muscle contraction

If you have had back pain, odds are that you have visited either a physical therapist or a chiropractor. They are the most frequented medical practitioners for all types of structural pain, and our teacher community has been enriched by both these (and many other types of) practitioners. For this post, I have invited Vera Baziuk, a chiropractor and Gokhale Method® teacher based in Edmonton, Canada, to join me for a Q&A. We would like to share with you how she sees the interface between chiropractic and our method. 

Gokhale Method teacher and chiropractor Vera Baziuk.

E: How did you first discover the Gokhale Method?

V: I was researching the best home exercises and stretches for certain patients for back pain relief. I felt that this was a missing component in chiropractic for fully resolving back pain. I stumbled upon an interview with you and Dr. Mercola. What you said in the beginning about the J-spine grabbed my attention. I immediately went to the Gokhale Method website and downloaded your book, 8 Steps to a Pain-Free Back

This was one of those career aha moments, when I know on an inner, deeper level, that something is right and what I need to be doing. I began looking into teacher training in November 2019, however, teacher training was not going to be possible with a three-month-old, and I still needed to take the Foundations course. Then COVID hit.

I took the online Elements course in the spring/summer of 2020, right in the middle of COVID, and waited for the announcement of teacher training. In fall of 2021, I gained in-person experience in a Pop-up class in Palo Alto. That weekend was amazing! I had never felt quite the stretch before as when Esther adjusted my stretchsitting. I shall never forget that initial amazing feeling of lengthening in my erector spinae muscles and ultimately the spine. I wanted everyone I knew to feel how good that felt. If I wasn’t hooked before, I was after that class! 

Gokhale Method teacher Sabina Blumauer guides a student in stretchsitting.

E: Were you initially skeptical about the Gokhale Method?

V: No, I wasn’t. The interview I heard between you and Dr. Mercola made complete sense. The book and Elements made a well-presented argument for the natural J-shape of the spine, supported by analysis of body mechanics, muscle contraction, and relaxation. Hundreds of photos showed how the spine looks when posture is done well in daily activities—and how things look when it is not. It became evident that poor posture was the real culprit to back pain. And that the posture pot of gold is still attainable at any age. 

E: Do you see any divergence between chiropractic and the Gokhale Method? 

V: The main thing I encounter, from fellow health professionals and patients, is confusion about healthy spine shape and pelvic position. 

For example, in conventional trainings, having an anterior pelvic tilt is equated with having an excessive lumbar lordosis. The Gokhale Method makes the important distinction between upper lumbar lordosis (undesirable) and L5-S1 angle (desirable). The Gokhale Method also uses more descriptive and “sticky” language when it comes to spinal shape—instead of talking about lordosis and kyphosis, we refer to J-spines, C-spines, and S-spines; this helps students understand what they need to embody more accurately and easily. This is explained and illustrated in detail in your book, and also addressed in a blog post on spine shape and another on pelvic angle.

E: Has the Gokhale Method complimented your practice as a chiropractor?

V: Incorporating the Gokhale Method into my practice is a natural fit because, ideally, there is an active and passive component to most healing. 

Passive care is when the chiropractor (or therapist) does something to you, like an adjustment, mobilization, TENS, ultrasound, laser, soft tissue therapy, or acupuncture. While these modalities can be effective in providing relief from pain, they often do not solve the root cause of the problem. Unfortunately, perhaps due to persuasive marketing, people often expect entirely passive solutions for their back pain. They begin to believe that a magic bullet for back pain relief exists.

Here I am giving a patient a chiropractic adjustment. This is an example of passive care, using diagnostic skills and clinical knowledge, plus hands on techniques, to effect change.

Active care consists of therapists providing tools to their patients/clients that they can use in their day-to-day lives to help them in recovery. These may be cryotherapy or heat, exercises to strengthen muscles and stretches to lengthen muscles, nutritional advice to improve healing, stress management tips, and general physical fitness recommendations. This active care component is critical in creating lasting, functional changes.

The Gokhale Method provides high quality active care. It is an educational intervention that teaches and empowers people to make gentle changes to their body 24/7, often with both immediate and cumulative benefits. I don’t know of any other intervention that does this so comprehensively and also includes the J-spine paradigm. 

E: So you see the Gokhale Method and chiropractic as working together? 

V: Yes, absolutely. The Gokhale Method helps chiropractic adjustments hold more effectively and chiropractic adjustments give people a welcome jumpstart on feeling better. 

Most people who come for chiropractic treatment have sustained a lot of damage over the years in their muscles, tendons, ligaments, discs, and joints, so experiencing a break from their cycle of pain is very welcome. But partial or repeated short-term relief from pain is ultimately unsatisfying, both for the patient and practitioner. The Gokhale Method offers ways of transforming the postural habits that caused the problem in the first place. I find that, given most people’s starting point, a combination approach restores function, gives long term relief, and improves comfort along the way. 

My Gokhale Method students find learning how to rest and sleep in comfortable, therapeutic positions makes an invaluable contribution to their recovery. Here I am teaching stretchlying.

E: What impact has the Gokhale Method had on your thinking about chiropractic? 

V: I feel like my eyes have finally opened. For example, revisiting my textbooks, I noticed that references to posture are minimal and often an afterthought. Dr. David Magee is a well-respected physiotherapist who has written numerous classic orthopedic and physical examination books that both chiropractors and physiotherapists still learn from today. I began to wonder why, in one of his books, Posture Assessment is Chapter 15 of 17? It should be Chapter 1! Nearly all musculoskeletal conditions are a direct result of poor posture. 

E: Do you discuss the subject of posture with your patients?

V: I now see my patients’ complaints through the Gokhale lens, with posture as the starting point. Looking at someone in the past, I could see their posture was not ideal, but I still dealt with their presenting complaint in parts, not as a whole. For the past year, I have switched my filter and now consider all musculoskeletal pain in relation to posture. 

When speaking to patients for the first time, I begin to paint the picture of what healthy posture looks like and how their current posture compares. We then explore options to solve the problem with some immediate pain relief solutions and a longer-term relief and prevention strategy—the Gokhale Method. 

Teaching my Gokhale Method students healthy bending not only enables them to avoid future back pain flare-ups and protect against damage, it also brings many other biomechanical benefits—such as natural length in the hamstrings and improved hip joint mobility.

For existing patients, I periodically offer observations on how their current posture is very likely contributing to a flare up or increase of pain from their last appointment. Many wholeheartedly welcome hearing more about the Gokhale Method.

E: Can you share a specific case where the Gokhale Method has enhanced the outcome for a patient?

V: In September of 2023, I met Kay Chui Lee, who is happy to share his journey. He was referred by a massage therapist, and presented wearing a cervical collar for an acquired torticollis (neck twist to one side). His posture was a significant C-shaped spine, with a very tucked pelvis and his hips parked forward. His erector spinae were perhaps the tightest I have ever felt. In addition, he had tight sternocleidomastoid, scalene, levator scapulae, and trapezius muscles. His gluteal muscular tone was weak. 

Kay Lee started as a chiropractic patient, and, to best serve his needs, I also encouraged him to enroll in the Gokhale Foundations course. He stopped wearing his cervical collar about halfway through the course. After the course, his neck and head rotation to the right had improved and there were times when Kay was able to look straight ahead. 

A combination of the Gokhale Method and chiropractic treatment is enabling Kay Lee to gradually become more upright. His head and neck are returning to a more natural, comfortable, and symmetric alignment. 

He walks daily, practicing what he learnt in glidewalking, and reports doing so without the fatigue he used to feel after a walk. He sleeps better and can manage his day with greater comfort. The texture in his erector spinae muscles is softening and he reports less pain with muscle work. To date, Kay continues with chiropractic treatment and there are ongoing improvements. I am hopeful that with alumni classes, online or in-person, he will continue to improve.

E: Thanks, Vera, for sharing how you are using chiropractic alongside the Gokhale Method. I am sure your insights will help both our students, and chiropractors and their patients, to embrace this complementary pairing with a new level of confidence.

Best next action steps 

If you would like to improve your posture, 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…

Using the word “eccentric” might sound like I’m about to write about muscles behaving in weird ways that are different from usual muscle behavior! 

Virginia Fox and Buster Keaton prop each other up in The Electric House (1922).
These muscle actions are ek-sen-trik! Wikimedia

But what I’m referring to, eccentric muscle contraction, is often pronounced ee-sen-trik, not ek-sen-trik.

How muscles contract

Eccentric muscle contraction is the reverse of the concentric contraction that we typically associate with muscle training. For example, the dumbbell curl that makes the bicep prominent as you lift the weight towards your shoulder is a concentric contraction. The muscle contracts and shortens. But lowering the dumbbell back down again, which requires the muscle to lengthen, also takes muscular control, and that is called an eccentric contraction. So the muscle is being asked to both stretch and resist at the same time. 

Lifting a weight such as a dumbbell works the biceps femoris concentrically, while lowering it works it eccentrically. Pexels

Although there is still much to be discovered about how our muscles and tendinous tissues work at a cellular level, eccentric contractions have well understood characteristics that make them of particular interest to medics, athletes, physical therapists, and researchers. And they play an important role in healthy posture.

Walking upstairs and downstairs 

Dr Michael Mosley, a well-known broadcaster on health and wellness in the UK, presents a radio series for the BBC called Just One Thing. Each 14-minute show explores just one thing that you can do to improve your health. (We would like to see him do a show on healthy posture! Consider suggesting this here.) Back in April he looked at the benefits of eccentric exercise and movement. 

One of Mosley’s favorite studies had people walk either up or down the stairs of a 10-story building twice a week, using the elevator in the other direction. Both groups saw improvements in many health outcomes—but those walking down the stairs—doing more eccentric rather than concentric muscle work—did better. They were fitter, having a lower resting heart rate despite doing less cardiovascular exercise, had lower insulin sensitivity and lower blood fat levels, better bone density, superior balance, and twice the improvement in muscle strength. Seems like those step-climbing machines at the gym could be rigged the other way around!

Gym work on elliptical trainers and step machines emphasizes concentric muscular contraction and cardiovascular effort. Pixabay

Eccentric muscle contractions dominate as we lower our weight walking down hills and stairs. They have been proven to bring particular health and fitness gains. Wikimedia

Calories you save vs. calories you use

Mosley interviewed Tony Kay, professor of biomechanics at the University of Northampton. Kay explained that the muscle-lengthening phase of exercise is also more efficient than the muscle-contracting phase because eccentric contractions only need approximately one quarter of the energy of a concentric contraction, employing fewer muscle fibers, and generally not lifting against gravity. However, eccentric work burns more calories than a seemingly tougher concentric workout because it creates more microscopic tears in the muscle, and so after exercising the body has to raise its metabolic rate to repair and build back stronger. 

Professor Kay has also conducted studies that demonstrate superior gains in bone density, and range of motion, through eccentric work. These various benefits can be effectively targeted for a wide range of needs, from post-injury rehabilitation, or strength training in the elderly, to developing elite athletic performance. 

Everyday eccentric movement and exercise

Eccentric muscle contraction, just like healthy posture, is most useful once integrated into everyday tasks and movement. For example, to lift the front of the forward foot clear of the floor while walking, tibialis anterior works concentrically, but then eccentrically to lower it. If you are prone to trips and falls, perhaps due to an underused and weak tibialis anterior, it can be woken up and strengthened by our Gokhale Method® toe tap exercise. You can learn toe tap here.

The tibialis anterior muscle runs along the shin bone (tibia), its long tendon attaching under the front of the foot to lift and lower it with fine control. Wikimedia, Wikimedia

Another especially beneficial exercise for most people in our culture is the Gokhale Method shoulder roll. It helps correct the common rounding of the shoulders that occurs with poor posture. This better aligns the joints to prevent impingements and arthritic change, and helps open the chest for healthier breathing. There are various muscular actions involved in shoulder roll, but slowly releasing the trapezius muscle (traps) downward (eccentric contraction) after they have lifted the shoulder (concentric contraction) is key to this maneuver. You can learn shoulder roll here.

The upper and mid portions of the trapezius muscle contract concentrically to lift the shoulder upward in shoulder roll, and eccentrically to lower it into its healthier new position. Wikimedia

Can eccentric work help with my tight hamstrings?

Eccentric work can be used to lengthen muscles just as it can be used to strengthen them. Most people in our culture have tight hamstrings, often despite regular stretching, even done over decades. Far better to learn how to sit, walk, and, most importantly, bend in ways that not only spare your back from damage, but also don’t cause the hamstrings to be overly tight in the first place. In addition, bending, done well, will naturally, eccentrically lengthen your hamstrings. We call this way of bending hip-hinging, and it is one of the more advanced techniques we teach in our Gokhale Method® in-person Foundations and Pop-up courses, and our online Elements course. 

Women doing laundry. Photograph by Balys Buračas, Lithuania, 1923.
In traditional cultures people hip-hinge to bend, sparing spinal discs and nerves, maintaining hip mobility, and preserving good length in their hamstrings. www.epaveldas.lt

Keeping eccentric muscle training comfortable and safe

I asked our Gokhale Fitness expert, Eric Fernandez, if there are any downsides to eccentric muscle training. Eric offered two tips to proof your workout: 

1. Watch out for DOMS! (Delayed Onset Muscular Soreness) Unaccustomed eccentric exercise is known to cause muscle damage, or micro-tears in the muscle, which is followed by delayed inflammation and soreness. To avoid this, work up the intensity of your exercise very gradually.
2. With eccentric exercise you are generally lowering or resisting a weight—whether that’s a  dumbbell or your own body weight, such as when walking downstairs. You run the risk of the weight moving you, rather than you moving the weight. So, pick exercises and weights where you can build up gradually, remain in control, and safely release the weight or steady yourself if necessary.

Eric demonstrates single arm bent over rows. This exercise targets the lats (latissimus dorsi), working them concentrically to lift, and eccentrically to slowly lower the kettlebell. Eric follows this with an eccentric lats stretch using the wall.

Eric demonstrates a kneeling lunge. Usually this is a passive, sinking downward stretch. Here, by driving the kneeling leg forward, he also produces an eccentric contraction, potentially deepening the stretch and strengthening the hip flexor tendons.

Eric often uses eccentric exercise in his Gokhale Fitness classes, Monday–Saturday, 3:00–3:25 pm PT. If you are reading this blog and would like to try exercising the Gokhale way and develop healthy posture at the same time, you are welcome to sign up for your Gokhale Exercise free trial here. We look forward to seeing you there!

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, including Weightlifting and the Gokhale Method with Eric on Tuesday, August 30, 4:30 pm.