Shoulders

In my experience, people are often unaware that their posture has greatly contributed to their muscular problems and damage. 

In this blog post I would like to talk about a frequently injured group of muscles that attach the arm to the torso at the shoulder blade—the rotator cuff. The rotator cuff helps rotate the arm and lift it sideways and is also responsible for stabilizing the shoulder joint.

The four muscles of the rotator cuff are supraspinatus, infraspinatus, and teres minor, which lie on the back of the shoulder blade, and subscapularis which lies on the front.

Why we get rotator cuff problems

It’s common for people to be rounded forward in modern times. Many of us habitually adopt a closed, slumped posture with tight muscles across the chest, while the muscles of the upper back and shoulders are often overstretched and lacking in tone. This front-to-back imbalance goes with holding the arms too closely to the body, and too far forward. The muscles of the rotator cuff are mechanically disadvantaged by such postural distortion, and put under undue stress. 

The slumped shoulder posture common in today’s culture leaves the muscles of the rotator cuff prone to injury.

This painting from 1881 shows both women using the rotator cuff while their shoulders maintain a healthy posterior position. Detail from Mending the Nets by Winslow Homer.

Traditional cultures preserve healthy posture for the shoulders. The shoulder and arm of this village carpenter in Burkina Faso align with the back half of his body, not the front. This posterior shoulder position arranges the bones and muscles optimally for rotator cuff health and mechanical advantage.

Of the four muscles in the rotator cuff group, the one that suffers most frequently from poor postural habits is supraspinatus. Supraspinatus is the uppermost rotator cuff muscle. It lies along the top of the shoulder blade and passes through a narrow passage to attach to the humeral head (ball of the shoulder joint). 

Tears can happen through sudden trauma—perhaps due to a fall or a vigorous shoulder movement in sport—or through more gradual wear and tear that leaves the far portion of the muscle like a frayed rug. Depending on the injury, surgical repair may be necessary, followed by physical therapy for up to a year. 

The narrow passage of supraspinatus can lead to wear and tear if the shoulder joint is misaligned due to poor posture.

How the Gokhale Method helps restore rotator cuff health

The good news about your rotator cuff is that it can be improved and often fully healed by adopting natural, healthy posture. 

The local solution is to learn how to do a shoulder roll. This technique will take each shoulder home to its natural position, where it lived when you were a young child. 

The shoulder roll picks up all the bones that make up the shoulder—the upper arm, the collar bone, and the shoulder blade—and allows them to reposition and settle in better alignment with one another. This creates appropriate space for all the soft tissues in the area, including the muscles, bursae, blood vessels, and nerves, so they can function well. 

Shoulder rolls are a more effective and sustainable solution than simply pulling your shoulders back or “sitting up straight.” These common measures tend to create additional problems such as inflamed rhomboids and a swayed lower back.

To practice the Gokhale Method shoulder roll:

1. Relax your shoulder girdle
2. Glide one shoulder forward
3. Rotate your shoulder upward
4. Continue to rotate it back as far as is comfortable. Let it relax down.

Tip: Make sure the movement occurs in your shoulder. Resist the tendency to wave your arms, sway your back, or twist your torso or neck.

This gentle sequence of movement restores a healthy position for your shoulder joint and rotator cuff—one roll at a time.

Students often report that learning the shoulder roll has brought additional benefits such as a more open chest, improved breathing, and improved blood flow to the arms and hands. Over time, performing shoulder rolls counters thoracic kyphosis, or rounding. Its gentle “massaging” action feels pleasant, can relieve knotted muscle tension in the area, and ease neck tension and headaches. You can make a start on your shoulder roll with our free video here.

Happy shoulders are part of healthy posture

Your new healthier shoulder position will always work best in the wider context of your posture as a whole. A change in one place facilitates shifts elsewhere, and vice versa. For example, your shoulder alignment is affected by your head position, your breathing, the angle of your ribcage and pelvis, and even how you stand. The position of your pelvis in particular affects your shoulders and upper body.

The principles and techniques that will help you to remodel your posture are taught in logical sequence and detail in our in-person Foundations course, one-day Pop-up course, and our online Elements course. If you have or are recovering from rotator cuff problems, the Gokhale Exercise program can help you to exercise in a way that is safe, therapeutic, and fun! 

Best next action steps for newcomers

If you would like insight on your posture, consider scheduling 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.

Cycling has been a passionate sport and hobby of mine for decades. I am no longer a professional bike racer; I am now a mother and Gokhale Method® teacher. As a result, I have become more observant of what can “go wrong,” posturally speaking, when riding a bicycle. And I work to improve my posture as I pedal. For example, it takes vigilance to keep my shoulders back and my head aligned with my torso. I now know how cycling can enhance my form, and vice versa. I also enjoy modeling key posture principles to guide my daughters and partner so that they too can be comfortable and healthy on a bicycle.

Cycling is a part of family life

In this blog post I would like to share with you some of the cycling activities and posture tips that have benefitted us as a family. Prior to parenthood, my partner and I raced and trained together for many years, traveling to quite a few states and even abroad to indulge our passion. When our daughters were born, we decided that, at least in our busy city, Somerville, MA (the most densely populated city on the Eastern Seaboard, USA!), we would get about with them on bicycles instead of driving. 

Here I am supporting a customized cruiser with our daughter, Willa, aged two, in a car seat on the back. My partner, Skip, sits on a customized tandem with Coco, aged five. Car seats worked well as carriers and even allowed Willa to nap during our outings. Can you make out the second car seat on the front of my cruiser?   

Of necessity, we hauled our young daughters around on homemade bicycle “carrier-cruisers,” with car seats attached. Both bikes offered comfortable arrangements for young children—and great exercise for us parents! These days, there are so many choices of bicycles made for transporting children, it might feel overwhelming and hard to know where to start. Bike shops are now a terrific resource, happy to offer guidance and expertise, help with fittings and even track down special equipment if needed. With so many options out there, including information on the internet, you won’t have to customize your own bicycle unless you want to. 

Cycling makes a better world for our children

We know it’s better for our environment to cycle than to drive everywhere. Some people choose to live car-free, and that certainly saves money, as well as the planet! We are thankful for the bike lanes that are becoming a more prevalent part of the infrastructure in cities and suburbs alike. As bike lanes make cycling more accessible, you’ll find more people of all ages pedaling instead of driving, which in turn makes it safer for everyone. 

Charity rides or fundraisers are a great way to enjoy family time together while also supporting good causes. These benefit rides are usually closed to traffic, or directed by officials, which makes the ride casual and relaxed. Varied routes are offered, making the event open to a wider range of ability and fitness levels. 

Here we are doing a kids Pan-Mass Challenge, raising money for cancer research and treatment. Coco, aged five, is leading the pack on this 10K ride.

Notice the two photographers’ interest in Skip’s bicycle arrangement, with the little bike attached by bungees to the front so that Willa, aged two and a half, could ride a bit of the course too.

The Graves family has just completed the D2R2 (The Deerfield Dirt Road Randonée) fundraiser ride. They chose the moderate, yet challenging, 48.6-mile route, and will celebrate with a refreshing plunge in the river, and a BBQ for a refuel. Their son is just nine years old—the family that rides together, has fun together! 

Here is Lloyd Graves aged seven, getting ready to bike to school with his dad. Studies¹ have shown that children who walk or ride their bicycle to school are more engaged and ready to learn than those who have been driven to school. Their circulatory system is boosted, and also their executive functioning is activated and neural pathways have been firing, both being used to make decisions before even entering the classroom. 

Now that my daughters are 15 and 12, they’re ready to explore the world on their own to a degree. By cycling they now have the skills and self-confidence to ferry themselves around our city to meet up with friends or attend their extracurricular activities. 

We all need bikes that fit our bodies! 

You can consider bicycles as an extension of the human body, and both adults and children need bikes that fit them, for efficiency, safety, and enjoyment. Most often an ill-fitting bicycle is too small, which forces hunching and rounding of the shoulders and compression of the whole spine—neither of which are helpful for your posture or body mechanics. As kids grow so quickly it is especially important to watch out for this. With the right size, and sometimes even type of bicycle, it is possible to enjoy all the benefits of cycling from being very young until well into old age. 

›
Rachel Holt on tricycle, Dummer, New Hampshire, about 1927. This is a charming portrait. From a cycling perspective, Rachel could do with a bigger bike, so that her thighs can drop down and she no longer has to tuck her pelvis and round her back. She will also be able to pedal a lot more efficiently! Jim Griffin

A bicycle that is too big may have a child too stretched out to reach the handlebars comfortably, and/or bouncing on the saddle in an effort to reach the pedals, which stresses the hips. It can also be a challenge to maneuver, adding unnecessary strain and making it unsafe. 

This tricycle is still a little too big for its rider to reach the pedals and the ground—though she’ll soon grow into it! kenheyman.com

The benefits of balance bikes

We can begin bike riding at an early age, and even new walkers or soon-to-be walkers, can consider using a “balance bike.” They have some advantages over a tricycle. Balance bikes are built without pedals, so the novice rider can focus on balance and steering. (Pedals can also be taken off some bikes, then put back on when the child is ready.) With balance bikes, all the propulsion is with the feet actively pushing the ground away and behind, so there is a natural tendency for the body to adopt a position of biomechanical advantage by sitting with a tipped forward pelvis. This is an example of posture aiding our movement; when the feet go behind our hips, they can better push the ground away from us. This action comes readily since little children aren't fighting a tight psoas, or struggling with stiff joints. This is an action we would like our feet to do in walking, which is to actively engage with pushing on the ground beneath us. It is amazing how fast tiny children can propel themselves using just their feet to paddle along! 

Our daughter Willa, aged 11 months, scooting along on her Strider® balance bike. Notice how she keeps her shoulders back and leans slightly forward. Balance bikes encourage children to propel themselves with natural foot strength.

Another benefit to learning to ride without pedals is that, by definition, a child can easily reach the ground, so a parent is not pushing or guiding from behind or towing the handlebars in an effort to help the child maintain balance. This often sees the parent adopt a very compromised position, hunching over and distorting the back. Best to help the child learn to ride solo; take them to a grassy area or quiet, dead-end street or parking lot where they can let fly!   

This beautiful illustration shows the mother maintaining a straight back as she bends forward to guide her child learning to ride. Most parents do not bend so well, causing cumulative damage to their spinal discs. Esté MacLeod

Modeling healthy posture for your children

One of the best ways a parent can encourage their children to maintain healthy posture on a bike is to model it themselves. For example, once you get used to sitting with the behind behind and the pelvis tipped forward rather than tucked under, it is not only comfortable, but, pretty soon, preferred. We teach a similar style of sitting in the Gokhale Method called stacksitting, for when you don’t have a backrest for support. You can learn how to stacksit here. 

Willa, aged four, sitting forward enough on her “banana” seat to comfortably reach the handlebars and maintain her shoulders back. See how she stacksits beautifully, with her back straight and behind behind.

On a bicycle you may also be sitting leaning forward, which, to do well, requires more inner corset activity and also the ability to hip-hinge, which are both explained in detail in Esther Gokhale’s book, 8 Steps to a Pain-Free Back. 

Here Skip and I are both sitting angled forward. Skip is the leader in navigation, I’m leading in posture! My head, shoulders, and behind are further back, where we would like them to be. We’re enjoying quality time working in tandem! 

Even holding the handlebars in a relaxed way actually begins with relaxed shoulders that stay open and back. Just because you are reaching forward for something, does not mean the shoulders need to round forward. A tip I offer my children is to do a shoulder roll when we come to a stoplight. This allows the shoulders to “reset” if they have come forward a bit, or even a lot! We teach shoulder rolls in the Gokhale Method as a gentle way to open up the chest and allow the shoulders to rest back where they belong. Teaching this early on is good practice for other daily activities; if one can maintain shoulders back in place while using the arms out front on a bicycle, then keeping them back in place in other contexts, like at a computer, will be easier and become habitual. You can learn how to shoulder roll here. 

Willa, aged 12, helmet on and excited for a morning bicycle ride on the Cape Cod Rail Trail. One of the benefits of riding a bicycle at any age is the joyousness that comes from moving your body and exploring the world around you. 

In fact, nearly all the postural principles that we teach in our in-person Foundations course, Pop-up course, or online Elements course, can help your cycling to become more efficient, healthier, and more comfortable. If you would like expert help with your cycling posture, or to find out more about how our courses could help you with any activity, get started with an online or in-person Initial Consultation with any Gokhale Method® teacher. Or sign up for one of our free online workshops below. 

Reference:

¹ “Why Your Kids Should Walk or Bike to School This Year.” Saferoutes Utah. Accessed on July 5, 2022. https://saferoutes.utah.gov/why-your-kids-should-walk-or-bike-to-school-this-year/

If you are fortunate and have photographs going back three, four, or even more generations, you likely possess a compelling tool for posture improvement. How and why exactly are these images so useful?

Abraham Lincoln with his youngest son, Tad, 1864. Wikipedia

The invention of photography allows us to look back in time as far as the 1840s. It is rare to possess family photographs going this far back, both because heirlooms tend to get lost over time, and because fewer photographs were taken then due to the cost of the elaborate processes in those times. But many of us have portraits of our great grandparents’ generation—whose posture is usually much healthier than what we see today. 

Rediscovering ancestral posture can be fun! In our 1-2-3 Move program we regularly have a “Show and Tell” during which participants share old family photographs. The inspiration for change that these pictures bring to their owners, as well as to the online community, is powerful. 

Sue Beltram shares a photograph of her parents who both show healthier posture than her own generation.

Old photographs connect you to forebears who lived their lives in a culture of healthier posture. As I explain in my book, 8 Steps to a Pain-Free Back, industrialization was the first challenge to society’s posture. Healthy kinesthetic traditions that had been passed down for centuries decayed as younger people left their families to migrate to new cities and even new continents for work. Posture went further awry in the 1920s, when a seismic shift in clothing fashions and furniture design actively encouraged a “relaxed” posture that tucked the pelvis, rounded the upper body, and sent the head forward. Slouching made its entrance!

In the 1920s it became fashionable to slouch, as this photograph shows. 

Viewing old family photographs, it’s details such as the shape of a mouth or the curve of a brow that give you a feeling of kinship and likeness. But photographs of your ancestors can also give you a direct strong message about the genetic basis for the healthy posture that could have been yours. You can experience that healthy posture as a characteristic of your “tribe,” rather than an attribute from some distant land. Ideally, you now have a precious resource to inspire you to reclaim your postural birthright. 

Gokhale Method teacher Sheelagh Tobin shares three photos from her grandfather’s life on the daily
1-2-3 Move program.

Posture that keeps your muscles, joints, and bones healthy is part of your genetic heritage. Whatever distortions you suffer from are merely a result of cultural, familial, or individual misunderstandings, and very probably can be restored with the right knowledge, effort, and support. Guiding students through this transformative process is the purpose of all of our courses: our online Elements course, our six-lesson in-person Foundations Course and one-day in-person Pop-Up Course.

The Mendocino County Museum donated several spare antique photographic prints to the Gokhale Method Institute’s collection.
Here I use one to talk about neck posture with participants on the daily 1-2-3 Move exercise program.

Antique portraits often show a strong, well-aligned neck. The neck can easily support and balance the head when it has appropriate support from deep postural muscles such as the longus colli, which lies along both sides of the front of the cervical spine. When these muscles are weak and underused, the head and neck hang forward. This forces tissues at the back of the neck and in the upper back to carry weight they were not designed to; it also compresses the cervical vertebrae, discs, and nerves.

Healthy head carriage allows the head to rest on the axis of the spine while the chin rests down.

Old family photos usually also show particulars about the relaxed carriage of the head on a well-stacked spine. With the head well poised, the face angles downward and the eyes are better oriented to move as needed. 

The Fisk University Jubilee Singers, c. 1870, all have their shoulders well back in a wide, relaxed position. Wikipedia

Another characteristic that is common in old photos and rare today is posterior shoulder placement and an open upper chest. In the group portrait above you can see how everyone’s shoulders are posteriorly positioned with the upper arm often remaining aligned with the back half of the torso. The very best way to start to get your shoulders into this healthy posterior alignment is to do shoulder rolls. This gentle maneuver avoids arching the back or tensing the muscles between your shoulder blades in an effort to get your shoulders back. Enjoy this video that shows you how.

Most of us spend a good deal of time in our cars, commuting, chauffeuring kids around, doing errands, or if we’re lucky, heading out to an adventure spot. Much of this time is spent being physically uncomfortable, especially if the car was manufactured in the last decade. There seems to be a downward spiral of poor posture and design that reflects poor posture - which in turn worsens posture. How can we break this cycle?

The industry standard for human form reflects the average in society: shoulders forward, S-shaped spine, and forward head. Car seats are designed to fit these features.

A checklist for healthy posture when driving includes:

1. Shoulders:  back and down
2. Neck: elongated and stacked over the spine
3. Bottom: well back in the seat
4. Spine: elongated and well-stacked

Modern car seats often make these simple posture practices challenging or impossible. The good news is that it’s relatively easy to fix almost any kind of carseat to make it conducive to good posture. 

1. Shoulder positioning. You may find that the “bolsters” in your carseat get in the way of placing your shoulders back.
   

   The bolsters add considerable horizontal curve to this seat upright, and prevent the arms and shoulders from resting back beside the torso.

   
   The origin of bolsters lies in the racing car industry - bolsters keep racing car drivers in their seats as they whizz around corners at high speeds. For those of us not compelled to turn corners at 100 mph, the bolsters are an annoyance that make it impossible to set the shoulders in a comfortable and healthy place. Solution: Build up the backrest area between the bolsters, so your torso is no longer sunk between the bolsters with your shoulders forced forward. Depending on how much your car’s bolsters protrude, a towel folded over a couple of times may suffice, or you may need a much thicker support. When I travel, I use rental cars. With each rental car, my first action is to profile it: will a single Stretchsit cushion suffice or will it need additional thickness? Technique: After adding some thickness to the mid-portion of the chair upright, move one shoulder at a time a little forward, a little up, and then significantly back and down. Once you have your shoulders back in place, you may discover you need to move your seat closer to the steering wheel to comfortably hold the steering wheel. Be sure to keep a safe distance from the airbag. 
    
2. Neck support. Have you noticed that many car headrests push your head forward uncomfortably? The degree seems to get worse with the years. Headrests now have a new official name, which is “head restraint.” They are shaped to stick far enough out that the head is resting against the headrest and would not have any space in which to whip backward in the event of a collision. 
   
   
   The head restraint, as headrests are now named, reflect, and perpetuate, forward head posture.
   
   The standard that determines the extent to which the head restraint juts forward is the Crash Test Dummy. The Crash Test Dummy was modeled on a person with typical Forward Head Posture, and therein lies the rub.
   
   
   
   The Crash Test Dummy has forward head posture
   
   When I taught a workshop to the designers at Johnson Controls in Ann Arbor, they pointed to my Stretchsit cushion and remarked “the reason your products are popular is that we’re legally obliged to design seats the way we do.” It is sad when designers become constrained by deterioration in people's posture. 
   
   
   Forward head posture is now so common it negatively influences car headrest design.
   
   Solution: Very similar to the solution for bolsters, but the extent of how much you build up the central portion of the backrest now depends on how much the head restraint juts forward. DO NOT turn the headrest around 180 degrees or remove it or sit forward in your seat - in case of an accident, this would put you at risk of severe damage from whiplash. Technique: Determine the best posture you are able to assume in your neck. Now pad the central portion of the backrest so that the headrest works to rest your head against. Elongate your neck in any of the five ways described in 8 Steps to a Pain-Free Back, and “hook” the back of your head against the headrest so your neck is getting a gentle stretch. 
    
3. Setting the bottom back in the seat. This is not a problem in most cars. Some notable exceptions are: 

• very old cars whose seats have worn down so your bottom sinks into a “cave.” 
  
  
  Some carseats wear out in ways that create a "cave" for your bottom to sink into. 
  
  Solution: build up the cave to horizontal or near horizontal. Do not build it up to be a wedge - wedges are helpful for stacksitting, but not for stretchsitting, and in a car you want to stretchsit, not stacksit.  
   
• Bucket seats: Ouch. Solution: It’s very difficult to fix these. I recommend starting from scratch - go to Relax the Back, buy a seat to place in your bucket seat, and modify as needed.
  
  
  Bucket seats are very difficult to modify so they support healthy posture
   

4. Spine support. Does your car seat have lumbar support? This is based on conventional wisdom about an S-shaped spine being normal and healthy.
   
   
   An unhealthy amount of built-in lumbar support in a carseat.
   
   My experience is that it causes extra curvature in the spine, tight back muscles, degenerated discs, and arthritic changes in the vertebrae. Solution: What you really need is a thoracic support that you can stretch your back against. Technique: Use a Stretchsit cushion (if you have a fabric seat, a folded towel can also provide the grip you need) suspended behind your mid-back. Follow the instructions in 8 Steps to a Pain-Free Back to stretchsit and put your lower back into a gentle, comfortable amount of traction. 

So what can you do to set your car up for healthy posture?

• If you're in the market for buying a car, examine the carseat. Some brands are better than average in the design of their seats. The Fiat 500, for example, has a head rest that works with healthy neck posture, and has bolsters that do not extend all the way up shoulder level. 
  
  
  The Fiat 500 is an example of car model that has a relatively well-designed carseat.
   
• The Stretchsit cushion is remarkably effective in mitigating a lot of flaws in carseat design. It can neutralize the effects of exaggerated lumbar support, deep bolsters, and head restraints that jut forward too far. In addition, it facilitates stretchsitting, which is healthful in itself, but also dampens the effect of bumps and jolts in driving, especially on bumpy roads.  
  
  
  The Stretchsit cushion helps transform poor carseats into healthy carseats.
   
• Set yourself up with good posture. No matter how good your carseat is, there is no substitute for knowing what to do in your own body. Stretchsitting, which is one of the easiest Gokhale Method techniques, is well suited to driving. Lengthen your spine against a support at the level of your mid-back, roll your shoulders back, elongate your neck against the head rest, and enjoy the ride!

Our cushion ships with Amazon Prime from Amazon Exclusives.

For our full range of products check out the store.

What kind of car do you drive and how well do the seats work to support you? How have you improved your carseat?