CASE STUDIES BY DR. JEREMY JAMES
Tony Caine: Low Back Pain. History of Surgery for Lumbar Disc Herniation
Tony Caine came to me with a long history of back problems. He had suffered a disc herniation in his 20s and had surgery to fix it. Since the surgery, he had experienced recurring low back pain which at times was debilitating. He undertook various conservative therapies such as Pilates, personal training, yoga, physical therapy, and chiropractic, with very limited success. His back pain got steadily worse over time, culminating in a debilitating episode while on vacation that rendered him unable to do the most basic functions such as tying his shoes or getting out of bed. Tony came to me in a state of desperation.
The first thing I did was ask Tony about all of his physical activities. I know from research and experience that all of Tony’s therapeutic activities have aspects that can prevent healing of the low back and prolong imbalances and weaknesses. I asked him to stop them all for the short term, until we got his back under control. Later, we would add all of these back in, with some small changes.
Tony undertook a three-month program with me, which involved retraining him in all aspects of movement, rebuilding and rebalancing his core muscles, improving range of motion and flexibility in the hips, and educating him on what to do and not to do to allow his back to heal and strengthen. Specifically, he had overdeveloped his anterior abdominal muscles at the expense of the lateral wall muscles (front vs. side of the core). This created a significant imbalance that caused his lumbar spine (low back) to bear too much load through the lower discs. In addition, he had extremely tight hamstrings because of weak and inactive gluteal muscles — which also contributed to putting asymmetrical, damaging loads on his lumbar spine.
After three months of core training, education, and flexibility work, I passed Tony on to a knowledgeable personal trainer who guided him through fine tuning his workout routine and removing any dangerous exercises from it. Today, Tony is pain free and has returned to all activities without fear or discomfort.
My name is Tony Caine. I am 60 years old and I lead and active Colorado life style — hiking, mountain biking, climbing, skiing, and golfing. However, it hasn’t always been this way.
I’ve had a history of chronic back pain, including [a] surgery in 1987. Three years ago, my back pain was so severe [that] I couldn’t do any of the physical actives I love. Back pain caused me to miss social and school events. At my worst, I couldn’t even tie my own shoes. I experienced days where I couldn’t get off the floor and succumbed to drugs to relieve pain. The exercise routines I thought were strengthening my back weren’t helping. Rest made no difference. In short, back pain was making my life miserable and I knew I had to take action.
I went to a neurosurgeon who fortunately provided the advice that physical therapy was the first approach. I then had the fortune of being introduced to Dr. Jeremy James. Jeremy was empathetic to my circumstance and immediately provided a positive outlook that I could get back to an active lifestyle. He assured me that with the right approach and a commitment to consistent work, I could eliminate my back pain and maintain a healthy, pain free back! Basically, I had a path to getting my life back.
Jeremy’s approach started with determining some of the root causes of my back pain, providing an understanding of the muscles supporting my spine, and altering a few basic daily movement patterns. Then we started with a few static exercises to activate muscles supporting my spine. We established an early goal of being able to tie my shoes without pain.
Each week, we progressed with more and newer exercises. Equally important to the physical routine, I became optimistic about my back health. I finally had a positive path and hope! As I developed better core strength and my back became more stable, we were able to implement more aggressive exercises. Jeremy’s routine was never redundant and consistently pushed me to improve my back and core strength and mobility.
Today, I am back to all my physical activity with zero back pain. My path to a healthy back wasn’t immediate; it took several months and a commitment to complete the exercise routines diligently. But I made steady progress from the beginning. And yes, I can tie my own shoes now!
Most important, I now have the knowledge, resources, and a pattern to maintain a healthy back!
Thank you, Dr. Jeremy James!
Kay Dunton: Low Back Pain. Sacroiliac (SI) Joint Sprain
Kay has experienced intermittent bouts of severe low back pain from a hard fall on the buttocks in 2000, resulting in a sacroiliac (SI) joint sprain. Because of the laxity of the ligaments resulting from the fall, Kay had a chronically unstable SI joint. Various treatments such as chiropractic, massage, cupping, and acupuncture offered her short-term relief during painful flare ups — but permanent relief was never found. Kay was referred to me in 2014 as a last resort. Like most of my clients, she was jaded and her expectations were low.
I began by teaching Kay about her condition. While there was nothing that I could do to change the integrity of her ligaments, I could help her strengthen the muscles surrounding the SI joint and change her behaviors such as the way she bent, twisted, sat, and lifted to avoid putting stress and load through the SI joint. The combination of increased strength in the gluteal muscles, core, and hip flexors, the changes in the way she moved and lived, and her understanding of how to brace her core to support her SI joint, Kay is now relatively pain free and her debilitating episodes have gone from one per week to one per year. To be clear, her ligaments are still lax and the damage remains, but she has learned to avoid the behaviors that load the joint and has gotten her life back on track, free of the constant fear of a crushing flareup.
I started working with Jeremy in 2014 after suffering for years with episodes of very intense low back pain. It all started with a fall in 2000 that caused permanent damage to my SI joint. Since the fall I would experience regular periods of terrible low back and pelvic pain and a feeling of being out of alignment. I was told that the fall caused a sprain to ligaments in my pelvis, resulting in a permanently unstable SI joint. I saw many chiropractors, massage therapists, doctors, and acupuncturists. While some of these were able to give me short term relief, I never experienced any lasting relief. I lived in constant fear that bending down to pick something up or some other formerly insignificant activity would cause days of pain. Jeremy taught me how to use the muscles in my core to support my SI joint and guided me through a program to strengthen the muscles in my pelvis to keep myself in alignment. He also showed me how to move so that I could go through life without the fear of putting myself “out.” Once I got my low back pain under control, Jeremy upped my workouts to include movements and fast paced exercises I would have not thought possible. If I follow his protocol I am mostly pain free. My episodes are far less frequent and much less severe if they do happen. They are usually a result of me doing something I shouldn’t have done or falling off of the exercise wagon. I am now able to live my life free of the stress and fear of debilitating pain.
Bob Hurst: Foraminal Stenosis of the Cervical Spine (Neck)
Bob Hurst suffered from foraminal stenosis in the cervical spine (neck) for decades beginning in the 90s. Formerly a banker at a prestigious bank, Bob’s work involved extensive overseas travel and working at a desk. Over the years Bob’s cervical spine degenerated from the pressures caused by these activities and eventually caused stenosis at multiple levels of his cervical spine, resulting in neck and arm pain and numbness and tingling in the arms and hands.
Bob was referred to me by a friend of his and came in with very low expectations because of his long battle with the condition and his experience with other conservative therapies including physical therapy, injections, chiropractic, yoga, and Pilates. Bob presented with a pattern I was very familiar with in people who work at desk and travel: forward head carriage, hypertonic subscapular muscles, weak rotator cuff muscles, and weak and inactive gluteal muscles. And because of his love of yoga, Bob was also too mobile in many joints and lacked the stability necessary to maintain a stiff and stable cervical spine, preventing symptoms from stenosis.
We immediately discontinued all his exercise-related activities for a short time and started Bob on a program of lumbar (not cervical) spine stability to begin with. It is crucial to build stability in the lumbar spine (low back) before attempting to correct dysfunction in the cervical spine. After about four weeks, Bob displayed signs of a stable lumbar spine so we moved on to therapy focused on his cervical spinal stenosis. We built strength and endurance in the deep neck flexors, stability of the scapula, strength in the rotator cuff and strength, and awareness of the gluteal muscles. In addition, I taught Bob how to keep good posture when working at his desk and taught him the importance of shifting positions regularly to avoid putting harmful forces through one part of his spine for too long a time.
After six months, all of Bob’s symptoms resolved and he was able to resume all of his normal activities, including golf, with some modifications.
I have had serious neck stenosis issues for years and to put it simply: Jeremy has fixed me. A combination of neck and back strengthening exercises, patiently rolled out over time, has made the difference. He is extremely knowledgeable, thoughtful, easy to work with, and a great guy – [an] unbeatable combination!
Richard Jelinek: Neck Pain and Low Back Pain. Spondylolisthesis at L4, Multilevel Cervical Stenosis, Degenerative Disc Disease
Richard, a very fit 80 year old, came to me after years of debilitating neck pain and chronic low back pain. Richard had given up on lifting anything overhead because of intermittent episodes of severe neck pain and spasm associated with these movements. He had suffered a serious accident on an ATV in 1999, resulting in a subdural hematoma and possibly a lumbar vertebral fracture (no imaging was done on low back at the time; spondylolisthesis was discovered later). Since the accident he experienced neck spasms and headaches almost any time he lifted anything over five pounds above his head. These spasms could last for days and rendered him unable to work and bedridden.
Richard had developed some protective, compensatory patterns after his wreck to protect his neck and low back. These patterns are useful in the short term to keep the neck and low back stiff, avoiding further injury. Unfortunately, once he had recovered from the accident, these faulty movement patterns remained. Richard had continued to exhibit these protective movement patterns for years, resulting in using the wrong muscles to lift overhead, which ultimately strained them and caused painful tension and spasms in the upper trapezius muscles. These tense, overworked muscles would go into spasm when Richard lifted anything heavy because they weren’t getting help from the other muscles of the rotator cuff. The spasms were causing the debilitating neck pain and headaches. Once Richard learned to stabilize his scapula (shoulder blade) by bracing his core and engaging his subscapularis muscle, he was able to learn to lift properly and develop strength and tone in the muscles of the rotator cuff. Richard can now lift overhead without any problem. The debilitating spasms are a thing of the past.
Richard’s intermittent episodes of low back pain were caused by excessive twisting and bending in the lumbar spine, which irritated the spondylolisthesis. Richard learned to sit, stand, and move in neutral spine and developed the core endurance and strength to support his spine, resulting in a dramatic reduction in the intensity and frequency of the spondylolisthesis-related low back pain episodes. The spondylolisthesis remains, but he is almost always asymptomatic because he has learned not to aggravate it and can now do all the activities he loves: skiing, mountain biking, and walking. Not bad for an 80 year old!
I was referred to Jeremy by a close friend who had a great outcome with him. I have had neck and back issues for years that have prevented me from doing simple movements such as lifting anything overhead. Certain movements would cause excruciating neck pain that would last for days. I dreaded these episodes so much I avoided these movements at all costs. Chiropractors and physical therapists would always provide me with short-term relief once I was in pain, but they never showed me how to stop these things on my own. Within a few sessions, Jeremy helped me regain enough strength in my back and upper body to allow me to lift overhead without these episodes. In addition, my low back feels better than it has in many years. If I follow Jeremy’s program, I feel great.
Juliette Ferrell: Neck Pain and Low Back Pain. Postpartum Lumbar Spine Instability, Degenerative Disc Disease
Juliette started to experience regular low back pain after giving birth to her second child. By the time she had her fourth and final child, the pain had transitioned from an annoyance to a major disruptive factor in her life. I explained to Juliette that some women experience a very unpleasant side effect from childbirth because of the hormone relaxin, which helps prepare the pelvis to expand to give birth. Some women experience long-term laxity in the ligaments in the low back and pelvis. The laxity can make them very sensitive to strain and stress in the low back, resulting in severe back pain with certain activities and movements.
Juliette was already very fit and disciplined, so it wasn’t difficult to get her to do the necessary work to stabilize her back. It was more a matter of teaching her the correct way to brace her neutral spine and move properly with neutral spine to avoid putting harmful loads through her low back. Within a few weeks this became natural to her. Finally, I showed her the exercises she needed to stop doing and replaced them with safe and effective alternatives. Now, she is nearly always pain free and leads a very active life, participating regularly in skiing and hiking and maintaining a demanding workout regimen.
I am a mother of four and love to exercise and stay active. Surprisingly, a lot of my exercises and activities were contributing to my recurring back problems. Jeremy quickly identified and cut the harmful exercises out of my routine and introduced safe alternatives. He also investigated things I would never have thought of that ended up being contributors to my back problem, including my mattress and the way I rode my bike in spin class. Now, following Jeremy’s rules, I am almost always completely pain free. When I do have the occasional mild flare up, I know how to end it myself, thanks to the knowledge I got from Jeremy’s careful teaching. I am more active than I was 10 years ago.
Bubba Eggleston: Low Back Pain. History of Surgery for Lumbar Disc Herniation
Bubba came to see me because of lingering back pain after surgery for a disc herniation. The surgery relieved his leg symptoms but not his back pain. In addition, Bubba was hesitant to get back to the activities he loved out of fear of hurting himself again. Bubba didn’t feel that the physical therapy following his surgery was sufficient in protecting his back, and his ongoing back pain was a major concern.
After our initial evaluation ruled out any concerns about his lumbar discs, I took Bubba to the gym and asked him to walk me through his exercise routine. It was an expected and unfortunately all too common sight: lots of core exercises that involved putting the lumbar spine into dangerous positions, lots of heavy weights lifted without proper lumbar spine stabilization and support, or lack of glute strength. Bubba was very similar to many of my motivated, hard-working clients: they are determined and work hard to take care of their backs and bodies, but they just haven’t received the proper instruction and guidance. With a few weeks of training, altering his exercise routine and teaching him how to safely resume the activities he loved, Bubba got back on the right track and his back pain resolved. He returned to all activities and is still going strong. He is a perfect example of countless others I’ve helped like him.
Following back surgery in the fall of 2014 and physical therapy to recover I was introduced to Jeremy through a friend. [It] could have been one of the most significant introductions of my life. His series of foundational exercises have helped me rebuild from the inside out and are still a part of my daily routine three years later. Incorporating his ideas into my workout has made my core so much stronger than [it] ever was and it allows me to participate in so many of the activities we live for here in Colorado. I love to ski, hike, mountain bike, and even coach youth football. The coolest part is I get do these things with my two kids (ages 9 and 11) thanks to Jeremy.
*The above case studies are from clients of Jeremy James, D.C. and their experiences about being treated by him in person at The Aspen Club Back Institute. Each case study is from a real client who received personalized, in-person treatment and advice from Dr. James. The results that these clients experienced apply only to those individual clients. No one was paid for providing a case study. All results were self-reported by the clients and are subjective, so they cannot be confirmed.
The clients listed above did not participate in the BackForever program. Participants in the BackForever program will not receive personalized care and advice like the clients listed above. However, all of the exercises and educational tutorials completed by those individuals are included in the BackForever program.
BackForever does not and cannot guarantee that BackForever participants will experience the results that are the same or substantially similar to results experienced by these clients. These clients should not be considered typical or atypical results for the BackForever program, as these clients did not participate in the BackForever program.
The Aspen Club Back Institute is not associated or affiliated with, nor does the Aspen Club Back Institute endorse, the BackForever website or BackForever program.
In 2010, I was very fortunate to meet Jeremy James in his position of Director/Therapist at Aspen Back and Body. After many attempts to overcome chronic low back and pelvic pain, I made the trip to Aspen and was rewarded with a definitive plan to recapture my quality of life.
Jeremy’s plans for my transformation began with the initial telephone evaluation. Many of his credos have become my daily constitution.
Jeremy and this experience provided me with the mindset to return home and continue evolving and growing into the stronger and healthier woman I am today. Thank you so much, Jeremy James. Nothing in life is worthwhile without your health! My husband and I wish you and yours the best of everything.
Most of my friends close to my age have problems with their backs. Jeremy was one of the few chiropractors, trainers, or physical therapists who first analyzed the source of my problem and prescribed exercises that focused on minimizing the pain I was dealing with daily. I have always felt and believed that Jeremy’s attention to my issues were personal to me, and effective in order to help me live my life normally.
Whether you are an athlete who wants to optimize your potential, an individual who has goals to improve their overall health and fitness, or someone with acute and chronic issues that no one else has been able to address, you should consider Dr. James’s program. In my mid 30s I felt invincible and was a top athlete in my age group, with a tremendous body. Due to a car accident that had crossed my path, acute and chronic issues started affecting my strength, agility, and ability to perform the athletic activities I enjoy at optimum levels. For over a decade I had been seeking, but regrettably not receiving, the appropriate treatment to diminish the cause of my chronic pain and issues. I had gone to numerous respected, well-known clinics across the country and with frustration – no one was able to resolve my acute and chronic pain and range of motion issues in my back, neck, hip, and pelvis. My symptoms for temporary relief were always addressed, but regrettably, the cause creating the symptoms had not been resolved, so the pain would always reappear.
Working with Dr. James has truly been a life changing experience for me. Today, I feel better than I have in over a decade, and the chronic headache, range of motion, and other infuriating issues I was constantly dealing with are not impacting me on a daily / regular basis.