 Welcoming to the stage again here is a man that just got his bachelor's degree last year from Southampton Solent University and is also working on his PhD. He's gonna talk about high intensity exercise, the lower back, give him a round of applause. James Steele second. James Steele the second. Yeah here we go. I knew that was gonna happen. There we go. There we go. Got it. Yeah. Bending over too much. Okay guys, right. I'm hoping that this talk isn't gonna bore any of you too much. I was a bit sort of apprehensive about talking about this topic to you guys. It's a big interest of mine obviously. I'm doing my PhD in it. I'm doing a lot of intensive research on it. So for me it's very interesting. So I had to think quite a lot about how to relate it to you guys. And really I kind of thought about how more to talk about how prevalent it is, yet how unpretentious the nature of chronic low back pain is. I mean like who has had back pain, got back pain, knows someone with back pain? That's probably about 80% of you, which corresponds to the research figures quite interestingly. But anyway, yeah just really to kind of give you an introduction of how I kind of got into it. Because a lot of people ask me that. They say you know, how did you get into back pain? It's a bit of a weird topic. Like Peter said, I've just finished my bachelor's degree in applied sports science. Before I started that I was very interested in kind of like exercise and how it relates to health and fitness despite their shady definitions and the effect that exercise can have on the body. So I went and did an applied sports science degree with my main focus being on exercise physiology. At that time I was getting introduced to kind of the concepts of high intensity training. I'm sure you guys are aware of like Drew Bay, Doug McGuff, Arthur Jones. And I was reading their works. I was reading my Mensa's works at the time. And kind of coincidentally when I then got to Southampton-Silent to start my degree, one of my lecturers there was involved with some research using the med-ex equipment. We specifically had a med-ex lumber extension machine there. And it was quite interesting that I was just reading all of Arthur Jones' works at the time and I kind of arrived at the university and was like, med-ex, med-ex, where do I know that name from? And I was like, oh yeah, Arthur Jones invented that. And I got involved with the research and it kind of stemmed from there. I really developed my interest in high intensity training, went back, looked at all the research, you know, was thoroughly convinced by the evidence supporting it and then moved through kind of the same way Arthur progressed from high intensity training involved with Nautilus and moving through to strength testing and then rehabilitation for the lower back and other parts of the body as well. And looking through the research, I saw that there are a lot of big holes in our understanding of, you know, predominantly what might be the main causative factor of back pain and potentially how we can try and treat that and try and either prevent it or rehabilitate it for people who suffer from it. So today's talk, I'm going to try and kind of first of all introduce you know, why care about it? What's it to you guys? Whether you've got back pain? I mean, yeah? Exactly. The gentleman's just said, you know, it's really, really annoying, like to just have this chronic pain around you like the whole time or recurrently, you know, popping up, popping down. It's really annoying and, you know, kind of relating to other themes in the conference as well. If you've got bad back, you know, maybe bad posture and it doesn't look so attractive. It doesn't really convey the kind of message you'd want to, to maybe women or other people you're trying to build relationships with. So we're going to talk about, you know, why is it important to care about it? We're then going to discuss maybe maybe, you know, why is it so prevalent? You know, so many of you've got it, so many people have got it. The figures are really high. But if they're so high, there's got to be something that's causing it, something that's having a real impact on it and something that's meaning that it's going to, you know, that it's kind of permeates our society. So we're going to go through some of my ideas based on my reading around the literature of what the main sort of like associations with lower back pain are and what I think has the most influencing factor on why the majority of people suffer from it. We're then going to kind of cover what you can actually do about it, because it's all well in back pain. This is causing it. Or this might be causing it. This is the main factor. Great. Now what do I do? It's good to have some information of, you know, how can you tackle it? How can you deal with it? How can you do something about it? How can you improve your situation? Because that's the main reason why all you guys are here, getting information and learning how to apply it and improve, you know, your lives, basically. I'm going to spend a bit of time just kind of going over what I'm doing and the impact I kind of envisage that my research is going to have and talking to you a bit about what specific areas I'm looking at and why I'm looking at them and how that kind of like is involved with lower back pain and then we're going to conclude and we'll have some time for questions. Just in case any of you aren't aware, although I'm pretty sure most of you are, that's the lower back, the bottom five lumbar vertebrae and that's where my main area of interest is. So anyone's got questions above there or below there. I don't want to step outside my area of expertise. So I'll give you I can give you an opinion, but if I don't know, I'll tell you I don't know and I wouldn't be able to answer the question. But anything in between those five vertebrae, I've probably got the knowledge that I can give you a good answer on it. So I try and save your questions for something relevant. Okay, so why care about the lower back? Well, first thing to do is to give back pain a definition. What is back pain? If we're going to learn how to tackle something and why it's even important to care about it, we need to kind of define it and know what it means. Like Anthony was saying yesterday, some words and some definitions have lost meaning over the years. So to tackle a problem, you need to be able to define it and know what the problem actually is. Well, back pains usually describe as a kind of tension or sawness or stiffness or all these kind of words that are used to describe what is essentially an overarching kind of condition in the lower back. Like you say, any of these things tension, sawness, stiffness, sharp pains, anything like that, they can be annoying and they have an impact on our lives. We also kind of categorize lower back pain into into various different sort of like subcategories. Now acute pain is what we consider sort of short term pain. So lasting anywhere up to sort of like 12 weeks. Acute pain would usually be involved with an injury, maybe a sports injury, maybe you trip down the stairs or anything that puts you back out, so to speak, and causes a pain. And 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 do, the actual pain will tend to go away after about sort of at most, you know, up to that sort of like, sorry, it's a 12 weeks, two weeks after that sort of like initial two week period. The problem is, it's when the pain doesn't go away after those periods. And it turns into what we then categorize as subacute pain and eventually develops into chronic pain. And chronic pain is anything that any pain that's lasted for a longer period than 12 weeks. And usually in those cases it's when it develops into, you know, years. I've got some people who are involved in my research, who I do my testing and rehab with, who some of them have had pain for 30 years. You know, they've spent their whole life in pain, basically. And you know, there's no way to lead your life. You know, you want to be happy, don't want to be suffering. One of the other kind of problems with it, and I was speaking to a gentleman earlier about it, is it's very difficult, actually it was cameraman. It's very difficult to give back pain in a lot of cases a diagnosis. I mean, we'll go on to it in a second. But there are a lot of different things associated with back pain that may be or may not be causing pain. They may be or may not be affecting the joints biomechanics and then having a subsequent impact on other structures which may elicit a pain response. You know, they may or may not be affecting function, so how the joint biomechanics actually function. So a lot of the time it's very difficult to say, right, you have back pain and this is causing your back pain or this is causing the pain that you're experiencing. You know, it may be nerve impingement, it may be, you know, this degeneration, this sensitization, or it could be ligamentous, it could be muscular, it could be actual muscular strain or sprain. But in the majority of the cases, diagnosis comes up short. So people are labeled as non-specific, you know, you've got back pain, but we know if I can idea what's causing it. So in those cases, it's very difficult to then say, oh, if we've got no idea what's causing it, how are you supposed to know what to do about it? And this is where the majority of my kind of like research is involved with. It's dealing with, you know, what is probably causing that non-specific category, because it's around 85% of people with chronic low back pain have this non-specific category given to them. And it's only that sort of like 15% that you can say, you know, you know, you've got this problem, you've got the specific pathology, the specific condition with your lower back and it's definitely causing you pain. So I'm focusing on kind of like, how can we figure out what's causing that or what may be the predominant cause of those non-specific cases? And then how can we address that?