rehabilitation

August is peak holiday time across the northern hemisphere, and many of us who live here will find ourselves poolside, or even better, in it!

Being in water has the natural advantage of lifting weight off the joints while providing gentle resistance training. Aching backs or knees can find relief from compression in the natural buoyancy that water provides. This has made pool exercises a popular prescription with physical therapists over many years, especially for post-operative or post-injury rehabilitation. 

On land, to relieve pain and compression, people usually use elaborate measures like inversion tables, traction units, or going to outer space! In the Gokhale Method we provide decompression for the lower back relatively simply with the Stretchsit® Cushion or the nubs on our Gokhale™Pain-Free Chair. But stepping into water is the simplest of all, giving you freedom of movement and the ability to strengthen yourself simultaneously.

Pool exercise also provides a fun and refreshing environment for exercise in summer heat waves! Wikimedia

This blog post gives you three ways to harness the unique benefits of being in water to practice and develop healthier posture. These exercises are challenging enough to do as a stand-alone workout or as a way to prime your swim session.

Healthy posture habits honed in water will benefit your daily life on land, as well as giving you greater stability and power for your swimming or other sports. 

For safety and best results, I recommend that you progress the session in the order given here, starting with Exercise 1 and, once you are familiar with it, move on to Exercise 2 and finally add Exercise 3. 

1. Stabilize your spine by using your inner corset

You will use a natural brace of muscles as you walk across the pool. It will give you the stability you need to cut through the resistance of the water without wobbling and threatening the alignment of your spine. 

Imagine you are getting into ice cold water. Feel how all the muscles around your middle can contract and make you more slender. You want to work hard enough to feel this from deep in the pelvis all the way up to your rib cage. You want to feel the muscular engagement all the way around your mid torso, like a tightly laced corset. 

The muscles of the inner corset include the deep intrinsic back muscles, the abdominis transversus, and the obliques. 

Gokhale Method teacher Eric Fernandez shows how engaging the inner corset draws the abdomen in and makes the torso slender.

This is one way of recruiting your “inner corset," which will help stabilize your spine as you walk and is key to swimming with a more streamlined, efficient stroke. We teach this technique and others in more detail in our in-person Foundations course, one-day Pop-up course, our online Elements course, plus our Gokhale Exercise program. You can read more about your inner corset here.

2. Headload to lengthen your neck and to find deep spinal support

In industrialized cultures we have an epidemic of forward head carriage, putting enormous strain on the neck and structures throughout the back. Finding healthy alignment through your neck, combined with the inner corset, helps your whole spine to support itself well. Resting even a modest additional weight on the head can help us to find our vertical axis and stand tall. This is the reason I developed the Gokhale™ Head Cushion. 

Headloading encourages recruitment of the deepest muscles of the inner corset and the neck, especially the longus colli at the front of the spine. 

In the pool I suggest you use what you have at hand—your hands! Rest them on your head and push up against them with your head. Keep your nose and chin angled downward. Proceed very gently if you have neck issues. You can gradually build up the intensity over a number of sessions. 

Gokhale Method teacher Clare Chapman headloading in the pool using the weight of hands and arms. Create space between your shoulders and your ears—keep your shoulders down as your neck grows tall. 

Establishing healthy length in your neck will help you to retain a straighter, more spacious alignment while swimming, especially in breaststroke where people tend to crane their necks to hold their heads above water. Consider training to swim with your head in the water, if you do not do this already, which will enable a much healthier alignment of your torso, neck, and head.

Especially when you raise your arms, you may need to use your rib anchor muscles to prevent your back from swaying.

3. Power up your walking using your feet and glutes

Many of us compromise our walking by overusing our quads and hip flexors (psoas muscle) and underusing our glutes. We predominantly reach our front leg forward in our strides, instead of generating propulsion from the rear leg with our glutes and foot muscles. 

Our ancestors and many people living in more traditional or nonindustrialized societies—where joint and back pain are rare—walk using their glute and foot muscles more than we typically do.

As you walk in the pool, make each step a rep. Each step wants to progress through a pose that includes a straight back leg and a bent front knee. As each leg goes back behind you in turn, squeeze your buttock muscles on that side. Engage the upper outer quadrant of your glute pack. This is not the kind of glute squeeze that clenches your lower butt cheeks together and tucks your pelvis. 

Gokhale Method Alumna Christine Andrew working hard to achieve healthy walking form in the buoyancy and resistance of water.

Grab the floor of the pool with the whole sole of your foot, and then push off from your toes. Focus on maintaining the convex foot shape as you do this. Propel to glide forward, not bounce upward.

Eric actively grabs the floor of the pool with each foot to pull the body forward and then push back.

Putting it all together: Aim to keep healthy form and walk as smoothly as you can through the water. This develops both healthy length and muscle power in the right places.

If you notice your back arches back as you walk, take smaller steps and lean more forward until you master the art of keeping your spine stable with the rib anchor and inner corset techniques. Enjoy!

Best next action steps for newcomers

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

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

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.