surgery

In 2014, at age sixty-four, I began to experience pain in my left hip that eventually became quite debilitating. For the first time in my life, I went to a chiropractor, which resulted in relief that lasted a couple of years. By 2015 I had consulted first one, then a second orthopedic surgeon, who recommended a hip replacement due to osteoarthritis. 

The first clinic I went to, I felt like I was visiting a bone and joint factory…I decided to wait. The second place, they were reading another patient’s notes! That doesn’t give you a lot of confidence!! Not feeling completely comfortable with either of the surgeons, I began doing my own research. 

I longed to get back to hiking and walking pain-free.

I’m not one of those people who jump into things, especially surgery. So I went to a clinic where they did a lot of rehabilitative physical therapy and I asked one of the PT’s: of the people you work with who have success with their surgery, which surgeons do they use? And that’s how I found my hip surgeon. After a successful surgery in January 2016, as well as physical therapy sessions with the excellent physical therapist who recommended the surgeon to me, I recovered quickly and was thrilled to resume walking without pain.  

During the summer of 2018, while out shopping, I experienced both of my knees feeling as if they were on fire. My knees continued to bother me, but, afraid an orthopedic surgeon would tell me I needed surgery, I consulted a sports medicine doctor. He performed X-rays and confirmed that I had osteoarthritis in both knees. He suggested physical therapy and braces, as well as steroid shots (which I declined). Physical therapy helped to provide some relief as the muscles around my knees strengthened.

The following year, I read an article by Christiane Northrup, M.D., in which she shared information about the Gokhale Method®. I researched the method and learned that a one-day Pop Up course, one of the in-person ways to learn the Gokhale Method, would soon be offered in a nearby town, Boulder, Colorado. After the course, I did my best to focus on glidewalking, which did reduce the bone-on-bone knee pain.               

    
Everyday activities, such as bending, are taught in Gokhale Method group courses. Bending can be done in ways that align the bones well, use muscles appropriately, and spare the joints. Learning to hip-hinge benefits the knees, hips, shoulders and neck, and more besides.

I made it until June 2021, when I had successful bilateral knee replacements with the same surgeon.  I opted to do them both at the same time to get it over with, but recovery was challenging. After weeks of physical therapy, I was told to just do normal everyday activities. However, I did not feel I was making the progress I wanted.

My husband took these photos of my knee replacement X-rays at my 6-week post-operative follow-up appointment. Our joints are precious things to take care of!

Because COVID was still raging, I joined the new Gokhale daily online program. This enabled me to extend my recovery in a more enjoyable and focused way, and my knees became ever stronger. Even now, if I am unable to participate in the day’s live session, just receiving the email about the topic of the day is a great reminder and encourages me to focus on practice. And I regularly watch the replays if I miss a session.

Gokhale Exercise members receive a daily email outlining the day’s program, complete with an inspirational posture reminder image. This was May 7, 2024.

In February 2023 I began experiencing pain in my hands and my left shoulder. I was diagnosed with Carpal Tunnel Syndrome (CTS) and given exercises and braces for my wrists/hands to wear at night. While the shoulder responded and had some improvement, my hands were still an issue.

At a follow-up appointment six weeks later, it was suggested I could have “a little surgery” on both hands to fix the issue. I looked up information about CTS and the surgery, and learned the pros and cons of having that done. I lived with the pain off and on until this year, when in early 2024 a diagnostic nerve test was performed by a neurologist to check the severity and cause of my particular CTS. Even though C7 (the seventh neck vertebra where nerves to the back of the arm, wrist, hand, and middle finger exit the spinal cord) was mentioned to me during the nerve assessment, the hand specialist who ordered the test did not mention it at a follow-up visit. He suggested surgery on both hands. A day after this appointment, I called the doctor’s office to find out more about possible C7 involvement and to ask if that might be the cause of my CTS. If so, how would surgery to snip the ligaments in my hands fix the problem? Since I never received a response, I did not schedule surgery.  

Pain-free wrists and a mobile neck are important to enjoy my hobbies. Here I am on a painting course that my daughter and I took together.

An X-ray of my cervical spine in March did indicate osteoarthritis in my neck, which in our society would be regarded as “normal” for my age. I discussed this finding with my chiropractor, who uses the Gonstead Technique. She felt confident that regular, gentle adjustments of affected areas, found by palpation and the use of a heat sensor that indicates inflammation, could be successful in eliminating the CTS symptoms. She checked my grip strength and adjusted my hands and wrists. Because I had difficulty using my hands for so long due to pain and numbness, they had become stiff and weak. I was also given suggestions about what I might do to help with my neck after my appointment. This made me once again think about what more I could do to contribute to my own healing.

My neck X-rays showed several areas of degeneration and misalignment that would potentially cause radicular pain. 

It had been almost five years since I first attended the one-day Pop Up course. I would say that up until recently, I had been somewhat “dabbling” in the Gokhale Method, without a full understanding or commitment to change my posture. Although chiropractic treatments helped to relieve my symptoms, I recognized that a healthy baseline posture was lacking, resulting in repeated misalignments. Understanding that an issue with my cervical spine might actually be the cause of my CTS, I finally came to the realization that I had been overly relying on others to fix me, and that I also needed to do everything I could to help myself. Just the thought of yet another surgery became extremely motivating!

That’s when I decided to circle back to the Gokhale Method. During an Online Follow-up with Esther in January this year, I explained that I wanted more confidence about what I should be doing for my posture and wanted coaching. Shortly after, I began the one-on-one online Elements course with Esther, which ended in April. In the early sessions, it was difficult for me to even get into positions that required me to use my hands and shoulders. By about halfway through the course, my pain from CTS had subsided, as well as the stiffness and pain in my shoulders which had not been in the healthy place they should be. I used to change up my mattresses and pillows a lot, but now I realize it’s not all about these external things—good mattresses and pillows can help, but how you position your body makes a big difference. 

On a regular basis, non-genetic scolioses/asymmetries tend to diminish with standard Gokhale Method training—that is, without any special focus. In my case, it reduced the strain on my neck. This surprised and delighted me.

Now for the really great news! I have not experienced CTS at all since completing the Elements course. While I practice healthy posture with my whole body, as everything interrelates, my main focus has been on my neck, head, and shoulder placement. Chiropractic appointments have gone from bi-weekly, to weekly, and now, only occasionally. For weeks now, C7 has not needed an adjustment and it makes my heart so happy when my chiro tells me the instrument that measures heat and inflammation in that area is clear! She has seen how my improved posture is making a difference and has been extremely supportive of the Gokhale Method.  

My exercise and walking had greatly diminished over the years after the onset of osteoarthritis, pain, and then surgeries. My upper body has been my main concern recently, but other techniques, such as glidewalking, have greatly improved my mobility and stamina. I would like to take the Advanced Glidewalking course in the future. I am working my way back to a healthy weight and an active life—thanks to the Gokhale Method.    

In this video I share how glidewalking has enabled me to travel and walk longer distances in comfort.

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My name is Sheila Bond, and I am the mother of four sweet kids, an artist, a knit and jewelry designer, and a private art teacher. In this blog post I would like to share with you my Gokhale Method® journey out of pain and despair.

Photo of me after my second disc herniation in seven years.

On May 6, 2022, I severely herniated the spinal disc between my L4/L5 vertebrae. In addition I had developed bursitis in my left hip during the previous three months, I believe from sitting improperly teaching online classes.

It happened on the Friday before Mother’s Day. By Saturday morning I could barely move and thought I might die or at the very least never recover. I ordered a TENS unit (transcutaneous electrical nerve stimulation, a mild electrical current to give pain relief) from Walgreens, and bought Salonpas patches and a walking cane. I took three Advil and two extra strength Tylenol alternating every six hours. 

I had previously herniated my L4/L5 in 2015, and had a laminectomy (a surgical operation to remove part of the back of vertebrae, usually to relieve pressure on nerves.) That surgery had left me in terrible pain. When I told the surgeon I was still in pain in my tailbone/sacrum area, he told me he could remove my tailbone. I declined. Following surgery, I also went to physical therapy for a year and a half, but it gave me more pain than it took away.

   
My MRI from January 2015, showing my first L4/L5 herniation (red arrow).  

My MRI from May 2022, showing my second L4/L5 herniation. I was particularly disturbed by the amount of tissue damage in the area after my first surgery (circled in blue).

It wasn’t until five years later when I discovered a traditional Chinese acupuncturist that I found any real relief in that area. During that timespan I was also diagnosed with EDS (Ehlers-Danlos Syndrome, a connective tissue disorder), and discovered that I consequently had a hypermobile sacrum that was prone to dislocation.

Returning to May 2022, I was in denial that it could be my spine and insisted it must be my hip causing the electrifying pain that ran all the way from my hip to my foot. I thought maybe it was something wrong with the joint. I just really didn’t want it to be my spine again. On Monday, May 9, I finally agreed to go to the ER after hearing that my GP could not squeeze me in.

The electrifying pain ran all the way from my hip to my foot.

At the ER they gave me an IV, Valium and Fentanyl. It barely touched the pain, and only for an hour, and then they’d give me more. They did an MRI of my back and an X-ray of my hip. After about four hours they sent me home with the diagnosis of a severely herniated disc and bursitis in my hip. They gave me 10 Vicodin pain pills, 30 muscle relaxants, and a package of steroids and told me to see an orthopedic surgeon or a neurosurgeon. 

The ER room looked bleak, just like my state of mind.

The pain continued. I couldn’t dress myself. I could barely move or function at all. I called the orthopedic surgeon the next day who said my hip didn’t need an operation since the problem was bursitis, and that I should see a spinal surgeon or a neurosurgeon. I did not as I was so scared by my last experience. (I didn’t take the steroids either.) Instead, on May 12, I headed three hours away with my youngest kid in tow to see an acupuncturist who specialized in chronic pain and spinal injuries.

There was severe weather on my agonizing 3 hour drive to seek help. But I was desperate—and determined.

The acupuncturist recommended daily treatment so I checked into a hotel. She told me all my L1-L5 discs were not doing well. After five days of treatment, I experienced some pain relief, but sadly I tripped on my cane and fell into a wall, reversing any healing done. The pain then became so bad that I felt as though I was being constantly electrocuted. I couldn’t sleep. I drew and painted from my bed trying to explain what I was feeling. 

I tried to communicate my experience visually.

I am the main breadwinner for my family and I really could not miss work. I tried to teach my private Zoom art classes, but standing and sitting were both unbearable. I forced myself to teach some of them and rescheduled others. My birthday was on the 22nd and I felt like I was on my deathbed. I am used to being the one to care for others, so this was a terrible place for me to be.

I felt so bad for all my kids. I took the youngest one, who was with me, to the zoo, but had to use an electric wheelchair. I took the prescribed Vicodin and muscle relaxants to make it through, but still had to keep changing positions, fighting the pain. Some of the time I couldn’t even hold the steering wheel to make the wheelchair go, and then my kid would offer to steer for me. We didn’t stay long.

This video shows a GIF I made from two drawings to express the pain I experienced.

My sweet sister Aileen who lived states away was worried about me. She had recovered from back pain having worked with Esther Gokhale in California, and told me Esther could help me and sent me the Gokhale Method website. From my hotel bed she and my father helped me to sign up for the 18-session online Elements course. 

Before meeting Esther Gokhale I tried. . . 

Ice
Advil
Norco
Tylenol
Tens unit
Massager
Hydration 
Electrolytes 
Arnica salve
Heating pads 
Cyclobenzaprine
Lowering my chair 
Gentle safe stretches  
B and C vitamins, zinc 
Short walks every day 
Heat wrap around calf
Gentle and slow motion 
Hot baths with Epsom salts
Trying to correct my posture myself
Hand massage of my leg muscles, daily
Inversion table—horrible, won’t do it again
Acupuncture—two weeks of daily treatment 
Herbal tea from my acupuncturist and herbalist 

I met Esther on May 24 from my hotel room over Zoom. Esther was kind and gentle, and confident that she could help me. I couldn’t sit so Esther guided me to a position lying on the floor with my feet in a chair—that relieved enough of the pain so we could talk. We set up the sessions to begin on May 31. It was so hard to take the before-course posture photos.

From the very first Elements lesson I found some relief. It was small gains at first, but I could tell the difference. I was in so much pain even the littlest movements were hard. The tiniest shifts helped a lot. I hadn’t slept well in so long.

Esther thought pain medication might be helpful to assist me though the sessions. Finally in the middle of June I went to see the neurosurgeon. I carried with me my copy of 8 Steps to a Pain Free Back. I told him I had been having private posture lessons with Esther Gokhale—I had done five at that point. He hadn’t heard of the Gokhale Method, and, as he could see that my herniation was pressing against my spinal nerves, he wanted to do surgery immediately. I told him I wanted to continue to try to heal myself, and that I wanted to try pain medication to support that. He couldn’t believe I had held on so long in my condition, and I think he realized my strength and conviction. He made an appointment for a spinal injection in two weeks’ time (which I never had) and prescribed me the second strongest Percocets available. 

I took the pain medication for only three-to-four days as they made me nauseous, but it was long enough to give me some relief and I was able to do more during our posture sessions. Each session gave me a posture gem that I needed to know. I practiced over Zoom with Esther, and by myself in between our sessions. It was amazing to me that I was learning how to heal myself and avoid pain. 

Today I find myself returning to making joyful and more optimistic drawings like this sketch of a tree, looking skyward.

Things really began to shift for me about a third of the way through the course. When Esther taught me standing, I changed my stance by kidney-bean shaping my feet, externally rotating my legs, and relaxing my pelvis and belly, allowing my behind to be behind me. I’ve had four kids, and had gotten used to holding tension and trying not to let my belly show. I had become scared to move out of my “locked up” position for fear of more pain. After learning how to relax into a healthy standing posture, a huge percentage of the back pain dissipated. 

Around mid-July, halfway through Elements, we started learning to glidewalk. This brought another huge shift, as my searing leg pain finally started to recede. I had admired my sister’s strong, smooth way of walking since she had taken the in-person Foundations Course, and now I too was learning how to keep my back heel down, and to land on a bent front knee. Having struggled even to stand for months, getting walking again took some determination just to move a few yards. 

By August I was able to return to making jewelry like this charoite and copper pendant.

By lesson 14 or 15 I was able to walk without a cane. I realized I still had to focus on anchoring my ribs as well as all the changes with my gait. I still hear Esther saying to me “heel down, ribs down. . . ” Having a teacher prompt you in real time was so helpful.

Some days were better than others, and progress ebbed and flowed. I have learned that I need to treat myself with love and patience. I had become so used to having to push through my pain to look after everybody else—to work, look after my kids, even just to get the dishes done. 

I still keep a 20-minute reminder (app) on my phone, to bring me back to mindfulness about my posture, whatever I’m doing. I realize that the pathway for the disc herniation is still there—but I feel that it isn’t going to happen again because I now have the tools to stay long, strong, and well aligned in my back.

I’m getting back to living again. I’m able to teach my private art classes comfortably and have hope for the future.

At the end of my 18 lessons, I actually danced to the 1-2-3 Move Gokhale Exercise program. I have always loved dance, and it was thrilling to start to do that again, at my own gentle pace. I want to share my story far and wide, so please share this post. Everyone in pain deserves to have realistic hope, and to know that they can heal.

If you would like guidance on any aspect of your posture and spine shape, consider scheduling an Initial Consultation, online or in person, with a Gokhale Method teacher.

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 blog post explains how some common yoga injuries occur and how applying the principles of healthy posture to yoga postures replaces this scenario with movements that are good for your body.

Yoga postures and back pain

Growing up in Mumbai, India, my Dutch mother was a student of BKS Iyengar and the Satyananda yogis, and keen for me also to learn yoga asanas, or postures. I practiced, and, being reasonably athletic as a child and already trained in Indian classical dance (Bharata Natyam), did not find it particularly difficult to choreograph the back bends, forward bends, and twists that were asked of me. I became a yoga model, demonstrating postures alongside visiting swamis’ presentations to induce the audience to sign up for upcoming yoga courses.

This photograph shows me teaching yoga as best as I knew how in 1979, standing with a sway in my back (and putting excess flexion into my student's neck).

Aged 15, I came to the United States as an exchange student and proceeded to go to college here. It was while doing a yoga pose in college that I first experienced a significant back episode with severe spasms. A few years later I injured my back while windsurfing; this time it took five days of bed rest to recover. I did weight training to strengthen my back, and returned to normal activity. 

When nine months pregnant with my first child, my back problem resurfaced with an onset of sciatica. After my baby’s birth, it grew worse, leading to surgery for a large disc herniation at L5-S1 a year later. Within another year the pain had returned. I declined a second surgery, and instead deepened my quest to understand the causes of back pain and how best to resolve it. 

An MRI scan done in 1987 revealed the cause of my sciatica and severe back pain—a large herniation at L5-S1.

Yoga postures require healthy posture

I learned from my life experience, as well as that of key teachers such as Noelle Perez, that in the industrialized world we do not use our bodies well. As our posture has deteriorated, traditional ways of performing everyday tasks in sitting, standing, and bending positions have become distorted. These damaging postural patterns are now deeply embedded in our culture and have even been unwittingly carried through into therapeutic activities such as yoga. 

How is it that yoga asanas, developed to bring strength, flexibility, and relaxation to the body, are now causing frequent injury? This question has been the subject of much media coverage in recent decades, including the provocative New York Times article in 2012, How Yoga Can Wreck Your Body¹. From a Gokhale Method® perspective, the primary problem is that poor posture in the population at large, including yoga students, combined with misguided conventional wisdom shared by yoga teachers about what constitutes good posture, has created a perfect storm. 

I came to realize that much of the flexibility I had as a young yoga model came from the wrong places—it was achieved at the expense of my lumbar discs and nerves as I compressed them to sway back, round forward, and twist. Let’s take a look at how yogis are likely to be causing themselves injuries and how using the Gokhale Method to apply the principles of healthy posture will avoid them:

Back bends

A large group of yoga postures are backbends. Bending backwards is something that is generally done extremely poorly in our culture, with most of the bend occuring around waist level. This puts a great deal of pressure on discs, nerves, and soft tissue in an area of the lumbar spine already compressed by tight erector spinae (long back muscles). This shortened baseline length is due to poor posture and furniture, part of our culture’s paradigm shift away from a healthy spine shape. You can read more about spine shape in my blog post What Shape is Your Spine? 

Many versions of Warrior pose, or Virabhadrasana in Sanskrit, are taught with a significant bend in the upper lumbar spine or thoraco-lumbar junction. This is especially a problem when one or both arms are lifted, encouraging the ribs to pop up. Pixabay

Even mild sways perpetuate tight muscles in the lumbar area and correspond with a lack of healthy articulation at L5-S1, the lumbosacral junction. Pexels

Gokhale Method teacher Lang Liu shows how anchoring your rib cage prevents swaying and encourages healthy articulation at L5-S1. You can read more about our approach to this pose in my blog post Why Keep the Body forward in Warrior I 

Forward bends

Many yoga postures contain some form of forward bend. This can be standing, sitting, symmetrical or asymmetrical, with the legs together or wide apart. Regardless of these permutations, from a Gokhale Method perspective, the key point is to make bending healthy and avoid the damage that comes with rounding the back, distending the spinal ligaments, and pinching the front of the discs.

Standing forward bends (Uttanasana) are often taught with legs straight. This leaves most students in our culture, who have tight hamstrings, straining towards the ground with their shoulders pulled forward. It also rounds the back, distending the spinal ligaments and pinching the front of the discs. Hanging off the lower back is also aggravating for the sacro-iliac joints and soft tissue in the area. Pexels

Bending the knees softens tight hamstrings allowing a lower bend to the floor—but this student is still rounding her torso to reach over her pelvis and legs to reach the floor. Pexels

This man is using blocks to reach the floor. He is still rounding his back, and severely compressing his neck to try and look ahead. Pexels

Unfortunately this well-meaning mother is teaching her daughter poor bending form. This is especially regrettable as young children naturally tend to bend healthily by hip-hinging. Pexels

In seated forward bends yoga students often hunch forward. This compounds any rounding already established in the upper back, and forward rounding of the shoulders. Her head also strains forward, chin up, compressing the back of the neck. Pexels

Gokhale Method teacher Cecily Frederick hip-hinges in a standing forward bend. Her pelvis rotates forward around the femoral heads (tops of the thigh bones that form part of the hip joints). Her spine remains long, rather than rounding. 

Twists

In twisting postures (Parivrtti), it is especially important that your movement is not concentrated at a particular level of the spine, but is well distributed. Levering into a twist by pushing or pulling with the arms or legs can cause a twist to concentrate at any vulnerable point. Typically people will twist most in the mid-spine at T12-L1. Here the more axially mobile thoracic spine meets the lumbar area, where the orientation of the facet joints limit rotation. This is likely to result in disc bulging or even herniation at this junction, pinching of the nerves, and undue stress on the bony spine.

This woman is twisting mostly at the waist. Pexels

This seated twist shows tucking of the pelvis. There is considerable rotation at the base of the shoulder blades as the yogini levers with her arms against a fixed pelvis and legs. Wikimedia

A lying twist with one knee reaching the floor and the opposite shoulder remaining there is an extreme rotation for most people. It will often compromise healthy posture. In this case the woman is using her forearm and tucking her pelvis slightly to get her knees down. It is better to prioritize  healthy movement over achieving the “correct” shape. Pexels

Gokhale Method teacher Clare Chapman in a lying twist. Allowing the pelvis to rest back and the thighs to separate avoids tucking and encourages more rotation in the hips. 

We recommend that you initiate twists using the muscles of the torso’s inner corset, especially the obliques. The inner corset is explained in detail in Lesson 5 of my book 8 Steps to a Pain-Free Back. Using these muscles means that the lumbar spine is protected while the muscles originating in the thoracic area and connecting to the pelvis power the rotation. Engaging the inner corset also lengthens the spine avoiding the common pitfall of imposing rotation on top of flexion (rounding) or extension (swaying) or any other kind of compression. 

Twists should mainly occur and be appropriately distributed in the joints best designed for them—the ankles (standing twists), hips, the thoracic spine, and the neck. Small amounts of rotation can contribute from elsewhere, but pushing beyond natural limits anywhere by applying force is a recipe for injury and pain.

Before executing yoga bends or twists, we recommend that you first learn the basics of the Gokhale Method® in our in-person Foundations Course, Pop-Up courses, or online Elements. These courses teach you how to bend back without swaying, and how to bend forward in a way that profoundly benefits rather than damages your body. The Gokhale Method Online University has many offerings for Alumni which explore additional movements such as shearing and twisting in ways that are healthy.

If you are a yoga practitioner who suffers from recurrent bouts of back pain or strain, have stopped practicing due to injury, or have been put off even trying yoga, then a solution is at hand! 

It has long been my ambition to offer yoga classes with healthy posture. I am delighted that one of our most experienced and accomplished teachers, Lang Liu, will offer regular Tuesday and Thursday Gokhale Yoga classes, ​​7:00 am (Pacific Time), starting April 21, as part of our Alumni Gokhale Exercise program. 

We look forward to seeing you there.

Gokhale Method teacher Lang Liu looks forward to seeing you in the Gokhale Yoga class.

References:

¹ William Broad, “How Yoga Can Wreck Your Body”, New York Times Magazine, Jan. 5, 2012,
https://www.nytimes.com/2012/01/08/magazine/how-yoga-can-wreck-your-body.html 

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…

Anissa Morgan is 46 years old and was born and raised in San Antonio, Texas. In her own words, her relationship with her body has “always been a little messed up.” She didn’t like how she looked. Growing up, her mom frequently told her that she was slouching and "should pull her shoulders back," anecdotal posture advice many of us have heard.

In adulthood, Anissa spent some time in the Army Reserves as a petroleum specialist. The military approach to posture reinforced what she’d heard from her mom in childhood: that she “shouldn’t be slouching and that everything should look ‘a certain way.’” In her job, she would deliver fuel to military vehicles such as airplanes, cars, and trucks. She had to leave this position due to medical hardship after her first husband suffered a severe accident and broke his back, resulting in his paralysis from the waist down. She didn’t have anyone else to take care of both her husband and her young daughter, so she left the military. It was a short career, but she loved a lot about the military experience and the connections she formed with people during her service.

Anissa, 46, has seen her life dramatically changed by the Gokhale Method. Image supplied.

As the primary caregiver of her then-husband, the load on her body was extreme. She would have to carry her husband’s wheelchair, even while pregnant. Not long afterward, she and her husband divorced. Between pregnancy, childbirth, parenting, and the end of her relationship, she endured a lot of emotional and physical trauma.

“I was never an athlete or in super-great shape, but when I was in the military, I’d started having problems with my knees and my feet. My arches started to fall then,” says Anissa. She feels that may have been the first sign that things were going wrong.

Military posture guidelines encouraging tension and artificial positioning in the body predispose servicemembers to posture problems, which can lead to pain and injury. Image courtesy 272447 on Pixabay.

After her time in the Army Reserves, Anissa recovered from her divorce and eventually remarried. She found a job working at the Officer’s Club doing clerical and computer work. Computers were just coming into widespread use at the time. After that, with her valuable skills, she began working at the computer helpdesk at the USAA office in San Antonio. One element of her job with USAA involved travel: visiting field adjusters to set up laptops for them. One day, after a training, carrying a heavy load of equipment and baggage, she bent over and felt something give. After a couple of weeks where her back was “uncomfortable,” she visited her husband’s chiropractor, which was “like magic.” One morning, however, while making lunch for her three daughters, she bent over to pick up a box of Capri Suns and couldn’t stand back up again, and could hardly lift her leg. That’s where “the really major problems” began.

This continued until she was about 32 and her “back was done,” leaving her unable to work due to severe pain.

With her level of pain, sitting at a computer desk all day was excruciating. “Even with the great resources they have there, like standing desks and the people that would come in from Ergonomics who would tell you how you were ‘supposed to sit and stand’ — all of which I now know was wrong — it just wasn’t possible for me anymore, so I stopped working at about 32.”

Sufficiently severe pain makes even desk jobs impossible, as it did for Anissa. Image courtesy Claudio Scott on Pixabay.

“It just didn’t work”
It turned out that Anissa had a rupture in the spinal disc between her L4 and L5 vertebrae, which resulted in severe pain in her lower back and radiating down her legs, into her calves, and a loss of feeling in her toes. At the time, all she wanted was to have her back “fixed” so she could be sent back to work. By then, she had 3 small children and a job she loved. She needed to be able to show up in her life. With this in mind, she opted to have laminectomy surgery to hopefully resolve her symptoms.

Although the laminectomy gave her around 6 months of improved symptoms, the surgery soon revealed itself to have been unsuccessful in resolving her pain, which returned and began radiating down her legs again. A second surgery was proposed to fuse her L4 and L5 vertebrae. Her surgeon’s perspective had been tightly focused on the disc as the cause of Anissa’s problems, suggesting that once it was removed and that joint was fused, she would “feel grand.” There was again a little relief soon after the second surgery, but it quickly became apparent that even after this fusion, working at a desk all day wasn’t good for her body and something she could tolerate. The one way Anissa could tolerate it was with the use of opioid pain medication, although this further complicated her ability to do her mentally demanding job — troubleshooting computer problems — well. “You’re problem-solving — that’s your gig,” Anissa says. “And when your brain can’t fire, there’s no solving going on. Unfortunately, that was the end of that.”

Within a year of the first surgery, she was starting to feel pain in her legs in a different location. At the time, she had a wonderful pain management doctor, but Anissa was still concerned about the side effects and addictive potential of opiate painkillers. She began feeling terrible pain on the front of her thigh, which would command all her attention while driving an hour and a half to visit a friend. By the time she got home, she’d have a bruise on her leg where she’d been pressing the muscle, trying to get some relief. Her pain management doctor recommended another MRI, which revealed that the discs above and below her fusion site were herniated — just a year after the fusion surgery.

For Anissa, surgery was a “band-aid” treatment which did not eliminate her pain long-term. Image courtesy Sasin Tipchai on Pixabay.

“My decade of darkness”
The worst of Anissa’s severe, debilitating pain lasted a decade during which she didn’t know what else to try. She tried acupuncture, and completed five different courses of physical therapy within a couple of years. She’d given it “everything [she] knew how to do” and was still having to resort to taking enough opioid pain medication to keep herself comfortable while trying to balance the demands of her body with those of being a wife and a mother. “That,” she says, “was my decade of darkness. There was no moment that was comfortable. There was no joy left in my life, because all I could think about was the pain in my spine, which then started radiating up through my thoracic spine and neck. My whole body hurt all the time.”

Anissa was hitting rock bottom. She would wake up at night heaving and sobbing from pain. She didn’t know what else to do or what to try. All her doctors wanted to do was more surgery: fusing two or even three more levels of her spine. Her pain management doctor would give her steroid injections and trigger point therapy, all of which were wonderful, but they weren’t long-term fixes and only took the edge off the pain. She felt like a burden to everyone, and a failure, and didn’t see how she was going to go on living like that.

In a moment of deep desperation, Anissa hid in the closet, kneeled, and prayed for assistance. In her own words, she “saw the light” and was filled with a new determination. She decided to start over, trying every approach again, so that if she did have to resort to another surgery, she would know that she had done everything she possibly could to avoid putting herself in a worse situation. That was her nightmare: that she would do what the surgeons advised and the new surgery would only do what the second surgery had done.

Opioid painkillers were something Anissa was not happy about having to take in such large doses. Image courtesy newsong on Pixabay.

The next day she got online and went in search of acupuncture. She Googled and found an acupuncturist and someone’s testimonial called him a “gift from God,” and hoped that perhaps he could be such a gift for her as well. She walked into the acupuncturist’s office barely able to lift her feet to walk, with numbness in her feet so severe she would avoid the stairs at her house for days at a time for fear of falling. By going to the acupuncture appointment, she felt she was just doing her due diligence and crossing something off the list.

Her first acupuncture treatment was “excruciating.” The acupuncturist is “old-school,” from Taiwan, and she found him somewhat frightening and difficult to understand. After the treatment, he asked her, “How do you feel?” And she replied that she didn’t know, but that she might have been feeling a bit better. She was experiencing a pulsing sensation which was new to her, and which she found encouraging. When he prompted her to lift her legs to waist level by raising his hands as targets for her to reach toward, she was shocked to be able to do so, considering that she had barely been able to walk into the office for her appointment. She got back up from the treatment table “thanking God that maybe this was something” that would continue to help her. She now had hope that something better — perhaps even relief — might be possible.

Acupuncture was the first partially effective intervention Anissa found, but it didn’t fix her underlying posture issues. Image courtesy Hamilton Viana Viana on Pixabay.

Over the next three months, she frequented her acupuncturist, seeing him by her choice for treatment two to three times a week. She could feel the healing occurring in her body. The treatments reduced her pain to a tolerable level. Her next target was stopping the narcotic pain medication she’d resorted to for years. Someone in a chat room online told her about kratom, which she investigated and then used for a short time in order to transition away from the prescription painkillers. “I’ve been pharmaceutical-free for going on about four or five years now. But during that time, I still had pain.” At this point, she still had pain to contend with, but “not to the level where everything was darkness.”

“I’ve learned now that if I manage my life right, I can have joy again. I can do things again.”

The Gokhale Method is something Anissa first heard about from a friend.

A new approach to pain relief
Anissa first heard of the Gokhale Method from a friend with whom she had a reciprocal coaching arrangement: Anissa would life-coach her friend, and her friend health-coached Anissa. “She said, ‘You know, I heard about this, and it might help you.’” Anissa looked it up, watched a few videos, and bought herself a copy of 8 Steps to a Pain-Free Back as it was more within financial reach than enrolling in a course immediately. “Let me see what I can get from the $20 book first, before I further the investment. From the book, I was able to tell that it was something and that it made sense to me. With what I had been through and what they had tried to teach me and what was so different.”

Anissa “almost didn’t go to the Pop-up Course.” She was aware Esther was travel-teaching in Texas, but the courses weren’t near Anissa. However, they were close enough for her to try to get to. She felt it was a sign: a response to her prayers. “I was actually experiencing higher-than-normal pain, the most I’d had in a few years, and I really wanted to go, but I didn’t know if I could. I didn't know if I was physically capable.” Determined, Anissa ended up driving 5 hours to Dallas — a drive that would be impossible for her most of the time due to her pain levels, but the endpoint of which was so important to her she didn’t want to miss it. She was assisted on the drive by one of her daughters.

During the drive back to San Antonio back from the Pop-up Course in Dallas, Anissa asked her daughter to take this picture of her standing without pain at a rest area — a truly memorable moment. Image supplied.

Dramatic results in a single day
By the end of the Pop-up Course and the drive home to San Antonio, Anissa almost couldn’t believe the results. “My camel hump on my neck was gone! And I knew it was gone, but I questioned how that had happened.” Just that day, she had noticed her longstanding kyphosis, also known as a “buffalo hump” or “dowager’s hump,” during the halfway point of the course, when she was experiencing some of her usual pain and applied a topical pain relief cream to it. She regularly asked her husband to rub this kyphotic hump to provide her some fleeting relief. But after the Pop-up Course, the hump was gone. This was a big change; nothing she’d ever done before had ever had such dramatic results in such a short amount of time. “The book was great, but I really needed the hands-on [learning], and I need to do the Foundations Course next. My body is used to being a certain way, and it’s taking time to train my brain to do things differently.”

In her own words, Anissa is “thrifty, so [the course tuition] felt like a lot of money.” It was actually her and her husband’s anniversary weekend and she wanted to do something with him for the occasion, but she reconsidered. “I thought, what better gift could I give to my husband than feeling better?”

“Acupuncture has helped me manage my pain to where I can have a life now. It’s a more limited capacity than I would maybe prefer. But what the Gokhale Method did is open the door up wider.” A couple of weeks after the course, Anissa and her husband took a trip to Marble Falls and went hiking for the first time in maybe 15 years. “I remembered how much I loved it, and how good it feels to stand in nature — wow, Lord, really! This is in my backyard? And I never would have seen it, because I was afraid [of debilitating pain].” On her hiking trip, she realized the course was “worth all that money and then some, because we get to do things we used to not be able to do, that we hadn’t done in a really long time. So it was amazing.”

Anissa’s once-debilitating pain is now well-managed enough to let her live her life again, as in this photo during her hiking trip to Marble Falls. Image supplied.

“An answer to prayer”
When she does experience pain, the Gokhale Method has given Anissa the tools to realize that something is in need of adjustment. Anissa is humble and adamant that, in spite of her excellent and heartening results, her posture journey is only beginning. “I only know this much, and it’s made such a huge difference,” she says. “Even knowing that much has made a huge difference. And there’s so much more.” The private online follow-up session with Kathleen was a needed refresher on the techniques. Being able to bring the method home to her space, to her desk, and to her home context was incredibly helpful for Anissa. Aside from the pain relief, Anissa appreciates the comprehensive nature of the Gokhale Method. “It’s for your whole body, working with your whole body the way it was designed to work,” unlike exercises focused only on giving people superficial benefits, like “great abs.”

When asked what Anissa treasures being able to do with her body, it’s the simple things that are most important. She has a young grandson, and being able to pick him up and get on the floor and play with him are precious. The freedom of being able to get in the car and drive for 10 hours and end up in New Mexico, for example, is a blessing. “I want a body that doesn’t limit my capacity to do what I do and what’s important, not to be sitting there with family and friends and wondering when I can go home because my back hurts so much. I want to be able to actually enjoy conversation and interaction with people without the primary brain focus being the pain in my body.”

Anissa considers her whole journey to have been “an answer to prayer. It was too weird the way it all happened, and the results. I always know it’s special — a gift — when it goes this well. Not that the process has been easy, because I feel like I’m constantly having to work on it and I have so much more to learn. But to get such an immediate injection of hope, to feel that maybe I wouldn’t at some point be managing the symptoms of my pain with acupuncture and supplements. I have hope that this can build up to more as I go further in the process and learn to work with my body the way it was designed to be.”

And given her history, she’s no stranger to despair. “I know what it’s like to lose hope. I know how different your life can turn out if you can’t be pointed and guided in a direction that’s not pharmaceuticals, that’s not injections, that’s not surgeries. I’ve met so many people whose long-term results are a disaster. Maybe in the beginning they’re ok, the first few years out, but talk to them 5 years after surgery and they’re all miserable, too. I’d like to be able to help share this and help save people from the decade of disaster I experienced myself.” Thankfully, with the Gokhale Method on her side, Anissa has a brighter future to look forward to.

Future generations, and our ability to show up for them, can prove excellent motivation for reducing our pain and improving our functionality. Image courtesy Sasin Tipchai on Pixabay.

We set a high bar for our six-lesson Gokhale Method Foundations course. We expect our students will 

1. Sit, stand, walk, lie, and bend in new (old!) and better ways
2. Experience significantly less pain and more function
3. Expect more from their body and life. 
4. Use the word “life-transforming” somewhere in their evaluation forms.

Even with this high bar, a student sometimes surprises us with the extent or speed of their progress over the course. Abigayil Tamara is one such student - here is her story. 

My Experience With the Gokhale Method
~Abigayil Tamara, MA, MSW

I looked into the Gokhale Method after someone in a grocery store told me how much it had helped his mother. 

My back issues began over 34 years ago, in 1983. I was given epidural injections. When I reached the point where I was unable to sit down, I had my first back surgery, a laminectomy on L4/L5, L5/S1. After the surgery, I used a walker for many years. In 2009, I had a second back surgery, a fusion at L4/L5, L5/S1. My third and fourth back surgeries In 2013 and 2016 involved removal of previous hardware, and fusion of L1-S1. Besides walkers, canes, and mobility scooters, I also had a service dog with a harness that I used for balance and support. Over the years I have worn a number of braces including two substantial back braces and braces for both legs. My back issues had resulted in burning in both calves and feet, and bursitis in both hips with pain extending down my right leg.  I have had numerous tries of Physical Therapy, the most successful being Aquatic Physical Therapy in a warm water pool. Since my last surgery I have seen three Physiatrists and two Internists, one with an Anesthesiology specialty, in my search to heal my back, resolve severe pain, increase my functionality, and be able to stop wearing the brace I had worn for over ten months following the last surgery.

With my history, I wasn’t sure that the Gokhale Method® was going to be able to help. I attended the Free Workshop, and then had a consultation with Esther Gokhale. I found her extremely knowledgeable, and able to immediately offer help for my situation. She taught me how to engage and develop my Inner Corset. I then started the Foundations Course individually with Monisha White. After the first session with Monisha I was able to discontinue use of my back brace and haven’t needed it since. With Monisha’s help I was able to continually improve my posture, with Stretchsitting (I love shoulder rolls), Stacksitting, Tallstanding, Stretchlying (side and back), Glidewalking, Hip-Hinging, and wonderful Kidney-bean shaped feet. Because my back was very stiff and painful, lying down and going to bed had been extremely difficult activities. Once I learned Stretchlying, lying in bed was very comfortable, and I looked forward to getting into bed.

Having spent years as a teacher and in helping professions, it is always wonderful to find others who are passionate about their subject matter and able to teach in a way that enables others to absorb the information and apply it in their lives. This has been my experience with the Gokhale Method®. Demonstration, visuals, positioning my body, review, practice, and homework involving reading and exercises continually reinforced the information.

I own the Gokhale Pain Free™ Chair and two Stretchsit® Cushions (one permanently in my car, and the other for use on chairs at home or other places), and these help me sit comfortably. 

With the conclusion of the six session Foundations Course, I am engaging in continuation of the learning. It is important to me to build on current knowledge, to continually practice, stay engaged with others on this journey and learn new information. I am a senior with years of having a compromised back. I was amazed that in a short time with the Gokhale Method I was able to make significant changes to enhance the quality of my life. I am hopeful that others will learn this information and avoid the many years of suffering that characterized my life. I am very appreciative of Esther Gokhale’s work, and grateful for the many methods she has developed to help others.

Stretchsitting®

The difference in neck curvature between the two is particularly marked

Stacksitting®

Note the strong improvement in shoulder and head placement

Hiphinging

Abigayil will now build up the flexibility and strength she needs to deepen her bend, instead of compromising her spine above her fusions to reach the ground

Tallstanding®

Notice how much stronger and more confident Abigayil appears while standing, after!

A quote from one of my cherished Gokhale Method students captures the before of his posture-improving, pain-eliminating journey with me:

"I was a managing director at a telecommunications company supervising a lot of people, but there would be days when I’d put in my time lying on the floor in my office--to take pressure off my spine. At first colleagues would walk in and do a double-take, but gradually they become accustomed to my having to stretch out the floor while I worked. This had become my new normal."

Another quote offers a glimpse of the happy hereafter, in particular, the adventurous life this man has been leading since we concluded our regularly scheduled, one-on-one work together, in 2008. 

"My wife and I just came back from a trip to Machu Picchu and the Galapagos. All the climbing of the Inca ruins and the walking over the lava fields of the islands went so very smoothly I never had even one issue of back trouble. Believe me, I could not be happier."

The remarkable fellow is Mike King of San Ramon, California, and I was thrilled when he agreed to share his dramatic journey into and out of debilitating back pain.

What follows is Mike's "travelogue."

"Esther, I never thought I would be able to be doing something like this. Thank you, thank you, thank you."

The "back story" to my back story

"I'm 75 now, and if I look at the kinds of things I did in my life that contributed to what turned out to be debilitating back pain, it includes putting myself through college by working in a truck service station, working on very large and very heavy tires, using pneumatic wrenches to take them off and put them on. It was physically awkward and very taxing work. I also played football in high school and college and was involved in several car accidents. These were among the contributing factors. "The first signs of trouble appeared in 1974. Especially when I did yard work or any other manual labor I would be very achey; I would really feel it. But it wasn't a big deal back then, because I could get through these episodes by popping anti-inflammatories and easing up on the manual labor. The pain wasn't yet chronic. "But by the late 1980s my back problems intensified. The pain would last longer, and it would be more restrictive in terms of what I could do. For example: I’ve always been someone who’s been in the gym; I enjoyed working out, and I ran. But when back pain began to catch up with me, I had to quit running and cut back on working out. My life began to change."

From bad back to worse

"In the 1990s I was doing a lot of international business travel, which meant frequent long flights and hotels with strange beds. This was at a time when I was becoming severely physically limited--when not only  was something like yard work out of the question, but walking had become a chore. "Yet another issue was pain-related sleep deprivation, which of course exacerbates the difficulties of any challenging situation. And when my back problem became chronic--when I saw how much of my lifestyle I was having to let go--I became terribly discouraged. Feeling uncomfortable after a workout is one thing, but when disabling pain comes at you all at once it's pretty hard to take. So, out of desperation, in June 1998, I saw my first neurosurgeon."

The diagnosis

"Long story short, the neurosurgeon ran a number of tests and did a number of scans and diagnosed extensive sciatica due primarily to damaged L4 and L5 discs impinging upon nerves radiating out from my spinal cord. And his recommendation was surgery on my lumbar spine.

Contrast the herniated lumbar disc impinging upon the spinal nerve, at bottom, with the healthy disc, at top.

"By this time I was in serious pain and walking with a cane, and in desperation I agreed to have surgery--a laminectomy and a discectomy, which basically involve the carving out of some bone to get to the damaged discs that were protruding out and pressing in on spinal nerve roots."

Two surgeries: the good--and the bad & ugly

The bad

"When I came out of the first surgery--even after a longer than normal period of recovery--it became apparent that I was in worse shape than when I went in. It's not like I was looking for a miracle, but I was expecting some relief because the neurosurgeon had painted a rosy scenario of a positive outcome. Instead, the surgery was a failure."

The ugly

"At one post-op visit my wife, who was extremely concerned, explained to the neurosurgeon that I was feeling discouraged because I was still in terrible pain and still so debilitated. And the neurosurgeon turned to her and said, 'Well, that explains why he's not getting better. He's not getting better, because of his attitude.' "Jan looked at him and said, 'No. He's discouraged because the surgery didn’t work, and you’re not taking responsibility for it.'

"In desperation, I agreed to have surgery."

"So we quickly moved on, but of course by that time the damage had been done."

The good

"Nine months later, in April 1999, I had a second back surgery, basically to clean up the results of the first failed surgery. And though I came out of that with the usual post-back surgery kinds of issues, I felt sufficiently well to travel on business to Hungary just one month later. And I got eight good years out of that second procedure, because it was done well and because I was very careful about what I did and got better at reading the warning signs. Once again, I was able to travel, work out in the gym, enjoy my life. So that second surgery turned out to be a really good thing--for a while."

Back surgery number 3?

"In late 2006, early 2007, my back pain returned, but this time I now had foot drop, a condition that can occur when herniated spinal discs in the lower back impinge on spinal nerve roots. Because foot drop made it hard for me to walk and keep my balance, it prompted a visit to a third neurosurgeon, who--as he showed me X-rays and MRIs--identified a number of discs causing my problems, specifically: L3-L4, L4-L5, and L5-S1. But when he said, 'You're looking at major spinal fusion,' I said to myself, 'I’m not going to have a third back surgery. I'm not going to put my body through this. I've got to find another way."

"Adriaen Brouwer's 'The Back Operation,' 1636, captures only some of the pain of surgical interventions."

Identifying with the man from la Mancha

An impossible dream?

"To say I became preoccupied with a need to feel better is an understatement, because when you're in pain and desperate for relief, you will find all sorts of people who claim they can heal you. For me, the experience was like going through a smorgasbord line, trying countless alternatives, none of which worked and some of which actually hurt me. And I began to view my quest as a sort of impossible dream to find a way to take care of my problem, without submitting to spinal fusion.  "I’m not a student of Cervantes, but as I got deeper into my quest the classic tale of Don Quixote began to resonate. As you no doubt know, the story centers on an idealistic but confused man's wanderings to do good works.  An indomitable inner will and extraordinary determination propelled him on his journey, despite real and imagined obstacles he encountered at every turn. And it occurred to me that people who suffer from debilitating back pain follow a similar path. While perhaps not as delusional as Don Quixote, we’re forever searching the Internet, gathering the latest information on surgical and nonsurgical approaches; we’re able to recite the definition of chronic pain; we try heat and then we try cold; we try pain blockers, anti-inflammatories, and muscle-spasm medications. We visit neurosurgeons, orthopedic surgeons, chiropractors, naturopaths, homeopaths--every imaginable alternative practitioner.  We seek second opinions and third opinions, and then, because we're still hurting, we seek more.

"Don Quixote's indomitable spirit inspired me."

"I put a lot of miles on my car and paid a lot of fees, in search of a solution, but my quest was really wearing on me because I was beginning to believe there wasn’tan answer. And as the prospect of fusion surgery loomed ever larger, and as I could see life as I once knew it slipping away from me, I grew more concerned.  Until one night, I plucked up a copy of Costco's magazine."

A serendipitous discovery

"Deep inside the magazine, I found a small article linking posture to back pain. It was very brief, with almost no detail, but after I read it I thought, 'Hey, this something I haven’t tried!' Of course I was more than a little skeptical that the approach developed by Esther Gokhale, with its focus on posture, could have a significant effect on my back pain, but I was determined to check it out. So I gave Esther's office a call and signed up for a 1-hour free session."

"It was just incredibly serendipitous how I came to discover the Gokhale Method.”

"Later, when I got to know Esther, I asked, 'Was Costco selling your book?' It wasn’t. The story just kind of appeared, and the fact that I would find it -- and jump on it -- was just incredibly serendipitous."

What's posture going to do for me?

"By the time I met Esther I was walking with a cane and getting through the day on a heavy-duty dose of Vicodin; I was not in good shape. So when my wife and I attended the one-hour introductory session, my mindset was: 'This is kind of weird. What's posture going to do for me?' But when the session concluded and a man in the back of the room stood up and said, 'I just have to tell you something, Esther. I’m a neurosurgeon, and you’ve done more for a number of my patients than I could ever do with surgery,' I thought, 'Bingo, this is what I needed to hear.' "On the spot I signed up for the Gokhale Method Foundations course, opting for six private sessions with Esther. And I bought a copy of her book, 8 Steps to a Pain-Free Back. The amazing thing—and even I have trouble believing this--was that  I literally could feel a positive change after each session. At our first meeting, I learned how to sit. Now that may seem like a very simple thing to do. (I know I certainly thought it was,  because I’d been sitting for a lot of years and it never occurred to me that I should be doing this any differently.) But it soon became apparent that I had a lot to learn, and that I was going to have to do some serious reprogramming of old habits. And for six weeks I worked really hard, learning and practicing Esther's techniques.

"As I progressed through the six classes, Esther helped me understand the big picture of her program. One of the nice aspects of the Gokhale Method, I should add, is that it’s not something you need to go back and re-enroll in every month--or even every six months (although for a while, I greatly benefited from quarterly 'tune-ups'). Instead, you learn techniques that you can easily practice in the course of your daily life."

Reclaiming my life

"I finished the course in 2008, so it’s been five years. And at age 75  I’m enjoying life and doing everything I want to do. One thing I hugely enjoy is being out and about with my camera, finding things to photograph, and--since working with Esther--I’ve done wonderfully well when I travel. My wife and I are just back from China; last year we hiked around Machu Picchu and the Galapagos; the year before we explored southern Africa--and next year I'm returning to Africa. We’ve seen so many amazing things and I’m grateful to the Gokhale Method for helping me regain the mobility I need to do all this--I'm grateful to Esther and her method for enabling me to (quite literally) reclaim my life.

"Freedom from back pain means freedom to travel. Here I am in Tiananmen Square."

"I feel lucky to have visited the Cape of Good Hope and lucky to feel well enough to explore more of Africa next year."

Photo Credits: Mike King, Machu Picchu, 2012:  Jan King Herniated lumbar discs: Wikimedia Commons Surgeon: Wikimedia Commons"The Back Operation," Adriaen Brouwer: Wikimedia Commons "Don Quixote," Honoré Daumier: Wikipedia "Getting Back to Our Roots": Screen shot from The Costco Connection Esther Gokhale and Mike King from Back Pain: The Primal Posture Solution video: gokhalemethod.com Mike King, Beijing: Jan King  Mike King, Cape Point Lighthouse, near the Cape of Good Hope: Jan King

At the end of his rope after chiropractic, physical therapy, massage and surgery, a Transportation Planning Consultant finds relief with Gokhale Method Foundations Course.

Travis Dunn, PhD, remembers clearly the onset of his excruciating back pain. He was all of 24 years old.

“It first appeared while I was on vacation in June 2005,” he recalls. “There was no specific, major incident that precipitated the pain, but it grew sharper and more debilitating over the course of a week or so, including occasional sciatica.”

He would start each day with his back pain registering “one or two” on a scale of ten, he recalls. As soon as he sat, the pain would grow worse. “If I were to remain seated, I’d be at seven or eight within a half hour. When I stood up, I would be like a hunchback,” he says, bending over to show how contorted his body was. “Then I would have to stretch to reset my muscles before I could sit down.”

He survived his workday by taking walking breaks—some were part of his regular routine of walking to meetings or lunch. Others were add-ons to a fully loaded workday. All told, he’d spend an hour or so walking each day, just so he could sit and work. When the pain became unbearable, he would rearrange his desk and stand at his computer, which helped only slightly.

Dunn opted for a conservative approach to treatment, starting with chiropractic care. “The chiropractor took x-rays, then put them up on the wall and showed me where everything was wrong in my spine. He said I’d see him three or four times a week at first, and then we’d taper off after that as I got better.” That lasted two months. “I wanted to believe it would work, and he told me it would. But I saw no difference.”

Over the following two years Dunn tried therapeutic massage—“short-term relief measured in hours, not days.” Next came six months of physical therapy, which provided some help if he maintained a strict regimen. Dunn had cortisone injections twice, with no benefit. 

“Long road trips and air travel were nightmares,” he recalls. Over-the-counter pain killers had no effect, he says, and he studiously avoided prescription pain relievers or muscle relaxants. “I knew of people with back pain similar to mine, who had become prescription pain killer addicts; I didn’t want to go down that trail.”

Dunn finally went to an orthopedic surgeon who, unlike the chiropractor, saw nothing of concern on the x-rays. “He looked at the same x-rays as my chiropractor and said, “You can’t see anything from these.” The orthopedist ordered an MRI, which showed a herniated L4-L5 disc.

After exhausting what he thought were all of his alternatives, he had surgery in December 2006, an L4-L5 discectomy to remove the herniation. It relieved his occasional sciatic pain, but the low back pain continued. “I followed up with routine physical therapy for the next 6 months which helped me to manage the pain, but if I skipped even one day of stretches and exercises I was miserable,” he says. 

At this point Dunn estimates he was out of pocket about $7,000 and that his health insurance company had absorbed at least another $20,000. He also missed work for a month while recovering from the surgery.

For the next several years he managed his pain with a strict regimen of stretching and exercise, but still struggled at work where he spent long hours sitting at a desk. The pain was constant, he remembers, with its severity tempered only modestly by stretching and back exercises.

The ordeal was at least as taxing emotionally as it was physically and financially. “I was never clinically depressed, but over time it took a toll on me emotionally,” Dunn recalls. “I’m an engineer by training. I solve problems, and I couldn’t figure this one out. I was going to all the medical professionals you’re supposed to go to, and they couldn’t fix it."

“The despair part of it is this fear that you’re going to have to live with this for the rest of your life. The longer it went on, especially after the surgery didn’t resolve the underlying back pain, the more I was left wondering if this was going to be a chronic lifelong cross to bear. I never stopped looking for answers, but I had five years of very limited success. And when a problem lasts that long, you can lose hope.”

In April 2010, nearly five years after the pain began, he took the three-day intensive Gokhale Method Foundation course. 

“It was intuitive, in a way that was revealing, or eye opening,” he recalls. He had seen Gokhale Method creator Esther Gokhale’s book, and the class came naturally to him. “I remember sitting down for the opening session, and listening to her explanation of posture. It was very intuitive, and I felt very comfortable. I saw results almost immediately."

“I quickly realized that many of the stretches and sitting positions I had been using to find relief were, according to the Gokhale Method, counterproductive. For example, arching or swaying my back and using a lot of lumbar cushioning—that was a big one—were actually making things worse. I had no guidance or foundation for the geometry and physics of a healthy back, so I used countless positions and exercises, many of which were ill-advised. Esther’s method was a very logical philosophy, easy to follow.”

Dunn shared an email he wrote to Gokhale six months after taking her course. "My low-back pain is, for the most part, a memory. I have applied your methods principally to my sitting, which was always the most uncomfortable position for me. The results are striking. Whereas in the past it was a struggle to get through a day (complete with standing / stretching / walking breaks every 10 minutes or so), I can now sit uninterrupted and pain free for long stretches."

“As evidence of that, I have traveled from Boston in the past three months twice to Portugal (that's four flights of seven+ hours each), twice to Texas (four flights of three+ hours), and once to Mexico (two flights of four+ hours). Each time, I flew comfortably and pain free!"

Dunn—now a 32-year-old transportation planning consultant—travels regularly overseas and has driven twice across the country—all pain free. And his advice to others in back pain? 

“This method is something everyone should be doing, regardless of whether they’re in pain. I notice posture now. I notice how people are sitting. For those in pain, it’s easy, low cost, and a low-hanging fruit. I wish I had done it first.”

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!