traction

You’ve tweaked your back. It may be a stabbing pain that catches with certain movements, it may be that you cannot straighten up, or maybe it’s an electrical, nervy sensation in your buttock.  

A back spasm is never welcome—but it is a signal we can act on—when we know how. Image by: Kampus Production

It’s true that time is a great healer—and that most back pain resolves itself without intervention—but there are also things we can do to accelerate the healing, that can help us feel better immediately, and protect us in the longer term. 

Should I take pain meds?

Pain meds (muscle relaxants, anti-inflammatories, and pain signal blockers) can be useful in allowing you to remain reasonably active, preserve your mental health, work, care for dependents, and more. They can also have negative side effects and create dependence. Using pain meds is a very individual decision to be made with your medical advisors, but if you do use meds, be sure you are using the relief they give you as a window of opportunity to address the root causes of your back pain.

Should I keep moving or rest up? 

There is research showing that for back pain, maintaining normal activities as tolerated gives a better outcome than bed rest. Maintaining gentle movement is nearly always advisable as it promotes healthy circulation and healing in the injured area. It also counters joint stiffness, muscle weakness, and loss of fitness. As the saying goes, “motion is lotion.” Maintaining regular activities as tolerated also helps you keep up with your friends, hobbies, and tasks, and staves off depression. 

In our experience doing normal activities with truly normal (healthy) posture gives an even better outcome.

Activities done with healthy posture are protective against back spasms and injuries.

Move like you are meant to

Unless it was a freak accident, think back to what caused this spasm. Going forward, what are you going to do differently to make sure it doesn’t happen again? Are there movements to avoid until you have learned what is truly healthy for your body, be that in bending, twisting, or reaching? Students have sometimes discovered that certain “healthy” exercises, such as cat-cow, or roll-downs, feel wonderful at the time, but that such alternating flexion and extension provokes their backs to stiffen up or spasm later. 

Poorly designed stretch and mobility exercises such as cat-cow actually push deeper into existing curves, provoking inflammation and stiffness. Images from Freepik 

Non-drug treatments 

Alternative or additional treatment for back spasms might include massage, physical therapy, acupuncture, chiropractic, and osteopathy. It would be fair to say that while many of our students find one or more of these modalities helpful, they are seldom sufficient to get to the root cause of their back flare-ups and prevent them from recurring. When I was a practicing acupuncturist, I found that my patients responded better to treatment for back pain when I also helped them with their posture. Their bodies could heal and strengthen better when they stopped unwittingly reverting to poor bending, lifting, walking, sitting, and sleeping positions after their treatments.

Gokhale Method® solutions

I would like to offer two key Gokhale Method techniques that can accelerate your journey out of pain, plus get you started on creating the baseline conditions to keep your back healthy into the future. 

You will use readily available surfaces—a mattress or an exercise mat, and the backrest of a chair—to put your back into mild traction. You will be able to use this surface to contact and gently stretch your skin, which stretches the flesh underneath and gently eases your vertebrae apart. This will gradually tease out tension and spasm, facilitate circulation and healing, and bring peace to the area. These techniques are useful for five minute “resets” during the day, or for hours at a time, as needed.

Caution: If your back pain is persistent or severe, we recommend you consult your medical team prior to using these techniques.

Technique 1: Stretchlying

Stretchlying can transform lying down into therapeutic traction and comfort—even as you sleep. You can get started with this video.

Technique 2: Stretchsitting

Stretchsitting can transform compressive sitting (and driving) into hours of therapeutic traction and comfort. You can get started with this video.

You can learn these techniques in greater detail, with modifications for your body, in our in-person Foundations Course and our online Gokhale Elements. My book, 8 Steps to a Pain-Free Back, has illustrated, step-by-step instructions. Our stretchsit® cushion is a handy tool to make poorly designed chairs more comfortable and healthy. Here you can find a video on how to attach it to just about any chair. We’ve put it on sale until April 1 for $54.90, discounted from $59.90, plus free domestic shipping.

The stretchsit® cushion not only creates a healthier shape for your backrest, its soft “sticky” nubs are specially designed to give comfortable traction. 

Doing things differently

Pain is nature's biofeedback mechanism—one which alerts us to the threat or occurrence of injury, which we should act on. Unfortunately our culture has not equipped us well to interpret our pain signals, nor to understand the systematic errors we may be making in our body use. 

Once we recognize that poor postural habits are the root cause of our back pain, the process of change can begin. A teacher’s experienced eye can be invaluable in assessing your individual postural patterns and issues, helping you to steer out of trouble and into a healthier relationship with your body.

The way we make every movement determines whether our back has length and support, or is vulnerable to damaging stress. Here I am guiding a student in glidewalking. 

Best next action steps 

If you would like to know how changing your posture can prevent your back pain, 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…

This Thanksgiving I would like to honor two people who profoundly influenced the development of the Gokhale Method®.

Thanksgiving is a time to acknowledge those who lit your way. Image: Unsplash

Noëlle Perez-Christiaens (1925–2019) was my most important influence on this path, and my gateway to inputs from the eminent yoga teacher B.K.S. Iyengar (1918–2014), the French anatomist André Dalmas (1910–1999), and their numerous discoveries. Noëlle was a beautician by background, who developed an avid interest in yoga. This passion took her to India and B.K.S. Iyengar, where she had the good fortune to be one of Iyengar’s early students at a time when he had as few as four pupils gathered together in his living room for lessons. Later, Noëlle also had access to Iyengar’s medical yoga clinic. 

Noëlle studying with Iyengar in his home.

Noëlle was a witness to Iyengar’s process and absorbed numerous lessons from him that got passed down to her students. Many of these have found their way into the Gokhale Method:

   1. Copying the body mechanics of functional people 

With great insight, Iyengar told his students to “Walk behind the women in the Indian marketplace, and when your shadow looks like theirs you will have learned something.” The idea of mimicking the movement patterns of people in nonindustrial cultures fueled many of Noëlle’s discoveries and was a key part of my training. This kind of anthropological-visual mimicry makes its way into just about every class, article, and offering of the Gokhale Method. Based on our scientific understanding of the human visual cortex being very large and developed (this is reflected in the folk wisdom of “a picture is worth a 1,000 words”), our offerings rarely miss an opportunity to use photographs, video clips, or artwork to amplify the movement principles being taught. 

A young woman walks through a marketplace, casting her distinctive shadow. Odisha, India.

2. Using props and innovating 

Iyengar was the first yogi I know of to improvise using simple household props to better aid his students to achieve the shapes and poses he taught. He did this reluctantly because Indian culture values following tradition far more than improvisation (this has changed in recent years). But when his foreign students could not do what he wanted them to do, no matter how much he cajoled, exhorted, and ridiculed them (it’s a well-known joke that BKS stands for “bite, kick, shout”), he resorted to using blocks, ropes, towels, chairs, and whatnot to help the right things happen. In the West, we would regard his inventiveness as part of his genius, but he did these things almost apologetically. 

Iyengar Yoga can use extensive props, as in this version of Vasisthasana, or side plank pose. (Senior Iyengar Yogi, Eyal Shifroni). Image: Wikimedia

Noëlle was similarly inventive and improvisational. I remember being very impressed when, during a private session in Portugal where I was her translator, she gathered up some fallen blossoms and clumped them together to form makeshift metatarsal arch supports. Using props and tools to help students learn better/quicker/deeper plays a big role in the Gokhale Method. Thanks to modern tech, our learning aids include wearables ( SpineTracker™ and PostureTracker™), but we have also developed simpler props like rollers, cushions, wedges, and chairs.

Gokhale Method teacher Clare Chapman helps a student to find healthy vertical alignment with a tall neck by using the Gokhale® Head Cushion. 

3. The need for traction in the spine 

Iyengar’s studio ended up having ropes and swings all over the place. My father, who suffered from sciatic pain, and who was introduced to Iyengar’s studio by my mother, was invariably sent to hang upside down from one of the yoga swings at the start of his lessons. Iyengar also used edges, surfaces, ropes, or plain old hands and feet to get students’ spines to relinquish some of their unhealthy compression. Noëlle’s genius was to incorporate these techniques into everyday life activities, for example, sleeping. 

In the Gokhale Method, almost every student’s journey begins with traction. The two low-hanging juicy fruit techniques of stretchsitting and stretchlying are perfect starting points on any student’s journey. To facilitate stretchsitting, I invented the Stretchsit® Cushion and the Gokhale® Pain-Free Chair. Stretchlying doesn’t require props other than household pillows. By beginning with these two techniques, students often get relief from compression-related pain as early as Day 1, are better prepared to learn other techniques, and avoid flare-ups along the way. 

Gokhale Method teacher Sabina Blumauer guides a student preparing to stretchsit against a backrest with a Stretchsit® Cushion.

Though Iyengar and Noëlle were both opposed to systematizing and formalizing any of their teachings, I have discovered that for beginner students with back pain, it’s critical to precede any reshaping of the spine with gentle, sustained traction; otherwise one risks herniating a disc, pinching a spinal nerve, or triggering back spasms. 

4. Modern Westerners need support to sit

An Indian in a traditional household eats all their meals sitting cross-legged unaided on the floor. It works if you grew up with it. It doesn’t work for people who grew up sitting at dining tables and using raised toilets. I’ve discussed the anatomic and developmental reasons for this elsewhere but Iyengar approached the problem empirically. When he saw his Western students struggling to sit upright, he came up with blocks on the floor and blanket-wedges on chairs. These simple solutions worked. 

Geeta Iyengar, Iyengar’s eldest daughter, sitting on an improvised wedge of folded blankets. Image: thepracticeroom.in

I tried to come up with a more elegant and universal solution for years. It was, ironically, easier to build a wedge into the chair I designed than to come up with a free-standing wedge. The chair was designed a decade ago; the wedge only came into being this year. 

The Gokhale® Wedge offers a portable and elegant way to enable relaxed, upright sitting.

5. Using the breath to lengthen the torso

Pranayama is a branch of yoga that teaches numerous breathing techniques to address a variety of physical and mental states. Iyengar considered it an advanced practice and beginners were not introduced to pranayama techniques until they were well-advanced in their hatha yoga (asana/yoga pose) practice.

Pranayama, as taught by Iyengar, and here by his eldest daughter, Geeta, is a complex and deep practice. Dr Geeta Iyengar - How to Sit in Pranayama

Noelle brought the key technique of using the breath to lengthen the back into the basics of her Aplomb® teachings, using it both as a way of relaxing muscles and testing alignment. I have found this technique invaluable in myself and for teaching. 

When the pelvis has healthy anteversion, the spine can stack well and be upright without tension. The relaxation of the erector spinae muscles allows the spine to lengthen with each breath. This breathing motion is highly therapeutic, improving circulation, mobility, and healing throughout the torso. 

Many of our teachers have backgrounds in yoga and other traditions that include instruction in breathing. Our teacher community is in active discussion about how to bring additional insights about breathing into our offerings, using our signature filters of simplicity, science, history, and anthropology.

6. Never give up on a student 

Iyengar was dogged in helping students make changes. He and Noëlle were extremely skilled in making seemingly magical things happen for pupils. They both used a carrot and stick approach; I prefer only carrots, but carry a similar, deep-seated conviction that a whole lot is possible with the right approach, techniques, language, and inspiration.

I'm immensely grateful for the teachings of Noëlle Perez and B.K.S. Iyengar at the beginning of my journey—they helped me leave my crippling back pain behind, and they inspired and shaped the Gokhale Method. There’s still a long journey ahead towards wider accessibility, more evidence-based research, and mainstream acceptance, but thanks to the head start provided by Noëlle’s and Iyengar’s contributions, I believe we are within reach of a solution for a problem that plagues far too many of us in the modern world. 

Best next action steps for newcomers

If you would like to know which posture changes will help you be pain-free and functional, schedule an Initial Consultation, online, or in person.

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

People are sitting poorly and continue to blame sitting for their back pain. We believe the solution to this problem is more urgently needed than ever… and that the solution is now more readily available than ever, given one of the Gokhale Institute’s recent projects. I am excited to tell you about The Secrets to Pain-Free Sitting, a pledge show we made with producer Frank Zamacona for American Public Television (APT). 

The Secrets to Pain-Free Sitting TV show teaches techniques to sit comfortably, including using your backrest to give gentle traction to the spine. Here I am helping Susan van Niekerk, a key member of our admin team, to stretchsit. 

Gokhale Method teacher Eric Fernandez enjoys a reclined version of the highly therapeutic stretchsitting technique. 

Sitting has become a problem

In recent years people have become confused about and even afraid of sitting. Sitting is considered problematic in our society, both because it is associated with an unhealthy level of inactivity, and because it is generally done with poor posture, leading to discomfort and pain. 

In recent decades a range of books and audiobooks have given the impression that sitting is the enemy of movement. In truth, both are important and both need to be done well. 

Inactivity has been baked into aspects of our culture for many decades, caused by various factors including long hours of desk work, the design of our environment, and car use. I have long advocated frequent exercise breaks from sedentary work, as well as active recreation. We recently started Gokhale Exercise as a contribution to positive change in this area, and it’s already helping our Alumni community to get fitter, stronger, and more flexible while they continue to improve their posture. By learning good form while exercising, they are also reducing their risk of injury and wear and tear.

The pain and discomfort that many people experience when seated for any period of time understandably gives sitting a bad reputation. Given that the mission of the Gokhale Institute is “to make back pain rare,” should we be discouraging people from sitting? I don’t believe so. 

I prefer to celebrate the fact that sitting is a natural, universal, and important human activity. I would go so far as to say human civilization requires it. There are many tasks that benefit from the rest, stillness, and mental focus afforded by sitting. Imagine nursing a baby, playing the piano, writing a book, creating pottery, watching a movie, eating a meal, or taking a flight, without being able to sit!

Sitting has enabled human civilization to develop all manner of skills, talents, and ideas. Unsplash(bottom image)

The Gokhale Method® approach to preventing and healing back pain is based on observing traditional societies around the world where people report very low levels of back pain and few other musculoskeletal problems. People in these traditional societies have maintained healthy posture and also sit as part of their daily lives, sometimes for long periods doing crafts or preparing food. And they sit on all kinds of seats, not only on the floor or squatting. The key is that they sit well.

People in different traditional societies all over the world share the ability to sit well. Here you see people in Africa, Thailand, and India.

Gokhale Method students learn these natural posture principles, plus the techniques they need to implement them. They discover healthy ways to go about their daily tasks, work, sports, hobbies, and even sleep positions. This process builds strength and resilience in the body, minimizing compression, tension, and degeneration. 

Since the COVID-19 pandemic, there have been reports of and also research into an increase in back pain¹. There are likely several reasons for this increase which are related to sitting poorly. Many people switched to working from home, hunching over laptops, rather than using their usual office workstations. There was also much more remote working in general as, where possible, activities that had been done in-person switched to online platforms. For example, the Gokhale Method, in addition to teaching in-person Foundations and Pop-up courses, developed our online Elements course. 

This graph shows an increased number of tweets in the US about back pain in November 2020, during the pandemic, as against the lower number of such tweets the year before.¹ www.ncbi.nlm.nih.gov

Years of experience assure me that not only can sitting be pain free, but that it can be done in ways that are positively therapeutic for the back and spine. This knowledge is exactly what we want to take into the American home with our 45-minute show. Below is a trailer to whet your appetite!

Enjoy this short preview of what’s in store with our Secrets to Pain-Free Sitting TV show.

The network uptake for Secrets to Pain-Free Sitting has already exceeded expectations. The show began airing on June 2, 2022, and as I write this, 32 networks have already screened the show. You can find the air dates for Secrets to Pain-Free Sitting in your area here. Should you need to request for it to be shown in your area, you can email APT at [email protected]. We hope you will enjoy watching it and recommend it to your friends and family. 

To complement the TV show, we are offering a number of special online workshops where you will be coached in 5 Top Tips for Sitting Well. In these bespoke workshops Gokhale Method teachers will be helping me to give you personal attention and answer your questions. I look forward to seeing you there! 

References:

¹ Krzysztof Fiok et al. “A Study of the Effects of the COVID-19 Pandemic on the Experience of Back Pain Reported on Twitter ® in the United States: A Natural Language Processing Approach.” Int J Environ Res Public Health. May 2021; 18(9): 4543. PubMed (Apr 25 2021) doi: 10.3390/ijerph18094543

Our Free Online Workshop program continues as usual:

I frequently get questions about what makes a good office chair. Of course, some office chairs are primarily fashioned for style and aesthetic appeal. In general, I would say these may be easy on the eye, but, over time, hard on the body!

 This office chair sparkles with 1960s retro-chic. However, its markedly concave seat will internally rotate your legs, encouraging malalignment in the hips and knees, and flat feet. Its straight backrest leaves no space for your behind, encouraging you to sit on your tail and tuck your pelvis. lakeland-furniture.co.uk

Ergonomic chairs

People often ask my opinion on how various ergonomic chairs on the market might help them. This makes sense given the rising prevalence of back pain¹. “Ergonomic” means that something is designed primarily for the health, comfort, and protection of users, and among the specific chairs people ask me about, the Herman Miller Aeron Chair tops the list. To answer efficiently, I like to compare and contrast it with the chair I designed, the Gokhale Method Pain-Free™ chair, as this embodies the posture principles confirmed by my research and experience. 

The Herman Miller Aeron Chair. hermanmiller.com

The Gokhale Method Pain-Free chair.

Even though they are both designed to be “ergonomic,” they are clearly very different. The Gokhale Method Pain-Free chair reflects the paradigm shift that underlies the Gokhale Method® philosophy. This makes the chair quite different from every other office chair on the market.

How chairs shape your spine

The Aeron chair has been designed following the conventional wisdom of the S-shaped spine, the “S” being formed by alternating lumbar, thoracic, and cervical curves. Over the last 100 years or so, this shape has become the received knowledge learned by physical therapists, medics, and designers, resulting in chairs whose contours support a significant curve in the lumbar area, and accommodate a thoracic curve in the upper back. From a Gokhale Method perspective this excessive curvature is the primary cause of disc bulges and herniations, nerve impingements, muscular spasms, and the degenerative conditions that cause back pain. 

The Aeron chair is based on the concept of significant lumbar and thoracic curvature being desirable.  hermanmiller.com

The Gokhale Method advocates a J-shaped spine, which is the shape we see in infants and young children, in historical artifacts and photographs, and which still persists in non-industrial societies across the world. The J-spine is especially relevant when sitting upright, where, due to an anteverted pelvis, the behind is behind and the vertebrae of the spine can stack more vertically. We call this stacksitting.

No tensing the back muscles to get upright, no collapsing into a slump—and no alternating between these two problematic positions, which is a common strategy to try and relieve the discomfort they cause. Just comfortable, healthy sitting. You can read more about spine shape here.

Sitting upright at your desk

Both the Herman Miller Aeron Chair and the Gokhale Method Pain-Free chair have a waterfall front (where the seat pan front angles downward), which is ideal for upright sitting. If you know how to arrange your legs and trunk well, this will facilitate pelvic anteversion and all the good things for your spine and general health that come with it. Pelvic anteversion is central to the Gokhale Method and is taught in our in-person Foundations Course, Pop-up courses, or online Elements Course. 

The seat pan of the Aeron chair features a waterfall front in a mesh fabric. Some users may find the adjustment lever under the seat is too close for easy operation when the seat is tilted forward for stacksitting.  hermanmiller.com

I designed the seat pan of my chair using a combination of materials that give optimal support for sitting. The sitz bones need to experience a firm foundation for the pelvis and spine above, but they also need to be padded for comfort. In my experience this combination cannot be equalled or improved on by a single material or mesh fabric.

The seat pan of the Gokhale chair combines materials for optimal support and comfort.

Note that the metal backrest support is curved to accommodate the behind behind, another feature that helps in anteversion of the pelvis. 

To further aid stacksitting the Gokhale Method Pain-Free chair seat pan also has four soft, textured, rubbery nubs sewn into its front edge. These provide grip which help keep your pelvic position, and prevent any slipping off the chair. 

The Gokhale chair seat pan features four nubs which help you to stacksit for upright working at your desk.

Our seat pan is also slightly convex to facilitate external rotation of the legs and feet—that is, it encourages them to gently turn outward. This brings healthy alignment of the hip, knee, and ankle joints, and also the foot arches. A mesh fabric, pulled taut, cannot support external rotation in this way. 

Stacksitting with healthy external rotation of the legs. 

Armrests

Many office chairs come with armrests. It is healthier for the shoulders, which are very mobile joints, not to be continually fixed in position by armrests, however adjustable. Far better to learn to shoulder roll, which encourages range of motion and optimal arrangement in the joint. Shoulder rolls also help adjacent problem areas such as the trapezius muscle, neck, and upper back, and improve circulation to the area. A well-connected shoulder can support the weight of the arm effortlessly as you do your tasks.

Arm rests also create the significant problem of not being able to come close in to the keyboard, thus encouraging rounding of the shoulders. The absence of arm rests allows an almost cockpit like feeling of being surrounded by the desk and keyboard with no temptation to migrate the shoulders forward.

Backrests—traction trumps lumbar support

The Y-shaped feature at the back of the recent models of the Aeron chair has a support for the base of the spine which can be used to support the sacrum in mild anteversion. It also has a lumbar support which is less aggressively curved than that of earlier models. While these are considerable improvements, the mesh back of the Aeron chair is still not able to provide therapeutic length to the spine through traction, as the Gokhale chair does, or space for posterior shoulder placement. Nor does the backrest easily accommodate our trusty Stretchsit® Cushion. 

A contemporary Aeron chair features support for the base of the spine (sacrum) and lumbar area.  hermanmiller.com

The Gokhale chair backrest provides therapeutic length to the lumbar spine with soft, built-in nubs for traction.

Beyond supporting a healthy J-shape in your spine, ideally a backrest would also help tease out any tension in the lumbar area. The Stretchsit Cushion success in improving back shape and reducing back tension has inspired the same successful features in our Pain-Free chair. With a little know-how, these soft textured nubs in the backrest can give you hours of therapeutic traction at your desk, reducing pressure on your spinal discs and nerves, and improving circulation in the surrounding tissues. We call this stretchsitting. 

Are adjustable chairs better?

As consumers we have become increasingly familiar with hi-tech products that we can adjust and customize to meet our individual needs and preferences, and the Aeron chair reflects this throughout its design. 

The Gokhale Method Pain-Free chair requires just one adjustment, and that is the gas lift height adjuster. This is key to the use of the chair, which is designed to be raised for stacksitting so the thighs and pelvis can angle downward, and lowered a little for stretchsitting against the backrest so that the feet can still meet the floor well. The lifting mechanism comes in three different heights, and there is also our Petite Gokhale Method Pain-Free™ Chair, ideal for both smaller people and smaller spaces. 

The Petite Gokhale Method Pain-Free chair gives a range of working heights, and a foot ring. 

Foot rings

One additional feature on our Petite Gokhale chair is a foot ring, which gives more options for foot and leg placement, and prevents legs from dangling and pulling the pelvis into a tuck. It also avoids the constriction to circulation which may occur if the thighs hang over a seat edge.

A foot ring helps take care of the lower body—an area often overlooked in conventional office chairs. 

From a Gokhale Method perspective, adjustments for spinal curves or arm rests are simply not required once the basics of healthy posture are understood. Better to address these fundamentals before going all out on the bells and whistles. This means there’s less to go wrong—with your chair, and your body!

Sitting well is a partnership 

Almost every employer who wants to demonstrate care for their executives finds themselves purchasing a Herman Miller chair. Yet within the budget of an Aeron chair they can buy a Gokhale chair and treat their employee to a one day Pop-up Course or six-lesson Group Foundations Course in the Gokhale Method where they will learn postural skills that last a lifetime.

Healthy sitting is a partnership. It takes a good chair on the one hand, and good posture on the other. With the Gokhale Method Pain-Free™ chair and the Gokhale Method you have the perfect combination.

References:

¹Janet K. Freburger et al., “The Rising Prevalence of Chronic Low Back Pain,” Archives of Internal Medicine 169, no. 3 (Feb. 2009), 251–58, doi: 10.1001/archinternmed.2008.543

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.

I developed excruciating lower back pain in 2001. I was a tennis player, downhill skier, and a marathon runner. I was also under a lot of financial pressure in a stressful job as a consumer class action lawyer with my own firm. 

Excruciating back pain challenged my ability to continue working. Forthepeople.com

My doctor diagnosed me with a herniated disc at L4-L5. He said that a piece of my disc was sitting on the spinal nerve. I tried everything to stop my pain but nothing worked. In January 2002 I underwent a laminectomy which removed the piece of disc and some of the vertebral bone next to the herniation to make room for the nerve root.

A laminectomy is a common lumbar surgery to remove some or all of the lamina (a part of the vertebra) to relieve pressure on nerves trapped by herniated discs or stenosis (narrowing of the nerve canals). Wikipedia

After the surgery, my back pain was more intense than before. It was very difficult to get out of bed in the morning. My five-year-old daughter imitated me doing a sort of downward dog yoga pose, with a lot of groaning, just to get out of bed in the morning. I could not move comfortably, nor could I stay still. I remember business meetings in restaurants—just looking at the chairs there I would feel pain.

Few modern chairs help us to sit well. Most chairs either encourage a swayback (left) or a tucked pelvis (right). Wikipedia

I also tried acupuncture treatment, but it was too painful to lie down. It hurt. Hurt to stand. Hurt to sit. Hurt to walk. Hurt to sleep. Everything hurt. 

I received cortisone injections from a pain specialist. I was ecstatic to get a needle in my spine because it gave me temporary relief from the agonizing pain that radiated all the way from my lumbar spine down my leg. Unfortunately, the relief didn’t last. 

Pain from pressure on the sciatic nerve can radiate from the origins of the nerve in the lumbar spine all the way to the foot. Wikipedia

I seriously considered a spinal cord stimulator. It was like an implanted super transcutaneous electrical nerve stimulation (TENS) machine, but I am very glad that I changed my mind as it required subsequent surgeries and I really did not want something implanted in my body. I was prescribed multiple pain relieving medications. 

I participated in a number of lengthy courses, including some pilates and Bikram yoga, that focused on cultivating more strength and flexibility to relieve my back pain. Yoga gave me some temporary relief but nothing permanent. I also used a pilates reformer once a week for several months but it didn’t help. It started to remind me of a medieval torture device. 

Using specialized equipment without knowledge of primal architecture can hurt rather than help. Wikipedia

I also went to a physical therapist and my pain was still not relieved.

Massage from a skilled practitioner can help alleviate soft tissue tension and back pain. Ideally, it would be combined with posture training to get to the root of the problem. Pixabay

In an attempt to relieve my pain on the way to court, I would slouch in my car almost horizontally, with both an ice pack down the back of my pants and the seat warmer on. I remember the pain forcing me to lie down on the floor at an arbitration where I represented a class of homeowners in a case worth tens of millions of dollars. Other lawyers stared at me as if I were a defective space alien. 

Despairing, I thought I would never get better. I knew people with similar levels of pain who had retired. Because of my love of being a consumer protection lawyer and my financial responsibilities, this was not an option. The stress caused me to tighten up even more, worsening the pain. I felt like I was trapped in a downward spiral.

I explored the principle of mind over matter. I meditated daily and continue to do so. I read Dr. John Sarno’s books. Dr. Sarno would say first eliminate any physical cause, then heal back pain by dealing with any repressed anger or other negative emotion. But my pain persisted.

Eventually I came across  Esther Gokhale's book, 8 Steps to a Pain Free-Back, and subsequently took the Foundations Course in 2011 with a Gokhale Method teacher in San Francisco. As I have said many times, Esther Gokhale is my hero! I have given her book to numerous family members and friends. They don’t believe me that there are 21 pages about how to sit in a car—or a restaurant chair—but every one of those pages is precious to me as they have saved me hours of agony. The Stretchsit® Cushion and Esther’s instructions allowed me to drive without pain. The Gokhale Pain-Free™Chair is still my favorite office chair. I still use the stretchlying technique that I learned in detail there, gently introducing traction to one segment of my spine at a time.

This healthy neck stretch is from a recent 1-2-3 Move class for our Alumni.

I now have zero back pain. Because of the Gokhale Method I can finally lie comfortably in bed, sit, stand, walk, bend, and live my life. I returned to running six mile runs along California beaches and trails all over King's Mountain. Due to wear and tear on my knees over the years, I am now an active swimmer, hiker, and biker. 

Out on my bike, I enjoy being physically active again, with the occasional wipeout.

My back has tolerated a recent move into a home with 41 steps. I carry furniture, groceries, etc. up and down those steps with no back problems. I am once again enjoying being the pain-free, calm, and happy person that I used to be.

Out hiking with my wife, Susie.