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In this episode of Insights at the Edge, my guest is Dr. Ken Hansraj. Dr. Ken is a spinal and orthopedic surgeon with more than 20 years of experience specializing in preventative medicine and using minimally invasive approaches to spinal care whenever possible. He’s well-known for his work on “text neck,” what happens to our neck when we’re texting and engaging with our smartphones. And he’s appeared on CNN, CBS, Fox, NBC, ABC, and NPR. He was named one of America’s Most Compassionate Doctors in 2020 by Vitals. And with Sounds True, Dr. Ken is the author of a new book, it’s called Watch Your Back: Nine Proven Strategies to Reduce Your Neck and Back Pain Without Surgery.
Dr. Ken is a research scientist, a clinician, someone who is very dedicated to helping people and a genuine spiritual practitioner in his own right. His program, Watch Your Back, is his gift to us, to help the many, many tens of millions of people who are suffering from back pain discover how there are immediate actions that we can take that often provide tremendous relief. Here’s my conversation with Dr. Ken Hansraj.
Dr. Ken, by way of introduction of you to our listeners, tell me a little bit about your personal journey of becoming a spinal and orthopedic surgeon. How did that happen?
Ken Hansraj: Well, my life is a blessed and really gifted life. I’ve had phenomenal mentors, and so I worked with, for example, Chitranjan Ranawat, who invented the knee replacement for mankind, and I worked very closely with him. And when I did knees and hips, I realized it’s all been figured out and I wanted a challenge, so I went to the spine. And so I chose the spine for myself and for self-discovery.
TS: I’m curious, right here at the beginning, how you see the spine. You call it the tower of power, and I thought that’s interesting. Get me behind your eyes, how you look at the spine and the neck, both, and their connection.
KH: The spine, the back, the mid-back, the neck—so as surgeons, we would typically look at it physically and structurally, but at every moment I’m fully aware that the spine has emotional, has connections to divinity, has power and energy that’s just not defined. And so when we fix a spine, we fix many parts of a person’s life. It’s energetic, it’s beautiful.
TS: Now it’s interesting, I wasn’t expecting you to say connected to divinity. How do you see the spine connected to our divinity?
KH: So when I was in my 40s, I did a lot of self-exploration and trying to be a better me, and I feel, aha! You’re not expecting this from a surgeon, but I feel the chakras, the alignment, the energies are all spine-based, and certainly if the spine is not working or if it’s not functional, you do not have the opportunity to personally enlighten yourself.
TS: Dr. Ken, who knew what I’d hear here? OK, the very first line of your new book, Watch Your Back: Nine Proven Strategies to Reduce Your Neck and Back Pain Without Surgery, the very first line, “Many people will tell you that if you consult a surgeon for medical advice, surgery is the inevitable outcome.” And yet you continue to say that you’ve seen approximately 40,000 patients, and 10 percent or so have had surgery, which means 90 percent haven’t had surgery. So how did you come to the view that even though people were coming to you, I’m coming to you because you’re a surgeon, an orthopedic surgeon, but back surgery is not necessarily what 90 percent of the people need. How did you come to that perspective?
KH: Oh, that’s just plain good medicine. The vast majority of people do not, Tami, require surgery. So if you came to me and your neck is hurting, and your back is hurting, you’re not just 90 percent not requiring surgery, you’re probably 99 percent not requiring surgery. And then I’m starting to realize that my results are not necessarily just surgery, and even when patients have surgery, they’re all of these strategies that we can help them even further to get good results and better results.
TS: Now, your book puts together these nine proven strategies. How did you come up with these nine approaches? What was your method for doing that?
KH: So in 2012, I stopped a five-year study and published a book, Keys to an Amazing Life. So I had worked with great academic surgeons, really amazing, great. And I did, in my earlier life, I did amazing, great, if I may say so myself. For example, I did 10 survivorship studies, which are highest level mathematical studies of surgeries. And then I stop. I wanted something more. My studies are sitting in the libraries globally and they’re really not giving contribution. They’re not worthless, but they’re not helpful, in my opinion. And so I wanted to help people, regular people. And so I started down the path of helping people, how would I help this person myself, and how would I help others? So I started exploring.
TS: That’s when you started exploring, but then how did you come up with these nine different approaches that is your Watch Your Back program?
KH: So from reading, from attending courses, from reading a lot, from doing my own personal developments. And so it’s the practice, it’s the practice of seeing thousands of patients and you get to try this and try that and do this and do that and you see what works. And over a few decades, I really honed it in. And then, well, scientifically, we stumbled on a study. So I was working with Richard Rubenstein and Shay Pantano. And so we started simply, this is really now our contribution to these nine strategies that are scientific.
So we looked at, what is the weight of a head? And so the weight of a head is 10 to 12 pounds. And when we figured out the weight of a head, I did an amazing study, which became the Text Neck study, which is a finite element study, which is really the kind of mathematics you use to define or make a space rocket. We found out when the head is straight up, it weighs 10 pounds, as you lean forward 15 degrees, 27 pounds, 30 degrees, 45 pounds, and 60 degrees, 60 pounds. And so when media found the study, the study went on most, if not every, television channel on the planet and every single newspaper on the planet. So you asked a really deep question. So we did this finite study.
At this point in my life, I’m not a serious academic surgeon and I was really happy to get the media and thinking I’m helping people too. But something amazing happened, which was sort of tough when it was happening. Almost every country restudied the study and were saying, “Oh my goodness, are we really scientists?” I’m happy to tell you that we got validated and we realized we had a strong model and we did nine other studies. And so it’s a personal discovery, to answer your question. And then we stumbled upon or we developed to having finite element study to help people starting with your neck, how to protect your neck by being in good posture.
TS: Now, text neck, this means you’re studying what’s happening to the neck when we’re texting on our phone. And I presume that also means when we’re texting or even when we’re deeply engaged in looking at our social media feed or reading the news or all the things we’re doing when we’re bent overlooking at our phone. So many of us spend hours a day doing that. What’s the solution? How am I supposed to be on my phone and have proper supportive posture for my neck and back?
KH: The solution really starts with—I’m sure at some point you may want to talk about our meditations, but in Watch Your Back, we talk about many meditations, which is really a flash of awareness, right? First, the person needs that flash of awareness. They need to know, oh my goodness, I was not aware and oh my goodness, this is not good for me. And we quantified it. And so, so many people are helped just by the flash of awareness. They were just not aware that doing this, which is I tilted my head down 90 degrees, is really terrible for your spine. Unless we say, Hey, that’s 60 pounds of pressure, or four or five bowling balls hanging onto your head in weight or pressure like that, then they’re suddenly aware.
People all over the world are smart, they’re good, they’re kind, and when they become aware, it is an amazing thing, and just the awareness is so powerful. If I don’t tell them what to do, they’ll figure it out. They’re going, “I can’t do that. Now I understand why my neck hurts, so why I’m tired.” And they would immediately straighten up. But we have definite strategies for good posture.
TS: OK, but I get the flash of awareness. So I’m aware now that I don’t want to have all these bowling balls pulling my head down, but I need to send a text. What am I going to [do]. I mean, I have several things I need to do on my phone, want to do on my phone, how do I do that and keep my head upright?
KH: So then this becomes, the question is how do you embrace proper posture when you’re texting or when you’re using your smart devices? And so proper posture is, first of all, it’s really, really gentle. If you do proper posture like a British soldier who was defending the queen when she was alive, then you’re stiff and you’re rigid, and that in itself is painful. The proper posture, this awareness, this knowledge, it’s something gentle. It’s something really beautiful. There’s nothing stiff about it.
So proper posture is your ears above your shoulder, and the quickest way to do that is imagine having a string from your head is pulling you up gently. And when you pull straight up, you now are approaching being straight in the spine or what’s called a neutral spine. And then when you’re straightened and you’re elevated, and your head is up, and your joints are elongated, you’re feeling better already.
So proper posture is head straight up and your shoulders open. So at all times, when you’re embracing good posture, you want to have your shoulders open or your angel wings in the back of your chest contracted. And so you want to have your head straight up, your angel wings contracted but not in a stiff way. So then when you have your smart device, you can either lift it up in front of you, it doesn’t have to be exactly in front of your eyes because you do have eyeballs.
And I was on an interview with the great guru, Sri Sri Ravi Shankar, where he pointed out to me, he goes, “Just move your eyeballs.” It was an amazing, beautiful attachment to my message. And he pointed out that you could look down a bit or you could look up a bit, but you don’t have to have your device straight in front of you, but you always, always watch where your head is in space.
TS: Now, Dr. Ken, you write that posture, having good posture or bad posture as the case may be, is the primary cause of back pain. That bad posture is the primary cause of back pain. So I want to go into this a little bit more because you also write that back pain is the leading disability worldwide that people suffer from. I mean, I didn’t know until I read your book how pervasive back pain is. I don’t know if you want to share some of the statistics, but I was floored by it, to be honest with you.
KH: Here’s some facts, starting with the Bill and Melinda Gates Global Burden of Disability Study, back pain is number one, and neck pain is number four. Every day, 577 million people around the planet, 7 percent of us, have back pain causing disability, and 290 million or 4 percent of us are suffering with neck pain for a total of 867 million people suffering at any one time.
TS: Yes, amazing statistics, if we haven’t been aware of that. And back to the notion of posture being the primary cause of back pain, you mentioned that we can visualize a string at the top of our head, and I want to make sure I understand this properly. Where does the string touch our head? Is it right in the center of our head? Is it back more, a little bit towards that soft spot where the sutures come together? Where’s the string pulling up from?
KH: That’s an amazing question. Gosh, I have not thought about that. It’s a string that goes, I’m thinking the center to the back of the skull, just pulling you straight up. It’s more of a metaphor than an actual string.
TS: OK, of course. And I get the metaphor of the angel wings being tucked back too and opening my shoulders. The part that isn’t as clear to me is when I do this, I do start to feel a little stiff, a little like I’m trying to have good posture or something. Where does the relaxation come in? How do you help your patients introduce that softening quality?
KH: So I created a stretch called, medically, it’s called a supination external rotation stretch. But, so if you drop your hands to your side and you turn your palms forward as though you’re going for sup, that supination, and when you turn your palms forward, you’ll see it’s easy to get into the position of externally rotating or opening up the chest or closing the angel wings or the scapula.
And so first of all, there’s the awareness and then there’s the attempt to do it. And even though I’ve spent so much time thinking about posture, when I go running, and I run fairly slow, I’m running maybe five miles, seven miles, ten miles, I start to slouch, and then my hands start talking to me, my hands supinate, and then I come back up. It’s been the best reminder possible, we’re never going to really be straight and shoulders open at all time.
It becomes an awareness and a practice and a reminder to keep it loose, keep it gentle, keep it pain-free, keep it fun. It’s not rigid, otherwise we would crazy glue your scapula together or something like that. It’s just a new way of thinking that really, when you embrace it, you have less pain and you feel better and you’re doing more, and so then you quickly go back to it. It’s easy to catch on to.
TS: OK, now I’m thinking of people who are chronically suffering from severe back pain and they’re like, “Yes, I’m glad you’re talking about posture. Next, you’re going to talk about stress, and I need surgery. I have this kind of physiological problem. And please don’t tell me this is just a question of posture and stress and emotions and things like that. Come on.” And so I’m curious, the 10 percent of people who did have surgery under your care, what ended up being their challenges specifically? Like, oh, that’s when surgery is actually needed.
KH: So when you ask this question, what pops into my mind is, it’s a bit scientific, but it really generates the answer for you. So if you have degenerative disc disease, which is wear and tear of the disc spaces, sometimes it’s tender. So at all times in the annulus you have tears that are called annular tears. So at all times you have this defect, but sometimes the interface is hot and sometimes the interface is cold. And so sometimes you have the same tears and it causes no pain at all. And so sometimes when you’re bending, lifting, twisting, reaching, stressing, it’s like squeezing lemons at the interface of the disc space and the disc space squeezes out inflammatory mediators, inflammatory chemicals, and they cause pain.
So you can have problems, you can have defects and have cool interfaces, and you can have defects. And if you’re bending, lifting, twisting, reaching aggressively, like if you are a water delivery guy delivering two tons of water a day, then you’re really stressing those defects and the defects become hot and you’re more likely for surgery. But some people who need surgery, some people have a large herniated disc, a mechanical obstruction in the canal, or they have spinal stenosis. And so then we clean it up, or sometimes there’s a spondylolysis, which is a shifting of the spine. And so we stabilize that segment.
And then when we’re done and we start again, we say, “Hey, avoid bending, lifting, twisting, reaching, take long hot showers, embrace deep breathing, embrace good posture.” Again, these strategies help the people who have had surgeries as well.
TS: Now, one of the recommendations you make very strongly throughout Watch Your Back, pain is the power of movement. It seems like it’s a core part of your program. Because I think sometimes when we have back pain, we just want to lie on the couch, like, “No, I don’t want to move. Are you kidding me? I’m in pain.” I’m not going to move. And your recommendations are, oh, these movements are actually important for many, many people who are attempting to recover from back pain. So talk a little bit about that, how we don’t want to move, but moving’s good.
KH: Moving’s great, actually. So to really discuss movement, we need to understand at every level you have a spinal cord or a spinal sack that has nerve roots, and the nerve roots exit the spine to the various parts of the body. For example, making a bicep muscle or extending your wrist or extending your elbow and/or walking, flexing the knee or flexing the foot, all these motor functions are carried by nerve roots and the nerve roots exit under the facet joints.
Now, the facet joints, I mean, it’s really very, very special in the spine. People are not aware that they have these beautiful jewels called facet joints. And the facet joints, they’re no different from a hip or knee joint in that they are physiological joints that give range of motion and function.
And so now what happens at the level of the facet joint, the nerve exits underneath the facet joint. And if you’re not moving, the facet joint becomes stiff and it hurts, and then the nerve underneath the facet joint becomes stiff and it hurts. So you have a combination of hurt. So no matter what you do, I recommend that you move the joints and move the nerve, simple as walking or swimming or stationary biking or just, if you can’t do those, then you can just do flexion, extension of the neck or of the back. And I’m sure we’ll get to deep belly breathing, which also moves the joints and the nerves. But movement is great because you move the spine joints, they’re jewels, they’re amazing.
Wawrinka, the great tennis player, if you watch him carefully, he winds up his joints, he goes all the way back and then he serves and he gets amazing 135 mile per hour serves, because he’s using and he understands the power of the facet joint in sports. But as regular people, we need to move those joints, because otherwise they become stiff and painful, and move those joints, otherwise the nerves underneath become stiff and tender, causing then pain in the nerve running down the leg or running down the arm
TS: For a healthy spine, how much movement is needed?
KH: So, wow, again, there are so many different levels of healthy spine. Now, we talked about Wawrinka a moment ago, and he physiologically uses the spine in a very unusual way to wind up and crank his serves, which is amazing. But most of the patients, and most Americans and Canadians and world citizens are just not aware they have these beautiful jewels called facet joints. They’re not aware that they need to move it. And so I think for a regular person, we need to move our joints every day.
The athletes will find their way to super physiologically enhance their movement and force some stresses they can exert on a tennis ball by other techniques. But certainly we need to do our exercises like flexion extension, looking left, looking right, bending, things like that to enhance our movement.
TS: What do you think of the whole notion people say that sitting is the new smoking? And I’m thinking, for someone like myself who—I basically work at a desk all day, I’m typing, I’m in meetings, I’m talking on the phone, my job is to sit in front of my computer and work all day, and then I could have sitting disease, as it’s called. What’s your view of that?
KH: I’m so glad you brought the topic up because it brings up another topic near and dear to my heart. So one of the things I have not done as of yet, and I want to do it, is a bit of gratitude. So I’m thankful to you and your company to move ahead with our project and we’re hoping to help the world. I’m thankful to my dear friend Richard Rubenstein, who’s always, always guided me. I’m thankful to Diane Reverand.
If you listen to me carefully, I’m a mathematician and an application specialist and finding ways mathematically and so on. I wrote a book on the wall, my best friends say, “Yes, it’s a good technical manual.” And I thought it was at the level for the general public. So there introduces my great combination writer, Diane Reverand. She has the ability to bring my thoughts in a harlequin romance kind of fashion. You want to turn the pages. So thank you, Diane.
But the person to be thanked for the “sitting is the new smoking” is Tim Cook, and he really deserves, that’s brilliant when he said it. That’s really brilliant calling out. And yes, sitting is the new smoking. It can cause cancer, it can cause inflammation, and so many things that are wrong including depression and so on. So your question specifically is when I went into my gratitude?
TS: My question about sitting being the new smoking as somebody who sits for a living, what are your suggestions so that I can be healthy and do my work?
KH: So again, I say move. It’s simple, move. And so in Watch Your Back, we have 20 stretches that you can move while you’re sitting. So very fondly I refer to my beautiful patients as my lazy Americans. So if you say, “Hey, look, I’m not getting up to move.” There are 20 stretches that we listed that you can do while you’re sitting, flexion, extension, cat cow for example. But certainly every hour you should get up and move two to five minutes.
TS: That’s a lot, two to five minutes every hour. That’s a lot.
KH: Apple, I believe, I think at about ten of the hour, alarms go off and everybody gets up and moves.
TS: Now, Dr. Ken, you mentioned belly breathing previously, and in Watch Your Back, you actually write that you do belly breathing something like a hundred times a day. That’s just part of your day. So tell us what it is. Teach us how you do belly breathing and what are the benefits?
KH: So deep belly breathing is an amazing, amazing augmentation of the spine. So the benefits are profound and tremendous. So deep belly breathing is the ability to breathe deeply into your nose to the point of where your belly goes up, and when your belly goes up, well, then by a physiological definition, your lungs come all the way down, you’re expanding your lungs all the way down. And then when your belly is out and you breathe all the way in so that your belly compresses to your spine and then your lungs close all the way up, so you’re physiologically moving the lungs to highest capacity.
The goodness of deep belly breathing starts with oxygenating your body. And so I always seem to forget that profound goodness, and it takes away anxiety and stress. It does. If you’re feeling stressed, if you do ten deep belly breaths, you’re in a different place right away. Your body physiologically changes.
As a spinal surgeon, what I’m fascinated with is, when you’re breathing deeply, you’re moving the nerves and the spinal channel just a little bit. And the nerves have just a few ways of moving. So for example, when you’re walking and running, they’re indirectly moving, but you’re purposefully choosing to move those spinal nerves in the spinal channel. And so you’re massaging the nerves that could be tender. Furthermore, and very, very interesting, is the fact that around the spinal cord you have spinal fluid, and spinal fluid has very little ways of really getting motion. And the motion of the spinal fluid is important for the metabolism of the brain and the metabolism of the spinal cord and the nerve roots.
So when you breathe deeply, the motion of the spinal fluid increases and I believe it increases the metabolic capacity of the brain and the spinal cord and the nerve roots, and it may protect as we get older for things like Alzheimer’s or neurodegenerative disease.
TS: Dr. Ken, could you take us through a belly breathing practice? Can we do it together right now and can you talk us through it?
KH: Certainly. So I will talk you through and we’ll do it. So first, there are two parts. You breathe in through your nose and you put one hand on your chest and one hand on your belly. And so you breathe in through the nose and your belly goes up, right? And you breathe out through your mouth and the belly goes down. So I’ll walk you through it. So breathe in through your nose in five steps, breathe in, breathe in, breathe in, breathe in, breathe in, hold, exhale through the mouth in five incremental steps.
TS: Thank you. Thanks for demonstrating that. Now, as someone who has suffered from back pain off and on in my life, I’m going to say something that I’m sure you’ve heard your clients say. I’m curious if you can offer an explanation, which is, there have been times when I really am suffering from quite a bit of pain, quite a bit, like, oh my God, I’m thinking to myself, I don’t know, something must be really out of sync, out of alignment. This is terrible. And then I do exercises for maybe just like two days, three days. I do a set of exercises and breathing and different things and the pain’s gone, and I’m like, “What is this pain that can be so real, so terrible, so debilitating and then transient?” It’s gone. It’s gone in a few days. And I think it wasn’t in my head, it was very real. I mean, it was real pain. What’s your explanation of that, particularly around back and neck pain?
KH: One of the great things, here I’m selling my book, one of the great things of my book is I tell 25 stories, and I think it’s story number one or two where we tell Jack’s story, and you’re describing really what’s the common most affliction to the spine. And so if you’re sitting at a desk or you’re in a stress position for a few days, again, the spine joints get stuck and they can become really tender, really painful, a real big deal emergency. And then you start, you unwind, you get off the desk, you start to move, you take a long hot shower, you do flexion, you do extension, and the joints release, and they are very forgiving and they come back to pain-free very fast. And I think it’s just that simple.
TS: It’s amazing. I think that’s where your Watch Your Back program can really provide relief for so many people if they try these breathing exercises and the stretching exercises that you recommend. One question I have for you has to do with aging and the health of our spine and how you see that. And is it just like, look, you need to do these exercises your whole life, Tami. It’s not like you do them and then put them down and go back. No, it’s a lifelong program because as you age it’s going to become even more important. So how do you see that?
KH: So Tami, it’s we define beautifully in an image of how the spine ages over time, and so from 30 and 45 and 65 or so, the spine doesn’t really deform, is a correct word. You don’t have big hunches or big belly hunches, but at the same time your maximum bone strength is about 28. The spine is decreasing in strength in the bony structure and starting to break down more and more at an accelerated rate. So you want to watch your back, you want to pay attention to your spine from a young age.
Now, attention works in this fashion, sometimes for six months you’ll really be on, and then for three months you’ll be partially on. I mean, that’s natural what I see with myself and with others. But you’re talking about aging in the spine. When you start to look at what happens to the spine at 75 and 85 and 95, and the curves start getting really large in the thoracic spine, you start getting microfractures or real fractures in the thoracic and lumbar spine. And then your body compensates by flexing at the hip joint, making you shorter and then flexing at the knee joint, making you further shorter, then your head pitches forward.
So one view of that diagram would keep you really aligned to the fact that, hey, I want to be limber and I want to be supple and strong in the spine. I want to protect myself. I don’t want to allow it to degenerate in the usual fashion.
TS: Sounds like I’m going to be doing exercises for the rest of my life.
KH: So when you do the exercises, you’re really building a better body and a better day and better feel good. So the payment is much more than the exercise.
TS: Yes, true enough. Now, in terms of triggers for back pain, you point out a couple of others that I think are important to mention. One of them has to do with how belly fat influences the stress, the impact on our spine. And I wonder if you can share a bit about that. I was very inspired, reading Watch Your Back, around not having too much belly fat for yet another reason, yet another reason—it’s relationship to back pain.
KH: Belly fat is one of—if you’re going to watch your back, which is great and you want to live a long life, and there’s so many people, for example, my super coach, Dan Sullivan in Toronto, took an oath to live to 156. And there are people that are saying, “Hey, I’m going to live over a hundred with a good mind and body,” then you have to watch your back and certainly you have to watch belly fat. And so belly fat is a harbinger of everything bad, including, it’s not as beautiful, but you have an increased risk of heart problems and hypertension and diabetes and heart attack, but also cancers, you have an increased risk of cancer, and also if that’s not enough, you have an increased risk of metastatic cancer. So just a bad item to have.
Now, a quick story about my study. So we had developed the model and it was battle-tested globally and then we were very happy. And so we wanted to test our model in various other items. And so the Dallas Heart Study Group did an amazing study. They spent millions and they did a derivative study and, really, they created an algorithm to calculate the amount of belly fat for each person, Black, white, Hispanics, men and women. And so they created numbers that were masses of belly fat. And so we took their masses, with their permission and their cooperation, we took their masses and we plugged it into our finite algorithm and we converted into belly fat forces.
And so, at 30 inches for a woman, it’s like having two bowling balls or 22 pounds of force. And at 40 inches it’s like having a nine-year-old child amount of force on your belly with 58 pounds of force, and 50 inches, it’s 95 pounds of force, which is like a baby crib. I mean, so the numbers are tremendous in terms of the forces that are generated to the spine.
TS: What does that mean: forces on the spine?
KH: The most common denominator is bowling ball. So if I took a bowling ball and loaded it onto your spine, then it would exert 12 or, depending on the weight of the bowling ball, 12 or 15 pounds. And so the bigger your waist circumference gets, the more belly mass you have and the belly mass exerts a certain amount of force to the spine. And that’s what I mean.
TS: How much force though is my spine designed to be able to happily handle? Like, “Hey, I’m a tower of power, I got this.” To what degree?
KH: I pray a lot. I really do. I don’t have responses as to the pattern that says I want my people to have 25 pounds of force. And I’m being funny with your question. I don’t have a divine answer, but I do know that we can quantify the forces, and I mean the forces at 25 inches, it’s just 4.9 pounds of force for a woman on the average and 2.8 pounds of force for a man on the average, while at 50 inches on a man, it’s about 65 pounds of force, which is a lot, or 58 hardcover books. But how much can we tolerate? Gosh, I honestly don’t have an answer for that, but I know less is better.
TS: Sure. Now, one aspect of your Watch Your Back program in terms of looking at what can trigger back pain that got my attention had to do with wearing a backpack and that it’s not necessarily a good impact on the spine to wear a backpack. And I thought, well, I’ve heard that having a purse that goes to one side isn’t good either. And then I thought, well, how am I supposed to carry my stuff around Dr. Ken? How am I supposed to carry my phone, which I need to keep my head straight, but look at regularly? I have my phone, my wallet, my keys, where am I supposed to put all this stuff?
KH: So Tami, that’s another great question and an exploration that we did. So we asked the question, if you put a book in the backpack, how much does it weigh to the spine in forces? So every book you put in a backpack weighs seven times to the spine. So when you lean forward 20 degrees, then it weighs 12 times to the spine. And so when we broke the study, CBS News sent in Tom, I’m blanking on his last name, and he interviewed a young girl that we worked with and got her stabilized and carrying more and properly and so on.
And it’s a big problem because, and especially the young kids, if you have a child or a grandchild six-years-old or ten-years-old, all of a sudden you’re saying, “Hey, where are you going with 50 pounds on your back?” It’s easy to see that. And so, CBS News did a separate assessment of all of the studies that said, Hey, what is a safe number? Our studies said, Hey, when you put a book in a backpack, it’s seven times to the spine. And when you lean forward 20 degrees, it’s 12 times, but CBS consolidated the studies and they found that a safe number is 10 percent of your body weight. I’m crediting them appropriately, they did that work. And so 10 percent of your body weight, and that’s not a lot if you think about it.
TS: What is your recommendation though, besides not having too much weight that you’re carrying, for the best tool to carry your stuff? What is it? Is it like a fanny pack? Is that the best approach? What’s the best method here for carrying stuff?
KH: The method I use daily is a bag that rolls.
TS: Oh.
KH: Yes.
TS: It’s like a small suitcasey kind of thing, very small that has wheels on it that you’re—
KH: Exactly
TS: Interesting.
KH: And the companies, they compete now to give you the most comfortable wheels, so they’re frictionless as you roll along and they’re better and better bags and better and better wheels. I just sat down yesterday with a dear patient of mine. I sat down with her, I did her L5, I fixed it with kyphoplasty. She is essentially pain free and she’s very happy. She’s getting ready to go to Saudi Arabia for a religious trip. And so I worked with her. I said, “Even though you’re out of pain in the lower back, you have a fractured area that we fixed. And so I want you to know that you do not load up and carry a lot of stresses.” And I pointed out the backpack study to her.
And also it really begs the question, what do you really need to carry in a backpack that is so important and so heavy all the time? And it begs the question of really looking at if you are hoarding in a backpack, there are consequences to the spine.
TS: Sure, it all makes sense. I think of times when I was younger, when I actually went backpacking and carried 80 pounds or 50 pounds, I had a sleeping bag and a tent and camping tools and all of that. Do you think that’s just a sport or an activity that’s going to be proven not to be good for us or no, there are healthy ways to do it?
KH: So it comes at the level of thought first. Why do you have these objects in your backpack? So necessity should be the number one reason to have things in your backpack. And certainly if you’re going on a camping trip to—
TS: Sure.
KH: —some wonderful place in Colorado, I’m not going to be able to stop you to put all the things you want in there, but not regularly, not daily.
TS: Right. Now, one of the things, Dr. Ken, that surprised me in your Watch Your Back program was that you had a section on sleep. And I thought, huh, I had no idea that getting a good night’s sleep had anything to do with spinal health and not having back pain. So what’s the connection there?
KH: Well, sleep is a very powerful factor. So many people, they just frazzle and degenerate emotionally with anxiety and their lives fall apart. I tell a story of an anesthesiologist I saw and she was not sleeping and I helped her to sleep and she reclaimed her life. It’s just that simple. I was writing orders one day and she came to me and she says, “Hey.” And I said, “What’s up?” And so we went to it. We got an MRI. The MRI was not so normal and she wasn’t sleeping. She was sleeping four to six hours. And we got her to do the Watch Your Back program. We got her to be mindful of blue light in the room and we got her to be much more thoughtful of her sleep pattern. And she’s back to normal, fully back to normal, no neck pain. And her relationships with her husband and children are far, far better.
TS: Now, we can’t have this conversation, Dr. Ken, without touching on the topic, and it’s a overall big word here—stress, And how when I feel stressed, so whether it’s stress about money or stress about work or stress about this or that thing not working out, that that has a direct readout, at least in my experience, on what’s happening in terms of the level of back pain that I might be experiencing. And I’m wondering what your explanation is for that.
KH: It’s quite simple, actually. Well, wow, here I am being technical again. So when you’re stressed—
TS: OK, you’re doing your job by being technical and I’m doing my job by trying to make sure that the everyday person, who’s suffering from back pain and anxious thoughts, understands what you’re saying. So you go ahead and be technical.
KH: Moment of gratitude, a call-out to Shay Pantano. She is phenomenal and I love Shay. Shay has gotten our message globally, billions and billions of views. OK, the stress and why it’s technically simple. So we’re sitting here having a polite conversation, but let’s say I reached out with my words and I started to hurt your feelings, and I say things that hurt your feelings. In a moment you’ll stiffen up, and your breathing becomes shallow, and your heart rate becomes irregular. It becomes more of a sympathetic fight-or-flight body. And I know you’re fully well aware of this, I’ve listened to some of your books that really attack this sympathetic parasympathetic cascade, and you must be parasympathetic to be the great yogi.
So if I hurt you or if you’re hurt in any way, a whole different body emerges and your brain is different and your heart rate is different and your breathing is different and your GI tract is different and even your genitals and your legs, they’re all different functions. They’re now in a fight-or-flight mode, I’m being attacked. In the olden days, it’d be, I’m being attacked by a tiger. It’s the same thing. And then to release that, you just use the strategies of Watch Your Back, you breathe deeply, you work with the thoughts, and you stretch. I mean, stress is a fight-or-flight response. That’s how it works.
TS: Now, I’m going to go ahead and ask you a personal question here, and it may apply to some of our other listeners as well, which is, I was diagnosed with scoliosis as a young person, and I wore a back brace for 18 months when I was in my adolescence. And I’m curious what your understanding is of that curvature of the spine and what we can do later in life so that the scoliosis doesn’t create a lot of pain for us in our life, but how do you even see and view scoliosis?
KH: Scoliosis is a, here’s a technical answer, it’s a three-dimensional rotation of the curve. It’s not just you bend over one way, it’s the whole spine is rotated up and down three dimensionally. Technically, scoliosis does not cause pain, but on top of your scoliosis, you’re just like every other human being where you get wear and tear, degeneration, breakdown. You can get a degenerative disc disease and you will, like everybody else, you can get a herniated disc like everybody else. You can get stenosis like everybody else. And then if you combine that with a stressful lifestyle and poor posture, then you’ll have pain. But the scoliosis is not fully a red herring, but scoliosis in itself will not cause you pain most of the time.
TS: OK. Dr. Ken, I’m going to go out a little bit on a limb here. One of the things that people often write about, people who are interested in emotional and psychological correlates with physical illnesses, is they’ll say, when you have lower back pain, that’s stress about money. And when you have mid-back pain, that’s this or that, or neck pain relates to this or that. And I’m curious if you, through all your work with now 40,000 plus patients, if you’ve seen any mapping of emotions or psychological tendencies and how that relates to different painful expressions, or if you think people are “stretching” no pun intended, but they’re stretching to make these associations. And as a medical doctor, you have some questions about it, where do you land on this?
KH: So I’m sure at some point there’ll be some of my colleagues on the board examination at the American Academy of Orthopedic Surgeon and the North American Spine Society who are very interested in your question and my answer to your question, and certainly, so I have seen stress and manifestations of stress. I have helped so many people calm so many things down and helped them in so many profound ways. And it’s incredible. But to have a compendium of or a dictionary of right ear or left ear, or chin, or chest, I’m certain I do not have a specific location for the stresses and manifestations of stresses.
TS: And do you yourself, Dr. Ken, ever get back or neck pain?
KH: Absolutely. So one of the things I wrote, and I think I sent you a copy, I wrote a meditation call, “Lift: Meditations to Boost Back Health.” And I’m very creative and I do pray a lot and I do all of these things, I do them. And it came to me to use the word tensionometer. And so if you talk about going out on the limb with a tensionometer, in my meditation, deep belly breathing and tensionometer meditation, I located the head, the trapezius, the muscle under the neck and the lower back muscles as areas to keep an eye on, and to start to—I get my tension in the trapezius. And so when I’m extremely tired or when I’ve done 12 to 14 hours, three to four days, my trapezius tensionometer is nine out of ten, and then I have to take care of myself.
TS: How do we each use this idea of a tensionometer in our life?
KH: Again, it’s an awareness, right? So if you say, oh, and the stretch on it, and I did it in my meditation, so I say, hey, if you are on your job and you want to know how you feel about your work, ask your back tensionometer. If you’re at work and you’re nine out of ten, you need another job. And I playfully say, if you’re in a relationship and you want to know how you feel about your relationship, ask your neck tensionometer. But it’s just an awareness and adding a scale and a number to it is excellent because when I could put a number to my tensionometer, I now know I need to back off, decompress, rest, long hot showers, a massage, whatever it takes. But so putting a number to a tension to a specific part of your body, I think it’s an amazing strategy to becoming more aware and consciousness of your stresses.
TS: All right, finally, Dr. Ken, you’ve created the Watch Your Back program. And now with Sounds True, you’ve published the book Watch Your Back: Nine Proven Strategies to Reduce Your Neck and Back Pain Without Surgery. What do you hope people will get out of the program, the Watch Your Back program?
KH: So I have tremendous ambition and bizarrely, I’ve had this ambition to help people globally and we have. And so, one of the thoughts is, which Shay and Richard, we calculated, our studies have helped the world to keep their heads up. And if the world keeps our heads up just 15 degrees because they’re subconsciously aware that you should keep your head up, then we’re saving the world 21 trillion pounds of force off their necks per year. And it’s amazing. We believe we’re going to heaven for it. We believe we’ve done a really big good. My book is just a combination of strategies that we pray that we will help so many people. We want to do a major big good with Watch Your Back.
TS: OK. Well, I am going to have to ask you one final question after the final question because we started and you said that our spine is a connection with divinity, and a couple of times you’ve mentioned praying yourself. And so I’d like to have a deeper understanding of how you experience the divine and what it is you are praying for or to, bring me into the divine world of Dr. Ken for a moment.
KH: So I’m really humble. Honestly, I am. So I would say I’m not the guy to ask the question, but it won’t be the truth. I just, like everybody else that aspires to find divinity, I know that when I’m deeply rested, I know that when I’m deeply meditative, I know that when I’m on the back roads running and meditating and contemplating, I’m able to find divine flashes of tremendous beauty right next to me. And that’s good enough for me. I’m no better than anybody else, but that’s what I have achieved so far.
TS: I’ve been speaking with Dr. Ken Hansraj. He’s the author of the new book, Watch Your Back: Nine Proven Strategies to Reduce Your Neck and Back Pain Without Surgery. The book contains a whole nine-part program and many, many exercises. And there are images and pictures of how you do the exercises for different forms of stretching, and I’m looking through it here. The hamstring stretch with the towel, the bridge, the Superman posture, stretches that you can do in water, the seated leg razor and more. There’s a whole section on nutrition to help reduce back pain. I’m looking at now pictures of neck rotations. This is a book I’m going to keep and use. So thank you Dr. Ken Hansraj, watch your back.
KH: Thank you too, Tami.
TS: And if you’d like to watch Insights at the Edge on video and participate in after-the-show Q&A conversations with featured presenters and have the chance to ask your questions, come join us on Sounds True One, a new membership community that features premium shows, live classes and community events. Let’s learn and grow together. Come join us at join.soundstrue.com. Sounds True: waking up the world.
