knee replacement

Rob Buirgy reached out having sustained a multiple fragment compression fracture of his T12 vertebra (in the middle of the back). Despite being in a body brace afterwards, having already followed the Gokhale Method for a couple of years, Rob’s instinct told him that our method would be able to help him regain an active life. More recently, he has also fully recovered from a whole knee replacement. In this blog post he explains how healthy posture set him up for success… 
—Esther Gokhale

Meet Rob, whose passions include hiking and rafting.

Healing my back

In December 2023, during a vacation excursion to a Mexican cenote (deep water well) in the Riviera Maya region, I’d had a bad jump from a 12m high platform; thankfully, we were required to wear life jackets for this activity! I had serious pain and muscle spasms immediately when I sustained the fracture. With the life jacket, I was able to float for about 30 minutes while I figured out what to do. Later I went to a local clinic. With no x-ray, and because my function was good, the doctor had me bend to touch my toes (so dangerous!), and determined that I had only strained my back. I later realized this was far from the correct diagnosis. Once I was back home, I was diagnosed with a serious “burst” fracture at T12, and prescribed a TLSO brace for three months. I could easily have had a bone fragment cut into my spinal cord—I got lucky!

If there are any insights here for anyone who might have sustained a spinal fracture but not know for sure, I would say, get checked out immediately. I only even suspected it might be a compression fracture due to previous experience with this type of injury at L1 from a rock climbing accident back in 1977. 

I am so grateful that I was already familiar with the Gokhale Method®. I had followed the method for about two years and decided to get in touch with Esther for a personal consultation to find out what adaptations I could do during my rehab. I discovered there was a lot I could do to preserve and improve my posture and movement, even though I wouldn’t be moving my spine for a few months.

I had already read 8 Steps to a Pain-Free Back, and after my consultation I was able to come back to it with much more confidence that I could make a full recovery.

Physical therapy was not an option while I was wearing the brace. However, I could take the online Gokhale Elements course, and so I was able to start and self-direct my recovery, at my pace, much earlier than expected, with approval from my medical professionals. I worked with a new level of detail on rolling my shoulders, keeping my neck tall, and preserving my foot strength while being less active than usual. As time went on, my health professionals said it was safe to engage my inner corset and bend by gently hip-hinging.

Not much movement was possible for three months while the shattered vertebra healed. The brace had to immobilize my spine.

Just eight months after my fracture I had a prearranged wilderness raft trip with a big group of friends and family. We were running Gates of Lodore on the Green River through Colorado and Utah. This trip had been a motivating goal since my recovery started—rowing our 16-foot raft with two passengers would be a real test of my recovery! Given my compromised fitness, we planned for back-up rowers, but the frequently strong winds were overwhelming for them. I didn’t know this beforehand, but it turned out I was ready for the challenge.

Me preparing for rowing on the raft—with “Sister,” my extra crew member!

I managed well by focusing on hip-hinging to set up my forward stroke, knowing how to position my shoulders, neck, and head, plus keep my spine long and straight. I didn’t have the same trunk strength I had before, but I could maintain a healthy alignment to both keep my spine safe and generate the power needed. I rowed up to six hours a day for four days. Yes, I was tired and a bit achy at night, but nothing that threatened my recovery. I will continue to row this way—the biomechanics of it are much better than how I used to row; I used to allow my back and shoulders to round, and then sway as I pulled back.

Knee rehabilitation

I’m currently recovering from a total left knee replacement after many decades of soccer and coaching took their toll. I finally undertook the knee surgery I had been resisting because I thought that my healthier biomechanics would allow me to gain full advantage from my new knee. Before the operation, I prepared by focusing on movement patterns and conditioning joint-supporting muscles. During that time, even though my knee was compromised, I focused on glidewalking to best coordinate my gait, learning how to use my glutes properly, how to use my feet well, and also what to look for in a hiking shoe.

My new knee joint posing for the x-ray!

Post-operatively, my experience with the Gokhale Method shines through. At this point I have met or exceeded all my recovery milestones. Getting the quadriceps muscle to work correctly, and extending the leg fully behind, are often problematic with this type of joint replacement. Three weeks in, my physical therapist determined that I did not need specific therapy to recover my gait. By applying the Gokhale Method principles, my healthy gait came back incredibly fast, and I moved on to compatible strength and balance exercises sooner than expected. As an added benefit, my upright, relaxed, and well-balanced overall posture also improves my proprioception (sense of where I am in space). This has enabled me to better adapt to my new joint and leg alignment as I tackle varying terrain and other situations. 

When I was first learning glidewalking, I would keep my hands resting on the top of my glutes to check if they were working—that was the only way I could feel them activating! My daughter is a dance instructor, and although I’m not into dance as such, experimenting with the modified Samba step that Esther teaches helped me to find that little bit of lateral hip action that I had been missing with each stride.

If I had focused only on the linear movement, I never would have found that natural glute and hip action. I have been a long-distance hiker all my adult life, and I was shocked to realize that I had been throwing my legs out to move forward, but I wasn’t taking advantage of the glute propulsion from behind and all its benefits.

Finding appropriate activation and relaxation in the glutes and hips is part of developing a smoother  walk.

I’m so glad to be a Gokhale Method student, because all is going well and I’m on track resuming the active life that I love. Three years ago I was often focused on my knee hurting, my back hurting, and I had little optimism about future activities. Today, I’m planning my next outing!

Reflections on healing and recovery

My doctors and therapists have said I should expect to have chronic back pain—but so far, it’s getting more comfortable, not worse, as I get stronger and more active. I’ve had great success with combining healthy posture with physical exercises, and using pain medication only when necessary. When we’re recovering from injury or surgery, there is often medication in the mix, and I think we can end up going for the pain meds when it’s actually something other than physical pain we are trying to address, such as frustration or despondency. 

With healthier posture that’s more open, relaxed, and strong, my affect has changed, and my entire outlook on life has improved—overall it’s very uplifting. I think “uplifting” is a great word to describe my experience, both in body and mind. After everything I’ve gone through, if I am having a struggle on a particular day, I know that a body scan and simple adjustments will immediately improve my outlook. Now, I can’t help but notice people’s posture and how they move—there are so many people who would benefit from this method. Hopefully, sharing my story will encourage others to come on board.

Special Spring Into Action free online workshops for newcomers

We encourage newcomers to enjoy Esther’s special, free, Put a Spring in Your Step: Glidewalk your Way to Healthy, Pain-Free Movement Gokhale Method beginner workshop, on Saturday, April 26, 11:00 a.m.–12:00 p.m. (PST). Esther will be teaching glidewalking techniques you can start practicing straight away. The workshop will launch a special, free 5-Day Glidewalking challenge to which all participants will automatically be enrolled, to help you develop your walking power! Find out more, and sign up here.

Best next action steps 

If you would like help to enjoy an active life by learning healthy 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…

In 2014, at age sixty-four, I began to experience pain in my left hip that eventually became quite debilitating. For the first time in my life, I went to a chiropractor, which resulted in relief that lasted a couple of years. By 2015 I had consulted first one, then a second orthopedic surgeon, who recommended a hip replacement due to osteoarthritis. 

The first clinic I went to, I felt like I was visiting a bone and joint factory…I decided to wait. The second place, they were reading another patient’s notes! That doesn’t give you a lot of confidence!! Not feeling completely comfortable with either of the surgeons, I began doing my own research. 

I longed to get back to hiking and walking pain-free.

I’m not one of those people who jump into things, especially surgery. So I went to a clinic where they did a lot of rehabilitative physical therapy and I asked one of the PT’s: of the people you work with who have success with their surgery, which surgeons do they use? And that’s how I found my hip surgeon. After a successful surgery in January 2016, as well as physical therapy sessions with the excellent physical therapist who recommended the surgeon to me, I recovered quickly and was thrilled to resume walking without pain.  

During the summer of 2018, while out shopping, I experienced both of my knees feeling as if they were on fire. My knees continued to bother me, but, afraid an orthopedic surgeon would tell me I needed surgery, I consulted a sports medicine doctor. He performed X-rays and confirmed that I had osteoarthritis in both knees. He suggested physical therapy and braces, as well as steroid shots (which I declined). Physical therapy helped to provide some relief as the muscles around my knees strengthened.

The following year, I read an article by Christiane Northrup, M.D., in which she shared information about the Gokhale Method®. I researched the method and learned that a one-day Pop Up course, one of the in-person ways to learn the Gokhale Method, would soon be offered in a nearby town, Boulder, Colorado. After the course, I did my best to focus on glidewalking, which did reduce the bone-on-bone knee pain.               

    
Everyday activities, such as bending, are taught in Gokhale Method group courses. Bending can be done in ways that align the bones well, use muscles appropriately, and spare the joints. Learning to hip-hinge benefits the knees, hips, shoulders and neck, and more besides.

I made it until June 2021, when I had successful bilateral knee replacements with the same surgeon.  I opted to do them both at the same time to get it over with, but recovery was challenging. After weeks of physical therapy, I was told to just do normal everyday activities. However, I did not feel I was making the progress I wanted.

My husband took these photos of my knee replacement X-rays at my 6-week post-operative follow-up appointment. Our joints are precious things to take care of!

Because COVID was still raging, I joined the new Gokhale daily online program. This enabled me to extend my recovery in a more enjoyable and focused way, and my knees became ever stronger. Even now, if I am unable to participate in the day’s live session, just receiving the email about the topic of the day is a great reminder and encourages me to focus on practice. And I regularly watch the replays if I miss a session.

Gokhale Exercise members receive a daily email outlining the day’s program, complete with an inspirational posture reminder image. This was May 7, 2024.

In February 2023 I began experiencing pain in my hands and my left shoulder. I was diagnosed with Carpal Tunnel Syndrome (CTS) and given exercises and braces for my wrists/hands to wear at night. While the shoulder responded and had some improvement, my hands were still an issue.

At a follow-up appointment six weeks later, it was suggested I could have “a little surgery” on both hands to fix the issue. I looked up information about CTS and the surgery, and learned the pros and cons of having that done. I lived with the pain off and on until this year, when in early 2024 a diagnostic nerve test was performed by a neurologist to check the severity and cause of my particular CTS. Even though C7 (the seventh neck vertebra where nerves to the back of the arm, wrist, hand, and middle finger exit the spinal cord) was mentioned to me during the nerve assessment, the hand specialist who ordered the test did not mention it at a follow-up visit. He suggested surgery on both hands. A day after this appointment, I called the doctor’s office to find out more about possible C7 involvement and to ask if that might be the cause of my CTS. If so, how would surgery to snip the ligaments in my hands fix the problem? Since I never received a response, I did not schedule surgery.  

Pain-free wrists and a mobile neck are important to enjoy my hobbies. Here I am on a painting course that my daughter and I took together.

An X-ray of my cervical spine in March did indicate osteoarthritis in my neck, which in our society would be regarded as “normal” for my age. I discussed this finding with my chiropractor, who uses the Gonstead Technique. She felt confident that regular, gentle adjustments of affected areas, found by palpation and the use of a heat sensor that indicates inflammation, could be successful in eliminating the CTS symptoms. She checked my grip strength and adjusted my hands and wrists. Because I had difficulty using my hands for so long due to pain and numbness, they had become stiff and weak. I was also given suggestions about what I might do to help with my neck after my appointment. This made me once again think about what more I could do to contribute to my own healing.

My neck X-rays showed several areas of degeneration and misalignment that would potentially cause radicular pain. 

It had been almost five years since I first attended the one-day Pop Up course. I would say that up until recently, I had been somewhat “dabbling” in the Gokhale Method, without a full understanding or commitment to change my posture. Although chiropractic treatments helped to relieve my symptoms, I recognized that a healthy baseline posture was lacking, resulting in repeated misalignments. Understanding that an issue with my cervical spine might actually be the cause of my CTS, I finally came to the realization that I had been overly relying on others to fix me, and that I also needed to do everything I could to help myself. Just the thought of yet another surgery became extremely motivating!

That’s when I decided to circle back to the Gokhale Method. During an Online Follow-up with Esther in January this year, I explained that I wanted more confidence about what I should be doing for my posture and wanted coaching. Shortly after, I began the one-on-one online Elements course with Esther, which ended in April. In the early sessions, it was difficult for me to even get into positions that required me to use my hands and shoulders. By about halfway through the course, my pain from CTS had subsided, as well as the stiffness and pain in my shoulders which had not been in the healthy place they should be. I used to change up my mattresses and pillows a lot, but now I realize it’s not all about these external things—good mattresses and pillows can help, but how you position your body makes a big difference. 

On a regular basis, non-genetic scolioses/asymmetries tend to diminish with standard Gokhale Method training—that is, without any special focus. In my case, it reduced the strain on my neck. This surprised and delighted me.

Now for the really great news! I have not experienced CTS at all since completing the Elements course. While I practice healthy posture with my whole body, as everything interrelates, my main focus has been on my neck, head, and shoulder placement. Chiropractic appointments have gone from bi-weekly, to weekly, and now, only occasionally. For weeks now, C7 has not needed an adjustment and it makes my heart so happy when my chiro tells me the instrument that measures heat and inflammation in that area is clear! She has seen how my improved posture is making a difference and has been extremely supportive of the Gokhale Method.  

My exercise and walking had greatly diminished over the years after the onset of osteoarthritis, pain, and then surgeries. My upper body has been my main concern recently, but other techniques, such as glidewalking, have greatly improved my mobility and stamina. I would like to take the Advanced Glidewalking course in the future. I am working my way back to a healthy weight and an active life—thanks to the Gokhale Method.    

In this video I share how glidewalking has enabled me to travel and walk longer distances in comfort.

Best next action steps 

If you would like to improve your joint health, 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…