Philip Pape: 0:01

If you're over 40 and you've been struggling with persistent back pain or joint inflammation that's keeping you from enjoying your favorite activities, and you've tried everything without lasting relief, this episode's for you. Join me and fitness expert Megan Dahlman as we reveal how to manage and potentially eliminate midlife back pain for good. Learn the true causes and the difference between chemical and mechanical solutions, discover why back pain isn't an inevitable part of aging, and get the blueprint to reclaim your active lifestyle. Stop limiting yourself. It's time to live pain-free, no matter your age.

Philip Pape: 0:40

Welcome to Wits and Weights, the podcast that blends evidence and engineering to help you build smart, efficient systems to achieve your dream physique. I'm your host, philip Pape, and today we're diving into the epidemic of back pain and joint inflammation, especially for those of us over 40, with the fierce, the fun fitness expert, megan Dahlman. Megan is a certified strength and conditioning specialist who has been featured in the Washington Post and Muscle and Fitness, her magazine. She's host of the popular podcast Self-Care Simplified. We've been on each other's shows, so definitely go follow her show, and she's coached hundreds of women over the past 15 years, helping them feel strong, healthy and confident in their bodies. Megan and I had a lot of fun talking to each other about menopause, belly fat last time. We've talked about training, we've talked about protein, we've talked about building muscle, and I'm stoked to collaborate again so that you can learn about the hidden causes of midlife back pain, the surprising solutions that do and don't work, and how to tailor your approach for lasting relief. Megan, it's good to see you again.

Megan Dahlman: 1:42

So good to see you again, Philip. This is great. I'm excited for this conversation. I love talking about back pain, of all things.

Philip Pape: 1:49

And it's such a popular topic, isn't it? You would almost think like, okay, I've been there, done that. But wow, I mean I know the few episodes I've done on it solo and guests have been pretty popular and you and I seem to have a hit when we get together and people love to hear all the things they can do to improve their health. So when it comes to women in their mid-40s or older and they're struggling with chronic back pain, let's say someone has come to you who's tried everything painkillers, the chiropractors, maybe surgery. They've considered surgery and nothing is giving them that relief and they're just, they feel almost hopeless, like I'm just going to have to live with it, right, I mean, what's the first thing you tell her?

Megan Dahlman: 2:24

Well, the first thing I say is no, you do not have to live with this, and I think that's what we've been told. I we have this impression that, oh, once you reach midlife, it's inevitable, you're going to have back pain. It's just a natural part of aging. And oh well, we were watching my husband and I were watching a standup comedy a little bit ago and it was a huge joke and everybody in the audience was laughing about it because they could all resonate with like, oh, you reach 40, you're going to have back pain. Ha ha ha.

Megan Dahlman: 2:56

And I'm like no, no, no, no, this is not an inevitable part of aging and there are absolutely things that you can do to significantly improve the way that your back feels.

Megan Dahlman: 3:09

And so I don't want people to just say this is how it is and then continue to live their life just sweeping it under the rug, because if they don't do something about it, like if you continue to push through the pain, it will impact your body on so many levels, probably levels that you don't anticipate. You'll probably start moving less in general, which we all know that contributes to lower metabolism, less muscle mass on your body. The rest of your joints will start to hurt, you'll start to lose motivation and pretty soon you'll wake up like five, 10 years later and realize, wow, I am in incredibly terrible shape and most people can trace it all the way back to back pain and that was kind of like the beginning of this downward spiral just this low grade, chronic back pain. So if we can take care of this, this opens the door to you living a full, fulfilling life for many years to come.

Philip Pape: 4:06

Awesome. That's why we're talking today, because people want to know what do I do. But before we get there, I do want to frame the context because I know you've mentioned that some staggering high number of adults like 540 million, something like that suffer from back pain. So we know it's common. I've dealt with it in the past. Almost every client I've had has some level of that or had had. Because they don't anymore, because Megan and I know it, I don't know how to help you out. Can you just break down why it is so prevalent, especially for women in midlife, but even in general?

Megan Dahlman: 4:37

Yeah, I mean the stats are staggering. You're right, it's 540 million adults right now are suffering from some form of back pain, and I think we can clump a bunch of different things into that. There's just general lumbar spine pain, but there's also things like sciatica, SI, joint dysfunction, so things like that that are kind of all around this low back hip pelvis issue. So it's kind of all in there. And the stats show that women actually are more likely to suffer from back pain than men. So in women, 45 and older, approximately 35% of women have suffered from back pain in the last three months which is pretty wild.

Megan Dahlman: 5:18

That's a third of women, and then that stat increases with age, so it goes up to nearly half of all women will have back pain around 75 years old if you don't do something about it.

Megan Dahlman: 5:32

So I think a lot of that is potentially especially with women.

Megan Dahlman: 5:36

A lot of that is potentially due to just the shape of the pelvis and, for many women that have been pregnant, the stresses of going through pregnancy and childbirth and some of the changes that occur to your pelvis during that time and the integrity of your pelvic floor muscles, the integrity of your core all of those things can change during that time and if you're not careful to go back in and heal those muscles and re-strengthen them over time, it can slowly degenerate and just slowly get worse and worse as far as like having that really important core stability in there. And then the biggest thing for women in midlife is those hormonal changes and I know we're going to talk a lot about that, but that is, you have that double whammy of maybe you were pregnant years ago where you dealt with sciatica when you were pregnant and diastasis, recti, separated abdominals, pelvic floor issues never really dealt with it. And now we get to 45 years old, and now we throw these hormonal issues into the mix and we just have this storm for back pain of some form.

Philip Pape: 6:43

So let's go there and talk about the hormones, because you know, I hadn't even thought about the fact that, yeah, your spine and your general anatomy basically shifts from pregnancy and potentially quite a bit, and then now you add in the storm of hormones peri-postmenopause. I know we want to talk about joint inflammation as well. So if they're connected, I would love to hear that connection. But regardless, what is the link between hormones and some of these challenges?

Megan Dahlman: 7:10

Absolutely. It's huge. Women have estrogen receptor all over their body, essentially in every system of their body. So your muscle tissues have estrogen receptors. Pelvic floor muscles, those are muscle tissues, those have estrogen receptors. Pelvic floor muscles, those are muscle tissues, those have estrogen receptors. Even your joint fluid, that synovial fluid in the joint, has estrogen receptors.

Megan Dahlman: 7:33

And what estrogen does? It's one of the things like magic hormones. It really helps to maintain the integrity of your muscle cells. It helps to keep inflammation at bay, especially in your joint spaces. It's kind of this magical hormone that keeps all your cells working properly. But when we slowly turn off that estrogen hose, like when your body slowly starts to produce less and less estrogen, all of those issues now can float to the surface. So no longer do your muscles have just this natural integrity. Now you have to work at it to keep your muscle tissues maintaining their strength and function. No longer do you have just natural joint fluid that is naturally anti-inflammatory. Now you have to work a little harder, because the moment we've removed that estrogen from the picture, that inflammation especially has a heyday in your body.

Philip Pape: 8:32

Yeah, that visual of these receptors everywhere. That's very powerful, because sometimes hormones are a little bit of black magic for people to understand. Right, they're these signalers and you're like okay, so what's the distinction for a specific hormone and also for women, and why is this all happening? And we know it's a natural process with aging, but, aside from hormone replacement therapy, is there anything we can do about? It is the question that people want to know. Yeah, and we can get into specifics now about solutions for back pain and whatnot, but just starting with hormones, where would you take that discussion?

Megan Dahlman: 9:04

solutions- for back pain and whatnot, but just starting with hormones, where would you take that discussion? Yeah, I mean, what's interesting is when you talk to and listen to, doctors that specifically specialize in menopause hormone therapies they'll always say in conjunction with good, healthy habits.

Philip Pape: 9:20

Yeah. Nutrition and lifestyle yeah.

Megan Dahlman: 9:21

This is going to work best in conjunction with good, healthy habits. So I always like to remind people we always need to start there, no matter what. So your fitness, absolutely. We need to make sure that you are exercising regularly and in very intentional ways that are advantageous to those core muscles, specifically, since we're talking about back pain, especially the pelvic floor, knowing that oh, now that I don't have estrogen in my system as much, my pelvic floor muscles. They're a massive part of my core and when those lose their integrity, my back will probably hurt. I can't tell you how many women have back pain because they have weak pelvic floor. They just go hand in hand. Same with sciatica or SI joint issues. So we can work on strengthening your pelvic floor.

Megan Dahlman: 10:12

And then, of course, on the nutrition side of things, there's a lot that we can do for improving muscle mass. So fueling your body in a way that stimulates or just is helpful to maintain and build the integrity of your muscles. We want to be doing that and eating in a way that's anti-inflammatory. Now that we know that that's, inflammation can have a heyday in your body right now. So let's eat in a way that keeps that at bay.

Megan Dahlman: 10:40

And then the two other things that are that should be part of the equation is your sleep. When you don't get adequate sleep, inflammation increases again and it also impacts your body's ability to. It impacts your insulin sensitivity and your body's ability to manage glucose properly, and so that can increase your body's inflammation as well. And then stress is kind of the cousin to lacking sleep. They kind of go hand in hand. When you don't have adequate or just good stress management skills, once again inflammation has a heyday that cortisol rises, your insulin sensitivity goes down, and so it's just this perfect storm. So all of those things are within your control, apart from going down the road of hormone therapy and I would recommend everybody to explore that option with your doctor. But to know that, okay, stress, sleep, fitness, nutrition, all of those things are within my control. So let's see what I can do about all those things.

Philip Pape: 11:42

Yeah, it's empowering, and those four pillars are the same ones we always come back to, isn't?

Carol: 11:47

it.

Philip Pape: 11:47

You and I just recorded yesterday on your show.

Philip Pape: 11:50

Same thing. It's like it's okay, which is good, right, because it's not this confusing, obtuse, complicated thing. Necessarily, not to say it's easy, quote unquote, but we know what to do. Let's break down a few of those, starting with the fitness. You mentioned pelvic floor strengthening. I think you recently did a I think it was an episode and spoiler alert you talked about glutes, supporting the glutes for your back, which all sounds to me like strength training, and so the question is what is the most, I guess, accessible approach for most women listening, who may be not training yet, or maybe they just got started, but they're not entirely sure what to do?

Megan Dahlman: 12:30

Core, absolutely Like we got to start with your core, but it does help to have an understanding of what your core actually is. I think sometimes we hear core like you need to do core work, and we immediately equate that to abs. You know, and I always say it's kind of like mirror muscle training. We all have a tendency to walk in front of a mirror and want to just train the muscles that we can see in the mirror. And your abs, those six pack muscles. Maybe your obliques kind of fall into that category.

Megan Dahlman: 12:59

But when it comes to good quality core training, the type of core training that's going to eliminate back and hip pain and improve your function for many years to come, it has to be three-dimensional. And your core is made up of your pelvic floor on the bottom, your diaphragm on the top. Believe it or not, your diaphragm is one of the largest muscles of your core and then it's also comprised of those deep inner layers of core muscles that connect directly to your pelvis and your spine. Those include some hip flexors and those absolutely include your glutes on the backside. And then we get to the big abdominal muscles that you can see in some of those low back muscles that you can see. So a good core training program is going to impact all of those muscles. It's going to include training for all of those muscles and it sounds like oh my goodness. Then if there's like 25 core muscles, do I need 25 different exercises?

Philip Pape: 13:57

That's how people think sometimes.

Megan Dahlman: 13:58

I know and I usually say let's just start with three. So the best three core exercises to begin with, first of all, is learning how to do a pelvic tilt with an exhale. So what that's going to do is it's going to combine some of those deeper, the deepest layers of core muscles, the ones that attach directly into your lumbar spine, your pelvic floor muscles, and then, when we add an exhale to it, that connects your diaphragm with it too. So the way you do this a good way is just laying on your back, tucking your pelvis under or tucking your tailbone under, so you feel your low back pressing into the floor. Once you get that position like, exhale and push all of the air out and then release everything and do it again and you're going to instantly feel like, oh wow, there was a good bracing sensation that I felt there.

Megan Dahlman: 14:52

The second exercise is a good glute bridge. So just in that same position, you're on your back, you've got your feet planted, you got to press through your heels. Mind you, it's got to be the heels. If you press through your toes to lift your hips up off the floor, you'll be working your quads a little bit more and we really wanna get those glutes working. So, pressing through the heels, squeezing your buns and pushing your hips up, not overarching at the top, but just getting those glutes working. So that's another really great core exercise.

Megan Dahlman: 15:18

And then, if you do have the ability to get on your hands and knees some people just can't. They don't like that pressure on the hands and knees. But if you can, most people listening probably can flip over onto your hands and knees and do the bird dogs. So this is a classic exercise where you have your opposites lifting, so your right arm extended, your left leg extended out behind you.

Megan Dahlman: 15:42

Big mistake that people make with this exercise is that they don't achieve a neutral spine first. They just kind of get in position and lift and think about let me lift as high as I can, I'm working the muscles across my back. It's like actually you're working your anti-rotators and your stabilizers. So the purpose of that exercise is not to just lift as high as you can and feel your back muscles, it's really to lock in on neutral spine. So I always find that doing that exhale gets all of your pelvic floor, your diaphragm, all of those deep core muscles engaged and locked in. And then extend your opposites and think about reaching them straight forward and straight back. So those are kind of a big three exercises that are a great place for anybody to start with good quality core training.

Philip Pape: 16:32

The pelvic tilt with exhale, the glute bridge and the bird dogs. And I've definitely experienced bird dogs back in my CrossFit days as part of the warmup we actually did those a lot dead bugs and all sorts of things. Oh yeah, so so a couple of follow-ups on these. Then you mentioned bracing. What are your thoughts on bracing in general, like the Valsalva maneuver, when you start to, I guess, upgrade or graduate into bigger lifts or full-on strength training with free weights and things like that? What are your thoughts?

Megan Dahlman: 17:00

Yeah, I think the. So the Valsalva Nuva is very advanced actually and a lot of people can achieve the same level of success. What we're trying to do is create a lot of intra-abdominal pressure is what's going on there, so creating a lot of pressure inside the abdominal cavity to stabilize the lumbar spine. So I would not recommend experimenting with the Valsalva maneuver if you don't already know how to perform a good Kegel and I don't care if you are a man or a woman understanding how to engage your pelvic floor muscles. That alone, combined with a powerful exhale and it doesn't need to be holding your breath but exhaling during the movement, especially exhaling during the pushing phase of a movement those two things combined can create a lot of that intra-abdominal pressure without the risk of sending your blood pressure through the roof. So that is sometimes a risk with amateurs doing the Valsalva maneuver is that they'll hold their breath, creating a lot of this intra-abdominal pressure. They'll bust out four, five reps of something super heavy and then they'll pass out.

Philip Pape: 18:17

Yeah, because they shouldn't be holding their breath the whole time. Yeah, yes.

Megan Dahlman: 18:21

So I would say, explore learning how to create that intra-abdominal pressure by understanding, engaging the pelvic floor in combination with a slow, firm exhale that can create enough bracing and core stability when you do heavy lifting that you probably don't need. You might not need the Valsalva, you might not even need a belt, you might not A lot of people do. If you're going super heavy, it could be helpful. But knowing how to almost create your own internal internal belt, like with a really firm, hard exhale combined with a pelvic floor engagement, it's almost like you're putting on this like internal belt.

Philip Pape: 19:04

Yeah, and I'm kind of TMI squeezing as we do this just thinking about it. It's good, you know, it's funny. One lift that surprisingly engages all of that is the overhead press with a barbell, if you do it right, because then you have to squeeze your quads and engage your glutes.

Megan Dahlman: 19:20

Yes, and I will mention, since you brought that up, a big mistake that a lot of people make with overhead pressing is, as they push their arms up, their rib cage will float up and in turn, cause their low back to arch. So if you think about what happens if you squeeze your shoulder blades back really far and it causes your rib cage to kind of lift and flare up, most likely what will also happen at the same time is that your low back, your lumbar spine, will arch a little bit extra and in that moment your abdominal muscles are disengaged. And so whenever I teach people how to do an overhead press, I always say let's tuck your rib cage down first, just a little bit. Let's connect it to the top of your hip bone and feel a little bit of that core engagement, and then extend your arms overhead and try to get all of the action just from your shoulder blades and your shoulder joint, and we don't want to see any of that rib cage flare because that could put your low back at risk.

Megan Dahlman: 20:23

So even though the rib cage flare is happening on the front side. It can, in turn, make your low back hurt when you're lifting.

Philip Pape: 20:28

It's so true, and that personal experience from back in the day too. And don't forget the shrug at the top when you get to the top, really shrug all the way through to avoid that impingement. Yeah, all good lessons we've had experience with. So, all right, I mean we can go down a rabbit hole with lifting. But there's other things I want to cover for folks, because you mentioned nutrition. Yes, and I reached out to my community this week. I'm like Megan's back on. They're super excited. I said what do you guys want to know? And all of a sudden there were all these questions about collagen. Of course, it always gets to some like one specific thing. But you mentioned anti-inflammatory, and that is the loaded trigger phrase for the fitness industry, because there's so much misinformation about I'll call them inflammatory foods, which I think is way too much of an oversimplification. So how does it play a role in back pain? What do you mean by anti-inflammatory? What do you mean by fueling your body, just to not overcomplicate it?

Megan Dahlman: 21:19

There are certain foods that have a tendency if you do have a propensity to be more inflammatory maybe you don't exercise regularly because exercise is an anti-inflammatory that keeps your body's just chronic inflammation levels at bay. If you don't sleep well, if your stress is out of control, like if you already have this inflammatory environment, then certain foods can add to it, can like put fuel on the fire. So those foods tend to be packaged, processed foods, especially foods that are high in processed carbohydrates and high in added sugars. I always like to say added sugars. You and I talked about this yesterday together, about fruit, and yes, fruit has natural sugars, but we don't want to worry about natural sugars in food. Dairy foods have natural. Lactose is a sugar. It's a naturally occurring sugar, so it's not going to have the same inflammatory effect in your body as having a package of Skittles Like it's very different. So added sugars are the things that you just want to kind of be more aware of. Foods that are high, like high amounts of saturated fats that are not being balanced with the other forms of good healthy fats and I have to always be careful when I say healthy fats, because saturated fat is a healthy fat too. It starts to get bonkers in your body when you have too much of that in relation to the other forms of fats, and then alcohol can be inflammatory as well. Now what's cool, though, is that there are foods that have shown to ratchet down inflammation levels, and the two big powerhouses are foods that are high in polyphenols and omega-3 fatty acids. These are kind of like your super team of eating more foods with polyphenols and omega-3s. This can actually help to pull down your body's inflammation levels, and you can actually see an improvement in the way your joints feel because of this.

Megan Dahlman: 23:28

So polyphenols these are just compounds that are found in certain fruits and vegetables. Actually, berries are really high in them. Leafy greens are really high in them. Leafy greens are really high in polyphenols. Cruciferous vegetables those are like the broccoli, cauliflower, brussels sprouts, cabbage those are really high in polyphenols. So I always say if you can have a salad every day, if you can have berries every day, you're doing pretty great. If you can have those cruciferous vegetables a couple times a week, that's going to be great. Omega-3 fatty acids those, of course, are found in flax seeds, flax seed oil, chia, walnuts, fish. All of these things are pretty high in omega-3 fatty acids, so those can help too. So those are kind of the big powerhouses of anti-inflammatories. You got the polyphenols and the omega-3s.

Carol: 24:16

Before I started working with Philip, I had been trying to lose weight and was really struggling with consistency. But from the very beginning, philip took the time to listen to me and understand my goals. He taught me the importance of fueling my body with the right foods to optimize my training in the gym, and I lost 20 pounds. My training in the gym and I lost 20 pounds. More importantly, I gained self-confidence. What sets Philip apart is the personal connection. He supported and encouraged me every step of the way. So if you're looking for a coach who cares about your journey as much as you do, I highly recommend Philip Pape.

Philip Pape: 24:56

Yeah, I think it's always nice when we have yet another reason to eat fruits and vegetables, because, you know, when I grew up it was like just eat them, they're good for you. You know, it was like Popeye's spinach, you know like. But you mentioned. You know we talk about fiber, we talk about fullness, we talk about nutrients, but you mentioned compounds like polyphenols and those are not on the nutrition label. Generally, we sometimes miss information, miss space information when just looking at the label, not realizing, wow, berries have so many other hidden things in there. You know what I mean and that's important to understand. And then omega-3s you mentioned. A lot of people go to fish, but you're saying you've also got the ALA. What?

Philip Pape: 25:39

is that Alpha-leonide acid, which is in flaxseed chia walnuts. So a good diversity of those is super helpful, which is why a lot of people take fish oil pills when they don't need enough and that kind of gives them a little bit of the anti-inflammatory.

Megan Dahlman: 25:51

Absolutely yeah, yeah.

Philip Pape: 25:53

Now collagen. So, going back to collagen, right, there's the different types of collagen, there's collagen peptides, there's like a curcuminoid and collagen blends and like joint pill supplements. What are your thoughts on the whole topic of collagen?

Megan Dahlman: 26:07

You know, research is just not clear, like we don't have enough data that shows that it actually is helpful. Um, there definitely is not enough data to show that it actually is helpful. There definitely is not enough data to show that it's helpful for hair, skin and nails. That's, I think, a big reason why people take it is the hair, skin and nails. What we do know is that being protein deficient in general is not good for any of your connective tissues. So collagen, peptides these are just the specific amino acids that your connective tissues are made up of. But if you were to just make sure that you're getting adequate protein period, we're going to be covering a lot of those bases.

Megan Dahlman: 26:51

I would say taking a collagen powder would be really helpful for someone who is not getting their protein enough protein on a regular basis. I would probably recommend that they would start with a whey protein first. It covers a lot of those bases and in fact, the same amino acids, those same peptides and collagen powder are found in a whey protein isolate, so you don't need to have the super expensive collagen one. The data is just kind of shaky on it. There's been a little bit of data that it can help with connective tissue, like with joint tissue, tendons, ligaments. But in the grand scheme of things the amount that it actually is beneficial is really marginal. So I don't think it's the wonder supplement that people are saying it is.

Philip Pape: 27:40

So I agree a hundred percent. And for the listeners, just so you know, I did not prep Megan with this at all. What's funny is I have an episode coming out next week called Collagen Does Not Build Muscle.

Philip Pape: 27:50

And it's because there is a study this year that was reviewed that compared collagen to whey and pea and rice and found that whey and pea and rice stimulate muscle protein synthesis. Collagen doesn't at all Right Right and, like you said, it's kind of like EAAs and BCAAs when they were popular. If I have a client comes in, it's like I take EAAs. I'm like waste of money. Stop taking it, go eat food, go get protein. You don't need it.

Megan Dahlman: 28:13

Yeah, yeah. And what's funny is that collagen is actually an incomplete protein, like a collagen peptide.

Philip Pape: 28:19

It's like two acids, right it's two of the acids.

Megan Dahlman: 28:22

And if you take away protein powder like it's, it's all nine, like you get all all the essentials and more, including the ones that are found in the collagen. So yeah, I'm glad we agree on that.

Philip Pape: 28:37

No for sure. I'm glad you're up on the evidence and people need to understand, because it is funny how often when I ask these things, like give me your questions, they always go right to like supplements, and definitely not. I'm not talking bad about any of my community listening. You guys know who you are. I love you all. I love the listeners. I think the same thing because I'm like well, I understand the basics. Now I need to get down to the nitty gritty. And it's good to ask these questions because sometimes you'd be surprised at things that are helpful you know that might otherwise get dismissed.

Megan Dahlman: 29:05

Well, and I find too, with people that have a whole lineup of supplements on their counter, it helps them feel like I'm doing some wonderful things for my health, where there's some really big things that are getting overlooked, like just staying active all day long, like increasing your neat you know, increasing your non-exercise activity, sleeping better, like all of those things would give you a much bigger health benefit than having $500 worth of supplements on your counter. So I always say let's start with the big picture stuff first and make sure those things are in place. Then you might never need $500 a month worth of supplements. Yeah, I love that. Go save your money.

Philip Pape: 29:49

Yeah, and you come to it from a holistic or a whole body perspective. When you mentioned things like sleep and people are rolling their eyes, oh, here we go again with sleep. But there's a reason for that because, like you said, it is an anti-inflammatory, it improves insulin sensitivity, it reduces belly fat I think we've talked about that before reduces belly fat. And so when you say sleep, stress management and strength training, all of those do the same thing they're an anti-inflammatory. Well, now tie that to back pain. Does that mean that if you're just doing them in general, for most people will show significant improvement pretty quickly? What's your experience there?

Megan Dahlman: 30:25

It can take a while because this is it is. So we mentioned briefly the difference between, like, chemical and mechanical causes of back pain. Chemical and mechanical causes of back pain. So the chemical side of things reducing overall inflammation, seeing improvements in those inflammatory markers inside of your body that can take a little bit of a while, a little bit of time to float to the surface and really reap those benefits. So stick with it because it's worth it. Stay consistent at it. But it might be two months, three months before you're really noticing like, wow, I'm not feeling as lethargic or achy or not. I don't have as much of this like hot, achy joint feel as I go about my day. It could take a little while.

Megan Dahlman: 31:13

The mechanical side of things can be really quickly, can feel improvements really quickly if we're improving those mechanical things. So that's the core strength that I was talking about. It's also just improving your alignment and posture as you go about the day. If your spine is out of good alignment, if you walk around with a constant anterior pelvic tilt or posterior pelvic tilt where your pelvis is just like out of whack all day long, that hurts, it, puts your joints out of alignment and puts a lot of stress on them puts a lot of stress on your discs and on all the surrounding tissues. If we can improve your alignment and help it stay there, you might get immediate relief from that, which is pretty cool. So for someone that might be struggling to sleep at night, maybe because their back hurts, you know, it's kind of like the chicken and the egg thing, it's like well you're telling me I need to sleep better, but I can't sleep better because my back hurts all night long.

Megan Dahlman: 32:10

It's like, okay, I totally get that. So let me give you a few tools that potentially you could do right before bed to ease some of the joint pain, ease some of that muscle tension and perhaps help you sleep a little bit better. So doing some good hip stretches right before bed, like a figure four stretch, a hamstring stretch, doing those pelvic tucks with the exhale it decompresses your spine, it helps engage your core muscles. Doing a glute bridge right before bed helps activate your hip muscles so that all that pressure is not right on your lumbar spine. All of those things could potentially help you get into a more comfortable position when you're sleeping and help you sleep all night long. And so that's the mechanical side that ends up having an impact on the chemical thing, because you end up sleeping better. You know what I mean.

Philip Pape: 33:02

Yes, yes, and to take that even further, because the concept I like to use for this is upward, spiraling from positive psychology where one thing leads to another to another. It's also could be called habit stacking, whatever, right, but you just mentioned how those things can help your back feel better so you can sleep. It also gives you a chance to create this pre-bed ritual which I'm always telling people, like if you can get off your screen, you know that's one of the best things you can do right before bed. But you need to replace it with something because nobody can just jump into bed. So you know, whether that's reading a book, breath work, meditation or guess what, you're strengthening of your core before bed because you have back pain and then you'll also sleep better. Two for one, megan, I love it. This is good stuff.

Philip Pape: 33:44

Yeah, yeah, we're checking a lot of boxes off with that one, checking all the boxes yeah, it's just like when someone has a whole host of metabolic issues and it's like it's just excess body fat will probably fix most of them. You know, I don't want to be simplistic, but really is. Let's not try to solve all these things, let's just solve the main thing See what's left and then we'll attack those For sure, for sure Core strength. So we come from slightly different camps, even though I agree with everything you're saying. We come from slightly different camps from a strength training perspective and From a strength training perspective and I'll explain what I mean in a second but I like how you define core as like the trunk, the posterior chain, the glutes.

Philip Pape: 34:21

It's like this massive chain and set of stuff around the middle that supports everything. And I know just you know the other day doing heavy Romanian deadlifts, I'm always thinking like brace neutrality, core tightness, it's like so important or something's gonna get injured. And it also helps your back because you can do some movement you don't think is back related like a bench press and then feel back pain from that because you're not tight with your core.

Philip Pape: 34:49

So where I'm going with that is. What are your thoughts on, then? Traditional strength training, movements for back pain, like deadlifts, squats and the like.

Megan Dahlman: 34:57

I think that they can be really helpful for the exact reason that you just said. When I'm going through that movement, I am having to engage my core and pay attention to the neutrality and really brace and create that integrity around my spine. It can be some of the best core training. My spine, it can be some of the best core training. However, if you do those movements and load them up with pretty heavy loads, if you don't already have the coordination of knowing how to engage those muscles properly, if you don't have the awareness of what good technique and posture is, if you don't already have a certain base level of core strength, it could put you at risk. So they could either be excellent core exercises and really really great for your back, or it could be sabotaging your back and actually really hurt your back if you do them incorrectly and don't have good core engagement as you do them. You could go either way really.

Philip Pape: 35:56

No, no, it makes sense because when I think of the person so some people are what's the word another guy used. He'd be called like not athletically clumsy, but just, oh man, I don't know what the word is. It's somewhat derogatory, but it's people who aren't necessarily naturally athletic when they try to lift weights right. And so if you say, okay, start this whole body strength training program and just go and do it, they can really hurt themselves, even at a lightweight, even if you say start light, even if they watch videos, even if they post form checks other than having a personal trainer who knows what they're doing, which is few and far between, I'm sorry to say, and you're one of the ones who do. It takes a lot of that to be doing in concert with learning those lifts to get it right, whereas what you're suggesting is maybe there's a pre-phase. That's really intelligent, to take time doing and get mind-body connection right, mind-body connection with what's going on, and then you can apply it to other things. Yeah, absolutely.

Megan Dahlman: 36:48

And whenever I start with any of my clients, we spend a lot of time training the core, no matter what, whether you have back pain or not, like we're, we're just going to do it, because anytime you lift or push or just ambulate through your day, all of those forces go through your core. So if you don't have back pain now, if we don't train your core, you will get it. It will happen. And that's when it is inevitable, Like that's. If you don't train your core muscles, like then. Yeah, I could. I could say you will most likely get back pain at some point in the future, especially if you continue to strength train and continue to just lift heavy weights without having a good foundation of core control and knowing how to activate and engage your core when you're going through those heavier lifting exercises.

Philip Pape: 37:44

Yeah, one of the first things you said was you know, also, don't push through pain. So even if you are one of those men or women who are already lifting maybe you're already doing that and you start to get that fatigue. It often starts as just a little bit of throbbing, a little bit of pain, that soreness that persists longer than it should. It's very localized. It can kind of ramp up and up and if you can't tell again, I have personal experience that's what happens and if you push too hard, something's going to give, and that's where you need to listen to yourself. What about? Okay? So a couple other things, a couple other topics before we wrap up the mental side and maybe even the ergonomics of working from home.

Philip Pape: 38:17

So, mentally, a while back, I there's this guy, maybe you know him, this doctor who was big into all back pain is mental, like all of it's psychological, which I know is not the case, but it was very compelling argument. He had worked with like thousands of people who had persistent sciatica and back pain and they just had to come to terms and resolve the emotions around it. I don't know precisely what it was that. Are you aware of this school of thought?

Megan Dahlman: 38:43

I am and I. So here's the thing like pain is all perceived in your brain. So pain is just some sort of signal that your body is sending to your brain and sometimes your brain can do funny things and perceive pain that isn't actually damage. So I've had this a lot with individuals where maybe years ago they had an incident where they hurt their back and now they have this really strong memory of this happened. And now whenever I get into this position, I'm scared, I tense up and my brain starts to perceive that that there's some sort of damage occurring in the area. This happens a lot with cramping. Muscles cramp a lot, they cramp constantly and especially weak, underdeveloped muscles and a cramp can sometimes feel like damage is happening, because it can be very painful of having constant tension and cramping in a muscle and guarding and this happens a lot in your, especially your low back muscles and your brain will start to perceive that like something has been damaged.

Megan Dahlman: 39:55

And for a lot of people, especially with a history of back pain, frequently I'll say did you do anything Like? I'll ask them was there an acute injury that happened here? Did you feel a pop? Did you experience, like whoa, just suddenly a ripping or a tearing feeling or something like that. Most of them are like no, it just kind of came on over time.

Megan Dahlman: 40:19

Most of the time, I have discovered that it is a guarding sensation. Like those lumbar spine muscles, a lot of those deep core muscles, like those lumbar spine muscles, a lot of those deep core muscles felt like they were being put under a stressor that it wasn't ready for, and so they guard and clamp down. That is a very powerful feeling and your brain will sometimes perceive that as damage. Something happened and we got to guard even more and we got to guard even more. So quite often, just getting that person in a comfortable position and telling them to do deep breath work to get those muscles to release and to stop cramping and guarding is one of the most powerful things. Now, is that mind over matter? No, there is actually something mechanical going on that's creating the pain. There was muscle tension, guarding, clamping, so it's not all in your head.

Philip Pape: 41:17

I find that that might be a really discouraging thing to hear like oh, it's all in your head Right Like gaslighting almost yeah, yeah.

Megan Dahlman: 41:21

Yeah, and I don't find that that's very helpful. But there can be a really powerful mind-body connection and sometimes learning how to override those cramping and guarding mechanisms that your body naturally will want to do when it feels stressed out can be a really powerful thing for pain connections associated with that for something positive, but it helps to know what that positive thing is, and that's where the information you're sharing is so powerful and helpful.

Philip Pape: 41:53

So for those of us who are working from home right and sitting down all day, I think of the ergonomic aspects of back pain like just sitting. What are your thoughts on what people can do differently as far as their day-to-day pattern when they are working from home for long stretches?

Megan Dahlman: 42:10

Movement first and foremost. So even if you have a perfect ergonomic setup, your joints will get cranky if they stay in one spot for too long, even if they're perfectly aligned. So what happens when you don't continue to move and lubricate your joints? Like that? Synovial fluid actually can start to seep out of the joint space a little bit and then once you move, that joint kind of vacuums it back up and it lubricates the joint. So if you are in one spot for very long, really try to train your body like every 20, 30 minutes. No matter where I am, even if I have a perfect ergonomic setup, I need to still move, no matter what. If possible, I do recommend people getting a standing desk. I have an up, a high-low desk, a standing desk. I love it because I know you're standing. Now I'm actually sitting right now.

Philip Pape: 43:02

It's hard to tell sometimes, right.

Megan Dahlman: 43:03

Yeah, I go back and forth between standing and sitting all day long. It's not that sitting is bad, because sometimes when people are standing they'll actually stand with poor posture too. So just staying moving is the most important thing. A couple of things to think about as you are.

Megan Dahlman: 43:20

Whether standing or sitting, is thinking of good posture, starting with your pelvis. Often we think of posture beginning with our shoulders and like just our shoulder blades and not slouching. But if you think of posture, it really begins at the pelvis. And if you can keep your pelvis really well aligned we don't want it tipping one direction, like cocked out to the side, we don't want it dumping forward or slumped under If we can keep your pelvis as level as possible, then we can work up and down the chain from there to have good alignment.

Megan Dahlman: 43:51

So a neutral pelvis. So if you're sitting in your chair, a lot of people will sit to the side, lean, tip their hips over to the side, arch too much or slump too far under. So whatever you need to do or they'll cross their legs. So having your feet planted perfectly level so that your pelvis is sitting level, same with when you're standing. Having your feet planted level so that your pelvis is level, so good ergonomic posture starts there, starts with your pelvis, and then just stay moving as much as you can throughout the day.

Philip Pape: 44:28

Yeah, you kind of called me out on the standing right Because I have a standing desk. I have a couple of standing desks and sometimes you can just get stuck there for too long and you're like I got to move, or I got to at least fidget, and then kind of walk around or sit for a while. It's crazy. Just this week I recorded with was yeah, Brian Borstein, and he's a big fan of exercise snacks right, oh, I love that idea yeah.

Philip Pape: 44:54

And I know he didn't make up the term, but yeah, and the one he likes. And I can do this because I have stairs. So anybody who has stairs is just three or four times an hour run up and down the stairs for a minute and you get not only the movement, you get the blood flow, you get the exercise, you get the kind of cardio, you get it all you know and it kind of breaks that cycle of constantly sitting or standing. So that's just one thought.

Megan Dahlman: 45:12

I love that. That's so great.

Philip Pape: 45:14

Yeah.

Megan Dahlman: 45:14

No, I love the exercise snack idea and really that comes back to you know, motion is lotion and and this is the power that you have with the mechanical side of things is just continuing to keep your joints, every joint on your body, moving in an optimal range of motion. Some joints, by the way, are not designed to move a lot, so, like your lumbar spine joints, they're not designed to be super flexible. That's one thing we didn't really touch on. But a lot of people, when they feel like, oh, my low back is hurting, I need to do this really big back stretch, I got a round way over or twist or arch, usually the tension is actually coming from tight hips. Your hips are supposed to be really flexible, not your lumbar spine. So doing some good stretches, targeted stretches for areas that really do carry that tension, lubricating joints through a range of motion that they need to stay lubricated through, all of those things can really help accomplish creating a body that just feels great and doesn't have those joint aches and pains.

Philip Pape: 46:22

Yeah, and for those who like to do yoga or something like that, I think Megan's routine and she's got a lot of them and I know you have plenty of content on this, so we could share something in the show notes but it could be your yoga routine almost. If back pain is an issue for you, make that your stretching and movement. Some people are time crunched. Obviously, if you have hours and hours, you want to do yoga too. That's fine. It's a lot of information. So if you had to give the listeners one actionable tip that they can implement today and just start reducing their back pain and inflammation, what would it be?

Megan Dahlman: 46:53

You know, I would say that probably the most powerful tool at your disposal is that simple pelvic tilt with the exhale, because in that moment most people go through their day with an anterior pelvic tilt and that creates a lot of that lumbar spine compression. So learning how to just change and shift the angle of your pelvis, having that control and coordination, is so powerful that can really reduce, instantly reduce, that feeling of pressure on your low back. And then when you add the exhale to it, that's also engaging those deep core muscles. So if there's anything you do that will help your back feel better, at least start moving in that direction. Learn how to do that specific movement.

Philip Pape: 47:41

Yeah, I love that. It'll help with this. It'll also prime you for more advanced movements later on, cause again, that's super important for certain lifts as well. Okay, I love it. I hope we can put a good resource in there for that specific thing. Megan, I'm sure you have something we can point people to.

Megan Dahlman: 47:57

Yeah, absolutely. My free five-day core tune-up program. So five days I lead you through the very best core exercises. And what's funny is I created this as a great way to on-ramp people into my full back and hip fix program. So it's a 30-day program where I help you eliminate all your back and hip pain. But what has happened is that this free five-day core tune-up usually in the first five days we get rid of the back pain completely and most people are like I don't feel like I need it. I know I'm like shoot, maybe I made it too good.

Philip Pape: 48:29

That will pay off in other ways. Trust me, it'll pay off in other ways. You know, with people you know.

Megan Dahlman: 48:33

It's a good little program so I would recommend starting there. It's a great. It's easy to follow, beginner friendly, less than 10 minutes a day. It builds. It's so great. So 5daycorecom. So it's so great, so five day corecom.

Philip Pape: 48:46

So I will throw that in there from from a woman of integrity for you to get a back of integrity. We will throw that in there, that's awesome.

Megan Dahlman: 48:57

I love it. Is there anything else you wish I had asked related to this? You know I feel like we covered so much and I know in the beginning we talked about a little bit. You know, is back pain inevitable and it's not. It's not inevitable and it's not. It's not inevitable.

Megan Dahlman: 49:11

And I just want to reiterate that there's so much within your control and it might be that you have to continue to revisit these things because you always need to be eating healthy. It's not like you eat a salad once and one and done, like okay, good, now I'm healthy. This is training. Like making sure that your back stays healthy, means that you have to continue to revisit this stuff. Like I'm going to be training my core until the day that I die. Same with I'm going to be eating salads until the day that I die and moving and walk, like as much as with the is within my control. So it's not necessarily a one and done thing, but you do have so much in your power to ensure that you do have a healthy back. It's not inevitable. Back pain is not inevitable.

Philip Pape: 49:59

It's not inevitable and if you make it something that gives you that freedom and that movement, it should be enjoyable. That's something you want to keep doing because it just feeds back on itself and, again, mind-body connection. All right, so we talked about the core course that we'll throw in there, but where can listeners learn more about you, megan?

Megan Dahlman: 50:17

Definitely come check out my podcast, philip. You've been a great guest on my show that self-care simplified. And then we have I'm not sure when this episode is going live but we have a brand new weekly newsletter that's coming out called weekly jumpstart free newsletter. Full of incredible information exercises, recipes, tips, um, I think the first edition is all about joint pain and inflammation actually. So every week we're sending out this newsletter, so it's just weekly. Jumpstartcom is where you can sign up for the free newsletter, so we're trying to get as many people just this really good quality information each week in a good, digestible way. So definitely check that stuff out.

Philip Pape: 51:01

Perfect, I will throw that in the show notes and for the listener you know, check out Megan's podcast Self-Care Simplified. Our episode is going to be on there as well. We talked what did we talk about? Fat loss, right? Personalized fat loss.

Megan Dahlman: 51:13

Yeah, it was good, it was really good.

Philip Pape: 51:15

So check that out and keep coming back. And Megan, again, let's keep in touch because it's always awesome to talk to you. You're so full of energy and light and wisdom, which is a great combination.