the brain, it just activates the sensory motor cortex. Once you are feeling whether you're actually feeling the muscles contract, whether your brain is just sensing that, then you're going to ask them to relax and try and get the tension down as close to zero as possible, okay, but without forcing it, because obviously, if we're in a level of spasm, we're not going to zero, but as as much as we can. Allow yourself to rest and relax there for at least 30 seconds to a minute, and then we would go into what would normally be a posterior pelvic tilt, where we think about the tummy muscles in between the pelvis and the ribs, contract them between the pelvis and the ribs, it's almost like the world's tiniest ever abdominal crunch.

SPEAKER_01 46:59

Yep.

SPEAKER_00 46:59

Contracting the tummy muscles and then slowly relaxing them, and again, trying to feel the muscles coming back to zero and the back and the front of the body becoming equal. Again, resting for 30 seconds to a minute and just doing that two or three times to each side. But again, the movement itself isn't important, it's more the thinking about the contracting of the muscle and the thinking about relaxing the muscle that that then gets the brain in control of the muscle again. Once the brain is aware of the tension, it can then start to take back control and start to turn it down.

SPEAKER_01 47:37

Love it, love it. Yeah, and I I was just practicing it as you were talking me through it. I was just like, yeah, let me just practice that. So there's that's an awesome um way to start, especially if you're in a lot of pain, you've got a spasm, spasms are the worst thing ever.

SPEAKER_00 47:53

Absolutely, and you know, this is the exercise that I is one of my foundational ones. I say it's the one that I still use, going back to you know, like the basics. You know, if I feel that my back is a little bit niggly, I I can maybe I can feel my nervousness is is a little bit dysregulated, it in that can change the state of the muscles. Um, you know, we're about the fight or flight, you know, stress, anxious, change the state of the muscles. Then I just do that minute or two, a little bit of arch and flatten, and then just crack on because it just allows my nerve, my my brain to go, oh yeah, we're holding a bit more tension now. Okay, recognize that, let it go. And I say it's about repetition, the more you re the more you repeat, you know, the more the brain recognizes and the more sensitive the brain becomes without fixating.

SPEAKER_01 48:40

Yeah, that makes total sense. Norma, this has been awesome. Your knowledge is flawless. Um, you dropped some words that I couldn't even remember. I was like, okay. Um so where can people reach out to find more about your work and what you do? Because I know you have an awesome newsletter as well. So where can people find you?

SPEAKER_00 48:57

Yeah, so I'm on Facebook at Norma Pearson Fitness. The best thing is to connect me on Facebook. I'm also at on Instagram at Norma PearsonFitness again. Um if you click on my profile picture on Facebook on the banner at the top, there's a link to subscribe to my newsletter, which is the Movement Chronicle. Comes out every Monday at 7 a.m. straight into your inbox so you don't need to worry about algorithms and Facebook and everything. And so the newsletter in itself is just a bite-sized nugget, um, a truth bomb, an insight into pain, relief, and movement. And then there's uh a link to a blog if you wanted to go into into a little bit more detail um into that topic of the newsletter.

SPEAKER_01 49:40

Awesome. So, ladies and gents, I know there's a few gentlemen that listening to my podcast. Go and check Norma's content. I will make sure it's all in the show notes for everybody. Um Norma, thank you for bringing in your knowledge and you are you are awesome. I love your content. But that's just you know, just me fang that's me fanboying on you. Um yeah, I hope so. I hope people reach out and get some real help because these problems will hold them back in many parts of their life. And I'll people you know we want them to move freely and happily, and then they can come to me and squat. So if you listen to this and you've got some value, share this with a friend or family, give us a review, and we'll see you on the next episode. Bye for now.