Andrew: Great to chat again, mate. Now, take us through, I’ve gotta say, you know, from this sort of orthodox perspective of physiotherapy, it’s kind of like me with my nursing background when I just used to poo-poo nutraceuticals outright without any knowledge of them. What opened your mind to the merits of nutraceuticals in therapy?

Jesse: Yeah. It’s a great question. It’s something I’ve pondered myself actually. And I think it really all started for me when I started my journey towards my own health. So I started working pretty closely with personal trainers at quite an elite level, so working often three, four sessions a week and we sort of got quite deep into the whole diet, nutrition, and how it affects your mind, body. And that that’s when I started to use nutraceuticals myself and feel and really recognize the benefits.

And from there, I started to realize that there was a lot of merit to get nutrition and minerals and vitamins and I could feel and see the benefit that I was having in myself and how it was affecting my own training and physique. And yeah, from there, I started to work a bit closer with naturopaths and dietitians and took on board some of their advice and then it sort of prompted my own interest into studying and reading.

And I started to read different books about gene health and vitamins, in addition to what I was already studying about anatomy and physiology. I started to just be curious about various, I guess, yeah, supplements and how they worked and what the research was around it and what the benefits were. And a bit of trial and error on my own front, you know, made the typical mistakes of using certain things at the wrong times and not being able to sleep and things like that. But I’ve come a long way since then.

And yeah, I guess in terms of how it fell into my practice, when I graduated, I didn’t initially start using them. And it wasn’t until I started to use them more myself with more of a targeted specific effect and I realized it was really important for me to actually understand how I could. And that’s when I started to reach out to different brands, practitioner-grade brands, and I found there was so much information and educational content out there by different brands to help practitioners help their clients.

So I started to access that more. And then just by reading and attending seminars and things like that, I could start to pretty feel quite confident with recommending and, you know, giving a little bit of guidance to people. And then I think from there it sort of started to become more and more prevalent, more and more part of my practice. Started off very slowly and I still use things quite conservatively and slowly, but yeah.

Andrew: Cool. Take us through your sport. What’s the level? You said that you were at…

Jesse: Yeah, my sport.

Andrew: …at an elite level.

Jesse: Yeah. It was…well, competitive. So I was doing a competitive physique competition, so fitness physique, more of an aesthetic thing. And that was quite challenging. I played basketball quite intensely as well, representative level. And yeah, it was A grade, and that really took its toll on my body. So being able to recover and yeah, train as well at the same time was really…I really found that to be quite useful in terms of focusing on being able to use nutrition and vitamins and minerals to help aid that. And yeah, I rarely got injured the whole time. I did my first fitness comp when I was 20, I played second. I was pretty happy with that. And yeah, that was a real experience and just…

Andrew: Well done.

Jesse: Thank you. So it was…seems like a long time ago now, but at the time, it was a real rewarding experience despite me probably thinking, now, it was a bit of a waste of time, but…

Andrew: Well, it’s never a waste of time because you’ve…I think you probably know exactly what athletes go through with regards to injuries or potential injuries and recovering from them. So you know, not just the risks, but indeed how to correct them.

Jesse: Yeah, exactly.

Andrew: So take us through the contribution that nutrition and diet has in the musculoskeletal system. I guess, first, let’s do a sort of, you know, review of what nutrients are important, what dietary components are important, as well.

Jesse: Yeah. That’s a great question. I think first and foremost for me, what I find is just being hydrated, water. You know, our body’s really 70% water. And I think that’s something that I see a lot, is especially with my manual therapy side of what I do, feeling people’s tissues. You can really tell when someone’s dehydrated and you get that sort of grittiness, there’s adhesions, the lack of flexibility and extensibility in the tissues.

When you’re working on thousands of bodies over the course of my career, you know when someone’s not drinking enough water and that in itself I think is, you know, our body’s 70% water on average. And even something like the intervertebral discs, our tendons, ligaments, a lot of it is water and comes down to that. So…

Andrew: It’s really interesting.

Jesse: Yeah. So I think people kind of forget how important it is. You know, sky water, I like to call it. It’s really important because without that, we just don’t have that flow of circulation, there’s no blood, the lymphatic system can’t do its job, and yeah, all the fibres and the myofascial system, they become tight and brittle and they just won’t stretch and lengthen like they should.

So one of the biggest things I tell people is, are you drinking enough water? And there’s a simple calculation for that that I use and that was taught to me by a nutritionist. It’s your body weight multiplied by 0.03. So body weight in kilos times 0.03, and that gives you the amount of water in litres that you need for optimal hydration based off your body weight. So that’s something I often just…a number I just pull out for people. And you can do it in five seconds. And a lot of people don’t realize they’re not actually getting enough water and they ask me, “You know, oh, is tea or coffee, does that count, or juices or smoothies?”

And to me, the answer is no, because, you know, tea and coffee, it’s not gonna hydrate you in your cells like water is because that’s the property of water, is it’s so clear. Our cells absorb it up because it’s emptiness, you know, and it also helps to clear out impurities and flush out toxins and acid and things from our tissues, our musculoskeletal system.

So it’s just like if you have clear water and you put a teabag in it, the water pulls out the tea, in the same way, it pulls out a lot of the toxins and the buildup. So particularly for someone who’s exercising or training athletes or just people doing a lot of work, manual labour, you need water, otherwise, you’re not gonna feel…you’re gonna be tight and you’re gonna cause some kind of strain.

Andrew: Yeah, yeah. You know, it’s really interesting that even orthodox practitioners are well-versed and well accepting of partial pressure of oxygen versus carbon dioxide. Excuse me. But when you talk about water, there seems to be this resistance to embrace a higher amount by orthodox practitioners, even though given the function of the kidneys, the kidneys aren’t a filter, they’re a siphon. And so more water will actually get rid of more solutes. It’s just the way that they work. There’s a guidance thing, sorry, guidance physiology.

But it’s really interesting when you speak about joints and, you know, we think about the circulatory system or we might even think about complexion, you know, that sort of outward expression, if you like, of the importance of water to the tissue fluids. But we don’t think about not just interstitial fluid, but organs, tissues. Like for instance, you were mentioning intervertebral discs, collagen, you know, glucosamine chondroitin hold onto water. That’s how they work. That’s really interesting, interesting mind flip. Thank you for that. I’m learning. This is good.

Jesse: Me too. Yeah. Well, it’s something so simple, I think, and it’s just one of those low-hanging fruits. I find a lot of patients get a lot of value-added if they actually stick and abide by the recommendations. But you mentioned something as well that I definitely have found to be helpful, especially in the clientele that I see, it’s collagen and its role in the musculoskeletal system.

I think my understanding of collagen is that it is really, it’s the word itself means gel. It’s a Greek word, collagen. And I think a lot of people don’t understand what it is or where it comes from or why it’s important to take. But when you look at our current diet and what’s available to us, even in a supermarket or you go to a restaurant, there’s not a lot of collagen around for us to consume.

And our ancestors and as humans, we’ve evolved consuming collagen probably up until the last maybe 60, 50 years we kind of stopped. I know my grandmother’s recipe book has bone soup in it, you know, and recipes of all that kind of stuff and the bone marrow and the fat of that. So I think, yeah, a lot of our current understanding around it is based off research when really it was like just part of our everyday life was consuming collagen…

Andrew: Yeah.

Jesse: …from different sources.

Andrew: I think we got caught up in these three sort of macronutrient sort of things about, you know, protein, carbs, and fat, you know, and we forgot what we ate with those.

Jesse: Exactly, exactly. Yeah. So I find that collagen is really, really important from my own personal experience with using it and consuming it for my own recovery and well-being and just skin, hair, nails. And in a lot of clients as well, I find that their symptoms and just general sort of the feedback that they give once they start increasing the amount of collagen that they’re taking is huge, you know?

And, again, we talk about those structures like the intervertebral discs or the tendons anywhere sort of from 7% up to 30% collagen. It’s in that matrix like a spider web. So if we’re not consuming it from our dietary sources and our body’s not able to produce it, then it’s really hard for people to have that same strength in those connective tissues.

Andrew: Cool. I wanna just sort of circle back for a tick with regards to your athletic prowess. And, like, you mentioned two things that were…that normally one would think about them being quite juxtaposed, physique training and basketball. So you’ve got, you know, basketball with the explosive energy, the compression issues with regards to tissues when you’re jumping, when you’re landing, twisting, things like that. And then you’re getting, you know, body sculpting, do I say that? Body sculpting, body…

Jesse: Yeah.

Andrew: …or physique training?

Jesse: Body sculpting. Yeah.

Andrew: So with that sort of thing, would you treat it as an explosive type force when you, you know, have to strike a pose and flex the muscles in a way that presents aesthetically to the judges? Is that like a…?

Jesse: Explosive. Yeah, is it a similar contraction? No, they’re two different things.

Andrew: It’s not… Yeah.

Jesse: Yeah, they’re two very different functions. So what I found was that…

Andrew: Because you’re getting…

Jesse: …the physique training was slowing me down, but in some ways, it was speeding me up because it depends on your coach. And I was fortunate to have some very good coaches and they were aware of, you know, my dual interest. So it wasn’t… And I wasn’t at that level that I was so big that I could actually…I was…still looked fairly healthy body weight, naturally as well. And I think it’s just having strength is super important, but when you are posing and flexing, you are, it’s really just that isometric contraction. It’s that…yeah. And it’s almost…

Andrew: With all tension, like for instance, on your biceps and triceps at one time.

Jesse: Correct. Correct.

Andrew: Does that create that juxtaposed…? Because you’re creating tension on both muscles, an extensor and a flexor, does it create a risk of injury at the insertion of that muscle, those muscles?

Jesse: I wouldn’t say that it creates a risk of injury. I would say that it helps to stabilize the joint in a way. What it probably does over time by doing those kind of sustained isometric poses would be you become quite inflexible and immobile.

Andrew: Right.

Jesse: Yeah. Which in itself is…I’m sure we’ll touch on that later, but immobility in a joint is one of the biggest risk factors for injury. So in hindsight, it was just me pursuing my interests. There wasn’t any sort of rhyme or reason to what I was…what sports or, you know, activities I was doing. I definitely wouldn’t recommend people pursue both. So, yeah, you want that elasticity and that power versus…yeah.

Andrew: Yeah. So let’s go into injuries. And if you’re talking, you know, about jumping and landing and things like that, lower back pain because what is it, 50% of the population? Is that right?

Jesse: Yeah. Well, I think some people say, in Australia, it can be up to 70% of people have suffered from low back pain.

Andrew: Whoa.

Jesse: Yeah.

Andrew: Whoa. Okay.

Jesse: At some point in their lives. Yeah.

Andrew: Yeah. So what works and where is the place? I like that you mentioned judicial supplementation. But, you know, what do you use? We’re talking about collagen. You know, previously, we used to use glucosamine. I’ve never, ever found the hydrochloride form works with anything other than fingers and toes. And indeed there’s the negative trial, the GAIT trial on that.

Interestingly, medicos who don’t know about different types of nutrients will poo-poo all of glucosamine based on the GAIT trial without looking at that issue of that journal, I think it was JAMA. And even in that issue, that same issue, there was an editorial piece saying, “Dudes, you’ve used the wrong form in the GAIT trial. You should have been using glucosamine sulphate.”

And then of course, we have to include chondroitin sulphate and the co-factors that we use for collagen. But now we’ve got collagen. In the past, we didn’t use collagen because we couldn’t, we weren’t allowed by the TGA. Now we are allowed to use collagen. So, of course, there’s this flip to using collagen.

Jesse: Yeah, as the superior…

Andrew: Do you ever use glucosamine in your history or…?

Jesse: I haven’t. I haven’t. And I think it’s more because of the fact that we have collagen so readily available and I just got onto collagen so early.

Andrew: So what’s its place? Where can it work in lower back pain? And you mentioned inflexibility. You know, what’s its place? How do you actually assess a patient for suitability of collagen? Or perhaps even, no, listen, you need to work on your core strength and some flexibility and that’ll take away your lower back pain.

Jesse: Yeah. Look, it’s… I don’t ever start there. It’s definitely, it’s a supplement to the primary things that I offer. With lower back pain, it is, I guess it’s just like anything, it’s such a big broad term. For me, I really need to understand what is causing this or what things are causing it, the biggest contributing factors. Like, I guess the way I…or what I like to do in my sessions is kind of map out all the causes of pain.

So I guess you have the pain as the problem and where are the roots of this problem and which roots are the biggest? Which things, out of all the web of determinants that could be contributing to this person’s complaint, what things are weighing the heaviest on them physically, mentally, emotionally, environmentally, socially? What is causing that person’s back, tissues, discs, spine, nerves, fascia, muscles to send those signals to the brain? And why is the brain then saying, “Hey, there’s something wrong. You need to feel pain?”

So, for me, it all starts with just a real thorough health history, understanding all of their health issues, making sure you get a clear…because the lower back is so closely connected to the abdomen and the core, I don’t like to use the word core, but the trunk rather, there’s previous surgeries, there’s a range of things that can be causing it.

I mean, one of the things that I find the most is really just inactivity, sitting, inability to stabilize in the trunk. So just having very poor lumbar pelvic stability, which is something that I think a lot of people suffer from. And the other things as well that I often find is referred pain. So, pain, as we know, can be referred from visceral structures to somatic structures that are innovated by the same spinal nerve.

So, for example, you might get a young person, early twenties, female, and they have sort of intermittent low back pain that gets worse, but they don’t quite know why. And then if you map out their symptoms and you understand their health, their health history, it actually shows that, oh, when they’re menstruating, it gets worse. So then you know that there’s a direct correlation between what’s going on, and it may not necessarily all be coming from their back. It could be something that is being contributed to by an issue with their ovaries, which they need to go see someone for. So it’s really important to not overlook that.

And, you know, I had a really heartbreaking experience with my own mother who was suffering from low back pain. And it was…she came to her doctor and then after, she came to me. And we all thought it was, [inaudible 00:22:21] you know? And I was assessing her and sort of treating her for a couple of weeks. It was about two or three weeks. And I said to her, “Mom, you know, I don’t think this is…this isn’t your typical discogenic pain. This is something else. You know, it’s in the area, the lower back, lumbar-sacral junction. But it’s not…I’m not feeling…It’s not presenting in the typical way. I think you should get an MRI.”

So, she did. She got the MRI and they found there was a huge mass, a tumour that was actually pressing on the spinal nerve in her sacrum, which was causing referred pain down the legs. So you know, it’s the things that we all learn about at university, these red flags and things. But I think once you get out into clinic and you start actually seeing clients, you kind of forget about it because we’re in our clinic, in our room with the person, there’s only just so much you can think about at one time. So, yeah, I think it’s one of those things where when someone says to me, low back pain, it’s like, well, yeah, it could be anything.

Andrew: Can I ask? You said something very important, it’s critical to learn, and that is, how do you tell the difference between discogenic and viscerogenic type pain? What are the differentiating factors in the pain presentation?

Jesse: Yeah. It’s something that I think I’m still getting my head around because there’s so many sites and sources of referrals. But palpation is a really big tool that I use so just my own sensory acuity in my fingers, being able to sort of reproduce their pain with palpation and pressure of the spine, but also pressure on the organs as well.

Yeah. So being able to…because often, if it is coming from the viscera and you are able to get in and you know where to go and you know your anatomy well enough, you can actually find that, oh, it could be that, you know, it’s your stomach or your intestine or your colon if I press on that and does that refer to the back? And there has been some cases where I’ve found that it is the abdomen that’s the problem. And you’re pressing it and its symptom reproduction through palpation is a big one.

Another one is also just mechanical assessment. So, obviously, we know with flexion, the discs are more…if they’re already protruding, extruded, then there’s certain tests that we know have very good sensitivity and specificity when it comes to being able to deduce whether it is disc involvement. So that’s definitely something that I utilize, like the slump, active straight leg raise, increasing intra-abdominal pressure, those sorts of things, and even just the mechanism as well. So the mechanism of action around their pain presentation so that, you know, when I’m prolonged sitting or prolonged static standing, I feel it. Versus, a visceral somatic referral might be more along the lines of after I eat certain foods or after I go to the toilet or yeah, this certain time of the month. Yes, yeah. Or…yeah.

Andrew: Got it.

Jesse: There’s a whole range.

Andrew: So it’s more detective work rather than the characteristics of the pain itself. Sharp, stabbing, burning, dull, throbbing, that sort of pain sensation description. What you are looking at is further than that. You’re looking at other things that might affect when, where, how that pain is presented.

Jesse: Yeah, exactly. I mean, don’t get me wrong, I still do take those pain characteristics into account, but the brain doesn’t differentiate between those things because we’re talking about, it’s at the dorsal horn, like, in the…if you go back into, I guess, year-one anatomy, you know, the merging of the spinal nerve, it gets information from all those, the skin, the skeletal tissues, the organs, and it all converges into that one spinal nerve which goes in.

And if someone’s saying, “Hey, I’ve got pain there.” Well, yeah, okay. It could be that you’re getting that sharp pain from… You know, the body’s pain is such a…it’s such a subjective experience, such an individual experience.

Andrew: Personal experience, yeah.

Jesse: It’s very hard for me to use the characteristics of the pain to determine where it’s coming from. So I don’t rely…

Andrew: Got it. Thank you for that.

Jesse: …heavily on that. Yeah.

Andrew: No, no, that’s cool because, like, I was wondering about, you know, we’ve evolved from the pain GAIT theory, which was current when I went through nursing. And we’ve evolved from that to this sort of psychosocial physio aspect of pain. We know more about, you know, complex regional pain syndrome, chronic neurogenic neuropathic pain, blah, blah, blah.

Pain can be influenced by stress, even how you’re being spoken to by a health practitioner. Indeed, it’s in the guidelines of pain management about how you, your words to a patient can affect their management of pain. And this is something that health practitioners don’t give enough credence to. How you treat somebody is going to affect how well their pain is gonna be managed. It’s huge. It’s such a huge issue.

Jesse: Absolutely.

Andrew: Jesse, because we were talking a little bit about sport before, there’s so much that I want to cover and we’ve only got a certain amount of time. So can we talk about sports-related injuries as well? You know, like you’ve got simple things like, you know, you’re rolling an ankle and “pulling a muscle,” tight backs, sore necks, things like that, hips that might be sore, but then you’ve got real structural, possibly surgical things like SLAP tears and, you know, bulging discs and all of that sort of thing. Can you take us through that spectrum in 20 words or less with how you manage, let’s say the words remedial? And that seems rather [inaudible 00:29:09].

Jesse: Remedial.

Andrew: But let’s say more remedial to more chronic fulminant type of issues.

Jesse: Sure. Yeah. So I think the biggest misconception that I have to battle with, with anything along the sports injury spectrum, whether it be acute or chronic, it’s the use of ice and anti-inflammatories. And the perceived benefit in musculoskeletal strains and sprains, tears and things like that. Because, often, people will come to me saying, “You know, I’ve put ice on it. I’ve taken anti-inflammatories, it’s not getting better. I’ve rested it,” following that typical RICE principle.

So this is something that I’m really…I’ve been really blessed to understand the inflammatory cycle, the tissue healing process in quite good detail just from paying attention in my anatomy and physiology classes. So the first thing is ice. I think, you know, people use ice a lot, sprain an ankle, slap some ice on it. Is that going to actually do anything to change the temperature of the internal tissue that’s damaged? When you think about it, that’s gonna cause frostbite if you do that for long enough. Okay?

So what is it actually doing? All it’s doing is providing a bit of proprioceptive, I guess, distraction from the pain. It’s not helping with the healing at all. So there is actually some…quite a lot of information in sports medicine journals and textbooks that show that ice inhibits lymphatic drainage because you are stopping the lymph vessels from doing their work and carrying that excessive fluid through the tissues by putting ice on it for prolonged periods. So, it’s…especially around an injured area. So I think to try and control swelling. So that’s something that I think is, for me, I don’t recommend ice unless people want to use it or they feel like it helps their pain.

Andrew: I mean, this is now the ground swell is starting to take shape, isn’t it, with regards to the controversy of ice in RICE. And I totally get your point about it inhibits a natural process of inflammation because of our fear…

Jesse: Absolutely.

Andrew: …of inflammation and our wanting to switch off inflammation rather than control inflammation.

Jesse: Absolutely.

Andrew: It’s the switch mentality there.

Jesse: The swelling is a good thing. Yeah. Swelling is necessary. It’s a fundamental component, a phase one of the healing process. You know, the amount of fluid that’s sent to a damaged area, whether it be your intervertebral discs or your labrum in your shoulder or, you know, your anterior cruciate ligament. It’s not a chaotic arbitrary process, it’s a vigilantly regulated process designed to help the body regain homeostasis. And it depends on the lymphatic system to move that fluid around and to help to regulate it.

I mean, when you think about it, the lymphatic system, it’s really just a scavenger. It’s just cleaning up that excess fluid. You know, it’s taking all those proteins, those molecules, that debris from the damage and it’s like a flooded house or a flooded yard, you know, it’s needing to move that out through the capillaries eventually back into the circulatory system. So if we interfere with that in a healthy person, we’re disrupting the healing process, you know? And I really like what you said about our fear of inflammation.

Andrew: Where are we at with the research about this with regards to drainage? You know, you mentioned lymphatics, getting rid of damaged tissue particles, and indeed in the end, the be-all and end-all is healing. Do we have any information yet that says that not doing RICE is better at healing people’s inflamed joints? Do we have that bridge, yet?

Jesse: Yeah. It’s been known for a long time. There is sports medicine, “The Use of Cryotherapy in Sports Injuries,” volume three, “Sports Medicine,” the “Textbook of Medical Physiology: 10th Edition.” It’s in the textbooks on how the lymphatic system works. And there’s even research out there about…that’s talking about anti-inflammatories and how the effect of non-steroidal anti-inflammatory effects on bone healing. So there’s research that’s been done on the use of anti-inflammatories in fracture healing.

So I think we know that inflammation can occur without healing, we know that. But healing cannot occur without inflammation happening, first. You know, the inflammatory phase, it’s mediated by the same prostaglandins that are blocked by non-steroidal anti-inflammatories.

So in a healthy healing process, we all learn that it’s that proliferative phase that comes following the inflammatory phase, you know, and then those fibroblasts come in and they build that extracellular matrix. And then, we have that maturation phase and if all goes well, the functional tissue is laid down. That’s just standard textbook, you know, physiology and anatomy. But the key point is that each phase of the healing cycle is necessary for the subsequent phase. If we interfere with that…yeah. So I think that it’s definitely out there, the research is out there, it’s just…

Andrew: If you think about non-steroidal anti-inflammatory drugs, they’re the perfect drug because what they do is they take away the horrible symptom that you don’t like while inhibiting the healing, chondroprotective…or forgive me, the chondro rejuvenative processes of the body, they inhibit that. So what does that mean? That means you need more drug. So it’s the perfect drug that manages the horrible symptom while prolonging its need.

Jesse: Yeah. That’s a great analogy. I like to use the one, it’s like having the check engine light…

Andrew: Don’t use brands.

Jesse: …in your car. No, it’s like having the check engine light come on in your car and then just pulling out the cable of the light and just nothing’s wrong, just…

Andrew: Nothing’s wrong.

Jesse: Yeah. So don’t get me wrong, they have their place, ice, and anti-inflammatories, but I think people relying on them and using them as the go-to, for me, it’s…yeah, it’s one of the…it’s one of the things I spend the most time educating and sort of re-educating people on.

Andrew: Jesse, we have a lot to cover and I can already sense we’re not even scratching the surface yet. So I’m gonna say right now, would you join us back for a part two? Because…

Jesse: Sure. Sure.

Andrew: We are gonna go…I’m gonna ask you a couple of questions. We haven’t got a lot of time left, but I wanna ask a couple of questions, but there’s so much more that we need to get into. Would you mind joining us…

Jesse: Sure.

Andrew: …back for a part two in the new year? Is that cool?

Jesse: If it’s this much fun, you might…yeah, we can do it.

Andrew: Done. Done. All right. So what about more muscle-related pain? You know, do you favour the use of things like branched-chains in the use with, let’s say DOMS, delayed onset muscle soreness, or do you stick to things like magnesium, which is just hopefully going to relax myofibril? How do you balance therapy? What do you choose? And please put that in the…

Jesse: What do I choose?

Andrew: …context of physical therapies.

Jesse: Yeah. So, well, let…I put a lot of merit to magnesium and its role in musculoskeletal function. As we know, magnesium is critical for the electrical potentials to take place that cause and affect muscle activity. So if we don’t have enough magnesium circulating in our tissues, we’re not actually gonna get nice quality muscle contractions.

And there’s, as you know, there’s a lot of research around the benefits of magnesium in bone health, and it makes up about 1% of the mineral content of bone and things like that. But particularly for those, I guess, overuse repetitive strain-related complaints, one of the biggest things that I find in terms of being able to help people is not enough mobility and stretching and not enough stability and strength, first and foremost. Because there’s one thing to be able to get more magnesium into their circulation and then it…in the hope that it’ll get absorbed into their tissues and, yeah, relax the nervous system a little bit more.

But the biggest thing I find is just not enough stretching of the fascia, the ligaments, the muscles. Because as we know, fascia, it’s always moving and responding to the tensile load that gets placed on it. So it adapts and thickens and tightens in response to what we’re doing. So like right now, for example, we’re both sitting. And when we sit, our hip flexes are shortening and they stay shortened and our abdominals are slightly shortened.

So when we stand back up, all that’s been shortened pulling us down into flexion. So the extensors have such a hard time to overpower and overwork that. So, hence, why our back and our glutes, and middle back, erector spinae muscles, and multifidus rotatores can just become hyperactive because they’re having to overcome the shortening that takes place in the front side of the body. And if you think about how many people are sitting for hours and hours, you know, at work, eating, going to the movies, driving a car, even sleeping in the fetal position, you’re in that sort of flexed posture, I think it’s…you know, it’s inevitable that we all become tight and have some kind of repetitive overuse.

Andrew: Yeah. But is the treatment of that though, you would think, therefore, that it would be stretching the abdominals and the hip muscles or the extensor muscles, but…

Jesse: Exactly.

Andrew: …you need to stretch the back because that almost snaps, sort of almost…

Jesse: Yeah, well it’s…

Andrew: Counter strain, is that the right word?

Jesse: Counter strains, yeah. Look, it really depends on…

Andrew: It’s not the wrong word.

Jesse: …depends on…it depends on the person. So it depends on what’s causing their particular complaint, so their particular injury. So if I examine someone and they…because obviously I assess range in the hips and I can feel the hip flexes in the back and you can always sort of, once you work on someone, you can feel what it is that’s blocked with simple, you know, full multi-segmental standing extension, flexion, isolated hip extension, isolated trunk extension, you can see quite quickly what’s not moving where.

And like a hand break on a car, it’s obvious when the hand break’s on, when you take the hand break off, you release the hip flexes, you release your abdominals, and all of a sudden they’re like, “Hey, my back feels so much better,” then you know, clinical reasoning. Okay. It was actually the tightness in the front that was pulling you down, causing the back muscles to be hyperactive, hypertonic to try and overcome, to extend you up because they’re anti-gravity muscles to maintain upright erect posture.

Andrew: Right.

Jesse: Yeah. So I guess…

Andrew: Gotcha.

Jesse: The body, the musculoskeletal system, it’s working, it’s very intelligent. The receptors all over our body in the muscles spindles, the Golgi tendon organs in the ligaments. There’s even receptors in your bones’ osteo receptors that are detecting strain and tightness and, you know, mechanoreceptors and things like that. All that information’s getting sent up into the central nervous system, which is computing, deducing, whether or not how much pain you want to feel or you need to feel based off the perceived threat in your life. So you can imagine that… That’s right.

Andrew: Big topic.

Jesse: Big topic. Big topic. So you kind of have to look at things, zoom out and then zoom in when it comes to these sort of repetitive overuse injuries, tight back, necks, hips.

Andrew: Yep. We have to go through and we won’t have time today, so Jesse, I’m gonna thank you for today. But next time we meet, I really wanna go through more of the sports injuries and if we can sort of do a, let’s say, a condition-based sort of symptom treatment type podcast, that’d be wonderful because I’m learning so much from you right now. It’s fantastic. It’s awesome stuff you’re doing.

Jesse: You’re so welcome, Andrew. Thanks for having me. I look forward to next time.

Andrew: And thank you everyone for joining us today. Of course, you’ll be able to catch up on the show notes for today’s podcast. Remember there’s gonna be a part two, so some of the references will be shared between the podcasts. And of course, there’s gonna be all of the other podcasts on the “Designs for Health” website. I’m Andrew Whitfield-Cook, this is “Wellness by Designs.”