S-spine

There are so many things in my life that I feel thankful for, and Thanksgiving gives an opportunity to reflect on these feelings of gratitude. For our newsletter I wanted to share the deep gratitude I have for my personal journey out of back pain, and for how that journey continues as a growing ability to support and empower others in this direction. 

When I came to write this blog post, I quickly realized that this is a daunting task! The truth is that so many people have played invaluable parts, both great and small, in helping me to create the Gokhale Method® that it’s impossible to pay tribute to everyone in a short piece of writing. So I decided there will be other posts of gratitude, including to my teachers, to the people around the globe on whom this work is based, and to our team of dedicated teachers and staff. But on this National Day of Thanksgiving, I’d like to focus on things related to living and working in the US.

The settling of people from all over the world in North and South America has brought innovation and enthusiasm for new ideas. This is Sebastian Münster’s Map of the New World, published in 1540. Wikipedia

The US has a uniquely multifaceted heritage

I feel grateful to live in the salad bowl that is the US. At its best, the US benefits from embracing ideas and traditions from all over the world. It has a track record of weaving together influences that enhance the richness of life and result in vibrant, new, and exciting ways of solving problems. 

One of the ways in which the Gokhale Method® is quintessentially American is that it draws on healthy inputs from different cultures, theories, technologies, and more. We actively search out kinesthetic traditions of people all over the world, past and present, and learn from the best of what works. Since so many people visit and settle in the US, studying other movement and bodywork traditions becomes especially accessible, whether we are looking at massage, dance, or gardening.

Nirmala, a baby masseur from India visiting friends in California, prepares to massage a baby on her lap.

Gokhale Method alumna Joan Baez dancing in her kitchen with her friend Jesus Morales (better known as Chuy), who hails from Mexico. He has typically excellent form—his behind stays behind, his back is upright, and his shoulders remain back.

American “can do” can help to solve back pain 

Americans have some qualities in common with teenagers—a boldness to experiment and reinvent ourselves, and a willingness to put ourselves out there without necessarily having the training or experience to get the job done. A can-do mentality with readiness to learn along the way doesn’t guarantee success (according to the US Bureau of Labor Statistics, only 35% of new businesses survive for 10 years), but the businesses that do survive often couldn’t have gotten off the ground at all through more conventional progression and do provide valuable services and products to society. 

I don’t have an MBA, and I started the Gokhale Method 30 years ago with no idea of how to launch a business, manage staff, or use an Excel spreadsheet. Many mistakes happened along the way, and yet our small raft of a company became seaworthy, is still afloat, and continues to set sail in new waters to bring relief to an increasing number of people. 

We have evolved a highly efficient and effective solution to back pain and other debilitating musculoskeletal problems—15,000 people have taken our courses to date, and over 250,000 copies of 8 Steps to a Pain Free Back have sold. There’s much more to be done, though—back pain remains the number one cause of disability globally, and 80% of people in the US alone are expected to experience a significant back problem during their lives. The Gokhale Method mission “to make back pain rare” continues. 

Each statistic represents a personal story of pain, disability, and often financial stress. www.thegoodbody.com

Innovation is recognized and valued in the US 

I’ve been promoting the J-spine paradigm for over three decades now. (You can read more about spine shape here.) It’s a radical departure from conventional wisdom’s S-spine paradigm, but based on compelling arguments and a growing body of evidence, the Gokhale Method has been welcomed into physician training courses, retreats, and conferences, and will now be the subject of a randomized control trial (RCT) at a major university. This level of openness and acceptance of disruptive approaches is more common in the US than in many other societies. 

Americans love new ideas—even when they’re old ideas!

Back in the 1990s I was studying posture in Portugal, because the average posture in southern Europe was still notably healthier than in the US. While I was carrying my baby on my back, using an African wrap, concerned people who saw me would give well-meaning advice on how to carry a baby properly. Of course, this came from their best intentions to help me take care of my baby, but still, back in the US, I found people around me much more amenable to incorporating such techniques. Here I encounter people wanting to learn this traditional skill I had originally learned from an African friend. 

I am carrying my youngest daughter on my back. This way of carrying infants encourages healthy posture in both mother and child. 

Philanthropy and support

For most of my time in the US I have lived in the Bay area, which happens to have one of the highest densities of philanthropic donors in the US. Innumerable students from the Bay Area and elsewhere in the US over the years have stepped up in a variety of ways to offer support to our organization by way of legal advice, mentorship, business strategy, and funding for research. In 2020 we managed to raise enough money in donations for the randomized control trial (RCT) that is happening in a major university next year, from students who wanted to see the benefits they received from this work extended to a wider public.

Of course it’s natural to have the largest following, and therefore the largest number of supporters, locally. In fact, in spite of the distances, people from all over the globe have stepped up to offer a variety of kinds of support—back pain is truly a global problem.

Our company continues to receive much “behind the scenes” help. Often these supporters stepped up without me asking. A number of people eminent in their field, including musician, artist, and activist Joan Baez, have been extremely generous with their endorsement of our method. We have also received donations—of antique photographs and artifacts showing healthy posture—to the Gokhale Method Institute’s collection. People have come forward and offered us accommodation and venues. There is truly no way that our organization could have reached its current level without all this help.

It especially touches my heart when students are courageous and willing to share their story, be that by talking to others, writing a blog post, or giving a testimonial. This is never an expectation, but another gift for which I am truly thankful as it inspires others to have realistic hope that they too can learn the Gokhale Method and live without pain.

Many of our students generously share their stories. Here is Sheila Bond, who was featured in our most recent blog post.

Americans are at the frontier of wearable tech 

Over the last seven years, we’ve developed ground-breaking wearables, including our user-friendly PostureTracker™. No door was ever closed to us for lack of formal training in technology or tech enterprise. We learned as we went along and persisted through to the finish line and now have a unique and sophisticated tool to assist our students in transforming their posture education into posture habits. PostureTracker is now available as an add-on to our in-person Foundations and Pop-up courses, our online Elements course, as well our in-person and online Alumni offerings. Our next deep-dive online Alumni PostureTracker Course starts on January 11 next year.

This clip from our Secrets to Pain-Free Sitting DVD shows students using our PostureTracker wearable.

Being positive is cool in the US

Positive reinforcement as a teaching style, as well as a tenet of company culture, is a data-supported choice that has been widely embraced in the US. I was raised with some degree of the Calvinistic notion that a little negativity is a necessary part of being real. And my own posture training included spurs like, “How can you stand to be so ugly?” (To many of us this will be surprising, but as part of “old school” pedagogy, it’s nowhere near caning school children, which used to be a common practice). So I’m grateful I got to see that authentic positive reinforcement works, works really well, and leaves no scars behind.  

I believe a positive approach is especially important in the field of posture because posture has historically been laced with negative reinforcement, ridicule, and even racism. Posture is a very personal matter for most people, so it is important that people feel safe, embraced, and encouraged as they go about their journey of improving themselves. It is an integral part of our teacher training that a positive stance is woven into our teaching, our touch, and our vision, and I feel grateful for my 45+ years in the US for supporting this. 

Julie and I celebrate with our most recently trained teachers—this time in Germany! (Left to right: Michal, Ines, Julie, Me, and Johanna.)

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 is about sitting with a backrest, which could be the back part of a chair, or something added to the chair for additional support and comfort. 

A well-designed backrest can contribute to a healthier back—but a poorly designed one can cause tension and pain. Pexels

Support and relief

Virtually any backrest will give relief that a tired back will appreciate. Support is certainly preferable when we sit for longer periods of time to enjoy reading, TV, a movie, or, if we are lucky, live theater. 

With the trunk slightly inclined against a backrest, there is less compressive force due to gravity acting on the spine. In addition, the trunk stabilizer muscles get a break. When we are driving or traveling by plane or train, a backrest also confers additional protection from vibration or any untoward impact. 

Backrests can certainly improve your comfort but it is also true that many do more harm than good. It makes sense to be discerning about your backrests and to understand the ways in which they can help or hurt.

Shaping your back 

There is unfortunately a significant disadvantage that is built into most modern backrests. A backrest will shape your back as you lean into it and almost all backrests introduce excess curvature, with a significant concave curve in the lower back (lumbar area) and a significant convex curve in the upper back (thoracic area). This is driven by the incorrect paradigm of the S-shaped spine.

This medical illustration of a spine (1990) is S-shaped, displaying the excessive curvature that can result in pinched nerves and compressed intervertebral discs. Traite d'Anatomie Humaine

This spinal shape is considered to be normal (as well as ideal) in today’s conventional wisdom. Physical therapists and medics are taught this S-shape paradigm, which is explained in detail in my book, 8 Steps to a Pain-Free Back, and in our blog post Which Shape is Your Spine? 

The S-shaped spine has become the concept that determines the design of our furniture, including backrests for chairs and car seats. 

Most backrests follow the S-shaped spine paradigm and are designed to give “lumbar support.” This creates exaggerated curvature and compression in the lumbar spine.

Office and gaming chair backrests are often engineered with exaggerated contours. These distort the spine’s natural alignment. Such excessive curves curtail the spine’s ability to lengthen.

This style of easy chair has less drastic curves but will still result in some lumbar and upper back distortion; it also pushes the shoulders and head forward. Back2.co

This lounger has a mild thoracic curve which still encourages the upper back to round. 

What you want is a backrest that reflects and promotes the healthy spinal shape that we all enjoyed as toddlers and is still prevalent in many nonindustrialized areas of the world. The shape of a modern letter “J” is a good shorthand to describe this relatively straight alignment of the vertebral column and the pronounced angle at the lumbosacral junction. Unlike the S-shaped spine, there is no exaggerated lumbar sway or thoracic curvature. You can see this shape embodied in the Ubong hunter’s torso shown below. It is J-shaped rather than S-shaped. 

These Ubong tribesmen have a J-spine.

This medical illustration from 1911 more closely depicts the J-shape spine rather than the S-shape of modern conventional wisdom. The only pronounced curve is at the L5/S1 junction at the base of the spinal column.

A backrest with gentle traction

Beyond supporting a healthy J-shape in your spine, ideally a backrest would also stretch your spine, especially in the lumbar area. With a little know-how you can get hours of therapeutic traction into your day, reducing pressure on your spinal discs and nerves and improving circulation in the surrounding tissues. We call this combination of healthy shape and traction stretchsitting.

This schoolboy in Brazil has healthy posture and instinctively uses the backrest to stretchsit, lengthening his spine. 

How to choose a backrest

1. If your chair’s backrest already offers some friction (e.g., textured fabric) and you don’t mind adjusting it when you sit, a folded towel can serve you adequately for stretchsitting. This video will show you how.
2. Our Stretchsit® Cushion creates healthier contours and provides traction with its soft, grippy nubs. It comes with extension straps that hold its position without repeated adjustments.

The Gokhale Method Stretchsit® Cushion comes with adjustable straps and can transform most chairs and car seats.

Teaching stretchsitting with a Gokhale Method Stretchsit® Cushion on a folding chair.

3. The Gokhale Pain-Free™chair is designed to provide healthy contours and traction for stretchsitting. It has the additional advantage of having a built-in wedge, a waterfall front, and other features making it suitable for stacksitting (sitting without a backrest). 

The Gokhale Pain-Free™chair has a custom forged “back upright” (the metal piece that goes between the seat pan and the backrest) to allow your behind to be behind. This allows your spine to have a healthy J-shape. The backrest has sticky nubs sewn into it to provide therapeutic gentle traction.

Free Online Workshop

If you would like to find out more about healthy sitting, including using a backrest, sign up for my FREE Online Workshop.

At the beginning of the pandemic, my tween daughter was the dancer in my house. When her in-person hip-hop class was canceled, she quickly turned online for inspiration, showering me with her 30-second Tik Toks.

I was amused, but resolute that dancing online was not for me. I had my own exercise regime, at the heart of which were a series of Pilates-based exercises that I had incorporated in the hopes of healing a nagging injury. 

But now, 16 months into the pandemic, I’m dancing online too, maybe even more than my 12-year-old. This is thanks to Esther Gokhale and her unbelievably fabulous community who, like me, wanted to find a safe, therapeutic, and fun way of exercising after injuring our backs.

I first heard Esther years ago on a podcast and subsequently checked her book 8 Steps to a Pain-Free Back out of the library. I remember being especially interested in the pictures of women holding their babies so comfortably; I had recently given birth, and I tried my best to imitate the women pictured. 

Me with Baby Yael in 2013. I now see I had a very pronounced S-shape curve. 

From reviewing pictures of myself during that time, I see now that I did a poor imitation, but at the time I didn’t have any pain, so I returned the book to the library. 

However, last November while experiencing non-stop back pain, I purchased the book, which led me to Esther’s website and one-on-one coaching. Six weeks later, after completing the Elements course, this is what I wrote to friends and family in my 2021 New Year’s letter:

I’ve been relearning how to walk, stand, and sleep over the past six weeks. This is what one does when she becomes so desperate for relief from unrelenting sciatica, the kind that starts in the buttock and runs down to the calf. It all began with a yoga injury in May 2019, but the pain became unbearable after our move (hello, stress and grief, and, yes, more disc degeneration.)

An MRI from December 2020 had pinpointed “severe facet arthritis bilaterally” at L4-5, and mild to moderate facet damage elsewhere. I had tried everything from PT to Pilates, from massage to medical marijuana, but what seems to have made the biggest difference is the Gokhale Method, which attempts to reteach the body how to do the work of everyday life without further degrading our discs.

I was skeptical about how much I could actually learn online from a Gokhale coach, given that postural work benefits from hands-on adjustments and corrections. But with COVID-19 raging, this is not the time for in-person classes. Happily for me, my coach was terrific, and after completing the 18 introductory classes, I’m feeling so much better. It’s definitely not a magic bullet, but it’s the best thing I’ve tried so far, and I want to believe that if I keep it up, I’ll eventually be pain free. Here’s hoping I can report that next year.

Seven months later, I am thrilled to say that I am indeed pain-free and living a full life that enables me to care for my family, return to writing, and relaunch my health coaching practice that I had put on hold due to the pandemic and pain.

My recovery has been so complete that in May I undertook training to become a certified canoe instructor and am now teaching at the American Canoe Association’s Camp Sebago in New York. 

Now free from back pain and sciatica I am once again able to canoe.

Even though I feel great, I know that wellness takes regular work, and I’m grateful for the ongoing Gokhale Exercise program. Gokhale Fitness teacher Eric Fernandez has gotten me to enjoy strength training; teachers Kathleen O’Donohue and Roberta Cooks are responsible for me incorporating Moving Meditation into my morning routine, while Esther’s daily 1-2-3 Move program has rekindled my love of dance and taught me steps from traditions that include bharata natyam, samba, capoeira, 50s rock, and reggae. Joan Baez’s music is a fave—she is a student of Esther’s and will often be dancing on the screen with the rest of us. 

Head-loading is a fun way to practice many important posture principles, shown here on the 1-2-3 Move program. 

Esther will also occasionally focus on yoga asanas and offer modifications that have enabled me to safely return to a yoga practice. If you see me balancing boxes (or my canoe) on my head, it’s thanks to all the practice I’ve now had with the Gokhale™ Head Cushion, gently “head-loading” my way to a taller, healthier neck. Thanks to the Gokhale Pain-Free™ Chair and Gokhale Stretchsit® Cushion, I’m also able to sit well at my desk and to drive long distances without pain, something that was impossible seven months ago.

1-2-3 Move often features artefacts such as Greek statues, Indian deities, or photographs of people from different cultures going about their work. Esther points out that examples of healthy posture by Americans are more readily found some generations back, in works such as those by Grant Wood or Winslow Homer.  

A Basket of Clams, 1873, Winslow Homer

My favorite class was the one devoted to the Hindu deity Ganesh, who takes the form of an elephant with a pot belly. While dancing to the “Ballad of Ganesha” by Lil Darkie, we took a cue from Ganesh, who holds himself beautifully, despite his roly-poly largesse. Esther talked about how strong abs are something that everyone, no matter what size, can cultivate. If Ganesh can carry himself well, the rest of us can do so as well. She made a similar point using images of Japanese sumo wrestlers. I deeply appreciate that Esther, raised in India by her Dutch mother and Indian father, takes a global perspective on healing. 

Dancing Ganesh, India, 900–1000 AD, sandstone - Fitchburg Art Museum

As a Functional Nutrition and Lifestyle Practitioner, I’ve come to view the Gokhale Method as nonnegotiable, or what Andrea Nakayama, CEO of the Functional Nutrition Alliance, calls “Tier 1”—the basics that must be in place before supplementation (Tier 2) or any kind of medical intervention (Tier 3). 

Tier 1 includes community support, something that is available in any Gokhale Method group class. These social and emotional components of healing, and the importance of surrounding yourself with healthy posture cues from people, artwork, and music, are frequently discussed during the Q&A on the 1-2-3 Move program. 

In this 1-2-3 Move video, Esther shows how traditional artefacts such as shadow puppets from Java, Indonesia, inspire us to free our arms and open the chest.

The Gokhale Method is not against appropriate medication or procedures. Back in February when I was still having some pain upon waking every morning, I asked Esther what she thought of “injections” as a way to mitigate this. To my surprise she said that she sometimes suggests that her students consider this “Tier 3” approach, but only after they have tried “Tier 1” first. Medical interventions such as injections and painkillers can create a window of pain-relief that enables students to learn to improve their posture and address the root cause of their problem. 

I had already had an injection into my SI joint the previous September, which didn’t give me any relief. So I booked a one-on-one appointment with Esther, who pinpointed an excessive curve in my lumbar area. The transformation I brought about in my spine led to me being used as an example of progress in a blog post about spine shape. 

My “before” (above) and “after” (below) Elements photos show a considerable change from an S-spine towards a J-spine. You can read more about spine shape here.

With ongoing attention to creating more of a J-spine and less of an S-spine I no longer have pain. Perhaps even more importantly, I have greater trust that my body, with the right support, can heal.

Loren Edelson is a Functional Nutrition and Lifestyle Practitioner who writes Given the Givens, a bimonthly newsletter on reaching our full potential, even after receiving a life-changing diagnosis. To subscribe, visit https://loren6c2.substack.com/welcome

SCIJ isn’t a very memorable acronym, but the shapes of the letters do accurately represent the four most common spinal shapes. In this blog post you will discover which SCIJ category you belong in, what changes you might want to make, and the first baby steps to improve your spinal shape.

The letter “S” is widely used to describe the conventional paradigm for an ideal shape of the spine. The Gokhale Method perspective is that we need a paradigm shift.

Loren had developed a pronounced S-shaped spine before she took the Gokhale Elements online course. Tightened lower back muscles formed a pronounced lumbar curve, and her upper back had to round over to return her to upright. 

S. This is the spinal shape considered to be normal (as well as ideal) in today’s conventional wisdom. You will find the S template for spinal shape in lay circles, alternative health circles, as well as medical circles. Massage therapists, yoga teachers, physical therapists, and medics, are all taught the S-shape paradigm, which may include arguments about the strength of arches and “opposing curves'' and their ability to absorb vertical load like a spring.

The S-spine consists of a significant concave curve in the lower back meeting a significant convex curve in the upper back. From the Gokhale Method perspective, both curves are exaggerated and can lead to pain and dysfunction. This posture loads the spinal joints and takes a lot of muscular tension to maintain. It is the reason, we posit, that maintaining “good posture” has a reputation for being hard work. If this shape fits your spinal contour, it is unlikely to have been called out by either conventional or alternative practitioners. After all, it is the described ideal. If you have faced the frustration of having your back “go out” soon after an intervention, or your symptoms return again and again, a possible reason is that your S-shaped spine has never been recognized as the root of your problem, let alone be treated. 

This medical illustration (1990) displays the excessive curvature that can result in pinched nerves and compressed intervertebral discs. 

As both the vertebrae and the intervertebral discs have virtually parallel upper and lower surfaces, like a cylinder, the exaggerated curves of the S-spine create pinch points that can impinge on nerves, and cause wear and tear on the discs and degenerative change in the bones. Any of the tissues of the back, shoulder area, and neck might well “complain” about being obliged to maintain these contours.

An ideal first step to improving the shape of your S-spine would be stretchsitting. You can begin to learn stretchsitting here.

The letter “C” describes the most common modern posture of all—slumped.

The C-shaped spine will curve more at the top if we hunch more…

or curve more at the bottom if we tuck more…

either way, a C-shaped spine is bad news for our discs.

The C-spine is the product of slumped posture, with the tail tucked between the legs, shoulders rounded, and head forward. This compresses the front of the spinal discs, squeezing the interior contents (the nucleus pulposus) backward. This is the most dangerous direction to load the spinal discs since the nerve roots exit the spine right behind the discs. Slumping with a C-spine also overstretches and weakens the ligaments around the spine, undermining their ability to maintain the integrity of our all-important spinal column. Many people alternate between forcing an S-shape in their spine in the name of “good posture” (wrong!) and collapsing into a C-shape when they are fatigued from their efforts. Both these shapes in fact cause damage—in different ways—and need to be replaced with a J-shape (keep reading!). 

An ideal first step to improving the shape of your C-spine would be learning to use your inner corset, the deep muscles of the abdomen and back which support and protect the spine. This is explained in detail in my book, 8 Steps to a Pain-Free Back.

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The I-spine shape results from a “sinking into oneself” without a significant increase in spinal curvature. 
Older people may develop an I-spine as they lose height due to spinal degeneration. Unsplash

The I-spine is common in older folk living in modern industrialized societies. There are no particularly pronounced contours in the spine, but rather a general “melting into itself” with the disappearance of 1 or more inches in height accompanying the aging process. The shrinkage is often the result of degeneration in the discs or mini-fractures in the vertebrae. Some diagnoses that might accompany this spinal shape include osteoporosis and stenosis. The pelvis is tucked, there is no angle between the buttocks and the back, and the buttocks are underdeveloped. Though the I-shape is most common in older people, it can begin at a young age with tucking the pelvis.

This photo of Taylor Swift shows how a tucked pelvis flattens the lumbosacral angle, and disadvantages the gluteal muscles, combining to produce a flat “behind." 

An ideal first step to improving your I-spine would be to learn stretchlying on your back.

The letter J represents the healthiest spinal shape. 

The shape of this Ubong tribesman’s back is best described as a J-spine.

Though rarely preserved in adults in modern industrialized societies, the J-spine is the shape we all enjoyed as toddlers and is still prevalent in many nonindustrialized areas of the world. This “J” is a modern, stylized “J,” reflecting the relatively straight alignment of the vertebral column and the pronounced angle at the lumbosacral junction. There is no exaggerated lumbar sway or thoracic curvature. You can see this shape embodied in the Ubong hunter’s torso. 

This medical illustration from 1911 more closely depicts the J-shape spine rather than the S-shape of modern conventional wisdom. The only pronounced curve is at the L5/S1 junction at the base of the spinal column.

Since taking the Gokhale Elements online course, Loren has made good progress in losing unwanted curvature in her back. Her upper lumbar spine has straightened out considerably. Over time, given her dedication, we expect to see her most pronounced curve move lower as she continues to cultivate her J-spine. 

If you are interested in restoring your J-spine, we recommend taking our Elements course (one-on-one coaching online), or our Foundations Course (one-on-one or small groups in-person) or Pop-up Course (not available during COVID). These courses teach you to systematically lengthen, strengthen, and remodel your spine to a healthier J-shape in a safe and effective way. 

To gradually and safely improve their spinal shape students learn well-honed techniques using their fingertips to monitor their spinal groove, kinesthetic and visual cues, customized exercises, and visualizations. Because it is still challenging to rely heavily on your proprioceptive sense, we have also developed the PostureTracker™, a tool that tells students exactly where they are positioned using Bluetooth sensor technology. PostureTracker tracks the shape of your spine in real time—it gives immediate and intuitive feedback, is easy to use, and reveals information about your spine that a plain mirror cannot show you. Though PostureTracker is not yet available for sale, it is available as a loner (while supplies last) to students who sign up for the online one-on-one Gokhale Elements course.

If you sway in your lumbar area, PostureTracker will show what is going on with your spine.

To get an idea of the current shape of your spine, view yourself side-on. You can use a mirror, but it is best to photograph or video yourself, or use several mirrors, so that you can observe your shape without turning your head. Take a while to study yourself both sitting and standing. Notice that your spine changes if you alternate between swaying and slumping. You may discover that your habitual posture combines elements from two or more of the categories we have described—for example, you may most closely resemble the I-spine, except that your head and neck jut forward.

The curves in our spines precisely reflect our everyday posture habits.

If you would like a trained eye to help you understand your spinal shape and how to improve it we recommend an online Initial Consultation with a Gokhale Method teacher. In-person Initial Consultations may also be available depending on the COVID status of your area.