The Answer to the Question: “Sam, what do you do?”
After literally HUNDREDS of consultations over the years, and an equal amount of requests via email, I’ve decided to put together a video of what I do to explain my methodology and work. Here you go inquiring minds!
How To Isolate The Transverse Abdominus for Back Pain Relief
In this clip, I’ll show you how to activate one of the MOST important muscles to address with regards to lower back pain. This muscle, called the transverse abdominus, is essentially a ‘corset’ for the spine. Dysfunction in this muscle is VERY common in individuals with back pain, and restoring its function is a key objective for reducing further episodes of pain.
Click here to get your Stabilizer Pressure Biofeedback Unit!
How to Perform an Abdominal Plank Exercise Properly for Back Pain Relief
How to Find Neutral Spinal Alignment Through Pelvic Tilting
Correction Of Forward Head Posture
Part 1
Part 2
Treatment for Sacroiliac Joint Pain
What is the Sacroiliac Joint?
The joint is comprised of the area in which the sacrum and iliac bones meet.
Stabilization of the SI Joint: Two Types
Form Closure
Form closure is the stability that happens when the tight fitting joint surfaces of the SI joint are close together. This is very much dependent on the size and shape of each person’s structure.
Force Closure
Force closure is the support offered to the SI joint by the ligaments and muscular systems.
Most research is is clear that no muscles directly move the SI joints, but its important to understand how their dysfunction can promote sacroiliac joint dysfunction.
Addressing Sacroiliac Joint Pain
Sacroiliac joint treatment options beyond medical interventions are quite simple, in fact. They need to be separated into 2 different scenarios:
What to do when the sacroiliac joint is OUT:
As mentioned previously, there are not any muscles in particular that move the SI joints. However, there are some movements that are useful in assisting the mobilization of the sacroiliac joints.
Unfortunately, sometimes its not possible to get the joints back into balance on your own. Many times with patients, I have to help them by anchoring certain parts of their pelvis or sacrum while they perform movements in order to re-balance the area. Therefore, its recommended to see a trained professional to help with this.
The good news is, on more than a number of occasions, someone walks into my office with sacroiliac joint pain of a 9 on a 10 scale, and within 5 minutes, I can get them down to a 2 or a 3. This just demonstrates how much potential to cause pain these joints have, AND how quickly it can be resolved by doing the right steps to resolve it.
What to do when the sacroiliac joint is IN:
Once significant pain is resolved, and sacroiliac joint inflammation is reduced, corrective exercises and stretches must be implemented in order to effectively restore balance to the muscular “slings” that support the area.
Sacroiliac joint exercises need to focus on two areas. Some of the key muscles that need to be addressed are found in two different “layers” of muscles.
The Inner Unit:
The inner unit muscles are a deep set of muscles that help stabilize your entire core and are frequently shut off, or possess inappropriate activation patterns during periods of pain. They include:
-The muscles of the pelvic floor
-The transverse abdominus
-The multifidus
-The diaphragm
These muscles must be isolated to ensure proper activation and sequencing, then integrated with the next group of muscles, called the Outer Unit.
The Outer Unit:
The outer unit is further segmented into 4 systems, but in essence, involves the following muscles:
-The gluteals (all of them)
-The spinal erectors
-The abdominal wall
-The groin muscles
-The hip flexor and quadricep muscles
The real trick to resolving any problem with back pain seems to always come back to the correction of the deep muscular stabilizer systems of the body, then re-integrating them with the larger, more powerful muscles.
If you don’t follow this sequence, your results will be limited to symptom relief for the short term. I have seen this time and again in my practice with patients who have progressed their programs too quickly just to “get stronger”.
When I end up seeing them after the many therapists they have seen prior to me, I have to take them back to the beginning anyway. In this situation, unfortunately, they have been taught to OVER activate the larger muscles, and I have to re-train them to focus on the micro-movements that need to be done.
Lesson here: Whats worth doing is worth doing RIGHT the first time!
Emotional Reasons Why Muscles Won’t Release?
I saw a patient yesterday that sparked today’s blog about an interesting issue that comes up while
performing corrective stretching programs.
Why is it that some muscles just won’t release?
First off, we must keep in mind the driving influence for muscle tension, and that is your central nervous system.
You see, your muscles are frankly quite stupid. They aren’t the “brains” behind the operation so to speak.
Your muscular system takes the cues from what your nervous system tells it to do.
However, that does NOT mean that muscles can’t have their own problems. For example, there is a close
correlation between the amount of athletic training years (or years in the gym also!) and the amount of muscular adhesions and scar tissue someone has.
Why? Well, the more years you have “beat up” your body as a result of training, you will have had strains, micro damage and so forth to your muscles.
In this situation, your muscles will respond VERY well to stretching and specific massage techniques like neuromuscular therapy applied to certain areas.
Now, back to the central nervous system. There are 2 major divisions, the Sympathetic and the Parasympathetic.
Sympathetic is the “fight or flight” aspect, while Parasympathetic is the “rest and relaxation” aspect.
Sympathetic stimulation will increase muscle tension in preparation for a potentially stressful event. This is the primary reason for the inability to get a muscle to relax.
Now begs the question, what causes sympathetic stimulation?
Thats one LONG list!
Worry
Fear
Anxiety
Restlessness
Food allergies
Digestive issues
Nutritional deficiencies
Illness
Organ distress
This is by far not an exhaustive list!
Of course, this is one of primary reasons why I address nutrition and emotional stress in my programs. It has
led to breakthroughs in some of the most challenging cases I have seen!
Soon, I’ll be coming out with some resources on how to address these factors, so keep checking back!
Sam–
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http://www.youtube.com/user/HolisticSam
“Sequence” Is The Key To Relief
Out of the myriad of factors that are involved in the process of getting results with lower back pain, one of the more important areas that I have discovered to be critical involves the ORDER in which things are done.
Here is the BEST activity that will dramatically impact the results you get from your lower back pain relief program:
1. Relax FIRST before you do anything!
I know this one may sound obvious, but it is rarely addressed. Its important to keep in mind that pain causes increased muscle tension and increased activation of the sympathetic branch of your central nervous system, the “fight or flight” part. When this happens for long periods of time, the habitual muscle tension patterns become unconscious. Basically, you aren’t aware that you are holding your body in a tense way.
By performing a relaxation-inducing activity, particularly one that involves actively paying attention to your body, you can decrease the tone in your muscles, thus allowing increased blood flow and function. One of the very best activities for doing this is a sort of meditation.
Start off by laying on your back. Close your eyes, and allow yourself to lay in the most comfortable way on your back. Start by focusing your attention on your big toe. Focus on relaxing and letting go all of the tension in the muscles in that toe. Then allow that relaxation response to spread to your other toes. Allow it to move up to the soles of your feet, then your ankles. Continue this process, muscle group by muscle group, until you have every muscle in your body completely relaxed.
Do your best NOT to fall asleep!!
After you have done this, you will have allowed the tone in your postural muscles to relax, and will get MUCH better results from your corrective stretching and exercise program!
Try it and let me know how it works for you!
–Sam
The Non-Surgical Approach To Disc Herniations: Part 3
Welcome back to part 3 of this special series on my non-surgical approach to disc herniations. As mentioned previously, the information in this blog is for INFORMATION ONLY. Please DO NOT attempt any movements that have not been approved by your doctor. Failure to listen to this advice could potentially cause you more pain if used inappropriately, or in use with a mis-diagnoses.
So, with that said, I am now going to introduce to you a movement that has brought me a tremendous amount of success with patients with disc herniations. I don’t take credit for this movement, originally learned through Robin Mckenzie, a renowned physical therapist who introduced flexion and extension based therapies for spinal dysfunctions.
This movement, along with what I have been talking about all along, is focused on improving extension in your spine, which is ideal for relieving pressure on spinal discs, particularly of the posterior disc bulge variety. In this video, I will explain how to perform the movement:
As you have seen, there are a few progressions to this movement. It is CRITICAL to make sure you start with the MOST appropriate level of the movement based on your pain levels and to the degree that your disc is bulging. This movement at times can create quite a bit of discomfort if done with too much intensity, even if it is the best thing for you.
When giving this protocol, I usually start off with the following protocol:
1. Lay face down for 3-10 minutes to allow muscles to relax and pain levels to diminish
2. If you feel better, then slowly begin to work yourself up onto your forearms, and relax there for 30 seconds to 60 seconds, depending on comfort.
3. You may then rest for 30 seconds, and repeat for 3-6 reps, or move to the next movement.
4. Prop yourself up onto your elbows, then repeat the procedure as outlined in #3
5. Lastly, begin performing the pushup to tolerance and/or upper body endurance, repeated for 10 repetitions.
There may be a stage between each of these steps by 1-7 days, depending on the severity of the condition. If all done on the same day, proceeding through the steps as sort of a “warm up” procedure, then each set (from 1-5) is only done once.
This procedure may be done as frequently as every hour on the hour, especially if you work at a seated postion all day, as compressive loads during sitting are one of the worst for disc bulges.
Again, this is ONLY a general outline. When using this in my practice, often times it will be INDIVIDUALIZED with EVERY patient, depending on pain levels, severity of the condition, and VERY importantly, how well they are sticking to the lifestyle outlines!


