Jan 15, 2020

Back Health for Life with Schuyler Grant

If you have lower back pain, you are not alone: 80 percent of adults suffer low back pain at some point in their lives. Today our guide to this topic is yoga teacher Schuyler Grant. How to sit, how to stand, how to sleep, even how stress and psychology interact with chronic pain — she covers it all. Check out her new Commune course, Back to the Core, at onecommune.com/core.

Jeff VO: Welcome to Commune, a global wellness community and online course platform featuring some of the world’s greatest teachers. We’re on a mission to inspire, heal, pass down wisdom, and bring the world closer together.  

This is the Commune podcast, where each week we explore the ideas and practices that help us live healthy, connected and purpose-filled lives.

You can check out our courses, our community and everything we do at onecommune.com 

If you have lower back pain, you are not alone. 80 percent of adults suffer low back pain at some point in their lives from muscle spasms and strains to ruptured and herniated discs, from arthritis to sciatica. If you’ve experienced back pain, you know how debilitating it can be.

Back pain is personal for me. As a middle-aged athlete who thinks he’s 25, my back will go into spasm on the tennis court when I am not properly warmed up. And I will hobble about complaining endlessly  to my wife-cum-nurse. Fortunately, my back married well. My wife, Schuyler Grant, is an expert on back care. And she shares her vast knowledge with is on the show today.

Schuyler suffered from debilitating chronic pain which came to a head on our honeymoon. I had expected to spend a lot of time in bed over this period. But this is not exactly what I had in mind. During this period, Schuyler discovered back expert John Sarno and it completely and thoroughly changed her back and her life.  

Schuyler has integrated Sarno with her own yoga practice and teachings and has  remained largely pain-free for the last 20 years. She shares her deep knowledge on back care today on the show. You can also access Schuyler’s dorsal wisdom on her new free Commune course called Back to the Core.  Just go to onecommune.com/core to sign up. 

I’m Jeff Krasno and welcome to Commune.

Schuyler: As well as being your wife and your co-conspirator in most things, I am a longtime yoga teacher. I also am a longtime chronic pain sufferer who has largely made her way out of pain and learned a lot and in the process. But anyone who has suffered chronic pain knows that, that experience and that identification goes with you for the rest of your life. Because it's a life-changing thing to experience chronic pain. I can definitively say that the trajectory of my life was formed by it and the fact that I'm no longer in pain, is one of the real ... Is really one of the things that I'm most proud of in my self work. [crosstalk 00:01:26].

Jeff: So the source of your pain, it goes back to when you were a child. I wasn't there. I feel like since we were always destined to be together, I feel like I was there. I've heard this story many times that I think some wayward hippie ran you over in a VW bus, is that correct? 

Schuyler: Well, you could say the inception of the story of my pain started when I was a little girl and I was, I don't know, two years old. I was living on a hippie commune and my mom was doing something like making sauerkraut in the kitchen and I toddled out of the house. And one of the women who lived with us was backing out in her VW van and knocked me over and ran me over. My mom, as the story goes, had some kind of a psychic experience, knowing where I was and that I was in trouble, and ran out and in her misguided psychic experience, yelled and then the woman reversed and ran back over me. That's a great story. 

Anyway, I survived, clearly, and in my second incarnation, my second life, I was sort of a miracle. I think the doctors thought maybe my parents were just stoned and made it up. But I think it really did happen. As I went into my teens and my early 20s, I had a lot of recurring back pain. One of the things that-

Jeff: Directly related to that incident.

Schuyler: I'll get to that. So, yes, that was what I believed. I went to chiropractors and doctors and the whole panoply of experts in the field, starting in my teens, and then even more when I was in my 20s. That was the diagnosis was that I'd had this traumatic injury and MRI showed that I had a bulging disc between L4 and L5, and that my spine looked like an old woman's. That I had early onset degeneration-

Jeff: But not your face. 

Schuyler: Well, that's only in the last decade. My spine is amazing now but my face not so much. It's kind of like your ass or your face. Anyway. So there was with this story in my head that I had this deteriorated, destroyed back and I had this traumatic injury when I was two and that was why. I found yoga, as part of my journey to try and get out of pain. I started doing yoga in my early 20s. What I found in practicing yoga, was that it was incredible bomb and made me feel great sometimes and other times, it made it worse, and it would set my back into a spasm. So it was both medicine and poison, but I knew there was something there. 

So starting when I was around 22, I kind of tussled away with this practice. And then there was a number of other things that I learned through that decade, through my 20s that were really the additional building blocks to my healing. It's a story that will probably sound very familiar to many people who've gone through the journey of chronic pain. The first was that I read a book by a doctor named Dr. John Sarno when I was 26 or 27. Yes, I will digress. Because when we were 25, we went on our honeymoon. And because we were 25 and had no life, it was an extended honeymoon in Brazil for three months. That's when my back went into the worst spasm of my life.

You remember well carrying me not across the threshold in romantic, candlelit evening but to the bathroom because I literally couldn't walk to the bathroom to pee. So I was in like, a for the first time in my life, it wasn't just like, it's chronically painful and had trouble getting up, but I actually couldn't move. I was fully debilitated. So when we came back from that, I knew that I was maybe going to have to get surgery or I was going to have to do something radical. That's when someone gave me a book by Dr. John Sarno. 

Schuyler: So many doctors can't understand where it comes from, because very often the pain that patients feel is not even necessarily related to the underlying condition. There's actually one of the things that at the same time that I was getting into reading Dr. Sarno and other doctors who were doing the same kind of body of research.

Schuyler: So there was a study in the Journal of American Medicine in the mid-90s, where they looked at like 100 X-rays of backs of people who suffered no back pain. They just took a random sample of people who had no problems. And only 35% of those people had no problems. There was only like 35% had "good spines" and the rest of them had herniation and bulging this, and bone spurs and degeneration. But they didn't experience any pain. And then there are people who suffer debilitating back pain, neck pain, and there's nothing that you could find on an MRI or an X-ray. So that in itself, I mean, it's pretty stark evidence that it's far more complicated than what's going on physiologically.

Jeff: Right. 

Schuyler: So yes, there can be torn tissue. That needs to repair. Just like any torn tissue in the body needs to repair. If there's inflammation and then that's compressing nerves, or a bulging disc that's pressing out and compressing a nerve. That's an underlying condition and it's insanely painful. Just to be clear, by saying that there would be a psychological underpinning to pain doesn't mean by any stretch of the imagination that the pain isn't real. The pain is very, very real. But what happens is that when there is pain, the brain creates signals that generally create spasming around a trauma. This is often called the pain-spasm-pain cycle. 

So you do something that's dramatic, a sharp twist or turn or a fold, or you sleep in a funny way, you lift a heavy object, or you just have a chronic physical pattern that you do in your body over and over. So what causes the underlying condition? It might not be something dramatic, it might not even look like an injury. It might not be something that you could actually exactly pin it a date to. But you actually have muscular strain. And then especially in the spine, which is so close to our central nervous system, your brain sends out a message for your body to contract the muscles around that spot, basically to act kind of like a physical splint around that spot. So the muscles all around it, which aren't injured, those seize up. 

And then when those muscles seize up you stop getting blood flow to those tissues, muscles, tendons, nerves, all of those things need blood flow, and it's called ischemia. And so your regulated blood flow, even a minor reduction of blood flow to tissues causes a pain. That reduction of blood flow itself, causes pain. You're not getting nutrients, you're not getting blood, and then you're not releasing waste product from those tissues. And that causes pain, even though there's not an injury there. There's no torn tissue. And then the Pain sends a message to your brain that there's an injury. And then it sends a message back to your muscles to contract some more. So that's the pain spasm loop that your body and brain get into this totally fucked up dance. 

Even though after a certain amount of time, the tear or the physiological problem may well have healed, you're still in this loop, and now that's being generated by your brain. So your brain has to cut the loop. So people who have been through this process, it's not like you understand like ... I'm really at the point, for example, now where I don't even really buy my old story about getting run over and that's why my back was screwed up. I mean, yeah, I have this underlying ... I have a seriously bulging disc between my lumbar four and five. I was in chronic debilitating pain in my 20s. I developed a mental and physiological practice over 15, 20 years that took me out of pain.

At the end of that time, I thought, oh my god, clearly, I fixed my back. And then I went like seven years ago and had my back scanned, again, same spine, more degeneration, same bulging discs, but just more general atrophying of the spine that would look kind of like, actually it kind of grew into my own back because I guess my back look kind of like an old lady. Now, I do have the back of an old lady. So it's not worse, but it's not better, but I don't have pain. I know now that now I truly don't just understand intellectually, but I understand somatically, that I'm okay. That I'm not a victim of my history or of the pain itself if it should come. 

Because it's not like I don't ever have back pain, but if I feel it coming on before, my whole body would go into red alert, and I just knew that this was it. Oh my god, it's going to be so bad. I have to get an airplane or whatever. I'm projecting into the future the misery of this pain episode that's about to hit me. And now I know that it's stress and that, yeah, I have this underlying back that's not perfect, but my back's fine. I live in the same back all the time and sometimes it hurts, and sometimes it doesn't. 

I have a whole bunch of tools in my tool belt just from living for a long time and doing the hard work of figuring out what my body needs physiologically to be out of pain. And the psychological part is like, okay, well, you're stressed out, you need to rest a little bit more. This is the way your body's telling you that you need to chill out a little bit or you need to address one of many of the many things that are rattling me. So I don't go into the mental spiral, which doesn't send me into the physical spiral.

Jeff: Right. But you're not saying that the key to alleviating back pain is essentially surrendering to God, to a power greater than you. I mean, that you're saying that there's a psychological element of back pain that you can address through, I guess, therapy, meditation, de-stressing techniques, but there are also physiological practices that you can begin to also address the issue. 

Schuyler: Totally. So this is where I would diverged from someone like John Sarno, where I definitely think there's a psychological component, and I also think that we as people who suffer from any kind of pain, but back pain specifically, which is so complex, 

Schuyler: Or someone who wants to preempt that need to do the physical work to keep the body healthy, and everybody needs to find out what that is for them. I've found my way through yoga and I can, I'd love to speak more to why I think that it's a really good methodology. But it doesn't have to be yoga, it could really be anything. Something like yoga, or Tai Chi, or any physical practice that is also considered a mind body practice, is so perfectly positioned for this. Because it's not just conditioning the body, but it's conditioning the body in tandem with conditioning the mind, and looking at the interplay between the body and the mind. With yoga, specifically through the conduit of the breath, which is such a potent way to address the lack of oxygen getting to muscle tissue, which is causing your pain spasm spiral.

That's a physiological piece bridging into the psychological piece. Then yes, I would say absolutely you need to do the psychological work, and whether that is surrendering to God and that gives you really, truly deep, real peace, resolution of your trauma. Or it's psychoanalysis, or it's meditation, and you just really work through the things that are gnawing at you in a very deep way. To be clear, it's not... The psychological piece of this is not, is never going to be something simple. I don't know. I couldn't, to be honest, it's not like I can look back and say, "Oh, it was that thing." I had a really amazing childhood. It's not like, I don't feel like somebody who is full of simmering rage, I've wonderful parents and had a really, really loving childhood.

But we all inherit these inner pressures and stresses. One of the things that Sarno and his inheritors say is that the personality types that tend to suffer from psychologically induced chronic pain are people who have a lot of ambition, and have a lot of self judgment in their... They put a lot of pressure on themselves. Interestingly, another personality type is people who are do-gooders, and put a lot of pressure on themselves that way. Not just around their own performance in a worker or a social way, but about doing really good things in the world. Which is so interesting to me because I can't, I'm not saying I'm that person at all.

Jeff: You're not in either camp.

Schuyler: No. No, you jerk. I would put myself in the first camp, but not necessarily in the second.

Jeff: No ambition, and no charitable impulse. Your back should be perfect.

Schuyler: Only when it comes to my husband. Anyway, it's self pressure. It's like self-imposed pressure would be the simmering, boiling pot underneath that psychosis.

Jeff: Right, but don't you think that modernity creates the conditions for back pain?

Schuyler: Absolutely.

Jeff: I think I read 80% of adults suffer from some form of acute or chronic back pain, depending. In some ways, I suppose evolutionary biology hasn't really caught up with the changing circumstances of modernity that have progressed. Regressed, so quickly that if you essentially go back in history to the agricultural revolution, well we weren't really designed to bend over and harvest crops and carry big satchels of grain. You probably saw the first instances of back pain some 10,000 years ago, as we changed our cultural habits and the way that we lived. Then of course, scientific revolution, industrial revolution, people working heavy machinery. Until now, which is essentially a sit down culture, where people just sit at their desks all day. All of those things contribute to back pain, an unhealthy spine. And that our evolution hasn't selected for a new body yet because we're just not moving, because we're moving so quickly.

Schuyler: Our habits are moving so much faster than our ability to evolve, for sure. Yes, 100% and there's no question that the best thing proactively and physiologically that we can do, is move consistently and stop sitting. It's just from a very technical standpoint, the human body is not a designed to do what we're doing right now, sitting in a chair with our femurs at a 90 degree angle to our pelvis. It's probably one of the most detrimental habits we all take on on a regular basis.

Jeff: So how should we sit?

Schuyler: Well we should squat. If we can't squat, we should stand as much as we can, stand and move. This whole revolution in standing desks and people walking around with earbuds in and having a mobile office, is a good thing.

Jeff: No squats at desks yet.

Schuyler: Ball chairs, which we happen to have at our house in some abundance. Really any...

Jeff: Why the ball chair, because it engages your core, is that right?

Schuyler: Yeah. Well the ball chair A, it makes your butt a little higher than your knees. So as soon as the angle between your thigh bone, your femur going into your hip socket is more obtuse, like wider open angle, it's going to allow the muscles at the front of your hips, your psoas and your more exterior hip flexor muscles, to relax a little bit. As soon as you're in a 90 degree or tighter flexion, it's going to grab. Unless you're really deep flection like a squat, in which case the thighbone drops deeper into the socket again and it's a more stable spot. What we don't want is what's called our psoas, it's really three muscles called the iliopsoas, contracted and turned on all the time, because that's our big fight or flight muscle.

That's another one of those loops, like the pain-spasm-pain loop. Your psoas, this big muscle that is really meant to help us charge forward and run away from a saber tooth tiger, is not meant to be on all the time. It's meant to be able to turn on but then turn off. So much of what we do psychologically and physiologically in our bodies and our nervous systems now, is turn that on all the time. And that big long muscle is kind of like a long flank steak, and it runs from at the back of your spine or the front side of your spine, in your kind of deep, deep belly, front, back, belly, front, back. It connects right around the bottom ribs where your diaphragm is, and then runs all the way down to your inner upper thigh bones. It's the longest muscle and one of the deepest muscles in your body.

So when that's just chronically on, it's really the same stuff as your back. It's, your back belly is your inner back. And that's a lot of what the course that I did for commune is about, is both strengthening and opening that that muscle group in the body. Because we want it to be pliable, we want it to be really strong, and we also want it to be really soft. Many people have either a completely atrophied psoas, is weak, or they have a super tight, hard, immovable psoas. Both of those things, bad news.

Jeff: Yeah, hard to get at the psoas.

Schuyler: Super hard to get at. You can palpate it or a massage therapist can do it, but it's really, really painful.

Jeff: Oh yes. The Thai massage.

Schuyler: Yeah, the heel and the lower gut. Yeah.

Jeff: So maybe take a moment to just go over some basic back anatomy, because there's a lot of terms that get thrown around. L3, L5, the thoracic back, the lumbar, coccyx, I don't even know what I'm talking about.

Schuyler: But you look cute saying it.

Jeff: Cervical curve.

Schuyler: Sure. Your spine has a few S curves. It has a few curves. It's in an S curve, I should say. A healthy spine has a curve in where your neck is, and then a curve in where your lower back is, and then it dips out where your upper back is, your upper middle back. That's called your thoracic spine, where your upper back is, around where your shoulder blades are. Then your neck is your cervical spine, and your lower back is your lumbar spine. And then your lumbar spine then ends at your sacrum. Yogis love to talk about the sacrum, it's just one of those things. Your sacrum is really the very bottom of your spine, and that's where it lodges right into the top of your pelvis. It's kind of shaped like a little spade, and it sits right in the top of the pelvis, which is shaped kind of like an inverted spade. 

Kind of getting back to this sitting issue is that when we sit in a regular chair, very often the tailbone is kind of rolling underneath us. And the lower back, instead of having a nice good rounded shape, bulges back and so you flatten out your lumbar spine. Then all the muscles around that will start to grab on at both the front and the back. At the front in that psoas area, there's grabbing on at the front. And in the back you've lost the balance of the curve. If you don't have this S curve, this set of curves you've lost... It's sort of, what would you call it, like a spring. The spring of your spine, which gives it shock absorption. Instead you're just, you've made your spine into more of like a rod, and it's lost its ability to take the shocks of everyday life. You've set up a cascade of counterbalancing tightness in the body.

The other really chronic pattern that we see is, in part of modern day life, is in the neck. 

Driving, typing, texting, carrying babies, carrying bags. That forward shift of the shoulders sends our head forward, tightens the front of our body, and then turns all the muscles in the back of the body on super tight and locked on to hold our body in position. It's what's called locked long in the back. So the muscles of the back are long, but not loose. They're long but tight, and the muscles in the front are locked short, they're tight and short. Then that just causes imbalances. Restriction of oxygen flow, ischemia, pain cycles of pain-spasm-pain.

Schuyler: You should endeavor to sit with the crown of your head, stacked over your tailbone, your chest open, your shoulders back, the sides of your neck back. So your spine basically stacked, enabling that S curve to come into its fullest fruition.

Jeff: Say that again because you speak so quickly when you talk about anatomy that I don't think anybody understands you. So just say it again.

Schuyler: Okay, so actually let's just close our eyes. You close your eyes and everybody who's listening, close your eyes unless you're driving. Get yourself somewhere still, and with your eyes closed, just do a little mental inventory of your spine and your head, there sitting at the top of your spine. See if you can feel where the crown of your head balances in relation to the very bottom of your spine. That's your tailbone right there at the very bottom.

See if you were to slide the sides of your neck back a little bit and draw the outer upper shoulders, the outer upper arm bones and shoulders back a little bit. And then maybe to lengthen your tailbone down, if you feel you've got a lot of curve in your lower back. Or maybe if you feel in your inner inventory, in your mind's eye, that your lower back is really flat, to poke your tailbone back a little bit. See if you could find the place where your chest feels broad at the front, but not pinched at the back.

The sides of your neck slide back and feel soft, and the crown of your head feels balanced on top of your tailbone. So there's a feeling of stacking top over bottom, and then in between there's a lightness in the curve of your neck, the soft roundness of your upper back still being broad at the front, and a nice curve in your lumbar. A nice curve in the lower back, just above your pelvis.

Then you'd like for those curves ideally to remain in place without over-efforting, because efforting then just leads to patterns of tightness. It's not like if you have, you can open your eyes now, darling. It's not as if you can restructure your body in a day, or a week, or a month. It's one of the reasons that doing conscious practices like yoga or feldenkrais, or pilates, where you are actively working on the alignment of your body in different shapes. All different shapes, not standing, not seated, in a whole variety of postures. You're constantly bringing your attention back to where your body is in space, and trying to rebalance it in all different relationships to gravity.

That's what over time. And that just takes time. It takes usually for most of us decades, if not years, to get into dysfunction. So untangling that is just, it has to be a patient endeavor. But I do believe, I really truly in my heart believe that the body wants to heal, until we die and we're all headed in that direction. But most of the time in our bodies, most things are going right. The fact that you're sitting around and doing anything, even if you're in chronic pain and you feel like things are going so wrong. When we are in pain, all you feel is the pain.

At the same time, all of the unseen forces that are going forth in the most incredible, miraculous way, are so right. So I always try so hard, and it's really hard when you're not feeling good, but to remember that mostly living is a cascade of things going right.

Jeff: That's an optimistic thought. Can you unpack a few of the other things that you talk about and teach in the course? Both from a breath perspective and a core perspective?

Schuyler: The breath. Really one could do I think a deep dive on the breath and pain recovery, that would be phenomenal. Put that on the long list of things to do. But the breath is this incredible translator or conduit between the seen and the unseen. In case you don't know anything about our nervous system, there is the sympathetic and the parasympathetic nervous system, which are both part of our unconscious nervous system. The things that, all of the processes that we don't control.

Our digestion, our heart rate, the cascade of hormones that course through our body, our orgasm. All of the things, the defecation, all of the things.

Schuyler: So there are all these processes that that we largely cannot, that we can't control. Except the breath, and the breath is the thing between our somatic nervous system, our walking around doing the things that we can consciously control and do. And all of the things, actually most of the things that go on in our body that we can't control and do, the breath is the only thing that we actively can choose to control.

Mostly, 99% of the day or even 100% of the day for many people, we don't even think about the breath. We certainly don't think about changing it. So the breath is the gateway. It's the gateway between the seen and the unseen. The breath is the way that 

Schuyler: Can really experience in a totally real world way how we can turn on what's called the parasympathetic nervous system, which is our rest and digest nervous system, and our sympathetic nervous system, which is our quote unquote fight or flight nervous system. You can watch your breath put you in either one of those places, you can actively use your breath to put yourself or take yourself out of one of those states or another.

So when I started to get a glimpse of that through the yoga practice, I was like, "Oh my, yeah. Yeah, that is powerful. That's a real thing. And I want to understand that. I want to have a cerebral and a physiological experience of that control or that play. Control's the wrong word, but it's really like interplay with this thing, this unseen thing that's so magical and powerful." And so, I definitely got into practicing pranayama in on my own and then teaching some in my classes. And at the same time, I was fascinated with what's called Uddiyana Bandha.

And so I, through this Bandha work, started to feel my deep core, which I'd never. I didn't even know that you could feel the difference between your ... I just thought, "Oh, there's your stomach muscles. Those are your abs." And I started to get like, "Oh no, actually. I actually can feel those are my outer abs, those are my inner abs. And, oh my God, I'm feeling my diaphragm." Which you know, not everybody wants to do. But if you're having a long relationship with pain in those areas, it's super interesting and transformative to start to dissect your own anatomy.

And so I would insert a lot of this Bandha work on my own when I was in my home practice and I'd kind of sneak it into my practice if I was in a class, but it was unorthodox. Like what I was actually just doing was not ... People in a traditional yoga class would use Mula Bandha for sure. And sometimes people will, say, use Uddiyana Bandha. It's kind of thrown around in yoga, but what they're really generally saying is engage your core. But the Bandha work that I'm doing, I'm talking about, for Uddiayana Bandha is actually not engage your core, it's actually stretch and open your core and then be able to engage it, like deep inside. So it's very nontraditional core work.

And it just became really clear to me that most of us are weak and tight in our bellies. Even if we're strong in parts of our belly, like a lot of people have a strong rectus because they do some kind of crunches or some kind of ab work, but most people are tight and weak in their transversus and then in their psoas and all those other muscle groups.

Jeff: So not only weak, but it seems like unaware?

Schuyler: And totally unaware, yes. But you could be ... If you have a super healthy muscle group, you don't even need to be aware of it. I mean, the only reason to be aware is to mitigate future pain or remedy current pain.

Jeff: I think there are very few people out there that have spent the time and the effort to cultivate the skills to be able to isolate and identify secondary and tertiary muscle groups. I mean, that's pretty rare.

Schuyler: Sure. You only do that when you're forced to because you can't get out of bed. But yeah. So I started incorporating eventually, like I did that kind of, I was like on the sly doing that in my practice for a long time. And then I started slowly incorporating it into my classes and certainly into workshops, which is really the context that you need to introduce that information to a newer student group. And you know, some people are kind of like, "Oh, that's cool, weird, cool." And then some people are like, "I had like an aha moment of like, 'Oh yeah, yeah.'" And then sometimes people, students will ...

Sometimes students will come to one of these workshops and they don't have any back pain, per se. And then a month later I'll get an email saying, "I've suffered from chronic constipation for 20 years. And for the first time in my life, I'm having a regular poop. And I wasn't even interested in pursuing poops. But that's so great. But it doesn't surprise me. I mean, it's all like, again, it's not rocket science. If you heal and open up the muscles of your belly, you're going to heal and open up your digestive organs and the organs of elimination. So it's, to me, so exciting and phenomenal to pursue practices that take us into inner space because why not? You know, we walk around in this body largely ignoring it except for this little sheath on the outside. And maybe if we're an athlete or a weekend warrior, we're interested in our muscles, the things you can see. But there's this whole universe in there that's truly, truly fascinating. I've only scratched the surface.

Jeff: Well it sounds like more than a surface. So we talked a little bit about work environment and sitting. And then we talked about some other kind of active practices and techniques. And then, I wonder if you could address sleep and I mean obviously, unless you have insomnia like me, you spend 30%, 35% of your life asleep or in bed or lying down. And are there preferred positions for sleep that people should be taking for optimal back health?

Schuyler: Yes. The consensus really is on your back on a firm mattress. If you can't sleep on your back, then better to sleep on your side with a pillow that has your head more or less in line with your spine. Not higher, not lower. So your spine is balanced. And then worst of all is sleeping on your stomach, but that's really nice. And I know you do it.

Jeff: Yes. Sometimes. Often.

Schuyler: Yeah. Sleeping on your stomach, the worst because when you think about that, like your head's going to inevitably have to turn to one side or another, which is not going to be the optimal alignment of your head to your spine.

Jeff: What else would you say for people that are experiencing pain, where is their first stop? What's their first resource? What's their first practice? How do they get in? Because you're obviously talking about Bandha work and some things that are-

Schuyler: Fairly esoteric.

Jeff: Yeah. And advanced and requires some degree of awareness or a practice for, I suppose, an average guy like me who's sort of a weekend warrior athlete professional that suffers in and out of lower back pain. I don't want to reduce this to five hacks for back health, but I'm going to for a second. I mean just, what are the kind of basic common denominator ways that we can maintain health in our back?

Schuyler: Yeah. So I would say number one, you need to, if you suffer from pain, you need to assess whether it's chronic pain. And if it's chronic pain, I very strongly recommend that you be open to examining whether it has a psychological component while 100% acknowledging that the pain that you're feeling is totally real and it is actually a physiological phenomenon that you're experiencing. But entertain the idea that you could do some inner work that would be groundbreaking for you in changing your relationship to that pain and the pain spasm, pain cycle. That's number one.

And then you have to find what the modality that works for you in your life and in your philosophical and religious framework that actually helps you do the work, the inner work. And then from a lifestyle perspective, we need to move. None of us move enough. And so, some of us have more leisure time to be able to move, some don't. But almost everyone can move more than they do already. It's the kind of classic but boring take the stairs instead of the elevator, at lunch, go for a walk. For the most part, we need to exercise more and less with less impact. So much better to get moderate exercise regularly than to go be a weekend warrior. I mean, a lot of injury happens to people who are sedentary for long periods and then go out and exercise hard.

Look at your posture on a regular basis. Like, adjust the way that you work if you work on a laptop or a phone. And be a big dork and get your keyboard up to a place where your spine is in good alignment and your shoulders are back and you're not hunched forward and your head's not dropping forward. Because even if your problem is lower back pain, that rounding, the slumping forward, kyphosis, this is called, in your middle upper back is going to set your whole spine off in a cascade of badness.

That's three hacks. Your fourth hack is to get really interested in strengthening your deep core and whether you are doing it at the gym or you're doing Pilates or you're doing yoga, know that you could have an amazing, super strong, awesome abs without ever doing a crunch again, ever in your life. I'm actually really down on crunching. I think that many of us are over strong and short in our outer abs, the rectus that I talked about, the six pack abs. Those shortening tend to draw your front body tighter, that same hunched forward posture is not what we need. We need strong but long outer abs and a strong, deep core. So I mean, for example, in a yoga class, when you're doing plank, that's a deep core exercise because gravity is pulling your organs down and you are using your deep core and your outer core muscles to hold your organs up against gravity.

So any kind of exercise that you do. And I share in the course that the abdominal exercise that I do, as you know, it's probably the only thing I do almost every day, but I do the deep core exercise that's so dumb looking and it really like, it's the beginning of it barely looks like anything. It's really like an inner core resistance exercise, but it's basically like creating a strong and healthy inner corset for your body that stabilizes your spine and holds your organs in so that the rest of your body can move and be still and in motion more efficiently. 

And then, learn to release that. Because the same way you wouldn't want to have tight hamstrings, you don't want to have tight abs. Right? We have this weird psychosis in our culture about having tight abs, but you don't want to have a tight-

Jeff: Thank God, for me.

Jeff: You are an amazing woman. I am always shocked by how much you know and how much that I don't know that you know until I started this podcast. Now I have you on all the time just to keep the marriage going and spicy and impressive. You are so impressive. And you've helped so many people through back pain. You've caused a lot of mental anguish along the way.

Schuyler: I send your back into spasm on a regular basis, but then you wouldn't have the good work to do.

Jeff: That's true. I love you.

Schuyler: I love you too, honey.

Jeff: Okay.


Jeff VO: Thanks for listening to today’s show. Honestly, my wife never ceases to amaze me with all her knowledge. It’s a joy doing this episode because  not only could it help save my back but I also learn something about her … after 32 years together, it’s lovely to continue to discover your partner’s brilliance.

Schuyler has helped so many people with their back pain. If you suffer from acute or  chronic pain, I hope you’ve gleaned something. You can check out Schuyler’s back care course, called Back to the Core, at onecommune.com.

That’s  it from the Commune for this week. Please subscribe and leave us a review. And, more importantly, email me at [email protected] I always love hearing directly from you. 

That’s it from the Commune for this week. I am Jeff Krasno and, in honor of Ram Dass, in love, include me.

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