History

It has been 14 years since my book 8 Steps to a Pain-Free Back came out in hard copy. For years I had wished I had a book to send to those people who called me from the East Coast or Midwest. These were often relatives or friends of people I had worked with in California, who were suffering terrible back pain and needed help. And so I got writing. 

A book to solve back pain

Although there was clearly a huge need for a book to solve back pain, I was still surprised to find I had written a bestseller. It reached number two on Amazon.com following our American Public Television program in 2011, and number three following the New York Times article (paywall) naming me “The Posture Guru of Silicon Valley” in 2013. It has now been published in 12 languages (Croatian later this year), and sold over 250,000 copies.

 8 Steps to a Pain-Free Back is available in many languages: Spanish, Croatian, English, Polish, Simplified Chinese, Traditional Chinese, German, Korean, Arabic, Russian, Hungarian, Slovenian, and Italian editions. 

Digital download or hard copy?

In recent times digital books have revolutionized publishing. It is perhaps surprising that figures from the US publishing industry show that, in 2020, hard copy was still outselling downloads by 2 to 1¹. 8 Steps to a Pain-Free Back is available as a digital download, but the paperback version continues to be in high demand. I have come to realize that there are numerous and perhaps unusual virtues for having a paperback edition of this book, some of which I would like to share to inspire you!

Every digital book has the primary advantages of price and portability, but can remain out of sight and out of mind. Encountering a physical book invites you to engage with it, to pick it up and thumb through it. You don’t have to sign into wifi or wait for it to load—you just start reading. 

Visual cues help pattern healthy posture

One factor which works against us developing and maintaining healthy posture in our society is that we don’t have good examples and reminders around us. In fact, we are continually exposed to a norm of bad posture, while our culture’s idea of good posture, the S-shaped spine, is deeply problematic. What we want is to be surrounded by healthy visual examples on which to model ourselves.

8 Steps to a Pain-Free Back has over 1,100 images, mostly photographs, showing healthy posture from all over the world, from history, and in infants. Students find these images a motivating and practical reminder on their posture journey. Many a person has fallen in love with the African carpenter on the frontispiece, who insisted I take his picture, or marveled at the babies stacksitting with ease. 

This African carpenter stands tall and relaxed by his bench. This is also excellent form for preparing food in the kitchen, or any work at a counter. 8 Steps to a Pain-Free Back, pg 3.

My youngest child stacksitting next to her “sitting tub.” 8 Steps to a Pain-Free Back, pg 69.

You can of course collect your own posture pinups, and I encourage you to do so. But selecting your favorites from 8 Steps to a Pain-Free Back is convenient, plus you will know the posture shown passes muster. The quality of the prints means that they look completely at home popped into a frame, or even laminated and placed around the garden or garage or in your shower stall (true story about the tallstanding image leading Lesson 6). The key thing is to place them exactly where you need the reminders. For example:

Here I am reaching up to engage my inner corset. Use this reminder near a high shelf or cupboard that you regularly reach up to. 8 Steps to a Pain-Free Back, pg 127.

This African woman is hip-hinging as she harvests water chestnuts—a perfect picture reminder for your vegetable garden.  8 Steps to a Pain-Free Back, pg 151.

Here I am stretchsitting. Place this reminder by your easy chair or sofa, where you may otherwise tuck and slouch. 8 Steps to a Pain-Free Back, pg 47.

If you are of a technical bent you may be drawn to the many diagrams. Students find the mechanism of a shoulder roll drawing helpful in executing this technique. The shoulder roll helps your shoulder joint to return home to a healthy posterior position. 

The mechanism of a shoulder roll diagram is especially useful at any desk or computer. 8 Steps to a Pain-Free Back, pg 42.

Lastly, the recaps at the end of each chapter make a handy cheat sheet while you are revising a new technique. For example, the recap of stretchlying on the side may be beneficial pinned onto your bedside table. 

Starting a conversation about healthy posture

Your book can take pride of place on the coffee table, where, unlike a download, it will always be there to catch the eye. This is a nice organic way of keeping posture on your radar and introducing it as a talking point with family and visitors. We certainly know of parents who leave 8 Steps to a Pain-Free Back strategically placed for their children to discover!

The coffee table is a great place for browsing a book. 

Introducing your wider circle to healthy posture 

If you are part of a wellness group, then 8 Steps to a Pain-Free Back is a natural fit for study. If you are a book club member, then this may be the book you are looking for to invite discussion beyond back pain extending into anthropology, history, health, and lifestyle. 

Given that 80% of people in the US will experience back pain², not to mention the many other musculoskeletal problems addressed in its pages, this book has broad relevance. Many of our students are grateful to have discovered 8 Steps while visiting their physician or other healthcare professional. 

To help you spread the word among your family and social networks we have created “clan packs." The launch price has an additional discount: 4 books for $79 (instead of $99), or 8 books for $119 (instead of $159), and is valid until March 13, 2022.

Sometimes when I speak at conferences or wellness events (e.g., Google, Mimosa Systems, TiE Silicon Valley, Global Fund for Women), the company offers their employees/members/donors a gift copy of my book. To encourage this, we offer special bulk discounts. For information please contact [email protected]. For speaking engagements please contact [email protected]. 

References:

¹Felix Richter, “Infographic: E-Books Still No Match for Printed Books,” Statista Infographics, August 9, 2021, https://www.statista.com/chart/24709/e-book-and-printed-book-penetration/. 

²Janet K. Freburger et al., “The Rising Prevalence of Chronic Low Back Pain,” Arch Intern Med 169, no. 3 (2009): 251-258, doi:10.1001/archinternmed.2008.543

Free Online Workshops

If you would like to find out more about how the Gokhale Method can help support you, sign up to join one of our upcoming FREE Online Workshops.

This bronze figure shows an open chest and “heart space;” his shoulders are well back and his ribcage is anchored. He is part of a fountain in Piccadilly Circus, London, sculpted by Sir Alfred Gilbert in 1893. Referred to (erroneously) as “Eros,” the figure is in fact Anteros, Eros’ brother, who represents a more mature, less capricious love. Original image courtesy Gareth Williams under CC BY 2.0.

“Heart space” is a term used in yoga to describe the upper part of the chest where the heart is located. Valentine’s Day is an ideal time to give some special attention to this region, and explore its relation to your posture and wellbeing. 

The Gokhale Method teaches four particular techniques which enable you to open your chest without doing damage to your back:

1. Rib anchor video
   Learning to engage your rib anchor is an important first step. It will prevent your lower ribs from popping up and your back from swaying in the techniques that follow.
    
2. Up and back with the neck video
   By drawing the base of the skull gently backwards and upwards, the chest is no longer crowded into the body, but rather allowed to expand outwards and upwards.
    

3. Shoulder rolls video
   Shoulder rolls help position the arms further back along the torso, which immediately opens the chest to expansion with breathing. In the long run, this results in a larger, more open chest.

This Ecuadorian school teacher is much loved by his pupils. Note that the teacher and his pupils have open chests and posterior shoulder placement.

4. Breathing into the upper chest
   The first three techniques may already leave you feeling more open-hearted. They enable you to breathe more deeply, but this may not yet be your habit. Take a few slow, deep breaths that further open your upper chest. Then rest a few breaths before repeating. It is common to feel resistance in the chest at first, but by using these techniques to open your structure and deepen your breathing, with practice it will become easy and pleasurable. 

The functioning of the heart is clearly essential to good health and life itself, but the organ and its position in the chest are also given special importance in many religious and cultural frameworks. Even our language is full of familiar, evocative idioms such as “from the bottom of my heart,” “faint-hearted,” “heart of the matter,” “heart and soul,” “heartening,” and so on.  Let’s explore the symbolism and associations a little further, especially where they intersect with posture.

Heart symbolism in Western European cultures
Let’s begin with St. Valentine. According to most popular accounts, Saint Valentine was either a priest or a bishop in the times of the Roman Empire, who, with great bravery and compassion, ministered to persecuted Christians. He was martyred and buried north of Rome on February 14, which has been observed as St. Valentine's Day since 496 AD. Another plausible legend suggests that when Roman Emperor Claudius II outlawed marriage for young men – reasoning that single men made better soldiers than those with wives and families – Valentine defied Claudius and continued to perform marriages for young lovers in secret. 

Whichever legend has truth, love, bravery, and compassion are all qualities said to reside in the heart in many Western European cultures. In Catholic Christianity, the Sacred Heart of Jesus symbolises his unconditional love, and the church and its patrons commissioned many paintings on this theme. These paintings show the heart radiating divinity; they often also show the very visceral detail of an attached aorta!  

Allegorical painting of the Sacred Heart of Jesus. The central heart radiates hearts gathered up by putti (cherubs). Painting by Robert la Longe, ca. 1705. Public domain, via Wikimedia Commons.

The heart-shaped symbol ♡ evolved around the 14th century, loosely based on the organ’s shape. Today we have numerous emojis preprogrammed in our smartphones, ready to use as shorthand for love, broken-heartedness, and associated feelings and events.

Heart symbolism in South Asian and East Asian cultures
Many Asian cultures also identify the heart space as essential to our wellbeing. Traditional Indian medicine describes energy centers, or chakras, that lie along the central axis of the body. The heart chakra (Anahata) is considered the center of love and compassion that can become blocked by grief or selfishness. An unblocked anahata is associated with loving-kindness and peacefulness. Tibetan Buddhist understandings of chakras also typically include a chakra located in the center of the chest.

This illustration from an 1899 Tibetan manuscript shows the body’s energy centers (chakras), including the twelve-petalled heart chakra. Public domain. Original image courtesy Wikimedia Commons.

In Japanese language and culture, the word kokoro (distinct from the physical organ) encapsulates heart, spirit, mind, and soul, among other concepts. And in Chinese medicine, the Mu, or front correspondence point, of the heart is located at the midpoint of the nipples, and is used to heal emotional hurt.

This Buddha figure in Sri Lanka displays a beautifully relaxed, open chest and heart space. Original image courtesy Sadaham Yathra on Pexels.

Posture and the heart space
Of course, with its emphasis on our structure, it is natural to think of healthy posture and the Gokhale Method as primarily benefiting our bodies. It is certainly true that having a well-developed ribcage and open chest are important ingredients for a straight spine and well-positioned shoulders. Such good structure also benefits physiological functions such as blood circulation, breathing, digestion, and allows space for the brachial nerve plexus. However, our structure is also intimately connected to our body language, revealing and communicating how we feel.

An open heart space can often look like balanced, approachable confidence. Original image courtesy nappy on Pexels.

A mounting body of research connects open upper body posture with confidence and vitality; and crumpled upper body posture with depression, exhaustion, shame, and poor health. According to a 2017 New Zealand study, it is more challenging to be depressed with open upper body posture than with slumped upper body posture. According to another, even our performance in subjects like math improves when we adopt an open posture.

These subway commuters, with their varied seated and standing postures, demonstrate a wide range of heart space openness. Original image courtesy Laura Dewilde on Unsplash.

It strikes me that there is much cross-cultural convergence on associating this area of the body with “matters of the heart.” How does your experience and knowledge of other cultures stack up with this?

Harvesting rye with scythes in early twentieth-century Lithuania. Original photograph Balys Buročas, 1923.

The Gokhale Method has improved my understanding of how posture correlates to our health and physicality. The method is based on healthy body architecture and has been informed by movement patterns from populations without back pain, those shared by our ancestors worldwide. This inspired me to take a look at my own forefathers in Lithuania, especially their posture while laboring in the fields. 

Memories of my youth
I was born and raised in urban Soviet Lithuania. Yet, we had a little plot of land outside the city in “kolektyviniai sodai” (collective gardens) and most of our weekends and summers were spent there. It was heaven to play in the fields, but there was always plenty of work.

My sister and I were often assigned weeding, watering, or harvesting to complete. It was definitely good exercise and a learning experience. I remember how proud I was when, one summer, my dad deemed me grown-up enough to show me how to cut grass with a scythe. It took a lot of coordination and control to swing the blade just so, to catch the grass low enough and to not drive the blade into the ground.

Harvesting rye with scythes in Juodėnai village, Lithuania. Original photograph Povilas Butkus, 1938.

In the summertime, we frequently visited with our relatives in the country. The grownups helped with harvesting and us kids followed them around and entertained ourselves with lighter tasks. My parents, aunts, and uncles all grew up on farms and were used to this type of work. I remember them teasing each other and laughing in the fields. Yet, it was hard work and they were all exhausted by the end of the day.

My own ancestors in Old Lithuania, like ancestral peoples everywhere, must have carried much body wisdom. Working the land shaped their bodies and their posture. Theirs wasn’t just a weekend task: it was a day-by-day, year-after-year way of life.

Photo treasures
Much more recently, I found a treasure trove of photos on E-paveldas. I immediately recognized the pristine body architecture and beautiful movements of the Lithuanian farmers. Here were women and men working with a clear J-shaped spine — which is found in highly functioning and musculoskeletally sound populations and is a cornerstone of the Gokhale Method. I was not surprised to see the J-spine show up in historical photos from Lithuania. How else could one exert oneself on a daily basis and remain productive and intact?

Before machinery, harvesting was a communal affair. Men did most of the chopping, plowing, and scything. Women raked and gathered, but also did heavier work when needed. Hay and grain harvesting was done with scythes. When harvesting grain, as in both photographs above, the cuttings were gathered and bundled into neat bunches and stacked in big piles in the fields. If harvesting hay, the cuttings were first spread out to dry and once dry, the hay was gathered and transported to the barns (below).

Young women from Didsodė village harvesting hay. Original photographer unknown, ca. 1940.

In the picture below, we see women hefting piles of dry hay to load up a horse cart.

Women loading harvested and dried hay onto a horse cart. Original photographer unknown, 1935.

Postural highlights
These old photographs give us a good view of people’s silhouettes. In contrast to modern-day postural tendencies in industrialized societies, there is no tucking of the pelvis. Behinds are very much behind. Shoulders are back and necks are lengthened. That’s J-spine, the same spinal shape we all had when we were little! 

This body architecture sets a foundation for inner corset engagement. Here, the obliques, transverse abdominis, rotatores, and multifidi muscles are all engaged. 

The inner corset muscles stabilize and decompress the spine so there is no wear and tear on spinal structures during exertion. This is how repetitively thrusting with pitchforks, lifting weights over the head, forcefully swinging scythes across the body, or reaching and pulling with rakes can be performed without hurting one’s back. Of course, the inner corset muscles get a huge workout! Meanwhile, they become stronger and in turn better support the spine.

Additionally, heavy arm and shoulder actions require correct shoulder placement. Notice that the farmers’ chests are open and wide, and shoulders are set further back. This shoulder location allows for better arm circulation, opens the chest cavity for better breathing, and prevents the upper spine from slumping. This position is key for efficient movement and protection from injury.

Bending well is essential to avoid back pain. You can see all the women hinging beautifully from their hips and keeping their backs flat while harvesting potatoes, doing laundry, and cooking. In spite of long hours bending, they did not hunch their shoulders, round their backs, or distort their spines.

Potato harvest in the Džiuginėnai fields. Original photograph Juzefas Perkovskis, 1940.

This healthy way of bending does no damage to the bones, discs or ligaments. Instead, it strengthens the muscles in the back (erectors and rhomboids) and provides the best stretch for the leg and hip muscles (external hip rotators and hamstrings).

Women hip-hinging while doing laundry. Original photograph Balys Buračas, 1923.

Hip-hinging while cooking in an open-air summer kitchen. Original photograph Stasys Vaitkus, 1937.

Another beautiful image (below) depicts three shepherd boys with their instruments. Notice that their lengthened leg and hip muscles in turn allow the spine to stack without slumping even when squatting on the ground. Their legs remain externally rotated, and their foot arches intact.

Village shepherds. Note the deep, healthy squat at left. Original photograph Stasys Vaitkus, 1938. 

In the last image (below), an older couple carries a yoke (naščiai) and baskets. What a clever way to carry a load! The yoke is placed close to the spine — the best place to bear weight, just like in weight lifting, while arms and hands are spared.

Marija and Augustas Šarkai on their way to harvest potatoes. Group Photograph/Bernardas Aleknavičius, 1971.

This couple encapsulates what we find across all ancestral populations:

1. Their feet are turned out and bean-shaped.

2. Their behinds are behind them.

3. Their ribcages are flush with the contours of the torsos, which means their lower backs are lengthened.

4. Their shoulders are set way back and their arms are externally rotated.

5. Their necks are long; their chins angle down.

Furthermore, this couple is not young anymore. I am sure they worked throughout their lives, yet they retain beautiful, erect posture.

Reflection
This was a brief glimpse of village life in Lithuania in the early twentieth century. The photographs of my ancestors laboring in the fields are brimming with body wisdom. This wisdom is a part of a common worldwide heritage that has been displaced by modern culture. Yet, it is still available to us through photographs, stories from elders, and posture work.

I felt inspired by the wisdom and proud of my Lithuanian heritage when looking at these pictures. I encourage you to do the same! Look through your own family photos, if you have them, or historical photography books. Let these images inspire you and reaffirm how well our bodies are designed, and how sturdy and strong they are when used well.

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.

The oldest surviving dated Chinese Buddha figure shows surprisingly slumped posture. Note the forward head, absence of a stacked spine, and tucked pelvis. He would not look out of place with a smartphone in his hand!

This surprisingly hunched Chinese Buddha figure is the oldest dated Chinese Buddha figure that has survived into modern times. The inscription on its base dates it to 338 AD, 500 years after Buddhism came to China from India. Compare the Chinese Buddha figure with this Indian Buddha figure from roughly 800-1000 AD…
 

This North Indian Buddha figure from the post-Gupta period (7th - 8th century AD) shows excellent form. He has a well-stacked spine, open shoulders, and an elongated neck.

There is a dramatic difference in posture. The Chinese figure looks like a lot of modern folk, whereas the Indian one looks upright and relaxed. Why the difference?

Since the models these figures were based on, and everything and everyone contemporaneous to them are long dead, the best we can do is to make educated guesses about these characters.

India, compared to China, is a warm country. Much of the Indian population sits on the floor cross-legged to gather, eat, play, socialize, and more. To this day, the default praying position is cross-legged without props.

Devotees attending a puja in a temple in Bhubansewar, Orissa.

China, by contrast, is generally a cold country, being further north. It is not comfortable to sit cross-legged on the floor in a cold country, and accordingly, it is common for Han Chinese people to use furniture. In fact, China has many famous styles of furniture, like Ming and Qing Dynasty furniture, and the oldest sitting implements date to earlier than 1000 BC.

This historical northern Chinese furniture dates back to the Liao Dynasty (907-1125 AD). Though they are weathered, the chairs’ armrests, backrests, and seat shape give clues about posture in this period. Original image is licensed by Wikimedia Commons user smartneddy under CC BY-SA 2.5.

As is true in our culture, when people sit on chairs, stools, and benches, the hip socket (acetabulum) is not subject to the same forces as in a person who sits cross-legged on the floor habitually. In my blog post about cross-legged sitting, I use a common-sense argument about why the shape of the hip sockets of someone who grew up sitting on the floor are different from those of someone who grew up sitting on chairs. By the time we are 16 years old, the hip socket is entirely ossified and not amenable to significant shaping or “editing”. For this reason, most modern people from colder climates cannot sit comfortably on the floor for long periods without props. This is also why, I conjecture, this oldest Chinese Buddha figure shows an awkward and uncomfortable posture as he sits cross-legged without props.

I imagine the model for the Chinese Buddha statue to have been a dedicated seeker, eager to embody every aspect of his chosen spiritual tradition. Some of these borrowed aspects would have worked well, probably bestowing on him benefits in his chosen path and practice. The borrowed posture, however, does not help him. He would do better with a prop. If he used a prop to elevate his ischial tuberosities (sitz bones) and let his pelvis tip forward, he would all of a sudden discover that he could be upright without any tension or effort. His back could rise and fall with his inhalations and exhalations. And he would be spared much degeneration and discomfort. My guess is that he had the skills to work with much of his pain, but maybe not all of it, maybe not all the time, and maybe not into his old age. The mind has amazing capabilities to override pain signals, but when those pain signals can be quite addressed at their root with simple mechanical solutions, this is worth learning how to do. The mind can then be used to try to address more unavoidable pain, both physical and emotional.

This young woman’s posture, with her protruding head, slumped shoulders, and tucked pelvis, shares many similarities with that of the ancient Chinese Buddha figure. Original image courtesy Andrew Le on Unsplash.

With such slumped posture, my experience indicates that the model’s chest and back would be encumbered by the cantilevered weight of the upper body, and not available for easy expansion. Only the belly is readily available for expansion. The person would learn to soften the belly to allow for easier expansion with the breath. In my imaginings, the belly breathing pattern that started out as a hack could easily get mistaken for a desirable practice to emulate. And this misperception continues into modern times.

If there is any truth to this storyline, the posture demonstrated by the oldest Chinese Buddha figure serves as a cautionary tale. It reminds us that practices develop and thrive in a culturally-specific context. When we import a practice from a different context, it behooves us to consider which portions of the practice can be imported whole, which need modification for local conditions and use, and which need to be edited out of our local version of the practice.

Centuries later, in Japan, Buddhist practitioners invented the zafu, the perfect prop for hip sockets of the kind found in cold countries. A zafu enables a modern meditator to be upright and relaxed, just like the Buddha!

Elevating the seat can make a big difference in meditation posture.

Do you engage in practices you find challenging that are easy in the country of their origin? How have you modified an “imported” cultural practice?