(Originally posted at HealWild.com) The epidemic of blown-out spines is one of those manifestations of our society’s collective bad health that I found shocking as a novice acupuncturist. Before seeing my own patients, I had no idea that something so fundamental as our backbone could fail that easily and in so many people. A blown-out L5-S1 (the base of the lower lumbar spine, where it meets the sacrum) is the most common orthopedic ailment I’m likely to see in clinic, followed by cervical spine issues, and related problems like sciatica, nerve issues into the arms, numbness and tingling in the hands and feet, headaches, and other terrible problems.
Though I’m usually successful treating the resulting pain with acupuncture, my drive to get to the root of things has kept me on a quest to understand modern back problems. As part of this quest, last November I attended a 3-day workshop with Esther Gokhale, author of the book 8 Steps to a Pain-Free Back: Natural Posture Solutions for Pain in the Back, Neck, Shoulder, Hip, Knee and Foot and founder of of the Gokhale Method. I had first come across her work via Mark’s Daily Apple, where Mark Sisson spoke highly of her “Stretchlying” technique as a way of enhancing sleep quality. Here’s a great introductory article he posted about her method.
When I heard my friends in Montreal were inviting Gokhale to their Aikido dojo to teach the weekend Gokhale Method Foundations course, it re-sparked my interest and spurred me to dive into her work in search of some answers. Taking the in-person workshop was one of the most enlightening experiences I’ve had in nearly a decade of studying natural health.
The Weston A. Price of Orthopedics
I’ve studied posture intensively across different disciplines over the years, including Aikido training, Zen meditation retreats, yoga, Qi Gong, Ba Gua, and even Feldenkrais Method workshops… but Gokhale’s work stood out to me as unique due to its far-reaching ancestral perspective. Suffering with her own terrible low back issues, Gokhale (a Harvard and Princeton biochemistry grad) had traveled the world looking at ancestral patterns to determine a baseline for human health, in this case, spine health. In linking up the disparate wisdom of traditional peoples and cultural lineages, her work struck me as very similar to the nutrition research of Ancestral Health hero Dr. Weston A. Price.
Gokhale modeled the posture and movement of pockets of traditional and modern people who still had excellent spinal health and what she calls “intact kinesthetic traditions.” This means their cultures/families are still passing on good posture and movement to the next generation, through example and instruction but also through such methods as how they hold and carry babies from birth, and their furniture (or lack thereof), carrying and working methods. She put together what these examples had in common to create a system for rehabilitating posture: the “8 steps” of her book, including instructions on sitting, standing, lying, sidelying, bending, and walking with “Primal Posture”–the basic posture that we evolved to thrive with.
As with other discoveries in the Ancestral Health movement, it’s important in studying Primal Posture to let go of your preconceptions. Much of what you have been taught (if anything) is probably incorrect, or at least incomplete. Check out Gokhale’s website and especially her book for some amazing images that she gathered of healthy posture around the world.
Are you a J-shape, a C-shape or an S-shape?
One of Gokhale’s discoveries was that societies with healthy kinesthetic traditions all stood, sat, held babies, walked, and reached in ways that maintained their spines in a beautiful J-shape. This means, the spine overall is very straight, with just subtle curvature– not an “S”-shape as often described in modern anatomy textbooks and images. (Such textbook images, Gokhale says, actually are depicting a pathological spine shape that has become the “new normal.”)
In a J-spine, at the very base of the nicely stacked cervical, thoracic and lumbar spine, the L5-S1 joint juts out at about 45 degrees (depending somewhat on ethnicity– Africans have a more pronounced angle, Asians less pronounced, and Europeans/South Asians somewhere in between). L5-S1 is wedge-shaped in a healthy spine, creating this lovely angle and letting the butt jut out, where its muscles can work efficiently to help us walk and balance. Think of how a woman carrying a vase on her head would look– nicely stacked neck and spine; shoulders back; activated butt; J-shape.
In cultures that have lost a healthy kinesthetic tradition, the sacrum is usually overly tucked-under. This compresses and distorts the wedge-shaped L5-S1, setting it up for degeneration. From there on up, we usually either have a C-shaped spine (think of the whole spine as bowed, with the head sticking forward) or an S-shaped (think of a sway in the mid back to correct for the lower tuck; ribcage sticking out; and head leaning forward to compensate). Here are some examples of S- and C-shapes in otherwise fit-looking people (photos courtesy of Esther Gokhale):
My experience with Gokhale Method Foundations course
Though so far I’m lucky enough to have evaded chronic back pain through my relatively decent posture and exercise, I learned at the workshop that I definitely fall in the common S-shape category (as do many tall women, emulating the slightly slouchy fashion template that’s been in place since the 1920s). Following the steps of the workshop, I felt a glorious, effortless stretch in the back of my neck, relief of arch pain I get in on and off in one foot, and surprisingly, an almost instantaneous warming of the extremities due to improved circulation.
In the workshop we learned basic sitting, lying, standing, bending and walking patterns (as described in the 8-step book) that both protect the spine and help to gradually restore length. I learned that even though I’m more flexible than average, I don’t have near the hamstring and psoas flexibility required for a healthy forward bend and stride. But, “glidewalking” and “hip-hinging” as taught by Gokhale already had me lengthening my hams and psoas with everyday movements.
The everyday nature of Gokhale’s system struck me as especially powerful– instead of having to set aside time for rehabilitative exercises, the Gokhale Method allows you to recover healthy spine shape with the basic movements of life. This is akin to recovering your health not by eating special, expensive “superfoods” now and then, but by eating healthy, nutritious foods at each meal.
I’ve been working each day to implement what I’ve learned and am noticing many benefits, for myself and my patients. I can’t recommend Gokhale’s book and workshops highly enough to anyone who is interested in long-term, non-invasive solutions to back and neck pain, or preventing these and other orthopedic problems in the first place. You can learn more by visiting gokhalemethod.com.