most back pain episodes are the result of …...when damage to your spine occurs, your brain causes...

Master Manual

Master Manual

Copyright © 2019 by Mixed Martial Media Inc. – All Rights Reserved. No part of

this work may be reproduced or transmitted in any form or by any means without

express written permission of Eric Wong or Mixed Martial Media Inc.

Published by: Mixed Martial Media Inc.

1139 College Street, 1st Floor

Toronto, Ontario, Canada

M6H 1B5

E-mail: [email protected]

Web: www.precisionmovement.coach

This program is designed to improve your fitness. Not cure cancer, gonorrhea, or

any other disease you may have. While a lot of time and effort has been invested

in making this program as effective and safe as possible, you may still hurt

yourself while doing it. You may even die. While both are unlikely, if either

happens, it’s not my fault. It could’ve been just the trigger for something that’s

been hanging around for a while, waiting to come out. That’s why before starting

any exercise program, including this one, you may want to get cleared by your

doctor. If you have any weird symptoms like dizziness, pain in your left arm,

forgetfulness, or anything else that’s not normal, stop and seek medical help. If

you choose not to obtain the consent of your physician and/or work with your

physician throughout the duration of your time using the recommendations in the

program, you are agreeing to accept full responsibility for your actions. I don’t

know what the law says if your doctor is fat and unhealthy, though, in which case

you may want to get a new doctor. You can’t give what you don’t have! This is my

legal disclaimer as well as a tidbit of sound advice.

Disclaimer

There is always a risk of injury when performing any type of exercise. You must

consult with your physician prior to beginning any exercise program or if you have

any medical condition or injury that contraindicates physical activity. If you

experience any light-headedness, dizziness, or shortness of breath while

exercising, stop the movement and consult a physician. The exercise information

is not meant to provide any medical advice; it is for educational purposes only. No

liability is assumed by Mixed Martial Media Inc. for any of the information

contained herein.

Master Manual

Table of Contents

Introduction .......................................................................................................... 4

Myths and Misconceptions ................................................................................. 7

The 5 Things to Avoid at All Costs ...................................................................... 14

Background Info and Terminology .................................................................... 16

Anatomy of the Spine ......................................................................................... 17

Core Muscles ....................................................................................................... 26

Key Concepts ....................................................................................................... 32

Bulletproof Back Program Overview ................................................................. 37

BPB Strategy #1 – Effectively Manage Acute Symptoms ........................... 37

BPB Strategy #2 – Remove Aggravating Factors ....................................... 37

BPB Strategy #3 - Address Muscular Imbalances and Poor Posture ...... 39

BPB Strategy #4 – Increase Hip and Thoracic Spine Mobility .................. 40

BPB Strategy #5 – Functionally Train Core Stabilizer Muscles ................. 42

BPB Strategy #6 – Perfect Exercise .............................................................. 46

BPB Strategy #7 – Train Advanced Core Stability ...................................... 47

Additional Considerations .................................................................................. 53

Master Manual

Introduction

It’s a normal day like any other.

You wake up, get cleaned up, eat your breakfast and make sure you’ve got

everything that you need while you’re out.

You go to tie your shoes, then, UH, OH.

Your back goes out.

You stay hunched over, unable to straighten up

because it seems like everything completely locks

up.

You fight intense pain to straighten your back as you

stand up hoping that you can get on with your day,

but there’s no way you can function like this.

Are you familiar with this scenario?

If this has ever happened to you, especially if it’s happened during a seemingly

harmless task like tying your shoes or

picking up a pencil from the floor, you

might’ve thought it was your back was

just weak and went out from that

simple bend.

Makes sense – it happened during the

act, so that must’ve been it, right?

Well, not exactly.

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The Principle of Repetitive Stress

The simple act of bending over didn’t cause your back pain, but it was the

trigger.

What caused your back pain is the accumulation of the hundreds or thousands

of times your back was subject to stress prior to this single event, and the

event was where the tolerance of your tissues just gave up, as depicted in the

graph to the right (from McGill’s book Low Back Disorders).

It’s just like those popsicle stick bridges you built in grade school (those were

the fun days, weren’t they).

You keep adding weight to it and it bends and bends until finally, SNAP.

That’s exactly what happens to your back, albeit a little less dramatic.

Most Back Pain Episodes Are the Result of Repetitive Strain

Changing your thinking about back pain is necessary if you’re going to

eliminate it from your life.

So instead of thinking, “I never know when my back is gonna go” you now know

your back never just goes, it’s actually been going for a long time.

Over time, the tissues reach their breaking point and that’s when you feel the

intense pain and the seemingly never-ending spasms that go along with

throwing your back out.

The thing is, there are many factors that cause stress on the lumbar spine in

your day-to-day life, especially if you play sports and workout regularly.

Lots of sitting, lifting improperly, poor exercise technique or just poor exercise

choices all accumulate and it could be that simple act of tying your shoe that

finally sends you over the edge.

In this program, you’ll learn how to identify and eliminate those seemingly

routine tasks that could be contributing to your back pain, as well as learn how

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to minimize the stress on your spine by addressing all of the factors that you

have control over.

That’s why a multi-faceted approach is necessary to address your back pain.

Enter the Bulletproof Back program…

There are 7 key strategies employed in this program. I call them the

‘Bulletproof Strategies’. They are:

1. Effectively Manage Acute Symptoms

2. Remove Aggravating Factors From Work and Home

3. Address Muscular Imbalances and Posture

4. Increase Hip and Thoracic Spine Mobility

5. Functionally Train Core Stabilizer Muscles

6. Develop Perfect Exercise and Functional Movement Technique

7. Train Advanced Core Stability

We’re going to dive into each of these factors in depth so you understand how

they’re going to set you free from back pain in a moment.

But first, I want to clear up some common myths surrounding low back pain…

SIDE NOTE: you don’t need to memorize everything in this manual – it’s

provided to give you the science and logic that goes into this program. If you

find some of the concepts confusing at first, come back to it later. There’s no

test. ☺

Master Manual

Common Back Pain Myths and Misconceptions

“When your back goes and you’re in pain you should stretch”

This is by far the WORST recommendation I hear and it’s probably the one I

hear most.

I’ve dealt with many clients and athletes who hurt their back, went to their

therapist and were then given a home program of generic stretches to do.

Oh and of course they had to come in 3 times per week for treatment.

Do not, I repeat, DO NOT stretch when you throw your back out, even if it feels

good.

Here’s what happens when your back ‘goes out’:

When damage to your spine occurs, your brain causes all of the muscles

around the injured area to contract tightly, sending the muscles into spasm.

Back spasms are what happen in the acute phase.

Because the muscles only have so much energy to contract, they then get tired,

which is the lingering phase, where your back feels achy and sore.

Stretching the muscles and working on increasing flexibility is the exact

opposite of what your brain is trying to do – stabilize your spine so that no

further damage can occur.

Just think - what will be easier to injure – a spine that’s surrounded by loose

muscles, or a spine that’s surrounded by muscles that are tight and

contracted?

You see, your brain is smart and trying to protect you!

So if you don’t stretch, what should you do?

Basically, what your brain wants to do in the first place – stabilize the spine.

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You’ve got to tell your brain that your muscles are working and ready to

stabilize the spine if necessary.

That’s why I’ve had so much success implementing the Damage Control routine

with clients, family, friends and others who tell me they regularly have back

pain.

When you perform the Damage Control routine, you’re working all of the key

stabilizer muscles of the spine, which then tells your brain that your muscles

are working and doing their job, ending the spasms and pain.

It’s important to perform all of the exercises properly, which is why I created a

video and manual specifically for the Damage Control routine.

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“Bed rest is needed for back pain to go away”

Sometimes, low back pain and sciatica symptoms (i.e. pain or

numbness/tingling going down the buttocks and leg) may be relieved with lying

down. Because of this, some people make the mistake that they should be on

bed rest.

According to a study published in 2004, for people with acute low back pain,

advice to rest in bed is less effective than advice to stay active. They found that

those people with acute low back pain who were told to rest in bed have a little

more pain and a little less functional recovery than those that were advised to

stay active.

They also found that this didn’t change whether it was only 2 or 3 days of bed

rest or 7 days of bed rest.

If you have sciatica, there’s no difference between advice to rest in bed and

advice to stay active. So the message from this study: if you have low back pain

without any accompanying sciatica symptoms in the legs, don’t stay in bed for

more than a day – stay active and carry on with your life.

“Whenever I get back pain, I just pop a few Advil or Robaxacet and I’m

good”

Painkillers such as a non-steroidal anti-

inflammatory drug (NSAIDs) may be

prescribed by your doctor for acute

back pain. This medication may be

helpful to relieve inflammation,

swelling, but it’s important that you

know that the medication will only mask

your symptoms and not change any of

the things that caused your back pain in

the first place.

They may even contribute to making

things worse because if you don’t have

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any pain, you might go back to the activities, movements or exercises that

caused your pain in the first place and do even more damage.

So your goal is to minimize the amount of medications you take, aiming to get

off them as soon as possible. The Damage Control routine can help drastically

or completely eliminate acute pain symptoms so you don’t need any pills.

The same goes for topical analgesics that basically numb the pain.

If you do use these products, make sure you don’t do anything that will cause

further damage.

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“Doing sit-ups is good for your back”

Whenever you do situps, you’re flexing your lumbar spine, which will either

exacerbate current symptoms or contribute to tissue damage in the backs of

most people.

They will not necessarily increase back health, even though they do strengthen

the abdominals.

You must address all of the muscles around the core and all of the factors that

contribute to your back pain, not just the abdominals, which you’ll learn about

and do by following this program.

“Back extensions are the best back exercise”

Although back extensions can be useful in increasing the strength of your low

back muscles, they are a poor choice in early stages if you have back pain, and

a relatively poor choice for functional performance.

The thing is, you’re never going to perform a task in sport or life where your

feet are strapped down and you’re lifting yourself up and down from your hips

only.

Plus, most people do back extensions wrong by letting their low backs round at

the bottom of the movement.

So instead of back extensions, we’ll be using exercises that create less stress

on the spine in the earlier Phases and exercises that are more functional to

sport and life in latter Phases.

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“Being active and fit is all you need to have a healthy back”

Unfortunately this is just not the case, as I learned after my surgery.

I worked out and played sports regularly but my back was never perfect and I

never had 100% confidence that it wouldn’t go out.

Although being active and fit is much better than being sedentary, you’ve got

to understand the mechanisms of low back pain, how your back gets injured

and what to do to stop it from happening.

Simple exercising or playing sports will not heal your back or correct any

deficiencies you have that result in low back pain.

“Wearing a back belt during weight training will prevent low back

injuries”

According to a study by McGill in 1993, the findings showed that those who

have never had a previous back injury appear to have no protection from a

back injury by wearing a belt. Also, those who were injured while wearing a

back belt risk a more severe subsequent injury.

Wearing a back belt may give you the perception that you can lift and do more

and this may lead you to lift more than you’re actually capable of.

Many top level powerlifters wear back belts to increase their performance.

Unless you’re a top powerlifter yourself, I suggest you avoid the back belt and

focus on maintaining good technique and building your body symmetrically.

Even if you do wear a belt, you’ve got to learn proper lifting mechanics first, as

a belt won’t help you if you’re not lifting properly in the first place.

Of special note - belts also increase intra-abdominal pressure and blood

pressure. Given the relationship between increased blood pressure and

increased risk of stroke, there are definitely concerns regarding back belts.

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So if you wish to wear a belt for lifting or during work (industrial tasks), make

sure you’re screened for cardiovascular risk by your family physician first

“Sitting in the optimal position (i.e. good ergonomics) will prevent back

pain”

Having your chair, desk, and computer set up in an “ergonomic” way is

definitely a good thing.

However, this posture is only ideal for short periods of time and should be

switched up every 10 minutes.

This is because tissue loads must be transferred from tissue to tissue to

minimize the risk of damaging one tissue through cumulative trauma.

So, you must change positions frequently as opposed to trying to sit in one

position all day.

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Things to Avoid at All Costs If You Have Back Pain

Before we go any further, I want you to know the things to stop doing right

now so that you’re not further injuring your back.

I’ve already mentioned a few in the Myths and Misconceptions section, but I

want to summarize them for you in one place so you can use this as a kind of

checklist.

AVOID ALL STRETCHES OF THE LOW BACK

Flexibility is the exact opposite of what you need in your low back to be pain

free. Thesse are the specific stretches that many people are prescribed that

they should not be doing:

→ Any toe touches, sit and reach, or stretches where you bend forward

→ Any stretches where you twist or rotate the spine

→ Any knee-to-chest stretches where you pull 1 or both knees to your

chest

→ Any stretch where you’re unable to maintain a neutral spine (see page

18)

AVOID ALL EXERCISES WHERE YOUR BACK IS ROUNDED

This program will be replacing your current routine, but many people will want

to continue doing classes like Yoga or Pilates or other activities where the low

back rounds forward.

If you’re going to continue these activities, tell the instructor before hand that

you can’t do certain exercises so if they see you not doing anything to not

bother you.

AVOID ALL TWISTING MOTIONS OF THE SPINE

This includes any exercise, stretch and movement where you have to twist at

the back, as twisting and rotation is one of the most powerful damaging forces

on the spine.

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For everyday life, you may think there are some twisting motions that are

unavoidable, but I’ll show you how to do what you need to do without twisting

your spine.

AVOID ANY EXERCISE THAT CAUSES YOU PAIN

‘No pain, no gain’ doesn’t apply here. Especially in the Acute or Corrective

Phases, your goal is to eliminate pain and focus on perfect movement instead.

You know the difference between injury causing pain and muscle fatigue, so

stop anything that you think may have the slightest chance of being damaging

to the spine.

STOP USING PAINKILLERS ‘PROACTIVELY’

As you already learned, painkillers and creams like A535 mask pain, which

might allow you to continue doing things that are damaging to your back.

If you need these things because of severe pain, that’s OK, but do not use them

proactively, as they’ll set you up for more serious damage to occur.

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Important Background Info and Terminology

It’s important to educate yourself and understand why you get back pain, the

structures involved and how to prevent it from happening in the future.

To do so, you’ll need to learn some new words and concepts.

I’ve done my best to explain things in easy to understand terms and break

concepts down into simple examples and real-world analogies.

Although all you really need to do is follow the program to end your back pain,

I believe that understanding what makes the program what it is will help you

stick to it and will help you avoid all of the misinformation that’s in wide

circulation.

In this section we’re going to go through anatomy, concepts related to back

health and other terminology that you’ll need to know to understand what’s

going on in this program.

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Anatomy of the Spine

Spinal Regions

There are 3 areas of the spine: cervical, thoracic, and lumbar, as shown in the

picture:

Notice how the curves alternate between each region to the next.

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Vertebrae (Singular = Vertebra)

The vertebrae are the bones of the spine. In the entire spine, there are 24

vertebrae: 7 cervical, 12 thoracic and 5 lumbar.

These lumbar vertebrae provide a movable support structure and protect the

spinal cord from injury.

Intervertebral Disc

Intervertebral discs, or simply ‘discs’ are located between the vertebrae. The

discs mainly act as shock absorbers in the spine, dissipating forces.

Without the discs, fractures of the vertebrae would occur more easily.

The disc has an outer layer called the annulus fibrosus which holds a gel-like

substance in the middle of the disc, which is called the nucleus pulposus.

Think of the disc as a jelly doughnut, where the annulus fibrosis is the dough

and the nucleus pulposus is the jelly. If you press down on the front of the

doughnut, the jelly will move to the back.

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This can happen in the disc as well.

If there is enough force or an accumulation of pressure on the front of the disc,

the gel can get forced out the back of a disc, which is called a disc herniation.

A less severe condition can occur when the gel is bulged to the back and

stretches out the annulus fibrosus layer (but the gel has not squirted out of the

annulus fibrosus layer yet) – this is called a disc bulge.

When the gel gets squirted out and puts pressure on a nearby nerve, this is

called a nerve root compression from a disc herniation.

We’ll get more into these concepts in the Acute Treatment Guide.

Nerve Roots

Nerve roots are nerves that emerge from the spinal cord. There are a pair of

nerve roots (one on the left and one on the right) that exit at each level of the

spine.

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After they exit the spine, they become nerves that run into the extremities like

the arms, hands, legs, feet and toes.

These nerves provide sensation to the skin and allow the muscles in body to

function.

If there’s an irritation or compression of the nerve roots, symptoms you may

experience include numbness to touch, tingling and/or weakness anywhere

down the course of the nerve.

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Foramen

This is the hole where the nerve roots exit the lumbar spine. There is a pair of

foramen for each level, and one per side. The foramen is formed by the bony

surfaces of the vertebrae.

Ligaments

Ligaments are strong fibrous tissues that attach firmly from bone to bone.

Ligaments in the low back can be found attaching from vertebrae to vertebrae

and surrounding the discs.

Sample of some ligaments in the spine

These ligaments provide support and stability to the low back and can become

sprained if they are stretched awkwardly.

Spraining a ligament generally happens during a very forceful lift or movement

at the end range of motion, something like picking up a heavy box by rounding

your back forward without bending your knees, or throwing something that’s

very heavy sideways.

Injuries to ligaments take much longer to heal compared to muscle injuries, so

heavy lifting with a rounded back and twisting forcefully are movements that

you’ll want to avoid as much as possible.

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Thoracolumbar Fascia (TLF)

The thoracolumbar fascia, also referred to as the lumbodorsal fascia is made

up of several layers of tissue in the low back. These layers of tissue are

important for stability in

the low back in a few different ways.

First, the TLF surrounds the muscles of the low back stiffening these muscles

when they contract. It’s like blowing up a balloon that’s in a plastic bag. Once

the balloon gets full enough, it will press out against the bag and will make the

bag tight.

Well the muscles are the balloon and the TLF is like the bag.

Sorry for the crappy analogy, but it’s the best I could come up with!

Secondly, when you bend forward, there is passive tension put on the fascia

and this increased tension supports the lower lumbar spine.

Finally, other muscles of the low back including the latissimus dorsi, glutes,

transverse abdominis and internal obliques all insert into the TLF, so

contraction of these muscles together pulls on the fascia and increases

tension, acting like your own personal back belt.

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Function of the Core

There are many different definitions of the core muscles, but for this program,

we’re going to refer to the core muscles as the group of muscles that surround

the lumbar spine.

There are 3 main groups of musculature: the posterior (back), the lateral (side)

and the anterior (front).

Each group has both superficial and deep layers of muscles, as well as sheaths

of connective tissue that are kind of like saran wrap called fascia.

Just remember that saran wrap keeps food fresh, which sounds like fascia and

you’re all set. At least that’s what got me through university.

Because the term ‘core stability’ is very common to hear in fitness circles, you’d

think that people, especially the experts, would know how to train core stability

properly.

Unfortunately, this is not the case.

I’ve asked groups of normal people and experts to shout out names of core

stability exercises and I always get situps and crunches as the most common.

Think for a moment – what does the term ‘stability’ imply?

Exactly! Stable, staying still, not moving.

So what are you doing when you’re performing a situp or crunch?

That’s right – moving the core.

So if we want to train the core for what it’s made for (nice rhyme), then we’ve

got to use stability exercises, that is, exercises that require you to stay still and

not move.

For all movements of daily life and sports, the core is your link between your

lower body, where you generate force and power, and your upper body, where

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you use the force or power that was generated in your lower body for

whatever task you want to perform.

No core = no power.

Or if, through the use of machines like leg extensions and chest press

machines you develop your external muscles without concurrently developing

your core muscles, you may be able to generate power, but sooner or later,

you’ll be in pain because of the gross muscular imbalances that you’ve

developed.

Now an easy to picture sport example would be a baseball swing.

Watch any good baseball player swing a bat and the rotation starts in the lower

body, then the power is transferred through the torso into the upper body,

and finally, the bat swings around to (hopefully) smash the ball out of the park.

Notice how the hips start facing you, then end up turned towards the right and

how the core stays neutral the whole way as opposed to twisting around.

You can experience the difference right now:

1. Stand up and try a proper baseball swing that starts in the lower body

and ends with your hips facing the pitcher

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2. Compare this to a swing that includes only twisting of your torso and

your arms, keeping your hips facing the same direction the whole time

(don’t swing hard)

If the core were the power generator, the 2nd swing would be more powerful.

But it’s not – the legs are the power generator – as you can tell from the 1st

example.

Same goes for any sport – boxing, golf, hockey, shot put, tennis – any sport

that’s performed on your feet works the same way, which is why training for

core stability is such an important concept.

So the function of the core is twofold:

1. To transfer power from the lower body to the upper body

2. To protect the spine and internal organs from damage like body armor

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Core Muscles

As mentioned earlier, there are 3 main groupings of muscles of the core:

anterior, lateral and posterior.

Here’s a table of the main muscles in each grouping and where they lie relative

to each other:

Layer Anterior Lateral Posterior

Deep Transverse abdominis

(TVA)

Quadratus

lumborum (QL) Multifidus

Middle ~ Internal oblique (IO) Lumbar

extensors

Superficial Rectus abdominis (RA) External oblique (EO)

Latissimus dorsi

(Lats)

and Glutes

Because the main function of the core is to transfer power from the

lower body to the upper body, the main function of all of these muscles is

to work together to create core stability.

During certain movements, some muscles are more active than others, but

they’re all working during tasks where core stability is required.

For example, during a rotational movement like a baseball swing, the IO and

EO muscles work more than when you lift something off the ground – but

they’re active during both.

If you study any anatomy text book or take an anatomy class in university,

you’ll learn all of the different actions of every muscle, but in the real world, all

muscles work together to provide movement and it’s the end function that

matters.

Now, I’m just going to describe some of the special roles of each muscle as

opposed to their function in isolation.

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Transverse Abdominis (TVA)

The main function of the TVA is to provide

stability to the spine via tension on the

thoracolumbar fascia and through the

intra-abdominal pressure mechanism,

which you’ll learn about in the next

section.

You can’t see or touch this muscle

because it’s the deepest muscle in the

abdominal wall, but you can see when it’s

functioning when you try to put on a pair of jeans that are too tight – it draws

your belly button in towards the spine.

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Rectus Abdominis (RA)

This is the main muscle responsible for the crunch movement, it aids in

increasing intra-abdominal pressure, as well, it provides protection to the

organs from taking a blow to the stomach and helps in exhaling powerfully.

Internal Obliques (IO) and External Obliques (EO)

The obliques work more during rotational stability, for example, swinging a

golf club, baseball bat or tennis racquet, or pushing a door open with one arm.

The EO also causes a posterior pelvic tilt, which

you’ll learn about in the next section.

Quadratus Lumborum (QL)

This muscle is very active in any side-bending

movements, but research by McGill shows that it’s

main function is to act as a stabilizer, as it’s

location and attachments to the spine suggest it

works as powerful stabilizer.

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The QL is also of note because it is often chronically tight, contributing to

postural dysfunctions such as scoliosis and shoulder height discrepancies.

This makes sense, because in a person with back pain, the QL would be one of

the first muscles to be sent into spasm and muscles that are in spasm often

become facilitated and chronically tight.

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Multifidus

The multifidus is the deepest muscle of the posterior group and it’s very

important in providing something called segmental stability, which you’ll learn

more about in Bulletproof Strategy #5.

It spans between 2 – 4 vertebrae at a time, keeping the vertebrae in line with

the other vertebrae above and below, making it the perfect muscle to ensure

that each vertebrae is sitting in the right place on top of one another.

Lumbar Extensors

The lumbar extensors, also known as the erector spinae, are the big muscles in

the low back that you can feel, whose main function is to lift.

They’re super strong muscles and can do a lot. But when you round your back,

these muscles almost completely shut off, making them useless.

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Latissimus Dorsi (Lats) and Glutes

Although the lats are mainly known as the Chinup muscle and the glutes are in

your butt, in terms of back health, the main function of these groups is to work

together to tense the thoracolumbar fascia during lifting tasks, which you

learned in the previous section provides stability to the spine.

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Key Concepts and Additional Terminology

Neutral Spine

Neutral spine isn’t necessarily a movement, but it’s something you’ll have to

know how to find as almost every exercise you perform will be in neutral spine.

Neutral spine is when you’re in perfect posture and you have the natural

curves throughout your spine, as shown in the picture below:

Because of modern day life, desk jobs, cars, etc, the most common spinal

posture is a head that protrudes forward, an exaggerated thoracic curve and a

flat lumbar curve.

Your ability to find and maintain neutral

spine during all movements is directly

related to your back pain, so you’ll be

training this ability a lot as you progress

through this program.

Pelvic Tilt

There are 2 directions to tilt your pelvis:

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anterior and posterior.

Think of the anterior pelvic tilt as sticking your butt out. For this movement you

use your low back muscles and hip flexors.

Now for the posterior pelvic tilt, imagine that you have a tail. To perform the

posterior pelvic tilt, tuck the tail between your legs, using your abdominals and

glutes.

Both movements should only occur at your pelvis.

Your shoulders shouldn’t move and your knees shouldn’t bend.

Stand up and practice the movement now so you understand what I’m talking

about when I say ‘stick your butt out’ or ‘tuck your tail’ in the videos.

Hollowing

When I refer to hollowing, you’re not just sucking your gut in as much as

possible.

To properly do it you want perform the movement slowly and gently,

imagining the movement coming from your belly button and below. Nothing

else should move and you should be able to breathe naturally while holding it.

Correct Hollowing Movement Incorrect Hollowing Movement

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If you do the movement too fast or hard, you’ll recruit muscles other than the

transverse abdominis (TVA), which is what we’re targeting.

Hollowing of the stomach contributes to the intra-abdominal pressure (IAP)

mechanism that you learned about earlier, which assists in keeping your spine

stable.

In the Acute and Corrective Phases, you’ll perform some simple exercises to

develop your ability to recruit your TVA properly. You’ll then progress through

more advanced exercises to ensure you can perform this function in different

positions and during dynamic movements.

Make sure you don’t skip these even if you can do them easily and hold for the

prescribed time, as constant repetition improves not only your endurance but

also the neuromuscular link between your brain and the TVA, allowing you to

use this muscle when you need it.

Unfortunately, a myth persists that this movement is the cure to back pain, but

it’s not the only movement that provides stability to the spine…

Bracing

Let’s go through a little drill so that

you can understand exactly what

bracing is…

Imagine that someone is about to

punch you in the stomach. Now flex

so that it won’t hurt so much.

That’s pretty much bracing. It’s

activating all of your core muscles

together to stiffen your spine via

the contracted muscles themselves

and increasing IAP and another

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mechanism involving the thoracolumbar fascia.

The one thing you don’t want to do is push your stomach out when bracing.

This differs from hollowing because during hollowing, you’re only activating the

deepest muscle – the TVA.

For optimal stability, you want to hollow first, then brace.

Doing so the other way around can make it difficult to activate the TVA if your

TVA isn’t working like it should.

However, adding bracing on top of hollowing gives you the most stability and

helps you engage all of the muscles and various mechanisms responsible for

spine stability.

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Intra-abdominal Pressure (IAP)

IAP is a mechanism that helps to provide stablity to the lumbar spine.

However, it does not reduce compression forces in the spine as has been

suggested for many years.

Instead, the increased stiffness IAP adds to the trunk helps prevent tissue

strain and failure from buckling under heavy loads.

IAP is accomplished by a few different techniques: the Valsalva maneuver,

abdominal hollowing and abdominal bracing.

The Valsalva maneuver should only be used during maximal lifts, which you

won’t do in this program.

To perform the Valsalva maneuver, all you have to do is blow out as hard as

you can, but don’t let any air come out of your mouth or nose.

The Valsalva maneuver causes a contraction of the TVA, IO and EO and since

these muscles are attached to the TLF, they provide stability to the lumbar

spine.

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Bulletproof Back Program Overview

Now let’s go through the 7 strategies that you’ll be implementing in this

program…

BULLETPROOF Strategy #1 – Effectively Manage Acute Symptoms

The first step in effectively managing your acute symptoms is knowing why

your back is in pain in the first place.

Even if you’re not currently experiencing back pain, the questionnaire in the

Comprehensive Physical Assessment will direct you to the best strategies for

acutely managing your specific symptoms and sources of pain so that you’re

back to living your life as soon as possible.

BULLETPROOF Strategy #2 – Remove Aggravating Factors From Work and

Home

You spend about 90% of your time between home, work and in the car.

So making sure that these 3 areas of your life aren’t contributing to increased

stress on your low back will take a lot of strain away from your back and spine.

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The Fundamental movement videos are the place to start to learn how to

move properly, whether you’re bending over, lifting, squatting, playing with

your kids, doing laundry – basically all of the tasks of everyday life.

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BULLETPROOF Strategy #3 - Address Muscular Imbalances and Poor

Posture

If you’re out of balance in the muscles around the hip and lumbar spine, you’re

constantly placing more stress on the structures at rest and during

movements.

When you’re in a good neutral posture with proper alignment, the vertebrae

aren’t being pulled in any direction and sit nicely on top of one another,

minimizing the stress and strain in all of the tissues in the spine.

But if you’re out of alignment, one area of your spine will have more strain on

it than the others, whether it be muscular, ligament or disc.

For example, if you’ve got a flat-back posture, which is a muscular imbalance in

the muscles that cross the hip joint, such as tight hamstrings, tight abdominals

and weak hip flexors, there is more pressure on the anterior (towards your

stomach) portion of the discs.

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Back of Body | Front of Body

This pressure causes the nucleus (like an egg yolk) to be pushed posteriorly

(towards your back), which over time, can result in a disc bulge or herniation.

Addressing muscular imbalances and poor posture is one of the first steps

you’ll take in this program to bulletproof your back.

BULLETPROOF Strategy #4 – Increase Hip and Thoracic Spine Mobility

One of the most under utilized concepts in treating chronic back pain sufferers

is addressing both hip and thoracic spine mobility.

If you’re very mobile in the hips and thoracic spine, the lumbar spine can stay

in a very safe neutral position during everyday life, sport, and exercise.

But if you’re lacking mobility in any of these areas, to do certain movements

and exercises the mobility has to come from somewhere.

Often, it’ll come from the lumbar spine, which is a big problem, because the

lumbar spine is designed for stability, not mobility. When the lumbar spine

moves, that’s when repetitive strain occurs and pain is the result.

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In the pictures below, you can see the difference between mobile and stiff hips

in the Stiff-leg Deadlift, a common and great exercise:

Even though the guy looks to have greater range of motion because the bar is

lower on his legs, the girl has a nice flat back and it looks like she’s sticking her

butt out, while the guy looks like he’s tucking his tail between his legs.

You can see how flat the girl’s low back is, compared to the guy’s which is

rounded, and at risk of injury. Luckily he’s not lifting anything of significance,

but that’s besides the point…

By the looks of the picture, the guy should’ve stopped lowering the bar once it

got to the top of his kneecaps or even higher, because that’s all the range he

has before the movement starts to come from the low back rounding forward.

So the key for him would be to increase hamstring length and only work the

range of motion where he could keep a neutral spine in this exercise, and

that’s what you’ll learn to do as you work through this program.

Specific exercises for improving both thoracic and hip mobility are included to

ensure you can keep a neutral spine in any movement you’ll encounter in life

or sport.

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BULLETPROOF Strategy #5 – Functionally Train Core Stabilizer Muscles

If you exercise, before you started, did you test the function of your deep

stabilizer muscles?

If not, then you might be shocked at your inability to perform simple looking

exercises that specifically target these muscles, which include the Transverse

abdominis (TVA), internal and external obliques, quadratus lumborum and

multifidus.

The key in getting these muscles working is to start with very simple

exercises and slowly progress your towards more challenging ones.

Focus on consistent, measurable progress

The thing is, if you’re active and fit or athletic, then your body can figure out

how to do these simple exercises very quickly, but often, you’ll use other

muscles to do the job instead of the deep stabilizers.

If you’ve never had proper control over these deep stabilizers or they became

inhibited because of injury and/or disuse, they become sleepy and let the big

superficial muscles do the job. The big muscles can then become facilitated.

We’ll talk about this in a second…

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The deep stabilizers can do things that the big muscles can’t, such as

providing stability between adjoining vertebrae, which is called

segmental stability.

Let’s take a look at an example so you fully understand the concept of

segmental stability, as it’s very important to grasp and implement properly to

be completely free from back pain.

In the lumbar spine, the multifidus are deep stabilizers that provide segmental

stability while the erector spinae muscles are the big guys that are very strong

and provide more gross movements like leaning back or bringing your chest

off the ground when you’re lying flat on your stomach.

Multifidus Erector Spinae

While both muscle groups span your entire spine, the multifidus are broken up

into little segments, with each segment crossing 2-4 vertebrae only, while the

erector spinae basically attach at the bottom and top of your spine.

So when the multifidus contracts, it locks up 2-4 vertebrae so they can’t move

anywhere.

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But if the erector spinae contracts, there are at least 12 vertebrae between the

top and bottom of the muscle, so they are less tightly held compared to when

the multifidus contracts.

To break this down into an even simpler example, look at the following 2

diagrams:

Multifidus Erector Spinae

Which structure is more stable?

And that’s why you need to work these deep stabilizer muscles to free yourself

from back pain.

In the program, you’ll be doing some seemingly easy exercises, but the key is

to perform them properly and as instructed in the videos, and progress them

slowly so that your body has time to get used to using the deep muscles

instead of always recruiting the big muscles.

When your body uses a certain group of muscles over other muscles, they’re

said to be facilitated.

I first learned about the concept of inhibited and facilitated muscles from Paul

Chek, who learned it from a Czech physical therapist named Dr. Vladimir Janda.

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Here’s a very common scenario of how the deep muscles can become inhibited

and the big muscles can become facilitated.

You sit all day at a desk. You sit in your car to go home. Then it’s time to eat

where you sit at the kitchen table and finally you sit on the couch or at the

computer for a couple of hours before you go to bed.

In this scenario, there’s no need for your deep muscles to work, because you’re

in a stable environment all day long.

Repeat this long enough and the stabilizers atrophy and the nerve pathways

waste away, in effect, inhibiting these muscles.

Then, you have an incident where you need the deep stabilizers, like when

you’re lifting something heavy, and because they’ve atrophied away, your back

goes out.

Now, your body’s thinking, “I need to tighten and stiffen up so that I can’t move

and hurt myself again” which is what’s happening when you have muscle

spasms.

The thing is, the deep muscles are basically dead, so your body recruits the big

strong muscles. This recruitment of the big muscles, especially in a time of

distress, heightens their neuromuscular pathways, making it easier in the

future for your nervous system to recruit these big muscles again.

This is how they become facilitated and it causes a vicious loop where you

recruit the big muscles over and over in favour of the deep muscles, further

embedding the inhibition and facilitation pattern that causes your back pain.

I’ve done my best to make this understandable for you, but even if you don’t

fully grasp the concept yet, the key is to ensure you follow the program as

outlined and don’t rush ahead thinking the exercises are too easy, as you’ll be

keeping the vicious cycle in play.

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BULLETPROOF Strategy #6 – Perfect Exercise and Functional Movement

Technique

Whenever I walk into a commercial gym where people are working out by

themselves AND with trainers, a chill often goes down my (stable) spine and I

can actually see people’s bodies being ruined before my eyes.

Back when I used to work as a trainer in a gym, I used to try and help people

with their exercise technique, but I’d often get ignored or people thought I was

just trying to sell them personal training so I just stopped doing it. With the

internet, it’s even worse, as we’ve got even less qualified people freely giving

advice and touting themselves as experts.

All Too Common Exercise Instructional Picture on the Internet Showing

Horrible Form

Perfect exercise technique is crucial in keeping your back healthy as poor

technique will results in excessive stress on the spine, as shown in this Squat.

Nowadays, whenever I train new athletes, I’m amazed at how horrible their

exercise technique is.

This is from guys who are Black Belts in various martial arts and compete at

the highest levels of the sport.

And they’re amazed at how many little details there are in performing an

exercise properly.

That’s why for this program, I produced high quality videos where I go in-depth

on how to perform each exercise in perfect technique

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When you’re learning each exercise, workout along with the videos over and

over until perfect technique becomes a habit.

BULLETPROOF Strategy #7 – Train Advanced Core Stability

There are 3 methods that you’ll work through starting in the Foundation phase

to train advanced core stability:

1. Multi-dimensional (3D) Core Stability

2. Dynamic Core Stability

3. Challenge Core Stability

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Multi-Dimensional (3D) Core Stability Training

There are 3 planes of motion: frontal, sagittal and transverse.

Let’s do a few different movements so you know exactly which plane is which.

Reach up over head with one arm. Now bend over to the side like you’re

stretching the side of your torso. This is a movement in the frontal plane.

Now swing one arm up and down like you’re a soldier marching. This is a

sagittal plane movement.

Finally, imagine there’s a big pot of soup in front of you and you’re holding a

big spoon in both hands and you’re stirring the soup.

This is the transverse (rotational) plane.

Told you this was the fun part! ☺

Now if you go to the gym, what plane do almost all of the machines work?

If you guessed sagittal, you’re right.

What’s next?

Frontal is a distant second.

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And that makes the transverse plane the least worked plane of motion of all.

But, if you’re to take a look at almost EVERY sport and many tasks in everyday

life, they require lots of work in the transverse plane!

Now, you need to be able to stabilize your core in any combination of two or all

3 planes at one time, on top of the fact that you need to be able to first

stabilize in each plane separately.

So that’s a total of 7 different types of stabilization needed from the core!

[FYI – there’s sagittal, frontal, transverse by themselves, then sagittal-frontal,

sagittal-transverse, frontal-transverse and finally all 3 planes together, totaling

7]

But if you’ve only done crunches, planks and oblique type exercises, you’ve

only hit probably 3 of these different types, if that.

An example of a 2D core stability exercise is a 1-arm plank.

Get into the normal plank position, then without moving your body, put one

arm behind your back.

When you’re on one arm, it should look exactly the same as when you’re on

both arms.

The normal plank exercise works the sagittal plane, while the 1-arm variation

adds in the transverse plane.

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Dynamic Core Stability Training

Simple stabilization exercises are great, especially when you add the 2D and

3D exercises into the mix.

But these exercises don’t train the core to be able to stabilize while other parts

of the body are moving.

Core stability during dynamic conditions is when you’re doing something with

your arms or legs and your core needs to be stable to perform the movement

properly.

Every movement and free weight exercise that you do requires this to some

degree, but you’ll be buildling up to more challenging exercises such as the 1-

arm tripod row, which requires you to maintain a neutral spine in a tripod

plank position while doing a 1-arm row.

The 1-arm tripod row is an example of integrating both multi-dimensional core

stability as well as dynamic core stability – you need to stabilize in the sagittal

and transverse planes of motion (with a little bit of frontal plane thrown in)

while performing a movement with a limb.

This position is similar to the 1-arm plank position described above and it has

the same core stability requirements: sagittal and transverse stability.

BUT, adding the 1-arm row into the mix makes it even harder, because a)

you’re adding load and b) the movement challenges the core to be solid in a

more difficult environment.

So this is the 2nd method you need to bulletproof your back.

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Challenge Core Stability Training

The final piece of the puzzle is challenge stability training. This is the type of

training that separates the strong from the weak and will truly ensure your

back is ready for anything.

Challenge Stability training is when you perform core stability exercises (either

basic, multi-dimensional, or dynamic) while you’re breathing hard and your

heart is pounding out of your chest.

This goes back to my MMA background.

Generally, a fighter is only fresh in the first minute or two of a fight.

After that, they’re breathing hard and their heart rates are anywhere in the

150-170 bpm range.

So they need to be able to access that core stability that they worked so hard

for in training in the fight.

But if they always did their core exercises when they were fresh, the training

may not translate over to the fight.

The thing is that because you’re breathing hard, the diaphragm will be moving

in and out and you’ll want to relax your core muscles.

But, relaxed core muscles won’t transfer any power into strikes or other

moves, so we’ve got to train at elevated respiratory and heart rates to get as

specific as possible to what we’ll need.

Now, in everyday life, you may not think

this is so important.

But let’s say you’re helping your buddy

move.

By the way, don’t bother asking me to

help you move, because I’ll have to lie

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and make up some lame excuse. I hate moving!

Anyway it’s not like this is a relaxed thing to be doing and usually you want to

finish as soon as possible so you can go do something enjoyable.

So you’re rushing around and then you get to the last item in the truck and it’s

that big, ugly, smelly couch that should’ve found it’s way to the dump but

instead may be your ticket to a couple of Tylenol and a few days on the couch.

Or, let’s say you’re running around with your kids, then you go to scoop them

up and give them a big airplane ride and OOPS,

there goes the back.

So it’s not just cage fighters that need this quality,

other athletes, helpful friends and parents all need it

too.

Challenge stability is the final piece of the puzzle in

training the core and in developing a bulletproof

back.

By integrating all 3 of these methods on a solid foundation that was created

through the previous stages, you’ll finally have 100% confidence in your back.

Now that you’ve read the foundation of the Bulletproof Back program, it’s time

to watch the Fundamentals videos.

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Additional Considerations

A Big Belly

Although fat loss is not the main goal of this

program, you must take this into consideration if

you have chronic back pain.

Do a survey of women before and after

pregnancy and see how many of them

experience back pain the bigger their belly gets.

This is clear data showing that that excessive

weight around the midsection contributes to back

pain. .

If you’ve got a big belly and back pain is an issue,

losing the gut will go a long way towards taking

excessive stress off of your spine and healing your back.

You can definitely use the exercise program in this manual, as well as add in

some moderate intensity aerobic exercise 3 times per week.

During the Corrective phase I would avoid any high-intensity interval training

to ensure your back is getting the rest it needs to heal.

I recommend you wait until the beginning of the Foundation Phase if you’re

planning on performing more intense aerobic exercise and interval training.

But by far the biggest factor when it comes to fat loss is what you eat.

There are many different dietary programs that will help you lose fat, the key is

to find the one that you can stick to.

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Organ Health

I’ve listed organ health here because I want you to at least be aware of the

numerous factors that can cause back pain.

Organ health is one of those numerous causes, but I have not encountered

any individuals whose back pain didn’t disappear by following this program.

If you work through this program diligently, making sure you’re hitting all

targets and you still have back pain, this may be something to consider.

Think of it this way – when someone has a heart attack, what is a tell-tale sign?

That’s right – pain in the left arm.

That’s how your internal organs can affect your back.

Specifically, the organs located in the torso are the most likely to contribute to

organ related back pain, including the liver, kidneys, intestines and colon.

The reason why this happens is because the organs share nerve roots with the

muscles in the back and if the organs are under excessive stress, are

dysfunctional or have other problems, nerve energy will be directed to those

organs more than the muscles, resulting in possible weakness, soreness or

atrophy.

If you’ve got a history of organ trouble in your family like liver disease and you

work your way through this program without any success, please see a doctor

and get checked out.

most back pain episodes are the result of …...when damage to your spine occurs, your brain causes...

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