S-shaped spine

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…

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…

It has been 14 years since my book 8 Steps to a Pain-Free Back came out in hard copy. For years I had wished I had a book to send to those people who called me from the East Coast or Midwest. These were often relatives or friends of people I had worked with in California, who were suffering terrible back pain and needed help. And so I got writing. 

A book to solve back pain

Although there was clearly a huge need for a book to solve back pain, I was still surprised to find I had written a bestseller. It reached number two on Amazon.com following our American Public Television program in 2011, and number three following the New York Times article (paywall) naming me “The Posture Guru of Silicon Valley” in 2013. It has now been published in 12 languages (Croatian later this year), and sold over 250,000 copies.

 8 Steps to a Pain-Free Back is available in many languages: Spanish, Croatian, English, Polish, Simplified Chinese, Traditional Chinese, German, Korean, Arabic, Russian, Hungarian, Slovenian, and Italian editions. 

Digital download or hard copy?

In recent times digital books have revolutionized publishing. It is perhaps surprising that figures from the US publishing industry show that, in 2020, hard copy was still outselling downloads by 2 to 1¹. 8 Steps to a Pain-Free Back is available as a digital download, but the paperback version continues to be in high demand. I have come to realize that there are numerous and perhaps unusual virtues for having a paperback edition of this book, some of which I would like to share to inspire you!

Every digital book has the primary advantages of price and portability, but can remain out of sight and out of mind. Encountering a physical book invites you to engage with it, to pick it up and thumb through it. You don’t have to sign into wifi or wait for it to load—you just start reading. 

Visual cues help pattern healthy posture

One factor which works against us developing and maintaining healthy posture in our society is that we don’t have good examples and reminders around us. In fact, we are continually exposed to a norm of bad posture, while our culture’s idea of good posture, the S-shaped spine, is deeply problematic. What we want is to be surrounded by healthy visual examples on which to model ourselves.

8 Steps to a Pain-Free Back has over 1,100 images, mostly photographs, showing healthy posture from all over the world, from history, and in infants. Students find these images a motivating and practical reminder on their posture journey. Many a person has fallen in love with the African carpenter on the frontispiece, who insisted I take his picture, or marveled at the babies stacksitting with ease. 

This African carpenter stands tall and relaxed by his bench. This is also excellent form for preparing food in the kitchen, or any work at a counter. 8 Steps to a Pain-Free Back, pg 3.

My youngest child stacksitting next to her “sitting tub.” 8 Steps to a Pain-Free Back, pg 69.

You can of course collect your own posture pinups, and I encourage you to do so. But selecting your favorites from 8 Steps to a Pain-Free Back is convenient, plus you will know the posture shown passes muster. The quality of the prints means that they look completely at home popped into a frame, or even laminated and placed around the garden or garage or in your shower stall (true story about the tallstanding image leading Lesson 6). The key thing is to place them exactly where you need the reminders. For example:

Here I am reaching up to engage my inner corset. Use this reminder near a high shelf or cupboard that you regularly reach up to. 8 Steps to a Pain-Free Back, pg 127.

This African woman is hip-hinging as she harvests water chestnuts—a perfect picture reminder for your vegetable garden.  8 Steps to a Pain-Free Back, pg 151.

Here I am stretchsitting. Place this reminder by your easy chair or sofa, where you may otherwise tuck and slouch. 8 Steps to a Pain-Free Back, pg 47.

If you are of a technical bent you may be drawn to the many diagrams. Students find the mechanism of a shoulder roll drawing helpful in executing this technique. The shoulder roll helps your shoulder joint to return home to a healthy posterior position. 

The mechanism of a shoulder roll diagram is especially useful at any desk or computer. 8 Steps to a Pain-Free Back, pg 42.

Lastly, the recaps at the end of each chapter make a handy cheat sheet while you are revising a new technique. For example, the recap of stretchlying on the side may be beneficial pinned onto your bedside table. 

Starting a conversation about healthy posture

Your book can take pride of place on the coffee table, where, unlike a download, it will always be there to catch the eye. This is a nice organic way of keeping posture on your radar and introducing it as a talking point with family and visitors. We certainly know of parents who leave 8 Steps to a Pain-Free Back strategically placed for their children to discover!

The coffee table is a great place for browsing a book. 

Introducing your wider circle to healthy posture 

If you are part of a wellness group, then 8 Steps to a Pain-Free Back is a natural fit for study. If you are a book club member, then this may be the book you are looking for to invite discussion beyond back pain extending into anthropology, history, health, and lifestyle. 

Given that 80% of people in the US will experience back pain², not to mention the many other musculoskeletal problems addressed in its pages, this book has broad relevance. Many of our students are grateful to have discovered 8 Steps while visiting their physician or other healthcare professional. 

To help you spread the word among your family and social networks we have created “clan packs." The launch price has an additional discount: 4 books for $79 (instead of $99), or 8 books for $119 (instead of $159), and is valid until March 13, 2022.

Sometimes when I speak at conferences or wellness events (e.g., Google, Mimosa Systems, TiE Silicon Valley, Global Fund for Women), the company offers their employees/members/donors a gift copy of my book. To encourage this, we offer special bulk discounts. For information please contact [email protected]. For speaking engagements please contact [email protected]. 

References:

¹Felix Richter, “Infographic: E-Books Still No Match for Printed Books,” Statista Infographics, August 9, 2021, https://www.statista.com/chart/24709/e-book-and-printed-book-penetration/. 

²Janet K. Freburger et al., “The Rising Prevalence of Chronic Low Back Pain,” Arch Intern Med 169, no. 3 (2009): 251-258, doi:10.1001/archinternmed.2008.543

Free Online Workshops

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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.

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