Is poor posture to blame for your pain?

pharaohs sitting

What if someone told you that making a few relatively simple changes to things you do every day sitting, standing, walking, even sleeping could relieve or extinguish pain, or prevent it altogether? And making these changes would be a matter of relearning something, so wouldn’t entail lots of time, effort, or money. Sounds pretty good, right?

The pretty accurately describes the Gokhale Method, “a systematic process of restoring pain-free posture and movement,” which Esther Gokhale practices in her Palo Alto, Calif., center. Gokhale (pronounced GO-CLAY), a licensed acupuncturist, once experienced debilitating back and sciatic pain that even surgery failed to help.

Searching for a better way, she studied a variety of methods and techniques, including the Alexander Technique and the work of the Aplomb Institute. From her research, review of the medical literature, and work with clients in her acupuncture practice, Gokhale developed her method. In addition to teaching workshops around world, she has written 8 Steps to a Pain-Free Back. She was recently profiled in The New York Times.

Pain Resource recently spoke to Gokhale to learn more about how the method, which focuses on adjusting posture to ease pain and improve overall health and well-being, and how it might help chronic-pain patients. Here’s an excerpt of our interview:

3448-014Pain Resource:  “Primal Posture” is at the heart of your method namely that if we could regain a healthy posture that we were all born with we could ease or avoid pain. Can you explain?

Esther Gokhale: It’s the posture that you find in our hunter-gatherer ancestors or even our great-great-grandparents, that we all shared when we were 2 and that people in nonindustrial cultures still retain. The architecture of the body that I claim is natural is pain-free, highly functional, and beautiful.

Primal posture is a J-spine rather an S- or C-shaped spine. [Your] behind is definitely behind [you]; the upper lumbar area [of the back] is lengthened rather than very curved, and the bones [of the spine] stack well so that the muscles are relatively relaxed and there is strength and ease and flow in the body. The circulation is unencumbered by tension, and it’s like human beings reach their full potential with this kind of architecture.

3448-087PR: How did you discover this?

EG: The hard way: I had back pain severe sciatic pain that wouldn’t respond to any of a plethora of conservative and alternative measures that I tried, so I had to cast a very wide net to find a solution. I was also a practicing acupuncturist, so I was seeing other people with pain and I had begun to wonder why human beings were so poorly designed and kept falling apart. The conclusion I came to is that we’re extremely well-designed creatures. The problem is that we were born without a user’s manual and the culture doesn’t support us very well. It’s an ongoing process; I’m still evolving my process, and it gets richer over the years.

PR: What have we forgotten about movement that we knew as infants and young children?

EG: In general, you want to use muscles and spare your joints that’s one general principle. You want to respect the baseline shape of your spine through your movement. “Stacking of the bones” helps prevent osteoporosis and osteoarthritis.

3458-014PR: How does this work?

EG: To avoid osteoporosis you want to create appropriate weight-bearing on bones. You can help avoid osteoarthritis by not creating edgewise compression in the vertebrae, which [impedes] muscle relaxation needed to promote healthy circulation. The vertebrae are designed to be stacked. … If you have a poorly aligned stack of vertebrae, instead of having face-to-face, healthy compression [between the bones of the spine and the disks], you have just the edges of the vertebrae stressed … which is the beginning of the process of osteoarthritis. … Healthy stacking does all kinds of good things to your bones; unhealthy stacking is bad for bones and disks.

3448-056PR: You note that there’s a lot of erroneous information about posture out there. What don’t many of us understand about it? What are some common myths?

EG: It begins with what our parents tell us: “Stand up straight” and “sit up straight.” This tends to tense up the low back, with the chest pressed out. It’s an S spine with edgewise compression of the bones, which leads to unhealthy, compressed disks.

Another one is “chin up, chest out,” which leads to all kinds of unhealthy pressure on the most vulnerable part of the spine: the cervical (neck) and lumbar (low back) areas. Even medical professionals are encouraging people to tuck their pelvis, but that puts a lot of unhealthy pressures on disks, which can lead to sciatic pain.

Ergonomic chairs, too. They are informing the body on a way to be, what the shape [of the back] should be. Without exception, it’s always an S-shaped curve [when sitting in these chairs] and I believe that and I have data to support that a J spine is natural and healthy, and gives people the result of being highly functional and pain-free.

What’s happened in the professional world is that the average human structure has gotten mistaken for normal and even ideal. We’re being shepherded toward what’s average today, but with an 80% incidence of back pain, you don’t really want to copy the average. You want to go back in time.

I teach people from a medical illustration from 1911. … [People living then had] a totally different shape in the spine. It makes so much sense. That’s the journey I guide people through; I see myself as a posture guide.

Pain Resource will have more posture advice from Esther Gokhale next week, so check back!

Do you think posture plays a role in pain? Please join our community today to discuss.


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