Muscle for Life with Mike Matthews - Mark Rippetoe on the Absolute Easiest Way to Get Rid of Back Pain

Episode Date: November 16, 2018

You don’t have to read much of the pain literature to discover that it’s a fairly mysterious thing. Some people experience regular and excruciating pain for no apparent reason while others experience very little pain despite having severe structural damage. And this is especially true of back pain, which is can be a truly baffling phenomenon that seems to follow no discernable patterns or rules as far as prognosis and treatment go. That sucks too because the fact is most everyone will experience back pain at some point in their lives, and sometimes it’ll resolve on its own and sometimes it won’t. When it doesn’t resolve, many people go see doctors and specialists and do x-rays and MRIs only to find their way back to square one, with no idea why their back hurts so much and what to do about it. Well, “what to do about it” is what Mark Rippetoe and I talk about in this episode. Whether you’ve been struggling with back pain for years, have only had it a few times in the past, or just want to do whatever you can to avoid it in the future, I think you’re going to enjoy this chat. In it, Mark and I discuss common questions such as . . . - What causes low back pain for most people? - How effective is surgery for reducing back pain? - Should you keep doing squats and deadlifts if you have back pain? - How helpful is stretching for back pain? - How long does it take for low back pain to go away? The bottom line is by the end of this interview, you’re going to know more about back pain than most people ever will, along with some counterintuitive tips about how to deal with it that you probably haven’t heard elsewhere. 6:57 - Why do people experience back pain? 10:50 - Is back pain seen more in mammals that are walking on their two feet than quadrupeds? 11:30 - What is a Q-angle? 13:07 - Why does the degeneration of a disk result it back pain? 23:02 - What do you do if deadlifting or squatting hurts your back? 29:58 - What do you think of foam rolling, massages, and active release therapy? 35:17 - Does yoga positively affect back pain when training? 38:46 - What are some equipment recommendations to help prevent back pain? 40:38 - Are there any substitutes for the deadlift when experiencing back pain? 52:19 - Where can people find you and your work? Want to get my best advice on how to gain muscle and strength and lose fat faster? Sign up for my free newsletter! Click here: https://www.muscleforlife.com/signup/

our experience has been, and look on my board, and this is discussed thousands of times, people come into the gym with chronic back pain. They've had two or three years. They start training the squat and the deadlift. Three weeks later, their back pain is gone. Hey, Mike Matthews here from Muscle for Life and Legion Athletics. That was a loud hey. Sorry if I freaked you out. Anyways, I am excited to present today's episode with you because it is an interview with my favorite interviewee, Mark Ripito. Always fun to chat with Mark. And this time we are talking about back pain. Now, I thought this was a particularly interesting conversation and that the sensation of pain is particularly

interesting because you don't have to read much of the pain literature to discover that it is a fairly mysterious thing. Some people will experience regular and excruciating pain for no apparent reason with absolutely nothing apparently wrong with whatever's hurting so much, while other people will go on and live their lives experiencing very little pain despite having severe structural damage. For example, one of my neighbors is a surgeon and just recently he had a woman come in who was experiencing a lot of pain in her knees, checks her knees out, and he said they were the most flawless knees he had ever seen. These knees were perfect. There was no reason why her knees should be hurting the way that they were. And then he had another patient who had

bone on bone arthritis, I believe in his back. It was in his back or in his knees. But anyways, so this guy comes in for a checkup and my neighbor was a bit concerned when he saw the x-ray. He was like, whoa, this is bad. How are you doing? And the guy was like, yeah, I'm doing pretty well. Actually, I ran six miles today. My back, I think it was back. My back's a little bit sore, you know, but no big deal. And my neighbor's like, what? How is that possible? And so that is part of the mystery of pain. And it is especially true in the case of back pain, which can be a truly baffling phenomenon that seems to follow no discernible patterns or rules as far as prognosis and treatment go. And that sucks because the fact is that most everyone, including you and me, will experience back pain at some point in their lives and in our lives. I've already had it a little bit here and there from weightlifting things. And sometimes it will just resolve on its own,

and sometimes it won't. And when it doesn't resolve, what many people ultimately end up doing is going to see doctors and specialists and, you know, they do x-rays and MRIs and so forth, only to find out that they know nothing. They are back to square one with no idea why their back is hurting so much and what they should do about it. And all that, and particularly what to do about it, is what Mark Ripito and I talk about in today's episode. So whether you have been struggling with back pain for some time now, or maybe you've only had it a couple times in the past, or you just want to do whatever you can to avoid it in the future, or at least best avoid it, I think you are going to enjoy our chat. In it, Mark and I are going to discuss answers to very common questions, such as what causes

low back pain for most people? How effective is surgery for reducing back pain? Should you keep doing squats and deadlifts if you have back pain? How helpful is stretching for back pain? How long does it take for back pain to go away? And more. This is where I would normally plug a sponsor to pay the bills, but I'm not big on promoting stuff that I don't personally use and believe in. So instead, I'm just going to quickly tell you about something of mine, specifically by flexible dieting cookbook, The Shredded Chef. Now, this book has sold over 200,000 copies in the last several years and helped thousands of men and women get the bodies they really want, eating the types of food they really love, which is why it has over 700 reviews on Amazon with a four and a half star average.

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Right. We're going to let other people talk about that. Let other people fall into that quagmire. We shall remain above the fray. Yes. Instead, we're just going to talk about back pain. Yeah, back pain, which everybody has. Fortunately, I guess I'm one of the few people who does not, although I have had it before. You're just very young.

Yeah, it's true. But I have already experienced it before, so I do know what it's like. The numbers are rather impressive on back pain. Virtually all humans, all, 100% of the human race above the age of 30, has at one time experienced back pain or is currently experiencing back pain. And I mean 100%. This is an interesting statistic if you'll think about it. 100% of the human race does not experience chest pain. They don't experience headaches. I think probably everybody's had a headache at one time or another.

But basically take any other joint. Right. It's a universal experience, MacMaine is. And it's interesting why that would be. And I have a pretty good explanation for that, if you'd like to hear it. Yeah, please share. Well, I'll tell you. It's a function of our evolutionary history. All quadrupeds have the same spinal arrangement that we do.

All quadrupeds have the same spinal arrangement that we do. They have a series of rather similar vertebral segments that are separated by a flexible intervertebral disc. Hox genes, this sort of thing in operation. So you've got a column of movable bones and the spine is movable in fish and in quadrupeds in order that in fish, a swimming motion can take place and in quadrupeds in order that a flexion and extension longitudinally along the spine could take place so that they can walk, right? So, that's the evolutionary purpose of the intervertebral discs is to effect motion along this long column of movable bones. The discs separate those bones and allow for motion along what must be a non-rigid body segment. Well, about four million years ago, somebody got the bright idea to stand up. And as a result of that, foot anatomy changed, pelvic anatomy changed.

We developed a Q angle, the angle from along the femur from proximal at the acetabulum down to the knee. We've got an inward sloping angle that allowed us to more efficiently support ourselves in an upright position. You'll notice gorillas don't have that same Q angle. Their femurs come straight down out of the pelvis because they are not quadrupeds. They're not full-time quadrupeds. When all these changes came into effect to enable us to become quadrupeds, the spine fundamentally changed its function and its position from placing the intervertebral discs in nothing but moment force, now they came into compression. The same structure four million years ago came into a completely different expression of the

force of gravity. Four million years is not a lot of time in an evolutionary sense. And as a result, the discs, which were essentially exactly the same as you see them today, when you buy a T-bone steak in the store, that little piece of cartilage at the top of the T-bone steak is an intervertebral disc. It's got layers like an onion. If you've paid attention to this, you've seen this. And ours are the same way, except that now we are standing upright and we're placing that same structure that was previously designed just to facilitate movement is now placed in a situation of compression where it now becomes a supportive element in that bony column. And it's not very well adapted to that because it hasn't had time

to get adapted to that. And as a result, 100% of human spines, and I mean this quite seriously, 100% of human spines will show some degenerative effects in the intervertebral disc anatomy, degenerative effects in the intervertebral disc anatomy, changes that get worse as you get older. In other words, it is normal. And is that seen more in mammals that are walking on their two feet as opposed to quadrupeds? Well, that's what I'm saying. There aren't any mammals that aren't walking on their two feet as opposed to quadrupeds, except for us and maybe kangaroos. I'm not familiar enough with kangaroo zoology. Do you know if anything similar is seen in monkeys, for example, or apes? No, it's not seen in monkeys or apes because they don't spend enough time bipedally to have found it necessary to adapt to that.

Well, look at gorilla morphology. Their pelvis and their femurs, femurs come essentially straight down out of their pelvis. They don't have a Q angle like we do. Now, the Q angle is that inward, it's that kind of inward angle, right? Yeah. Exactly. The inward angle from pelvis to knee is the Q angle. What that does is line up the feet underneath the pelvis so that you can walk bipedally in a mechanically efficient manner. When you see a chimpanzee or you see a gorilla walking bipedally, they do it for a few steps because they're not very good at it. Hell, I've got a friend that's got a dog that walks around on his hind legs all the time. But he's not, you know, he's just

weird. But they're adapted primarily to, you know, they'll be supported on all four legs. And in the case of a brachiating animal like a gibbon, most of their time is spent hanging from their arms, not being supported vertically on their legs. So what we've seen over time is an adaptation that's enabled us to free up our hands and our brains and all this other stuff that bipedalism enabled us to do. But we have paid a price because the design is not perfect. The design was developed in a quadrupedal environment, not a bipedal environment. As a result, all human beings, without exception,

develop some spinal degeneration because of the nature of the intervertebral disc in compression. And as a result of that, some back pain will be experienced by virtually every human being. And why does that pain just for people listening who don't know shit about joint pain or back pain? Why does the degeneration of a disc, which is just cartilage, why does that lead to pain? Well, now that's another extremely interesting question because it may not lead to any pain at all. Now, while it is true that back pain is a universal experience, and while it is true that intervertebral disc degeneration and bony changes as a result of that degeneration are 100% endemic in this population. It is not necessarily true that one causes the other. Now, let me try to explain this because this is not intuitively

obvious. If you are a 50-year-old man and you go to the doctor with back pain and he orders an MRI study on your lumbar, your lumbar spine. Since it is true that 100% of 50-year-old men will show some degenerative changes in their spine because that's normal. It's normal. Now, remember the technical definition of normal, okay? It is normal to have spinal degenerative changes in the lumbar spine. That's normal. So if you have back pain and you go into the doctor and he orders an MRI, he is going to see degenerative changes in your spine. at least previously, amongst doctors was to point to a point of degeneration on your spinal MRI, your lumbar MRI study, and say, well, look at there. This is degenerated. Your pain is in that area. Therefore, this must be the cause of your pain.

Now, stick with me. That may not be the case. It may not be the case that the thing you are able to identify as pathology, quote unquote, on the MRI study, that thing may well not be the cause of the pain. And here's the reason for that. It might not even be associated with it because if 100% of humans at the age of 50 have degenerative changes in their back, but not 100% of people have pain at that location in the back. And that's also true. I said 100% of people have transient back pain. We don't have, not everybody has chronic back pain. Mine's not hurting right now at all. And my lumbar MRI looks like Godzilla. You know, it's a nightmare.

But I'm not having any pain right there right now. but I'm not having any pain right there right now. So you cannot say that a pathological diagnosis of low back pain at L3, L4 is causing pain at L3, L4 because it may not be causing pain at L3, L4 despite the fact that there it is on the MRI. It may not be associated with pain. Furthermore, the converse is often true. You may go in with back pain at L3, L4, and they do an MRI study on you, and there ain't anything wrong at L3, L4.

There may be things wrong at L4, L5, L5, S1, but the pain is localized further north on the spine. And there's nothing there that indicates why it should be. In other words, if everybody goes in and shows degenerative changes in their lumbar MRI, but if the same person is not currently experiencing back pain, which is usually the case, it is not possible to say that degenerative changes in the spine are always associated with pain in the spine because they're not. This is a subtle point. I understand. Hey, quickly, before we carry on, if you are liking my podcast, would you please help spread

the word about it? Because no amount of marketing or advertising gimmicks can match the power of word of mouth. So if you are enjoying this episode and you think of someone else who might enjoy it as well, please do tell them about it. It really helps me. And if you are going to post about it on social media, definitely tag me so I can say thank you. You can find me on Instagram at MuscleForLifeFitness, Twitter at MuscleForLife, and Facebook at MuscleForLifeFitness. Let me give you another corroborating example. A famous study was done a long time ago with x-rays of horses' feet. And I believe, if my memory is correct, this is at the vet school, the big vet school at Georgia. X-rayed 1,000 horses' feet for navicular disease.

All right. Now, a horse is an interesting creature. He is basically walking around on his middle finger and the bones have changed to the point where all the other digits have receded up his foot and he is walking on the terminal phalanx of his middle digit. That's his coffin bone. Above the coffin bone are other bones, the navicular and the sesamoid. And lameness in horses has always been associated with supposed bony changes in all these structures, okay? And if a horse is lame, he's in trouble, right? He can't get around, he's in bad trouble. A lame horse is not good for anything. So lameness in horses is a big money-making thing in the horse industry.

Lameness is a big focus of attention and has been for thousands of years. So here's the interesting thing. These guys did this study on a thousand horses. And I'm just jerking these numbers out of my ass, but I promise you they're close. 50% of the horses they x-rayed showed positive for bony changes in their distal foot, coffin bone changes, navicular sesamoid changes. All right. 50% of those horses showed some lameness. And there was absolutely no correlation between the ones that were lame and the ones that showed bony changes in the distal phalanx. Now, isn't that interesting? In other words, a positive diagnosis of pathology in coffin bone navicular sesamoid is not necessarily indicative of symptoms of lameness.

It's the same with people's backs. It's exactly the same thing. You can't say that this thing on your lumbar MRI is causing these symptoms in your back pain. You can't say that because it's not true. As far as I understand, I mean, the research, the literature on pain is kind of mystifying, not just back pain, but just pain in general. Pain is kind of a mysterious thing. Pain in general is a funny thing. Exactly. Because of the psychosocial variables that are involved in pain.

Pain is a subjective sensation. Some people are extremely, extremely sensitive to input that they learn to interpret as pain. These people have what is called fibromyalgia. Okay. Some people, like myself, have learned to ignore it. I've got pain input if I think about it right now. Hell, I hurt my shoulder real bad benching last night. Couldn't sleep all night.

But right this minute, if I think about it, it's aching pretty bad, but I'm not thinking about it. My knees are bothering me all the time, a little bit, but I don't dwell on it. Yeah. It's like tinnitus. Some people can't not hear their tinnitus. I have tinnitus. If I stop and think about it, I'm hearing it right now, but I don't pay any attention to it. So there are other aspects to pain, just like tinnitus, that everyone experiences differently on an individual basis. And back pain is an extremely funny thing.

on an individual basis. And back pain is an extremely funny thing. Dude, listen, you people, if you've got back pain and you're 50 years old, if you go to the doctor and the doctor orders an MRI, he's going to find something wrong with your back. Do not, under any circumstances, let somebody operate on your back just because they have found degenerative changes in your spine. Do not do that. That is foolish. And in fact, the vast majority of decent neurosurgeons already know this and they won't do that. All right. Now, if you've got a ruptured intervertebral disc, you might be able to get somebody to try to operate this, depending extremely exquisitely on the individual cases. But ruptured discs heal too. Back pain is common amongst human beings. It's universal amongst human beings. But here's the interesting

thing about back pain that seems counterintuitive and is our biggest problem as human beings. But here's the interesting thing about back pain that seems counterintuitive and is our biggest problem as human beings to understand. Just because your back hurts does not mean you shouldn't lift weights. Just because your back hurts doesn't mean you shouldn't deadlift and you shouldn't squat. What if deadlifting or squatting makes it worse? What if it hurts your back? Do it again.

Really? And then do it again. Our experience has been, and look on my board, and this is discussed thousands of times, people come into the gym with chronic back pain. They've had two or three years. They start training the squat and the deadlift. Three weeks later,

their back pain is gone. See, but that sounds like a positive. I mean, were they though, did they have to work through even more pain while they were doing it? They might have had to, yes. Interesting. Just by what I'm saying, my point is just because the deadlift hurts your back, causes pain in your back, doesn't mean that it's damaging your back. Right. You see how difficult this is to explain to people? You know, we've been taught that the pain mechanism, don't do it. If it hurts, don't do it. That's not good advice. You know, depending on your particular situation, if you have back pain, simple back pain, and I'm not talking about

numbness and tingling in your feet. I'm not talking about you're pissing on yourself or you have fecal incontinence as a result of some kind of profound neurological problem. But if you've got simple back pain, we always recommend squats and deadlifts. Now, obviously, it goes without saying that the form must be correct. But the fact that a deadlift hurts your back does not mean that that deadlift is harming your back. And so I guess there are degrees here, right? There are degrees. There are always degrees if you can't stand it.

Yeah, so if it's extreme and excruciating. If you can't stand it, well, you can't do it. But if you can make yourself work through the pain, then you should make yourself work through the pain. It's important to remember that for all human beings, local transient back pain will occur during your lifetime. For everyone, you're going to have back pain. It is also true that that back pain will go away in two to four weeks, whether you do anything for it or not. And what we have found is that chronic low back pain, people whose backs have hurt for years at a time,

simple chronic low back pain goes away if you train the squat and the deadlift. Yeah, I've seen that. You've seen it a hundred times. If you think about it, yeah, I know your back hurts. My back hurts too. Shut up and do the set, you know, and you shut up and you do the set. And amazingly enough, if your form is correct, it doesn't hurt any worse when you get through than it did when you started. In fact, it may feel better. And in about three weeks,

the whole damn thing is gone. Where it's been there for years, it's gone. If you load the spine in compression and you correctly move it through moment, through leverage in the squat and the deadlift, the spine adapts to that by getting more strongly supported by the muscles that hold it in the correct position. So that's the mechanism that comes into play. We think that's the mechanism, but we don't actually know. It may actually be doing something to desensitize the discs and the nerves that are being aggravated by the discs. We don't know because that's never been studied and it never will be studied. I myself have noticed, I've had a little bit of back pain here and there. That was mostly from

SI joint getting pissed off and then just tight muscles. But I've noticed though in the past, even before I even had that as a thing, if I was off, even if I just, I'd say I took a week off, right? Usually I like to deload, but sometimes it's a rest week or sometimes let's say I'm sick and I'm off for, it's when I'm not lifting for, if I'm not training for a week, two weeks, I don't know. I can't remember the last time it took more than two weeks off, but I've noticed not just back, but like joint, you know, just joints in general, not whether it's a little bit of pain or a little bit of stiffness when I'm not training.

And then when I start training again, it all just goes away. when I'm not training. And then when I start training again, it all just goes away. Joints in general like to be used. And in our situation, used means loaded. Now, running is a different matter entirely. All right. A set of squats is five reps. How many reps is a five mile run? A shitload. You know, and the two exposures to the stress are not equivalent. Old runners generally are pretty crippled up and weak. Yeah. I don't know what they've accomplished, you know. They think their heart is in better shape, but I would argue that exposing the cardiorespiratory system to that much oxygen is it's not very good for it. You know, that's conventional wisdom.

And we're not here to argue that. All I'm saying is that it has been the experience of myself and everybody else that trains people the way we do that chronic back pain goes away. It doesn't just get better. It goes away when you squat and deadlift. And I understand that's counterintuitive. I understand we've all been taught to not do things that hurt. But in the case of your back, that doesn't work.

I understand it hurts for a bad back to deadlift. Do it anyway. It'll get better. Going back to an evolutionary perspective, 30,000 years ago, your back hurt. What did you do? You just sucked it up and kept going. Sucked it up and went on, or you were hyena food, right? We are not designed physiologically to rest. There are very, very few things about human existence that are improved by laying on your ass. And I understand that the world is dominated now by fat, lazy people who don't

want to hear that shit, but that's not my problem. The fact of the matter is that biology now is like biology was back then. And you had better analyze your day in the context of who you are physiologically, not who you are psychologically. Psychologically, you're more than likely a tower of lazy shit because that is the general norm. That's Mr. Tower of Lazy Shit to you, please. Right, right. But if you want to be better than that, you have to do things that are hard. You have to do things you'd rather not do. And a lot of that is physical.

You've got to do things physically you'd rather not do, some of which are going to hurt. I'm sorry. Not my fault. I didn't make things this way, but I do understand how things are. And the way things are is that your body adapts to what you ask it to do. If you ask it to lay on its lazy ass, it will adapt to laying on its lazy ass by getting weak and soft and squishy and stinky and smelly and mediocre, if you get up off of your ass, whether it's hurting or not,

and work through the pain, it will be better because you're making it need to be better, and it will because that's human physiology. What are your thoughts on stuff like foam rolling, massage, ART, dry kneading, grass, et cetera? I think it's mostly bullshit. Oh, yeah? Yeah, I really do. I haven't seen anything.

I can vouch for massages feel good. I can vouch for that. What feels good? Massages feel good. Well, it depends on who's giving it to you. Yeah. I've actually done a bit of ART. I had some biceps tendonitis sometime ago. Massages feel good. Well, it depends on who's giving it to you. Yeah. Happy endings feel good. I've done a bit of ART.

I had some biceps tendonitis sometime ago. You'll probably want to edit that out. What did you say? I said happy endings feel good. Yeah. As long as it's my wife, I'm okay with that. That's fine. That was the right thing to say, Mike.

That's very good. But just because things feel good, and I'm not saying don't go get a massage if you like getting a massage. I'm just saying, does it really help? There are some extremely useful aspects to active release therapy. I've experienced active release on my IT bands a couple of times that immediately helped. IT bands a couple of times that immediately helped. But by the same token, there aren't many more painful experiences than an IT band release. I wouldn't call it pleasant.

Yeah. You know, but just massage that where the girl smears lotion on its back and, you know, and rubs it in and shit. That doesn't accomplish anything. If you want to spend your money that way, go ahead. I'd rather just go to the show, you know? Yeah. Obviously, it comes down to the therapist and what they're doing. I've definitely, I've worked with some people in the past who kicked the shit out of me.

It definitely, I noticed that certain muscles were tighter when I was not getting massaged regularly. But again, it was, it wasn't grueling, but it wasn't a Swedish massage. They're digging in. And as far as ART goes, I had some biceps tendonitis some time ago and worked with a sports doctor who did some ART. And it helped. There's no question. It helped. And yeah, it did not feel good, but it definitely helped release. It was in the bicipital groove. There was just a lot of stuck tissue. It helped. No, I completely agree.

I do that same kind of work myself on people. And I know it works. There's no doubt it does. There's no doubt it works quite a bit. But as a general rule, do these adjunct kinds of therapies make a tremendous difference in your training? And I don't think they do. You're not going to get

guys that foam roll and have gotten used to the way that feels on their legs to tell you that it doesn't actually do anything. But I don't think it does. I don't think it does. Yeah. I mean, I think the research supports that, that it has slight effects possibly in some people, basically. If you like it and you feel like it does something for you, then do it. You know, if your brain likes it, then you need to do it. If you're used to getting a massage every week and you think it helps your training, well, you need to get the massage every week. If your massage therapist dies or you're stranded somewhere and you can't get your massage,

is it going to make a difference in your training? No, it's not. But that's not what I'm saying. People need to spend their money the way they want to. Okay. But I don't believe that any of these popular adjunct therapies are nearly as important as your actual training. Yes, that should be obvious. You know, something else I will vouch for is for months and months now, I've been doing about 10 minutes of yoga stretches and I just pulled them from, I did some yoga classes and, you know, did enough where I, okay, I've basically experienced all the, I've been run through the whole spectrum of these stretches. And so in my case, on my right side, my external

rotation was not horrible, but it was a lot less than on my left side. And my left side was missing a little bit on the internal rotation. And so anyways, there are a number of stretches for both upper body and lower body that just felt good. It felt like, oh, yeah, I definitely. If it feels good, then that's your happy ending. being. Yeah. Yeah. So, but I started doing what I did is I took a number of them and I've just been doing them for about 10 minutes a day for months. And I've obviously noticed, okay, my external rotation is much better on my right side. That's a good thing. And I don't know how much it has really impacted my training. However, I have noticed that for example, squats in particular feel a bit different. Now I feel a bit more muscle activation, I guess you could say, especially on my right side than previously in my quads. It has made a difference and it's made squatting a little bit more comfortable for what it's worth. Well, let's go back to our topic of back pain. Does yoga positively affect back pain as well

as lifting, as well as squats and deadlifts? I've had countless people tell me that it does not. You can stretch all day long, but it doesn't do the same thing as loading the structures and making those structures get stronger. Have you spoken to people, though, that do both? Have they noticed anything like what I just said? Well, yeah. My general impression is that the primary factor is the loading, not the yoga. Because if you take people who stretch, let's just call yoga stretching,

people who stretch for back pain, people who lift weights for back pain, and people who lift weights and stretch for back pain. The people who lift weights and stretch for back pain. The people who lift for back pain get better. The people who lift and stretch for back pain get better. And the people that stretch for back pain don't get better. What does that tell you? Right. The factor is the loading. And it's not hard to see why that works. What I've seen speaking also with people, and this is my experience, I've spoken with people is that again, some people have noticed that

the stretching has simply made the lifting, made certain exercises more comfortable. And that's nice. Possibly, but I know, you know, most of our people don't stretch at all and their, their lifting is perfectly comfortable. Yeah. I mean, previously, I didn't. However, I've always been flexible just because proper range of motion on the right exercises keeps you pretty flexible, actually. Bingo. If you squat below parallel and you get in a good position of lumbar extension before you deadlift and you lock your presses all the way out at the top, everything that should be operating in full range of motion is doing so under a load. So you're stretching when you lift. In other words, you're stretching when you lift.

Since we don't do quarter squats, we don't have problems associated with a lack of range of motion. And I just think that your time is better spent lifting correctly instead of lifting and wasting time stretching. In fact, the only warm-ups we ever do are the empty bar on the exercise we're about to do. Unless there's some kind of special problem you've got. Stretching is an enormous waste of time. But a bit of a bunch of studies done on it, and that's not even controversial, really. Stretching is a big waste. And that's, yeah, I mean, again,

I've read a bit of the literature just for some articles that I've written and stuff. And that, yeah, I would agree with that. It seems like maybe some dynamic type stuff might be useful for some people in some situations. But it's not, if you're going to do any stretching, and anybody listening, if you're going to do any stretching for whatever reason, and if it's just because you think it feels good, great. Then that's maybe that's the thing. The yoga for me, it feels good. I like,

you know, if you like yoga, do yoga. I like that. I have a more external rotation on my right side and it's not so obvious that, uh, I'm so imbalanced. If nothing else, I like that. Well, you must've been real damned imbalanced for somebody else to know. It was pretty, yeah, it was actually, you know, let's say, let's say sitting butterfly right on the ground. I could easily put my left, the outside of my left leg to the ground, but, you know, I was a few inches off the ground on my right side. It just, for whatever reason, you know, it's probably just growing up playing sports, being right-handed, right-footed. I don't know. Who knows? You know what I mean? What are your thoughts on equipment? Are there any equipment recommendations for just

helping prevent lower back pain, shoes, belt, anything like that? I think that if a person with back pain is going to deadlift and squat, I would put a belt on at anything heavier than 135. I do my first couple of sets without a belt at 135, and then I'll put a belt on at 135, do another couple more sets, and then go on up from there with a belt on. I think the minute you start having back pain, that a belt is an excellent idea in terms of helping you support your spine. And my thoughts on the use of a belt have been detailed in exquisite, boring intensity in the article on my website, The Belt and the Deadlift. And it's outside the scope of our discussion here. It's outside the scope of our discussion here, but if you're interested in how a belt actually works, what it does do, what it doesn't do, and why you should use one, the belt and the deadlift at startingstrength.com in the article section.

I think if your back's bothering you, if for no other reason to make your brain happy, put a belt on. Learn to use a belt. Yes. Makes sense. You should be squatting and deadlifting in proper shoes anyway, really, right? In squat shoes, in Olympic lifting shoes that are supportive with a little bit of a heel and a metatarsal strap with a non-squishy sole. Yeah. If you are serious about your training, the first piece of personal equipment you bought is a pair of shoes. the first piece of personal equipment you bought is a pair of shoes. If you're squatting and running shoes, then you are doing the equivalent of squatting on a mattress. That's stupid. You need

a firm interface between your foot and the floor. Get some shoes. Yeah, shoes and a belt. If you've got back pain, shoes and a belt. What about exercise variations? So let's say a back squat is really causing issues for somebody. Again, lower back pain is going to be the thing that we're talking about. What are your thoughts on maybe front squatting instead or any sort of variations or substitutes on the deadlift? No. The front squat is never a good idea for anybody except an Olympic weightlifter. As far as I'm concerned, I see no application for it. Olympic weightlifters have to train the front squat because that's how they get up out of their clean.

But a more vertical back angle in the squat does not solve the problem of the back being trained to support a load in a less vertical backache. Now, when you round the house, do you front squat a box of file paper up off the floor? Well, no. I mean, your back is always loaded in a more horizontal position than a front squat. Always. So why train the front squat? If you're an Olympic lifter, you have no choice. No one else benefits from taking spinal moment force out of an exercise. There are no deadlifts that can do that anyway.

You can't deadlift that way unless you use a trap bar. A trap bar, what the hell is it? What is that even for? People ask us about the trap bar all the time. Look at the lockout position at the top of a track bar deadlift. Does that look stable to you? Of course not. I mean, the reason why it's a thing, right, is less shearing force on the spine.

Yeah, but shearing force on the spine is a complete misunderstanding of what's happening on the spine. Once again, a more vertical back angle does not more effectively train the back than a more horizontal back angle. But it puts less shearing force, right? What do you mean by shearing force? I think you and I have spoken about this before. The spine does not fail in shear. The spine fails in flexion. When a deadlift is too heavy for your back, what happens to your back? Do you acquire a spondylolisthesis on the spot, or does the back round off? There is sheer force on the back, but there is no shearing on the back. Oh, I got it. That doesn't matter.

That's a good distinction. It's an extremely important distinction that people with PhDs in exercise physiology seem unable to grasp. Your back is not sheared in a deadlift. Your back flexes in a deadlift when it's too heavy. In other words, there are no examples in the literature of your back, of one vertebral body sliding relative to another vertebral body in a deadlift as a result of too heavy a weight. That's not what happened. Because proper shearing force then or shear

force would be where we have two sides. One is being pushed in one direction. One is being pushed in the other direction. Yes. Shear force is force that has two directional vectors as components. All right. Obviously, if you are turning a boat with a wrench, the wrench is under shear force. And that shear force is called moment. Moment is

a shear force because there's force going in two different directions. Anytime force is going in two different directions, it's shear. So there is compression, tension, and the shear force we call moment. Those are the three force components. In a deadlift, moment is depending on the angle of the back. When you're straight up at the top, it's in compression. And when you're in the start position, it's largely sheer called moment. We call it moment, which is a sheer force. All right. But in terms of shearing, that's a different use of the term. Okay. I thought those were synonymous, honestly. They're not synonymous at all.

Shearing means something has failed in two different directions. Now, if you get in a car wreck and the seatbelt across your lap holds your lumbar spine in position and your thoracic spine continues forward because you head on to train at 140 miles an hour, then your spine's sheared. That's not what happens in a deadlift. Sheared, in that case, is an extremely dynamic expression of force across the spine, but that's not what we do. That's not what we do when we deadlift or squat or anything else in the weight ring. So that don't, no, don't, don't confuse the two. Your spine doesn't fail in sure your spine fails inflection. Your job is to not let it flex.

And if you start with 135 and then go to 145 and then 155 and you're dead lifting with proper form. You're setting your low back and then you go to 165 and then 175 and then 180 and then you go to 185 and then 190 and 195 at 200 and eventually end up over 500 pounds. Guess what's happened to your back's ability to resist flexion? Improved. It got stronger. And that's the whole point of training is to accumulate strength by accumulating higher and higher loads in your training. And that's really the key then is it's not the horizontal. That's the key. That's the whole thing.

That's the whole thing. It doesn't matter that it's horizontal. What it matters is it starts off horizontal with a light enough weight to stay in extension. And then we add a little bit of weight at a time until it's able to stay in extension with a heavy load. That's the whole point. And in terms of flexion, then how that becomes shearing then is because obviously if something's flexed, it doesn't become shearing unless there's a dynamic force, which doesn't occur. You're not going to shear your back. I'm just trying to visualize.

So you have flexion, you have the bending, right? So you have the force going, you have a force going up and then on the ends, you have the force kind of going down or staying in place, right? So that's the bending. Wouldn't that be shear force? I mean, again, this may just be being ignorant. I'm just trying to picture it in my mind. Oh, I understand. It would be force along a beam. All right, let's look at beam stress. If you've got an I-beam, right, and you've got gigantic heavy weights on either end of the I-beam

and the I-beam is resting across a point of rotation. You can load the I-beam at each end to the extent that it will bend. All right? Now, across the top of that beam, the force is tension, and it stretches. Across the bottom of that I-beam, the force is compression and it buckles up, right? Your back does the same thing, all right? If your back fails to stay extended and goes into flexion, the muscles across the top, the lumbar erector muscles lengthen. In other words, they fail to stay isometric. And the back curves. The underside of the spine, the anterior side of the spine, the discs go into compression and they change configuration from open in the front to more closed in the front. Now, I suppose under extreme circumstances, this could produce

a disc injury, an intervertebral disc injury. But what we actually see is that the spine is fairly tolerant of flexion. And the way you know that is because every time you go into a Gold's gym, some jackass is deadlifting 315 with a completely round back, and he sets it down and he walks away and he's not dead. Yeah. For the hundredth time too. There's a guy at the gym I used to go to in Florida. I was like, how is this dude still walking? This is, this is actually a mystery.

Right. I've seen the, uh, a video of the, uh, coaching director of USAPL pulled a bar off the ground with a completely round lumbar spine. And he's fine. You know, the spine is tolerant of flexion. What it's not tolerant of is flexion and rotation at the same time. That's an excellent way to screw your back up. You know, bending over, picking up the lawnmower, and it's going to be in flexion because it's an awkwardly shaped object

and not a barbell. But it's light, so you can deal with that but then if you set it in the back of the truck by rotating at the spine and not by rotating at the feet that's a good way to hurt your back that's typically how that happens but inflection is not how you that's not just simple flexion. The back's fairly tolerant of that. But you wouldn't, you wouldn't, I mean, obviously you wouldn't recommend people to pay no attention to flexion in their back when they're pulling, right? Oh, no, no, no, no, no, no, no, no, no, no, no, no, no, no. You have to learn how to maintain extension.

This is the first thing we teach people in our seminar. This is the first thing we teach people in our seminar. Saturday morning, we spent 15 or 20 minutes talking about how to maintain lumbar extension. It's an extremely important part of learning how to lift weights correctly. If for no other reason to make sure that the lumbar spine is an effective transmitter of that moment for us. Right? You don't want a power leak. You're losing, you'll be losing energy. You're losing energy along that segment if the segment deforms under the load. Right. Like a rubber wrench, that's not a good way to

turn a bolt because do you tow a car with a chain or a spring. Same idea. A non-deformable component is the thing that most efficiently transmits force. And extended backs that stay in extension are non-deformable components and are therefore more efficient transmitters of force. So flexion is a bad idea. And flexion must be resisted. That's the point of doing the exercise. That's the point of deadlifting, right? Is to pull with the back in absolutely flat extension so that the muscles that keep it

flat get strong. Perfect. Well, those are all the questions I had. And I think one of the key takeaways for people is that, of course, if something's excruciating, if it's very painful, you need to not do it. If it's bringing tears to your eyes, you need to stop right away. If the pain is increasing through the set, something's wrong, don't do it anymore. If the pain stays the same through the set or gets better through the set, then you're doing something right.

And especially if the pain precedes the set, if it's just there all the time. If the pain precedes the set and it's there all the time, do the set. If the pain stays the same during the set, you're okay. If the pain increases during the set, something's wrong, put it down. But if you've got chronic back pain, the pain is going to be there before the set. Make up your mind, you're going to try it anyway. And what we always find is that chronic pain responds positively to a load. Perfect. I think that's it. Well, I appreciate your having me on, Michael. As always, as always. And in case people don't know where to find you, of course, startingstrength.com is... Startingstrength.com is the website. Big giant resource of all these kinds of info, all these kinds of information. We've got lots

and lots of articles, lots of posts on this. It's a good place to learn. The command center deep in the heart of Texas. Who else says that? Absolutely. Absolutely. All right. Thanks, Mark. Thanks, Mike. Talk to you soon. Hey there, it is Mike again. I hope you enjoyed this episode and found it interesting and helpful. And if you did, and don't mind doing me a favor and want to help me make this the most popular health and fitness podcast on the internet, then please leave a quick review of it on iTunes or wherever you're listening from. This not only convinces people that they should check the show out, it also increases its search visibility and thus helps more people find their way to me and learn how to build their best bodies ever too. And of course, if you want to be notified when the next episode goes live, then just

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