Question of the Day.

Holy hell, yesterday was quite a day for the blog. With the interview Tony Gentilcore was so kind enough to provide, this page blew the hell up!! On top of that work was a good day, I thought about how Darkwing Duck was a completely misunderstood cartoon hero, and I came to the conclusion that Miley Cyrus only needs to look to Lindsay Lohan to know what her future will bring in the next five years.








I know, I thought that too. She’s just one line of coke away from breaking daddy’s Achy Breaky Heart.

I also had a consultation yesterday with a great new client who has had some pretty serious back pain for the past couple of years. She’s met with doctors, physios, chiropractors, Workers Compensation Board healthcare professionals, and all sorts of other people who looked at her, X-rayed her, MRI’d her, probably probed her like the aliens do to trailer park folk, said there was nothing wrong with her, that she was fine, and pushed her through the system. So after meeting with the collective brain power that garnished probably about $3 million per year through our health care system, what has that gotten her? A whole bunch of appointments with people who said she was fine and who would tell her, I kid you not,

Just because you feel pain, doesn’t mean you’re actually in pain.


So suffice it to say, she wasn’t too hopeful that a lowly old trainer, whose client had referred her to me, was going to be able to help, because what the hell did I know? It wasn’t Dr. Dean Somerset she was going to see. Well, after getting her to go through some test, many of which NOT A SINGLE ONE OF HER DOCTORS TOOK HER THROUGH, I figured out that she had an extension rotation intolerance (I talked about this on Muscle Imbalances Revealed, and go through how to determine it, and fix it with basic exercises and progressions) and some redonkulously tight illiacus and obliques with almost no rectus activity, coupled with QL overactivation, all on her right side. She had reduced mobility through her pelvis, hypermobility through her lumbar spine, and almost no mobility through her thoracic spine.  Sounds like pretty much everything Mike Boyle and Gray Cook have been telling us with their joint-by-joint approach to assessments that typically results in chronic low back pain for years, doesn’t it? To test it out, I took her through a short series of exercises for extension rotation intolerance, like these ones shown in this sexiest use of Zig-tech footwear this side of Sidney Crosby…

…and amazingly within 5 minutes, she said her pain went from a 5/10 down to a 1/10, and she said that she was so excited to train with me because she hadn’t felt that good in more than three years. Not bad for 5 minutes.

So after only spending 5 minutes with her, she got more relief from a simple trainer, someone who was able to identify that her movement patterns were faulty and work on correcting them versus spending countless hours and thousands of taxpayer dollars meeting with doctors and other health care practitioners to try to figure out a diagnosis and do some mundane exercise program on the elliptical that didn’t correct the movement pattern dysfunctions, the apparent question of the day seems to be……

HOW THE HELL could all these highly educated and extremely well-paid mofo’s not check out how she moved and see there was something seriously wrong with her movement patterns??!? No one bothered to try to get her to work her core properly, trying to get her to not cheat her spinal movements and feed into her faulty patterns. NO NO!!! They had to cash their cheques and keep up with their boat payments and to make sure their wives had enough Botox to get them through the next few weeks or their faces would wind up looking like they were melting candles in the hot sun.

Seriously. WTF.

She had no problems on her scans. Her bones were fine, so were her discs. There was no soft tissue trauma found, other than muscle tightness and weakness. There was never a formal diagnosis given to her, and I’ll be the first to say that “extension rotation intolerance” doesn’t count as a diagnosis for anything, except for faulty movement patterns.

Stuff like this drives me apeshit batty. The kind of stupidly pissed off angry that makes me want to hit the “ANY” key, except THERE IS NO ANY KEY!!!!!

Why didn’t any of her doctors, occupational therapists, physiotherapists, or other people involved actually LOOK AT HOW SHE MOVED!!??!? Now, I am certain there are more than enough qualified doctors and physios and OTs out there that would actually look at their patients moving, and come to the conclusion they may need to be re-trained on how to move their bodies properly, but this was an epic fail of the medical system, where the person got no better, actually got worse, and wound up costing the taxpayers a heap of duckets in the process. No wonder our health care system is such a train wreck that’s stretched to the limit, full of holes everywhere and failing fast.

So do you want to know what I’m going to do with her to get her back feeling better? I’m going to show her how to squat, how to deadlift, and how to properly get her core to work. She went through a return to work program where they would say “Now do a plank and a squat, and I’ll come back in 5 minutes and see if you’re in any pain,” but would never actually see if she was doing it right or not. What a lot of people need to learn is that a piss poor exercise done with piss poor technique will result in piss poor movements that cause piss poor pain. By not checking her movements to make sure she wasn’t trying to compensate for her faulty mechanics (obviously she was or else her movement patterns wouldn’t be complete shite!!!), she was actually feeding into the problem, not fixing it!! That’s like giving a crackhead a textbook on how bad crack is for the body, complete with a sample of crack inside so they could see what the effects of crack on the body are. That’s like having Douchey McDouchenstein telling you how he picked up two skanks on the weekend who wound up stealing his wallet and car and how you’re a sucker for getting married, even though she’ll steal your wallet and car. That’s like saying you could actually believe it’s not butter!!

Oh, I also got her to take out her belly button piercing, because it will help increase her core recruitment, and has worked in dozens of people with chronic mechanical low back pain, but I’ll save that for another post. If you want to know more about this crazy voodoo science, put something in the comments section below.

Sorry to go on a rant her today, folks, but I’m getting tired of having people come into me after seeing doctor after doctor after useless tit of a doctor and getting pushed through the system with no actual progress being made. If you’re a doctor, physio or chiropractor, I hope I didn’t offend you, as I know this was a one-time situation that doesn’t represent all the qualified professionals out there. But as doctors, physios and chiropractors, you have to admit, there is a LOT of this going on. Where there’s pain, there are problems, not necessarily where the pain is, but there is a problem.

About deansomerset

Certified Strength & Conditioning Specialist, Post-Rehab Specialist, personal trainer and probably the coolest guy my mom knows, I try to impart a little knowledge with a sense of humor to keep people reading. I've always thought if it's something that can grab your attention, you're gonna remember it tomorrow!!
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11 Responses to Question of the Day.

  1. Sara Lundy says:

    I enjoyed the rant – ha ha – so now I know where you release your tension — silly me I fell for the serious expression. I was just looking for your cell phone number to text u and this popped up. I will share my latest experience with the health care system next time I see you – yes unfortunately we are doomed! I enjoyed your segment on women not sharing info re menstrual cycle — you know that does not apply to all… How goes the book? Say hi to “the wife” for me. See u in a few weeks. Sara

  2. Jeffrey McCarthy says:

    My lady-friend has a belly button ring. Tell me your secrets.

  3. Danny says:

    It’s actually extremely refreshing to see someone as qualified as you are bash the medical system. These situations happen so often, and most people just go on to believe so much of what they say. I’ve even encountered people who’ve said, “My physiotherapist says the pain is all in my head.” Fortunately, I know great chiropractors that have helped people tremendously through something as simple as ART and Graston, yet when I suggest these things, I’m looked at as being “woo-woo.” Someone on the outside looking in can easily write comments like the “paying for their wives’ Botox as cynical,” but its SO SO TRUE! Glad to see I’m not the only one that thinks they don’t know SHIT MOST OF THE TIME!

    • deansomerset says:

      Thanks Danny. I’ll be the first to admit I’m by no means an expert (I think anyone who calls themselves an expert in anything involving the body is full of shit and not to be trusted, much like Jillian Michales), and I’ll be the first one to admit when I don’t know what’s going on, I’ll send a client out to a qualified health care professional who I’ve worked with in the past. BUUUUUUUUUUUUT, there’s a whole lotta professionals just phoning it in on a lot of cases, just trying to cover their butts and not screw up too badly so that no one tries to sue them. Hopefully the system changes in the future, but with public dollars funding the entire thing, I’m not counting on it.

  4. Kyle says:


    Great post. I’m almost finished up with the doctor of PT stuff soon and about ready to hit the streets. Luckily after the CSCS and a fond liking for Cook and Sarhman I actually know how to assess a pattern, not just dance around the problem. It’s amazing the stuff I see from fellow PTs (oh the chiros) and especially PCPs, although I do enjoy when manual work to anterior hip plus mobilize anterior hip plus strengthen posterior hip for a patient who spends 8 hours at a desk blows a clinical instructors mind (i must be an expert)

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  6. Cat Wade says:

    I very much enjoyed this as well. I am in a similar situation with a friend who has been passed around the medical system, has had low back pain for YEARS and is in constant pain…… she is 23 years old and has been told “The muscles in your low back just did not develop.” I am young in the profession (College Strength Coach) but did the functional movement screen on her, and we are going from there. This girl has NO movement in her ankles, knee pain, NO movement in her hips, and a lot of low back pain……. how can Dr’s and PT’s screw something like this up??? Any advice or insight for me as I travel down this path with her?

    • deansomerset says:

      Get a copy of Muscle Imbalances Revealed (available in the Products section) and go through the Myofascial material I present to get a good idea of what may be going on with her back. Try out the assessments with her and see if you can find anything that may be helpful in designing her program. Best of luck!!!

  7. Pingback: Saturday 11/27/10 | Derby City CrossFit - Louisville, KY

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