Here is the link to the new version of ‘Be Careful About Back Surgery’.
Here is the link to the book Body In Action

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Part 1. Why Your Back Might Be Painful
Part 2. Getting Yourself Out Of Pain
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Part 3. The Mind Matters
Part 4. What You Can Do Yourself Hands-On
Part 5. Bending and Moving Normally Again
Part 6. How To Bend Safely and Squat
Part 7. Decompressing Your Spinal Base

(the AI face-enhancement may be a little over-zealous but the information’s there!)

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1. The Basics of How a Healthy Spine Works (21 mins)

2. Why a Spinal Segment Starts Causing Pain (19 mins)

3. The Stages of Spinal Breakdown Following Dehydration (21 mins)

4. Sustained Compression Causes Spinal Breakdown (16 mins)

5. Spinal Therapy Starts with Decompression (19 mins)

6. How to Do Your Own Spinal Decompression (30 mins)

7. Why Bending Is Magic for Backs (14 mins)

8. How to Bend Safely and Squat (6 mins)

9. The Trouble with Sitting (15 nins)

10. Appeasing a Spine in Crisis (7 mins)

11. How To Appease Your Spine (14 mins)

    
    See The Commemorative Page here

    

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Here’s the article copied (and I’ve added a couple more ‘tips’).

Though it is by no means a recent article, the message and my points to bear in mind about your back, remains the same.

What I found very interesting in this article was the survey of different ‘back apps’ all of which were found to be of low quality. Alas, I think that is true of most ‘back medicine’.

THE ‘FALSE’ MESSAGES GIVEN TO LOTS OF PEOPLE WITH BACK PAIN

Too many Australians are in pain.

According to a newly released Global Pain Index up to 97 per cent of the population are affected by pain with 86 per cent experiencing lower back pain specifically.

Relief from back pain does not come in the form of an app.

Back pain alone is believed to cost the healthcare system $4.8 billion each year and the cost to those suffering is also great – from quality of life, to seeking treatment, to longevity.

Research has revealed that millions of Australians are wasting their money on medications, which increase the risk of other health issues and offer ‘very limited short-term pain relief’.

As guidelines shift away from pharmacological treatments towards self-management techniques like exercise, relaxation and stress-reduction, an abundance of apps have flooded the market claiming to cure back pain.

But, of more than 700 apps available, none have the answer and can make that claim say the researchers of a recent study.

“There are many apps available to treat health conditions,” explained lead researcher Gustavo Machado from the University of Sydney’s School of Public Health. “So we decided to see if the apps for back pain were of good quality.”

They whittled down the apps on iTunes and Google Play to 61 that pledged to help people self-manage back pain.

“Generally they were low quality apps,” Machado said.

While some had “promising features”, apps are not regulated and many provided incorrect information.

“Sometimes they recommend people stay in bed or they recommend people stop doing some movements - there is no evidence that this or that movement causes back pain - that information is not supported by research,” Machado said.

Additionally, many did not provide educational information, which is considered an important component of treatment.

“A lot of people have concerns about their back - some people think their back is fragile, some people think they have a very serious condition happening,” Machado explained. “All that creates anxiety and that can exacerbate the symptoms. Once they’re educated that that’s not the case, the patient has much better outcomes.”

Similarly, none of the apps had been tested for efficacy.

“The main issue is that app developers claim they will provide pain relief to patients - they give this false message to patients,” Machado said. “This is not the case, because the app has not been tested. It has the potential but it has not been tested for that.

“That prompted us to do this review - to warn patients that these claims of quick pain relief is probably not true and patients should not solely rely on the apps.”

Rather, Machado advises people to seek advice from their health care professional.

Physiotherapist and back pain specialist, Sarah Key’s tips for a healthy spine

1. Stretch over strength. “Strength you need to have ... but it is lack of stretch that cobbles you over and it is lack of stretch that tethers you into the repetitive stooped postures of function,” says Key, who is a strong advocate of yoga.

2. Decompression. Lie with a back block or yoga brick under your pelvis, both to reverse the spinal compression of hours of crumpled sitting or between the shoulder blades to reverse the extended hunching in front of a computer that we do.

3. Don’t rely on the gym to get you through. Jarring, repetitive movements offer “diminishing returns”, Key says, and constant contracting of muscles can even exacerbate a problem.

4. Find a good, firm bed. “We used to sleep on skins on the floor.” See here Best Bed For a Bad Back

5. Keep calm. A worldwide study of centenarians found a common character trait was calmness. Key says we shouldn’t underestimate its importance to our health. And ideally, centre yourself through meditation for stress relief.

6. Find a good physio or masseuse with good hands. Find the point of pain and prise it free. “A therapist actually finding the pain - touching the pain - will mean that it is no longer hiding there like a gremlin in your spine holding you to ransom.”

7. Breathe properly — through the nose, using your diaphragm, not your neck muscles. “Proper breathing should be noiseless - but good breathing is another casualty of stressful living,” Key says, explaining poor breathing uses the accessory muscles of respiration in the neck, which can give you (or exacerbate) a neck problem.

8. Bend freely and “make your back do backy things”. Never restrict your movement, thinking you have to protect your back. Bracing yourself and keeping yourself rigid keeps the back bad - “besides, bending gives your discs a drink”.

9. In keeping with the point above, “never roll over like a log to get out of bed”. Make the spine move normally and unselfconsciously (bend over normally to get your socks on). Your spine will thank you.

10. Never sit bolt upright (particularly in the early stages of fixing your back) and always have a good bulky cushion in the chair to keep the spinal ‘S’ bend, deliberately pressing into your lower back. This keeps your spine supported, so that it does not crumple into a ‘C"‘ bend the longer you sit there. .
    

    Sarah Berry Sydney Morning Herald

The Little Blue Back Ball mobilises the spinal segments. It also helps break down fibrosed tissues and spinal adhesions, that may be the legacy of past inflammation and surgical procedures. The gentle local pressures of the Ball against your back also release tight spinal muscles where muscle spasm has set in. The Ball is an ideal treatment combination with the BackBlock, which is a decompression tool for pulling the spinal segments apart

The Back Ball is the simplest, most effective back tool there is (and the cheapest).
With each purchase, I include a 15 minute audio of me walking you through how to use it, which you can download and replay every time you do a session.

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The package of the ball and block is mailed to you but you have instant access to all the videos, written matter and audio files.

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Don’t hesitate to share the first two videos - it’s the bedrock of spinal therapy! The more people who know, the better.

The final video shows how to do your own spinal decompression in 3 easy steps, while at the same time it provides the evidence base and the rationale behind each step.

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The second video shows you exactly how to do the Air Twists. It is for Paid Subscribers only. See below

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Musculo-skeletal disorders are increasingly rampant across all modern societies, with huge increases in surgical replacement of painful joints. Projections worldwide suggest that by 2030 hip replacements could increase 171% and knee replacements by 189% compared with early‑2000s levels.

As usual, reasons postulated are multifactorial, including ‘soft’ western societies with sedentary lifestyles (often punctuated by sudden over-exertions of the ‘fitness culture’), obesity, ultra-processed foods with high sugar content and seed-oils causing raised inflammatory status and metabolic health decline

Recent evidence and clinical observations suggest that diet is a key driver of declining soft tissue strength, contributing to another quiet pandemic: pelvic organ prolapse (POP) as a consequence of soft tissue inflammation and degeneration.

Modern Diets on Soft Tissue Health

Processed foods – such a big part of modern eating - are high in seed-oils and low in collagen-supporting nutrients. Seed (or vegetable) oils are high in omega-6 polyunsaturated fats, which promote low-grade systemic inflammation.

Chronic inflammation impairs collagen synthesis, tendon and ligament repair, and muscle recovery, leading to weaker connective tissues throughout the body. Generalized connective tissue weakness affects musculo-skeletal joint integrity in the most obvious way –joint cartilage softens and erodes through to the bone, particularly of the large weight-bearing joints, causing pain and making it harder to get around.

But soft tissue incompetence can manifest in less obvious ways with the structural support of the abdominal contents. The super-incumbent load of the abdominal organs including the bladder, rectum and in the case of women, the uterus, can weaken the ligamentous support of the pelvic floor leading to pelvic organ prolapse.

The same connective tissue weakness is contributing to a rising incidence off hernias. Data from the Global Burden of Disease Study shows that the total number of hernia cases (inguinal, femoral, abdominal) worldwide increased by about 36% from 1990 to 2019. Men with hernias often show reduced collagen strength, altered collagen type ratios (less type I, more type III), and reduced tensile strength in fascia and ligaments.

Ultra-processed foods usually also lack essential amino acids such as glycine and proline, necessary for collagen production. High sugar intake can stiffen collagen fibers through glycation, while vitamin D deficiency reduces tissue repair capacity. Collectively, these nutritional deficiencies accelerate the decline of muscles, tendons, ligaments, and fascia, increasing the risk of pelvic floor dysfunction.

Pelvic Prolapse and Nutritional Vulnerability

Pelvic organ prolapse (POP) is an ancient problem that has negatively impacted women from different racial, ethnic, and cultural backgrounds for thousands of years.

The pelvic floor is a hammock-like sling spanning the lower abdomen. It is complex network of muscles, ligaments, and fascia that supports the bladder, uterus, and rectum. Weakening of the pelvic floor —whether due to chronic inflammation, poor collagen quality, or insufficient repair capacity—can result in pelvic organ prolapse. Epidemiological studies suggest that up to 50% of women may show some degree of pelvic organ prolapse on examination, though fewer report symptoms.

Many cases of POP are mild, but a significant minority experience symptomatic prolapse that affects quality of life. Early signs of bladder prolapse (cystocele) are pain on intercourse, ballooning in the anterior roof of the vagina, incomplete emptying of the bladder and associated recurrent bladder infections. Rectal prolapse can also result in difficulty passing stools.

POP can also contribute to lower back pain caused by attenuated lumbar connective tissues, like a heavy hanging basket of strained ligaments and fascia, and possible compensatory postures. Many cases of prolapse are not solely due to childbirth or aging and may reflect primary soft tissue weakening driven by nutritional factors. Recurrent pregnancies may further amplify these effects if tissues cannot repair optimally.

What Can You Do About Your Diet?

To help preserve connective tissue integrity:

· Eradicate seed oils from your cooking – use beef tallow to fry your chips (delicious!)

. No safflower oil (75 omega-6 g/100g), sunflower (65-70), grapeseed (60), corn (55-60), soybean (50-55), rapeseed (canola) oil (20 omega-6 g/100g) in your kitchen

. Olive oil (10 omega-6 g/100g), coconut oil (2)

· Avoid omega-6-heavy processed foods

· Cut out highly pro-inflammatory HFCS (high fructose corn syrup) and normal sugar (this may mean reducing fruit intake)

· Increase omega-3 fatty acids through SMASH fish (salmon, mackeral, anchovy, sardines, herring), grass-fed meats, leafy greens

· Ensure adequate intake of glycine- and proline-rich protein sources (bone broth)

· Eat the collagen tissue ‘gristle’ in slow-cooked cuts of meat (ox-tail, osso bucco, beef cheeks, lamb shoulder (not leg)

· Maintain antioxidant-rich fruit and vegetable consumption

· Ensure sufficient vitamin D through sunlight exposure or supplementation

What To Do Physically For a Weak Pelvic Floor?

· Avoid sudden physical exertion after prolonged sedentary periods

· Gradually increase resistance training but avoid weights

· Cease altogether strenuous abs exercise regime

. See Worst Abs Exercises

· Only do ‘reverse’ abs exercises with associated pelvic floor contractions

· See Best Abs Exercises

· Pelvic floor contractions ++

Graduated Pelvic Floor Exercises

Pelvic floor muscle strength re-training is a must.
Although the urology world advises against interrupting the flow when passing urine (for fear of causing urinary retention) this is the most effective way of testing pelvic floor strength.

For mild cases of pelvic organ prolapse, pelvic floor contractions can be done wherever you are, whatever the posture, whatever the time of day. Contractions should concentrate on tightening the front and the back of the pelvic floor, while at the same time lifting the sling upwards. Hold each contraction to the count of 5-10 without holding the breath. Repeat contractions up to 8-12 times.

Contractions should concentrate on sphincter control of both the urethra (from the bladder) and the anus at the back, without drowning out these contractions by simply tightening the gluteal (butt) muscles.

For more marked pelvic organ prolapse it helps to do the contractions when lying down to reduce the ballooning of the prolapse into the vaginal roof. This makes it easier to get a proprioceptive sense of the sling tightening and lifting. For marked prolapse, it helps to totally relieve the downward pressure on the pelvic floor by doing the contractions while doing ‘up-the-wall bridging’.

Advanced Pelvic Floor Exercises

Up-the-wall-bridging involves getting your bottom right into the skirting board at the bottom of the wall. This is best done lying on your side to get your sitting-bones in against the wall and then turning over onto your back, feet up the wall and knees bent.

You then lift your bottom by peeling your back off the floor, so that your pelvis is higher than your abdomen, thus relieving the pressure of the prolapse. In this position, hold each contraction to the count of 5-10 without holding the breath. Repeat contractions up to 8-12 times, although you may have to come down and regroup before lifting your bottom again to continue.

I am drawn to the subject of sleep precisely because I get so little of it . I am also reading the book This Is Your Mind on Plants by Michael Pollan, where he talks about our addiction to caffeine and how influential it has been in stimulating great advances in human endeavours. Thousands of coffeehouses springing up in London in the mid 17th century were vibrant meeting places where men gathered and exchanged ideas (political, financial and cultural) with their wits sharpened, unlike the effects of taverns serving ales. Women, on the other hand, were more likely to gather at home drinking tea, which has less than half the caffeine content of coffee.

Caffeine is a strong stimulant with a ‘quarter life’ of 12 hours. This means that if you drink a cup of coffee at midday, a quarter of the caffeine is still swilling around in your bloodstream – and your brain- at midnight. This addiction to stimulation – in my case, a day does not pass without me drinking copious cups of either tea or coffee each morning – also affects sleep and sleep quality.

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Poor sleep is associated with a variety of poor health outcomes from Alzheimer’s to heart problems, to obesity and depression. The best quality sleep is ‘deep sleep’ which is characterised by ‘slow wave’ activity of the brain. These low-frequency waves ‘synchronise many thousands on brain cells in a sort of neural symphony’. Rather like passing a comb back through the hair, smoothing out tangles and knots as it goes, slow waves travel from the frontal cortex to the back of the brain, distilling and consolidating ‘the blizzard of information we have taken in through the day’. Memories are carried to their more permanent repositories on these slow waves, but we get less deep sleep as we get older, which may explain why our memory falters.

Disturbances to sleep, such as getting up several times a night to go to the loo interrupts deep sleep and undermines the ‘slow wave’ activity of the brain. It appears that caffeine is the chief interrupter of deep sleep, whereas alcohol causes more mischief with the REM (rapid eye-movement) sleep, where all dreaming happens.

Poor sleep patterns perpetuate as people make a dive for the coffee machine first thing to gee themselves up after a bad night. (Pollan says that the rise in the number of Starbucks parallels exactly the rise in sleep deprivation). Coffee makes you sleep badly, so you need more of it, and stronger, the next morning to get yourself going. Coffee is the foe of good sleep, but it is also the friend of waking - and for many, it brings with it stronger currents of creativity.

For chronic insomniacs like me, breathing patterns going awry quickly become part of the picture. Often egged on in the small hours by ‘how bad will I feel tomorrow’ (just as important, how bad will I look) I notice how quickly anxiety about ‘not sleeping and what time is it’ crashes into my dreamy somnolence.

The first thing that happens is my breathing rate goes up, and with that my heart rate. I have never worked out whether it is adrenaline or cortisol coursing through my veins - perhaps it’s both - but I also know that thinking about it makes it worse (and I start to hear my heart clattering about in my chest). The good news is that, all going well, I can control this by getting my breathing back under control. Minimalist diaphragmatic breathing – not deep breathing - is what will woo me back to sleep.

The breathing rate going up is both cause and effect. Stress hormones will elevate both breathing and heart rate, but – and here’s the clue – deep breathing will also elevate both by blowing off too much carbon dioxide (CO2). Yes, that’s right, hyperventilation can set the whole body into discord. Indeed chronic over-breathing – and mouth breathing - can not only rob you of sleep, it can make you sick.

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Mehmet Oz, director of the Centre for Medicare & Medicaid Services, enraged the puritans that dominate the public health bureaucracy, even as he made some of us feel a little less bad about our festive season excesses. But the former surgeon was right to point out “there was never really good data to support” longstanding government advice that more than two (one) standard drinks a day is unhealthy.

News that inflation jumped substantially in December, contrary to official forecasts, was another reminder of the ignorance and propaganda that often underpins official or political pronouncements on economic topics, itself partly a consequence of the massive disagreement among experts about how the economy works, even 250 years after Adam Smith wrote The Wealth of Nations. Yet the public remains far too wedded to the idea that when it comes to medicine and science the official advice reflects some well-meaning, objective and optimal distillation of human knowledge.

The new US dietary recommendations, Food Pyramid 2025-2030.

Dr. Mehmet Oz

That’s far from the truth: these are a function of vested interests and group think as other areas. Richard Horton, editor of the respected medical journal The Lancet since 1995, wrote “much of the scientific literature, perhaps half, may simply be untrue … in part because of flagrant conflicts of interest … and obsession with fashionable trends”.

Scientists, he wrote more than a decade ago, “too often sculpt data to fit their preferred theory of the world”. Individuals don’t necessarily become saints when they don a lab coat or pick up a stethoscope. Good and bad people permeate all sectors.

In 2003, Canadian professor Joel Lexchin wrote in the British Medical Journal that he found a “fourfold greater chance of a clinical trial finding favourable results for a drug if that trial was sponsored by the pharmaceutical industry”.

The Global Financial Crisis revealed how the “revolving door” between financial regulators and big financial institutions can corrupt regulations.

The disastrous official response to Covid-19, which now appears to have fewer and fewer supporters as the years go on, suggests similar problems extend to the health sector. The bulk of Australia’s Therapeutic Goods Administration, for instance, which regulates pharmaceutical products, is funded by the pharmaceutical industry. That industry in turn is dominated by a few larger powerful firms, which have had to pay billions of dollars in fines for numerous offences in the US over many decades.

In the latest Dietary Guidelines for Americans, 2025–2030, issued earlier this month, the famous “food pyramid” had been inverted, up-ending decades of health dogma about the relative merits of different types of food. Bread and carbohydrates used to be at the bottom and fats and sugar at the top, implying they should be consumed a lot and a little, respectively. In the new version, “healthy fats”, proteins and dairy have been prioritised, with carbohydrates and fruit demoted, while sugar doesn’t feature at all.

Gary Taubes, author of numerous books on health eating, declared “a return to common sense”, deeming the changes “a necessary rejection of the focus on plant-based eating that was a direct outcome of the cholesterol dogma of the 1980s”.

Certainly most of us don’t have the expertise to evaluate competing claims about technical subjects but it’s possible governments could have contributed to the growing and shockingly high rates of chronic disease, especially in the US where 70 per cent of adults are obese, by downplaying the damage addictive sugars.

Big Food has a dubious history, too, having established in the 1960s the Sugar Research Foundation to pay Harvard scientists to downplay the negative impacts of sugar.

From left, Education Secretary Linda McMahon, Human Services Secretary Robert F. Kennedy Jr., and Interior Secretary Doug Burgum listen as President Donald Trump speaks during a cabinet meeting at the White House, Thursday, Jan. 29, 2026, in Washington. (AP Photo/Evan Vucci)

Health secretary Robert F Kennedy, Donald Trump’s most controversial cabinet pick, has courted controversy by reducing the number of recommended vaccines for children from 17 to 11. Some experts have attacked the change as reckless. Kennedy pointed out the new schedule was modelled on Denmark’s and the US had recommended more vaccines than the vast bulk of developed nations.

Is Denmark or the US correct? It’s hard for non-experts to know, but it’s a fair guess the focus of global pharmaceutical lobbying has been in Washington not Copenhagen.

It’s also a fact the number of recommended vaccines in the US soared since their manufacturers were given immunity from being sued over vaccine injuries by a federal law they lobbied for in 1986.

Whatever the scientific merits of Kennedy’s Make America Healthy Again health reforms, he’s given a voice to critics of the health establishment. And if there’s one thing we learned from the devastating response to the pandemic, it’s that the health establishment has been guilty of group think and institutional inertia.

Scientific and medical advances have radically improved our standard of living over decades, but there is still much we don’t know, especially in the moving feast of nutrition science, where it’s difficult to conduct controlled experiments. As Kennedy joked last week, Trump is still alive and fighting fit at 79 despite his own “poisonous” diet.

“To say physicians, nutritionists, and all those researchers and influencers who study or discuss the effect of diet on body weight and health live, in effect, in an intellectual church is not an unreasonable assertion,” Taubes added in his article.

Science isn’t a democracy. And as it’s practised by government officials has more in common with politics and religion than most of use realise.

Adam Creighton is chief economist at the Institute of Public Affairs.

Adam CreightonContributor

Adam Creighton is Senior Fellow and Chief Economist at the Institute of Public Affairs, which he joined in 2025 after 13 years as a journalist at The Australian, including as Economics Editor and finally as Washington Correspondent, where he covered the Biden presidency and the comeback of Donald Trump. He was a Journalist in Residence at the University of Chicago’s Booth School of Business in 2019. He’s written for The Economist and The Wall Street Journal from London and Washington DC, and authored book chapters on superannuation for Oxford University Press. He started his career at the Reserve Bank of Australia and the Australian Prudential Regulation Authority. He holds a Bachelor of Economics with First Class Honours from the University of New South Wales, and Master of Philosophy in Economics from Balliol College, Oxford, where he was a Commonwealth Scholar.

@Adam_Creighton

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Dear Sarah,

It was 2 1⁄2 years ago that you laid your hands and heels on me in New York City; and though we’ve had a Skype or two since, as of late, our communication has mostly been one-way with me taking in your Substack offerings—so I wanted to give you an update on how I’ve been faring on the infamous Sarah Key Protocol. At this time of our American Thanksgiving holiday, as I count my blessings, you, dear Sarah, are at the top of my list!

I have recounted below a bullet-point chronicle of the many ways you’ve helped me:

• Your Back Sufferers Bible completely re-educated me on essentially everything I’d been taught to believe by U.S. physios, doctors and surgeons. It was my first ray of hope and the beginning of a U-turn back to recovering my life. From its instruction I began to mobilize my painfully stiffened, rain-water-scooped back.

• You generously offered to sacrifice sizeable chunks of time to personally consult with and treat me when on your vacation to New York in 2023. It was there you found and “touched” my true pain source, nowhere near where my neurosurgeon said it was emanating (his diagnosis being based solely on imaging.)

• You dispelled my paralyzing fear that pain was my life-long sentence given I had already submitted to ADR spinal surgery (the best our medical experts could offer me) and I was still debilitated by it. Since my diagnosis had repeatedly been labeled “degenerative”, I had interpreted my condition as irreversible and therefore permanent.

• You provided me with a personalized exercise regimen, making available your video library which explained my spinal conditions in depth followed by exacting demonstrations of the exercises for treatment and restoration of my shrinking discs, leathery facets and atrophied multifidus. You continued to monitor my progress with subsequent Skype sessions, further adjusting my exercises, including imparting a bit of sound lecturing when I was apt to over-do them.

• You helped with my relentless burning mid-back spasms following my pectoral muscles repair operations (caused by botched reconstruction surgeries, post double-mastectomy) teaching me how to release the aggravated, tightened muscles and strengthen the weaker ones. The spasms can still be invoked by a long day in the kitchen handling my cast iron pots but I now know how to intercept the pain before it takes me over.

• You guided me on asserting from my orthopedic surgeon a CT scan which confirmed my acquired leg length discrepancy following TKR on my right knee; the discrepancy’s effect on my lumbar facet column has much improved simply by employing your recommended Sorbothane heel lift in my opposite shoe. Your

  tip-toe exercises have further strengthened (and lessened the foot pain) on my likewise acquired fallen right arch.

• Your multi-faceted knee exercise routine has nearly overhauled my thought-to- be-too-far-gone left knee, sparing it from joint replacement. It is nothing short of a miracle how that series (especially walking on my knees) has transformed it. Your videos also enlightened me to placing wedges in my shoes to compensate for my bow-legged supination, thereby reducing the pressure on my knee’s worn interior compartment —genius in its effectiveness and brilliantly simple. And yet, not one podiatrist ever examined the tell-tale sign of the undersides of my shoes whose outer soles always showed accelerated wear from my unbalanced strike.

• Through your podcasts that extend “beyond” backs, you’ve also improved the way I walk, the way I eat (no more industrial seed oils), and the way I think about pain (after I read a book you mentioned entitled Explain Pain which corroborates your adage to “keep moving normally.”) So, from my morning wiggle-waggles to my evening back-block trio, with bending, rocking, intrinsics and squatting in between, my day is peppered with the Sarah Key Method. I am thrilled to have reached the point that you mention would come when one day you catch yourself performing a simple movement with ease and fluidity that had for years generated pain and consternation.

• A further bonus is that I believe you unwittingly solved the mystery that had escaped my answering—that being “why” when I had been physically active my entire life, had my L5-S1 disc flattened to the thickness of a washer in the first place. The epiphany struck me when in one of your podcasts you spoke of a patient having taken several hard hits to the ground when parachuting in the military resulting in spinal compression shocks. My own chronic back pain had developed during my 10+ years as a prolific flight instructor, racking up nearly 5,000 hours in small aircraft, much of which was spent with student pilots practicing repeated “touch and go” landings. Enduring frequent hard landings as they struggled to learn the feel of the runway beneath them was just part of the job. Little did I realize the literal impact of their compression forces on my spinal disc(s).

You’ve helped me in all of these ways and yet it’s obvious your expertise runs even deeper. You’ve been able to combine an enormous wealth of knowledge with your own experiential wisdom into a synthesis of therapies that always make so much sense. As an author and speaker you have the uncanny talent of explaining an impressive vocabulary of anatomical complexities in terms anyone can understand. You share it generously, with both royal as well as us “common” back sufferers. You are our teacher, mentor, physio—and friend, inviting us into your gardens, your memoir, and even your family’s lively dinner conversation.

Speaking of dinner, before I close, I’ll share that three years ago my husband and I prepared a Thanksgiving meal for ourselves and (only) four guests, but by the time we sat down at the table my back hurt so bad I had no appetite. In contrast, today I am proud to report that because of you and your cornucopia of teachings, every day at our house is Thanksgiving. Thank you from the bottom of our hearts.

P & K
Santa Barbara, CA USA

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