#685: Dr. Shirley Sahrmann — A Legendary PT Does a Deep Dive on Tim’s Low-Back Issues, Teaches How to Unlearn Painful Patterns, Talks About Movement as Medicine (or Poison), and More | TED Radio Hour

Intro

In this episode of the TED Radio Hour, Dr. Shirley Sahrmann, a legendary physical therapist, dives deep into Tim Ferris’ low-back issues. She discusses the importance of unlearning painful movement patterns, the role of movement as medicine (or poison), and more. With over 60 years of experience, Dr. Sahrmann shares her expertise and insights on addressing the root causes of low back pain and improving overall movement.

Main Takeaways

Physical Therapy and Movement Science

• Dr. Shirley Sahrmann is an 85-year-old legend in the physical therapy world who has influenced top performance coaches.
• Her book, “Diagnosis and Treatment of Movement Impairment Syndromes,” is considered revolutionary by many in the field.
• The book focuses on diagnostic categories based on movement and how it induces musculoskeletal problems.
• Learning basic anatomy and medical terminology is a great investment in your health and can help you communicate better with professionals.
• Movement plays a different role in physical therapy now than it did in the past.

Understanding Low Back Pain

• Low back pain is a symptom, not a diagnosis.
• It’s important to address root causes rather than just treating symptoms.
• Naming low back pain by the movement that causes symptoms is important to address the root cause of the problem.
• Overdeveloped abdominals can increase compression on the spine, leading to pain.
• Stiffness of abdominal muscles can be checked by measuring the change in circumference of the rib cage during deep breathing.
• Excessive lower back sway or typical lower back sway can cause pain when standing or sitting on a hard surface.
• Stenosis is an abnormal narrowing of the spine that can cause nerve pressure and pain.

Unlearning Painful Movement Patterns

• Teaching patients in everyday activities is important to make correct movement patterns automatic.
• The psoas major muscle connects the upper and lower parts of the body and contributes to lower back pain.
• 70% of people with back pain have suboptimal hip movement, which can be caused by structural changes or passive tension.
• Identifying specific movements that contribute to overactivity in muscles like the tensor fasciae latae can help address back pain.
• Movement System Syndromes approach views movement as a system of systems, similar to the immune or metabolic systems.
• Doing movement correctly is important, just because you’re doing it doesn’t mean you’re doing it right.

Improving Posture and Alignment

• Corrective measures for shoulder issues include exercises for the serratus anterior, upper trapezius, rhomboids, and middle trapezius.
• Stretching should focus on improving stiffness rather than just stretching individual muscles.
• Addressing physical disabilities early on with discipline and good direction can improve quality of life and lead to longer, fuller lives.
• Quadruped movements can improve alignment and posture, leading to a more natural curve in the lower back and potentially decreasing thoracic kyphosis.
• Stretching out as much as possible is important for older people with a tendency towards collapse.

Summary

Physical Therapy and Movement Science

Dr. Shirley Sahrmann, an influential figure in physical therapy, shares her insights on movement science and the importance of understanding the body’s diagnostic categories based on movement. Her book, “Diagnosis and Treatment of Movement Impairment Syndromes,” is considered revolutionary in the field and emphasizes the significance of learning basic anatomy and medical terminology for better communication with professionals.

Understanding Low Back Pain

Low back pain is not a diagnosis but a symptom that requires addressing root causes. Dr. Sahrmann highlights the impact of overdeveloped abdominals and stiffness in abdominal muscles on spine compression. She also discusses the role of stenosis in nerve pressure and pain. By naming low back pain based on the movement that causes symptoms, the root cause can be identified and treated effectively.

Unlearning Painful Movement Patterns

Dr. Sahrmann emphasizes the importance of unlearning painful movement patterns and re-patterning movement to address musculoskeletal problems. Teaching patients correct movement patterns in everyday activities helps make them automatic. The involvement of the psoas major muscle and suboptimal hip movement in back pain is discussed, along with the significance of identifying specific movements that contribute to overactivity in certain muscles.

Improving Posture and Alignment

Corrective measures for shoulder issues involve exercises targeting specific muscles. Stretching should focus on improving stiffness rather than individual muscles. Dr. Sahrmann highlights the importance of addressing physical disabilities early on to improve quality of life. Quadruped movements can enhance alignment and posture, while stretching out as much as possible is crucial for older individuals prone to collapse.

Conclusion

Dr. Shirley Sahrmann’s expertise and insights in physical therapy and movement science provide valuable knowledge for addressing low back pain and improving overall movement. By understanding the root causes of pain and unlearning painful movement patterns, individuals can achieve better posture, alignment, and overall well-being. It’s essential to prioritize movement as medicine and adopt correct movement patterns in everyday activities for optimal health.