tight psoas

Dentists and Neck Pain

Dentists and Neck Pain

Esther Gokhale
Date

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. 

Dentist treating a patient, using a surgical telescope.
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.

Oral health practitioners grouped at a Gokhale Method workshop.
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., a specialist dentist.
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.

Dentist treating a patient, sitting upright with a relaxed J-spine.
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

 

How to Fix a Tight Psoas

How to Fix a Tight Psoas

Esther Gokhale
Date

When students first meet with a Gokhale Method® teacher they are sometimes surprised to learn that one of the reasons for their back pain is a tight psoas muscle. What does this little-known muscle, embedded deep within our bodies, have to do with back pain? And what do we need to do to have it recede in the background and leave our backs alone?

Get to know your psoas muscle 

Psoas major (pronounced so-as) is a deep-lying muscle with a downwards trajectory through the abdomen. There can be some individual variation, but it usually originates from T12-L4, and it inserts at the lesser trochanter of the femur. Its main job is to contract and pull the thigh up—as in walking, running, and climbing, for example. 

Anatomy drawing of the psoas muscle located in the body.
The psoas muscle lifts your thigh—or pulls on your lower back, depending on how it’s used.

For those who are not offended by meat analogies, this muscle is the filet mignon, or the tenderloin—it is meant to be lean, juicy, malleable, and stretchy. But in modern industrial populations, the psoas is often somewhat dry, tough, and short. The shortened length and tightness of the muscle can wreak havoc on the spine as it pulls forward on the lumbar spine, causing compression, wear and tear, and pain.

How do I know if I have a tight psoas?

There are various signs and symptoms associated with a tight psoas, including:

  • A pronounced sway in the lumbar area
  • Pain when going from sitting to standing
  • Back pain either caused or eased by walking
  • A sore insertion point on the thigh
  • Feeling stiff and unable to straighten up, or “vulnerable” in the lower back, especially first thing in the morning  

Why did my psoas get tight?

  • Sitting for extended periods without movement breaks is one reason that our psoas adapts to a shorter length because the muscle then spends a long time at the shorter end of the range of what it can do. 
  • The shortening effect of sitting is made more likely when we sit poorly with our pelvis tucked. A modern issue with sitting is that we have poorly designed furniture, such as bucket seats and deep sofas, which encourage us to tuck and slouch. 

Man sitting, tucked, on a fashionable white bucket-style chair.
Most modern furniture is designed for aesthetic appeal rather than to enable us to sit well. Image from: Pexels

  • Back pain patients are often recommended to use a chair with built in lumbar support, or to add a lumbar cushion. The extra curvature then reinforces a habit of swaying the lower back, which in turn enables the psoas to remain short and tight.

Mesh lumbar support in car
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. (Google, n.d.)

  • A tight psoas can also have a psychosomatic cause, as this muscle is deeply linked to both chronic stress and trauma responses in the body. We see this response even in babies in the Moro or startle reflex.

Restoring length in your psoas 

A common remedy for a tight psoas is a lunge or other psoas stretch. Though effective, the problem with this approach is that it is not possible to do enough stretching to make a sustainable difference to the length of this muscle. The stretch feels good, but the muscle quickly goes back to its short resting length. For some people, if they have been stretching aggressively and the attachments of the muscle are inflamed, stretching can cause additional pain and dysfunction.

Another common approach is to get a gifted practitioner to “release” your psoas. This very intense maneuver can also be effective, but has the same problem as the stretching approach—it provides temporary relief, but does not sustainably reset the resting length of the muscle when poor daily posture is shortening it.  

The only sustainable way I know of resetting a tight psoas is to recruit Nature’s solution for keeping this muscle healthy, which is to learn how to walk naturally/skillfully/effectively. 


Our natural gait pattern is evident in our young children, our ancestors, and villagers in non-industrialized parts of the world. It gives the psoas muscle both the engagement and stretch it needs in a gentle and consistent way.
(central painting: Fisher Girl, Winslow Homer, 1894. Museum at Amherst College, Petegorsky/Gipe.) 

Nature’s built-in solution to stretching your psoas

To describe the action of healthy walking, we use the term glidewalking. With this pattern, every step becomes a psoas stretch. Refinements in walking like learning to contract your glutes with every step and leaving your rear heel down for an extended time, augment the psoas stretch. If, however, you don’t know how to maintain a long, stable lumbar spine, these same improvements in gait can be counterproductive and pull your spine into additional sway.

Esther Gokhale demonstrating PostureTracker™showing a healthy back shape in walking
Our PostureTracker™ wearable enables you to monitor and maintain your rib anchor and a healthy, stable spine as you walk (shown in green), naturally stretching your psoas. Here I am on the Alumni Live Chat in December last year, demonstrating.

Esther Gokhale demonstrating PostureTracker™showing a swayed back in walking
PostureTracker™ will tell you (shown in red) if you forget your healthy posture cues! Notice that I have let my back sway severely at the end of my stride.

Advanced Glidewalking Course for Alumni

If you are an alumnus, you are encouraged to join me in our Advanced Glidewalking Course. This course is a comprehensive deep-dive to both revisit the basics of healthy, natural walking, refine its many components, and learn advanced techniques that are not included in our beginner courses. Your psoas will thank you! Six weekly lessons start Wednesday, February 28, 11 a.m. (PST), 8 p.m. (CET). You can sign up here.

Best next action steps for newcomers

If you are new to the Gokhale Method, get started by booking a consultation, online, or in person with one of our teachers to find out how the Gokhale Method can help you.

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

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