pronation

It is not uncommon for students to show up at our courses aware they have lost several inches of height since their youth. In our culture it is a widely held expectation that you grow up, and then, at some point in later life, start getting shorter again. We all see friends, neighbors, or family members who are on the downward run of this trajectory, and it is virtually common lore that you will “shrink” or stoop in later years.

Losing height in later life is characterized as inevitable in our society. Image from Freepik

Can I expect to lose height as I age?

It is true that trauma, malnutrition, or conditions such as degenerative disc disease or osteoporosis can lead to loss of height. But our experience of working with many thousands of people over the past three decades has shown that most height loss is due to poor posture.

Let’s consider the most common reasons that people lose height:

• A tucked pelvis: The pelvis is actually in its tallest orientation when it is anteverted, which means slightly tipped forward, rather than the commonly advocated “neutral pelvis.” Pelvic anteversion is evident in our infants, our ancestors, and those living in traditional societies today, and is what we teach our students. 

The tucked pelvis (a) is shorter and does not allow the spine to stack well on the sacrum and retain its height. More height is evident in the anteverted pelvis (b). 

• Unhealthy spinal curves: 

Sitting or standing with a tucked pelvis (a.), expect to see the spine adopt a compressive C-shape. This rounding of the back reduces overall height in sitting, standing, and walking. Trying to sit up or stand up straight with a tucked pelvis (b.) takes a lot of muscular tension to maintain and excessively loads the lumbar spinal joints and discs. And it also makes you shorter, not taller! A healthier arrangement (c.) allows the spine to stack in more of a J-shape, formed by a distinct L5-S1 angle, and then ascending with less curvature along the remainder of the spine. This taller spine provides space for the intervertebral joints, discs and nerves.

• A weak inner corset: Weak inner corset muscles allow undue pressure and wear and tear on the tissues, discs, nerves, and bones of the spine. This is a major cause of and contributor to degenerative spinal conditions. All can result in a visible loss of height and thickening around the waist area.
• Unhealthy bending: A lifetime of rounded bending overstretches the dorsal ligaments of the spine and produces excessive kyphosis, or rounding of the upper back—stooped posture.
• Forward head posture: A tucked pelvis and/or rounded upper back projects the neck and head forward. This brings excessive muscle tension and compression in the neck and upper back as the muscles endeavor to hold the head upright. 
• Collapsed foot arches: Loss of the natural arches displace the bones and weaken the tissues of the feet, causing localized problems such as plantar fasciitis, Morton’s Neuroma, and bunions. Height and healthy function can additionally be lost through internal rotation in the knees and hips. 

Most people in our society can expect to live into advanced years—but often with considerable physical and mobility challenges. Retaining or regaining healthy posture is key to remaining free from such disability.

Most of us are taller than we think! 

It is neither inevitable nor natural to lose height as you get older. In fact, we have found that it is possible for most people, including those with degenerative conditions, to regain some height!

For a period in pre-COVID days we diligently measured the height of our students before and after they took their Gokhale Foundations Course. They averaged a height increase of two thirds of an inch (1.7 cm). 

Sometimes people discover that they have stooped for years: through doing desk work in poor furniture; bending poorly; as the result of a physical or mental health crisis; or perhaps since trying to hide growth spurts in adolescence. Many of our students have a sudden awakening to the fact that they are taller than they thought. They report feeling elegant, stronger, and healthier.

Moving like we are meant to, for example using a healthy hip-hinge like these two Portuguese workers, preserves height well into older age.

It always astonished me how students seemed more delighted to measure taller than to get out of pain! Reflecting on this, I think students have often been hopeful that their pain will resolve, but are actually surprised when they find they have recovered long-lost height. For both reasons, I share their joy!

What works to restore healthy height and posture.

Clearly, gaining height doesn't happen within a weekend course through any sort of magical “regrowth”! Nor do you get there by redoubling your efforts to “stand up straight.” But you can make transformational changes by addressing the way in which you align your feet, legs, pelvis, spine, and head. And while many of our students gain an inch or more over time, even a millimeter of regained height can be the change from impinged nerves to a pain-free existence.

Molly, a student who is nearing the end of her online Gokhale® Elements course, just wrote us:

I've been fortunate to have a very active lifestyle these 67 years. As I age, I see some effects of gravity and poor habitual posture showing up. A diagnosis of osteopenia and osteoporosis has me on alert. I was exposed to the Gokhale Method® years ago by a yoga teacher and read Esther's Book 8 Steps to a Pain-Free Back. Now, I see great results from having a one-on-one online Gokhale teacher providing additional tips, cues, and feedback. In my annual check-up last week, I had gained a half inch (1.3 cm) in height! This is great news for my spine! Thank you, Gokhale Method.

Molly used to lock out her knees and sway her back in standing (left). She is making great progress (right) as she softens her knees, aligns and lengthens her spine with a more relaxed lower back and tall neck, and rolls her shoulders back home. 

My colleague Julie Johnson and I offered a special workshop called Women’s Empowerment Through Posture this week and were overwhelmed by the level of registrations and interest in this topic. Aging well without shrinking is one aspect of what we will be covering in our brand new group offering Women’s Empowerment Through Posture. Join us for six one-hour group sessions, in which we will work together to transform your posture to find a new level of confidence, relaxation, comfort, and self awareness—as well, of course, as helping with aches and pains. 

Best next action steps 

If you would like to know how to restore or make the most of your natural height, get started by booking a consultation, online, or in person with one of our teachers. 

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

We’re here to help with your New Year’s fitness resolution. Join us for a FREE 10-day New Year 3 x 3 Fitness Challenge, which is offered as part of the Gokhale Exercise program. It will be fun, safe, and effective, enabling you to build your strength without strain and injury, because, all the while, you are also training for healthy posture! 

Your 10-day challenge consists of three sets of three (3 x 3) popular exercises. Our approach to these well-known exercises is unlikely to be found in any standard gym or fitness program where, unfortunately, poor postural habits go undetected or are even unknowingly promoted. Here the exercises will be taught with our “Gokhale filter” to respect what is natural and healthy for your body.

The New Year 3 x 3 Challenge Exercises:

Exercise #1: Push-ups

Push-ups are a highly functional exercise that will assist you with many daily tasks and a range of activities—getting up from the floor, yoga, weight training, gardening, pushing heavy doors or strollers, etc.

A lot of people, especially women, have difficulty supporting their weight with their arms; their upper body muscles are much weaker than lower body muscles. That was certainly my story.

To this day I haven’t yet done a full push-up though I am getting tantalizingly close thanks to our Gokhale Fitness and Yoga programs. I can now lower myself to the ground with full control, (an excellent eccentric exercise, which you can read more about here), and can push up from part way up. I am hopeful that the 10-day New Year 3 x 3 Challenge will take me all the way! 

This push-up is done at a bench rather than on the floor to be easier. However, common problematic habits can still creep in, as Gokhale Fitness teacher Eric Fernandez demonstrates.

This push-up shows healthy form.

Exercise #2: Squats

Growing up in India, I was surrounded by people sitting on the floor and squatting frequently throughout the day. These habits contribute to greater mobility in the formation of the hip joint, and flexibility in the tissues surrounding the hip joint. 

People in our culture rarely have this degree of mobility and flexibility in the hips and ankles, and so squat poorly in a way that does damage—rounding the back and pronating the feet. This is more of a collapse downward than a well-supported, well-aligned squatting movement. 

In the 3 x 3 Fitness Challenge, Eric will show you how to do squats in a safe way, to boost the strength of your knees, quads, glutes, thighs, and whole lower body. Done well, deep squats are not only safe—research shows that they can improve the health of knee menisci and cartilage, ligaments, and bones.

This squat demonstrates poor form, such as internal rotation of the legs. 

This squat demonstrates healthy form.

Exercise #3: Deadlifts

Often known as a Romanian deadlift due to its popularity among weightlifters in Eastern Europe, a deadlift strengthens almost everything on the back of your upper and lower body. It is also a good exercise to test and develop hip mobility, and to develop bone density. 

The deadlift utilizes our primal way of bending, which we call hip-hinging. Hip-hinging is instinctively used by our infants, and widely by adults in many parts of the world where traditional patterns of movement have been maintained. Hip-hinging is taught in our Gokhale Method® in-person Foundations and Pop-up courses, and our online Elements course.

This deadlift demonstrates common mistakes such as rounding the back.

This deadlift demonstrates healthy form.

Here’s your Challenge:

Day 1: You’ll test how many reps of each exercise you can do in a minute. You’ll take a minute’s rest between each of the three sets, and between each exercise. 

Days 2–4: You will do other exercises that compliment and build up your strength for the 3 x 3 Fitness Challenge.

Day 5: Check-in on your goals.

Days 6–9: Continue with strength training.

Day 10: You’ll go through the challenge again and see in what ways you have improved. Expect an improvement in your strength, in the number of reps you can do, and in your range of motion!

Is this fitness challenge suitable for everyone?

The 3 x 3 Fitness Challenge is designed for practically everyone, with easier options given for those taking steps towards the full exercise, and additional challenges for those who find them relatively easy. 

People are often surprised at how working with healthy posture changes their experience of an exercise—depending on the situation, you may feel stronger and lighter, for example. Or you may discover that you were unknowingly “cheating” and can benefit your body by making different, healthier efforts.

If you have had an injury or surgery recently, or have a particular health issue, we recommend that you seek the advice of your preferred physician or health professional before starting the Challenge. We encourage everybody to work within their capabilities—this is not a no-pain, no-gain program!

I look forward to meeting you as we challenge ourselves to greater fitness, and healthier posture.

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. . .

Welcome to the third blog post in our series on running. My name is Michelle Ball, and I am a Gokhale Method® teacher in Tasmania. I am a lifelong runner and am passionate about sharing my experience with beginners as well as seasoned runners and everyone in between. Even if you don’t run, but do wear shoes, this blog post is for you!

Active feet come first

When it comes to advice about running, our feet often get sidelined by the subject of shoes. If you missed Part 2, which is about how to build healthy, active feet, we recommend you catch up here. 

The job of a good running shoe—performance and protection

At the level of elite sport, running shoes are designed with increasingly sophisticated technologies to enhance performance. Time will tell what long-term effect these may have on athletes. From the Gokhale Method® point of view the primary purpose of all shoes is to protect our feet and our weight-bearing joints while still allowing us to move as Nature intended. 

A lightweight, barefoot-style shoe gives my feet sufficient protection and lets them be active on a soft, forgiving surface like this sandy coastal trail.

Cushioning the joints

Over the last 50 years, the increase in urban running on hard surfaces, combined with a reduction in healthy posture and biomechanics, has made for a perfect storm of running injuries. These include runner’s knee (patellofemoral syndrome), Achilles tendonitis, shin splints (stress involving microfractures of the tibia), and plantar fasciitis (inflammation of the bottom of the foot). The design of modern running shoes has seen many innovations, twists, and turns, but one clear trend has been to increase the amount of protective padding in the form of thicker, spongier soles, air bladders, and gel at chambers. Whilst some degree of cushioning for the joints is desirable when running on unnaturally hard surfaces, it is now thought that overly thick soles reduce proprioceptive sensitivity and actually encourage runners to hit the ground harder. 

This contemporary road running shoe is heavily padded. From the Gokhale Method perspective, such bulk interferes with our ability to feel the ground and make softer landings and can encourage ankle turnover. Run4it

Strong, responsive feet combined with the natural gait pattern that arises from healthy posture can enable you to land more softly and avoid injury. Building in extreme cushioning cannot compensate for excessive heel strike and its damaging impact on poorly aligned joints. 

Healthy alignment of the ankle

The first time I experienced a running injury was in my twenties. I had bought a new pair of shoes. The salesman measured me and recommended shoes that were designed to prevent overpronation (inward turn) of the foot. They felt good in the store, but after rolling my ankles more than once, I realized the shoes recommended were predisposing me to injury. I found out later that I tended to supinate my feet very slightly and not pronate them. Having shoes that were heavily padded on the inside edge to keep my foot from rolling in, increased the chance of my foot rolling out. The result for me was torn lateral ligaments and crutches on several occasions for six weeks at a time. Once I even had a hairline fracture on the ankle coming down off a boulder. I learned the hard way how important it is to have your ankles well aligned. After buying shoes for normal ankle alignment, I didn’t roll my ankles anymore.

Your weight should align centrally and distribute evenly (left). In overpronation (center) weight bears down more on the inner foot and the ankle veers inward, and in supination (right) weight is carried on the outer foot as the ankle veers outward.

You can do a simple check on your ankle alignment using a mirror or have someone take a photograph. You want to be able to see your heel and ankle from behind.

An overpronated foot may show distortion of the Achilles tendon (right). Wikimedia

Poor ankle alignment may also show up as an ankle bone protruding markedly over the edge of the heel. Here my inner ankle bone shows I am overpronating my foot.

Kidney-bean shaping my foot has now aligned my ankle well. The Achilles tendon is straight, and each ankle bone is better aligned on either side of the heel. 

You can also get useful information by examining the soles of your shoes, which may show more wear and tear along the inner (overpronation) or outer (supination) edge. Check several pairs to ensure that what you see is not peculiar to just one pair of shoes. Compare the left and right shoe.

Learning to correct flat feet

The postural techniques that we teach in our in-person Foundations Course, online Elements, and Pop-up courses, will often be sufficient to correct overpronation, or “flat feet” as it’s commonly known. Here you can learn the detail of, for example, kidney-bean shaping your feet and externally rotating your legs, with a teacher to guide you.

If, after putting some time and effort into solving the problem, it persists, we recommend that you get advice from a good running shop and use your Gokhale Method knowledge to help choose a shoe appropriate for you. They can advise you on which particular shoes can best support you while you continue to work on your posture, remodeling your feet, and realigning your ankles. As you can see in the diagram below, both these measures can support a healthier structure.

This diagram shows how overpronation of the foot can misalign the ankle, knee, hip and spinal joints further up the chain.

Insoles and orthotics as training devices

An insole can add the necessary padding and support to help you transition from a padded shoe to a thinner or barefoot style running shoe. It is important to make this transition alongside learning protective and strengthening posture and foot work. Take your time—start with occasional short training runs in your new shoes, build up the proportion of your running in them gradually, and be very attentive to your form. 

In the Gokhale Method, we teach students to use the contours of an insole as a training device, gripping it to actively strengthen the arches of the feet, rather than just to prop them up. If it is best for you to use a more padded shoe, perhaps because you run on hard surfaces and/or have some degree of joint degeneration, then it will likely have a molded footbed that you can use in this way. 

If you have prescription orthotic insoles to correct overpronation or supination, don’t stop using them abruptly. Try using them less often as your feet gain the strength to support themselves better.

Healthy shoes need to be foot-shaped!

One of the most common faults with modern shoes—including running shoes—is the shape of the toe area, or toe box. The toe box of most shoes is tapered to some degree, which distorts the natural kidney-bean foot shape that the Gokhale Method encourages. We are all familiar with the pointed toe in many women’s fashion shoes, men’s winklepickers, and even cowboy boots—yet it surprises me how this tapering persists in sports and activity footwear. Even some shoes marketed as “barefoot” or “natural” reflect the conventional wisdom of a straight foot, rather than a healthy bean-shaped one. 

             
Most running shoes assume the feet to be straight and tapered at the toes (left). Nature’s blueprint for our feet maintains the external rotation and kidney-bean shape that we all have as infants (right). This is preserved throughout adulthood in traditional societies and explained in Esther Gokhale’s book, 8 Steps to a Pain-Free Back.

Note the bean-shaped contours and wide toes of this Indian woman’s feet. (Odisha, India, 2017) 
This strong, active foot would be constrained and deformed by a tapered running shoe.

Tipping forward/curve in modern shoes

Shoes with an upward toe curve have become increasingly popular. People like the feeling of forward momentum that they give, and they can encourage the glutes to work. Better to learn to use your glutes anyway, then this feature isn’t necessary, and you avoid the downside—the upward toe curve encourages your foot to peel off the ground passively, rather than grab and propel you forward. 

An upward toe curve depresses the transverse arch at the base of the toes. This concavity directs excessive weight through the ball of the foot and contributes to weaker plantar muscles and push-off. Run4it

I hope this blog post has helped you with your choice of running shoes. If you are in the market for a new pair, enjoy shopping with new confidence and purpose.

Rediscovering ancestral posture can be fun! In our online 1-2-3 Move program we have had several “Show and Tells” during which participants share old family photographs. The inspiration for healthy posture and positive change that these pictures bring to their descendants, as well as to the online community, is powerful. 

Here I am showing a photograph of me with my extended family in Holland. The tailoring of the traditional costumes we wore helped us to sit and stand with open, relaxed, and upright posture.

In Part 1 of this series we looked at the upper body. Here we are going to consider what our forebears can teach us about healthy alignment for the lower body—specifically, what needs to happen with the pelvis, legs, and feet. 

Ancestral photographs provide compelling evidence for what is taught in the Gokhale Method and can be a posture lesson in themselves. For example, in the print below it is striking that everyone is sitting on an anteverted pelvis, with externally rotated hips and legs, and feet angled outwards.

This group portrait shows how people sat with an anteverted pelvis, external rotation in their hips and legs, and feet pointing outward. It is one of several spare antique photographic prints donated by the Mendocino County Museum to the Gokhale Method Institute’s collection and also featured on the 1-2-3 Move exercise program. 

Pelvic anteversion 

Pelvic anteversion is the natural and healthy position for the human pelvis, in upright sitting and standing. “Anteversion” means the pelvic rim settles at a slight forward angle, rather than the “neutral” or “level” position which is often taught as ideal today. Most people in modern societies “tuck” or “retrovert” the pelvis in the opposite direction to anteversion, and consequently get into various kinds of trouble.

Anteversion is the pelvic angle you still see in historical artefacts, in our infants and children, and in populations throughout the non-industrialized world that suffer far less back pain than we do. This is explained and illustrated in detail in my book, 8 Steps to a Pain-Free Back. Below are just a few examples.

Antique statues, infants, and people in more traditional cultures all show a naturally anteverted pelvis. 

Legs externally rotated 

Pelvic anteversion is natural for our species, but was more prevalent prior to the 1920s, when traditional posture was still preserved and people had good role models. The prevailing dress codes of past times were also more conducive to healthy posture and movement patterns. For women, long, wide skirts allowed the legs to widen and the pelvis to settle well. In shorter skirts women tend to turn the knees inwards because of moral codes. Tight skirts and jeans will also tend to limit the range of movement in the hips in a way that traditional clothing does not. (Note: there is a healthy way to antevert the pelvis even when the knees are close together, but this takes a little more education and training.)

Pelvis nestled

A well-trained eye can also discern from a photograph the deep nestling of the pelvis between the leg bones that takes place when the legs are externally rotated. This nestling enables people to sit more forward on their sitz bones in an upright but relaxed position (below left). With the more common tucked pelvic position of modern times, a person is left with two equally unhealthy options for the torso: relaxed and slumped (below center) or upright and tense (below right). 

We have forgotten how to be upright and relaxed to the extent that when we look at old photographs with upright people, we mistakenly imagine that they are stiff and must be exerting a lot of effort to be upright.

Feet pointing outward

If you are lucky enough to have full-length family portraits you will see that the feet are angled outward in standing. This arises naturally from having external rotation in the hips. The current conventional wisdom that the feet should be parallel interferes with the healthy alignment and function of the lower limbs and pelvis. Without external rotation, feet are more likely to pronate (roll inward), knees to collapse inward (knock knees), and the pelvis will not articulate well with the heads of the femurs (hip joint). Students have reported much improvement in hip bursitis and impingements in the groin from gently progressing external rotation over time using Gokhale Method techniques. 

1-2-3 Move participant Linda Grande shares a photograph of her grandparents, taken around 1916, who emigrated from Sicily and met in Brooklyn. They both show beautiful posture, including outward pointing feet.

Finding external rotation

Our 1-2-3 Move Alumni exercise program gives participants further practical posture experience as well as sharing compelling history and theory. Below is a short video clip in which I introduce and teach a traditional Indian dance (Bharata Natyam) movement, which I learned as a child in Mumbai. Like most traditional dance forms, it encourages external rotation of the hips, legs, and feet. Dance is an excellent way to learn new movement patterns and make them feel familiar. Try this move for yourself! 

Traditional dance forms such as Bharata Natyam encourage external rotation of the hips, legs and feet.

The Gokhale Method® approach to posture and movement is always holistic, supports good habits, and develops healthy alignment that protects joints and soft tissues from injury. You can find out more in one of our new FREE Online Workshops. If you would like an expert one-on-one assessment of your posture and especially your lower body alignment, you can arrange an Online Initial Consultation or take an in-person Initial Consultation if you have a Gokhale Method Teacher near you.