You are now listening to The Model Health Show with Shawn Stevenson.
For more, visit themodelhealthshow.com.
Welcome to The Model Health Show.
This episode is so important because we're gonna be talking about some science-backed solutions for some of the most common ailments affecting our friends, our families, our communities and often ourselves.
We're gonna be talking about science-backed solutions for neck pain headaches, back pain really messed up posture just hunched over.
All right kyphotic, all right, walking around like one of those, like a bulldog.
But we're not bull nor dog, all right.
How do we address this and get ourselves in healthy positions, but also, most importantly, how do we get ourselves out of pain.
And that's one of the most powerful parts of this amazing conversation is we're going to be digging in deep to understand what pain actually is, how our experience of pain manifests, where does it come from, and the truth about how much power you actually have over your pain.
Again, this episode is vital and incredibly valuable.
So listen in and make sure Now let's get to our special guest and topic of the day.
Dr Joseph Damiani is a doctor of physical therapy who's treated countless patients suffering from TMJ disorders headaches, dizziness and chronic neck pain.
After personally experiencing chronic headaches and neck pain and brain fog, Dr Joe was driven to develop a signature process that integrates musculoskeletal and neuroplasticity science.
Over the past decade, he's refined his system to to help individuals worldwide to achieve a lasting relief and restore normal function.
Let's dive in this conversation with the amazing Dr. Joe Damiani.
Dr. Joe, welcome to the Model Health Show.
Good to see you, man.
Thank you so much.
Really appreciate you having me.
Of course.
All right, we're gonna talk about resolving neck pain, headaches, so much more.
But I wanna start off by talking about some common causes of neck pain that most people might not be aware of.
It's a very common for people to experience neck pain, but oftentimes they don't know some of the root causes.
And I wanna start off with the connection between neck pain and our butt.
Yeah, so pelvic floor core and then all the way up the chain to the neck and to the jaw, to all of it.
So there's a couple of different levels we could start with.
So we can start with fascia.
So there's fascial connections and lines throughout the entire body, feet to head.
Many of those lines.
One specifically, the deep line, goes through the pelvic floor and it goes all the way up through to the neck.
So imagine trying to treat neck pain in a vacuum.
This vertebrae is pinching something between the next vertebrae, or this muscle is really tight.
We can work very locally.
That's what I would call the pain generator.
So you have neck pain.
There's a specific structure and it produces.
That's what's producing your pain.
That's the pain generator.
We can release that, we can stretch it, we can get it to move and you feel better.
But if you zoom out, why was that pain generating structure dysfunctional in the first place?
You have to look at the bigger picture.
So when we look at fascia, if it was restricted in a certain area, it can pull you down and then it starts getting compressed.
It starts generating the pain, et cetera.
Another important distinction is our pelvis is the bottom of our spine, and then our spine goes all the way up and it holds our head.
And there's three distinct curves in there, right?
So the low back or the lumbar spine has a curve.
The upper back has a curve.
That's why you get rounded shoulders or hunched forward.
And then the neck has a curve in the opposite direction.
And this is important because it allows you to have shock absorption.
So imagine someone just pushed on the top of your head.
If it was stacked straight up, everything would just compress into each other.
But when you have these three curves, they can give, they can bend, they can work together.
So if your butt or your booty is not stabilizing your pelvis well enough, then that movement, that it has a domino effect up the chain to the neck.
And so we, whenever i look at someone who's suffering with pain, we look at where's the pain, where's the structure that's generating the pain.
Let's get you feeling better, but then let's zoom out and figure out what is actually driving that from afar, and then the hips could be a part of that.
Interesting, okay.
So what are some common issues with the glutes that might be affecting the neck?
Like maybe one side of the glute is firing and the other isn't, or just the glutes are just sleepy overall.
Or maybe they're hypertonic.
Yeah, absolutely.
So it's actually better for us to look at the bones before bone positions, before we look at the muscles.
So if our thighs, which are sitting under your pelvis, are not holding the pelvis equally like, it's not sitting perfectly and it's tilted forward, that's what we call the anterior pelvic tilt, or it's tilted backwards, that would be a posterior pelvic tilt.
Something in there is pulling it in a certain direction.
Could be tight muscles on the front, which would be your hip flexors, which everyone knows that tight hip flexors are common.
That automatically has a relationship to the muscles on the back, which are the glutes.
So while the front, the hip flexors are tight, the glutes get overstretched and then you can lose power and that can tilt your lower spine forward.
If you have too much strength or activation on one side, then you can start actually driving the pelvis towards that side.
And now you start putting a lateral more scoliosis type of.
I'm not saying that's the cause of scoliosis, but that type of curve into the spine.
And so all of these different things, if one side is tighter than the other, if generally they're too tight, if generally they're too strong or over-activated, it's going to change the position of the spine.
And then that goes up the chain.
So maybe the way that somebody's sitting chronically, you know, maybe they're sitting on a wallet, maybe they're, you know, constantly like leaning one way as they're driving.
Yeah.
So if you're like a mother who's holding the baby all the time on one side, if you're sitting for a while, maybe you're really good with exercise and you've overcorrected.
You know there's so many different factors, but it's just it's.
You have to just think of it as the foundation.
It is the foundation.
That, And everything on top is dependent on you finding balance in those structures and the glutes being a driving structure.
Okay.
One of the things that you said earlier is really already just like got me, just like my mind is blown.
Okay.
Because what we tend to do is we tend to attack where the pain is happening.
Yeah.
Right.
And so we come in, maybe it's massage.
Maybe it's some kind of like decompression tactic.
Maybe it's acupuncture.
There's all kinds of ways that we can attack it and go at the pain, but we're not necessarily resolving the pain and it's very likely to re-express itself.
And so we need to step back and look at the bigger picture.
And so I think that a lot of people listening who do experience back pain or neck pain or constant headaches.
It's like it's something that tends to keep popping up again and again, and again.
And so I wanna dig a little bit deeper on some of the common causes that people might not be aware of.
When it comes to, let's just stay in the realm of neck pain.
Sure.
So if your pain starts coming back again.
So some of the common reasons why someone would have pain in their neck again.
Let's go to that pain generating structure.
The vertebrae, how they sit on each other, it's out of balance.
So the discs in there, the ligaments, tendons, on one side, it's too tight.
And the other side, it's over lengthened, right?
So the structures themselves cause pain.
Then the muscles that are on top of the spine, which are supposed to hold it in position.
Again, one is working extra hard to pull it.
So basically imagine the structures on one side are tight.
So the muscle on the other side have to work extra hard to try to pull it in alignment.
Now you have a muscle that's overworking.
And then when the nerves come out of the neck, they are what determine if you feel pain or not.
So if there's compression, inflammation, or irritation, those structures as well will be irritated.
Okay.
So now you want to calm down those structures.
So you start mobilizing the spine.
You stop having it being tight on one side versus the other.
You start balancing out the muscle, or you start releasing the muscle.
So the muscle's painful, tend to spasm, you release it, the pain goes away.
You unlock that trapped nerve.
So now your sensation just flows naturally.
But again, if some of those structures beneath are painful, If you're on a faulty foundation, if you have the leaning tower of Pisa, if you just start trying to fix the upper part by bringing the building back the other way, without fixing that foundation, the fact that it's tilted, you're always going to end up back in that same position.
And so those are the structures that get irritated.
But again, it's that foundation that keeps it coming back.
And we also have to talk about the nervous system.
So this is a very important piece.
Let's say that you achieve that alignment in the spine.
Let's say that everything below the spine, the foundation, the hips, everything's working properly.
You're moving better, but you're still having pain.
You have to understand that your body is incapable of producing pain.
The only thing that produces pain is your brain.
So your body, the muscles, the joints.
They send signals up to the brain and the brain interprets it.
And if it looks at that signal and says eh, we're fine, this isn't a threat, then you don't feel any pain.
But if it says that's a threat, you're going to experience pain.
So there are two totally different things.
And that leads us into a bigger discussion.
Sometimes I've worked with people who have had intense scoliosis, terrible posture, no pain at all.
And I've seen people who are in optimal position to have pain.
And if the nervous system, for whatever reason, is stuck in a loop and it feels threatened, or it feels that there's danger, it's going to make you experience pain in the absence of a physical injury.
And so that is the bigger piece of all of this.
Oh man.
Okay.
Well, we got to talk about how do we break that chain, break that loop.
You know this is?
It's so fascinating because I think a lot of people have had to experience, for example, like again, the brain decides whether or not you're going to experience that pain.
Like maybe you get a bruise somewhere, like maybe, like you're In the mirror, you know.
It's like how the hell did I get this bruise on my back?
Like, but it would be painful that maybe if you saw it or you know when it happened, or you could see the bruise right.
And so it's just, again, it's a perception thing is a huge part of this.
And to have those examples again, when somebody's body is expressing what we would consider to be severe dysfunction and having no pain, versus somebody who just everything seems to be really optimal and they're experiencing pain.
Yeah.
And we struggle to find a reason why.
And it's just.
It's based on the brain and nervous system and getting the body out of this.
I guess a threat response or stress response.
Yeah.
So there's three ways that I've identified over time that this can happen.
And it's through either your emotions, right?
So your beliefs and your emotions.
It's about your awareness of the situation and And it's also about trust.
So let me just break those down for a second.
When we talk about the nervous system or neuroplasticity, let's start there.
It's your brain's ability to learn from experience, right?
So you have an experience and your brain learns from that.
But it's not just the learning, it's the way your brain interprets that experience.
So an example I like to use is, let's say you had two friends.
You have one friend who's very level-headed, cool, calm, collected.
You have another friend who has a tendency to get, who's very emotional, tightly wound, and you forget both of their birthdays.
So you forget the one friend's birthday, the calm level head of friend, and he goes, you know what?
He's got a family.
He's got a career.
He's busy.
I can't wait to see him again.
You forget the other friend's birthday.
The other friend's like, they always do this to me.
They put me last.
I just, you know what?
Forget it.
I'm done with them.
Same exact experience, completely different interpretation of the experience.
If you have pain that started and has not gone away.
And now you start saying, hmm, it's been a week, it's been a month, it's been six months.
Is this going to impact my career?
I have that vacation coming up next year.
Is that going to impact that?
Like, why am I getting different opinions from different doctors?
You're fearful, you're worried, you're putting more emphasis on it.
Those emotions ignite the fire and you're going through a fight or flight response.
Stress chemicals come in there and now you start having this pain over and over.
So that's one way emotions can ignite it.
Trust is another piece.
So let's say that one day you turned your neck all the way to the side or something happened, you had an injury.
Your brain says I let him move all the way over there because I trusted him and then he caused an injury for me.
So now I'm only going to let him move 20 in that direction, because last time I let him go all the way, he caused an injury.
So I'm going to protect it.
So now you start moving and you're like, I can't even move any more than that 20%.
There must be something horribly wrong inside my body.
You don't realize though that it's the nervous system trying to protect you.
And the last piece is the awareness.
So if you've ever been shopping for a new car, you go to a dealership, you see a car you never saw before and you say, you know what, I kind of like that car.
Let me go home and think about it.
And then on your way home, you drive home and suddenly that car is all over the road.
Did everyone just buy that car?
No, it's actually your brain is now tuned into it.
You're aware of it.
And that's what happens with pain.
You wake up in the morning.
Is it still there?
Yeah.
You get in the car.
Is it still there?
Yeah.
I'm working out.
Is it still there?
It's still there.
Think, think, think, think, think, think.
And this focus starts driving your awareness.
And sometimes I tell people I want you, for five minutes, to put all your focus into that same area of your body on the opposite side.
Just think, think, think, think, think, think.
And they start saying, huh, it's kind of tingling.
I feel pressure here.
I feel this going on.
They're picking up things they never even tuned into.
And so, when your emotions, when your awareness, when your trust are off, your brain goes into this protective mode and you start experiencing pain in the absence of physical injury.
So I know, I just went on a whole thing there, but like that's, and you have to address it in different ways based on what's driving it for every person.
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All right.
Of course, got a little little chips, little cookie.
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Right. at granola bars as a kid as well.
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You know I switch over.
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And now back to the show.
Let's just, to tap into some solutions here.
I know this is complex.
It's individual based, of course, but there are some tendencies, I'm sure.
What about the idea of like really going into the pain for a moment?
Because I think we're just kind of like trying to not look at it, just a vague awareness.
Like, is it there?
Is it there?
What if we really like?
Because I think there's two major ways like polar difference, ways of like addressing this.
Really digging in, looking at this pain to see how small it really is, potentially or completely, like turning the focus to something else and not being focused on the pain at all.
Yes, I love it.
That's a really good distinction.
And what I've found to be effective is first going towards the pain.
So you have to explore it.
It's just like anything in life.
You get an uncomfortable feeling when you encounter something you don't understand, but then you go into it and you understand it.
You're like, I can't believe I was so scared of that.
So with the pain, we have to explore it.
That doesn't mean you go full speed with no breaks into the pain, but you go a little bit into the pain, you explore it.
Can I actually move into this?
Can I use different strategies to calm the nervous system down to move into that area?
And you tinker and you learn, and the more, the deeper you go into it, the more curious you are, the more you explore.
That's when you really see people start opening up and doing things they couldn't do before now.
It gets to a point where, if you've achieved the result that you're looking for or you haven't yet, but you've been looking in, you've been exploring that pain going towards it if you can't extract any new information from that pain, there does come a time where we need to actually shift away from it.
So we need to stop that awareness, that car that you see on the road everywhere.
We need to shut that down.
Because sometimes, if you keep thinking about it, you keep thinking about it.
There's something called the reticular activating system in your brain.
It starts searching for it more.
It's like that term's always in your search bar.
So like the search engine keeps giving it to you.
So we do need to bail.
So it's all about exploring the pain and then understanding.
When have you gotten to that point where you can't extract new information by going into this?
And once you get to that point, that's when we need to change the approach.
If that answers your question,
Yeah, yeah.
I mean, we could... There's so much... This is the most amazing thing about it.
We've got the solutions already built into us.
Oh, yeah.
But we have to acknowledge that the pain we're experiencing is a result of our brain and our nervous system and its perspective about things right.
And so we can personify the pain.
We can... you know, investigate, like, is it a certain shape?
Is it a certain color?
Is it, and start to just really break down and see the different parts of it and bring some tangibility to it versus like this, this darkness?
It's so true.
Pain.
When you know, you grow this fear of it and you know for a reason.
But when you explore, like you said, you give it characteristics and traits and you you understand it better and it stops becoming this big, hairy thing.
And I think a lot of people just, they really need permission.
So because, if you think about it, if you have pain and you don't have permission to go the other way and stop being fearful and worrying about it, why would someone stop doing that?
Because they're going to think I need as much information as I need about this.
Because this what if this turns into something terrible?
Especially when we're talking about head, neck and jaw pain?
A lot of people secretly, under it all, think they have some type of tumor.
This is going to end their life.
Like something horribly wrong is going on.
So they need that permission.
And a lot of times I'm sure a lot of listeners can relate to.
They've had the tests, right?
A lot of people freak out.
So you, and with, well, um, for a good reason.
So you have these headaches, this distance, this dropping and burning eyes.
It won't go away.
Go get a brain scan, you go get an mri, you go to the ent, you go to the dentist, you go to the neurologist and 99 of the time, people who i interact with tell me nothing came up.
Nothing came up.
And once you've checked all those boxes, that's another thing.
It always comes to checking the box and you've gotten to this point you're starting to explore the pain.
If you can have that permission that says it's okay, this is your nervous system, they will follow.
But until you get that permission Again, there's a real consequence to not focusing on the pain.
What if I don't figure it out and it grows into something worse?
So it can be messy.
Yeah, just to hear from your again, your clinical experience 99 of the time.
It's not this big, gigantic issue.
It's a brain and nervous system thing that you can address.
I would say that we probably need to be more adamant about doing that work first before we go so far as to like because, as you know, things are changing.
We have wonderful access to imaging and just like, it's just getting better and better and better.
But you've seen this where imaging comes up and somebody has a terrible scan but then they don't have pain versus you know somebody might have you know.
Everything looks functionally correct.
Like we didn't find anything and yet they're experiencing this pain.
And so if somebody but here's the thing too they often find, especially as people get older, some kind of problem.
It's just like there's the thing yeah, but you don't, it's a correlation, you don't even know if that's the thing or when it happened, or you know, and it's a static thing.
So we can be.
Can you talk about that?
First of all, and also, i just want to encourage us to like let's do the brain and nervous system training and reframing proactively anyways, because you might not even need all this other stuff.
Yeah absolutely, i think that's really good way to put it, and you know Movement.
So the gold standard for determining what approach you should take is what your body responds to and what makes you better or worse.
So if you do have imaging and you have arthritis, let's just on the left side, right?
And theoretically you shouldn't turn your head or tilt your head to the left side, right?
Now, if you so, you have that piece of information right now.
You go to someone who can assess movement properly.
And they find that bringing you to the left side makes you feel better and the pain doesn't come back.
Are you going to trust that piece of information or the imaging piece of information that says you're going to have pain if you tilt left?
Of course, you're going to trust what is actual real, intangible in life, which is your body's response to movement.
And so imaging workups, brain scans, all of that.
There is nothing that's going to be better to rule out any type of dangerous or red flag dysfunction than having that imaging.
It's the gold standard.
But again, very commonly people have this and nothing shows up from a red flag standpoint.
And it's all this gray area in between.
You have a little arthritis there.
You have a little disc bulge here.
You have a little compression here.
You're not gonna treat them like a robot.
At this level, we do this.
At this level, we do this.
At this level, we do this.
We're gonna treat it based on your body's ability to move.
And then we explore that movement.
And that's how we start figuring out, all right, this guy's bucket really is the joints of the neck.
This guy's bucket is really more driven of nervous system.
This one is more habits and you start working and playing with it.
Taking accountability for your own health is what really gets you over the hump.
Understanding what you need to do and taking the right actions.
Most people don't get to that point until they're suffering for a long enough time, unfortunately.
But the people who I find who really fix themselves are the ones who have been suffering a long time.
And they say, all right, you know what?
I guess I'm going to have to be the advocate for my own health.
And I'm going to have to start testing and trying things you know, with other providers versus just like.
I have this imaging.
So it's over.
So I can't do anything, you know?
And so that's what it really comes down to.
All right.
So how do we do this?
How do we help to start to reestablish our perception of our pain?
So, all right.
So when we're talking about... We can stay in the head, neck, and jaw region.
We begin with movement.
So we begin with having someone move in a certain direction, assessing and seeing what makes the pain better, what makes the pain worse, what does not change the pain at all.
And we identify those movements that actually are going to produce that pain.
So now we have that.
And we need to determine how much nervous system is involved.
How much is it actual physical restriction?
And so there's movement assessments, which is like very technical, which we don't have to get into.
But the nervous system piece.
We have strategies that we can use to see if there can be improvements.
So one strategy would be multisensory strategies.
So where, if our nervous system is in pure protection mode, in order to get it to calm down and trust movement, we can first preemptively calm the nervous system.
So you can do things to stimulate more of the parasympathetic system.
You can do your deep breathing.
You can try to stimulate the nervous system with gargling and cold water.
And so you can try to get yourself in a situation where you're ready to accept the healing.
Using heat and hands-on work is a really good way to calm the nervous system.
Massage again.
It's not gonna fix that root cause, but it's gonna get your body in a state where it's telling the nervous system we're good like we can relax.
To actually achieve better movement.
We can do things like focusing on background noise, playing low level, relaxing music, doing simple things like tapping your fingers, rubbing your arm during the triggering movement.
And you can see if those actions improve your range of motion and your movement, which is completely in the absence of a physical strategy for the neck, you can start saying okay, maybe this is more nervous system based.
So we just either, we're testing the movement and then we're testing the nervous system.
And we have to do both of them in a vacuum.
To just like any other type of good health or medical procedure, we need to test, check the box and move to the next thing.
So it's just like a very high level way to look at it.
Yeah.
Would you say that the average person that's experiencing pain it's more of a hurt rather than like a true injury?
The people that I work with, it usually starts with some type of physical insult.
So there's two different things here also.
So we have the trauma world of it's something going on from a younger age.
If you read some of John Sarno's work, he talks about how, if your brain had to decide between processing some very traumatic event or having back pain, you're gonna be able to survive and thrive in this world with back pain more than having to process and face this horrible thing.
So your body gives you physical pain so that it distracts you from processing that memory or that trauma?
So in that world journaling, working into it, working with the therapist and those people will unlock pain because of that.
In the world that I work, in which I have some of that, I see a lot of people are like no like, I've always been happy.
I've had no pain, but I just, this thing happened.
It was a physical injury.
And then after a day, week, month, three months, it went away.
And now I'm worked up.
Now I'm worried.
Now I'm freaked out.
And so with those people now all of these things kick up because of the original.
It produces health anxiety.
So to answer your question, what do I see more?
I see that it really did start with something physical.
And for whatever reason there's many reasons that it could be it triggers this nervous system response where it still thinks it's in a threat.
And then we have to use physical movement.
You can't read a book and unlock this type of pain.
We need to rebuild that trust.
Yeah, with the system we need to calm down the emotions and it works all together.
You build the trust, you move better.
You see it's improving.
You stop like freaking out and worrying.
So now the emotional piece comes and once, to bring a full circle, once we get all that kind of revving, we go to the awareness piece and we say now we need to kick your brain out of this mode.
So we're done focusing on it, looking for patterns.
Now we're gonna.
When we do like neuroplastic strengthening exercises where we have people focus on, you know, a colorful object that's very distinctive.
You think about the patterns and the colors and the shape and you try to do it for 30 to 60 seconds.
And if the pain starts creeping in, you acknowledge it without emotion like okay, pain's coming in, I'm doing something else.
I'll deal with you later.
You try to see if you could bring that 30 seconds to 60 to multiple minutes and you start strengthening that muscle.
And just one other thing with it.
In our society there's certain things we are really good at this point at recognizing behaviors physical that impact your body physically, that we should avoid, right.
So it's like, if you're an ex-smoker or we just know you shouldn't smoke, right?
If you're an ex-smoker, stay away from cigarettes.
If you were an alcoholic and you're sober now, like stay out of bars.
You know that if you started a habit where you eat cookies before bed, you know that's fine, but then you should kind of kick that habit eventually before it turns into something worse.
When it comes to pain, for whatever reason, we see no problem.
We don't with just thinking about it all the time.
Like I have pain, what can I do?
I gotta think about it.
But you actually do have power over it.
You can work that muscle just like you work the muscle to resist alcohol, cigarettes, sugar.
You can resist the pain as well when it gets to that awareness point.
And that's something.
It's one of the harder pieces, but that's really where the major unlock can occur down the road.
Amazing, okay.
Wow, we've already got quite a few tactics, perspective shifts, you know, just even thinking about how you know, you just you mentioned like being able to activate that parasympathetic, AKA this rest and digest aspect of our nervous system, and how that can be helpful to help calm things down.
So this can be before some kind of movement treatment or during, right?
And so just thinking about kind of, you know, if there's a pain point that we're experiencing and again we're There, isn't like severe tissue damage, but our body's just caught in this pattern and just being able to like lean into it and just breathe, right.
And just activate that is incredibly valuable.
Thank you for mentioning that.
Yeah, that's, you're welcome.
And great questions because it's a huge, huge piece and you have to learn how to control that.
It's like, just again, just telling your body it's okay, telling your brain, your nervous system, it's okay.
It's okay.
I know that I did this thing and got a little upset.
Just being able to communicate with yourself, communicate with your body, with your tissues, and have more agency.
That's one of the things I also picked up from you in this conversation is how powerful we are.
But we tend to be so externally focused.
So we're not having that relationship as well.
But also, we don't receive education when it comes to pain.
And it's one of those things that every human being is going to experience.
And yet it's just this, like, there's no context.
There's no conversation, no education.
It's just like pain is pain.
It is what it is.
Exactly.
Exactly.
And a lot.
You know, I can't tell you how many times I've worked with someone who given them some strategies that made them better.
And they're like, but I tried this two years ago.
It gave me pain.
So I stopped doing it.
I'm like, yeah, you know, it was, it gave you pain and you were scared and that's fine.
Like you just didn't have the education behind it or you didn't use the nervous system pieces around it.
But I can't tell you how many people are out there who have probably tried the things that will unlock it, but it's like it wasn't the right progression.
You started too quick.
You fought yourself with your nervous system.
So when you really focus on that signal, it all comes down to the signal.
What's the dosage of the exercise and how are you communicating that with the nervous system?
Yeah.
All right, let's talk about another common, exceedingly common thing today when it comes to neck pain, which is the way that we're using our necks right.
Tack neck, constantly having our head down, and what it can do to the spine itself muscle imbalances.
And so talk a little bit about that, but also, can you give us a couple of ways that we can proactively help to reverse the issue?
Maybe, you know, some exercise that we can do.
Yeah, for sure.
So you know, Classic sitting for too long looking down at your phone, just being hunched, spending too much time on a comfortable couch.
You know what it does is if you look from again, we can actually tie it back to your first question about the hips.
You look at the pelvis, it rolls back.
So the entire rest of the spine rounds forward.
And if my hips are rolled forward and my, or if my hips are tilted back, my spine's rolled forward.
If you don't make a correction at the neck, you're going to be looking at the ground, right?
Even if you're standing in hunch, you're gonna be looking at the ground.
So you make that correction, and that correction is extending at the neck.
Now what this does, we separate the neck into the upper neck and lower neck, or mid-lower neck.
So the mid-lower neck, when it's shifted forward like that, that's when you start getting compression that causes pain down the shoulder blades, tops of shoulders, even to fingertips and, of course, on the sides of the neck.
But at the same time, your head tilted this way compresses the upper neck.
When you compress the upper neck, So I got to control myself because I could go in tangents.
But just to make it real simple, when you compress the upper neck, there's a connection point between the upper cervical spine and the jaw.
So you can have jaw pain and it's coming from the neck and you have no TMJ issues at all.
It can also produce dizziness, headaches, neck pain.
So you end up with these symptoms.
Why won't my dizziness go away?
Why won't my headaches go away?
I got this persistent jaw pain.
Or I'm getting pain down the shoulder blades.
I should use a tennis ball back there.
But it's really driven from the neck.
So just...
Classic, just hunching forward, looking down, or that correction coming back up.
It causes issues.
Simple things you could do.
We know that trigger points kick in once you've been in the same position for 20 minutes or longer.
Really, 60 minutes is when they really drive.
So just changing your position.
So you can do very simple without overcomplicating it.
Just get up and move around.
Do what you want.
March your feet, roll your shoulders, sit back down.
Very simple one.
Another one is actually... just activating the neck.
So there's a few different things that you can do, but I think most people at this point know what a chin tuck is, where you just bring your head back over your body.
I don't know if people do.
What is it?
Okay, fair.
So a chin tuck is basically when you're sitting there, if you look up, your spine bends backwards.
If you look down, your spine bends forward.
A chin tuck is when you take that leaning tower of Pisa and take all the floors and shift them on top of each other.
So an upright tower.
So you didn't tilt it back or down.
So it's where you basically bring your head straight back and make like a double chin, but your eyes stay on the horizon the whole time.
So if you think about your face, it doesn't tilt up or down.
It comes straight back.
That is an optimal position for the upper and lower neck.
Just by going into that movement, a few things happen.
You reduce compression, but you also activate muscles throughout the whole neck to hold you in a better position.
And once you do that, it's kind of like you warm up before you exercise, right?
Your muscles get activated and then you can actually generate more strength or you can be faster.
Whatever your goal is,
By actually going into more of a chin tuck and activating those muscles, you can now be good for the next period of time because you produce that activation.
And then just, you know, you can do turning left and right.
Just once you're in that tucked position, move the head around the spine.
So how many sets?
So for that, I like to keep it simple.
I tell people to do like 10 reps of it maybe, and then you can give it a rest after that until the next time for a couple hours.
I usually tell people every couple hours, go into about 10 of those and just reactivate if you're a person who sits a lot.
So you can get up every 20 to 30 minutes just for a minute and sit back down.
You can go into those talks.
I like to tell people to get a timer and put it on their desk, because at this point we don't pay attention to the notifications on our watches or phones.
There's just too many.
Like a cheap five dollar, two dollar timer from amazon put on your desk, hit it every 30 minutes, get up, um.
And then there's all these different ergonomic things.
I mean, i don't know how deep you want to go, like keeping the screen of your computer at or slightly below eye level.
Making sure that your feet are flat on the ground, your knees are at hip level um, your elbows are supported.
So these are actually really good chairs you got here.
Um, your wrists are neutral on the keyboard.
Um, everything matters.
Um, making sure, if you're in an office with windows, You should actually have the windows to your side.
If they're in front of you, they're glaring in your eyes.
If they're in back, they can bounce off the screen.
So it's best to have the windows on the side of your desk.
So yeah, there's a lot of stuff you can do.
Wow.
This also has me thinking about the you know it goes both ways with this but like vision issues and how we would extend our neck out forward just to see stuff over time, and how helpful it would be to do those 10 shots chin tucks, chin tucks several times throughout the day, you know, as you mentioned, just like 10 reps every couple of hours at least.
You could probably rack up you know 50 reps a day just putting your body back into a more optimal position.
So yeah, and that goes back to making sure you have the right screen and no glare from the window so you don't have to like tilt forward and your eyes checked.
But you bring up an important point too that If you want to fix yourself, you could have the best routine in the world and exactly exercise and nervous system stuff.
It's perfect.
And it's a 30 minute routine or whatever, 30, 40 minute routine.
And you do it right in the morning.
And then you say, did it.
And then you just go about your day and let the world, and then your day, just do what it wants with you.
And it's going to make up, it's going to wipe away all of your good efforts from that session in the morning.
When you really want to start unlocking change.
It's about taking strategies and sprinkling them in throughout the day.
Gravity, work, stress, you're doing this all day long.
So one little routine doesn't do enough.
So I would rather, instead of a 30-minute routine, have a one-minute routine five, six times a day.
And those five or six minutes will go so much further than a 30-minute routine.
And this is to reduce pain, not saying from a fitness perspective, just to be clear.
Got it.
Amazing.
What about... if we are in a situation where we're experiencing some neck pain or maybe we commonly have neck pain and we just wanna do something therapeutically or proactively, some prehab, what about some simple things that we could do maybe just with basic stuff around the house?
Like you don't gotta get fancy equipment, maybe like a towel or something like that.
So a towel or a band, a TheraBand or an exercise band works really well.
So what you can do is you can put that behind your head and just hold it forward.
I actually have a video that's gonna post this week.
We were just editing it this morning.
You put it behind your head and then you hold it and you bring your head back and forth.
Again, a deeper activation of those muscles.
You can take that same band and put it out in front of you, bring it out to the side.
So now you're gonna activate some of those scapular muscles through there.
And then you can in standing.
So if you wanna sit at your desk, simple things like just like moving your feet, marching The exercise I just showed with the bands are great.
If you want to stand up and do it, you can go against the wall, bring your arms back.
They're called wall angels, just coming up and down.
It gets your whole body upright.
You get your chest out, your head back, your arms overhead, up and down.
So now you've brought everything into the opposite direction of where you've been.
So to simplify it, whatever position you spend the most time in, You wanna do the opposite.
If you're standing all day.
These strategies are still effective, because usually your posture just can't hold that.
So you end up falling into that same position as sitting.
But you do wanna sit then.
You wanna let your legs rest.
So it's just about switching position.
You give your body movement and you're gonna feel better.
Yeah, because you could be standing sedentary as well.
So a chin tuck with a resistance band.
So very light, adding some resistance to that.
But what about moving- Band pull-aparts.
Pull-aparts.
What about moving- a band or towel down a little bit lower and maybe doing the head tilted back.
So a chin tuck brings your head straight back.
Some people will also benefit from once your back going up, because now it's a further extension of that original movement.
If you're one of those, I have pain in the middle and lower neck and it goes down to the arms.
Again, that mid lower piece that works great.
If you're one of those people that has the headaches neck jaw dizziness, that piece of it.
I shouldn't have said neck there.
So headaches, dizziness or jaw that's coming from the upper neck going back can actually provoke it because you're going to an extension.
For those people you may want to go forward and pull down, because now you're taking that upper neck and you're lengthening it.
So the lower neck gets too far forward and the upper neck gets too far back.
So when you fix it, you want the lower neck back and you want the upper neck down.
So you can look down and pull down like this for a hold.
You can also...
One I really like is put your hand on your chin and scoop kind of the little notch on the back of your head is the occipital bone, and try to pull your head almost like 10 degrees forward.
10 to 20 degrees forward, but straight up.
And again, imagine that upper neck getting a little more length and that can decompress it.
So if you're someone who has dizziness, you know the jaw pain, the headaches.
Focusing on that upper neck is really good.
And if you can do these in standing, that would be great.
So if you could get up, Do the chin tucks, add a band, open up the head up like that and stretch down and then go hit some wall angels.
I don't expect you to do that every 30 minutes, but if you can throw that in a couple of times a day, I think you'll be in really good shape.
Amazing.
You mentioned this term early on and I want to get, since we have you here, a little bit more understanding of what it is and how it can be one of the culprits behind pain in some ways.
But you mentioned fascia.
So can you talk a little bit about what fascia is and how does this potentially relate to pain?
So fascia is a system of tissue that's woven through our whole body.
It goes through your muscles and your ligaments and your tendons, your organs.
It engulfs everything.
And this system of tissue also has nerve endings.
So it's one of the richest areas of the body that actually has nerve endings, meaning that it can perceive stretch.
It can perceive tension.
It can give you information about proprioception, which means where your body is in space.
If you're about to fall over, it'll tell you, hey, you're leaning, take a step so you don't fall.
And mechanical receptors, which tell you if your body's stretched or compressed.
So it.
When you have a restriction and it goes in the front side, the back side, there's a spiral line that goes around you.
It goes into the arms.
When you have a restriction on one area of the body in that fascia because it goes all over, it can restrict you somewhere else.
So if the area over my right side of my front rib cage was compressed, that fascia, and I couldn't get out of there, then the upper back left side, which is the opposite part of my body, is going to be rounded forward right.
So now that piece of fascia is getting overstretched as well and then that will move up into the neck chain.
So if you feel like man, i just can't fix this left side of my neck and upper back issue, i fix it to your point earlier and i feel better when it comes back and you don't realize that you're compressed through the fascia on the opposite side.
That's why you keep falling into that area and that pain generating tissue keeps getting irritated.
So the different ways to get fascia one important piece of fascia is hydration, also making sure the tissue is hydrated.
So you can use regular diet for that and drinking water.
But if we can get in there and deeply release with medicine bowls and other tools, there's essentially like a pulsing effect where if there's adhesions, it can break them up.
But also, as you create that pressure, it creates a negative pressure and then you release and it opens up and then fluid wants to rush in there.
It's just like a sponge, right?
You squeeze a sponge.
When you let go, it pulls everything in.
So getting in there and actually putting forceful sustained, controlled pressure releases.
Different tools can help, but then moving the body as a unit.
So there's all these different ways to be on the floor and drop your head down and rotate to one way.
And so you're trying to get the entire piece of fascia from head to toe.
And so if you have someone just to give a concrete example, let's say that they can't bring their arm all the way back right,
So like imagine for anyone who's listening a baseball pitcher, how they have their elbow up a shoulder height and they cock the ball back and then they throw it forward.
If there's a restriction there.
If we wanna get more movement, we can address the capsule and the muscles and the tendons right at the shoulder joint that once we loosen them up, you can rotate your arm better.
Great, we did that.
But if the fascia that goes from your fingers across the elbow to the shoulder, down to the opposite foot, is tight, you've locally released the shoulder, but now that bigger picture is gonna pull you forward.
So we need to work on both of them.
So there's a time and a place for each of them.
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That pitching motion just got me thinking about Otani.
Yeah.
And I think he had two Tommy John surgeries.
Did he really?
Yeah.
I know he had at least one, but I think he had it twice.
And again, he's just still one of the top pitchers in baseball, let alone one of the greatest hitters.
It's really incredible to see.
Yeah.
A lot of those.
That's not my area of expertise, but A lot of those tendon injuries have to do with genetics as well.
Like obviously if you throw harder and you have poor mechanics.
So I actually did, when I was at hospital for special surgery, I did a little presentation on this.
And from what I can remember because it was a while ago, mechanics and throwing speed and power do impact that.
But ultimately, I believe what it came down to was just genetically how thick and strong your tendons are.
And don't quote me on that.
That's not the latest research, but that's what I remember about it.
So there's always a big genetic component to everything.
And I didn't mean to bring them up.
I know you're a Yankees fan, you know, but you know, it's just, it's really incredible.
You know what, and you're seeing this as well in sports.
Yeah, just the innovations that are happening as far as like prehab and, you know, integrating more physical therapy into the culture itself, outside of just when players get injured.
Yeah it's, it's such a beautiful thing.
Um, you need to, you know, be just moving the right way and and it has to do a lot of people who fall into pain it's because the right habits may have not been in place prior.
So when we have injury, we have injury, that freak accident injury, but then we have overuse injury.
So i was doing the same things over and over again improperly, so kind of goes both ways.
So just to emphasize again what the fascia is so is this like a?
Is it like a casing around our muscles?
Like what is this?
Can you help us to visualize?
To visualize it um, i mean, it's basically like when you're eating chicken and you have the stringy stuff around the muscles and you kind of pull it off.
But imagine that you had um, that picture of anatomy of someone just standing there with the arms out and you see all the muscles and they're just very defined muscles.
This one begins here and it ends there.
And this one begins here and ends there.
That's like the picture perfect image of muscles.
Fascia is like if you took a spider web and threw it over the whole thing, right?
I
And so now you see this white tissue and it thickens at different places and it's bigger and broader in different areas.
And if you take the right arm and pull it back, the left leg and hip is going to pull back also.
So just imagine a spider web got thrown over all the muscles of the body and that's what it is.
It just engulfs everything.
You mentioned rounded shoulders.
Yeah, earlier as well.
Like this is this kind of kyphotic, like a lot of people are.
You know, we're kind of devolving in a way.
Unfortunately.
But there are some solutions for this as well.
Again, you've already addressed like, some of the different components, but are there any specific exercises that can help with kind of opening our body back up and something that we can like start to incorporate?
Yeah, absolutely.
So when we talk about rounded shoulders, we talk about there's a couple things you have to look at.
So the spine itself is typically forward.
So just imagine your upright spine and it's rounded forward.
Now the shoulder blades, which are next to the spine, move out to the side, and the shoulder blades are connected to your shoulder, your arms or what most people consider the shoulders, and so those come forward right.
So now you have, the muscles on the front of the chest are tighter because the shoulders are rounded forward, But they're also shrunken down because it's a two-part thing.
You're forward and you're rounded.
So it's two different planes of motion.
So we need to get you upright more in a extending you so you're taller movement.
And we need to also get you back like we're pinching your shoulder blades together.
So a couple of things you could do.
Simple ones are using a foam roller.
This is a great one.
So you can lay back over a foam roller.
Sometimes I even tell people to take a dowel, like go to Home Depot and get like a one inch dowel and roll a towel around it and put it perpendicular to your back.
So you lay it on the ground and then you lay on it.
So it's going basically across your shoulder blades and you take another dowel and hold it in your hands and bring it over your head.
And so what happens is, as the dowel goes overhead, it puts more force on the upper back and it pushes you deeper into the foam roller or that dowel and it takes your vertebrae and it kind of pushes it forward a little.
So you're mobilizing yourself.
You do that for a little bit.
Then you take that foam roller or dowel that's under you, move it to a different area oh, that one's tight bring your arms overhead, do some reps, lean on it and you can open up that area.
Okay, and to, to get the opposite piece, which is the shoulder blades, coming backwards.
Um, you can put the foam roller vertical now, so it's on your spine, and just lay on it with your arms out, like you're kind of like making a uh, like a U shape, and let it stretch back.
So, when you think about what we've done so far, we've stretched the spine so it gets upright and we've stretched the muscles so that the shoulders can be unrounded.
Now you're more flexible, but how do you actually hold that position?
We can do strengthening exercises for that.
So if we want to strengthen the shoulder blades to come together, keep it simple.
We could use that same band exercise, or you could do this one where your elbows are by your side and you rotate out and squeeze.
Or...
So that gets the shoulder blades squeezed more, right?
So now we just, the only missing piece now is strengthening your ability to come upright.
And with that you can do like a simple probably Superman is a good one where you lay in your stomach and kind of lay down and bring your shoulders back and chin tuck.
So you always have to think about how am I loosening up the structures and how am I activating them?
But I will say this outside of some restrictions in those areas, the research also shows that fixing your posture is not to just go all in a nervous system the whole time is.
It's very habitual.
So you could do all the things I just told you to do, but you don't use your mind to sit up straight and it's not going to change a thing.
So again multiple times throughout the day, reinforcing that habit of just standing up straight.
That fixes your posture more than any of the other things.
So again, if we're talking about what's the pain generator and what's the second piece, the problem generator, is you not remembering to sit up straight?
And then we can look at oh, he remembers to sit up straight, but he keeps getting pulled forward.
Then we could find those other restrictions.
Does that work?
There's a lot of different ways to attack the answer.
Of course.
And the great benefit of having access to you is being able to just understand that we're all unique.
There are certain tendencies, of course, but just being able to ask questions to you know, to tinker, to find out, because there is a solution.
There is a way to relieve your pain.
And yeah, Just so that people know, again, to reemphasize this, like you are a wealth of knowledge.
You share so much.
If people are following you on social media, of course your YouTube channel incredible instructional videos.
But the great benefit today more than ever is like actually having access to you, right?
And having your online programs where people can actually ask you questions, where they can get that specific training and being able to look at other aspects, because we're just scratching the surface, because the body is so complex and we're living at this very complex time.
There are a lot of different external inputs and internal things as well that can put us into pain.
So can you talk about a little bit about where people can get access to your course and what you have available within that?
Thank you.
And I'll say you know everything's out there that you need, but understanding what to do and what progressions You know, that's really the key, because there can be so much overwhelm out there.
So if you just have systematically try check the box, move on to the next one, you get closer to that solution.
You can find me on social, Dr. Joe Damiani, Dr. Joe Damiani.
My website is physioloops.com.
And this goes back to that loop that is integrated between the body and the brain.
And if you don't work on it together, you can't break the loop.
So physioloops.com.
And so...
Yeah, I have a program where people can go through these processes and then I do group calls with them.
We do masterclasses.
We bring on other guests for masterclasses.
It's a community where people can work with each other.
I also have a coupon code for your listeners, Model Health.
If they put that in, they'll get 20% off.
But yeah, I'm available.
I try my best with DMs, but I'm sure as you know too, it's very hard to manage.
But yeah, that's really where they can find me amazing and this is where again, they can get more exclusive access to yes yeah, and that's model health together as one word.
And also, when people go there, you actually get, i believe, seven days free yes, trial anyways, just to take advantage to get in there and check everything out.
Yeah, so you get seven day free trial.
You get to start going through the modules.
We have every, so it's a 12 level program.
So there's nervous system work there's, there's the musculoskeletal progressions habits, all that stuff.
Um, and yeah, I mean I just every day we try to put, we try to just break down the information as simple as possible.
On my social
So it's like we obsess and we try to figure out how do we make this simpler?
How do we make it simpler?
How to make simpler.
And I love it.
Sometimes it drives you crazy.
How many times you got to try to rework something.
But I've just learned that if you can pass that information over to someone, that's what makes the difference.
Amazing.
So again, we'll put that for everybody in the show notes, physio loops.com.
You know, the thing that really resonated with me the most about you was, of course like yeah, the information is incredible how you're presenting things, your communication um, very tactical, but the main thing was your dedication to your family.
You know, like even reaching out to us, because i know like this is a really special uh, event and opportunity to have you here and to be here.
But you reached out to us like shank, is it possible like we could change the day, because i don't want to be away from my family that long, because you know you got four kids under five.
But you know just the way that you're structuring things and thinking about things and you know having a priority on your family and being there is is really special man.
So huge shout out to you for that.
Yeah.
I really, really appreciate that.
I appreciate the opportunity.
And, um, you know, I was taking advice from you earlier on how to balance everything.
So thank you for that as well.
Yeah.
Yeah.
It's my honor.
So again, everybody can follow you on social media, all the socials.
What's the handle again?
So it's Dr. Joe Damiani, D-R Joe Damiani.
Amazing.
You should be following you just in case anyways.
We tend to follow these accounts when something happens.
But as mentioned, the great thing is prehab, like this big movement for prehab.
If you know you have certain tendencies towards certain pain showing up, you can do stuff proactively now, which is really awesome.
And so last question for you.
What is the model that you're here to create for other people with how you live your life personally?
The model I wanna create is understanding your body and pursuing it with passion.
So being genuinely interested and excited to actually fix yourself, because if you don't have that obsession, if you don't have that joy in pursuing, you will give up along the way.
And so understanding that it's a process, You're going to check the boxes one by one.
And with the right information, you'll make it to where you're going.
It's just about really falling in love with the process.
Yeah.
That part.
Amazing.
Well, thank you so much again for coming to hang out with us today.
Thank you, Sean.
Really appreciate it.
Awesome.
The one and only Dr. Joe Damiani.
Thank you so much for tuning into this episode today.
I hope that you got a lot of value out of this.
And in the words of the Wu-Tang Clan, you got to protect your neck.
All right our neck, our spine and our nervous system, our peripheral nervous system, our brain.
All of this stuff is uber complicated, but there are some very basic tenets for us to establish and to retain proper function and also to help us to get out of pain if there is some malfunction, dysfunction and we were not protecting your neck.
All right, so following individuals like Dr. Joseph, is just priceless.
Again, this information was something that you had to be in the highest order of society to be able to have access to information like this, to experts like this.
And today, at the click of a button, we can get access, we can get education, we can get empowerment, but it's up to us what we do with it.
And so please share this information with the people that you care about.
Put it into practice for yourself.
And if you've been struggling with pain, this is something to invest in your education, your time into, because there is a way.
Where there's a will, there's 10000 ways.
And you being here today, something in you knows that you can get better, that you can feel better.
And I really appreciate you for taking the time to share your time with me and Dr. Joe today.
And listen.
We've got some incredible masterclasses and world-class guests coming your way very, very soon.
So make sure to stay tuned.
Take care, have an amazing day, and I'll talk with you soon.
