tendonitis

Next time you are in the dentist chair, spare a thought for your dentist’s posture and the postural demands of their job. Doing dental procedures shares many challenges with other surgical procedures, such as having to maintain a steady position for long periods, maintain a clear line of vision, and hold and manipulate tools with precision. Working in the oral cavity of a conscious patient is a pretty significant challenge. 

Dental professionals place many physical demands on their structure. They can be regarded as “occupational athletes.” Image from Pexels

Dental personnel and health

Unfortunately, these demands take a toll. Of adults in the U.S. general population, 13.8% experience significant neck pain; among dentists, that figure is a staggering 67%. Dentists and other oral health practitioners (OHPs), including dental nurses and hygienists, also report suffering from above average incidences of lower back pain, headaches, shoulder problems, and work-related tendonitis, bursitis, and carpal tunnel syndrome. Such problems can make life miserable, both in and out of the dental office. Some OHPs are forced to abandon a career they have spent up to eight years training for. Of dentists taking ill health retirement, 55% cited musculoskeletal disorders as the cause.

The Gokhale Method for Dentists and Oral Health Practitioners

Since 2008, well over 100 dental workers have sought out the Gokhale Method® to help them solve their posture puzzle and get out of pain. They are both welcome and in need of what our courses (in-person Foundations, one-day Pop-up, and online Elements) offer. Given their particular professional needs, we are now working with some of our dentist and hygienist alumni to develop a special Gokhale Method offering for oral health practitioners. 

This will be a tailored training delivered at dental offices, clinics, and teaching hospitals. The goal is  that oral health practitioners learn the posture tools they need to future-proof their careers.

An introductory workshop for oral health practitioners with Gokhale Method teacher Julie Johnson was recently received with great enthusiasm at a dental practice near Stuttgart, Germany. 

Dental practice team members, Bridget, Amy, and Julie, practice seated hip-hinging with teacher Julie Johnson. The Gokhale PostureTracker™ wearable gives biofeedback—and they’re having fun!

From a dentist’s perspective

One of Julie’s recent Gokhale Foundations students is Warren Blair, an American dentist living and working in Germany who, though counting himself fortunate to have had relatively few serious musculoskeletal aches and pains over his four decades of practice, understands the value of the Gokhale Method. 

Warren Blair, D.D.S., M.S.D., is a specialist in periodontology, implantology, microsurgery, and endodontics—and a student of posture!

Warren shared many things about the ergonomics of dentistry with us, both from the dentist’s and patient’s perspective:

The physical aspect is a problem—all dentists have problems. Some are in their mid-thirties and they're walking around crooked because they have a charley horse (muscle spasm). I periodically stretch the muscles around my back and shoulders, or pull away from my microscope eyepieces to reset. Doing the Gokhale Foundations I have learned that posture is key to the solution; having healthy posture early on in the profession will prevent future problems, but if problems with your musculoskeletal system do crop up then you can do something about it by changing your habits and adopting the principles of healthy posture.

Warren confirmed that dentists are taught not to round over their patients, and to work with their knees wide, but admitted that these positions are not always easy to maintain on the job. Learning and preserving healthy postural habits is especially difficult given that many dental workers, like most people in our culture, will, unfortunately, be approaching their training from a poor posture baseline. 

Healthy posture is an ecosystem

The basic instruction that trainees receive is not nearly as nuanced or integrated as the movement patterns taught in the Gokhale Method. In typical modern western fashion, we are all given stand-alone instructions, e.g., “don’t round when you bend.” The hip-hinging bend taught as part of the Gokhale Method is part of a whole movement pattern, involving nestling an anteverted pelvis, getting the femurs out of the way of the pelvis, anchoring the rib cage, engaging the inner corset, keeping the shoulders posterior, and maintaining a healthy neck position. Altogether, these elements give dentists the resilience needed for sustained bending, even with some variety of twist.

This practitioner is maintaining her J-spine, with her behind behind and her back tall and relaxed. This is a healthy baseline for sitting and forward bending. Image from Pexels

Posture instructions given in isolation don't translate very effectively into practice. However, as part of a holistic education that pays attention to the way we do everyday life activities, posture training becomes transformative. For example, walking well, both in and out of the office, is a natural reset for a tight psoas muscle. Learning to stacksit allows your breath to mobilize your back. Sleeping positions, done well, can enable you to heal damage and inflammation. 

Learning the Gokhale Method at work means you immediately put posture into practice in your profession, and sets up many opportunities for colleagues to support one another. If you are a dental or medical professional and would like to know more about how the Gokhale Method can help you and your team, please email: [email protected].

If you would like to support your dentist, send them this invitation to one of our free online workshops. 

Best next action steps 

If you would like to improve your posture, for work or leisure, get started by booking 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…

Since the pandemic we are delighted to have resumed teacher training and welcomed 12 new teachers to the Gokhale Method community in Europe and the U.S. We are also steadily growing our roots in the Southern Hemisphere. Below, Australia-based Teacher Tegan Kahn shares the story of how and why she decided to train.

One New Year’s Day many years ago, I made a resolution to “have better posture.” This was back before I had kids; when I had time and energy to devote to grand plans! But, like most New Year’s Resolutions, it fizzled out pretty quickly. For several days, I reminded myself every hour to sit up straight and pull my shoulders back. But because I didn’t know how to be tall and regal without holding myself stiffly, my efforts just made me more uncomfortable and tired than remaining in my perpetual slouch.

Me on New Year’s Day twenty years ago at age 16. Slouching was my default. I felt it was impossible to maintain “good” posture for more than a few minutes at a time. 

Me slouching at 22. Another beautiful dress spoilt by poor posture!

I used to experience all kinds of pain and dysfunction in my body: lower back pain, upper back strain, jaw tightness, shin splints, IT band tenderness, tight hamstrings, lactic acid buildup, and dodgy knees, to name a few. Even gentle massage on some parts of my body, such as the backs of my upper arms and lower legs, caused me to leap off the table. 

Despite attempting to stand up straight for this “before” photo, by the time I took the Gokhale Foundations Course in 2016 I was starting to develop a dowager’s hump (at the ripe old age of 28). I wonder what my posture would be like now had I continued on this trajectory.

One day when I was having my twice-weekly massage for typing-related forearm tendonitis (a repetitive strain injury covered by workers’ compensation), my massage therapist told me I had little crunchy crystals of lymphatic fluid along the lower left border of my rib cage. I had known for a long time that my lymphatic system was sluggish, but so slow-flowing that the fluid had crystallised was a bit of a wake-up call! 

That discovery led me to tumble down the YouTube rabbit hole of lymph and fascia research, where I stumbled upon Esther Gokhale’s TEDxStanford talk. It is hard to overstate how great an impact that six-minute video has had on my life. The slide Esther presented showing a J-shaped spine next to an S-shaped spine blew my mind. I had studied anatomy at university during my biology degrees but it had never occurred to me that my textbooks might have been based on incorrect assumptions. 

The illustration that immediately convinced me of the sound logic behind the Gokhale Method. If you’d like to learn more about it, consider reading our blog  What Shape Is Your Spine?

The logic of Esther’s presentation was so arresting I felt a bit dumbfounded (and a touch indignant) that I had never heard this information before. I set about reading and watching anything Gokhale Method-related that I could get my hands on. I was extremely fortunate that the original, and only Gokhale Method Teacher in Australia at that time, Michelle Ball, was offering a Gokhale Foundations Course in my home city of Canberra a mere three months after I watched the TEDx talk. I felt like the stars were aligning. 

I was already convinced by the theory and evidence basis of the Gokhale Method, but I was yet to see first-hand the ramifications of implementing it. My mum, who had been left with daily pain following a serious car accident before I was born, attended the Foundations Course with me. When she turned to me at the end of the first lesson and said, “this is the longest I've sat without pain in 30 years,” I was doubly sure that this was something I wanted to be involved with in a big way. In fact, Michelle may recall that even on that first day of the Course I was already asking her what the steps were for becoming a qualified Gokhale Method Teacher.

At that time, I was also struggling to find motivation to return to my job as a science writer for a university following my maternity leave—while my work had a worthwhile indirect impact, I was having trouble justifying being away from my little son to do work that wasn’t directly and palpably making a difference to people. Perhaps it was the sleep deprivation, or the deep well of support from my mum, that led to me booking the three of us (myself, mum, and my by-then-14-month-old) on flights to San Francisco to begin the week-long intensive training with Esther, the start of the qualifying process. Looking back, it seems kind of a crazy undertaking, but I’m glad I did it, as I’ve rarely been more sure of wanting to do something.

I feel extremely grateful to have gained the know-how to help preserve my kids’ naturally healthy posture. Although, with their J-spines still mostly intact, they are more often good posture role models for me than the other way around! 

Training with Esther was bliss. I was so fortunate to be in company with the beyond lovely Kathleen O’Donohue and Tiffany Mann, my fellow trainees. Every day we explored a wide variety of subjects relating to teaching the method and then practised our new skills on a willing Foundations Course cohort. I just loved the depth and nuance that’s involved in rolling someone’s shoulders to just the right position for them (and of course seeing the change in their facial expression when they realised it was now easy and comfortable to maintain healthy shoulder architecture!). Esther’s knowledge and expertise were awe-inspiring, and it was a jam-packed journey. One day we toured the Cantor Arts Center at Stanford University, analysing the posture of the sculptures; the next day she ordered in some Chinese food for our lunch (and when she ordered over the phone in fluent Chinese, I thought: “of course Esther speaks Chinese—what can’t she do?”)

Myself (second from left), Esther (second from right), and my fellow teacher trainees Tiffany Mann (right), and Kathleen O’Donohue after practising our hip-hinging while picking kale in Esther’s garden.

When I returned to Canberra with my head full of knowledge, I leapt straight into my case studies (my husband was the first and patiently continues to be my guinea pig all these years later), and was proud to become a fully-fledged Gokhale Method Teacher once my peers and Esther had reviewed the videos of my teaching and given their valuable advice and support. My enjoyment of teaching hasn’t lost its lustre. I love interacting with people from all walks of life, adapting my teaching style and my hands-on help to their particular bodies and personalities. I love seeing them smiling in their “after” pictures (hardly anyone smiles in the “before” pics!), and am always on a high when someone tells me how the techniques have improved their lives, in little and big ways. Although I have passed through the initial uncertainty of my early teaching experiences (it can be hard to believe what you’re doing will produce astounding results when all the health information around you is based on an entirely different paradigm of healthy human spinal shapes), I still sometimes feel the need to “pinch myself” when a student makes a particularly marked transformation in their posture and pain levels. 

I feel very privileged to be able to pass on this life-changing wisdom, and Michelle and I are excited to get this work to as many people who need us as we can. Some of our wonderful students have expressed interest in becoming Gokhale Method Teachers, too, and Esther is planning to come all the way to Australia to train them if there is enough interest. We wait to welcome them with open arms to work collaboratively on our mission to make back pain rare around the globe.

If you or someone you know are interested in hearing more about Gokhale Method teacher training with Esther Gokhale in Australia, please reach out to [email protected]. 

Best next action steps 

If you are new to the Gokhale Method, get started by booking a consultation, online, or in person with one of our teachers to find out how the Gokhale Method can help you.

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

     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.