arthritis

In keeping with Claudia’s wishes we are not going to use any photographs of her in this blog post. We are always happy to respect our contributors' wishes for privacy. We are very grateful for Claudia’s generosity in sharing her personal posture journey, and are sure that you, our readers, will appreciate it too.

—Esther Gokhale

How I came to the Gokhale Method

I decided to take the course with Esther in person for a few reasons—firstly, I have received emails periodically about her offerings for some years and actually live close to Palo Alto where she is based. Secondly, I have been having some physical challenges recently. Lastly, my 93-year-old mother passed away in December and I felt that, after settling her estate, taking the Foundations course would make good use of some of what I received. I felt, “this is my gift from my mother.” It would make my mother happy to know this is what I’ve done…

Towards the end of my Foundation course, our garden burst forth with abundant, fragrant plumeria flowers. I brought some to Esther for my lesson and she remembered them very fondly as Champa, or frangipani flowers, from growing up in India. Image by Claudia

Improvements despite hip arthritis and osteoporosis 

A few years back I was walking with a friend and my toe somehow got caught in a brick-paved area—I don’t even remember falling, but found myself on the ground. I broke my humerus and radius. I knew I had osteoporosis, and guessed it had gotten worse—my doctor wanted to put me on medication for it, but the more I read the less I wanted to take that route—so I looked into other possibilities. 

If you are prone to tripping, the Gokhale Method Toe Tap exercise will strengthen your tibialis anterior, the shin muscle whose tendon lifts the front of your foot clear of the ground. 

I fell again a couple of years later and didn’t break anything, but I did say to my doctor how stiff my hips were feeling, despite being so active. He advised me to get an X-ray, which confirmed that I had severe hip arthritis. This surprised me as I am very active and used to run marathons—my doctor told me right away that I should get hip replacements. I thought, “I am going to explore every alternative route.” 

I have also been working on my osteoporosis since my first fall, in 2020. Every week I do Osteostrong®, using weight machines that are geared for building your bones, and take a high-quality calcium and strontium supplement. I think these measures, combined with the healthy posture I learned with the Gokhale Method aligning my bones well to respond to gravity on a daily basis, are producing significant results. I recently got my DEXA scan for the last year and my spine bone density improved by 10% and my hip bone density 20.5%, to which my doctor said “Wow!”. 

Early success motivated me to discover glidewalking

My Foundations one-on-one course was six weeks of learning a couple of new posture techniques each week, and working to incorporate these into my daily life. I worked really hard all week between lessons, practicing and rereading the book—I felt very motivated to be prepared for the next week’s lesson as I was having some immediate success. I often found it helpful to look in the mirror to check my posture learning, just to be sure of what I was doing—for example, to see that I was keeping my shoulders rolled back.

Our shoulders are naturally positioned in a posterior position that gives space for the joint, muscles, tendons, blood vessels, and nerves that populate the shoulder girdle. Shoulder rolls can gradually return hunched shoulders to this healthier arrangement. You can learn to shoulder roll with this free video.

Other new things, such as glidewalking, felt like there was almost too much much to think about when I first learned the techniques, but slowly, steadily, my body just adapted. It was wonderful how all the pieces of the glidewalking instruction came together for me.

I work two days a week and I go for a long walk on my lunch break. With this regular practice, I was able to incrementally regain the flow in my walk… I could just keep going, and I no longer had any of the tension in my hip muscles that had crept in. It was like I just floated along. My body relaxed into it and there was a beautiful, primal familiarity: This is how good I used to feel.

Our natural gait pattern is optimal for our entire structure. For Alumni seeking to deepen their experience of glidewalking, the online Advanced Glidewalking course is designed to do just that. The next course starts October 7. 

How the Gokhale Method helps me at my job

For years I had my own lettering design studio, and then eleven years ago I started working for Trader Joe’s as a signwriter, doing the handwritten chalk boards and pricing signs. 

For those of you unfamiliar with Trader Joe’s signs, here is a taste of my artwork. Image by Claudia

My Gokhale Method course helped me a lot, as we often ended up hunched over our work at flat tables. Esther gave me some suggestions which I try to pass on to the many younger people in their twenties working there who are getting back pain. For example, we have brought in some drawing boards to slant back like easels and enable us to work in a more upright posture at the tables.

In bygone eras people would commonly use a slanted surface or easel for writing, drawing, and painting, rather than hunching over. This drawing is from an 1893 technical journal. Image from Wikimedia Commons

For my hips, the hardest thing is sitting for too long and not moving. Esther encouraged me to take movement breaks to stretch out my psoas and hip muscles, so I get up and find things that need doing around the store. I do have a Gokhale™Pain-Free Chair at home, and I wish I had one at work because I love it. The seat angle of this chair situates my hips perfectly and then I can put my behind behind and let the nubs in the back hold my spine just right. It makes my hips and spine very happy!

This video explains how and why the design of the Gokhale® Pain-Free Chair makes it uniquely comfortable—and therapeutic.

I also pay particular attention to my shoulders and my chin when at work. When I first started with Esther, she told me that I walked around with my chin way up, so I have learned to lengthen the back of my neck and keep my chin down now.

Building on my Foundations course

I finished my Foundations course at the end of June. But there were still some things around hip-hinging that needed gelling for me. So I went back August 1st, and am so glad I got the extra help I needed with my hips. Due to my severe hip arthritis Esther realized that I needed to start with a smaller range of motion and plenty of support, so she came up with ideas like me leaning on a table or wall to bend, and was constantly offering alternatives that enabled me to get a feel for where I was heading. 

One of the details Esther noticed was that I held my lower belly in all the time. All my life I had thought that was important; now I know to practice relaxing that area to allow for the alignment I need at the hips. 

Bending deeply happens most easily with the thighs out of the way (externally rotated and wide) and the lower belly relaxed.

Another thing that I needed to experience was the way that kidney bean shaping the feet enabled the rest of the leg to open up and externally rotate, which again changes things in the hip joint. We did that over and over so eventually I got to feel and manifest that difference. I now know so many aspects of  natural posture that will improve my joint health. 

Our foot’s natural kidney-bean shape and outward angle helps to support healthy hip joint architecture.

Healthy posture and what the future holds

I definitely feel I can go further in changing my posture. I have signed up for the Online University—I often do the daily program, and then there is so much more I can access in the video library. I sometimes find there’s something lands that I didn’t get the first time around. At the very least, I’m inspired by the daily reminder email. 

Each day your Gokhale Exercise email tells you what’s on, and gives you a visual reminder of the daily Posture Principle. 

I still regularly refer to Esther’s book, 8 Steps to a Pain-Free Back, which has so many layers of interesting information that I’m aware I haven’t yet fully absorbed. I am only at the tip of the iceberg with this beautiful Gokhale Method, but it has already been life-changing. This really is life-long inspiration and learning! 

Best next action steps 

If you would like to start or reboot your healthy posture journey, book a consultation, online or in person, with one of our teachers. 

You can sign up below to join any one of our upcoming FREE Online Workshops…

If you are prone to tripping, the Gokhale Method Toe Tap exercise will strengthen your tibialis anterior, the shin muscle whose tendon lifts the front of your foot clear of the ground.

This famous bust of Nefertiti (c. 1370 – c. 1330 BC) exhibits a forward-protruded head. Original image courtesy Wikipedia user Philip Pikart under CC-BY-SA 3.0.

In my travels, I enjoy visiting museums. In a concentrated space and in a short few hours, I am able to travel back in time and over large distances, and compare people from different cultures. What a remarkable gift from the craftspeople of the past!  

Many museums have a well-developed Egyptian collection. The Egyptians’ expertise in preserving their dead as well as the dry Egyptian climate has yielded a bounty of specimens from the distant past. Egyptian artifacts are often spectacular and modern audiences are drawn to Egyptian mummies, pyramids, thrones, and temples. So we get to enjoy glimpses into ancient Egypt remarkably easily.

Most people from the past, as evidenced by ancient art and sculpture, had excellent posture and musculoskeletal health. The pharaohs and upper crust of ancient Egypt, however, stand out as exceptions. Sitting on their thrones or standing in special ceremonies, they almost always have tucked pelvises and forward-protruding heads. Nefertiti (as seen above) is an example of an Egyptian royal who has her head “parked” extremely forward. Correspondingly, examinations of the mummified remains of pharaohs report advanced arthritis in the joints — much like what we find in modern populations.
 

Renenutet (shown here) and her husband Runy were part of Egyptian nobility in the reign of Seti I (1294 - 1279 BC). They served in local temples. Notice her tucked pelvis and protruded head and shoulders that are similar to problematic modern posture.

This relief from the 18th dynasty (c. 1335 BC) shows a royal couple (possibly Akhenaten and Nefertiti) in a garden. Notice their posture shows similar distortions to those we see in modern times: tucked pelvis, locked knees, lack of abdominal tone, and forward-protruded head. Original image courtesy Andreas Praefcke on Wikipedia.

By contrast, carvings and sculptures of Egyptian laborers — carrying palanquins, rowing ceremonial boats, and doing other manual work — have beautiful and healthy posture. They model an anteverted pelvis, erect spine, and vertical neck similar to those seen in non-industrial cultures the world over.

This funerary offering bearer (c. 1980 BC) shows excellent posture: a J-spine with anteverted pelvis and elongated spine, and posterior shoulders.

This close-up of the funerary offering bearer above shows her feet pointed slightly outwards and the placement of her behind behind her.

The workers on this funeral boat show excellent posture as they transport coffins in Ancient Egypt (c. 1980 BC).

This ancient Egyptian worker exhibits a perfect hip-hinge with shoulders remaining back.

What are we observing here? What made the pharaohs suffer the same poor musculoskeletal health we do? Was it affluence? Was it a departure from a working-class lifestyle? Was it a sedentary lifestyle? Was it fashion? 

If you live in a large city, you almost certainly have access to a collection of Egyptian art. The next time you visit the collection, please tell us about your observations. Or take a few photos and post or send them to us so we can comment on them.

     From the Argentine romantic composing a tango to the K-pop star strumming for an audience of thousands, guitars are a favorite instrument around the world. In fact, the guitar is the second most played instrument after the piano. (source). Amateur and professional players use a variety of playing positions - some are significantly more ergonomic than others. 

    In the classical position, the guitar is sharply angled up so that the wide end of the instrument’s body sits against one leg and the neck is held aloft with the opposite hand. This position allows the musician’s shoulders to be square and resting more posteriorly in line with the back instead of rolled forward as  in the modern style of playing with a horizontally aligned guitar.

Andre Segovia playing classical guitar with excellent form

The picture of Andres Segovia above shows the classical guitar-playing style. We can see that his shoulders remain home - they are open and back even while his arms reach forward to hold the frets and pluck the strings. In addition, his shoulders are relaxed and slope downward. His eyes look down at the instrument but his neck remains vertically aligned with his torso. While not overtly visible, his pelvis seems to be slightly rotated (anteverted), which  allows his back to stack upright. His positioning allows him to play for long periods with ease in spite of his advanced age. Segovia uses a footstool to help keep his guitar at a 45 degree angle. 

A "spacer" helping facilitate good playing form

In the image above, we see a rest placed between the instrument and the thigh to support the guitar. The support allows the player to keep her right shoulder farther back while playing.  

Generally, when standing, a strap is used to keep the guitar elevated. Regardless of the support used, the goal is the same - to maintain healthy posture while playing one’s instrument.

In the image below, we see the opposite - the guitar is played in a way that compromises the player’s posture. This very common playing position used is likely to cause her pain and injury despite her young age. Her right shoulder is rounded forward as she reaches for the strings and her head and neck are jutting forward for a better view of her playing. In addition, her pelvis is tucked, which causes her spine to round forward instead of stacking.  

Unfortunately it is not uncommon for musicians to develop sciatica, tendonitis, nerve damage, and arthritis, and careers can be cut short because of bad playing habits. It is critical to the health of the life-long guitarist that the instrument be held to accommodate healthy posture instead of distorting the posture to accommodate a poorly held guitar. This distinction is important. In the modern era we are quick to change positions to accommodate cellphones, computers, desks, and heavy bags. However, we need our bodies to last us nearly a century, so it is imperative that we endeavor to live our lives in ways that maintain our postural integrity. 

Join us in an upcoming Free Workshop (online or in person).  

Find a Foundations Course in your area to get the full training on the Gokhale Method!  

We also offer in person or online Initial Consultations with any of our qualified Gokhale Method teachers.

As the summer sun mellows and fall approaches, this is my favorite time of year to go hiking. Hiking brings so many benefits, from lifting your spirits and relaxing in fature, to catching up with friends and spending quality time with family.

The physical health benefits of walking are well documented. Choose your terrain well, and hiking provides great cardiovascular exercise for all ages. If you have a sedentary job, walking around town can be an important part of what helps you to achieve and maintain a healthy weight.

10,000 STEPS A DAY

If you like to track your progress, a pedometer to measure and increase your steps is a great fitness tool. Pedometer researcher Dr. Catrine Tudor-Locke published a study in "Medicine and Science in Sports and Exercise" in 2004, showing that men in the survey took an average of 7192 steps per day and the women an average of 5210. The research showed that a sedentary person however might average only 1,000 to 3,000 steps a day. For people in this category, gradually adding steps is the way to go.

A reasonable goal for most people is to increase average daily steps by 500 each week until you can easily average 10,000 per day.

MODERN KNEES HAVE ISSUES

Among the common problems that prevent people from walking very far are knee problems. Ironically, a common source of knee problems is a problematic gait. Moving less then compounds the problem with stiffness and weight gain, which puts even more stress on the knees, setting up a downward spiral.

In our culture we now have an epidemic of knee problems; most are not associated with any injury. Over half a million Americans a year are diagnosed with meniscus (cartilage) tears and bone spurs. They have sometimes suffered years of inflammation, pain and loss of mobility in the joint. Thankfully, surgical repairs can be pretty good at restoring knee function, but it's always best to prevent the damage, try to improve the situation simply if possible, and use surgery as a last resort.

Let’s look at the figures:

http://www.healthline.com/health/total-knee-replacement-surgery/statistics-infographic

• More than 4.5 million Americans are living with at least one total knee replacement. That is 4.7% of people aged 50 and over. By age 80+ the figure is 10% and rising

• Knee replacements increased by 84% from 1997 – 2009

• Osteoarthritis is the principal diagnosis of knee replacement recipients

http://www.healthline.com/health/total-knee-replacement-surgery/understanding-costs

• The average cost of knee replacement surgery is $49,500, plus in-patient charges of $7,500

• The average cost of knee arthroscopy surgery is $11,900

• An estimated 850,000 meniscus surgeries are performed each year

http://www.newchoicehealth.com/Directory/Procedure/130/Arthroscopic%20Knee%20Surgery

A SIMPLE PREVENTIVE POSTURE MEASURE FOR KNEES

If you observe young children’s gait, you will see that they land on a slightly bent front knee. You can also see this in people from non-industrial cultures. Bending the front knee provides extra shock absorption for the knee joint. By contrast, if you are in the habit of landing on a straight leg (a result of inappropriately using your quads to lengthen your stride) the knee cartilage will be subjected to a much greater force as your foot hits the ground.

Landing on a straight front leg is often accompanied by several other postural aberrations as listed below. Conversely, bending your front knee at landing can help induce some of the other aspects of a healthy gait like a stronger, more propulsive action in your back leg and buttocks.

TRY IT

Start from standing with your feet hip width apart in a relaxed micro-squat position (with your knee and hip joints softened). This will help antevert your pelvis. Now imagine you are walking up a hill. This will lean you slightly forward. Your back leg can now propel you forward and your front knee is more likely to be bent at the moment of impact. Squeeze the upper buttock muscles (gluteus medius) of your back leg as it propels you forward, and use this muscle to help slow the landing of your front foot. You should land heel first, but only by just a fraction ahead of the rest of your foot (avoid an extreme heel-toe one-two step). If you succeed in making your landing soft, you will be providing additional protection for the knee.

It may help to try walking barefoot, on dirt or grass if possible. When doing this, you will instrinctively land more softly to protect your feet, which are no longer over-protected by thick shoes.

A good general principle to keep in mind is to use your muscles and spare your joints.

In addition to being a healthier way to walk, you may experience that a lighter landing on a bent front leg is more pleasant than crashing to the ground with a rigid front leg.

Walking is one of the techniques where students most benefit from hands-on coaching. In our six-lesson Gokhale Method Foundations course, we introduce elements of walking in the first lesson and build on them with each successive lesson. This gives students a chance to digest, practice and refine their technique with feedback from the teacher.

Walking habits can be deeply ingrained in your muscle memory and even your psyche—after all, it’s part of who you are and has been a lifetime in the making! It often takes a lot of repetition and hands-on cueing to change these habits. Gokhale Method teachers are trained to help you learn good habits by logically breaking down walking into smaller moves and then linking the new moves together. We teach elements of walking in our Free Workshops, our Initial Consutations and, most comprehensively, in our six-lesson Gokhale Method Foundations course.

We hope to see you in person at one of these offerings!