 Christine Linders, physical therapist and board-certified orthopedic clinical specialist. Today we are going to learn the four secrets to a pain-free body and this is based on my 25 years of experience working in four different states, watching how people move, treating many patients of different age ranges, different generations, and as well being injured in so many parts of my body my whole life so I have great insight and those four secrets to a pain-free body are you need to have adequate ankle range emotion, you need to have improved posture, you need to have closer to normal alignment, and you need to have a well-functioning deep core. I didn't say strong deep core, I said well-functioning deep core. So let's go to video number one to learn the first secret and what you can do about it. One of the secrets to a pain-free body is having adequate range of motion in your ankles. If you don't have adequate range of motion right here you can end up with things like plantar fasciitis, bunions, achilles tendonitis, knee pain, and more. Also if you don't have enough range of motion in your ankles when you go to squat down like I have enough range of motion it can cause you to fall over backwards and you can also get back pain as you squat because you'll get to a point that your ankles don't bend anymore and your body will bend to get down more. We need about 20 degrees from this angle more than the L like that of normal range of motion for walking going up and down stairs, bending, etc. So the simple thing to do is stretch your ankle. It involves stretching your calf muscle, your gastroc, and your soleus. You're going to put one foot in front of the other, keeping the back legs straight and then you're going to bend the front knee, try to keep the back heel down. You're going to do 20 times a stretch and release. You can also wedge your foot up against something too to help if you're stretched, but if you're tight you want to do this. 20 times back and forth, switch to the other side, keep the back foot pointed directly forward. So you don't want to stretch like I see in the clinic like this where the foot is towed out. You want to look down and make sure it's in a straight line because you don't want to stretch your arch muscle. You want to stretch the tissue on the back of your leg and the back of your calf so you can get ankle range of motion. Then you're also going to do the second muscle, the soleus. Then you just bend the back leg like this and you'll feel the stretch a little bit lower towards your Achilles tendon. Hugely important if you're walking, if you're bending and you're going down like this, you're noticing you're losing your balance or you feel back strain. So enjoy. That's so important. I first discovered the importance of ankle range motion when I moved from California to New York City and I was having a lot of patients coming in with Achilles tendonitis, plantar fasciitis, knee pain, back pain and I couldn't figure out why. There was nothing wrong with their knee. There was nothing wrong with their back and I went to their ankle and everybody had the same problem. So I started checking all of my patients. Everybody had the same issue. They didn't have any more than that acute right angle and you need more. You need 20 degrees past that. So I started having everybody stretch their calves and their foot pain, their ankle pain, their knee pain, their back pain all started to go away. So that was my first introduction. And if you want to see my co-host here, Little Richie, this is his ankle right here. So that's the L I was talking about from the outside of the shin bone down to the foot and you need it to go further than that to be able to have the proper mechanics of this in your foot. So simple thing, stretching. Try it. You can do it in the morning. You can do it midday. I usually have people do 20 repetitions like that. I like dynamic stretching. It helps to really release the tissue without pain, without really just like stretching the tissue. So that's number one secret to a pain-free body is making sure you have adequate ankle range of motion and also a little asterisk. If you're getting older and you're 65 plus and you're noticing that your balance is becoming different or you feel like when you stand you're on your heels, stretch your calves because a tight ankle leads so too often to falls in people as they age. So let's get a video number two where we learn the second important secret to a pain-free body. The second secret to a pain-free body is having adequate core stability. And what I'm referring to right now is your core is just your deepest abdominal muscle, your deepest back muscle, your pelvic floor. We're going to go for this part of your core. So it's very simple. If you are having pain in your back, pain in your neck, pain in your shoulders, pain in your hip, pain in your knee, you could, it could be that you don't have a strong core and you're walking around unstable or unbalanced because this center part of your body is what needs to keep strong so that all of this will be stable. Even people that sit at a desk job can have elbow pain because their core is not stable. They're kind of sitting slouched, hanging on their bodies without the stability to keep this centered so that this part can move without pain. Simplest thing I say this all the time I've been saying it for years is suck it in. I don't mean air. I mean your stomach. You suck your stomach in. You go from your belly button and you move it in, move it in, move it in. Here's your diaphragm. You don't want to suck all that in because you can't breathe and your diaphragm is a valuable part of your core and it needs to work to keep you strong and to keep you breathing. But you go right here, belly button, move in, in and you can hear it might change the sound of my voice a little bit but it doesn't stop me from talking like pulling my diaphragm in. So pull your belly button in, engage your transverse abdominis which engages your deepest back muscles, your pelvic core and gives you a stable core. So I like to put one hand on the diaphragm, one hand on my belly button and pull the belly button in. Belly button in. Belly button in. It's a simplest way to do it during your function so you can be pain-free. So you can walk up the grocery style aisles, one aisle, pull your belly button in, walk up one aisle. Second aisle, let your belly button out. Third aisle, pull your belly button in to try to retrain your deep core to keep you stable but also getting in and out of the car. Belly button in and then reach for the car door. Belly button in, get up from the low toilet. Belly button in, get in and out of bed so that you can have a pain-free body by having a very strong That's a lot of information. So I'm just going to simplify it a little bit for you. And I was saying strong core, but the most important message for you when you do suck it in, when you pull your belly button in, is you want your deep core to be functioning well. The strength of having a six pack or doing tons of planks is not what I'm going after. I'm going after making sure that your transverse abdominis, that muscle that wraps around you like a corset, like a belt at your waistline, that muscle needs to turn on when your brain thinks I need to reach for the car door. When your brain thinks I need to scratch my face, that muscle needs to be well functioning. It needs to turn on first, activate your anatomical girdle, activate your deep back muscles to give you that stable, strong core so that when you reach, you're not like loosey-goosey out here and then you blow out your rotator cuff or you get like tennis elbow because you have a job that reaches all the time or you have a new baby or you're a golfer, a tennis player that's swinging on a racket and you don't have that transverse abdominis firing before you go to move to stabilize your middle so that everything out here has stability. So I just wanted to clarify that because I think it's important you're pulling in your belly button to retrain the mechanism of that muscle firing before your body generates motion. You can do it when you're sitting, you can do it when you're standing, you can do it when you're laying down. There's so many different ways to train the transverse abdominis, but the simplest one to getting pain free now that works with all of my patients. And I can say that because so many of them come back after the first visit and say, my back is better, it still hurts sometimes, but when I suck it in, it takes the pain away. I just forget. That's the most common thing that I hear from everybody when I teach them how to activate their deep core so that they can find stability. So it's a lot of information, but just note to self, suck it in before you move and retrain your anatomical girdle so that you can be stable in your body and pain free. Okay, let's go to the third secret to having a pain free body. The third secret is having good alignment. It doesn't have to be perfect alignment. It just has to be better alignment. So many of us will stand like this and you're off to one leg. But when you stand on one leg, you're causing your pelvis and your femur, your thigh bone to rotate and your spine is bending over to the side. So I'll show you from the back. So here I am standing. Here I am standing on one leg. You can see it pinching my spine right here. So you want to improve your alignment. Also you may be sitting leaning with one elbow on the table or one on your desk. And so if you do that and you're sitting and you're leaning, you can see the bend here even if it's in your car. So when you have improved alignment, which is your closer to this way and not this way or this way, your spine is aligned, all your muscles get messages from your brain to stabilize you and life is effortless. So to improve, to get closer to better alignment, try to center yourself and find equal weight on your feet when you're standing. Catch yourself if you're like, oh my gosh, wow, I'm shifting again. Notice and note how you're sitting in your chair at work, how you're sitting on your sofa, how you're sitting in your car and try to improve your alignment. If you can get better alignment more often throughout the day, you're gonna halt a pain process, halt muscle spasm and halt injury. But the other thing too is if you have arthritis in your knee or you have that tight calf that's not allowing your ankle to bend, something else will bend. So if your ankle doesn't go this way, your arch is going to have to collapse and it takes your knee in and you start to develop that this kind of posture where your knee is in. And when you do that, you can see my trunk shifting over here. A lot of people will have back pain from an arthritic knee that's come from having a bunion or a tight calf. So you want to look in the mirror at your leg alignment and make sure you've got pretty good alignment here and you're not standing with one foot turned out or even just standing like this. Look down. If you're like this, turn that one foot in a little bit more and you will note how when you walk, how different it feels. So enjoy that. Again, that's a lot of information about your alignment, where your feet are, when you're standing, where which foot you're leaning on, when you're standing, if you're shifting back and forth. But the first step is just awareness. So if you want to achieve a pain-free body, we need to improve how we hold our body. This is our machine that's going to last us for a lifetime. And I know I've had, I can't even count how many injuries I've had since I was 12 years old. And I am constantly saying that word to myself, improve. I pay attention, attention and awareness to how I'm holding myself. And am I perfect? Absolutely not. I work looking down, sometimes in the car, if I get tense, I catch myself lifting my chin up and then I get my neck hurts and then I say, okay, lift my chest, drop my chin down, long neck. So it's a constant thing to adjust your body, but first you have to be aware. And that's why I want to have those videos where I'm showing you. Look down right now. If you're sitting, watching this video, look and see if one foot is out to the right. Look and see if you're shifting to one side. Look and see if you're leaning forward with your chin up, leading to neck pain and headache. So awareness is key. A lot of times I do these talks and I tell people that and you see them kind of like, uncomfortably shifting like, oh yeah, I'm gonna sit back a little bit and looking around to see what everybody's doing because we're just going through life enjoying the freedom of our body. But when something hurts, it's telling us that we're doing something wrong. There's a message that's sending to us that we need to check ourselves and I know why because I'm a physical therapist because I've been highly trained and did lots of education, but I want to share that with you so that you can be pain-free too. It's just a little bit of awareness looking at where you're at and also a little bit of change. Reminders, sticky notes, anything like that. You can give yourself notes. You can set alerts on your phone if you're sitting at your desk and you want to improve. If you tend to sit one way, set an alarm to go for your five minutes, oh shoot, I'm doing again. Let me fix myself. If you're standing in an elevator or standing to work or standing at the sink, washing dishes, look down and see if that foot is out. Just a little bit of awareness and changes throughout your day will help you get a pain-free body now. If I could use my co-host here, Little Richie, to show you about the alignment, here's your spine. When I was standing on one leg, you could see the bending of my spine right in this area right here. The nerves pass outside of these vertebrae here and they go down your leg. When you are bending towards that, it decreases the space around your nerve and you can get painful things like you see your MRI and you find out you have stenosis. Now, because you're standing on this leg, you're having pain down that leg because you're actually pinching the area around where you have the stenosis, making the area where the nerve passes out more narrow and giving you symptoms. That's why if you checked all the people who had stenosis and you have this small group of people that have pain with stenosis and this big group of people who don't have pain with stenosis, it's usually just an alignment issue. We have different habits that we do that once we correct them, you can get out of your pain from your stenosis like the people that have stenosis that don't have pain. They just happen to have a job that doesn't involve them to shift side to side or they have really good posture habits or they have different hobbies than you and it's all different situations. They have less injuries than you've had when you were a kid. You had a car accident, all those things lead up to the story that is our body that can lead to pain in different places and now the knee alignment, if you have knee arthritis or you have that kind of crooked knee like that where your foot, if you look down, your foot is outside and you notice your knee is kind of going in an angle like this right here, that is because you're either walking with your foot out or your hip is weak over here and so it's all alignment. So pay attention how you go up and downstairs. Don't let your knee dive in when you go downstairs. Pretend like you have an imaginary finger out here and push your knee out so it's an alignment as you go up and downstairs. I use that with my family and my patients all the time and most of them are just like amazed that wow my knee doesn't hurt when I do that and it's just because you improved your alignment a little bit and the body likes that. Now before we go to the last video I'm going to talk a little bit because the last one is posture. I'm going to talk a little bit more about the alignment of your of your body here. So this skeleton little Richie here, his ear is over his shoulder, is over his hip and many of us if we had someone walk by with a camera and take a picture of us standing or sitting you wouldn't see that. We would see the head forward of the shoulder and that's what leads people to a lot of neck pain, shoulder pain, and back pain. So that said let's go to the fourth video to discover the fourth secret to a pain free body. The fourth secret is something many of us learned from our moms and our grandmoms when we were younger and it's posture. Posture is so important to the health and well-being of your body. It's so important to living a pain free life. If you are like this it's not a matter of if but when are you going to have neck pain, when are you going to have back pain, when are you going to have shoulder elbow pain. So let's talk about posture. When you stand up ideally, mine's not perfect either, I make an effort though to improve. Your ears should be over your shoulder, over your hip when you're standing. So if you're like this all you need to do is imagine like a string is pulling you up from your breastbone here, pulling you up. It looks like you're lifting your chest a little bit just yanking you up tall. You can also imagine that something's pulling you up from your head. If you're here and you are held by a string it will pull you up. You can squeeze your shoulder blades a little bit. It's important just not to sway your back like this and move back while you're trying to improve your posture. Sitting, if you sit and your knees are at your hip height it's going to be harder and you'll want to put yourself into what we call a posterior pelvic tilt. If you're sitting and you're struggling to sit up straight just drop your feet a little bit so that your knees are lower than your hips. You move your feet a little bit back and that will help you to not be slouched. But also supporting your back with a pillow when you're in any chair will help support the natural curve of your spine and help keep you here because here is very difficult to maintain without support. So this chair is too low but I'm showing you like if you're sitting you don't want to sit like this. Neck pain, shoulder pain, back pain is all going to come at some point. You want to get yourself into this position a more aligned position so that you can have a pain-free body and enjoy. So that's great. I wanted to make sure that everybody learns the importance of posture. It's something that I was nagged, reminded about all the time as a teenager as I was like slouching or slumping in a chair and so I appreciate that now. But also I have the education of knowing about biomechanics and body mechanics and alignment too and also having a car accident when I was younger. Before I was a PT I found myself just literally sitting super straight because when I looked down I had terrible neck pain and so I've learned it first hand through myself and then also added the knowledge as a physical therapist with my posture. It's something that I see in the clinic now the last probably eight to ten years more than I've ever seen is someone's posture being the cause of their neck, their shoulder, and their back pain and their headaches. So I did a show previously called your posture is causing your pain why and it's a big deal how we hold ourselves. We didn't have devices 15 years ago like we do today or 25 years ago I guess like we do today where everyone even small children are looking down at devices and it's a real problem gravity never takes a day off I always say that so constantly gravity is pulling on our skeleton and when we are sitting up straight there's not much effort going on in our body it's alignment stability and so that's great as soon as you go out of that alignment now muscles have to work to hold your body up against gravity and to fight the gravitational pull and that's what these beautiful devices are is we're constantly even just as you can see even just me tilting my head down or a lot of people are holding them down their laps and looking down like this I catch people all the time my head is I don't know 45 degrees down which puts a huge force on my neck and worse collagen is constantly turning over and you could reach around right now and see if you have that bump they call it a dowager somewhere you run your finger down your neck and right about where it hits the junction it hits your upper back you'll feel a little bump like that and that's just from looking down too much you're looking down too much and collagen is turning over in your body and we become the shape that we hold ourselves in most so if you're holding yourself upright your spine a little bit you over here is going to be in nice alignment if you're looking down this is the area that's going to become more bumped up because the vertebrae will constantly will start to bend forward that way and that's what leads to a lot of compression in the neck if you have C345 compression it's because as the spine bumps here the curve reversal has to go so extreme so then there's less space for the disc and less space for the nerves to come out of your vertebrae and so you start pinching discs and pinching nerves I wanted to tell you a little bit about the transverse abdominis I was trying to pull it up on my phone here I published an article in 2019 called the critical role of development of the transversus abdominis and the prevention and treatment olobac vein and it's available on PubMed it's a fantastic article I don't know if you can see it there but if you went into your Google search bar or whatever search engine you use and type in my name Christine Linders and transversus t-r-a-n-v-e-r-s-u-s abdominis a-b-d-o-m-i-n-i-s you'll find that article and it will teach you everything you want to know and the basics for activating your deep core so that you can get that well functioning core even if you have that six pack and you're doing cross fit and you're working out and playing sports and soccer and you've got back pain read that article because you can have a very strong and fit and activated superficial core which is your rectus abdominis the six pack muscle your external oblique but what you're lacking is a very well functioning deep core transversus abdominis internal oblique pelvic floor I can go on but read that article it's free thanks to hospital for special surgery they got it published for me all access and you can learn how to get your deep core functioning which is being masked by a very strong superficial core so I'm gonna go to video number five for a break now because I don't know if you hear in my videos oftentimes Garfield and Pookie my lovely little tabby kitties are talking so let's go to video number five and get a little grin Pookie you want to be a movie star? Garfy you want to be a movie star? You want to be on tv? Hi kitties what Garfy Pookie oh hello I thought that would be funny because those of you who have been watching my show for the past three plus years they tend to be laying in the background when I'm living here when I was living at the other place strewn throughout my videos and they really are a joy they've helped me get through this pandemic and so to wrap it up I just want to say there's four secrets to becoming pain-free and they're kind of the basics of body mechanic you want to have adequate range of motion you want to have pretty good alignment I'm not asking for perfection you need to have better posture when you're going about your day which means you need to put a little bit more attention into how you're holding your feet how you're sitting how you're standing just to improve I want everyone to improve so you can be pain-free the body's very forgiving you don't have to be perfect you just have to be a little bit better and last but not least activate your deep core suck it in you can see me kind of my posture pop up I can slouch and then suck my stomach in and it pops me up right away because it's cinching my waist and it's giving my low back stability so activate your deep core pull your belly button in towards your spine throughout the day set reminders so that you too can enjoy a pain-free body thank you so much for tuning in and if you need to get in touch with me you can check me out on LinkedIn it's Christine Linders or you can just email me at clindersrunatgmail.com if you want to get in touch with me if you have an idea for the show or if you'd like to have a virtual assessment thanks so much Think Tech Hawaii and everyone for allowing us to be here with you today Aloha life is better when you listen to your physical therapist and donate to us at thinktechawaii.com Mahalo