1. The 3 Most Common Sources
of Chronic Pain
(And How to Fix Them)
Modernhealthmonk.com
2. 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.)
3. 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
4. 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 your
joints and back
= chronic pain
5. The three most common imbalances
Pronation Distortion Syndrome
Lower Crossed Syndrome
Upper Crossed Syndrome
6. 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
7. 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
8. 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
9. 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
10. So how do we fix them?
Short term: Fix muscular tension & trigger points by
deep tissue massage like Myofascial release
and 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
13. Pronation Distortion Syndrome
Part 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 knees
and ankles properly
= Knee pain, ankle pain, foot dysfunctions, shin splints (if you’re a
runner)
14. Pronation Distortion Syndrome
Part 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.
15. Pronation Distortion Syndrome
Part 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 Band
Hip flexors)
B. Strengthen weakened muscles:
Gluteus Maximus
Gluteus Medius
16. Pronation Distortion Syndrome
Part 4: How to Fix It – Exercises For The Tight Muscle Groups
Stretches for the overly-tight muscle groups:
17. Pronation Distortion Syndrome
Part 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)
18. Pronation Distortion Syndrome
Part 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.
19. Lower Crossed Syndrome
If you’ve got:
• Lower back pain (especially
when exercising)
• Repeated hamstring pulls
• Anterior knee pain
20. Lower Crossed Syndrome
Part 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!
21. Lower Crossed Syndrome
Part 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.
22. Lower Crossed Syndrome
Part 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 Band
Hip flexors)
B. Strengthen weakened muscles:
Gluteus Maximus
Gluteus Medius
Abdominal muscles & transverse abdominis
25. Lower Crossed Syndrome
Part 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.
27. Upper Crossed Syndrome
Part 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
28. Upper Crossed Syndrome
Part 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.
29. Upper Crossed Syndrome
Part 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 neck
Trapezius
Sternocleidomastoid
Chest 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 neck
Re-align the shoulders, so that the shoulder blades are back
32. Upper Crossed Syndrome
Part 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.
34. 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 exercising
Gets body parts “stuck” in the wrong spot
== > PAIN
36. 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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http://modernhealthmonk.com/insiders-kit/
