stretchlying

Lengthening the spine is an important component of the Gokhale Method and the best way to begin a posture transformation. Creating space between the vertebrae decompresses the discs and promotes healthy nerve function. Allowing your spine to be in gentle traction often throughout the day is an excellent way of creating a healthy baseline. We can do this by sitting, standing and sleeping with good posture. In addition to these Gokhale Method basics, sometimes your back muscles crave an even deeper stretch. Below I’ve outlined three additional ways you can stretch your spine that are safe and therapeutic.

Stretchsitting and Stretchlying

Especially if you have back pain or a very sensitive back, creating a gentle stretch over a long period of time is a wonderful place to begin. Using external objects such as your bed (Stretchlying on the back or side), or your chair’s back rest (Stretchsitting), or a Stretchsit® Cushion​, can help stretch your back and relax your muscles. You can find directions for these techniques in 8 Steps to a Pain-Free Back.

Stretch your spine while you sit. Click here for an instructional video on stretchsitting.

One of the steps in stretchlying. Click here for an instructional video on stretchlying.

Inner Corset

There are times when you will not have the support of an external object. When you sit without a backrest or stand up, you still have the ability to lengthen our spine. By engaging your deep abdominal and back muscles, you can make yourself taller with the Inner Corset. Not only will this protect your spine during times of activity, or when lifting something, it can also provide an excellent stretch for your erector spinae muscles (the long muscles that run parallel to your spine). The erectors can be very tight for some of us, especially if we are struggling with a swayed back. Lift your arms high above your head as though you are reaching for a high shelf slightly in front of you. Then let your chest come up and around an imaginary bar at chest height, so as not to bend backwards into an arch. Feel how tall you can make your self and try and maintain that height even after the arms come back down to your sides.

Steps to engaging your inner corset. Download this chapter here from 8 Steps to a Pain-Free Back.

Jazz Shear

The ability to isolate the movement of your ribcage from your pelvis can be a challenging but excellent way to stretch your deepest back muscles (multifidi, rotatores). Stand in front of a mirror with your feet at least hip distance apart. Set your tallstanding position well with kidney bean shaped feet, soft knees and your ribs anchored with an anteverted pelvis. Place your hands on your hips to help keep them still. Then, let your entire ribcage shift laterally to the right. Feel a satisfying stretch in your deep back close to your spine. Then shift the ribs to the left. Watch that your pelvis doesn’t tuck or lift to one side. Also try and maintain your rib anchor as the ribs shift side to side—the front of the ribs want to stay flush with the abdomen, or you will sway your back. Try holding each side for 5-10 seconds at a time and try for about 20 reps. Or put on some engaging music and let your body yield to the rhythm.

Anchoring your ribcage and shifting it from side can be a great stretch while standing.

Quadratus Lumborum Stretch

The “QL” is a muscle that connects the back of your pelvis to your ribcage. It’s common for QL to be tight, unilaterally or bilaterally. When QL is tight on one side, it is often misdiagnosed as a leg length discrepancy and the person may be given a shoe lift that exacerbates the problem (always get this diagnosis double-checked). To stretch the QL muscle, find an open doorway with some room to the side to arrange your body as shown in the photo below. Create a long arc running from your left hand past your outstretched left arm, through your torso to the leftt leg through to the left heel. Lengthen this arc (and your left QL) by hooking your left fingers around the door jam and pulling your left foot away from the hold while gently arcing your body and stretching the left side of your torso in the process. Your left arm should be straight, your right leg forward and bent, and your left leg back and straight. Hold for at least 20 seconds to give your QL muscle a chance to release deeply. Repeat on the other side.

Left QL stretch using a doorway.

Modified baby pose

Place your lower legs about hip width on the floor and running parallel to each other. Toes relaxed. Place your forehead on the floor and your outstretched arms at a comfortable width as in the Muslim prayer position shown below. Let your bottom, the highest point in your body, gently pull away from where your forehead is weighted to the floor. Let your back mucles relax into a vertical stretch; let your outstretched arms augment the stretch around your spine at the shoulder blade level. It takes about 20 seconds to release the paraspinal muscles into this stretch.

All the best,
Esther

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We also offer in person or online Initial Consultations with any of our qualified Gokhale Method teachers.

I’ve had lying on my mind lately. I mean flat out, horizontal, no holds barred, delicious, snooze-inducing lying down. It’s not talked about much in the debate whether we should sit, stand, or treadmill our way to better lives. But I say, hey, lying is where it’s at when you are tired, when you need a break, when you need a rest. 

My son Nathan knows this quite well. When he Skypes with us, he is usually in his bed, covers pulled up high, computer set on the covers. He works lying, surfs lying, thinks about algorithms lying down. 

Nathan Skyping from his bed in Atlanta.

And just as I was thinking he was an outlier, I hear from my Sami friend Fredrik Prost (see previous post) that the Sami like to lie down a lot. “It feels natural” he says “when you are in a tepee” (their traditional mode of habitation), “but we do it in people’s kitchens too.” Here are two photos he sent me of his brothers lying in modern settings. 

Fredrik’s brother socializing in the traditional Sami side-lying position.

Another of Fredrik’s brothers has found an even cozier position
- he’s in good company

It’s most common for the Sami to lie on the side, face perched on a hand or fist. Notice that both brothers have their shoulders, hips and ankles aligned, as in side-stretchlying (score, Gokhale Method!)  

Much of the (truly civilized) world recognizes the value of the siesta, or afternoon nap. How delicious to wake up refreshed and ready for another round of the hurly burly that is life. 

My friend Kouka taking a nap with her niece in Burkina Faso.

We I’ve mentioned the idea of lying breaks and horizontal socializing, the universal response has been “how do you avoid falling asleep?!” Oy! Maybe that’s just what needs to happen! As we hurl ourselves through ever-accelerating lifestyles, a little sleep punctuation may provide an even better interlude than the gym breaks we sometimes guilt-trip ourselves into. Rest is profoundly missing in our lives as increasing numbers of people suffer insomnia, sleep apnea, restless leg syndrome, and, more generally, restless mind syndrome. In my experience, restlessness begets restlessness - it’s helpful to break the cycle of sleep deprivation and rest deprivation. My friend and celebrated sleep expert William Dement, certainly agrees. It has become his one-man mission to get people to sleep more. He teaches that sleep deprivation is at the root of many evils ranging from depression to automobile accidents. And here I would like to join forces with him - if lying down induces you to sleep, that’s evidence you are running a sleep deficit, and it’s never too soon to catch up on it. 

But I suspect the benefits of a nap or stretchlying respite go beyond catching up on sleep. I suspect that our nuts and bolts can use the break as well. Gravity is a formidable force. We’ve evolved to handle it well (better than we give ourselves credit for), but we’ve napped to break our vertical stances, if we are to judge from people living in indigenous cultures and traditional societies. 

Taking a healthful mid-day nap - it can happen any place
at any time if you are able to improvise. Burkina Faso.

Perhaps those naps are part of the design of what it mean to be human. Perhaps the systematic weeding out of rest and repose from modern lifestyles is part of the reason we are literally breaking apart. 

My son Nathan is 6’5” - most furniture doesn’t fit him well. I used to think that was why he needed to lie more than most. Another theory I had was that his enormous expenditure of energy playing Ultimate frisbee at a high level requires him to compensate by lying down unusually much. 

Nathan playing Ultimate frisbee, a sport that requires
enormous exertion.Does this lead him to lie down more than average?

 Or did I prime him in his childhood with acupuncture “resets” so he is conditioned to associate lying down with deep relaxation?

Nathan receiving an acupuncture treatment from me when
he was a child. Perhaps this strengthened his association
between lying down and relaxation?

Mostly, I’m thinking the young man has some primal wisdom intact - and I’ve decided to try his habit on for size.

I’ve moved a couch over to the side of the room and replaced it with a mat, some bolsters and pillows. I’m still warming up to the novelty of just lying down to chat with company - I might need to replace Brian's couch with a mat too to make it work. So far he has resisted - he likes to perch and think of theorems on the couch. He does like how the living room has opened up... we’ll see how this develops and I’ll keep you posted. 

Our current living room arrangement - a work in progress...

I’d love to hear about your ideas and/or adventures in lying down. Pray tell!

Join us in an upcoming Free Workshop (online or in person).  

Find a Foundations Course in your area to get the full training on the Gokhale Method!  

We also offer in person or online Initial Consultations with any of our qualified Gokhale Method teachers.

Students often ask me if there is a particular mattress that is in line with the Gokhale Method. While I do have a few suggestions, the most important part of lying down is how you do it. Stretchlying on your back or side to put some extra length in your back is key to navigating beds with any extra firmness or softness. Elongating the spine will also help mitigate the distortions caused by twisting and moving around in your sleep. If you learn how to use your body well, you will develop the ability to sleep and be comfortable on most surfaces.

While I do not endorse any particular brand or product, there are certain things to look for when purchasing a new mattress. What you most want from a bed is support and comfort—some structural element from the mattress to help you maintain your stretch, and some degree of softness that will cushion your contours. If you have any inflammation, disc degeneration, nerve compression or back discomfort, we favor a medium firm, high spring count mattress with a small amount of topper. The research shows that this is the most satisfactory for back pain. Here is why:

Firmness

When stretchlying on the back, if a mattress is too soft there will be too much sagging where your body is heavier, namely your hips, which will cause a sway. A high spring count will provide a structured even surface for your body to retain a stretch throughout the night.

You can lay comfortably on any surface if you have good structure.

Softness

Especially in stretchlying on the side, you want enough give to accommodate the discrepancy between a narrow waist and wider hips in women, or between narrow hips and broad shoulders in men. Some beds come with a pillow top, or you can place a soft topper on your medium firm mattress. 

If your bed does not accomodate your curves well,
you can use a small pillow or flannel sheet to support your waist,
thus preventing any distortion to your spine.

High Quality

When choosing your bed, make sure the quality is there. High quality beds usually have a higher spring count and keep their original shape for many years. In less expensive, lower quality beds, the springs may start to protrude and/or the mattress may begin to sag after a few months.

A firm foam mattress works well but some foams vary in quality depending on where in the original manufacturing block (cube) they were cut from. If the foam is too soft you will get a sagging effect. Be wary of beds that are overly conforming. These types of mattresses allow your whole body to sink and curve your shoulders forward when you are lying on your back.

You can lay comfortably on any surface if you have good structure. 

Travel Beds

If you are traveling or camping, I would go for an airbed or a Thermarest® pad. Airbeds provide a bit less leverage for lengthening your back in stretchlying. But as you get more proficient at stretchlying techniques, you are less dependent on the amount of firmness in your sleep surface. Thermarest pads, with their self-inflating cells, are surprisingly comfortable considering how little space they can pack into.

The bottom line is that if you are in pain, choose a bed with more structure. Otherwise, with your stretchlying skill set, you will be perfectly comfortable sleeping through the night on most sleeping surfaces.

Best,
Esther

   A four-year study involving 276 spine patients ages 53 to 75 published in the journal Spine suggests that we should--at the very least--take a deep breath and think twice before choosing epidural steroid injections to relieve the pain of lumbar spinal stenosis, not only because this oft-used treatment may not work, but also because it may cause more harm than good. Better yet and instead it might make sense to simply get in the habit of breathing deeply, which naturally lengthens the spine and helps relieve unhealthy stress on the vertebrae.... But more about Gokhale Method solutions in just a bit!

While the authors of "Epidural steroid injections are associated with less improvement in patients with lumbar spinal stenosis" caution that the unexpected results of this small, retrospective study warrant further investigation, a couple of findings leap out:

• Using well-established scales for measuring leg and lower back pain, the researchers found significantly less improvement among patients who had the steroid injections than among those who did not; this was true even among those patients who went on to have surgery. 
• Despite conflicting reports about the efficacy of epidural steroid injections in lumbar spinal stenosis, 69% of spinal surgeons consider ESIs to be the first-line invasive treatment when exercise and physical therapy have failed.

The Spine study—together with recent alarming reports of fungal meningitis, paralysis, and other risks associated with epidural injections—prompted me to tackle this topic today.

What is lumbar spinal stenosis?

Spinal stenosis is a narrowing of the open spaces in the spine that can compress nerve roots and cause pain and numbness in the neck, limbs and back. Lumbar spinal stenosis is the narrowing of the spinal canal in the lower back--that is, in the five vertebrae that run between the rib cage and the pelvis. If we dig a little deeper and consider the anatomy of the spine, itself, we find that stenosis can happen in a couple of places:

• The space at the center of the spine (central stenosis)
• The canals (or vertebral foramina) through which the spinal nerves pass (lateral stenosis)

Visualize it

I believe in the therapeutic value of mental imaging, but in order to visualize solutions to a problem, it helps to see and understand the problem, itself. Take a look at this information video.

No wonder lumbar spinal stenosis hurts! As we just saw, a number of factors can contribute to the narrowing of space in the spinal cord:

• Bulging discs
• Bone spurs (also called osteophytes)
• Thickened spinal ligaments
• Enlarged joints near the spinal canal

Not only do these bulges, spurs and hypertrophied ligaments and joints pinch nerves and cause pain in individual people, they represent a burden on our healthcare system and society at large.

"The growing epidemic"

In 2010, The American Academy of Orthopaedic Surgeons described lumbar spinal stenosis as "the growing epidemic," noting that with the aging of the population this already costly problem will only get worse:

• 8% to 11% of Americans are thought to be impacted by lumbar spinal stenosis.
• 2.4 million Americans are likely to be affected by 2021.
• As "boomers" increasingly qualify for Medicare benefits, government spending on lumbar spinal stenosis will no doubt increase.

Additional evidence was provided by the Chairman of the American Society of Interventional Pain Physicians, who, in a 2012 review of Medicare records, found that the number of  spine injections from 2000 to 2010 increased 159%. And the Centers for Medicare and Medicaid Services reported that in 2011 it paid providers $106.4 million for 252,288 injections, which averages out to $422 each. All of which raises the question: What can we do to prevent or manage lumber spinal stenosis apart from relying on costly epidural steroid injections, which may not work as well as people had hoped and which are now also associated with contamination and infection and other risks?

Gokhale Method solutions

If you'd rather not count yourself among the the 2.4 million Americans (and untold numbers of others outside the US) likely to be afflicted by lumbar spinal stenosis between now and the year 2021—or if you are currently experiencing pain from spinal stenosis and would prefer a non-interventional approach—then I recommend the following Gokhale Method techniques:

• Stretchsitting
• Stretchlying on your back
• Stretchlying on your side
• Using your inner corset

All of these techniques involve lengthening the spine, which—by increasing the space between the vertebrae, as well as the open spaces in the spinal canal where the nerves exit—take stress off the places where stenosis occurs. One way to enhance these powerful techniques is to use imagery, a method known to promote all kinds of healing, together with deep breathing, which will improve movement of macro- and micro- elements of the spine. To begin to test this out you might now take a very deep breath and, as you feel your spine naturally lengthen, imagine what it feels like to naturally stand like the beautiful kouros figure, just below.

The benefits of reestablishing good length in the spine cannot be overstated

Stretchsitting and stretchlying on back and sides

As noted above, Gokhale Method stretching techniques involve lengthening the spine (including, of course, the lumbar spine). Reestablishing natural length creates space and helps relieve unnatural stress by decompressing nerve roots as they branch away from the spinal cord via the spinal foramina. Spine-lengthening techniques also take pressure off bulging discs that can cause pain when they press in against spinal nerves. Relieving unnatural stress on the vertebrae via spine-lengthening and reshaping may also confer benefits by slowing or even halting the formation of unhealthy calcium deposits, which, when they form bone spurs, can poke into the spinal column, compress nerves, and cause pain.

Using your inner corset

Bracing the torso is also really important in preventing or managing lumbar spinal stenosis, and this can be accomplished by strengthening the deep abdominal and back muscles and making good use of what I call the "inner corset." We can actually relieve compression on the spine by transfering it to these strong central muscles, which are ideally placed to help carry the weight of the upper body. It follows that engaging the inner corset may also help minimize the pain that occurs when bone spurs intrude on the spinal cord or spinal nerves, as well as when spine instability (spondylolisthesis) narrows the spinal canal by allowing one vertebra to slip forward on another.

Complementary techniques

Breathing and mental imaging

Only when the body is in correct alignment can the natural action of breathing massage the tissues of the spinal area and confer its own therapeutic value in relieving the pain of lumbar spinal stenosis. And because mental imaging is known to help reduce stress and relieve back pain, it may be beneficial to consciously envision what's going on inside your body, every time you take a deep breath:

• With each inhalation, the spine lengthens and massages tissues in the back while relieving stress on entrapped spinal nerve roots.
• With the settling back that occurs with each exhalation, the natural massage-like action continues, and this goes on and on, with every breath.
• With the natural massage that occurs with each inhalation and exhalation, blood is pumped through the tissues around the spine, normalizing circulation in the area.
• Good circulation presumably normalizes related physiologic processes that might include calcium deposition and calcium reabsorption.
• Good circulation also promotes the flushing away of waste products.

To sum up, stimulating circulation in the lumbar region—both of which are achieved through the Gokhale Method—are invaluable in the prevention and amelioration of stress on the vertebrae.

Imagery can help relieve stress and minimize pain

Secondary benefits of Gokhale Method techniques

Lengthening your spine and using your inner corset are things you want to be doing anyway, in the course of your usual activities—not only to clear up pain stemming from lumbar spinal stenosis, but to make you look and feel better, overall. Added perks of learning and practicing low-cost, no-hassle Gokhale Method techniques include zero risk of infection and other adverse effects, and—beyond the initial learning—no expenditure of precious time.

Where to learn more?

You will learn to lengthen your spine and use your inner corset in Sessions 1, 2, and 3 of the Gokhale Method Foundations course, and in Lessons 1, 2, 4, and 5 of the book 8 Steps to a Pain-Free Back, as well as in Scenes 1, 2, 3, and 6 of the Back Pain: The Primal Posture Solution DVD.

Image and Video Credits: Spinal Stenosis: Wikimedia Commons Journal Cover: Spine Lumbar Spine: Wikimedia Commons Spinal Stenosis YouTube Video: DuPuy Kouros, Archaic Greek Youth: Gerard Mackworth-Young Feather collected in Washington State: Kevmin, Wikimedia Commons