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Interview with Pete Egoscue
Pain Relief Expert, Educator and Bestselling Author

Pete Ecoscue, an anatomical physiologist since 1978, is the creator of the Egoscue Method¨ for safe, effective, and permanent relief from chronic pain without prescription painkillers or invasive surgery. His exercise therapy program is acclaimed worldwide, and he has been consulted by some of the biggest names in sports. His books include Pain Free, The Egoscue Method of Health Through Motion, Pain Free for Women, and Pain Free at Your PC.

Interview by Janice Hughes and Dennis Hughes, Share Guide Publishers

Pete Egoscue photo


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The Share Guide: You wrote in your book Pain Free that chronic pain is sending us a message that's different than the one we think we're getting. What do you mean by this?

Pete Egoscue: We think we're getting the message of limitation, or that something is broken, and I don't believe that's true. I think the message we're getting is the body's only voice saying, "I can no longer compensate with what you've given me, and you need to address the situation." It's not that you're diseased, not that you're broken, but you have to pay attention to the body's voice because you've ignored all the other signposts that it threw up for you along the way-you went right through them, or you didn't recognize them. So now it's using pain, the loudest voice it has, and you will pay attention to this. Before pain comes limitation, what we often think is just aging. You know, we used to be able to get up on a step ladder, but now we can't. And we think, "Well, I'm getting old; I'm not supposed to be able to do that." We used to run, now we walk, or we used to walk, and now we ride a bike. But we think that's normal as long as there isn't any pain. Well it's not! The limitations are what we should pay attention to first.

The Share Guide: You've written that you chose to be a physical therapist as a direct result of going through a long rehab program yourself. What was your personal challenge?

Pete Egoscue: I got wounded in Vietnam, and not to make a big deal out of it, but it resulted in pain and limitation and so my quest started because I did not want to accept that as a way of life.

The Share Guide: You've written that muscles that are not regularly stimulated are put on hold. It seems the biggest factor causing so much chronic pain is that we don't move enough, we're very sedentary. Is that right?

Pete Egoscue: That's half right. Never have humans been busier than we are now. We are running from pillar to post so, yes, we do have compensations that have occurred because of our lifestyle. But we are still using the same body and we're still participating like never before in activity. The problem is that the body has a system of adaptation, and the adaptation is to the stimulus that we provide it--so even though we're very active, and we're trying to be fit and healthy, what's happened to us is that the posture muscles that were designed to hold us upright have grown increasingly dysfunctional. And this is escalating decade by decade, generation by generation. So that's where all this chronic pain is coming from. We are moving, but it's the body that we're bringing to the movement that's causing the problem.

The Share Guide: The body is pulled out of joint and loses balance when it uses other muscles to do the work of the major muscles that have atrophied. Can you talk a little bit about compensating muscles?

Pete Egoscue: The body works on a brilliant principle of what's called "vertical load." The skeleton has two jobs as a muscular skeletal organism--one is to bear weight, and the other is to absorb the shock of movement. It does this with joints called load joints, such as shoulder, hip, knee, and ankle. The law of vertical load says that in order for these joints to enjoy their range of motion, they must line up, meaning stacked one over the top of the other. This design requirement is the same for all human beings, male or female, short or tall, skinny or fat, it doesn't make any difference. Range of motion takes place from the inside out. The big posture muscles are the ones that no one can see. They're located down deep next to the skeleton. As they lose their function, the body begins to compensate. So what happens is a series of steps that are taken by the body because it's such an incredibly adaptable machine. The muscles of the outside, the ones you can see, eventually begin to do the work of vertical load, of stabilization, compensating for the inside muscles that have become dysfunctional. You end up acquiring a posture that is visible to an evaluation: one hip in a different position than the other, or one shoulder forward or higher than the other one. And this eventually leads to pain.

The Share Guide: You've mentioned in your books that it's possible to increase the dysfunction by over-exercising the compensating muscles. Can you elaborate on this?

Pete Egoscue: Let's say that we have a shoulder dysfunction, and the right shoulder, because of compensation, is in a different position than the left shoulder. Now let's take that person to the gym, and let's participate in a weight training program. What will happen is that the body will figure out a way to push those weights around or implement the exercise the person wants to do. The problem is that the muscles being recruited in one shoulder girdle are different than the muscles in the other shoulder girdle. You're still making exactly the same motion, but you're recruiting different muscles because of the posture position of the joints. So without realizing it you end up increasing the dysfunction as you strengthen those muscles in that position.

The Share Guide
: So if a person is thinking of starting an exercise routine, it would make sense to make sure that they were balanced before getting into it.

Pete Egoscue: That's correct. Unfortunately, most people in today's culture are posturally imbalanced, because of the demands of the culture--or lack of demands of the culture. Eventually there's going to be the signal of pain. And what happens when the signal of pain comes is that we make that classic mistake, which is stopping activity. There needs to be an awareness that we are bilateral, and that we are designed to be symmetrical. There is a huge penalty for not being symmetrical. So how does a person tell? It's very simple. Take off your shoes and socks, get on a hard surface, shut your eyes, and determine where the weight distribution is in your feet. Is it more towards the left or right? If you're anatomically balanced, the weight is evenly distributed left to right, and it's primarily centered on the balls of both feet. If this is not the case, you have an anatomical imbalance. And that means your immune system is being compromised, and your basic metabolisms are being compromised, and eventually there's going to be some kind of pain. People say, "I can't run downhill without pain; I can't go to the gym and do military presses without pain; I can't go to my office and sit in my chair; I can't drive my car without pain." The pain isn't the villain here. Pain is the signal that the body cannot function properly.

The Share Guide: If you're not in pain, then you're in balance?

Pete Egoscue: Not necessarily. If you're not bilaterally posturally correct, you already have limitations that have nothing to do with pain. For instance, you may have a hard time sleeping, you may be hypertensive, you may have diabetes. Many of the things that homeostasis can't explain because there's no mechanism to be fixed, are actually a result of postural imbalance. It's because we've compromised our basic metabolism. The primary indicator of metabolic health is the reaction of demand, which is muscular skeletal demand. So there are all these signals that we're off balance, even before actual physical pain starts. But eventually the pain is coming.

The Share Guide: Please explain the three R's of The Egoscue Method: Rediscovering the body's design is number one; restoring function is number two; and returning to health is number three.

Pete Egoscue: Rediscovering the design, that's the postural balance, that vertical load we talked about. And then, once you are aware of this, to restore the body to its function requires an absolute belief that this imbalance has nothing to do with poor design, nothing to do with our age, and nothing to do with genetics. It has to do with the reaction of the stimulus to our environment. So once that awareness happens, now you have two choices: you can change the stimulus or you can change the environment. Those are the only two choices you have. Well, most of us won't change our environment because it's not practical, so we've got to change the stimulus-to return ourselves to balance musculo-skeletally. Lastly, the return to health requires not just the change of physical stimulus, it also requires an emotional change. We have to change our MIND. That is the key. We need to realize that we're not fragile, we're not overly complicated, and we do have all the abilities necessary to get well.

The Share Guide: So you need to put yourself in a positive frame of mind?

Pete Egoscue: There's no question. I don't think health is the absence of pain; I think health is the absence of limitation.

The Share Guide: You have created a series of movements you call "E-cises." How do they re-teach the muscles what to do and how to do it?

Pete Egoscue: First of all, we personalize the process to the specific dysfunction. And the body always remembers its design memory, so when you start changing the stimulus with E-cises, the body has no choice, it changes. The goal is not to get rid of the pain, and it's not to allow the person to be able to do all the things they want to do again, even though both those things happen. The goal is to allow the body to return to its birthright, its design template, and it can because it never forgets the memory. All we're doing is providing the necessary stimulus, personalized to the postural dysfunction, and the client is implementing those stimulus by doing the E-cises. So the body goes, "I get it; I understand what you want me to do."

The Share Guide: Instead of waiting for pain to drive us to see the doctor, we should take action before the situation gets out of hand. Do you think most people wait too long?

Pete Egoscue: At the Egoscue University we've got four or five hundred students at the moment and a lot of them are physicians in hospitals. I hear two chronic laments from our students. First, people don't take good care of themselves. Second, they don't comply with recommedations. The physician sits the patient down and tells him he needs to eat more green vegetables, get more rest, or whatever it is. But the patient comes back and has the same bad chemistry. The physician says, "Did you get more rest?" "Well, no." "Did you eat more fruits and vegetables?" "No." So here is my answer to your question. Humans spend their whole lives seeking pleasure and avoiding pain. We've convinced ourselves culturally that we're healthy if we don't have pain. (Now pain can be psychological pain, like depression or low self-esteem. I am not just talking about physical pain.) We believe that the solution to our problem rests outside of ourselves. So do we wait too long to seek help outside of ourselves? No, I don't think so. I think we wait until our pain, whatever it is, has so compromised the environment that we've created for ourselves that we need to seek help. In other words, "I have got to deal with this now, because it is getting in the way of my life." So it isn't that we're dumb or that there's a lack of information out there, or that there aren't wonderful people to help us. It's that we believe that our solutions to our pain rest outside of ourselves. And, of course, that isn't true.

The Share Guide: Do you think that pain killers are the biggest factor in contributing to long-term problems by masking the pain and allowing people to ignore the problem?

Pete Egoscue: No, I think that the biggest problem with pain killers is that people think "OK, the pain's gone now, I'm well again." So it keeps people from addressing the core issue. Pain killers are a real problem in that regard, but they are sometimes incredibly beneficial as well.

The Share Guide
: Right, but if they're just providing symptomatic relief, without looking at the core issue, that can't be good.

Pete Egoscue: You're right. The chronic use of pain killers is incredibly detrimental to the endocrine system, the immune system of the body. It's brutal.

The Share Guide: You've written that 20 minutes a day of exercise can often be enough to give people sufficient motion. Would a 20 minute daily walk suffice as a starting point for people who are sedentary, and how rigorous should it be?

Pete Egoscue: It depends upon how much of your body you're using, and your posture. If you're walking but your feet point outward, then you're not using the posture muscles of your body, so your machine is relatively inefficient. If you're walking for strictly cardio purposes, you're not getting much bang for your buck if your posture is off because you're like an untuned car going down the road. But if you're functional, and your feet point straight ahead, then you're getting a tremendous benefit very quickly. This is because, just by the nature of the posture, the diaphragm is working so you're using the automatic breathing muscle-you're getting full lung expiration, the load on the heart is even and complete, the heart muscle understands the demand, and it ramps up to the demand in a clear, non-confusing way for the body.

The Share Guide: You have a few stories in your books about unsuccessful surgery done to correct pain, when better results could have been achieved with your methods. You have said that 99% percent of the surgery we have is elective. How much unnecessary surgery is done in the U.S. nowadays?

Pete Egoscue: It's a complicated answer to say necessary or unnecessary. Plus it depends on the community to which you speak. We've got surgeons in my university, so if you speak to them they'll say that there are very few unnecessary surgeries. The acute care system is a symptomatic system. It is based on the premise that at the origin of every symptom there is a disease, there is a problem. And it's based on that model of homeostasis which is stability through consistency. So medicine interprets that to mean that physiological regulation is to clamp each parameter at a set point-to set all the vital processes of the body at a particular point. And then since errors (one way or the other) are from that point, you need to correct them. All the therapies, such as surgery, are designed to restore the inappropriate value to a normal value. Now there's a whole new science out there, based on the term allostasis, originally coined by Pete Egoscuer Sterling, a professor of neurosciences at the University of Pennsylvania. Allostasis means stability through change, which means that there is no set point-the mechanisms are designed to change and control the variable, meaning the body is adaptable.

The Share Guide: Sounds like the mechanical view of medicine versus the holistic view.

Pete Egoscue: Correct. What typically happens in standard care is that when a patient sees their physician (a good physician, very well qualified) and that physician believes that there is something broken that needs to be fixed, they will often prescribe surgery. For example: a person shows up with nerve pain running down one of their legs. The physician quickly determines that's sciatica or ephemeral nerve pain, nerve referral down the leg. The physician is trained to believe that something is broken that needs to be fixed. MRIs and CAT scans, the diagnostic tools (they're marvelous, they're wonderful things) are used to trace the problem to it's origin: "Oh, look! There's a disc up against the nerve root."

The Share Guide: So this is the broken part?

Pete Egoscue: Right. Now it's up to the expertise of the physician as to what to do. The surgeon says, because he or she has done it a million times, "I can relieve that symptom by going in there and getting that disc off of that nerve root." And they're absolutely right; they can do that. This is elective surgery. And six months later the pain is back. Why did it come back? Did the surgeon do an unnecessary surgery? No, the surgeon did exactly what he or she said they were going to do, and they did a good job of it. The pain is back because they didn't ask the next question: "Why did that disc do that?" In their homeostatic model they are treating symptoms as if they were causes and they're not-unless you were hit by a truck, and there was some external stimulant. In the case of a car wreck you know that the source of the pain and the cause of the pain were the same thing--you've got a compound fracture, or something like that. But in most cases that's not it. So this is a round about answer as to whether there are unnecessary surgeries. I'll say that there are no unnecessary surgeries because what the patient and the surgeon decide on is, in 99% of the cases, perfectly and optimally performed. They do exactly what they say they are going to do. But what I think is that you know more about your health than anybody else. (Even though our culture doesn't believe that you do.) So to start asking the right questions, you've got to help your healthcare professional. You can't complain about chronic pain if you are not helping the situation. If you consult a physician or a therapist of any kind and you don't participate, what you are really doing is you are handicapping that professional's ability to help you. You have to ask the "why" questions, and you have to be an active participant. Now the tragedy of all this is that we are well-schooled on how to do that in every area of our life, except with our healthcare. We've convinced ourselves that we're fragile and complicated, and because of that only experts can help us solve our problems. It's just not true.

The Share Guide: I think the foundation of holistic healthcare is body, mind, and spirit; it's the larger organism. And there's also our active involvement in our evolution.

Pete Egoscue: Yes. That's why, when physicians often ask me why I think alternative care is exploding in growth, that's the answer I give them. Because many people are no longer comfortable with the expert/patient relationship. The only dialogue that an expert and a patient have is, "What is the symptom?" In the complementary care world, as you pointed out, the symptom is just part of the matrix. And that's why, in my view, that paradigm is growing so quickly.

The Share Guide: So is this the future of medicine?

Pete Egoscue: I believe that the current paradigm has already shifted. We're moving from the paradigm of expert-driven care to the new one of patient-driven care.

The Share Guide: I think that's why natural foods stores and fitness centers have grown so much in this country.

Pete Egoscue: Right. They're going through the roof because, in spite of all of the "scientific research" to the contrary, human beings instinctively understand that something that's grown organically is better for you than something that's not.


For more information about Pete Egoscue, visit his website at www.egoscue.com

Related Info:
A Glossary of Bodywork Therapies
Natural Relief from Back Pain
How To Heal Yourself
Acupuncture for Headaches
Preventing Osteoporosis
Living Well: A Guide to Anti-Aging
Alternative Practitioners


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