Lessons From Back Surgery- Part 2
In this episode, I continue telling the journey of my back surgery rehabilitation and the lessons learned. I was smart enough to know that I needed to do rehab somewhere other than where I worked, which led me to choose a pilates-based rehab provider. This set in motion seeing movement through a different lens and having me question that despite being strong and able to do so many "core" exercises, I still had difficulty feeling any reflexive core stabilization. I share my "AH-HA" moments and treatments that finally led to answers on why this was such a challenge.
Resources mentioned:
Listen to part 1: https://www.movementrev.com/podcast/season-1-episode-18-lessons-from-my-back-surgery-part-1
Make Your Own Rock Mat: https://www.movementrev.com/blog-pods/2018/5/17/revitalize-your-sole-the-benefits-of-freeing-your-feet-and-giving-your-feet-a-life
Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole body approach to care, however it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com
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Hey there and welcome. I'm Anna Hartman and this is Unreal Results, a podcast where I help you get better outcomes and gain the confidence that you can help anyone. Even the most complex cases. Join me as I teach about the influence of the visceral organs and the nervous system on movement, pain and injuries, all while shifting the paradigm of what whole body assessment and treatment really looks like.
I'm glad you're here. Let's dive in.
Hello? Hello. Welcome to another episode of the unreal results podcast. Um, Tell me. At you from Florence, Italy. Of all places. I am currently on the road with one of my track and field athletes. And, uh, he's over in Europe. Uh, doing some diamond league meets. So here we are. First time in Italy.
It was beautiful. I walked around today. And I had just a great. Great wok exploring everything and, um, Seen Florence. So. Now I am sitting down to record the podcast a little bit late, but a better, late than never. And then I'm about, uh,
Third year, 40 minutes of, or so before the first call of the relapse, revitalize mentorship. Uh, program for this year. So super excited to welcome the new people into the program. Uh, so busy day here in Florence, despite maybe what my Instagram seems like, because people are asking if I'm on vacation, not on vacation.
But did have time for about an hour and 40 minute walk today. So, um, We left off last week, talking about lessons from my back surgery. Uh, so my back surgery was in 2009. It was right before I turned 29. And about a month before I turned 29. And it was a tipping point. A big tipping point in my professional career of just.
Learning. Other things. Then main stream. Movement. Driven. Performance physical therapy and athletic training. And, uh, so like looking back on this journey, it was such an important. Part of my life and my growth as a professional. But it was very challenging in itself too. So I mentioned on the last podcast about the story leading up to the surgery, which is a little bit comical.
But then I also talked about how. It forced me for the first time to really learn how to make changes in the body. More from a movement side than a hands-on side. And, um, this is in a really important part of the journey. Um, while I was doing rehab, I decided I was smart enough to realize that since.
Obviously the people I worked with. I trust it a lot in terms of physical therapy and rehab. However, I did not trust myself in. Enough. To know that if I schedule appointments with them, for my rehab, that I would actually show up and do it. And also be left alone. Bye. All of the other people. The employees.
Coworkers and athletes.
There during my treatment time, I was smart enough to realize that if I was doing treatment in the place that I worked, I would probably still be working. On the business, as opposed to being focused on myself. And I wanted to give myself the gift of stepping away from work so that I could just focus on me and my own body in my rehab.
In this. In itself is an important lesson because. Um, it does take a lot of focus and, um, intention, and you have to be like fully in and fully with your body. This is. When I work with my athletes, why. Um, I'm not a big fan of them grabbing their phone, um, when I'm working on them, sometimes I'm all right with it, depending on what they do. But for the most part.
If they're working with me, they're blocked in and there. Uh, working, you know, we're work, we're working together, I'm working with their body on their body and it's a little bit of a dance and I need them paying attention and, and having the intention that we're in a healing. And like improving the body, getting to know the body phase.
So with that said, since I was going to be paying for rehab, I wanted to make sure that my money was well spent in terms of.
Not just finding a physical therapist that I trusted, but finding a physical therapist that could teach me something that I didn't know. So I wanted to go somewhere. That was a little bit out of the traditional realm of. Um, physical therapy for post-back surgery. And I found a, um, Pilates based rehabilitation practitioner.
Not too far away. That came well recommended. And, um, her name is Heather. Brummett. Shout out. Heather, she owns balance, uh, Pilates and physical therapy in Glendale, Arizona. And she is a Pollstar Pilates trained. Movement practitioner. And so I was like, this is perfect. Not only will I get to work on my own body, but I'll get to learn about how to use polarities in a rehab setting.
And this was a super important step for me. The, um,
The gift of this and this, and specifically why I chose a Pollstar Pilates practitioner, whether I really knew it at the time or not. Um, the benefit of choosing a Pollstar Pilates practitioner is that they're, um,
The, the training they have is one of the most comprehensive of all the Pilates programs. And it's really based on some foundational movement science. And, um, that has really, the way they teach Pilates is more from a movement lens versus a Pilates lens. And so. Within that I started learning a lot about.
Moving my limbs in different ways. What it really means to connect into my. Factual 10 Tegrity and to my core, and really the initial gifts, because obviously this Pilates journey was a long time, both rehab. And then while doing my rehab, I decided to go ahead and do the certification to become a rehab trained, um, pulsar, Pilates practitioner, myself.
And, um, during the rehab initially, let's talk about that to keep this on. Task with the, the, the episode. Um, one of the biggest things that we found was that. When I wanted to create some stability. Uh, around my core. My habit. Was too overly. Clench or squeeze the posterior pelvic floor. Which I thought at the time was squeezing my glutes.
I was really trying to bind down, create some stiffness in my pelvis. And this is probably from years of, well, this is, this is two things. One is from years of doing gymnastics. When I was a kid. This way that Quasha, that is very common in gymnastics. And in young adolescent girls who are hypermobile like myself.
Um, and I say that with an ashtray, I'm not, I don't have any hypermobility disorder, but I tend towards hyper mobile. Um, the tendency in this way back is to shift your weight back on your heels, tuck your butt under. So you push your center of mass forward because then your back is behind you. It's literally, if you can imagine a gymnast landing, right, sticking their landing from the bars or the vault or whatever, and that big arch position they get in their back, their upper bodies really far back, their pelvis is forward.
Kind of like a banana back. That this was my default posture. And in this posture, It puts a lot of, um, Load on the lumbar spine because it, it changes the position of the lumbar spine instead of being in a nice, um, lordosis. It actually flattens it out. Because. That posts your weight shift. In that clenching of the glutes tucks, your pelvis under posts really rotates you and starts to reverse the curve of your lumbar spine. And so you get a flat lumbar spine and then one typical pivot point up higher.
At the top of the pelvis, or even at the thoracolumbar junction that, um, and that even drive some, um, segmental instability there, which is more than likely. That in combination with a very high velocity car accident I was in, in when I was 16 is probably the initial insult that sort of destabilized in.
Um, created a lot of that segmental instability in my spine anyways. So. This is what we found in Pilates. That every time I needed to do something to connect into my like deep core, um, specifically the anterior part of my deep core, um, I just had a really hard time too, and I'd always try to clench and tuck my butt on diner.
And, um,
The first thing here too, was to even realize this standing position I started noticing. When I'd go back to work and I'd be standing in the, um, PT area at EXOS, I was like, oh my gosh. All of a sudden I was hyper aware. Uh, when I was just standing there, how often I locked my knees out, set my weight to my heels, clenched my butt, pushed it forward to support myself. So one of the most important.
Things I was trying to improve upon is keeping my body up on top of my legs, shifting my weight forward. And this going back to sort of the fundamentals of movement is this is our.
Well, you know, quote unquote, good posture, but this is also, I had lack, I was lacking a fundamental important piece of, um, motor control being, um, controlling my center of mass, right. Having balance the first strategy of loss, losing your balance is to have an ankle sway, being able to sway forward or anterior weight shift onto your.
On your feet. And I had told him I lost that. And so. Improving that became. Sort of the goal and improving my, obviously my course stability, um, and getting out of the habit of, um, using my. Legs my pelvis. Two. Cheat my core out of actually stabilizing. So we spend a lot of time, um, with the Pilates equipment, which is a great environment to help me connect into my core.
Which, um, I became better at, but it was still challenged, which will lead us into sort of another piece that I found, but I'm going to.
Um, Well, I guess that is the next piece I found. So first it was pain, like bringing awareness to that pattern, bringing that awareness to that pattern while. Working as I got tired. Um, I did notice towards the end of the day, it would be harder to get out of that pattern. And then, um,
The next step was another key piece of why I had such a difficult time connecting into my core, even with the Pilates environment. Um,
It was still pretty challenging. And I had to use a lot of conscious control over it, which is not ideal. We would really like that to be reflexive because thinking about. Uh, turning the muscle on or thinking about stabilizing. You've already lost the battle because life happens really fast and these things should be reflexive. And so, um, I never really had thought about it.
You know? Well, when I thought about it previously of like, why is this reflexively not happening? You know, the thought was that my something's wrong. Um, my body, I, you know, I'm broken my back's fucked up. And so this is just goes with the territory. Like your, you know, But I get shut down and, um, you lose your motor.
Control a little bit. And, um, it just takes a lot of repetitions of like turning things back on. And, um, I didn't fully appreciate the need for increased stiffness and the need for, um, looking at it more holistically of like, is there. Another reason, a deeper reason why perhaps my specifically my anterior core didn't want to reflexively turn on.
An example of this, you might have used in the movement world before. When you're doing an exercise, let's say, let's say even in the FMS world, because a lot of us are familiar with gray cooks. You know, functional movement screen and the corrective exercises from that, one of the corrective exercises, one of the things he pulls from R N T train. So reactive neuromuscular training.
Is to create a little core stiffness. He has, you do like a pull-down. Let's say you're doing the. Straight leg lowering, and you want some core control. So you lay on the ground in front of a cable machine and then you do a pull down and this pull down helps to engage the lats and the anterior core.
So a little bit of posterior anterior core to get a little connection, or let's say it's squeezing something between your knees, for the adductor in deep. Uh, frontal line connection, or even if it's at your hands, you know, you have a small.
Uh, flexible ball and you're squeezing it to turn on. Even those sort of things. I still had a hard time. Getting my obliques, getting my transverse abdominis, getting my abdominal muscles to turn right. For lack of a better way to say it turned on to create stiffness. And contraction and, um,
So. What's interesting though. If I did something posted earlier, right. If I pulled a band apart, Um, and I got my postier sling system to turn on that reflexively creates better stiffness around my core container. And so that was cool. And that means a lot of the exercises I chose to do when I was doing core control stuff. I did some sort of, you know, pulling out a posterior thing to create some stiffness across my core.
But I never, you know, I never really thought, like, is there a deeper reason why maybe I'm having such a hard time turning on my core and then. Throughout, you know, so I started this process, so I had the back surgery in 2009. I started PT, probably, um, the rehab based PT probably, you know, Six to eight weeks later.
In the fall of 2009, and then probably in 2010, I think is when I started doing, um, Pilates, like going through the curriculum to become a rehab provider. I was still obviously doing the exercises for my own body, but then I was doing a lot of Pilates because in order to become certified.
At least in the Mo in the Pollstar curriculum, you, you have to put a lot of hours of teaching as well as doing the work. So I was doing a lot of Pilates. And throughout this.
Timeline.
You know, 2010, 2011 is when I finally, um, when I, when I, uh, 2011, October, 2011 is when I pass the exam to. To be. Um, a postcard. Holidays practitioner. And ironically enough. Um, just two weeks before that I had a flare up in my back. I had traveled to. Japan. To teach a group of professionals in Japan. And I remember standing in line for customs and I was like, oh my gosh, I can feel my foot drop happening again. And it was just like devastating because I was like, here I am like almost two years post surgery.
And I've done all this rehab, like in, in arguably like one of the strongest, like cores. Like I remember my colleagues who felt sone saying that she's I can't, I just don't understand it because she's like, your core control is better than. So many people's like w what is going on? Right. And I was like, yeah, but it's, but I knew then too, I was like, yeah, but even then my core controls. Good. It's only good when I'm like,
Really thinking about connecting into it. And so there was still so some sort of missing piece that I wasn't getting, because I would still have these flare ups, you know, and this is, this is too, like, this is just kind of the timeline with back sometimes. And especially I shared in the last episode, you know, like,
I had a microdiscectomy. It's not like anything was necessarily fixed. It was just, we, we decompress the nerve root that was getting compressed. Compressed by the disc material and that's it. And then, you know, I still had two other letter. Levels that were extruded that we didn't do. So it's not like.
I went in and like how to fusion and like, you know, Again, it's not fixed. It was just. The surgery was very helpful and a great outcome, but. What you learn is, is basically like the best way to explain it is the transition from rehab, you know, is, you know, at first you pay attention and you, you know, you count or you recall how many days of the week.
Um, or how many even hours of the day that you felt good. And then it's like days of the week that you felt good. And then it's like how many days in the month? Then it's how many weeks in the month you felt good? And then. Pretty soon. It transitions from remembering all the good days to then the good days become so frequent that then you're like, oh, I only had a flare up. Like.
You know, Once or, you know, two times a week or once a month or every other month or every quarter. And so. Um, it was getting less and less, but that flare up at the, in, you know, in the fall of 2011 was a little frustrating because it was just like one of the worst ones and I had to call and, you know, get a dose back and.
Um, You know, It was frustrating to say the least. So anyways, um, I continued, you know, in between, I tried to return to some strength training to improve some stiffness and do some, you know, more like core base things I remember doing like, Single arm, um, bench, press and single arm row, and a lot of single arm stuff to try to get some, you know, anti-rotation type of stiffening happening and all the things that we do. And.
I did at EXOS that worked pretty well. Um, and it would. It never seemed to really shift anything. Uh, so anyways, um, you know, life happens and then that, uh, in 2011 was also when my mom was diagnosed with lung cancer. So then my focus even became less about my taking care of my own body and more about taking care of my mom.
And honestly it became like, just getting through the day. Um, it just getting through. Life. Um, life got pretty difficult then. I was traveling back and forth to help her, um, with her chemotherapy and, you know, still working and all the things. So it took me a while. But, um, You know, and I kind of continued on in the past.
I've had flare ups here and there. Um, Overall felt good. I could control them. And when a flare up happened with ibuprofen and, um, some movement strategies, I learned who Pilates, I was really helpful at taking my, you know, doing some movement-based things too. Segmental spine stuff and core stability things.
It did really give me a good arsenal of movements and exercises that could get me out of a flare up, which I am. Continued to be very grateful for. But there was clearly something missing because even all those years of practicing, and like I said, you know, being pretty strong in terms of what exercises I could do, it's was still.
I was still suffering from these bouts of segmental, instability and flare ups. So. Um, in the end of 2013, after my mom passed away, I had finally, um, signed up and taken my first visceral manipulation class. And that is the next big eyeopening piece in what I realized I was missing all those years, because what happened.
Was as soon as. In lab, we started working on the visceral organs. All of a sudden, I was like, oh my gosh. Even just on the treatment table, I was like, holy cow. You did treatment on that area. And then I went to roll over and I felt. For the first time and what felt like ages, which it was, it was probably years. I felt my core reflexively turn on and I was like, what? Like my anterior core.
And I was like, what? And then it made so much sense with what I was learning, right. Because my aunt here chorus, specially was, um, Not turning on so well, because I had a history of quite a bit of gut health issues going on at the time to. And I begin to notice a correlation between when my eating was really clean and my gut was feeling better and my back feeling better. And that.
And then getting treatment, the visceral manipulation treatment, both in the classroom, and then from my mentor, Veronica Campbell, after that, It was just, oh my gosh. Clear as day, what our role, my viscera and my gut health was playing in my back. And specifically my ability to connect into my core control.
And so adding this visceral manipulation piece in was a huge step forward in the struggle with my back. Then the next thing that actually came very soon, right after that. Right. Like I was like on this new, new plan with the visceral work and. Really figuring out how that all fit in, especially combining it with functional medicine type things too.
And then I took a course with Phillip beach and Phillip beaches and osteopath from New Zealand. You've probably heard me talk about him before. He's the author of the book, muscles and meridians, the manipulation of shape. And when I learned from him the first day, actually of his course, he was teaching a two day course at one of the Pilates conferences.
And I was at the first day, I was like, holy shit, this is what I'm missing. This is a piece. This is not only what I'm missing. This is what a lot of my clients are missing. In their movement practice. And, um, one of the things that he talked about was the need to introduce rock mats into your life, and basically introduce an interesting life for your.
Feet. And how the bottoms of the feet are neurologically, obviously the nerves that innervate the bottom of your feet come out of here. Lumbar. Sacral plexus and, um, How syncing better in your feet is going to improve motor control. Of the, uh, lumbo pelvic control. And it was like, oh, Like mind blowing for me. So I literally went.
I left the course that day. And I went directly to home Depot. I didn't go to home first. I went directly to home Depot and I bought the rocks and I bought, um, Uh, bathmat and I bought gorilla glue and I sat down on the floor and I started making my own rock mat. And. Um, by the end of that weekend, I think that course was like on a Wednesday.
Or Thursday, or it was either Wednesday, Thursday, Thursday, Friday, by the end of the weekend, I had used the rock man every day. At that point, he recommends getting at least 30 minutes a day, cumulative spending time on the rocks. And by the end of that, Weekend. I was no longer waking up with back pain and my mind was blown. And not only was I no longer waking up with back pain, but I was also able to go down the stairs at my condo without any knee pain, which I was having some significant knee pain at the time, too.
And, uh, And the knee pain. Has like an origin. I have like a very large chondral defect, like patella, femoral, chondral defect. So it's like, I always had like very icepick, sharp pain going down. The stairs. And, um, so not only was my. Back feeling better, but my knee pain was gone. With just four days of introducing the rock mats. And I was like, my mind was blown.
And over the years as the rock mass became like a big part of my practice and I've understood it even more, what I realized what was happening. And I would feel it in the mornings because they put the rock mat in my shower. Is, as soon as I stepped on the rocks, I would be forced to let go of the clench of the glute squeeze of the posterior pelvic floor. Keeping me in that post here, tilt, keeping my sway back posture, the flat lumbar spine.
As soon as I would step on them within like 20 seconds. I would literally feel that relax and then shift forward on the rocks. And that's what the rocks sort of force you to do the rocks because of the mechano reception of pressure from the rocks in your foot. There are rocks help your body instantly find a new position to be in that spreads out the surface area because more surface area means decreased pressure. And so it basically was a movement experience to create relaxation of the posterior pelvic floor.
I'll allow for a normal nutation. Of my, uh, counter nutation of my sacrum, why didn't even have my sits bones so I could. I find my anterior weight shift strategy shift, my whole center of mass forward. Which then was easier to bring my rib cage up on top of it. And this was something that I knew was important to I've been working on and learning from, with Elizabeth Larkam and some anatomy trains work. And it was just like a big.
Part a big piece that brought things together. And so not only did I add the rock mats into my life at that point, but I started adding in Phillip beaches, erector sizes to spending more time resting on the floor. More time getting up from the floor, improving my foot and ankle mobility, as well as my knee and hip mobility.
And then that was a huge piece of going for way longer. Without back pain. And there's one more piece to this puzzle that I'm going to share about. And as well as probably more little tidbits, but I'm going to save that for next week. So thank you for joining me for part two of the back surgery lessons. And, uh, I look forward to sharing more.
Next week, uh, next week, where will I be?
I think I'll be in Paris next week. So we'll see where I filmed the podcasts, but have a great guy have a great day. And I'll talk to you soon.
