Interview with Pete Egoscue
Pain Relief Expert,
Educator and Bestselling Author
Pete Ecoscue, an anatomical
physiologist since 1978, is the creator of the Egoscue Method¨
for safe, effective, and permanent relief from chronic pain without
prescription painkillers or invasive surgery. His exercise therapy
program is acclaimed worldwide, and he has been consulted by some of
the biggest names in sports. His books include Pain
Free, The Egoscue Method of Health Through Motion, Pain Free for Women,
and
Pain Free at Your PC.
Interview
by Janice Hughes and
Dennis Hughes, Share Guide
Publishers
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The Share Guide:
You wrote in your book Pain Free that chronic pain is sending us a
message that's different than the one we think we're getting. What do
you mean by this?
Pete Egoscue: We think we're getting the message of limitation, or
that something is broken, and I don't believe that's true. I think the
message we're getting is the body's only voice saying, "I can no longer
compensate with what you've given me, and you need to address the
situation." It's not that you're diseased, not that you're broken, but
you have to pay attention to the body's voice because you've ignored
all the other signposts that it threw up for you along the way-you went
right through them, or you didn't recognize them. So now it's using
pain, the loudest voice it has, and you will pay attention to this.
Before pain comes limitation, what we often think is just aging. You
know, we used to be able to get up on a step ladder, but now we can't.
And we think, "Well, I'm getting old; I'm not supposed to be able to do
that." We used to run, now we walk, or we used to walk, and now we ride
a bike. But we think that's normal as long as there isn't any pain.
Well it's not! The limitations are what we should pay attention to
first.
The Share Guide: You've written that you chose to be a physical therapist
as a direct result of going through a long rehab program yourself. What
was your personal challenge?
Pete Egoscue: I got wounded in Vietnam, and not to make a big deal out
of it, but it resulted in pain and limitation and so my quest started
because I did not want to accept that as a way of life.
The Share
Guide: You've written that
muscles that are not regularly stimulated are put on hold. It seems the
biggest factor causing so much chronic pain is that we don't move
enough, we're very sedentary. Is that right?
Pete Egoscue: That's half right. Never have humans been busier than we
are now. We are running from pillar to post so, yes, we do have
compensations that have occurred because of our lifestyle. But we are
still using the same body and we're still participating like never
before in activity. The problem is that the body has a system of
adaptation, and the adaptation is to the stimulus that we provide
it--so even though we're very active, and we're trying to be fit and
healthy, what's happened to us is that the posture muscles that were
designed to hold us upright have grown increasingly dysfunctional. And
this is escalating decade by decade, generation by generation. So
that's where all this chronic pain is coming from. We are moving, but
it's the body that we're bringing to the movement that's causing the
problem.
The Share
Guide: The body is pulled out of
joint and loses balance when it uses other muscles to do the work of
the major muscles that have atrophied. Can you talk a little bit about
compensating muscles?
Pete Egoscue: The body works on a brilliant principle of what's called
"vertical load." The skeleton has two jobs as a muscular skeletal
organism--one is to bear weight, and the other is to absorb the shock
of movement. It does this with joints called load joints, such as
shoulder, hip, knee, and ankle. The law of vertical load says that in
order for these joints to enjoy their range of motion, they must line
up, meaning stacked one over the top of the other. This design
requirement is the same for all human beings, male or female, short or
tall, skinny or fat, it doesn't make any difference. Range of motion
takes place from the inside out. The big posture muscles are the ones
that no one can see. They're located down deep next to the skeleton. As
they lose their function, the body begins to compensate. So what
happens is a series of steps that are taken by the body because it's
such an incredibly adaptable machine. The muscles of the outside, the
ones you can see, eventually begin to do the work of vertical load, of
stabilization, compensating for the inside muscles that have become
dysfunctional. You end up acquiring a posture that is visible to an
evaluation: one hip in a different position than the other, or one
shoulder forward or higher than the other one. And this eventually
leads to pain.
The Share
Guide: You've mentioned in your
books that it's possible to increase the dysfunction by over-exercising
the compensating muscles. Can you elaborate on this?
Pete Egoscue: Let's say that we have a shoulder dysfunction, and the
right shoulder, because of compensation, is in a different position
than the left shoulder. Now let's take that person to the gym, and
let's participate in a weight training program. What will happen is
that the body will figure out a way to push those weights around or
implement the exercise the person wants to do. The problem is that the
muscles being recruited in one shoulder girdle are different than the
muscles in the other shoulder girdle. You're still making exactly the
same motion, but you're recruiting different muscles because of the
posture position of the joints. So without realizing it you end up
increasing the dysfunction as you strengthen those muscles in that
position.
The Share Guide: So if a person is
thinking of starting an exercise routine, it would make sense to make
sure that they were balanced before getting into it.
Pete Egoscue: That's correct. Unfortunately, most people in today's
culture are posturally imbalanced, because of the demands of the
culture--or lack of demands of the culture. Eventually there's going to
be the signal of pain. And what happens when the signal of pain comes
is that we make that classic mistake, which is stopping activity. There
needs to be an awareness that we are bilateral, and that we are
designed to be symmetrical. There is a huge penalty for not being
symmetrical. So how does a person tell? It's very simple. Take off your
shoes and socks, get on a hard surface, shut your eyes, and determine
where the weight distribution is in your feet. Is it more towards the
left or right? If you're anatomically balanced, the weight is evenly
distributed left to right, and it's primarily centered on the balls of
both feet. If this is not the case, you have an anatomical imbalance.
And that means your immune system is being compromised, and your basic
metabolisms are being compromised, and eventually there's going to be
some kind of pain. People say, "I can't run downhill without pain; I
can't go to the gym and do military presses without pain; I can't go to
my office and sit in my chair; I can't drive my car without pain." The
pain isn't the villain here. Pain is the signal that the body cannot
function properly.
The Share
Guide: If you're not in pain,
then you're in balance?
Pete Egoscue: Not necessarily. If you're not bilaterally posturally
correct, you already have limitations that have nothing to do with
pain. For instance, you may have a hard time sleeping, you may be
hypertensive, you may have diabetes. Many of the things that
homeostasis can't explain because there's no mechanism to be fixed, are
actually a result of postural imbalance. It's because we've compromised
our basic metabolism. The primary indicator of metabolic health is the
reaction of demand, which is muscular skeletal demand. So there are all
these signals that we're off balance, even before actual physical pain
starts. But eventually the pain is coming.
The Share
Guide: Please explain the three
R's of The Egoscue Method: Rediscovering the body's design is number
one; restoring function is number two; and returning to health is
number three.
Pete Egoscue: Rediscovering the design, that's the postural balance,
that vertical load we talked about. And then, once you are aware of
this, to restore the body to its function requires an absolute belief
that this imbalance has nothing to do with poor design, nothing to do
with our age, and nothing to do with genetics. It has to do with the
reaction of the stimulus to our environment. So once that awareness
happens, now you have two choices: you can change the stimulus or you
can change the environment. Those are the only two choices you have.
Well, most of us won't change our environment because it's not
practical, so we've got to change the stimulus-to return ourselves to
balance musculo-skeletally. Lastly, the return to health requires not
just the change of physical stimulus, it also requires an emotional
change. We have to change our MIND. That is the key. We need to realize
that we're not fragile, we're not overly complicated, and we do have
all the abilities necessary to get well.
The Share
Guide: So you need to put
yourself in a positive frame of mind?
Pete Egoscue: There's no question. I don't think health is the absence
of pain; I think health is the absence of limitation.
The Share
Guide: You have created a series
of movements you call "E-cises." How do they re-teach the muscles what
to do and how to do it?
Pete Egoscue: First of all, we personalize the process to the specific
dysfunction. And the body always remembers its design memory, so when
you start changing the stimulus with E-cises, the body has no choice,
it changes. The goal is not to get rid of the pain, and it's not to
allow the person to be able to do all the things they want to do again,
even though both those things happen. The goal is to allow the body to
return to its birthright, its design template, and it can because it
never forgets the memory. All we're doing is providing the necessary
stimulus, personalized to the postural dysfunction, and the client is
implementing those stimulus by doing the E-cises. So the body goes, "I
get it; I understand what you want me to do."
The Share
Guide: Instead of waiting for
pain to drive us to see the doctor, we should take action before the
situation gets out of hand. Do you think most people wait too long?
Pete Egoscue: At the Egoscue University we've got four or five hundred
students at the moment and a lot of them are physicians in hospitals. I
hear two chronic laments from our students. First, people don't take
good care of themselves. Second, they don't comply with recommedations.
The physician sits the patient down and tells him he needs to eat more
green vegetables, get more rest, or whatever it is. But the patient
comes back and has the same bad chemistry. The physician says, "Did you
get more rest?" "Well, no." "Did you eat more fruits and vegetables?"
"No." So here is my answer to your question. Humans spend their whole
lives seeking pleasure and avoiding pain. We've convinced ourselves
culturally that we're healthy if we don't have pain. (Now pain can be
psychological pain, like depression or low self-esteem. I am not just
talking about physical pain.) We believe that the solution to our
problem rests outside of ourselves. So do we wait too long to seek help
outside of ourselves? No, I don't think so. I think we wait until our
pain, whatever it is, has so compromised the environment that we've
created for ourselves that we need to seek help. In other words, "I
have got to deal with this now, because it is getting in the way of my
life." So it isn't that we're dumb or that there's a lack of
information out there, or that there aren't wonderful people to help
us. It's that we believe that our solutions to our pain rest outside of
ourselves. And, of course, that isn't true.
The Share
Guide: Do you think that pain
killers are the biggest factor in contributing to long-term problems by
masking the pain and allowing people to ignore the problem?
Pete Egoscue: No, I think that the biggest problem with pain killers
is that people think "OK, the pain's gone now, I'm well again." So it
keeps people from addressing the core issue. Pain killers are a real
problem in that regard, but they are sometimes incredibly beneficial as
well.
The Share Guide: Right, but if they're
just providing symptomatic relief, without looking at the core issue,
that can't be good.
Pete Egoscue: You're right. The chronic use of pain killers is
incredibly detrimental to the endocrine system, the immune system of
the body. It's brutal.
The Share
Guide: You've written that 20
minutes a day of exercise can often be enough to give people sufficient
motion. Would a 20 minute daily walk suffice as a starting point for
people who are sedentary, and how rigorous should it be?
Pete Egoscue: It depends upon how much of your body you're using, and
your posture. If you're walking but your feet point outward, then
you're not using the posture muscles of your body, so your machine is
relatively inefficient. If you're walking for strictly cardio purposes,
you're not getting much bang for your buck if your posture is off
because you're like an untuned car going down the road. But if you're
functional, and your feet point straight ahead, then you're getting a
tremendous benefit very quickly. This is because, just by the nature of
the posture, the diaphragm is working so you're using the automatic
breathing muscle-you're getting full lung expiration, the load on the
heart is even and complete, the heart muscle understands the demand,
and it ramps up to the demand in a clear, non-confusing way for the
body.
The Share
Guide: You have a few stories in
your books about unsuccessful surgery done to correct pain, when better
results could have been achieved with your methods. You have said that
99% percent of the surgery we have is elective. How much unnecessary
surgery is done in the U.S. nowadays?
Pete Egoscue: It's a complicated answer to say necessary or
unnecessary. Plus it depends on the community to which you speak. We've
got surgeons in my university, so if you speak to them they'll say that
there are very few unnecessary surgeries. The acute care system is a
symptomatic system. It is based on the premise that at the origin of
every symptom there is a disease, there is a problem. And it's based on
that model of homeostasis which is stability through consistency. So
medicine interprets that to mean that physiological regulation is to
clamp each parameter at a set point-to set all the vital processes of
the body at a particular point. And then since errors (one way or the
other) are from that point, you need to correct them. All the
therapies, such as surgery, are designed to restore the inappropriate
value to a normal value. Now there's a whole new science out there,
based on the term allostasis, originally coined by Pete Egoscuer
Sterling, a professor of neurosciences at the University of
Pennsylvania. Allostasis means stability through change, which means
that there is no set point-the mechanisms are designed to change and
control the variable, meaning the body is adaptable.
The Share
Guide: Sounds like the
mechanical view of medicine versus the holistic view.
Pete Egoscue: Correct. What typically happens in standard care is that
when a patient sees their physician (a good physician, very well
qualified) and that physician believes that there is something broken
that needs to be fixed, they will often prescribe surgery. For example:
a person shows up with nerve pain running down one of their legs. The
physician quickly determines that's sciatica or ephemeral nerve pain,
nerve referral down the leg. The physician is trained to believe that
something is broken that needs to be fixed. MRIs and CAT scans, the
diagnostic tools (they're marvelous, they're wonderful things) are used
to trace the problem to it's origin: "Oh, look! There's a disc up
against the nerve root."
The Share
Guide: So this is the broken
part?
Pete Egoscue: Right. Now it's up to the expertise of the physician as
to what to do. The surgeon says, because he or she has done it a
million times, "I can relieve that symptom by going in there and
getting that disc off of that nerve root." And they're absolutely
right; they can do that. This is elective surgery. And six months later
the pain is back. Why did it come back? Did the surgeon do an
unnecessary surgery? No, the surgeon did exactly what he or she said
they were going to do, and they did a good job of it. The pain is back
because they didn't ask the next question: "Why did that disc do that?"
In their homeostatic model they are treating symptoms as if they were
causes and they're not-unless you were hit by a truck, and there was
some external stimulant. In the case of a car wreck you know that the
source of the pain and the cause of the pain were the same
thing--you've got a compound fracture, or something like that. But in
most cases that's not it. So this is a round about answer as to whether
there are unnecessary surgeries. I'll say that there are no unnecessary
surgeries because what the patient and the surgeon decide on is, in 99%
of the cases, perfectly and optimally performed. They do exactly what
they say they are going to do. But what I think is that you know more
about your health than anybody else. (Even though our culture doesn't
believe that you do.) So to start asking the right questions, you've
got to help your healthcare professional. You can't complain about
chronic pain if you are not helping the situation. If you consult a
physician or a therapist of any kind and you don't participate, what
you are really doing is you are handicapping that professional's
ability to help you. You have to ask the "why" questions, and you have
to be an active participant. Now the tragedy of all this is that we are
well-schooled on how to do that in every area of our life, except with
our healthcare. We've convinced ourselves that we're fragile and
complicated, and because of that only experts can help us solve our
problems. It's just not true.
The Share
Guide: I think the foundation of
holistic healthcare is body, mind, and spirit; it's the larger
organism. And there's also our active involvement in our evolution.
Pete Egoscue: Yes. That's why, when physicians often ask me why I
think alternative care is exploding in growth, that's the answer I give
them. Because many people are no longer comfortable with the
expert/patient relationship. The only dialogue that an expert and a
patient have is, "What is the symptom?" In the complementary care
world, as you pointed out, the symptom is just part of the matrix. And
that's why, in my view, that paradigm is growing so quickly.
The Share
Guide: So is this the future of
medicine?
Pete Egoscue: I believe that the current paradigm has already shifted.
We're moving from the paradigm of expert-driven care to the new one of
patient-driven care.
The Share
Guide: I think that's why
natural foods stores and fitness centers have grown so much in this
country.
Pete Egoscue: Right.
They're going through the roof because, in spite of all of the
"scientific research" to the contrary, human beings instinctively
understand that something that's grown organically is better for you
than something that's not.
For more information about Pete Egoscue, visit
his website at www.egoscue.com
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