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February 20, 2025 17 mins

In this episode, I dive into the 3 vital tips that you should know to reduce chronic low back pain.

These are based on over 10 years of experience treating hundreds of clients with low back pain unresolved with manual therapy, medication, surgery, or injections.

Because it is a more holistic view, addressing exercise selection, mental tips and more, I hope this will be a valuable episode to empower you to fix your own pain completely by yourself.


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Transcript

Episode Transcript

Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:01):
Hey, welcome to the Won Body WonLife Podcast.
Hi, I'm your host, Dr.
Jason Won, Lifestyle PhysicalTherapist and Strength Coach.
Today, I wanted to give youthree solid tips that I think
will help you to, not justimprove your low back pain, but
actually eliminate it.
And so low back pain is one ofthe most common.
symptoms and ailments that wesee in the world.
Over 90 percent of people in theworld will have some form of low

(00:25):
back pain at some point in theirlife.
I myself have gone through aseries of different low back
episodes from either injuringmyself or jumping from a fall
and tweaking my back to liftingweights off the floor.
And often times when we gothrough Huge episodes, or even
more frequent episodes, it cancause a lot of fear, anxiety, it

(00:46):
makes us second guess how ourbody is, it makes us feel that
we're actually aging a lotfaster than we actually are.
And me as an athlete, as well asa busy parent, I know for first
hand how it feels, so I canspeak for a lot of the parents
out there that maybe you were anathlete before, maybe you have
young kids or maybe you havekids that are older and is

(01:06):
oftentimes feeling harder toactually keep up with them.
Maybe you feel like your body isfragile.
Maybe you feel like you've had,so many low back episodes that
you're second guessing what yourbody is actually capable of.
So again, I wanted to share.
Again, three solid tips that Iknow will help to change your
life and also be able toeliminate that low back pain.

(01:29):
So the very first thing I wantto talk to you about is the role
in strength training, and what Icall training smarter, not
harder.
So if you think, for example,that it's simply just about
training hard, that's not themost critical piece.
We need to learn how to trainsmart, and this is what I mean.
Training smart is not justlifting heavy weights, it's also

(01:50):
challenging your body inmultiple planes.
So you have your low back.
And the spinous processes andthe many different vertebrae and
the muscles that accompany that,you need to learn that you need
to be able to strengthen areasabove as well as strengthen
areas below.
And what that means that justbecause you have low back pain,
you don't want to just load themuscles corresponding to the low

(02:11):
back.
You also want to strengthenmuscles above, like in the mid
back, and also muscles thatpertain to your shoulder.
And you also want to strengthenthe muscles below, which are
also accompanying your hip andyour pelvis.
So the muscles above, some ofthe more critical muscles that I
often see overlooked, are thelatissimus dorsi.
The latissimus dorsi is a musclethat attaches to the inferior

(02:32):
aspect of your shoulder blade,and attaches into the middle of
your back, but also attachesinto this weave of fascia, which
we call the thoracolumbarfascia.
And those that fascia is thishuge mesh of fibers that attach
directly to your lower back.
So if you're just loading themuscles of your lower back,

(02:54):
you're actually missing a lot ofthe muscles such as your
latissimus dorsi thatcontributes to not just
extension and inward rotation.
of your shoulder, but actuallywhen you do tense up those
muscles in your shoulder blade,it actually stabilizes your
lower back.
So we actually use our latmuscles to keep either weighted
objects or even babies or evengroceries.

(03:17):
We keep it close to the centerof our body by actually engaging
our latissimus dorsi.
So when I see a lot of myclients that oftentimes are
either doing barbell deadlifts,dumbbell deadlifts, you'll often
see them that they start toround their back or that their
shoulders flail away from theirbody.
And so by way of notstrengthening your lats or doing

(03:37):
isolated latissimus dorsiexercises, you're actually not
able to keep that bar or thatdumbbell close to your body.
And it often weighssignificantly when it comes to
functional demands.
So if you engage your latissimusdorsi, you'll notice that you
can keep your back a little bitstraighter when you're doing
heavy lifts or even justfunctional day to day lifting at

(04:00):
home.
And so I wouldn't stress, Iwould definitely stress the fact
that Let's just miss or she'sstrengthening is a huge part of
strengthening your lower back.
You're also looking at themuscles below your lower back
too, such as your groin muscles,namely your adductors and also
your glutes, as well as yourhamstrings.
All of those muscles arecontributors to hip extension.

(04:22):
So when we are lifting somethingoff the floor.
It's not just about our lats,which is the muscles up above,
but the muscles below alsocontribute greatly to hip
extension.
Our adductors, our groinmuscles, the adductor magnus, is
actually one of the moreimportant muscles that when you
are hinging from your hips, itactually is one of your more

(04:42):
powerful hip extensors.
So from a hip flex or a bentforward position, we actually
need our adductor.
To activate in order to get ourbody into a more straight
position.
So when we're talking abouttraining smart and not just
hard, we don't want to just doback extensor exercises,

(05:03):
although those are reallyimportant.
We also want to think about themuscles above and below.
Another principle that I sharewith a lot of my clients is
called multi plane stability oreven tri planer stability.
So we oftentimes will see a lotof exercise in the gym, such as
leg press, hamstring curls, quadextensions.
I love all these exercises.
These are all exercises that Itruly love.

(05:26):
But if you want to essentiallywhat I call quote unquote
bulletproof or even prevent lowback pain.
You want to be able tostrengthen outside of those
planes so the plane that we allare accustomed to is called the
sagittal plane These are whenour knees go forward or if our
butt goes backwards that'sstaying in that straight lane So
if you think about a freeway afreeway, you're in the middle

(05:49):
lane, so really you're onlythinking about going forward and
going backwards.
But we're not thinking about thefast lane and the slow lane,
which are like outside of thatmiddle lane.
If we're trying to ventureoutside of that plane, we want
to be thinking about the coronalplane, which is basically side
to side movements that is goingside to side, looking at hip and
toe.
ADduction, hip ABduction.

(06:11):
Those are muscles that we wantto be strengthening as well.
So namely our side glutes, likeour gluteus medius, but we also
want to be thinking about therotary plane as well.
So we Think about a car that'sdriving down the middle lane.
We also want to think about howwe can rotate that car side to
side.
And that's what's going to helpus to strengthen our body and
protect the ligaments and thedisc within our lower back by

(06:33):
also strengthening the rotaryplane as well.
A common myth that I often hearfrom a lot of doctors which
should be really put to death isdon't bend and twist, right?
Don't bend and twist, don't bendforward and rotate at the same
time.
That will stress out our disc.
But the thing is that we need tostress out.
We do it and actually need toput good stress into our

(06:54):
ligaments and into our disc inorder to strengthen and prevent
future.
Recurrent low back pain and thatis by strengthening again the
side to side plane as well asthe rotary plane Do not think
that your body is fragilethinking that you cannot bend
and rotate If you bend androtate and if you are actually
doing that in a calculatedmanner Meaning that objectively

(07:15):
you're actually Progressingreps, progressing resistance,
progressing weight, progressingspeed in a predictable manner,
actually logging those workoutsand actually seeing growth, you
will notice that you will becomemore accustomed to rotational as
well as side to side patterns,and that's going to further
strengthen your back.

(07:35):
So that is the first criticalstep when it comes to the tips
for low back pain is trainingsmart and not hard.
So we're thinking about areasabove and below, strengthening
those areas as well, but alsostrengthening any multi planar
fashion.
Okay.
So number two is modifyingstress factors and environmental
factors in your life.
We know that low back pain, andmaybe you don't, but low back

(07:58):
pain is not a manifestation ofjust physical symptoms, right?
That's what we call thebiomedical model.
The biomedical model wassomething that was coined back
in the day, meaning that alldisease and all dysfunction is a
product of just strictlyanatomical disease.
That means that if you have adisc issue, if you have some
sort of ligamentous dysfunction,that is the true cause of your

(08:20):
low back pain.
So once you have discdegeneration, once you have
muscles or let's say muscularsarcopenia or something that's
being confirmed by x ray andMRI, that is the tell all.
That means that because you havea disc issue, you forever will
live with low back pain.
And that can't be further fromthe truth.
We know now that there arepsychosocial factors, there are

(08:43):
many environmental factors thatcontribute to the pain
experience.
That means that, research showsthat, If you are of lower
socioeconomic status, meaningthat financially you are not
making as much, that is a stressfactor in itself, and that can
be a cause of low back pain orany other pain in your body.
We know that if you're goingthrough an abusive relationship,

(09:04):
if you're being in a fight withyour kids, if you have project
deadlines and they are coming upvery soon, or if you have a boss
that's always breathing downyour neck, these are all
contributing factors thatcontribute to the overall low
back pain experience.
When you're looking at the factthat if you're sleeping poorly,
if you're malnourished, again,these the facts is that low back

(09:27):
pain is not just strictlyphysical symptoms.
We need to be thinking about ourenvironment.
We need to be thinking about howwe mitigate stress.
And this is something I, I didback in my physical therapy
student days when I was doing mydissertation on positive versus
negative coping mechanisms.
So negative coping mechanismsare things like, if we are
stressed, We'll tend to venturetowards a sedentary behavior.

(09:52):
We'll tend to watch a lot moreTV.
Maybe we'll smoke or we'll drinkas a way in order to mitigate
stress.
But if we can choose morepositive coping mechanisms,
namely if we choose exercise ormovement or running outside,
Side as a way to combat stressthat oftentimes we can relieve

(10:13):
some of the mental stressors inour life, and that oftentimes
can make our low back feel a lotbetter too.
You'll be surprised that evenjust people that do what I call
awareness, breathing, groundingsomething, I teach to a lot of
my clients that if you becomemore aware of your stress, as in
you're not just letting stress.
Internalize and become physicalsymptoms such as low back pain,

(10:35):
but if you become more aware ofyour stress, then therefore you
can start to do things like justbreathing and becoming more
present and therefore groundingyourself in the present moment,
not worrying about the future ordwelling in the past.
That oftentimes that strategy ofwhat I call awareness,
breathing, grounding.
It can really make a hugedifference in terms of relieving

(10:58):
and outletting that mentalstress.
And when you are relieving oreven decreasing that amount of
mental stress.
Don't be surprised that your lowback starts to feel a lot better
as well.
And don't forget that, again,sleep and nutrition, huge parts,
and I would consider the twomost important pillars of
recovery from stress, physicallyor mentally, are critical

(11:20):
pieces.
Addressing your nutrition,eating more protein and fiber,
eating less processed foods,eating foods that are not as pro
inflammatory, those oftentimescontribute to the pain
experience.
And often when you're Lackingsleep such as quality or
quantity of sleep.
You want to be thinking abouthow much sleep you're getting in
Research shows that seven tonine hours is often that

(11:41):
critical Amount of sleep andthat actually does decrease with
age So as we get into our 40sand 60s, we oftentimes may need
less Sleep in order to functionbut nonetheless seven nine hours
is still a great point for thegeneral population And also
quality of sleep So what are youdoing going into the last

(12:02):
minutes of your sleep or eventhe last hour of your sleep?
Are you looking at social media?
Are you doing a lot of onlineshopping?
Are you thinking about a lot of?
Stressful things and a lot of todo's that you have to do the
next day, because if you are, ifyou're feeling overwhelmed or
anxious going into your sleep,that oftentimes will lower the
quality of your sleep.

(12:23):
So you may be getting a quantityof seven to nine hours sleep,
but maybe you're getting justlight sleep.
Maybe you're not getting thatdeep restful sleep that
oftentimes is critical forrecovery for improving just many
aspects of our life.
Sleep and nutrition.
Don't discount that andoftentimes look at your positive
coping mechanisms Whether youare if you are somebody that

(12:47):
oftentimes goes through a lot ofstress Think about the ways in
which you can replace some ofthe negative coping Mechanisms
with more positive copingmechanisms namely again, whether
it's meditation or exerciseOkay, so the last thing about
the last and final tip that Iwant to give about chronic low

(13:07):
back pain and how to relievethat for good is learning how,
learning how To basically takethat low back pain and make it
feel that much smaller, right?
So when we talk about thepsychosocial factors, we
oftentimes feel that pain isthis really large cloud That is

(13:27):
always raining on our parade wefail to realize that pain is
just a small entity when itcomes to the grand scheme of
what life actually is becauseLife is all about memories.
Life is about our family.
Life is about finances.
Life is about finding otherpurposes in life.
Yet, when we go throughrecurrent low back pain, we

(13:49):
often feel that is somethingthat consumes our every other
aspect of our life.
If we let pain consume our life.
consume it, consume ourfinances, consume our personal
life, consume our job, consumeour ability to play with our
kids.
Then we're going to make painfeel that much larger.
So we basically think about aword doc is that we're making

(14:10):
pain, which is just a smallthing and we're enlarging pain
to like this hundred size font.
Okay.
We're letting pain become thislarger cloud that is constantly
raining no matter where we go.
pain is always present.
Now, I oftentimes say this andwe can make pain feel smaller.
We can make you feel larger froma mental standpoint.
Okay.
One of my favorite quotes isthis, is that we want to make

(14:32):
sure that when it comes to pain,that pain is not something that
you live with.
Pain lives with you.
So if you say that pain liveswith me, then we're basically
saying that we're the largerentity and that pain is a
smaller entity.
Okay.
So mentally think about how paincan be a smaller part of your
life.

(14:52):
And I'm not saying that don'tdiscount your pain.
Don't just distract yourselffrom pain.
You want us to address your painthrough sound exercise, sleep,
again, nutrition and all those.
But, look at pain as somethingmuch smaller.
There is so much more to life.
Okay, there is your purpose.
Okay, there is your job.
There's the people around you.
There's your family and friends.

(15:13):
Okay, there's a lot more thingsto worry about or to improve
upon rather than just thinkingthat pain is the only thing that
I'm trying to get rid of andonce pain is completely
eliminated, that's when I decideto live life.
Okay, even for myself, somebodythat is a pain relief expert, I
know that Even for me, there'stimes where I'm working on a lot

(15:34):
of stuff.
I get stressed out myself about.
I'm just one normal person aswell.
And I often times will start tofeel discomfort in my lower back
or my neck.
I start to feel my shoulders gettight.
And that's just a part of life.
However, I can't let pain bethis consuming factor that's
going to prevent me from livingmy life, from living a fuller
quality of life.

(15:55):
Okay?
So if you could think about howYou know, instead of you are the
house and pain lives in yourhouse rather than like you are
this one little, person, thisone individual and you're living
inside of pain's house, flip thescript.
Okay, try to think about painbeing this small entity that you
can truly control.
From an objective standpoint andnot letting ping consume you so

(16:18):
hopefully that's helpful Andthat's it for this episode if
you found this episode trulyhelpful.
I appreciate if you give us abut also Let us know, by
subscribing and also leaving afive star review that way if you
leave a five star review Thisepisode and my many other
episodes will be able to inspireothers.
And I really hope that this caninspire you as well, especially
if you're somebody that's beendealing with chronic low back

(16:39):
pain.
I really hope that these threetips really inspire you to make
some changes.
So that's it for what I got forwhat I got for you today.
I'll leave you always with thisone quote that I always leave
all my episodes.
We only have one body, one life.
May every action you take be onethat makes you a better version
of you.
Take care and have a beautifulrest of your day.
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