hunching

In my experience, people are often unaware that their posture has greatly contributed to their muscular problems and damage. 

In this blog post I would like to talk about a frequently injured group of muscles that attach the arm to the torso at the shoulder blade—the rotator cuff. The rotator cuff helps rotate the arm and lift it sideways and is also responsible for stabilizing the shoulder joint.

The four muscles of the rotator cuff are supraspinatus, infraspinatus, and teres minor, which lie on the back of the shoulder blade, and subscapularis which lies on the front.

Why we get rotator cuff problems

It’s common for people to be rounded forward in modern times. Many of us habitually adopt a closed, slumped posture with tight muscles across the chest, while the muscles of the upper back and shoulders are often overstretched and lacking in tone. This front-to-back imbalance goes with holding the arms too closely to the body, and too far forward. The muscles of the rotator cuff are mechanically disadvantaged by such postural distortion, and put under undue stress. 

The slumped shoulder posture common in today’s culture leaves the muscles of the rotator cuff prone to injury.

This painting from 1881 shows both women using the rotator cuff while their shoulders maintain a healthy posterior position. Detail from Mending the Nets by Winslow Homer.

Traditional cultures preserve healthy posture for the shoulders. The shoulder and arm of this village carpenter in Burkina Faso align with the back half of his body, not the front. This posterior shoulder position arranges the bones and muscles optimally for rotator cuff health and mechanical advantage.

Of the four muscles in the rotator cuff group, the one that suffers most frequently from poor postural habits is supraspinatus. Supraspinatus is the uppermost rotator cuff muscle. It lies along the top of the shoulder blade and passes through a narrow passage to attach to the humeral head (ball of the shoulder joint). 

Tears can happen through sudden trauma—perhaps due to a fall or a vigorous shoulder movement in sport—or through more gradual wear and tear that leaves the far portion of the muscle like a frayed rug. Depending on the injury, surgical repair may be necessary, followed by physical therapy for up to a year. 

The narrow passage of supraspinatus can lead to wear and tear if the shoulder joint is misaligned due to poor posture.

How the Gokhale Method helps restore rotator cuff health

The good news about your rotator cuff is that it can be improved and often fully healed by adopting natural, healthy posture. 

The local solution is to learn how to do a shoulder roll. This technique will take each shoulder home to its natural position, where it lived when you were a young child. 

The shoulder roll picks up all the bones that make up the shoulder—the upper arm, the collar bone, and the shoulder blade—and allows them to reposition and settle in better alignment with one another. This creates appropriate space for all the soft tissues in the area, including the muscles, bursae, blood vessels, and nerves, so they can function well. 

Shoulder rolls are a more effective and sustainable solution than simply pulling your shoulders back or “sitting up straight.” These common measures tend to create additional problems such as inflamed rhomboids and a swayed lower back.

To practice the Gokhale Method shoulder roll:

1. Relax your shoulder girdle
2. Glide one shoulder forward
3. Rotate your shoulder upward
4. Continue to rotate it back as far as is comfortable. Let it relax down.

Tip: Make sure the movement occurs in your shoulder. Resist the tendency to wave your arms, sway your back, or twist your torso or neck.

This gentle sequence of movement restores a healthy position for your shoulder joint and rotator cuff—one roll at a time.

Students often report that learning the shoulder roll has brought additional benefits such as a more open chest, improved breathing, and improved blood flow to the arms and hands. Over time, performing shoulder rolls counters thoracic kyphosis, or rounding. Its gentle “massaging” action feels pleasant, can relieve knotted muscle tension in the area, and ease neck tension and headaches. You can make a start on your shoulder roll with our free video here.

Happy shoulders are part of healthy posture

Your new healthier shoulder position will always work best in the wider context of your posture as a whole. A change in one place facilitates shifts elsewhere, and vice versa. For example, your shoulder alignment is affected by your head position, your breathing, the angle of your ribcage and pelvis, and even how you stand. The position of your pelvis in particular affects your shoulders and upper body.

The principles and techniques that will help you to remodel your posture are taught in logical sequence and detail in our in-person Foundations course, one-day Pop-up course, and our online Elements course. If you have or are recovering from rotator cuff problems, the Gokhale Exercise program can help you to exercise in a way that is safe, therapeutic, and fun! 

Best next action steps for newcomers

If you would like insight on your posture, consider scheduling 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:

The healthy posture and positive change that antique images can bring to modern people are potentially transformational. In Part 1 of this series we looked at how learning from old photographs can benefit our upper body posture and in Part 2 the lower body.

Here we are going to focus on what antique portraits can teach us about small bends. The historical paintings for this post come from collections associated with Leland and Jane Stanford, famous for their business acumen, political influence, railroad building, and later, philanthropy as founders of Stanford University in California. 

Leland Stanford c. 1870. His open chest and posterior shoulder position are typical of the fine posture of his day. Wikipedia

How much do small bends really matter? After all, it is the deeper bends, perhaps with lifting involved, that pose a bigger threat to our spine. Here are three reasons to pay attention to small bends:

1. The start of a bend usually sets its trajectory. If you have a problematic start to your bend, it will likely continue that way.
2. Small bends are done more often. Any systematic error in your form can therefore create a significant amount of cumulative damage. They also present more opportunities for training in healthy posture habits.
3. Some people’s backs “go out” even with small bends.

Living on the Stanford campus for decades, I was a frequent visitor and admirer of many of the artefacts in the Cantor Arts Center (formally Stanford University Museum). Many of its artefacts represent the human story from foreign lands and ancient periods of history. But within the museum there is also a collection documenting the lives of the Stanford family, which represents a homegrown heritage that teaches us much of what we need to know about healthy posture. 

Let’s start with a painting of the Stanford family at leisure, celebrating the 10th birthday of Leland Stanford Jr. . .  

“Palo Alto Spring” by Thomas Hill, 1879, Cantor Arts Center, Stanford University. Kiddle

A girl playing croquet bends forward slightly (detail, right foreground). Kiddle

The girl playing croquet is an example of a small bend done pretty well. Notice how she angles forward almost exclusively at her hips, rather than at her waist, and also maintains an elegantly elongated spine. By angling forward at the hip joint, where the pelvis pivots around the top of the thigh bones, her hip joints get to enjoy the rotational movement they are designed for. Her spine follows her pelvis, with her back muscles and inner corset both gently working to keep her entire torso as one piece. 

When the pelvis and torso remain aligned, bending brings beneficial work for the hips,
 deep abdominal muscles, and back muscles (fig a.). 

This is a much healthier way to bend (fig a.) than fixing the pelvis in a tucked position and then rounding the spine to bend forward (fig b.). Rounding loads the discs, compressing them anteriorly and causing them to bulge posteriorly. With frequent repetition the microaggressions of even small bends take their toll on the discs. Rounding also overstretches the spinal ligaments, allowing for increasingly hunched posture. Even a small bend done in this way may be perceived by the brain as a threat and send the muscles into spasm, trying to prevent movement and protect against such misuse and damage. 

Rounding the back to bend squeezes the disc contents back, where they may bulge and impinge on the nerve roots  (fig b.).  

In the painting “The Last Spike” by Thomas Hill (below), you can see a small bend employed in a kneeling position. The two figures kneeling on either side of Stanford could be tucked and rounded, but instead, they are hinging at the hip joint and keeping their backs straight. The woman to their right, leaning on her parasol, also angles forward in a mild hip-hinge.

A late 19th century painting shows Stanford, one of the owners of the Central Pacific Railroad, standing ready to hammer the golden and ceremonial “Last Spike” into the ground at Promontory Summit, Utah, in May 1869. Wikimedia

Small bends can be as subtle as a nod or tiny inclination forward. In the foreground of a different painting below, also entitled “The Last Spike,” the onlooker on the left rounds his upper back as he looks downward. I suspect that his desire or need to show deference, also suggested by his removal of his cap, has overridden the prevailing bending posture of the day. Societal expectations around status and hierarchy are responsible for substantial postural degradation throughout history. More about that in a future blog post.

An alternative composition of “The Last Spike,” showing a less healthy type of small bend. historyisnowmagazine.com

This small degree of rounding is what many people do numerous times in a day to pick things up—perhaps to grab our car keys from a table or move things from the counter to the sink. Any forward movement with the upper back and head will often result in counter-tension in the lower back and/or pelvis to hold you there. Rather than compromise our backs, it is far healthier to keep our necks tall and bend at the hip joint. 

If you would like to practise this important contribution to your back health, join me for a “small bends” Gokhale Exercise class on Friday, November 12 at 9:45 a.m. (Pacific Time). If you have not yet subscribed to the 1-2-3 Move program, sign up now for your 7-day Gokhale Exercise Free Trial.

1-2-3 Move happens daily with Esther or guest teachers at 9:45 a.m. 
Gokhale Fitness with Eric runs Mondays, Wednesdays, Fridays from 7–7:25 a.m.
(Pacific Time), and Tuesdays, Thursdays, Saturdays from 3–3:25 p.m. (Pacific Time)
Gokhale Moving Meditation with Roberta is Mondays at 2 p.m. and with Kathleen is Wednesdays at 12 p.m. (Pacific Time)

Hunching over or rounding the upper back is often regarded as a hereditary characteristic. I frequently hear people say, “my back is stooped just like my mother, and her mother had it too.” 

Is a hunched back Nature or Nurture?

I agree that hunching is certainly a family trait—but it is largely a learned one, not inherited. 

We mostly learn our posture from our parents and family members. As we grow up, the role models around us in wider society also hold sway. Unfortunately, in our culture, these are usually pretty poor examples to follow. Our relationship to healthy posture has steadily been eroded over the past one hundred years, as I explain in my book 8 Steps to a Pain-Free Back.

Healthy, open posture, as shown here, was typical in Western societies until the late 19th and early 20th centuries. (Print donated by the Mendocino County Museum to the Gokhale Method Institute’s collection).

While it is true that some people have a greater genetic predisposition to these distortions, e.g., they may have slack ligaments which easily allow them to occur, these changes generally only manifest when a particular area of the body is subjected to sustained and inappropriate loading. When a person retains or relearns healthy posture, genetic predispositions have little opportunity for expression and for distortions to take hold.   

This mother in Burkina Faso positions her head, neck, shoulders, and arms in a way that is harmonious with retaining an upright and mostly flat upper back. Her child is also experiencing healthy posture—his arms and shoulders posterior, his chest open.

This well-meaning mother is unfortunately encouraging her daughter to round her back as she exercises. Pexels

Why does the upper back hunch?

In some respects, developing a rounded back is not dissimilar from developing bunions—both distortions are the body’s adaptation to a lack of support in the right place, and consequent overloading somewhere else. 

Bunions can form when the joint at the base of the big toe repeatedly takes weight that should be in the heel bone. This can be due to wearing a pointed or high-heeled shoe, or simply from habitually standing with weight through the forefoot rather than the heel. 

The upper back rounds when it is made to carry and counterbalance the weight of a forward hanging head, neck, shoulders, and arms. In healthy posture the upper body is supported by a more vertical J-shape alignment of the spine and the deep postural muscles, or “inner corset.” This prevents the spine from collapsing into an S-shape, C-shape, or I-shape. You can read more about spine shape here.

Sir Charles Walker, a British member of Parliament, being interviewed. A tucked pelvis will often result in a rounded upper back and forward head carriage. Channel 4 News (UK)

How to improve rounded, head forward posture

One of the best steps towards finding your J-spine alignment is to realign your head over your body. To develop the deep cervical muscles which counter excessive neck curves, I recommend using the Gokhale™ Head Cushion, which was specifically designed for this therapeutic purpose. It mimics the beneficial effects of head loading, but with a safe amount of weight for people in a society unpracticed in carrying on the head. 

People who carry weight on their head push up against it using their deep neck muscles (longus colli) and inner corset. Their central axis remains tall, with no rounding of the upper spine.

Caution: If you have any neck pain, or suspicion of herniation or other degeneration in the neck, do not do this exercise.

Headloading is a rarely taught but highly effective means of lengthening, strengthening, and aligning the neck, and freeing the upper back.

Upright and open posture is your birthright

By not hunching you can:

• Maintain your full height
• Retain a more youthful appearance
• Avoid muscular pain and tension, especially in the back and neck
• Avoid nerve pain, impingements, and poor circulation in the shoulders and arms
• Encourage the “inner corset” muscles to support and protect the spine
• Avoid compression and degeneration in the spine, including bone, discs, and nerves 
• Reduce your risk of osteopenia and osteoporosis in the spine as the bones receive
  the healthy stress they are designed for
• Enjoy healthier breathing and digestion

Hunching is not an inevitable part of aging

Often people start to notice they are hunching in middle or older age, maybe because it has become more pronounced. Hunching usually starts as a postural habit much earlier in life, yet goes largely unnoticed if there is little stiffness or pain in the area—and it is not yet linked negatively to associations with the aging process. In many traditional cultures people preserve an upright posture well into old age.

A lifetime of seated work does not make hunching inevitable, as the upright posture of this Ecuadorian backstrap loom weaver shows.

This elderly man in Indonesia has retained posterior shoulders and a wide, relatively flat upper back. Unsplash

This elderly farmer from the Yogyakarta region of Indonesia has preserved an open chest and shoulders that rest back. Unsplash

At whatever age you notice rounding in your back, it is important not to see it as inevitably leading to an extreme kyphosis (severe outward curvature) in the upper spine. Sometimes students come to us in dismay, perhaps shocked to have recently seen themselves so hunched in a particular photograph or video. Rather than despair, use this highly pertinent data as a springboard and incentive to return toward the healthy alignment you had as a young child. 

A young girl washes eggs for market near Falls Creek, Pennsylvania, 1940. She inclines slightly forward and lengthens the back of her neck to attend to the task. Her shoulders remain posterior, her chest open—no rounding over! Pinterest

How to mobilize a stiff upper back

In most situations using a suitable roller is my favorite way of mobilizing the upper back. It can ease stiffness in the vertebral joints, soften tight muscles, and improve circulation to the area. To ensure you get all of these up sides and none of the potential downsides from roller work, there are some important guidelines to follow:

• Use a roller that is the right size, density, texture, is non-slip, and robust. The Gokhale™ Roller meets these criteria.
• Rolling needs to be done with a safe technique and healthy postural form, not threaten injury to your back or neck.
• New freedom in the upper back must be balanced with healthy posture to improve muscular tone and alignment. This prevents newly acquired “give” in the area from resulting in further rounding.

Caution: If you have osteopenia or osteoporosis, or suspicion of herniation or other degeneration in your spine, do not do this exercise.

The Gokhale™ Roller has been specifically designed to help you on your posture journey towards a happy, hunch-free back.

How the Gokhale Method resolves hunched posture

Posture education often starts when people analyze their online or in-person Initial Consultation photographs with a teacher. Gokhale Method® teachers have a lot of experience in reassuring people who have a kyphosis (rounded upper back), explaining the mechanisms that got them hunched, and the logical steps they can take to turn this unwanted trajectory around. The Initial Consultation starts the process of students fine tuning their ability to read posture. It can be a revelation. 

Initial education in Gokhale Method techniques and the resulting changes can be rapid. Most students soon realize how amenable to change the arrangement of the skeleton and soft tissue can be. Changes to rounded posture are not only possible, but almost guaranteed as students progress through our in-person Foundations or Pop-up course, or online Elements course.

In the case of bony rigidity that has been in place for decades, we work to get improvement around fixed areas, and to prevent it from getting worse. With persistence and patience, a surprising degree of bony changes can take place over time. As with all body tissue, bone constantly renews itself in response to the way it is arranged and used.

Felicia Grimke, aged 32, was a very hunched and pain-plagued office worker.

Now a Gokhale Method alumna, Felicia continues to enjoy working on healthy posture and is virtually pain-free for the first time in many decades.

Many of our students have generously shared the story of their journey out of hunching and pain. Do be inspired by Felicia Grimke’s recent post on overcoming hunching, How the Gokhale Method Solved my Neck Pain and Transformed my Life, and sign up for one of our free online workshops below.