Hashimoto’s and Back Pain
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Thyroid Strong Podcast Episode 138 Transcript
If we start to correct any sort of hyper-mobility, any sort of movement dysfunctions and start to address either from an integrative medicine or a functional medicine approach to that low grade chronic inflammation we can start to feel better.
What’s up lovely ladies, Dr. Emily Kiberd Here with Thyroid Strong Podcast, I am a chiropractor, a mama to Elvis and Brooklyn and I have Hashimoto’s what is currently in remission. On this podcast, I share simple actionable steps with a little bit of tough love on how to lose that stubborn weight, get your energy, getting your life back, and finally learn how to work out without burning out living with Hashimoto’s.
What’s up lovely ladies, Dr. Emily Kiberd. Here Today we’re going to talk about Hashimoto’s and back pain. And as a chiropractor since 2007, I feel like I’m qualified to do this. I’ve seen a lot of backs in my lifetime, not only in my clinic or been wellness clinic in New York, but also with a second location. Now in Boulder, Colorado, I’ve seen a lot of backs. And the evolution of how I look at backs has changed, right.
So at the beginning, it was just looking at the joints, seeing if they’re moving, if they’re not moving if they’re rotated, looking for joints that are stuck, and then giving a high velocity, low amplitude adjustment. And that was how I practiced for a little while. And then I started to integrate soft tissue work like active release technique, which shortens the muscle, you pin the muscle and then you take that muscle through its range of motion. So a little different than if you’re just laying on a massage table and getting massage, you are not working the muscle through all the planes of motion. And really the goal is to increase blood flow increased oxygen to the muscle as well as break up any scar tissue.
I then started to integrate some yoga. And at the time, I did a 200 hour yoga certification, really following an Anusara yoga style, which isn’t really around much anymore due to the yoga drama that happens in the yoga world, and a falling out of the honors our leader and then I started so I started to integrate some yoga therapy. And then I started to integrate some different forms of rehabilitation postural Restoration Institute and then dynamic neuromuscular stabilization, which looks at how babies move and breathe and stabilize their core and central eight their joints, naturally, the first two years of life and hitting those milestones, naturally, right on this primal neurological level. So I started to integrate that. And then I started to integrate kettlebells and StrongFirst training.
So as a chiropractor, you really adjust that much anymore, I find that if you find the right stability, and the right mobility in the right places, you don’t need an adjustment unless you know your breathing is altered or your breathing is out of whack. Or you do something like some really heavy work and maybe you pop or rip out but I really only adjust when someone absolutely 100% needs it. And I always integrate rehab and strength into it. And I do this as well in person with the Hashi ladies. And so I want to talk about Hashimoto’s and back pain, right because typically when you think of Hashimoto’s you’re thinking of shoulders, hips, knees, kind of the joints that make up the extremities or the pillars of our house, our shoulders and our hips, where there’s lots of big thick tendons crossing the joint. That is where we often get a slower tendon turnover and pain.
But I have come across and maybe it’s because I’m a chiropractor and I see people who come in with joint pain and muscle aches all day, I see a lot of how she women come in with low back pain. And so you know the Hashi patients that struggle with joint pain and back pain, this pain, it makes it difficult for them to think clearly to sleep, right. They can’t get to sleep, they’re kind of rolling and tossing and turning in bed and really enjoy their life to the fullest when you are in pain, especially back pain. It is next level like it makes you nauseous. You can’t think straight it really ruins your whole day, which in turn makes it harder to manage your Hashimoto’s diagnosis well, but luckily, there are solutions and we’re going to talk about those.
But let’s talk about the reasons for back pain. So yes, we know Hashimoto’s that hypothyroid component. The under-active thyroid component can lead to joint pain, right? Every single cell in our body needs thyroid hormone. And if there’s less active thyroid hormone happening circulating in the body, our joints get achy or muscles get achy and like I said it’s typically in like the shoulders right we have frozen shoulder syndrome is often goes hand in hand with a hypothyroid diagnosis but There’s also this element of chronic inflammation present with Hashimoto’s, which can make your pain neurons more sensitive. And then this can make you overall more sensitive to pain. So that’s one of the reasons is kind of low grade chronic inflammation.
A great way is to figure out what is the root cause of that inflammation? Is it the foods you’re eating? Is it a gluten full diet instead of a gluten free diet? Is it exposure to mold that’s causing this low grade inflammation, a mold and mycotoxins I’ve had lots of podcast guests in the past Andrew Campbell, Ann Shippy, and Jill Crista. So so many podcast guests talk about mold and mycotoxins. It is my kryptonite, so I talk about it a lot. Maybe it’s some heavy metal toxicity causing low grade inflammation, or parasites that you picked up you didn’t even know. So chronic inflammation can make your pain neurons more sensitive. And that overall, can make you just more sensitive to pain in general.
A clinical observation that I have noticed in my own clinical practice is this element of joint laxity, joint hyper-mobility, lack of tissue integrity, low muscle mass and the hypothyroid Hashimoto’s. Ladies, how does this translate into your low back. So if you think about if you’re looking at someone from a profile view, and their knees are traveling back towards their ankles, like back behind their ankles that hyperextension of the knee, that translates up the kinetic chain, right. So typically, they’ll have glutes that are just to put it simply kind of turned off. And as a nice travel back, you still want to stay over your center of gravity. So you’ll sway your back, you’re kind of dump your pelvis into this anterior tilt dumped forward. And you will have an excess sway or kind of like a banana back in your low back, which can compress the SI joints, the sacroiliac joints, as well as the facets, the facets of the joints on the back of the spine.
So that sway can increase low back pain and then it keeps going up the spine right mid back, right between the shoulder blades is typically really tight. And then the neck, usually you’ll see like a little bit of a chin jut where the chin coming forward, ideally, the ears would be stacked over the shoulders, but the chin will come forward, kind of trying to almost pull us forward trying to help us find our center of gravity. So that is how it can also translate into the low back this Hashimoto’s causing some low back pain.
The other thing is it’s just harder to maintain muscle mass with hypothyroidism. So less muscle mass means joints that aren’t stable, it can just trigger tightness and weakness or deep tendon reflexes will be more sluggish and slower. So if we start to correct any sort of hyper-mobility, any sort of movement dysfunctions and start to address either from an integrative medicine or functional medicine approach to that low grade chronic inflammation, we can start to feel better.
Obviously there’s biomechanics kind of life circumstances that happen that can also make our Hashimoto’s back pain worse, repetitive exercise movements, creating more muscle and balance. I’m thinking of people who are going spinning a lot, right. So they sit at their desk all day. Maybe they have short tight hip flexors and then they go get on a spin bike and just kind of exacerbate that shortness and tightness of the hip flexors. Another thing would be if you think about those hyper mobile knees and the sway back and the chin jut, you put that person in a set of heels, ooh, that is going to increase all of those symptoms more sway back right because it’s offsetting it’s pushing you away from your center, more chin jaw.
I know if I wear heels I have a headache the next day crunches or things that are working your superficial core, right we might want to do crunches to think we’re getting a six pack but really it’s a superficial muscle. Yes, it flexes you and kind of does that crunch motion, but it doesn’t necessarily stabilize your core when it comes to picking up something heavy. Like a deadlift, a squat, pressing anything like that. So overworking maybe some superficial muscles core muscles to get that nice aesthetic six pack but really those are made in the kitchen, a sedentary lifestyle.
know there’s a spectrum of how she ladies there’s a type A go, go go burn the candle at both ends, do double SoulCycle classes. That was me. And then there’s the other end of the spectrum which is a very sedentary lifestyle. de-conditioned maybe you’re hitting like 2000 steps a day. That can make your back pain worse that sedentary lifestyle. Cross the board exercise helps alleviate pain.
Lastly, any sort of poor posture or poor ergonomic setup especially since so much of our life is sat at the desk sat behind a computer these days for many of us In the world, poor posture, like a screen that’s too low, right? Ideally, you want your eyes to hit the top third of your screen, if you are looking at it, as if you’re, you know, sitting up straight, there is no person working on a laptop that has that, that one’s kind of down and hunched over their screen. You know, if your legs are crossed your feet on on the floor, all these things are going to just add that load that burden on the low back. In an ideal world movement, hydrates the dis, right that we should be able to flex and round out. And we should be able to extend and rotate and side bend. I know when we think of perfect posture, we think of one position, right wherever upright in our ears, or over our shoulders and our hips. And there’s, you know, a gentle curve in the low back.
But really movement is dynamic, and our life is dynamic. And we should be able to own all those movements. And so when someone is always stuck in maybe an extension position, I call it extension, compression, compensation, etc, when we do go to flex forward, if we’ve been scared to bend forward, if we haven’t done it, there will be a lack of it’s called imbibition, where you’re literally hydrating the disk and the material around the disk. And it will be literally like drying, cracked, and then someone bends forward to pick up a pencil and then they throw out their back. So you want movement, if anything, do not sit on the couch, especially if you’re in pain.
So how do we start to fix this low back pain? Well, I like to address functional moves, I call then the essential seven. And they could start with bodyweight. So a hinge a squat a lunge a push a pull a carry an anti rotate. And doing those you could earn that form with bodyweight first, and then progress to weight. And then it progressed to heavier load, which would work your core, right, that tank of strength on the inside.
Oftentimes, I have to teach women how to breathe and brace before they pick up a weight, right. And this applies to your core. So you don’t want to suck your belly up. And then you don’t want to draw up and in this very much a Pilates cue. If you’re going to pick up a weight, if you’re going to lay horizontal and reformer knock yourself out. But if you ever look at a baby stabilizer core, and how they learn it on that neurodevelopmental level, they never stuck their belly in, only a poorly developing baby will suck their belly in, they breathe down in wide into the low back latterly. And then they brace and they keep that little tank of strength. So I teach my women to do the same when they’re doing those moves. That helps put an eccentric load on the transverse abdominus. The muscle that wraps all the way around is like our core set, you don’t want to pull that corset tight.
When you pull a weight, you want to breathe into that core set, embrace some of the other muscles, your obliques, your multivitamin in the back, your diaphragm makes up the top of that kind of tank of strength and then your pelvic floor muscles make up the bottom of your tank of strength. I’d like for women to warm up properly. So this is other than doing those essential seven moves, number two would be warming up properly. And I’m not talking about laying on a foam roller, throwing your leg up on the table and hanging on the hamstring stretch.
I’m talking about doing a movement flow that recreates how we moved as babies, right. So a baby didn’t crawl before they learned to bring their knees up to 90, right. So when we’re babies, between month three and six, we bring our knees up to 90. And we earn that little brace in that little tank of strength in our belly. And then we roll it four and a half months. And then we rock on hands and knees. And then we start to crawl. And then we put one foot in front of the other kind of you know, if our hand if we’re on all fours, we bring one foot to the outside of a hand. That’s a tripod and then we bring our hands up onto a surface and then we stand right but we had to earn all those milestones. So that’s how I have women warm up. They’re not on a bike. They’re not on a foam roller than on static stretching. They’re literally recreating those moves that we learned how we learned our movement patterns on that neurodevelopmental level.
Another way to start to heal the back is to learn how to get stacked so you learn your breath down And why’d you learn how to brace to keep that tank of strength and then you stay stacked? Right? So if you go back to that image of someone standing, you’re looking at them for the profile view. Their knees are traveling back behind their ankles, their pelvis has dumped forward in the anterior tilt and maybe their route flaring. And they have this big sway back that would be not stacked unstacked you want your ribs stacked over your pelvis, you want your ears over your shoulders of your hips of your knees that stacked right. So at the top of a deadlift, as you’re pulling the weight from the floor and standing up, you want to get to that stacked position, you don’t want to push through and overextend your hips and arch your back, you just want to kind of sneak your hips right under your ribs, and squeeze your tush and dial your feet. So that’s number three is getting stacked. Number four would be just improving your posture and your ergonomics. If you think about your workout, it has maybe 20 to 30 minutes of your day, maybe up to an hour if we’re lucky, and have the energy and the robustness and the resilience. And then the rest of the day, if we’re sitting our workout is literally a very, very small percentage of our day. So every other minute of our day as and contributes to whether we are not we have back pain, how we’re sitting how our desk is set up. So I like to start from the floor, I did a lot of ergonomic assessments.
When I was in New York, I ran a whole corporate wellness division of my clinic called Urban wellness, Corporate Solutions where we went into companies, and we did ergonomic talks. And we did ergonomic assessments one by one, literally, employee by employee, I had a team of four, and we just went down the rows and would adjust the desks and teach people how to sit while still creating some dynamic movement, right. But they had to kind of find that optimal posture first. So I like to start from the ground up. So if people put their feet on the floor, and if their feet are really close, like their legs are parallel and have them step their feet wide, it creates a broader and just more stable base of support. So if you looked at your legs, kind of like a 90 degree angle between the legs, feet on the floor, wherever the toes go, the knees will point and then have them have their ribs over the pelvis. So sometimes we lean forward, that will cause back pain, right?
If we’re leaning forward and the muscles of our low back or lumbar paraspinal’s are trying to pull us back over a center of gravity or hips all day, that will kind of crank on your erectors. So have them find their ribs stacked over the pelvis and try not to flare their ribs, and then have them move their keyboards such that their elbows are right next to their side, right.
So if we’re reaching forward all day, you could even do it just like sit, reach your arm out. After a while you’ll feel your back crank on right because your back is trying to feel trying to bring you back to your center. So elbows down towards your sides, close to your center. And then you’re typing right, which means you might have to bring your computer closer to you or you closer to your computer. And then keyboard eyes on the horizon should hit the top third of your keyboard. So if it’s too low, you’re gonna put some books under it and elevate it. If you have a laptop, you just elevated your laptop, you don’t want to have little T Rex arms, typing on the keyboard, you’ll have to get a wireless keyboard and mouse so you can keep your wrist slightly below your elbows. So that’s how I improve people’s posture and give them an ergonomic setup. Lastly, you want to address that low grade chronic inflammation getting to the root cause.
Obviously, there’s like the core basis you can do right, eating properly hitting your optimal protein targets, trying maybe a gluten and dairy free diet. Maybe even going a step further with like a low histamine diet. Cutting out alcohol that’s pretty much how I eat is a protein veg Paleo approach a little caffeine and I don’t drink second thing would be optimizing your sleep. So minimum six hours uninterrupted. I know a lot of women, if they only get six hours are probably not functioning very well. So especially with Hashimoto’s eight to nine hours a night, lack out curtains, earplugs, I really love the sleep crown that’s been my favorite kind of eye mask thing these days and cooler, which helps chill the bed. It’s a pad that you put between your sheets and your mattress can set the temperature I like a good 55 During the summer, but then, obviously, around 68 or 65 degrees Fahrenheit during the winter. And I just sleep so much deeper. So prioritizing sleep, trying to minimize any sort of blue light on the face before going to bed. Then the last thing is making sure you’re exercising. Obviously, the benefit of the exercise because exercise is inflammatory is the rest of recovery the days off in between the days of exercise and then checking all those triggers and the environmental factors that could be contributing to that chronic inflammatory load with Hashimoto’s.
So holding on to more body fat causes inflammation but some of the environmental factors that I think of our mold, mycotoxins, parasites, heavy metals, endocrine disruptors, like pesticides, drinking out of plastic, so starting to walk that journey, right, all of these things that I just mentioned, I just mentioned five different things that you could do for your low back pain. Some of them are biomechanical. Some of them are exercise related and some of them are inflammation related.
So hopefully you took some piece of information hopefully you had a pen and paper with you. You took some information away maybe it’s just one thing. If you took one thing away, I would love for you to go to iTunes subscribe rate and review and tell me that one thing that you learned it means the world to me, it makes a total difference of sharing the message of this journey of healing with your Hashimoto’s specially using exercise as part of the solution.
Just share it and get the word out to more harshly ladies in the world. Thank you for listening. Every single listen warms my heart and every single person who DMS me and writes in or leaves a review. Oh man, it just makes my day so I hope you enjoyed this episode and I’ll see you next time if you enjoyed this episode are even learned just one new piece of information to help you on your Hashimoto’s journey. Would you do me a huge favor, rate and review thyroid strong podcast on iTunes, Spotify or whatever platform you used to listen to this podcast and share what you liked. maybe learn something new.
And if you didn’t like it, well shoot me a DM on Instagram Dr. Emily Kiberd I read and respond to every single DM I truly believe all feedback is good feedback. Even the ugly comments if you’re interested in joining the thyroid strong course a home workout program using kettlebells and weights where I teach you how to work out without the burnout. Go to DrEmilyKiberd.com/tswaitlist. You’ll get all the most up to date information on when the course launches and goes live special deals and early access bonuses for myself and my functional medicine doctor friends again DrEmilykiberd.com/tswailtlist hope to see you on the inside ladies.