- February 28, 2024
“Usually the problem is that motion that’s problematic is occurring during all of your activities. The soul follows the rules of physics. It takes the path of least resistance. So if it’s easy to move there, it keeps moving there, and that’s what you’re trying to transpiration to make it easier to move at other places where you should be moving more.”
— Dr. Shirley Sahrmann
Shirley A. Sahrmann, PT, PhD, is Professor Emerita of Physical Therapy at Washington University School of Medicine in St. Louis, Missouri. She received her bachelor’s stratum in physical therapy and her masters and doctorate degrees in neurobiology from Washington University, where she joined the physical therapy sense and became the first director of their PhD program in movement science.
Shirley became a Catherine Worthingham Fellow of the American Physical Therapy Association in 1986 and in 1998 was selected to receive the Mary McMillan Award, the Association’s highest honor. She is a recipient of the Association’s Marion Williams Research Award, the Lucy Blair Service Award, the Kendall Practice Award, and the Inaugural John H.P. Maley Lecturer Award.
She has moreover received Washington University’s Distinguished Sense Award, the Distinguished Alumni Award, the School of Medicine’s Inaugural Distinguished Clinician Award, and an honorary doctorate from the University of Indianapolis. She has moreover received the Bowling-Erhard Orthopedic Clinical Practice Award from the Orthopaedic Academy of the APTA. She has served on the APTA Board of Directors and as president of the Missouri Chapter.
Her first book, Diagnosis and Treatment of Movement Impairment Syndromes, has been translated into seven languages. Her second book, Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines, has been equally influential in promoting movement diagnoses.
Please enjoy!
Listen to the episode on Apple Podcasts, Spotify, Overcast, Podcast Addict, Pocket Casts, Castbox, Google Podcasts, Amazon Music, or on your favorite podcast platform. You can watch the interview on YouTube here.
Brought to you by AG1 all-in-one nutritional supplement, LMNT electrolyte supplement, and Eight Sleep’s Pod Cover sleeping solution for dynamic cooling and heating.
The transcript of this episode can be found here. Transcripts of all episodes can be found here.
This episode is brought to you by LMNT! What is LMNT? It’s a delicious, sugar-free electrolyte drink mix. I’ve stocked up on boxes and boxes of this and usually use it 1–2 times per day. LMNT is formulated to help anyone with their electrolyte needs and perfectly suited to folks pursuit a keto, low-carb, or Paleo diet. If you are on a low-carb nutrition or fasting, electrolytes play a key role in relieving hunger, cramps, headaches, tiredness, and dizziness.
LMNT came up with a very special offer for you, my dear listeners. For a limited time, you can get a self-ruling LMNT Sample Pack with any purchase. This special offer is misogynist here: DrinkLMNT.com/Tim.
This episode is brought to you by AG1! I get asked all the time, “If you could use only one supplement, what would it be?” My wordplay is usually AG1, my all-in-one nutritional insurance. I recommended it in The 4-Hour Body in 2010 and did not get paid to do so. I do my weightier with nutrient-dense meals, of course, but AG1 further covers my bases with vitamins, minerals, and whole-food-sourced micronutrients that support gut health and the immune system.
Right now, you’ll get a 1-year supply of Vitamin D self-ruling with your first subscription purchase—a vital nutrient for a strong immune system and strong bones. Visit DrinkAG1.com/Tim to requirement this special offer today and receive your 1-year supply of Vitamin D (and 5 self-ruling AG1 travel packs) with your first subscription purchase! That’s up to a one-year supply of Vitamin D as widow value when you try their succulent and comprehensive daily, foundational nutrition supplement that supports whole-body health.
This episode is brought to you by Eight Sleep! Eight Sleep’s Pod Cover is the easiest and fastest way to sleep at the perfect temperature. It pairs dynamic cooling and heating with biometric tracking to offer the most wide (and user-friendly) solution on the market. Simply add the Pod Cover to your current mattress and start sleeping as tomfool as 55°F or as hot as 110°F. It moreover splits your bed in half, so your partner can segregate a totally variegated temperature.
Go to EightSleep.com/Tim and save $250 on the Eight Sleep Pod Cover. Eight Sleep currently ships within the USA, Canada, the UK, select countries in the EU, and Australia.
Want to hear an episode with someone who considers Dr. Sahrmann’s work a unconfined influence? Listen to my conversation with performance mentor Eric Cressey, in which we discussed why pinpointing the rationalization of lower-back pain can be so challenging, how seemingly unrelated meds can exacerbate pain, addressing and correcting suboptimal patterns of movement, improving thoracic mobility, defusing desk-bound damage, how to ask the right questions when seeking treatment for what ails you, and much more.
What was your favorite quote or lesson from this episode? Please let me know in the comments.
SCROLL BELOW FOR LINKS AND SHOW NOTES…
SELECTED LINKS FROM THE EPISODE
- Connect with Dr. Shirley Sahrmann:
2023 Speaking and Undertow Schedule | LinkedIn
- Essential Anatomy 5 iOS app
- Essential Anatomy 5 Android app
- Diagnosis and Treatment of Movement Impairment Syndromes by Shirley Sahrmann | Amazon
- Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines by Shirley Sahrmann | Amazon
- The Shoulder Joint | TeachMeAnatomy
- Becoming a Physical Therapist | APTA
- What is Translational Research? | UAMS Translational Research Institute
- The Vertebral Column | TeachMeAnatomy
- Ilium | Physiopedia
- Lumbosacral Transitional Vertebrae: Classification, Imaging Findings, and Clinical Relevance | American Journal of Neuroradiology
- Pelvic Tilt | Physiopedia
- Lumbar Spinal Stenosis | Johns Hopkins Medicine
- Traction: Types, Risks, and Aftercare | Healthline
- Relative Stiffness: What You Know, What You Don’t, and Why It Matters | MedBridge Blog
- Tensor Fascia Latae (TFL) | Physiopedia
- Hip Flexors | Physiopedia
- Hip Abductors | Physiopedia
- Hip Adductors | Physiopedia
- Piriformis | Physiopedia
- The Finer Points of the Quadruped Position | Functional Movement Systems
- How to Wall Sit: Techniques, Benefits, Variations | Verywell Health
- Prone vs. Supine vs. Prostrate | Merriam-Webster
- Human Movement System: Our Professional Identity | Physical Therapy
- What Is Metabolic Syndrome? | Johns Hopkins Medicine
- Lumbopelvic Rhythm | Physiopedia
- Anatomy Of The Psoas & Iliacus Muscles | Dr. Nabil Ebraheim
- Femoroacetabular Impingement | AAOS
- A Comprehensive Guide to the Infrasternal Angle & Compensation Layers | Conor Harris
- Pump Handle Motion and Skillet Handle Motion | MedicoPhysio Actors
- Should Lumbar Support Be Positioned on Your Higher or Lower Back? | Autonomous
- Moving Precisely? Or Taking the Path of Least Resistance? | Physical Therapy
- Pilates: What It Is and Health Benefits | Cleveland Clinic
- Anterior Superior Iliac Spine (ASIS) | Wikipedia
- Quadratus Lumborum | Physiopedia
- External Rectal Oblique | Physiopedia
- Paraspinal Muscles | Physiopedia
- Chronic Pain | Johns Hopkins Medicine
- Linda Van Dillen’s Research Profile | Washington University School of Medicine
- Enhancing The Movement System | Performance In Motion
- Peter Attia & Beth Lewis on Dynamic Neuromuscular Stabilization (DNS) | The Peter Attia Drive
- Dr. Shirley Sahrmann: Midlife Evaluation | St. Louis Magazine
- Shirley Sahrmann’s Lumbar Flexion Syndrome | Physiopedia
- The Confusing Concept of “Poor Posture” | Mobility Fit Physical Therapy
- Serratus Anterior | Physiopedia
- Latissimus Dorsi Muscle | Physiopedia
- How to Train Your Trapezius Muscle: Exercises & Workout | StrengthLog
- Stretching 101: Advantages and Disadvantages of Stretching | The Movement Athlete
- Kyphosis | Johns Hopkins Medicine
- Stretches for the Rectus Abdominis | eHowFitness
- Hip Bridges Are One of the Weightier Glute-Burning Moves — Here’s Why | Byrdie
- Shirley Sahrmann on Exercise and Aging Well | Physiospot
- Flexor Digitorum Profundus | Physiopedia
- How to do a Modified Push-Up | NASM
- Anterior Cruciate Ligament (ACL) Injuries | AAOS
- In-Toeing and Out-Toeing: Femoral Anterversion & Retroversion | SIM Physiotherapy
- What Is The Par Terre Position? | SportsLingo
- Scheuermann’s Kyphosis | Physiopedia
- Lordosis, Kyphosis, and Scoliosis: Know the Differences | Skoliosis
- AMA #41: Medicine 3.0, Developments in the Field of Aging, Healthy Habits in Times of Stress, and Increasingly | The Peter Attia Drive #231
SHOW NOTES
- [07:12] A unenduring terminology primer.
- [13:00] Why Shirley’s first typesetting is so influential among physical therapists.
- [15:54] The correlation between lifestyle and health hasn’t unchangingly been obvious.
- [18:16] Low when pain: not a diagnosis, but a symptom.
- [20:41] The trouble with overdeveloped abdominals.
- [22:32] What’s my problem?
- [30:14] The Movement Systems Syndromes (MSS) approach.
- [31:29] The wrong walk home.
- [33:01] Correcting bad habits.
- [35:00] Psoas it goes.
- [37:03] Other wontedly repeating culprits.
- [40:36] Pump handle and skillet handle.
- [43:41] The soul follows the path of least resistance.
- [48:00] Anterior superior iliac spine (ASIS)
- [49:20] How Shirley examines a new patient.
- [55:11] Assessing athletes vs. non-athletes.
- [56:18] Dynamic neuromuscular stabilization (DNS)
- [57:49] Collapso-smasho and squeezo-smasho.
- [59:10] Correcting low shoulders.
- [1:05:26] Stretching: yes or no?
- [1:09:56] Addressing my rectal stiffness.
- [1:16:28] When the spine doesn’t want to go withal for the ride.
- [1:18:38] How has Shirley made it to 86 with her physical and mental health intact?
- [1:34:32] What men should know well-nigh femoral retroversion.
- [1:38:44] If it walks like a duck…
- [1:41:11] Managing symptoms of Scheuermann’s disease.
- [1:42:49] Parting thoughts.
MORE SHIRLEY SAHRMANN QUOTES FROM THE INTERVIEW
“One of the things I unchangingly loved doing with patients was saying, ‘So, who taught you to walk?’ They say, ‘Nobody.’ I say, ‘That’s the problem.’ Just considering you’re doing it doesn’t midpoint you’re doing it right. You’re just doing it.”
— Dr. Shirley Sahrmann
“Exercise won’t transpiration the way you move. You have to transpiration the way you move, and that can modernize how muscles function.”
— Dr. Shirley Sahrmann
“Nothing is increasingly scary than ‘Here comes the pain. What did I do? How did I do it? How do I get out of it?’ And if you’re showing people, if you go this way, it hurts, if you do it this other way, it doesn’t hurt … they’re in tuition of [their symptoms], and they know what to do to subtract them.”
— Dr. Shirley Sahrmann
“Usually the problem is that motion that’s problematic is occurring during all of your activities. The soul follows the rules of physics. It takes the path of least resistance. So if it’s easy to move there, it keeps moving there, and that’s what you’re trying to transpiration to make it easier to move at other places where you should be moving more.”
— Dr. Shirley Sahrmann
“You want to ventilator your part-way of gravity, not pull it.”
— Dr. Shirley Sahrmann
“It’s not inevitable what’s going to happen to you. You can do things via lifestyle to modernize what your outcome’s going to be.”
— Dr. Shirley Sahrmann
“At least 70 percent of the people with when pain, it’s considering their hip’s not moving optimally.”
— Dr. Shirley Sahrmann
PEOPLE MENTIONED
GLOSSARY
- Pathology
- Glenohumeral Joint
- Glenoid Cavity
- Humerus
- Facet Joint
- Iliac Crest
- Stenosis
- Sacroiliac Joint (SI Joint)
- Tensor Fasciae Latae (TFL)
- Iliotibial Band
- Piriformis Muscle
- Psoas Major
- Psoas Minor
- Infrasternal Angle
- Lumbar Spine
- Thoracic Spine
- Intercostals
- Labrum
- Quadratus Lumborum (QL)
- Paraspinal Muscles
- Latissimus Dorsi
- Rhomboids
- Kyphosis
- Lordosis
- Rectus Abdominis
- Supine vs. Prone Position: Supine is lying on your back. Prone is lying on your stomach.
- Gluteus Medius
- Medial Rotation
- Lateral Rotation
- Femoral Retroversion
- Scheuermann’s Disease
The post Dr. Shirley Sahrmann — A Legendary PT Does a Deep Dive on Tim’s Low-Back Issues, Teaches How to Unlearn Painful Patterns, Talks Well-nigh Movement as Medicine (or Poison), and Increasingly (#685) appeared first on The Blog of Author Tim Ferriss.