Dinneen helps active people with low back pain develop the holistic think, eat, move skills they need to confidently retrain their back pain with ease. A true “teachers’ teacher” with 23 years experience, Dinneen is the creator of Retrain Back Pain®. She is a Backfit Pro as well as a NeuroKinetic Therapist, a Craniosacral Therapist and a Certified Nutrition Counselor.
Keep an eye out for the relaunch of Dinneen’s Back Rehab Boss online program. And in the meantime, get a free back flare up solutions video tutorial by clicking here: https://www.retrainbackpain.com/free-back-flare-up-solutions-optin
Caitlin: Check to check. Alright, we are back with another episode of The Practice Human Podcast. I’m your host, Caitlin Casella. It has been about two years since I last put out a Practice Human interview, and I’m delighted to report that I had a wonderful talk with Dinneen Viggiano about back pain, and I’m really excited for the things that we both have to share with you in the interview today.
If you’re wondering, hmm, why has it been two years since there’s a Practice Human episode and what’s. Been going on during that time. You can check out my last episode that welcomes you back to the reboot of the podcast for 2022. I had grand ambitions to batch record a whole bunch of interviews over the summer and put out episodes about twice a month throughout the entire fall.
And. That’s not happening, and I’m okay with that. I spent some time savoring the last bits of summer. I have really been enjoying the turn of season into fall here in New York City. It is my absolute, absolute favorite time of year, October in New York. So I’m kind of eating it up and enjoying my weekends and spending a lot of time in Central Park.
It’s a beautiful, crisp, uh, sunny. Cool Fall weekend in New York and I was in Central Park yesterday. I am a beginner at running, which is a lot of fun and a really great time of year to enjoy it. I spent, um, much of the early part of 2022. Working on slowly progressing into impact exercise. So training myself again for some jumping, which I hadn’t done in a really long time.
I started jump roping. I started doing some box jumps at the gym, um, and other kinds of just agility drills hopping around on my feet. And I found that very challenging. It was slow and steady to build capacity in my body, but it was also really challenging for my brain in terms of coordination. I love being a beginner and I love learning new things, and I think it was really good for my brain to learn how to jump again.
And then that progressed toward the end of summer and into the fall towards doing some running intervals. I am 40 years old. I will be 41 in November, and I’m just learning how to run and how to enjoy running, which was never, uh, something that I, I, I never enjoyed running before. I never wanted to run, but I’m learning to do it.
Very, very slowly, steadily, gradually with some brisk walk and run intervals. I am taking my own advice that I give to patients in the PT clinic who are either beginners at running or coming back to running after a break from running, or. Testing, out running while working with pain or rehabilitating injury.
Uh, so I’m going slow and steady. I’m enjoying my walk run intervals and, um, having a really good time getting outside. My body feels great. It feels like it’s great for my mind, just like the jumping was. And I’m excited to share with you a little more as I move along with that. You’ll probably be hearing about my experience with that, um, in future episodes.
For the interview that I have to share with you today, I spoke with Dinneen Viggiano about back pain. I reached out to Dinneen because I was really interested in hearing her thoughts on the importance of education in management of back pain. It brought us into a wonderful discussion about. Patient advocacy and interdisciplinary collaboration within the US healthcare system.
Besides talking about the importance of education in managing back pain, we also talked about the importance of a multifactorial approach. Looking at all facets of life and lifestyle when it comes to, um, managing and eventually hopefully resolving. Back pain. So, um, I’m gonna get right onto our talk.
I hope you enjoy my interview with Dinneen.
Hello everyone. I would like to introduce my guest today, Dinneen Viggiano. We are talking about. Back pain, specifically low back pain. And as a PT in the clinic, this is probably the, not probably, it is the, the most patients that I see come to me with low back pain. It’s incredibly prevalent in our society. And when I reached out to Dinneen to, um, float this topic of discussing low back pain, to get a little bit more focus in our discussion, I said, how about we talk about.
Education, the education that we provide as coaches or therapists to our clients. To help them with their back pain. And Dinneen replied and said, yes, that is the topic when it comes to treating back pain. Mm-hmm. Because education on back pain is so crucial in helping people, um, manage their pain and get out of pain.
So I’m really excited to talk to Dinneen about that specific topic today. Dinneen helps active people with low back pain, develop the holistic, think, eat, move skills they need to confidently retrain their back pain with ease. A true teacher’s teacher with 23 years experience, Dinneen is the creator of retrained back pain.
She’s a backfit pro as well as a neurotic therapist, a cranial sacral therapist, and a certified nutrition counselor. I think Dinneen, I have probably known you for about half, maybe more than half of those 23 years. I know Dinneen from, uh, teaching yoga, and I’m extra excited to talk to Dinneen today because of Deen’s background in yoga.
I. And all of the facets of back care and, um, nutrition that is denied brings to, uh, coaching and I and the practice. Human podcasts are all about interdisciplinary or multidisciplinary work because there are certain things that work well for certain people, and I think the more tools that we bring to the case, the better.
So, Dinneen, thank you so much for being here with me today.
Dinneen: I am super happy to be speaking with you and to be, uh, connecting with your community. Caitlin, thanks for having
Caitlin: me. Yeah, and I also wanna mention just, um, in terms of knowing Dinneen and our, our, oh, you might hear occasional muffled Gallup sounds and that is my cats running through the house cuz they decide to do this anytime I start a podcast.
So I wanted to say too, just on a personal note, um, Dinneen is a super cool New Yorker. And also has Two Cats. Yes, cats are friends of the Practice Human Podcast and you might hear mine a little bit today. So Dinneen, I wanted to start by asking you to speak from your lived experience, cuz you mentioned to me when we were setting up this interview that you are going through some midlife changes.
With your back specifically, and, and also you’ve been through some history of working with your parents and navigating the healthcare system with them. So I was wondering if you could just start by talking a little bit about kinda your inspiration in guiding you toward this passion for working with back pain and in creating, uh, your program, retrain back pain.
Dinneen: Yeah, sure. You know, I love that Practice Human, and that your goal and your mission is all about interdisciplinary and educational information for, for your community, because that’s really, that’s really the big elephant that’s kind of missing, is that there’s lots of specialists out there. In a whole bunch of different disciplines, but it’s really hard for those practices to collaborate, communicate, and to adopt and manifest an interdisciplinary approach.
So I’m really happy to speak on this topic cuz I think it is the future of WellCare going forward. So Brava. Mm-hmm. Yes.
Caitlin: Thank you. Yeah.
Dinneen: Um, so personally, you know, there’s, there’s a. Two, two major events that really sort of set me up for the work that I’m doing and prior to having back pain. Unfortunately, when I was in my twenties and thirties, I was primary caregiver for both of my parents as they navigated the US healthcare industrial complex for cancer, heart disease, and diabetes.
And you know, I learned through those experiences that doctors, nurses, and hospitals are really good at whatever they specialize in, but they’re not designed to actively manage, support, advise, or advocate for optimal patient outcomes that ultimately falls to the patient and hopefully their family if they’ve got some mm-hmm.
Caregivers at their side. And so that was an eye-opener for me, those 20 years of advocating for my parents’ care really taught me that doctors don’t really know best. They, and they certainly can’t keep track of everything and, and they do make mistakes. And so it was during those years that I became an expert patient advocate and developed a keen sense of the limitations of traditional American medical care.
And that informs a, a, a huge cornerstone of the retrained back pain. Model. Hmm. And then, um, personally I am a survivor of a lot of complex back conditions, so I was teaching for 10 years already and it was. So both of my parents have passed, and it was shortly after my mom’s death and my son’s birth had sort of coincided in the same two year period that I developed really debilitating back pain.
And as a movement pro, I tried to heal it in all the ways I knew how I was stretching and I was doing lots of yoga and I was doing lots of things that people say are good for back pain. And man, it just kept getting worse. Mm-hmm. And um, and, you know, There’s lots of movement pros out there who get injured, and we sort of feel like, kind of feel like failures when our body fails us, right?
Mm-hmm. It’s kind of like we’re in the industry and we should know better and we should know everything, and it’s, it’s really, it’s, it’s really humiliating and it’s kind of hard to manage when you’re s you’re, you, you think you’re a pro and then you don’t know what to do for yourself, right? So, yeah. So I went through that and um, you know, after some time I finally was like, I need to know what’s going on.
I mean, I was seeing massage therapists. I went to a chiropractor and an acupuncturist and I went to the foremost sort of back yoga specialist in New York and I was doing all this sort of complementary alternative medicine stuff and nothing was helping. So I went and I got some scans, and when I got the scans I got X-rays and MRIs and.
You know, the first thing I’ll say about scans is that they are not, they don’t always show you what’s going on. Mm-hmm. Yeah. And when you have an image, a medical image, you’re only gonna get, like, after I had these medical images, the doctors that I saw thereafter, except for one, they only looked at the radiology report.
Mm-hmm. They weren’t even double checking it on the actual image. And what happened was the radiologist, Missed about a third of the things that were going on in my spine. Hmm. Wow. So, so what was, what was reported was that I had degenerative disc disease and I had several herniations and I had two scoi and I also had, uh, a grade one to two sort of borderline spondylitis thesis.
Mm-hmm. And without going into detail just yet about what all those things mean, I chased those diagnoses for the better part of two years around New York City, and we got some good, we got some good resources in this big city, right? Yeah. So I wasn’t at a loss for resources. I was at a loss for money because I was losing money.
Like we’re talking a couple of thousand dollars of me trying to chase solutions, right? Um, and I kind of held up these scans like, look, this is what’s wrong with me. There must be a solution right around the corner. Mm. Mm-hmm. Um, and that’s probably one of the biggest myths about back pain is that just because you get a scan and a diagnosis doesn’t mean you get a solution and you get outta pain.
Right, exactly. And, uh, that was really harsh for me. I did not like that lesson that I learned.
Caitlin: Well, and also just because I think this is also one of the, the prevalent myths out there is that people tend to think that all things that show up on imaging are symptomatic, which they’re not necessarily.
And that anything that you feel as a symptom must be there somewhere in the imaging, which it’s not necessarily right. Mm-hmm. So people can have a clean scan and have pain, or they can have a scan that shows a lot of degenerative changes and not be in pain. Or they could have the correlation that we expect and have a clean scan and no pain, or lots of degenerative changes and lots of pain.
But, um, it doesn’t always correlate with symptoms. So I think that’s the kind of amorphous and tricky thing about looking at. Imaging and then looking at the presentation and symptoms of a person as they don’t always match up.
Dinneen: Yeah, yeah, exactly. And, and you know, that’s also one of the failings of our current back pain industry, which is that we go by scans and there’s not a lot of practitioners out there who are doing in-depth manual client history assessments, which is right. I trained with Dr. Stewart McGill as a Backfit Pro because he’s one of the few in North America who is, he really goes quite deep through his client history taking and manual assessments were, you know, through his methodology, we can find out things that are not gonna show up on a scan.
Caitlin: Right. Yeah, like a, a lot of people will go to a doctor, an orthopedist who will take a little bit of history and take imaging, but not do much or anything in the way of an actual physical examination. So, um, that’s right. So being connected to people who can look at, I mean, we’re gonna talk about this a lot, but look at movement and look at how your symptoms present with various motions and positions and do a real physical examination is so important.
Dinneen: Yeah. And it’s, it’s so rare too. So when you find those people, hold on to ’em. Yes. Yeah, I mean, the other thing that came out of, you know, this experience for me of, you know, trying to figure out what was wrong with my back is, you know, I, I learned that not through the, not necessarily all through the scans, but I did learn that I had spondylolisthesis, which.
It’s actually a specialty of mine. And for those of us who have spady, which we call it for short, it’s hard to find a practitioner, even physical therapists. Mm-hmm. It’s hard to find a practitioner who really knows what they’re doing with spady. Yeah. Um, and for those that don’t know spondylolisthesis, it’s derived from the Greek words spondulo meaning spine and lithe meaning to slip or slide. And it’s really when one bony segment of the spine, Uh, slides either anteriorly or posteriorly. More common is an anterior list thesis where, where the bone slips forward, right? And the thing about Spady is that, you know, if you’re just treating yourself for back pain, the things you do for back pain, like if you went for a 45 mile bike ride ride and you got back pain, or you drive a truck and you got back pain.
Or you know, you are a personal trainer or you do a lot of exercise or CrossFit and you got back pain. Those are different things that you would do than you would do if you have spondylolisthesis. A lot of the things that we would wanna do for spondylolisthesis are actually contra, like the regular back pain exercises.
A lot of that stuff is actually contraindicated for spady people. Hmm. So that’s one example where getting an X-ray would actually. Benefit you. Mm-hmm. Because you do wanna know if you have this, this condition, this spondylolisthesis, because if you’re following the Mackenzie protocol, for example, with Spady, it’s kind of catastrophic.
Caitlin:You’re thinking in terms of just kind of repetitive motion type of treatment in extension or inflection. Can you go into a little more detail about why, why something like that would be detrimental for a spondylolysis?
Dinneen: Yeah, the Mckenzie protocol. Is, you know, in shorthand, and I know this isn’t doing his whole body of work any justice, but the shorthand and what a lot of people have taken away from it is that laying on your abdomen and doing a press up through your hands and upper back, uh, that sort of prone.
Extension exercise. That’s sort of like the shorthand, um, catch off for what people think of when they think of the Mackenzie protocols when you’re doing a backend laying on your abdomen. Mm-hmm. And for people that have this, Um, anteriorly thesis where you’ve got this bony segment, it’s unstable, one segment is slipping forward, you know, going into, uh, a deep extension, any deep range of movement really, but going into a deep extension, such as in the Mackenzie protocol, will actually make it worse.
Right. And, uh, I I, if I had a dime for every client who’s gone through therapy and been. Put through the Mackenzie protocol. Mm-hmm. Um, even with anterior listhesis, I, you know, I really just, I don’t understand
Caitlin: it, but maybe this speaks to just kind of our, our gaps in the healthcare system. But a lot of people become so, Reliant on like going online and looking for videos of exercises to do to treat their pain.
And we’ll stumble upon something like that that’s kind of widely, uh, accessible or there’s lots of videos on it and it’s pretty user friendly and you can do it at home and you can treat your own back is kind of the, the talking point of Mackenzie. So I think also just a lot of people will fall into kind of a broad treatment that might not be appropriate.
When they don’t have the means or support to seek out the right kind of professional to treat their specific condition, right, they’re like Right. Tools for the specific job is really important.
Dinneen: Yeah. And, and as you mentioned, the right provider for your specific condition, I think. Yeah. Uh, you know, if we could, if somebody could come up with some sort of software database whereby you could type in, I’ve got these four things going on, who should I see?
And it’s gonna crisscross. You know, the appropriate professional training. You know, when you go on online for mental health professionals, it’ll show you what those people are specialized in and you can like pick out of a dropdown if you want somebody that does cognitive behavioral therapy or trauma informed or you know, something like that for the back pain industry would be really, really helpful.
Caitlin: Mm-hmm. Mm-hmm. Oh, definitely. Yeah.
Dinneen: Um, the other thing I wanted to speak to really quickly in my own, you know, something that really, um, kept me from finding my solutions was that I realized very far into my journey that, um, I had some pretty significant modic changes in my spine. And this is definitely like the bastard child of the low back pain world where nobody’s really looking for it, nobody’s really diagnosing it and nobody’s really treating it at all. And you know, my theory is that it probably has a huge amount. Of influence on people that walk away from a bazillion doctors and can’t find any solutions and just have like non-specific low back pain diagnosis.
And so for those of you that are listening that are wondering what are modic changes, is the term used to describe the changes of the vertebral endplate? So when you look at like mm-hmm. A bone, a vertebra, there’s a top and a bottom, like a ceiling and a floor. And that’s the endplate is the top and the bottom.
And it’s related to spinal degeneration and sometimes, you know, disc degeneration and compression and pressure, and they’re called modic changes. After Dr. Modic, who was the first doctor who who identified and classified these degenerative nplate changes, and what ends up happening is, Sometimes there’s like a, you know, we think about disc herniations going out into like the spinal canal or a lateral disc herniation, or a posterior disc herniation sometimes.
Mm-hmm. There’s so much pressure that the endplate actually gets, uh, broken by the discal pressure. Right? So instead of the disc going out, it kind of goes up and breaks the endplate, and then you get like, You know, arterial infiltration of the disc space and nerves and things that aren’t really super active.
Start to go into the vertebral endplate because there’s been a break. There’s been a, the introduction of oxygen via this, uh, protrusion. To be via this break in the endplate and then there, and then, and then it becomes an inflammatory disorder. So now you’ve got this thing in the middle of your bone and it’s, you know, the skin’s been broken essentially, and now you’ve got inflammation as set up in there.
Or sometimes there’s a little infection as well, gets set up there. And I think that this in particular is a good sort of, Transition to the discussion about inflammation and nutrition and things like that because I, I think a lot of people are walking around with modic inflammatory changes in their vertebral bodies that nobody’s really looking at, and nobody’s really trying that hard to identify nor treat.
Caitlin: Yeah. And I know, uh, in our discussion prior to this podcast, we did talk about going down this avenue of, um, nutritional treatment specifically for inflammation. Specifically for pain, and I think chronic pain. This is super important and, uh, this could be a whole podcast episode in and of itself. So just for those listening, I wanted to say that, um, Dinneen.
And I determined that we would touch on this topic a little bit, but maybe I’ll have to have you back at another time, Janine, to talk specifically about nutrition and inflammation and systemic inflammation, chronic pain. Cause that’s something I’ve learned a little bit about here and there, but I’m sure you have a lot more to say on it.
I just wanna say too, that if anyone listening is interested in going down that avenue and exploring it a bit further, Dinneen also does nutritional coaching.
Dinneen: Yeah. I mean, we could certainly chat about this in 20 different directions, but what I will say on the topic is the following. You know, I, I talk to my clients about the inflammatory load that we’re carrying at any given time, and this is even more relevant given the age of Covid pandemic.
And so at any given time, you know, inflammation is a natural body, the body’s natural process of managing injury, insult, or infection, right? But let’s say you’ve got allergies, and then let’s say you, you know, break your ankle and then let’s say you’ve got something going on in your back as well. Your inflammatory load is really high, like just carrying around allergies all the time.
You’ve already got a heavy inflammatory load and then you add a couple of insults or injuries. And your body’s working really hard to manage additional load, um, that the inflammatory processes of your immune system, is it, it gets a little handicapped. The more, the more crap you put on the truck as it were.
Um, I like to make an analogy to a game of Jenga. Remember that game with the blocks? Mm-hmm. Yeah, you pull out the Jenga. So, I think your immune system is a little bit like a game of Jenga and if you load it up too much, um, something eventually gives and. You know, managing, managing inflammatory insults as best you can with whatever tools you have at your disposal at any given point in your life is always a good idea.
Right? It’s gonna help us live longer. Mm-hmm. Um, but definitely feel better. We’re trying to get out of. Yeah, definitely for trying to get out of like an acute injury or, or a chronic injury. Um, if, you know, things make you inflamed like, oh, maybe I shouldn’t eat that pint of ice cream, cuz I get really inflamed from it, then don’t eat the pin of ice cream.
That’s overly simplistic, I realize. Yeah. Yeah.
Caitlin: Yeah. And I like that analogy of the Jenga. I’ve, I’ve heard an analogy from, um, someone that I really admire and follow, uh, Greg Layman, who uses a, a bucket metaphor of like, there’s only so many things that you can put in the bucket before it overflows.
Right? And those are like all, all the lifestyle factors and mm-hmm. And I think it’s a, It’s a helpful image in some ways too because it helps people understand that they have some control over a number of factors in their life, right? Where, you know, sometimes there are so many things that feel out of, out of control when someone is, especially in chronic pain or in pain for a long period of time.
And, um, I think by kind of identifying that there are multiple factors outside of just like the musculoskeletal things like. Position and, and exercise and movement and mobility and strength and, um, all these other lifestyle factors, including your diet and your sleep and your rest and your recovery and your stress levels and your job and home environment and all of those things play a part in contributing to our symptoms and that.
If we can get a handle on just a couple of them, right? Like if just a couple of them feel manageable, maybe it’s not so overwhelming in the big picture, and you can keep yourself just below that threshold of a flare up or symptoms by managing multiple different factors. So, And when I have talks with clients about this and, and this kind of brings us into our topic of education, I think it a lot of, a lot of kinda light bulbs go off and people find that, that, oh, actually there, those are things, there are a few things in there that I can like actually get a little bit of, of control over my life.
And if any one or two of those things is managed in a certain way, it just, it just keeps you below that threshold of, of your symptoms. Coming back or getting inflamed or, uh, showing up again as pain.
Dinneen: Yeah. Really well said. Really well said. I, you know, I, I also, I use the, uh, this other analogy, I use the garden analogy with my clients, so you’re like, oh, I’ve got some land.
I wanna, I wanna grow a garden. I want it to be beautiful and healthy and nourishing. You’re not just gonna walk outside and throw a bunch of seeds on this patch of dirt, right? In New York City, you’re gonna take out like the cigarette bots and the. Twinkie wrappers, you know, you gotta clean up the garden and take the weeds out.
Mm. And till, till the soil before you’re gonna throw in things that are gonna help the soil grow and produce. And so it’s removing in, in, in my world, it’s removing the Ts. Mm-hmm. Like one of the things that are really, obviously, like I talk to so many clients and one of the first things they all say to me is, I sit too much.
Well, if you already know that you sit too much, then that is something that you can take action on immediately. Yes. Like grow your garden. You wanna take the weeds out, you wanna remove as many s that are glaring. And, uh, you know, sometimes we need a professional to hold up a mirror and say, yes, do that.
But a lot of my clients already know a lot of the things that they should be doing. And on this topic of what you’re referring to about lifestyle factors and the bucket, And education. You know, you and I are like, kind of like, how do we educate all these people from the ground? And you know, I have a really, really simple solution.
And the solution is that when somebody goes to their doctor and they have back pain, I don’t think they should be sent to physical therapy. I think they should be sent to occupational therapy first. Oh, interesting. Okay. And then after four weeks of occupational therapy, then they should go to physical therapy after they’ve cleaned up all their shit movements.
Otherwise, you’re just planting in a dirty garden, like how are you gonna train somebody to do these 10 exercises when they’re not even. You know, standing in alignment or, you know, they’ve got so many other things that are impinging their, uh, uh, a healthy movement pattern. Why don’t you, you know, clean up the lifestyle things and take out some of the aggravations and then build the exercises on top of more healthy daily movements.
That’s kind of what I’m doing with my clients, actually, but it would be a lot easier if people got this training from, from, from our healthcare system. Yeah. All of the things that I teach my clients, uh, for example, in my online course, you don’t have to have a diagnosis. There’s a whole bunch of basic things that everybody can be doing better and everybody could be more cognizant and aware, um, and mindful of how they’re doing certain things.
And it applies to whether you have a herniation or stenosis or spondylolisthesis or whatever, like improving movement. And lifestyle, um, habits is sort of like a universal language that we would all benefit from learning regardless of what hmm, your diagnosis is. So the same principles are gonna apply across all diagnoses for basic movement improvement, lifestyle improvements.
Sure. Things like how you’re sitting, your work set up, how you drive your car, how you pick things up, how you open a door. Yeah. You know, all that stuff. Gotcha. It doesn’t matter what your diagnosis is, it just kind of how you navigate the world?
Dinneen: So I wonder if, if we got some of that sort of basic lifestyle, basic movement training into people and then, you know, I think for a lot of people just having that body of knowledge, um, I improves their symptoms because they’re not, they don’t continue to aggravate the injury.
Mm-hmm. Because A, you’re just teaching them to move more mindfully, and that in and of itself, Is worth its weight and gold.
Caitlin: Yeah. Yeah. I feel like I’ve gotten a lot of that, um, for myself and for, uh, patients who have been exposed to this method from, um, somatics and from the Feldon Christ Method.
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Again, just leave us a little review. Shoot your screenshot to email@example.com and I will send you this free gift that I think will really make your neck and shoulders feel great. That’s all. Thank you so much. Back to the interview. So Maddox and the Feldon Christ Method, I think it’s a pretty powerful system for helping people move efficiently or find ways to move.
Natural, everyday type functional waste, but. Without pain by exploring kind of in more of a mindful way, exploring motions in a number of different ways and contexts and relationships to gravity, um, I think it builds a lot of like trust for the. The nervous system to be able to, yeah. Have more movement options available cuz this is one of the things that I see a lot in the clinic when people come to me, especially when they’re just, just kind of getting through the first several days of an acute episode of back pain, is there aren’t a lot of movement options available.
Right. The kind of person who has to lean backwards and push their hands into the chair seat and lead with their hips to stand up because forward flexion from their hips and their lumbar spine just isn’t an option right now. You know? So people find a way that we’re really smart at kind of adapting, instantly adapting and finding a way to move that creates less pain.
But, um, I found some systems like, um, some of my somatics training and my film Christ Training to be incredibly powerful for helping people just kinda regain trust in normal motions that they’ve lost. And I think people in a more of a chronic condition don’t even realize how much they’ve shifted and adapted their motion.
To limit their choices over time. Right. It feels like, like they don’t realize how much their, their options have shrunk because that’s just the baseline that they’re living in. Mm-hmm. And, um, yeah. And so I think there’s, there’s, I. A lot of tools in certain systems out there that can just help people, like you’re saying, in, in, in every day.
Going from sitting to standing, rolling over in bed to get up out of bed in the morning, pushing and pulling a heavy door, um, and all of those things. I think there are ways that I think folks can be able to find ways to just expand their mobility options. So that they’re not so just kind of so limited in, in moving one, one specific way and any other way is gonna hurt
Dinneen: the work that you’re doing.
Incorporating that into, um, a rehab setting is incredibly invaluable. Um, and f you know, from my perspective, I think one of the issues here, and one of the things that those practices speak to is that so many of us are moving through life. Just the way we move through life, like this is just the way I do it.
This is just the way I get up and I get down and you know, getting out of a chair is not something that has required up until whatever point of injury. It hasn’t required awareness. Yes. Yeah. And so I think a lot of people, even even fitness pros, I think a lot of people are moving through their daily lives, through their daily movements without awareness and very quickly, and those two practices felt in Christ, in somatics.
Um, requires someone to slow down mm-hmm. And become aware and sense, um, in a pace and through a framework that we’re not trained to move that way. We’re not trained to listen and feel and sense and process. And so I think at a very base level that’s incredibly valuable for somebody, uh, trying to move with less pain.
Mm-hmm. So if you don’t, don’t take Caitlin’s classes yet on those things, you better go do it. Probably not when you’re an acute injury, but yeah.
Caitlin: Well, uh, yeah. Yeah, I would agree with that. Depends on where on the spectrum.
Dinneen: Speaking of which, can I, can I take this on just a little tangent because you mentioned spectrum and we’re talking about awareness and so from the educational standpoint, You know, one of the, one of the most important interventions I depend upon is getting people to a new place of understanding about their experience.
Dinneen: And their perception and better understanding about their individual back pain so that I can lead them to a place of knowledge, empowerment, responsibility, and competency. Right. Hmm. One of the first things that I do with my clients is, is help them to understand that their back pain is not, the amount of back pain you’re experiencing is not commensurate to the amount of brokenness or mechanical.
Damage in your back. Yeah. And setting people up to understand that the nervous system trumps the musculoskeletal system in prolongation or remediation of pain. Pain processing happens in the nervous system, right? Yeah. And so one of the first things I do with my clients on the topic of perception, since you were talking about somatics and feld in Christ, that’s retraining perception.
Coupled with movement, right? Mm-hmm. Um, and one of the first things I do is a, is it’s a purely intellectual sensory experience. And I help people to understand first that, and this is really important, so if you’re listening, lean in pain, pain. Perception of pain happens on a spectrum, right? Mm-hmm. And so, so many of us, when I was teaching in the Netherlands, um, four or five years ago, I did this, I was doing this exercise with my clients, with my, with my students, my trainees rather.
And um, and they were from all over Europe. And when I said, what are the other words you have for the, the discomfort in your body? Somebody raised their hand and said, you have so many more words in English. Than we have in German or in Dutch. Interesting. It’s a lot harder for us because we don’t have as many words.
And I said, all right, we’ll use English words that you can think of. Um, and so if you plot, if you learn to listen before you say ow or hurt or pain, you know, one of the first assignments I give my clients is you’re not allowed to say pain hurt or ouch in the first two weeks of us working together. Hmm.
So when you get that knee jerk kind of sensation in your body, Sit, breathe, sense and label it something different. Yeah. Could be pinchy, could be tight. Um, and in that way they’re starting to develop a better both sensory, perceptive and verbal vocabulary about the sensations that they’re feeling. And until we have this spectrum mapped out, mm-hmm.
And until we have this awareness of different types of sensations, you know, everything is pain, you’re always gonna reach for the pain pills and the big hammer. Mm-hmm. Right. But sometimes it’s a little achy. Yeah. And maybe you just need rest, or sometimes it’s crampy and pinchy and tight and maybe you need a massage or a therapy ball rollout.
Mm-hmm. So developing this, um, vocabulary and this awareness of the Spain’s pain spectrum is the first step in being able to figure out which tools are then appropriate for that particular sensation. Yeah.
Caitlin: Yeah. I love that.
Dinneen: That’s a, that’s a whole thing that I call reframing
Caitlin: pain. Yeah. Thank you so much for that, Janine.
I think the, the, the words are so important and I’m big on that too, kind of moving out of just describing everything as pain because, um, I think particularly when it comes to the low back, a place that feels. I, I find just in my experience and just reporting from a lot of my patients, it’s feels like more of a scary, vulnerable kind of part of the body to feel sensation in and mm-hmm we feel sensation there.
Like we feel sensation in the other part of the body, but I think people develop a really intimate relationship with the types of things they feel in their back. And, and I’ve encouraged patients at times to see it as like, yeah, my back feels maybe tired or worked. But, mm-hmm. You know, like, like we do exercises for that region of the body, and if you exercise any muscle group in your body, you’ll feel muscle soreness potentially to, you know, hopefully a kind of low grade muscle soreness that resolves within 24 to 48 hours, but some kind of muscle soreness.
It might feel worked, it might feel a little achy in the musculature afterwards, but people kind of freak out if they feel that in their low back. And it’s like, It might feel worked and a little sore like any other part of your body when you do some exercises. So I also just cuz because my, my framework primarily as a physical therapist is at some point getting people to active treatment, which is exercise.
Mm-hmm. How do we talk about what. Things feel like during and post exercise because you feel a lot of intense sensations in any part of the body when you’re working at a little bit higher level. So, so I think it’s really key in that department as well. Um, just to have other words to describe, um, sensation.
So, so important.
Dinneen: Yeah. Yeah. I mean, once, once somebody is over desensitized to pain, uh, all, all incoming stimuli is going to reproduce. You know, your body’s gonna feel like pain. Yeah. You know, even if you. Touch them with the feathers tension. That’s like, that goes back to that, um, yeah. Story that Lorimer Mosley talks about, about being scratched by a branch on a hike, right?
Mm-hmm. Yeah, I had a client who we had resolved her back pain and, um, she was a spin instructor and three months down the line she called me because her back pain had come back and we deconstructed the, the exact event of when her back pain reappeared and. We determined that she had gotten up on the pedals on the bike while she was teaching a spin class.
And the wire from her microphone was sort of slapping against her back as she was cycling. Hmm. And that sensory input of the wire touching her back, brought her right back into that, that place of oversensitivity. Yeah. And brought back all the pain. Yeah. Even though it wasn’t a painful sensory input.
Caitlin: Yeah. But for her it was. Yep. Right? Yep. Yep. It’s the, yeah. And this, this kind of goes back to, just to circle back to how we started this conversation, because I think it’s a really key topic, is that the amount, the degree of mechanical changes, structural changes might not correlate with the level of pain.
And I think it goes back to what I said early on about the imaging. You know that, that it is all. Perception. And it’s learned and it’s remembered in the nervous system and um, and in the brain. And it, there’s a huge spectrum that, that the, the severity of that pain can present on that isn’t. Proportional isn’t always, or doesn’t need to be proportional to the actual degree of mechanical injury.
Um, I think that’s kind of a key thing for people to understand when they’re working through pain.
Dinneen: Yeah. On that topic, you know, we talked a little, we touched a little bit about inflammatory load a little earlier in our discussion, and equally important is neural load. Mm-hmm. Or, or stress load, right?
Yeah. So we can’t actually understand or process if our, our, our nervous system is so overloaded, so stressed, not sleeping. Um, over desensitized from living with pain for so long. We’ve gotta find ways to tame the pain flame in the nervous system. First. Mm-hmm. Um, because until we can do that, it, people aren’t really even open to understanding.
You know, when you tell somebody that, you know, pain is, uh, a dysfunction of the nervous system or it’s, it’s your perception of it, they hear, it’s all in my head. Mm-hmm. They’re not even in a place of openness. That their nervous system is contributing, um, to keeping them in a place where they’re not able to perceive or sense differently or understand or make cognitive behavioral shifts, right?
If you’re so overloaded, neurally and through stress, you’re not in a place where you can make that cognitive shift that you need to make to start to retrain your nervous system to not be so sensitized to sensory inputs and to take a, a more constructive. Direction with, with things that are incoming.
Mm-hmm. It’s hard, it’s hard to be, it’s hard to take responsibility and to, to make changes when you’re completely overwhelmed is really the Yeah. The
Caitlin: bylaw for trying to do anything, I would say. Yes. Yeah. Yeah. Totally. Thank you for that because there, there is, I, I, I have read some discussion kind of in the research of pain science about this, this talking point of like, it’s, it’s in your brain, the pain is in your brain or whatever, and then people are like, like, yeah, you’re gaslighting me, you’re saying it’s all in my head that I’m just making this up.
It’s like, no, no, no, no. That’s not what we’re saying. That I do like kind of going, going the direction with education of, of educating, like you said, on the nervous system and that it’s, it’s in the nervous system, and the nervous system is in everything. It’s in every part of your body and, and it’s in your brain, you know, it’s like all of it.
And it’s your sensory system and it’s the way your sensory system takes in your environment and your life and everything else is going on around you. So it’s like, it’s, it’s everything. Um, when we’re talking about the nervous system,
Dinneen: And how you describe your, you know, I listen very intently when I ask people, tell me what’s going on with your back, because there’s so much gold in Oh yeah.
How people narrate their own story, right? Yeah, yeah.
Caitlin: Part. Where do you think your pain is coming from? What do you think’s happening? Why do you think you feel more pain at certain times and less pain at other times? Like those kind of questions.
Dinneen: Right. And you Oh yeah. You hear that they’re carrying around like falling off a horse when they were seven and their orthopedic spine specialist told them they had a spine of an 80 year old.
And, you know, all this stuff is playing a part to, um, our ability to, to move through. If, if we can find that. Fortitude to move through. We have to sort of disassemble a little bit of our own narrative and our own identification and, and self-identification. You know, after living with pain for a year or two or three or four, it is really hard to unwind somebody’s, uh, sense of self, uh, away from their injury.
Yeah. Yeah, you’d think they wanna move through it, but it, it’s been so long, it’s become such a, a strong part of how they relate to the world and their own body and their mistrust of their own body. That, um, understanding that and, and, and wanting, getting them to a place where they want to think about it and talk about it and live it differently.
Mm-hmm. You know, that’s, that’s part of the educational process as well. Yeah,
Caitlin: for sure. Like how do people just, what is their relationship with their condition and their pain and what’s their story? Yeah, there’s so much in that. Um, One thing I wanted to, um, ask you about Janine, cuz I’d like to, uh, tell our listeners a little bit of the specifics of what, what you offer and how people can work with you if they, if they are like nodding their head like, yes, yes, yes.
This is kind of helpful that I need right now. Um, you, you had mentioned that you work with a fairly specific demographic that is also. Your own demographic and, um, and specifically the kind of mechanisms for back pain or changes that you are going through in, uh, at kind of the stage of life that you’re in.
So I was wondering if you could speak a little bit more about that, homing in on, uh, a little bit more of a niche of the population and people that you work with and, and what are the key things in terms of, of working with back pain in this population?
Dinneen: Hmm. Thank you for asking that. Yeah. Yeah. So I, you know, Caitlin and I know each other through the yoga world.
I came up as a yoga teacher and then a, a teacher trainer for tuneup fitness. And so I’ve spent, you know, better part of a couple of decades, a deeply, deeply invested in the yoga world through, you know, the nineties and, and the early two thousands. And, um, It women, you know, throughout our medical system, as we all know, uh, women, there ain’t no research on the woman.
Nobody’s really looking at the woman. Um, and that’s no different for back pain. And I am completely convinced that the mechanisms for pain for women in general are different from the mechanisms of pain for men. Hmm. Uh, meaning the, the causes and the processes of how we develop, uh, mechanical, um, imbalances in the back, for example, but also women, um, between the ages of 30 and 65, and especially women in that age group who have done lots of yoga, um, have a very different, different process and different causes, uh, for pain than.
Then the general population, you know, I mentioned a truck driver who has back pain. That is gonna be a very different scenario than a woman who has been doing yoga five days a week for 15 years. Mm-hmm. Right? Yeah. And so for women, you know, we’ve got this hormonal fluctuation that happens. Every minute of every day.
Um, there’s a ligamentous laxity that happens within the lal phase of our menstrual cycle. There’s a whole different ligamentous situation that happens, uh, through childbirth, and nobody knows when that resolves itself after childbirth. It’s a whole big enigma. Hmm. And then there’s menopause, right? So through the course of a woman’s adult life, There is a ton of hormonal changes that affect our ligamentous laxity.
And then you take the women who are practicing yoga and you know, yoga is good for your back, is what we’ve all been, it’s been very well ingrained in us to think that if your back hurts, you should stretch it, and that yoga is the solution to everything. Sorry, I’m getting a little, getting a little snarky.
Um, but what I’ve found through my own experience and through many of my clients come from that place, come from that age group, and, uh, a lot of them have and continue to, to do yoga. The, the, the way the spine works, the way the body works is that the spine itself is not a structure of joints. A a, a complex joint that wants to be super bendy.
Hmm. There are places, there are joints in the body that wanna be bendy, that wanna be really mobile, like your ankles need to be mobile, but when you go up the structure, your knees need to be stable. Hmm. And then your hips really thrive on being quite mobile, but then your spine needs to be more stable.
Hmm. And then your shoulders can be mobile, but your elbows are not mobile. Right. So if you go every other sort of large complex of joints, that’s how sort of the stability mobility model works in the body. Hmm. And so stretching and becoming super bendy through yoga, that is not doing your back any good for like, once you can sort of touch your toes and you’re not stiff as a board mm-hmm.
That’s kind of good enough for your back. Like, you don’t need to put your head between your feet and twist like a pretzel. Um, you’re. The risk of, uh, especially with the hormonal changes in the female body, the risk of overstretching ligaments that are responsible for keeping the spine and the sacrum stable.
It’s, it, it’s a big deal. It’s a big deal. And you know, the women that I’ve, that I’ve worked with, I, I’ll just come right out and say it. Yoga creates instability in. Some of our joints and doing it more is not necessarily better. And because we’re a society that we always want to do things better and we want to compete, we’re often competing with ourselves when we walk into a yoga studio.
Mm-hmm. To. To do more to, to twist more or to forward bend deeper. Mm-hmm. Um, and that’s not really, you know, if you’ve got back pain and you wanna keep doing your yoga practice, your goal should be, um, to find a mid-range, probably no more than 60 to 70% of your end range, meaning how far you can go into a particular pose or stretch, and then to work on tightening up within that mid-range.
Yeah, that’s my advice for, yeah, people who like yoga who have back
Caitlin: pain mid range. I think, um, our friend Laurel Beavers, dof once said mid-range is the new black. I remember her saying that and I was like, it’s just like, let’s, let’s live in the mid-range for a little while. Not that, not that we can’t continue to explore end range.
Not that bad things will happen if we go to our end ranges, but like, how about we spend a little more time working in mid-range? And that’s just when she said, She has a way with words, but I just, that came to mind when you were talking about mid-range. I was like, yes, I want some t-shirt right now. Let’s let that be the basic for like, like our baseline, like work really well and efficiently and mid-range.
And then at times with, you know, with that foundation, explore, end ranges, maintain and ranges later in life. But yeah. Like mid-range is where it’s at. That’s where we live and that’s, and it’s important to be able to move. Well, I think, I think move well there have a lot of control over those ranges and then mm-hmm.
Bring that control with graded exposure towards your end ranges. Whereas I think some practices are, if you’re talking just on a kind of physical level, musculoskeletal level, there are a lot of things out there that are like, In range of the joint type modalities and, um, and if we’re always living there for like, all of our input and all of our, you know, exercise or movement that we’re getting day to day.
Um, I agree. Yeah. There, there’s, there’s work to do in the mid-range. It’s super, super
Dinneen: valuable. Yeah. And for people that don’t know what we’re talking about, Uh, we’re talking about range and what we’re really talking about is, you know, let’s say it’s your forward bend. Your range is how your end range is.
The very farthest you can go in a forward bend would be your end range. And Caitlin and I are talking about not going as far as you can go, just because you can like, Mindfully going to maybe 50 or 60 or 70% of your Yeah. Ability to stretch deeper and just stopping there and trying to find new ways to stabilize and work with your body and your breath in, in a middle range.
Not all the way at the end. Yeah. Yeah, yeah, yeah.
Caitlin: Thank you for describing that.
Dinneen:So, so yeah, on the topic of women, I think that, um, I, I think that a, you know, the women that I work with, they’re all go-getters. They all wanna do things on their own. They all know that if I just had the right tools, I. I can do this, but there’s the, you know, the way the back pain industry is set up and this is a, a, a smooth transition to retrain back pain and the back Rehab boss program.
Um, the way the back industry is set up is that when you go, when you, when you get back pain, a lot of people go to their primary doctor and say, I have back pain. Well, your primary doctor doesn’t. Really no squat about back pain. Mm-hmm. That’s not where he’s been trained to treat people. And he’ll often either refer you to another doctor or he’ll prescribe you an anti-inflammatory, an antispasmodic or an or a pain pill that’s really all your primary doctor can do for you.
Mm-hmm. And so a lot of people will go to a chiropractor or they’ll go to an Occupy. You know, you’ll start to see the same runaround that I did. Oh yeah. Yeah. Um, and so you know, all of those professionals, whether you go to an orthopedic surgeon or even a physical therapist, there’s, everybody’s really good at what they do.
They’re not really good at thinking outside of the box that they’ve been trained to do. Things in for whatever, however many decades they’re practicing their specialty. And none of those businesses, none of those medical practices or therapeutic practices are set up in such a way in that they have the time, the staff or the physical structure to be able to educate and support and follow up with people.
So there’s this little like, blind area. Even if you’re going to see an orthopedic doctor and you’ve got a great PT and you’ve got a nutritionist, um, there’s a lot of those practices aren’t really a, you’re not really able to call up and be like, you know, I did that. You know, I did that bird dog gave me, and for some odd reason I get this weird twinge in my ankle.
That dialogue is not like, Your PT can’t be like, can’t watch all of their clients, do all of their activities and be a place where you can go with a bazillion stupid questions and am I doing this exercise right? And you know, there, the businesses just aren’t set up for coaching support and accountability.
And so that’s where, that’s where I come in. That’s where my work comes in, is in that, in that space. Yeah.
Caitlin: Well, I will say too, um, I, I work in a. Clinic that does one-on-one treatments, so we, people can come to us and with all their questions, and I’ll take a big part of the session with, with questions in education.
I know a lot of PT clinics are not set up that way, and one of the things that I do see in PT as well, yes, I do one-on-one treatment sessions and I can watch everybody do all of their exercises and fine tune them with them and answer their questions. We hit a point where PT plan of care ends. And then the rest of life and exercise and going to the gym and going to dance classes and yoga classes, and ballet bar classes and spin classes is done without any further contact with the physical therapist.
And part of that is because insurance doesn’t allow a plan of care that goes beyond. A patient able to perform their activities of daily living, walking, commuting, going up and down subway, stairs, the things they have to do to, to, you know, to handle their daily demands. It really doesn’t cover care after that point.
And one of the things that we run into in physical therapy that’s really tricky is bridging this gap between discharge from pt. And then getting back into all your regular daily demands and more robust exercise classes and gym workouts without any guidance from that point on, you know? So yeah, I, I definitely see that as a gap in physical therapy as well.
And it’s, and, and I know something that’s kind of big out there in the conversation of like, like people who work with. More elite weightlifters and people who are going to like back to Olympic weightlifting and things like that. It’s like the PT in terms of coverage in our medical system, but people’s insurance can only take somebody so far, but doesn’t cover what they call return to sport, which is really unfortunate that we don’t get to follow.
Yeah. Our patients to that point.
Dinneen: I’m clapping, I’m clapping, I’m clapping. I don’t know if you know this, but my um, now 17 year old son just had a c l reconstruction this
Caitlin: year you mentioned? Yeah. Yeah. Ah,
Dinneen: And so that’s a tough one. He’s just been cleared for sport, but man, my part-time job for the last three months was I, I can’t tell you how many hours a week I was on the phone with insurance, fighting to get him a couple extra [00:05:00] weeks of mm-hmm.
Um, physical therapy. Yeah. Because he had accomplished his return to life. Yes. Parameters and they, they don’t cover return to sport. Like they don’t consider that you’ve got a youth athlete who’s gonna step on a football field.
Caitlin: Exactly. They, they, they’re not gonna cover. That’s got high risk of re-injury and a really long haul.
Yep. Rehab like, Up to a year if they’re returning to a sport where they’re gonna be running and cutting and jumping around an incom competi play, like there’s a much higher chance of re-entry there. So, yeah. Yeah, it’s a c l reconstruction’s, a really tough one in, in that arena, so I’m glad you brought that in as an example.
I have, yeah. I was pretty hell this year around here switch to, just switch over to self pay at that point. And, and keep, uh, keep following up with them once a week or every two weeks, um, and progressing their exercises and making sure they’re staying on top of what they need to be doing in the gym. It’s really important.
Mm-hmm. Yeah. But yeah, that’s not everybody can switch over to self pay when their insurance coverage ends. Yep.
Dinneen: Oh yeah. I mean, some of my clients, you know, they’re like, great, we’re doing great. I wanna get back on my road bike. I haven’t, I was gonna sell my road bike before we started working together and now I feel like I can do it.
Can you help me with that? And so I have them take a video and I have them. Ride their road bike. And, you know, I look at their positioning on the bike and luckily for me, my brother-in-law is a, a, a bike store owner. He’s been in the business for 50 years. Awesome. And I’ll share the videos with my brother-in-law and get some feedback about, you know, pedal position or seat position, or got clients that wanna return to golf and wanna return to weightlifting or whatever it is.
And yeah, I’m, I’m the one, I’m gonna help you get back into that yoga studio or get back into your dance class or, Um, can’t, I’m not much used for Olympic weightlifting, but I know the people that are. Yeah, exactly. So, you know, the other thing that, you know, the other I, I just wanna clarify here, I am not. I am not bashing, um, orthopedic surgeons or surgeries or physical therapists or all the other traditional lines of back care.
I am, uh, a conduit to those professionals and I can help you manage. Mm-hmm. Um, Which avenue is best for you, but I think, you know, part of the problem we’ve run into in our current state of care is that insurance is more likely to cover you for a back surgery than they’re gonna cover you for preventative.
Yeah. Um, lifestyle retraining. Mm-hmm. Right. So the first line of defense in back care currently is not the most conservative and people will often go to more aggressive treatments because it’s covered by their insurance, like you were saying. Yeah. Yeah. Yeah,
Caitlin: It’s a real conundrum. Um, and, and just to highlight what you said earlier about people being siloed into their specialties, I think that’s something that we can speak to all of the things that various professionals do really well and respect and honor them for that, and know where to refer people to for those specificities. But also talk really frankly about the holes in that kind of setup and the ways that it really disadvantages the patient that people are, and this is in all of healthcare, um, the way that.
Medical providers are so specialized that I, I can’t tell you how many times I’ve, I’ve seen patients that just get bounced around because they’re like, oh, no, no, no. If I, I won’t look at your hip until you go to this back person and they look at your back, and then you get an MRI for your back, and then you come to me with that and then I will look at your hip.
So it’s like, like people just get bounced around between. Specialists and no one’s connecting the dots and no one’s looking at the big picture. And I think it’s kind of one of the things that you said earlier in this conversation is like working with someone like you or, um, a team of people that, that work in multiple disciplines who are all communicating about a patient’s care, um, is, is really crucial and really key and, and definitely a missing element in our healthcare system.
Dinneen: Yeah, for sure. Hopefully we can change. Change the, change the dynamic. Yeah.
Caitlin: Dinneen, this has been really. Amazing. So many topics that we’ve covered here. It’s so insightful and, um, thank you for sharing all of your knowledge from all of your experience, um, working with your, your own conditions and your patients and um, or your patients’ clients.
Um, I don’t know what to call ’em. Call them these days, folks. Folks that you help out with their back pain. I like to end our practice, human interviews with a little bit more of a personal type question because I know as someone who has worked as a, a movement and yoga teacher and works as a pt, so many times we enter into.
Um, continuing education or professional development or learning and studying is for us, but really it is for us to better serve our populations that we work with. I like to follow up these interviews with a question about what you do that’s just for you or just for fun, or something that you’re engaged in that is kind of lighting you up.
So I was wondering if you could just end by talking about what you’re into outside of your professional work.
Dinneen: Sure. Um, yeah, I mean, despite having all those, um, Dreadful diagnoses in my spine. Um, I don’t have any back pain. I just wanna clarify that. Like I literally, I have no back pain. Um, because I do the work that I teach and I coach my clients with and, and, and it works. And I also don’t have, I don’t have an ACL ligament.
Um, and I’ve got a partially torn PCL ligament in one knee. Mm-hmm. Um, but I didn’t know that until two years ago. Mm-hmm. And I’ve been super active with, um, living with no ACL and Y, so you would think that I would be like not able to do anything. But I, you know, I ride my bike, I ride my bike around New York City a lot, and um, I go out dancing really frequently, like a couple of times a month.
I’m out. Boogieing down to, you know, house music and disco and, um, some hip hop around New York City. I got lots of DJ friends, shout out to my DJ friends in, in Bushwick. And, um, so I’m out and I’m dancing. I’m having fun and it’s great exercise. And, uh, I had given up, I had given up snowboarding. Um, when I tore my pcl when I found out, oh, I don’t have an acl L and that’s actually my PCL that was torn.
Um, I’m like, oh, that’s it. No more, no more snowboarding for me. I can’t play soccer. I can’t snowboard anymore. But then I had a little epiphany this past winter. I went on a snowboarding trip and didn’t board and I was like, well, if I get an ACL, PCL brace and I ride goofy, I can probably snowboard. So I’m gonna get back on the mountain.
I’m gonna, I’m gonna start snowboarding on the bunny hills. Uh, I never learned to ride switch, but I’m gonna, I’m gonna learn to ride goofy so that I can protect my left knee a little bit more. And I just started roller skating, which probably really isn’t good for my knee, but it’s definitely good for my back.
Caitlin: Yeah. Ah, I love it. I love rides. I mean,
Dinneen: provided, provided I haven’t, I haven’t really fallen yet, so I get, I’m quite careful. I’m not very good. Um, and I mentioned to Caitlin, um, Before we spoke on this interview that I found that this the without falling and without doing anything too dramatic on the, on the roller skates, what I found is that all the internal and external rotation of your hips to learn how to do like some artistic skating moves.
Mm-hmm. Not just skating around in a circle in a rink like I did when I was 10. Um, but all that artistic skating practice of turning your feet out and turning your feet in. Um, and even doing the dribbles on roller skates, it’s really done wonders for my pelvis and my SI joint. It’s really tightened things
Caitlin: up beautifully.
Yeah, that’s awesome. Yeah, I’m thinking about the kind of, um, almost like weaving, breeding movements on skates. It’s just all like, uh, abduction. Abduction we can just kinda squeezing in and pushing out and um, yeah. And that rotational moment that’s, um, Yeah, I think it feels really good getting on skates and getting, do roller skate movement.
Not very often, but yeah, I mean I used to, I used to a lot growing up and I’ve gotten back on roller skates a few times here and there. Um, I didn’t, this summer they opened up woman rink in Central Park as a skating rink in the second. Roller skating ring. Um, and at, at one point when I saw that, I was like, oh, definitely that’s happening.
And it hasn’t happened. I don’t know where the summer went, but time flies too fast. I, and then time to get over there. But, but yeah, I, I have, uh, fairly recently, I would say, um, within the last few years, I don’t think during the pandemic at all. I have, but I, I still do it every once in a while and, and I find that I can kinda like get right back into it after not doing it for a long time.
And it feels. Really, really good for me too. Kind of in my hips and low back.
Dinneen: Yeah. It’s fun. And you know, I, I gotta encourage people, you know, not when you’re in deep pain, but we have to, as humans, as bi petal humans, we have to keep challenging ourselves and we have to keep having fun. Yeah. And, um, And I, you know, I love learning new things and there’s a, there’s a great joy in feeling the wind in your hair on a bicycle.
Mm-hmm. Or on your snowboard, or, you know, doing something really frivolous and whimsical, like roller skating. Just, it’s just fun. And, and that’s, uh, you know, we gotta, we gotta work hard to maintain the joy in our life. So that’s part of my joy practice.
Caitlin: That’s so great. Paul. Well, thank you so much, Janine.
It has been lovely speaking with you. And I wanna end by telling folks about how they can reach you. I think you said you have a relaunch of your, uh, back Rehab boss program coming up online. If you wanna say a little bit about that, I don’t know if you have dates for that yet, but, um, maybe tell, tell people what they can expect from that kind of program or from one-on-one coaching with you.
Dinneen: Yeah, super cool. So both through the one-on-one coaching and through this online program called Back Rehab Boss, um, I help people understand, uh, the pain process in their body and help them develop the tools they need to. Confidently manage their back pain and their doctors, and not everybody that comes through the program is a hundred percent out of pain.
But everybody that comes through the program is a hundred percent more confident, uh, more empowered and more educated, and feeling really good about their options ahead of them. Mm-hmm. Which is a far cry from being hopeless and helpless and not knowing why you get back pain. Yeah. So it’s, it’s, it’s super exciting work and I’m really excited when my clients come through it and they regain being able to move the way they love to move.
So, um, I work with clients one-to-one through Zoom kind of all the time, and you can just email me for that. You can find me on social media as retrained back pain. If you go to my website, um, you can sign up for the waiting list for the Back Rehab Bus program, which I am gonna host, uh, two webinars, and then open up the online course, um, at the end of this month, early October.
So just go to retrain back pain on any social media or on my website. Go to programs and, uh, drop your name either for the newsletter or for the wait list for the Online Back Rehab Boss program. And, um, And we’ll get you in there and we’ll get you moving again.
Caitlin: Yeah. Awesome. And, and I’ll put, um, Dinneen, your, your social media handles and your website, uh, link in the show notes as well.
So if those of you wanna li who are listening, just wanna jump over there and, um, do a quick click through to see more of what Dinneen has to offer. You can do that. Thank
Dinneen: you so much. Thank you so much, Caitlin. This is really fun. We’ve got a lot of, a lot of things going on in common. I’m super excited for the work that you’re doing and, and your patients are super fortunate to have you and your in-depth body of knowledge and your experience to work with them through.
All kinds of things. So I’m super psyched for the work you’re doing and, and I’m, I’m really flattered and honored that you had me on your show. Thank you very much. Yeah, of
Caitlin: course. Same to you. And let’s catch up soon. We’ll get a coffee or something and talk shop a bit more.
Dinneen: Yeah, I’d love to do that. Go for a walk in Central Park.
Caitlin: Thank you so much for listening. I hope you enjoyed my talk with Dinneen today. If you have any questions, any comments, Any recommendations for the podcast, please send them to firstname.lastname@example.org. I will read and reply to all of your emails, and again, if you can really help us out here by supporting the podcast, subscribe or follow the show, it’ll help us spread these conversations far and wide.
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