bursitis

Next time you are in the dentist chair, spare a thought for your dentist’s posture and the postural demands of their job. Doing dental procedures shares many challenges with other surgical procedures, such as having to maintain a steady position for long periods, maintain a clear line of vision, and hold and manipulate tools with precision. Working in the oral cavity of a conscious patient is a pretty significant challenge. 

Dental professionals place many physical demands on their structure. They can be regarded as “occupational athletes.” Image from Pexels

Dental personnel and health

Unfortunately, these demands take a toll. Of adults in the U.S. general population, 13.8% experience significant neck pain; among dentists, that figure is a staggering 67%. Dentists and other oral health practitioners (OHPs), including dental nurses and hygienists, also report suffering from above average incidences of lower back pain, headaches, shoulder problems, and work-related tendonitis, bursitis, and carpal tunnel syndrome. Such problems can make life miserable, both in and out of the dental office. Some OHPs are forced to abandon a career they have spent up to eight years training for. Of dentists taking ill health retirement, 55% cited musculoskeletal disorders as the cause.

The Gokhale Method for Dentists and Oral Health Practitioners

Since 2008, well over 100 dental workers have sought out the Gokhale Method® to help them solve their posture puzzle and get out of pain. They are both welcome and in need of what our courses (in-person Foundations, one-day Pop-up, and online Elements) offer. Given their particular professional needs, we are now working with some of our dentist and hygienist alumni to develop a special Gokhale Method offering for oral health practitioners. 

This will be a tailored training delivered at dental offices, clinics, and teaching hospitals. The goal is  that oral health practitioners learn the posture tools they need to future-proof their careers.

An introductory workshop for oral health practitioners with Gokhale Method teacher Julie Johnson was recently received with great enthusiasm at a dental practice near Stuttgart, Germany. 

Dental practice team members, Bridget, Amy, and Julie, practice seated hip-hinging with teacher Julie Johnson. The Gokhale PostureTracker™ wearable gives biofeedback—and they’re having fun!

From a dentist’s perspective

One of Julie’s recent Gokhale Foundations students is Warren Blair, an American dentist living and working in Germany who, though counting himself fortunate to have had relatively few serious musculoskeletal aches and pains over his four decades of practice, understands the value of the Gokhale Method. 

Warren Blair, D.D.S., M.S.D., is a specialist in periodontology, implantology, microsurgery, and endodontics—and a student of posture!

Warren shared many things about the ergonomics of dentistry with us, both from the dentist’s and patient’s perspective:

The physical aspect is a problem—all dentists have problems. Some are in their mid-thirties and they're walking around crooked because they have a charley horse (muscle spasm). I periodically stretch the muscles around my back and shoulders, or pull away from my microscope eyepieces to reset. Doing the Gokhale Foundations I have learned that posture is key to the solution; having healthy posture early on in the profession will prevent future problems, but if problems with your musculoskeletal system do crop up then you can do something about it by changing your habits and adopting the principles of healthy posture.

Warren confirmed that dentists are taught not to round over their patients, and to work with their knees wide, but admitted that these positions are not always easy to maintain on the job. Learning and preserving healthy postural habits is especially difficult given that many dental workers, like most people in our culture, will, unfortunately, be approaching their training from a poor posture baseline. 

Healthy posture is an ecosystem

The basic instruction that trainees receive is not nearly as nuanced or integrated as the movement patterns taught in the Gokhale Method. In typical modern western fashion, we are all given stand-alone instructions, e.g., “don’t round when you bend.” The hip-hinging bend taught as part of the Gokhale Method is part of a whole movement pattern, involving nestling an anteverted pelvis, getting the femurs out of the way of the pelvis, anchoring the rib cage, engaging the inner corset, keeping the shoulders posterior, and maintaining a healthy neck position. Altogether, these elements give dentists the resilience needed for sustained bending, even with some variety of twist.

This practitioner is maintaining her J-spine, with her behind behind and her back tall and relaxed. This is a healthy baseline for sitting and forward bending. Image from Pexels

Posture instructions given in isolation don't translate very effectively into practice. However, as part of a holistic education that pays attention to the way we do everyday life activities, posture training becomes transformative. For example, walking well, both in and out of the office, is a natural reset for a tight psoas muscle. Learning to stacksit allows your breath to mobilize your back. Sleeping positions, done well, can enable you to heal damage and inflammation. 

Learning the Gokhale Method at work means you immediately put posture into practice in your profession, and sets up many opportunities for colleagues to support one another. If you are a dental or medical professional and would like to know more about how the Gokhale Method can help you and your team, please email: [email protected].

If you would like to support your dentist, send them this invitation to one of our free online workshops. 

Best next action steps 

If you would like to improve your posture, for work or leisure, 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…

My name is Sheila Bond, and I am the mother of four sweet kids, an artist, a knit and jewelry designer, and a private art teacher. In this blog post I would like to share with you my Gokhale Method® journey out of pain and despair.

Photo of me after my second disc herniation in seven years.

On May 6, 2022, I severely herniated the spinal disc between my L4/L5 vertebrae. In addition I had developed bursitis in my left hip during the previous three months, I believe from sitting improperly teaching online classes.

It happened on the Friday before Mother’s Day. By Saturday morning I could barely move and thought I might die or at the very least never recover. I ordered a TENS unit (transcutaneous electrical nerve stimulation, a mild electrical current to give pain relief) from Walgreens, and bought Salonpas patches and a walking cane. I took three Advil and two extra strength Tylenol alternating every six hours. 

I had previously herniated my L4/L5 in 2015, and had a laminectomy (a surgical operation to remove part of the back of vertebrae, usually to relieve pressure on nerves.) That surgery had left me in terrible pain. When I told the surgeon I was still in pain in my tailbone/sacrum area, he told me he could remove my tailbone. I declined. Following surgery, I also went to physical therapy for a year and a half, but it gave me more pain than it took away.

   
My MRI from January 2015, showing my first L4/L5 herniation (red arrow).  

My MRI from May 2022, showing my second L4/L5 herniation. I was particularly disturbed by the amount of tissue damage in the area after my first surgery (circled in blue).

It wasn’t until five years later when I discovered a traditional Chinese acupuncturist that I found any real relief in that area. During that timespan I was also diagnosed with EDS (Ehlers-Danlos Syndrome, a connective tissue disorder), and discovered that I consequently had a hypermobile sacrum that was prone to dislocation.

Returning to May 2022, I was in denial that it could be my spine and insisted it must be my hip causing the electrifying pain that ran all the way from my hip to my foot. I thought maybe it was something wrong with the joint. I just really didn’t want it to be my spine again. On Monday, May 9, I finally agreed to go to the ER after hearing that my GP could not squeeze me in.

The electrifying pain ran all the way from my hip to my foot.

At the ER they gave me an IV, Valium and Fentanyl. It barely touched the pain, and only for an hour, and then they’d give me more. They did an MRI of my back and an X-ray of my hip. After about four hours they sent me home with the diagnosis of a severely herniated disc and bursitis in my hip. They gave me 10 Vicodin pain pills, 30 muscle relaxants, and a package of steroids and told me to see an orthopedic surgeon or a neurosurgeon. 

The ER room looked bleak, just like my state of mind.

The pain continued. I couldn’t dress myself. I could barely move or function at all. I called the orthopedic surgeon the next day who said my hip didn’t need an operation since the problem was bursitis, and that I should see a spinal surgeon or a neurosurgeon. I did not as I was so scared by my last experience. (I didn’t take the steroids either.) Instead, on May 12, I headed three hours away with my youngest kid in tow to see an acupuncturist who specialized in chronic pain and spinal injuries.

There was severe weather on my agonizing 3 hour drive to seek help. But I was desperate—and determined.

The acupuncturist recommended daily treatment so I checked into a hotel. She told me all my L1-L5 discs were not doing well. After five days of treatment, I experienced some pain relief, but sadly I tripped on my cane and fell into a wall, reversing any healing done. The pain then became so bad that I felt as though I was being constantly electrocuted. I couldn’t sleep. I drew and painted from my bed trying to explain what I was feeling. 

I tried to communicate my experience visually.

I am the main breadwinner for my family and I really could not miss work. I tried to teach my private Zoom art classes, but standing and sitting were both unbearable. I forced myself to teach some of them and rescheduled others. My birthday was on the 22nd and I felt like I was on my deathbed. I am used to being the one to care for others, so this was a terrible place for me to be.

I felt so bad for all my kids. I took the youngest one, who was with me, to the zoo, but had to use an electric wheelchair. I took the prescribed Vicodin and muscle relaxants to make it through, but still had to keep changing positions, fighting the pain. Some of the time I couldn’t even hold the steering wheel to make the wheelchair go, and then my kid would offer to steer for me. We didn’t stay long.

This video shows a GIF I made from two drawings to express the pain I experienced.

My sweet sister Aileen who lived states away was worried about me. She had recovered from back pain having worked with Esther Gokhale in California, and told me Esther could help me and sent me the Gokhale Method website. From my hotel bed she and my father helped me to sign up for the 18-session online Elements course. 

Before meeting Esther Gokhale I tried. . . 

Ice
Advil
Norco
Tylenol
Tens unit
Massager
Hydration 
Electrolytes 
Arnica salve
Heating pads 
Cyclobenzaprine
Lowering my chair 
Gentle safe stretches  
B and C vitamins, zinc 
Short walks every day 
Heat wrap around calf
Gentle and slow motion 
Hot baths with Epsom salts
Trying to correct my posture myself
Hand massage of my leg muscles, daily
Inversion table—horrible, won’t do it again
Acupuncture—two weeks of daily treatment 
Herbal tea from my acupuncturist and herbalist 

I met Esther on May 24 from my hotel room over Zoom. Esther was kind and gentle, and confident that she could help me. I couldn’t sit so Esther guided me to a position lying on the floor with my feet in a chair—that relieved enough of the pain so we could talk. We set up the sessions to begin on May 31. It was so hard to take the before-course posture photos.

From the very first Elements lesson I found some relief. It was small gains at first, but I could tell the difference. I was in so much pain even the littlest movements were hard. The tiniest shifts helped a lot. I hadn’t slept well in so long.

Esther thought pain medication might be helpful to assist me though the sessions. Finally in the middle of June I went to see the neurosurgeon. I carried with me my copy of 8 Steps to a Pain Free Back. I told him I had been having private posture lessons with Esther Gokhale—I had done five at that point. He hadn’t heard of the Gokhale Method, and, as he could see that my herniation was pressing against my spinal nerves, he wanted to do surgery immediately. I told him I wanted to continue to try to heal myself, and that I wanted to try pain medication to support that. He couldn’t believe I had held on so long in my condition, and I think he realized my strength and conviction. He made an appointment for a spinal injection in two weeks’ time (which I never had) and prescribed me the second strongest Percocets available. 

I took the pain medication for only three-to-four days as they made me nauseous, but it was long enough to give me some relief and I was able to do more during our posture sessions. Each session gave me a posture gem that I needed to know. I practiced over Zoom with Esther, and by myself in between our sessions. It was amazing to me that I was learning how to heal myself and avoid pain. 

Today I find myself returning to making joyful and more optimistic drawings like this sketch of a tree, looking skyward.

Things really began to shift for me about a third of the way through the course. When Esther taught me standing, I changed my stance by kidney-bean shaping my feet, externally rotating my legs, and relaxing my pelvis and belly, allowing my behind to be behind me. I’ve had four kids, and had gotten used to holding tension and trying not to let my belly show. I had become scared to move out of my “locked up” position for fear of more pain. After learning how to relax into a healthy standing posture, a huge percentage of the back pain dissipated. 

Around mid-July, halfway through Elements, we started learning to glidewalk. This brought another huge shift, as my searing leg pain finally started to recede. I had admired my sister’s strong, smooth way of walking since she had taken the in-person Foundations Course, and now I too was learning how to keep my back heel down, and to land on a bent front knee. Having struggled even to stand for months, getting walking again took some determination just to move a few yards. 

By August I was able to return to making jewelry like this charoite and copper pendant.

By lesson 14 or 15 I was able to walk without a cane. I realized I still had to focus on anchoring my ribs as well as all the changes with my gait. I still hear Esther saying to me “heel down, ribs down. . . ” Having a teacher prompt you in real time was so helpful.

Some days were better than others, and progress ebbed and flowed. I have learned that I need to treat myself with love and patience. I had become so used to having to push through my pain to look after everybody else—to work, look after my kids, even just to get the dishes done. 

I still keep a 20-minute reminder (app) on my phone, to bring me back to mindfulness about my posture, whatever I’m doing. I realize that the pathway for the disc herniation is still there—but I feel that it isn’t going to happen again because I now have the tools to stay long, strong, and well aligned in my back.

I’m getting back to living again. I’m able to teach my private art classes comfortably and have hope for the future.

At the end of my 18 lessons, I actually danced to the 1-2-3 Move Gokhale Exercise program. I have always loved dance, and it was thrilling to start to do that again, at my own gentle pace. I want to share my story far and wide, so please share this post. Everyone in pain deserves to have realistic hope, and to know that they can heal.

If you would like guidance on any aspect of your posture and spine shape, consider scheduling an Initial Consultation, online or in person, with a Gokhale Method teacher.

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. . .