glutes

Balanced Walking in Older Age

Balanced Walking in Older Age

Esther Gokhale
Date

We assume in our culture that aging will necessarily be accompanied by a loss of height, increasingly stooped posture, loss of muscle strength, and a precarious inability to balance. But is this really the inevitable trajectory? Here we look at why this occurs and focus on how a healthy gait can help us maintain good balance throughout life, including into old age.


Walking sticks and poles help prevent falls but are poor compensation for loss 
of natural stability and balance from the feet and buttocks. Unsplash

Falls can have fatal consequences for the elderly, potentially resulting in broken bones and a cascade of problems that can ensue from hospitalization, injury, surgery, and immobility. Scientific data followed by the U.S. Department of Health and Human Services (HHS) has linked several known risk factors, attributing most falls to muscle weakness and problems with balance and gait. Conversely, elderly people who maintain their strength and ability to balance have been shown to mostly avoid trips, slips, and falls.

The importance of the glutes

When it comes to balance, there is good evidence to confirm that the role of the gluteal muscles (buttocks) is key. Research¹ has shown that having strong gluteal muscles and hip abductors differentiates non-fallers from fallers. These muscle groups include gluteus medius, a muscle that we pay a good deal of attention to in both our online Elements course and in-person Gokhale Method Foundations Course. 

 
The gluteus medius muscles form the
upper outer quadrants of the buttocks. Wikimedia

 
Healthily developed gluteus medius muscles are clearly visible 
in these Ubong tribesmen. (Borneo, Indonesia)

The attachments of gluteus medius high on the pelvis and wide at the hip joint position it to play an important role in steadying us when we walk. With a little coaching, it is easy to monitor its degree of engagement with the fingertips. This is also a good way of ensuring that other important muscles in the area are performing their function.


People who walk well use their back leg and glute strongly 
to propel themselves forward and maintain their balance.

Should I do glute exercises?

Well-targeted exercises are an effective intervention for jump-starting weak and sleepy glutes, and are therefore included in our courses. But your glutes would like around 5000 reps a day to maintain a good baseline tone—enough to drive most of us crazy. Fortunately, Nature has a saner solution—walking. Rather than dedicating a large percentage of your disposable time to doing exercises, if you walk well, squeezing your glutes, each step becomes a rep.  


Note the bean-shaped contours of this woman’s feet. (Odisha, India, 2017) 
She has strong, even inner and transverse arches 
giving the foot convexity rather than a collapsed shape.

Feet

At the other end of our walking gear are our feet. We treat our feet somewhat like prostheses to be shoved into shoes, with little regard for their function. But healthy feet are critical in gripping and grabbing the contours of the ground, even through shoes, as part of maintaining our balance. 


Natural gait includes a grabbing action by the foot as the glute contracts, with the back heel staying down
on the ground well into the step.

Glidewalking

A natural gait that makes good use of the glutes and feet is so rare these days that Gokhale Method teachers call it “glidewalking” to distinguish it from the various poor gait habits and compensations that most people develop in industrialized societies. 

Walking distortions

Monty Python’s “Ministry of Silly Walks” comedy sketch, starring John Cleese. 


The Monty Python “Ministry of Silly Walks” sketch shot to fame in 1970 and is still absurdly comic. Its silly walks are hilarious and clearly extreme, but some of their genius lies in their exaggeration of truth as they magnify the distortions and quirks that can be observed in our individual walking patterns.

A common walking distortion occurs when the pelvis is tucked under. Tucking the pelvis disadvantages the muscles of the glutes and feet which are designed to propel us forward. Without this propulsion from behind, muscles in the front of the body such as the psoas and quadriceps are obliged to take their place and pull us along. These muscles cannot give us the same stability however, and our ability to balance or catch ourselves from falling is reduced. 


Non-industrialized populations the world over, despite their varied environments and cultural habits, share a common gait pattern. This photograph (Laurence K. Marshall) reveals no appreciable differences in walking between individuals, male or female, child or adult. 

By contrast, if you observe a tribe or family of Kalahari Bushmen you might detect slight nuances, but each individual shares the same essential gait pattern. This is also observable in our young children and is preserved in the art and film of our ancestors prior to the 1920s.

All of the upside, none of the downside

While it’s true that any type of walking may bring benefits such as cardiovascular fitness, interaction with others, connection with Nature, and a low carbon footprint, there will be downsides for your balance if you have a poor gait pattern. A habit such as landing heavily means that your weight is committed forward too early in your step, removing the ability to side-step a loose tile or slippery floor. Many people lean backwards slightly as they walk, making them more prone to their heels slipping underneath them. By contrast, glidewalking is well balanced and stable, which lends it an innately peaceful and dignified quality. 


Gokhale Fitness teacher Eric Fernandez and Gokhale Moving Meditation teacher Kathleen O’Donohue take online participants through balance exercises and movements.

It’s not just an age thing

Many younger people with poorly developed walking muscles and a “flat butt” find themselves prone to falls and injury but are likely to put it down to poor coordination and clumsiness. Whatever your age, if you often feel unstable, trip frequently, notice that you struggle to stand on one leg in yoga classes, or cannot shift your weight smoothly in Tai Chi/Qigong, it is definitely worth looking at ways to improve your balance and movement.


Strengthening the gluteus medius muscles prepares you for glidewalking.

Learning to glidewalk

The best and safest starting point for learning glidewalking is to strengthen and become very familiar with using your gluteus medius muscles. You can find our favorite glute strengthening exercise, “leg raise,” in the exercise appendix of my book (pg. 213), “8 Steps to a Pain-Free Back”.

Or watch our Online University video clip here.

For those who are willing and able to follow detailed instructions, Lesson 8 in “8 Steps to a Pain-Free Back” takes you through the phases of glidewalking step-by-step. 

If you have the resources, I recommend contacting a Gokhale Method teacher who can coach you and tailor lessons to your needs. 

You are also invited to join me for the Free Online Workshop, Sturdy, Upright, and Tall: Posture for Aging, on June 29 (5 p.m. PT). Best foot forward!

          1. Mario Inacio et al., “Gluteal Muscle Composition Differentiates Fallers from Non-fallers in Community Dwelling Older Adults,” BMC Geriatrics 14, no. 37 (March 2014), https://doi.org/10.1186/1471-2318-14-37

How Joan Baez Got Her Booty Back at Age 79

How Joan Baez Got Her Booty Back at Age 79

​​​​​​​Esther Gokhale
Date


Joan Baez has upgraded her posture since this photo was taken, with benefits for her whole body.

If you’ve been participating in our ongoing Posture 1-2-3 Challenge for alumni, chances are you’ve seen my longtime student, Joan Baez, who regularly joins in. At age 79, she’s sturdy and beautiful, with shapely legs, toned arms, and a peachy, perky butt. Although we’ve all enjoyed her bodacious pipes for many decades, she hasn’t always been such a well-rounded posture student. In her 20s and 30s, her boombox was highly functional, but her booty was lacking.

Case in point: in 1973, at age 32, Joan visited Sing Sing to perform for the people imprisoned there. Her set list included the rousing anthem “I Shall Be Released,” followed by “Viva Mi Patria Bolivia,” a duet with her sister Mimi Fariña. Here she is, singing and playing her trusty guitar, connecting with her audience, doe-eyed and full-voiced in her signature way.

But below the belt things are different. At 3:56 you see a shot of Joan’s behind, and that it doesn’t fill out her pants. Her pants fall poorly on her derriere, because there isn’t the tone and muscle to hold the folds. Her voice sings, but her glutes hit a flat note.


The folds in the fabric of Joan’s pants over her backside while standing upright indicate a tucked pelvis and underdeveloped glutes.

Part of the reason her glutes were not developed is that she used to tuck her pelvis, which puts the glutes in a position of mechanical disadvantage. Tucking the pelvis also sets the framework for rounding the upper spine. This curvature — and the pain it caused her neck — is what she came to me for and what we have worked to transform.


Joan tucking her pelvis while playing guitar and singing.


Young Joan demonstrating a tucked pelvis and rounded upper spine while sitting on the grass.

A flat butt and tucked pelvis aren’t uniquely Joan’s problems. In fact, “glute amnesia” is widespread in our industrialized, increasingly sedentary society. For those of you who share this problem, we’ve developed a special Free Online Workshop called Wake Up Your Glutes: They Snooze, You Lose. If you are available to attend tomorrow, I will be delighted to teach you how to rouse your glutes in their natural context, which is walking. 

Joan is quite diligent about doing her exercises and staying active. She has also done a lot of self-care in general, for her body, mind, and spirit. The results are obvious: 


Joan in my garden last year, preparing to pick some calendula with a deep, healthy hip-hinge and her behind well behind.


Joan celebrating her 79th birthday at Yosemite. Note her excellent muscle tone and beautiful upright posture. Image courtesy Joan Baez.

The moral of this story is that aging doesn’t have to mean decline. You can actually improve with age, as Joan has. Yes, it takes a certain amount of investment and learning and discipline in implementing, but you can change. You can improve. Let’s do it! Let’s join Joan, let’s get our walking shoes, and let’s be walking down the line...

 

These Glutes Are Made For Walking

These Glutes Are Made For Walking

Esther Gokhale
Date


Khaddi Sagnia, World Athletics Championships in 2015 - ©Diego Azubel / EPA

Humans have really large butts. Your cat or dog, by contrast, has a very tiny bottom.


Dogs and cats have tiny bottoms

Chances are you’ve never stopped to think about how unique your own derriere is. Primate species are unique in having distinctive buttock anatomy—our buttocks allow us to sit upright without resting our weight on our feet, the way our pets do. Human buttocks, which are particularly muscular and well-developed, empower us to be bipedal, and propel us forward in walking and running. Even if you’re thinking, ‘I don’t have much of a butt at all,’ there’s no comparison between your behind—which has great potential!—and an ape's.


Our primate cousins have similar, but much less-developed gluteal muscles than we do.

Older scientific sources often cite walking as the reason for our large buttocks. Gluteus maximus and medius are important in stabilizing the pelvis and trunk—they keep us from tipping over when we lean into a brisk walk, as well as during older caveman-style activities like throwing and clubbing. (Marzke)

We also know that the gluteal muscles are key for running. The Olympic track and field athletes you’ve been watching in the last few weeks have strong glutes not only for balance, but also to power their bodies across the track, over hurdles, and through the air. All that energy and propulsion comes from the powerhouse of the lower body—the buttocks.


Khaddi Sagnia, long jumper, with well-developed glutes, walking down the track.

I believe that top athletes like Khaddi Sagnia dominate their sports not just from doing reps at the gym and on the field, but also from doing ‘Downtime Training®’—that is, practicing everyday tasks with excellent, natural form. When the glutes are strongly activated in walking, every step is a rep. This is a good example of Downtime Training.  As we can clearly see in Khaddi’s example, even her breezy walk down the track prepares her glutes for running and jumping.


Here you can see a video of Swedish long-jumper Khaddi Sagnia, who provides a beautiful example of well developed, active glutes.

Does an ideal walk select for athletic excellence, or does athletic training result in an excellent stride? I believe the two support each other. Someone who already has well-developed muscles from an excellent gait is more likely to excel at sports that involve running, jumping, and lunging; conversely, vigorous use of the glute pack and posterior chain in a sport will predispose a person to have a stronger, better co-ordinated stride. I believe that athletes competing at the Olympic level experience an upward spiral of healthy movement patterns reinforcing athletic excellence, which in turn reinforces healthy movement patterns.

Some recent scientific studies, citing electromyographic (EMG) experiments, have concluded that the gluteus maximus muscle is minimally active in many activities such as walking or climbing stairs, while being highly active during running. In an interview published in Nature about research on how humans evolved to be distance runners, Daniel Lieberman of Harvard claims that running seems to be the only reason that we have prominent buttocks. He has measured the activity of gluteus maximus in volunteers during a walk and a jog and says:

"When they walk their glutes barely fire up. But when they run it goes like billy-o." (Hopkin)

I believe that Lieberman’s finding reflects degenerate modern industrial gait more than it does an evolutionary truth about our species.


Modern-day underdeveloped butt


Lack of glute development accompanied by thoracic kyphosis


Our celebrities are not exempt from the under-developed glute phenomenon, as Taylor Swift demonstrates here.

As we see clearly in the example of Khaddi Sagnia, or other athletes, or indigenous people, or young children, the glutes are in fact actively used in walking and climbing. It’s only in very recent times that we find appreciable numbers of people who barely fire their glutes while walking.


Athletes, like the baseball players above, usually have well-developed gluteal muscles.


Maya White, Esther's oldest daughter, showing the typically toned glutes shared by young children.


The San indigenous people of the Kalahari, show well-toned glutes from walking and running with primal form.

I teach my students to glidewalk, an ancestral walking form whose mainstay is the activation of the gluteal pack of muscles. Try standing before a table or desk. Turn your right foot outwards while leaning your torso and pelvis forward. Now lift your right leg out behind you (you can hold the edge of the table for support). Your entire gluteal pack will contract – the hamstrings, gluteus maximus and gluteus medius. This is the action you want to find in every step you take.

There are other muscles that are part and parcel of a healthy gait – the calf muscles help launch the rear leg forward to its destination; the muscles on the underside of the foot help grip and grab contours on the earth – and we share these actions with other animal species. But buttock action is special – it marks us as a species, and as bipedal creatures – and it behooves us to use our butts more than most of us currently do.


A woman glidewalking in Cambodia

Scientists are right in describing the marked use of the glutes in running, and it is clear their current size is tied to an evolutionary propensity for distance running. Yet it seems unlikely that our ancestors, when they first came out of the trees, hit the ground running. Bipedal walking had to be a predecessor to running while our ancestors mastered balance and being upright. I believe prominently sized butts first developed when our ancestors began to walk upright, and that we want to follow the example of the Olympic athletes in engaging our glutes, not just when we run, but also when we walk.  This form of constant training will reinforce healthy posture, as well as strength. And if you’re really lucky, maybe you too will soon be cruising around sporting Olympic hot pants like Khaddi’s. Let us know when that happens - we’ll send our videographer over so we can all enjoy the moment!

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.

References

Bramble, Dennis M., and Daniel E. Lieberman. "Endurance Running and the Evolution of Homo." Nature 432.7015 (2004): 345-52. Web.

Fischer, Frederick J., and S. J. Houtz. "Evaluation of the Function of the Gluteus Maximus Muscle." American Journal of Physical Medicine 47.4 (1968): 182-91. PubMed. Web.

Hopkin, Michael. "Distance Running 'shaped Human Evolution'." Nature.com. Nature Publishing Group, 17 Nov. 2004. Web. 25 Aug. 2016. <http://www.nature.com/news/2004/041115/full/news041115-9.html>.

Lieberman, D. E. "The Human Gluteus Maximus and Its Role in Running."Journal of Experimental Biology 209.11 (2006): 2143-155. Web.

Marzke, Mary W., Julie M. Longhill, and Stanley A. Rasmussen. "Gluteus Maximus Muscle Function and the Origin of Hominid Bipedality." Am. J. Phys. Anthropol. American Journal of Physical Anthropology 77.4 (1988): 519-28. Web.

Gorgeous Glutes

Gorgeous Glutes

Esther Gokhale
Date

On our website, the top searches include, "glutes," "walking," and "butt." So I thought I'd take this chance to say a few words on the subject.

"Callipygian" is an English word of Greek origin. It means “of, pertaining to, or having beautiful buttocks”. The word, (pronounced kal-uh-PIDGE-ee-uhn), is derived from the Greek word “kalli” meaning beautiful, and “pyge” from the Greek word for rump or buttock.


Brazilian soldier on a swimming break in Cachoeira

In some cultures, a small, slim backside is preferred. But in others, it's a prominent rear end that stops traffic. Perceptions of beauty also vary over time. In Classical art, and also in the Renaissance aesthetic, the standard of female beauty included a wide posterior and hips. In recent decades, there's been an emphasis on very thin physiques, though this preference seems to be waning.


Cambodian dancers in a performance

Despite the changing nature of fashion, one thing that never goes out of style is a healthy body. So if you want to channel your inner callipygian beauty while also enhancing your overall wellness, try glidewalking. By squeezing and strengthening the gluteus muscles with each step, you'll walk your way to a regal rear!


Glidewalking in Cambodia

Facing the feet outward increases the chance of engaging the glutes, especially gluteus medius. If you're not feeling your glutes, it's probably because they're not used to working when you walk. Try taking just one step at a time and see if you can engage gluteus medius. Make sure your pelvis is tipped forward (anteverted) and try again (refer to Chapter 6 "Tallstanding" in 8 Steps to a Pain-Free Back for more details). Try pointing your back foot out a little and try again. Still flummoxed? Raise the back leg up off the ground with your back leg rotated outward. This should do it. Walk one step at a time until you can contract your glutes reliably. Then smooth it out into a walk.


How to Glidewalk:

1. When initiating a stride, relax the muscles around the hip joint of the leg moving forward and engage the lower buttock muscles of the back leg to propel the body forward.

2. Towards the end of the stride, use the gluteus medius muscle (at the upper outer quadrant of your buttock) of the back leg to gently land the front foot on the ground. Try to avoid free-falling to the ground. This technique strengthens the gluteus medius, giving you firmer, higher buttocks. 

Onward and upward,
Esther
 

Samba your way to beautiful glutes

Samba your way to beautiful glutes

Esther Gokhale
Date

 

Why Samba?

Apart from the fun, the exercise, and the infectious music that's central to this Brazilian dance form, I endorse Samba as a way to promote healthy posture. Among the many benefits, dancing Samba:

  • Involves a lot of lateral motion and hip mobility, something especially needed in our culture, where so many of us tend to move mostly forward and backward and not so much from side to side.
  • Engages the gluteal muscles, including the gluteus medius, which--though vitally important to so many kinds of natural movements--are underdeveloped or even "fast asleep" in too many people throughout the developed world.

If  you're still not persuaded to join our online Samba workshop, watch even just a couple of minutes of this 4-minute video, and I'll wager that many of you will accept my invitation to dance.

Samba de Roda

What you just saw was a marvelous demonstration of Samba de Roda, or "Samba in the round," which features solo dancers surrounded by musicians and other dancers, singing and clapping and sequentially inviting others to take their turn. An aspect of this form of Samba that holds special appeal as the basis for a training workshop is that learning involves a great deal of observation and imitation, and that those with relatively less skill are among those in the circle invited to join in. Also appealing is the fact that not only are the dancers' feet, calves, legs, hips, and abdomens constantly working, their gluteus medius muscles are also fully engaged. So much so, that before we start dancing I'd like to highlight this important pair of muscles.

To engage, or not to engage (the gluteus medius)...

...can there be any question?

Even when considered from the pure-vanity standpoint of having an attractive, perky derriere, my guess is that most of us would favor the Ubong tribesmen's gluteus medius muscles, which can easily be seen in the upper, outer quadrant of their buttocks just below their cloth belts, to the less distinctive gluteus medius muscles in the photo below.

What accounts for this "flat butt" look is the fact that these important muscles are underdeveloped and have not been adequately used.

What are the gluteus medius and why develop them?

The gluteus medius play an essential role in all kinds of natural movement, including walking, glidewalking, running, and samba dancing. In particular, these muscles:

  • Help keep the pelvis level on the hip joint of the weight-bearing leg. (Without the gluteus medius, we would take a step and your pelvis would sink to one side.)
  • Are essential to holding the pelvis in the anteverted, or tipped forward, position. (This is essential because the pelvis serves as our architectural foundation; when it is inappropriately tucked in, the rest of the body cannot properly stack, and pain problems may ensue.)
  • Are essential to gait and facilitate "soft landings" when we walk. (Unlike our hunter-gatherer ancestors who lightly, quietly tread when hunting prey, too many of us thump around causing damage to our structures.)

The gluteus medius are shown in red

The gluteus medius are shown in red

A couple of other reasons, which we will only touch on here, but will explore in future posts, relate to two painful disorders that arise, at least in part, out of underdeveloped or suboptimally performing gluteus medius muscles:

In a nutshell, a growing body of evidence indicates that gluteal medius health strongly correlates to knee health. If you have good strength in your gluteus medius, your knees will be in better shape, and PFPS is less likely to afflict you. Similarly, if your pelvis is appropriately oriented and your gluteus medius muscles are doing their job, the pyriformis muscles, which lie directly beneath gluteus medius, won't have to pick up inappropriate load and, due to suboptimal orientation and / or hypertrophy, impinge on the sciatic nerve, which exits the pelvis just underneath.One technique to engage the gluteus medius is to raise your leg back and up and out with the foot in an L-shaped position

One technique to locate the gluteus medius is to raise your leg back and up and turned out

How to locate and engage your gluteus medius and practice basic Samba steps

  1. Identify your gluteus medius as shown in the above photo. Once you feel where this muscle is, step away from the chair.
  2. Now, take a small step back with your right leg, press your heel into the ground, straighten your right leg, and squeeze the gluteus medius muscle in the upper, outer quadrant of your buttock until you can feel with your hand how hard it is.
  3. When your right gluteus medius is engaged, hold this position for a beat.
  4. Return to your starting position by moving your right leg forward.
  5. Now, go through the same motions with your left leg.
  6. Practice these steps, alternating right and left legs, until the squeezing of your gluteus medius becomes natural and familiar.

Samba_Engages_Gluteus_Medias

 

Samba steps teleseminar

A fun and helpful way to prepare for the teleseminar on Monday, October 21, 2013, is to watch one or more of the following Samba YouTubes, each highlighting slightly different aspects and methods. What's really helpful about this first video is that the dancer starts with pre-Samba steps, emphasizing the side to side movement of the hips. Keep in mind that there are many varieties of Samba, and that this dancer demonstrates just one style. My only cautionary note about this demonstration and the one that immediately follows is that the dancers slightly arch their upper lumbar regions in a way that's not ideal.

 

Apart from the occasional sound of wind in the microphone, the second video is worth watching because it offers another lesson in the basic Samba step--this time with music.

 

The third video also highlights a very basic Samba step very similar to the one just above, but the dancer does so without swaying her back. Another nice feature of this video is that the dancer varies the speed of the Samba steps, starting slowly and then picking up the pace to the point where the Samba becomes attractive.

 

Because some of you might be inspired by pure music, I also suggest that if time permits you check out some of my favorite Sambistas:

And if you join me for our Samba steps teleseminar, I'll share some of these favorites with you.

 

Photo and Video Credits: Samba de Roda YouTube: pousadamorrodesaopaulo.net Ubong Tribesmen: Esther Gokhale Gluteus Medius Anatomical Drawing: Wikimedia Commons Esther Engages Her Gluteus Medius: Gokhale Method Institute Samba Dancer: Wikimedia Commons Samba Steps Youtube: sambabody.com Learn Samba with Gianne Abbot: Bella Moda Brazil Basic Samba Footwork: Michele Bastos

These Knees were Made for Walking

These Knees were Made for Walking

Esther Gokhale
Date

As the summer sun mellows and fall approaches, this is my favorite time of year to go hiking. Hiking brings so many benefits, from lifting your spirits and relaxing in fature, to catching up with friends and spending quality time with family.

The physical health benefits of walking are well documented. Choose your terrain well, and hiking provides great cardiovascular exercise for all ages. If you have a sedentary job, walking around town can be an important part of what helps you to achieve and maintain a healthy weight.

10,000 STEPS A DAY

If you like to track your progress, a pedometer to measure and increase your steps is a great fitness tool. Pedometer researcher Dr. Catrine Tudor-Locke published a study in "Medicine and Science in Sports and Exercise" in 2004, showing that men in the survey took an average of 7192 steps per day and the women an average of 5210. The research showed that a sedentary person however might average only 1,000 to 3,000 steps a day. For people in this category, gradually adding steps is the way to go.

A reasonable goal for most people is to increase average daily steps by 500 each week until you can easily average 10,000 per day.

 

MODERN KNEES HAVE ISSUES

Among the common problems that prevent people from walking very far are knee problems. Ironically, a common source of knee problems is a problematic gait. Moving less then compounds the problem with stiffness and weight gain, which puts even more stress on the knees, setting up a downward spiral.

In our culture we now have an epidemic of knee problems; most are not associated with any injury. Over half a million Americans a year are diagnosed with meniscus (cartilage) tears and bone spurs. They have sometimes suffered years of inflammation, pain and loss of mobility in the joint. Thankfully, surgical repairs can be pretty good at restoring knee function, but it's always best to prevent the damage, try to improve the situation simply if possible, and use surgery as a last resort.

Let’s look at the figures:

http://www.healthline.com/health/total-knee-replacement-surgery/statistics-infographic

  • More than 4.5 million Americans are living with at least one total knee replacement. That is 4.7% of people aged 50 and over. By age 80+ the figure is 10% and rising

  • Knee replacements increased by 84% from 1997 – 2009

  • Osteoarthritis is the principal diagnosis of knee replacement recipients

http://www.healthline.com/health/total-knee-replacement-surgery/understanding-costs

  • The average cost of knee replacement surgery is $49,500, plus in-patient charges of $7,500

  • The average cost of knee arthroscopy surgery is $11,900

  • An estimated 850,000 meniscus surgeries are performed each year

http://www.newchoicehealth.com/Directory/Procedure/130/Arthroscopic%20Knee%20Surgery

 

 

A SIMPLE PREVENTIVE POSTURE MEASURE FOR KNEES

If you observe young children’s gait, you will see that they land on a slightly bent front knee. You can also see this in people from non-industrial cultures. Bending the front knee provides extra shock absorption for the knee joint. By contrast, if you are in the habit of landing on a straight leg (a result of inappropriately using your quads to lengthen your stride) the knee cartilage will be subjected to a much greater force as your foot hits the ground.


Landing on a straight front leg is often accompanied by several other postural aberrations as listed below. Conversely, bending your front knee at landing can help induce some of the other aspects of a healthy gait like a stronger, more propulsive action in your back leg and buttocks.

 

TRY IT

Start from standing with your feet hip width apart in a relaxed micro-squat position (with your knee and hip joints softened). This will help antevert your pelvis. Now imagine you are walking up a hill. This will lean you slightly forward. Your back leg can now propel you forward and your front knee is more likely to be bent at the moment of impact. Squeeze the upper buttock muscles (gluteus medius) of your back leg as it propels you forward, and use this muscle to help slow the landing of your front foot. You should land heel first, but only by just a fraction ahead of the rest of your foot (avoid an extreme heel-toe one-two step). If you succeed in making your landing soft, you will be providing additional protection for the knee.

It may help to try walking barefoot, on dirt or grass if possible. When doing this, you will instrinctively land more softly to protect your feet, which are no longer over-protected by thick shoes.

A good general principle to keep in mind is to use your muscles and spare your joints.

 

 

 

 

 

 

 

 

In addition to being a healthier way to walk, you may experience that a lighter landing on a bent front leg is more pleasant than crashing to the ground with a rigid front leg.

Walking is one of the techniques where students most benefit from hands-on coaching. In our six-lesson Gokhale Method Foundations course, we introduce elements of walking in the first lesson and build on them with each successive lesson. This gives students a chance to digest, practice and refine their technique with feedback from the teacher.

Walking habits can be deeply ingrained in your muscle memory and even your psyche—after all, it’s part of who you are and has been a lifetime in the making! It often takes a lot of repetition and hands-on cueing to change these habits. Gokhale Method teachers are trained to help you learn good habits by logically breaking down walking into smaller moves and then linking the new moves together. We teach elements of walking in our Free Workshops, our Initial Consutations and, most comprehensively, in our six-lesson Gokhale Method Foundations course.

We hope to see you in person at one of these offerings!

 

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