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The 3 Most Common Sources of Chronic Pain

(And How to Fix Them)

Almost all of us have chronic pain in our lives at some point, but many of us have aches and pains or chronic injuries that never go away.

… This is for you !

For those of you that keep getting repetitive injuries in sports, this will help immensely. (Tennis elbow, knee pain, shoulder issues when benching, lower back pain when running, etc.)

My own history of pain:

• Back Pain• Repetitive Tennis Elbow• Neck pain so bad I was an

insomniac for two years• Constant knee pain

during sports (5+ years)• Shoulder rotator cuff pain• … I had a LOT of issues

Which led me to study all of this stuff in detail

Muscle imbalances are extremely common in modern people because

• A. We’re sedentary (muscles get little use)• B. We’re inactive (certain areas tend to tighten up over

time)

The result?

Certain muscles get tight.

Others get weak.

= improper loading on yourjoints and back

= chronic pain

The three most common imbalances

Pronation Distortion Syndrome

Lower Crossed Syndrome

Upper Crossed Syndrome

Pronation Distortion Syndrome

What’s going on:• Knees are internally rotated• Feet are pronated• Imbalanced loading

Injuries you usually get:• Plantar fasciitis• Shin splints• Patellar tendonitis• Lower back pain

Lower Crossed Syndrome

What’s going on:• Pelvis is tilted forward• Exaggerated lower back arch

Injuries you usually get:• Repeated hamstring pulls• Anterior knee pain• Lower back pain

Upper Crossed Syndrome

What’s going on:• Head is poking out forward• Rounded (hunched) shoulders• Typical computer “caveman” posture

Injuries you usually get:• Headaches / Stiff neck• Biceps tendonitis • Rotator cuff issues (shoulder pain)• Carpal Tunnel Syndrome• Tennis Elbow• Burning between shoulder blades• Shoulder issues

The worst culprits?

#1 Inactivity

#2 Sitting

Why?

Sitting = tightening and shortening of some muscles, poor postural habits

Inactivity = muscles weaken

= Perfect environment for muscular imbalances

So how do we fix them?

Short term: Fix muscular tension & trigger points bydeep tissue massage like Myofascial releaseand trigger point therapy

Long term:

A. Strengthen the weakened muscles

B. Stretch the shortened muscles

C. Re-establish natural body alignment and biomechanics (how it all lines up)

… You can’t simply massage this stuff away for good.

The long-term strategy is absolutely crucial

Your Guide to Self Treatment

Pronation Distortion Syndrome

If you’ve got:• Plantar fasciitis• Shin splints• Patellar tendonitis• Lower back pain• Repeated ankle sprains• Knee pain

Pronation Distortion SyndromePart 1: What’s Actually Causing You Pain

What’s going on:

Knees are caving inwards

Ankles are collapsing inwards

Weight is not loading on the kneesand ankles properly

= Knee pain, ankle pain, foot dysfunctions, shin splints (if you’re a runner)

Pronation Distortion SyndromePart 2: Example

I was getting repeated knee pain only in my left knee from running and doing leg workouts.

Checked all my joints – origin?

Ankle!

I had major Pronation Distortion going on, my left ankle was caving in, and my knee was taking the weight instead of equally loading it into my foot.

Once I consciously made sure to equally load the weight on my foot, I stopped experiencing knee pain.

Pronation Distortion SyndromePart 3: How to Fix It

Some muscles are over-tight, while some are atrophied and weakened. So the solution is two-fold:

A. Stretch the shortened (over-tight) muscles:

Gastrocnemius/soleus Adductors IT BandHip flexors)

B. Strengthen weakened muscles:

Gluteus MaximusGluteus Medius

Pronation Distortion SyndromePart 4: How to Fix It – Exercises For The Tight Muscle Groups

Stretches for the overly-tight muscle groups:

Pronation Distortion SyndromePart 5: How to Fix It – Exercises For The Weakened Muscle Groups

Strengthen muscles that have grown weak (your butt):

(See the blog for the full workouts)

Pronation Distortion SyndromePart 6: How to Fix It – Re-Training

Be aware of your alignment when you exercise:

When running, make sure your entire foot loads the weight evenly.

When doing exercises involving squatting, pay attention.

Your knees should not be caving in, keep them pushed out.

Your feet should not be caving in, mentally think of keeping the balls of your feet and heel on the ground equally – at all times.

Lower Crossed Syndrome

If you’ve got:• Lower back pain (especially

when exercising)• Repeated hamstring pulls• Anterior knee pain

Lower Crossed SyndromePart 1: What’s Actually Causing You Pain

So what’s going on here?

Due to tightening of the hip flexor complex, the lower back is pulled into an overly-arched, tightened position.

= Back pain!

Lower Crossed SyndromePart 2: Example

For years, every time I would run or do squat workouts (including lunges), I had lower back pain after.

The constant lower back pain eventually turned into some deep pain that required myofascial release and trigger point therapy to fix short term.

However, the pain kept happening.

I later realized that my tight hip flexors were causing my back to over arch in deep squat type movements – and once I regularly stretched out the hip muscles, I stopped getting the pain.

Lower Crossed SyndromePart 3: How to Fix It

Some muscles are over-tight, while some are atrophied and weakened. So the solution is two-fold:

A. Stretch the shortened (over-tight) muscles:

Gastrocnemius/soleus Adductors IT BandHip flexors)

B. Strengthen weakened muscles:

Gluteus MaximusGluteus MediusAbdominal muscles & transverse abdominis

Lower Crossed SyndromePart 4: Mobility Exercises for Tight Muscle Groups

Lower Crossed SyndromePart 5: Exercises to Strengthen Weakened Muscles

Lower Crossed SyndromePart 6: How to Fix It – Re-Training

Be aware of your alignment when you exercise:

When doing exercises, make sure to clench your core and keep the abdominals tight.

People with lower crossed syndrome tend to have weaker abdominals since they’re stretched out.

During any squatting movements, clench the stomach tight. Many people complain of lower back pain from deep squats, or even “overhead” exercises.

Focus on clenching the core tight and not over-arching the back.

Upper Crossed Syndrome

If you’ve got:• Headaches / Stiff neck• Rotator cuff issues • Carpal Tunnel Syndrome• Tennis Elbow• Burning between shoulder blades• Shoulder issues

Upper Crossed SyndromePart 1: What’s Actually Causing You Pain

So what’s going on here?

The shoulders are hunched forward and the neck is protruding forward.

This causes all kinds of issues, from your neck and shoulder, all the way down to your wrist.

= Neck pain, shoulder issues and injuries, burning between shoulder blades, potential overuse injuries in the elbows

Upper Crossed SyndromePart 2: Example

I sit at a computer for 10 hours a day for work.

For years I’ve had repeated elbow tendinitis, shoulder injuries, burning between my shoulder blades, and terrible neck pain.

I’ve also had carpal tunnel syndrome in my left wrist – the same side of the body that I’ve had elbow and shoulder issues.

When I closely evaluated what was going on, I realized I had serious upper crossed syndrome – and that my left shoulder was more hunched over than my right.

After I focused on a daily shoulder flexibility regime, my pain improved dramatically.

Upper Crossed SyndromePart 3: How to Fix It

Some muscles are over-tight, while some are atrophied and weakened. So the solution is two-fold:

A. Stretch the shortened (over-tight) muscles:

Muscles in the upper back and neckTrapeziusSternocleidomastoidChest muscles, like pectoralis

B. Re-align the weakened muscles (I personally haven’t found strengthen exercises useful at all here, so I have a few other exercises instead)

Re-align the neckRe-align the shoulders, so that the shoulder blades are back

Upper Crossed SyndromePart 4: Mobility Exercises for Tight Muscle Groups

Upper Crossed SyndromePart 5: Alignment Exercises for Neck/Thoracic Back

Upper Crossed SyndromePart 6: How to Fix It – Re-Training

Be aware of your neck and shoulder posture when sitting.

The shoulders should always be rolled back – get in the habit of pulling your shoulder blades together throughout the day.

Spending too much time hunched over a computer will usually cause the shoulders to hunch forward.

The neck should not be jutting forward at all.

If you’re unsure what the “natural” posture of the neck is, do the “static back” exercise, and it will reset the neck – which can serve as a reminder for the rest of the day.

Fixing Chronic Pain

The Perils of Sedentary Life

Sedentary life often causes two things:

A. Weakening and atrophying of muscles B. Tightening of certain muscle groups from lack of movement (e.g.

muscles around hips)

….Result?

Chronic tension Improper biomechanics when exercisingGets body parts “stuck” in the wrong spot

== > PAIN

How Do I Fix and Prevent This?

Physical activity for 21st century humans:

Some kind of strength work (like weight training)

Some kind of flexibility work

Some kind of mobility work (particularly around joints causing you problems)

As little sitting as is humanly possible

Postural awareness

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