compression

In Spring last year we launched the Gokhale® Wedge. For years, our students have been requesting a convenient, ready-made wedge for upright sitting without a backrest, one that doesn’t require folding blankets and other makeshift (pun intended) measures. The requests also specified an attractive item to enjoy around the home or office, and that it be of durable quality, keeping its shape and good looks with daily use.

Many sitting wedges on the market provide a shallow, even slope that simply does not help you antevert your pelvis—at no place do they offer the steep incline that it takes to tip the pelvis forward “over a cliff,” so to speak. Worse, they are often too soft, allowing the bottom, which after all transmits most of the body’s weight to the wedge, to sink in too deeply, sometimes resulting in a reverse wedge! Some commercial wedges are simply too hard to be comfortable, and at best provide only one choice of angle for tipping the pelvis forward.

As infants we all sat easily with our behinds behind us, and our pelvis anteverted. A wedge helps us to regain this healthy angle. Image from Pexels

To implement the Gokhale Method technique of stacksitting, students require a firm but comfortable wedge with a choice of angles to tip the pelvis just the right amount for their particular body. This is required to be able to sit upright and relaxed, rather than the common back and forth between upright and tense, and relaxed but slumped. Stacksitting enables you to avoid compression on delicate spinal nerves, discs, and tissues, and encourages healthy breathing and organ function.

Your pelvis is the foundation for your spine and upper body. With the pelvis anteverted and a J-spine arising from a healthy L5-S1 angle and well-stacked vertebrae, the upper body can be upright and relaxed (a). Without a wedge, most people sit either relaxed but slumped (b), or upright but tense (c).

Simplicity can take longer

It’s astonishing to me how long it took to pare a design for a Gokhale wedge down to its essential elements. We’ve been working on this for over a decade. We’ve hired professional design consultants, graduate students in Product Design at Stanford, and discussed the matter amongst our teachers. After discarding dozens of designs that included sophisticated mechanisms for adjusting the slope of the wedge, or replicated the front edge of chairs from the period of Louis XIV, we finally came to a wedge that is beyond simple by comparison. 

Our wedge, which only saw the light of day in March last year, is the simplest of all the designs we came up with—it’s a simple piece of foam, with a simple covering, and a simple zipper to close it up. Admittedly, the foam has a special shape—though that is not immediately obvious—and is of a high quality, resilient spec. It has just the right amount of give to be comfortable yet firm. 

Meeting needs and expectations

Above all, our students need a wedge designed to translate healthy posture principles into action. And rather than being a one-size-fits-all, this posture-friendly wedge works even as the user’s J-spine and L5-S1 angle progresses. 

Based on eighteen months of user feedback, we can say that the Gokhale® Wedge is serving people extremely well. It has been a great inclusion with the online Elements course bundles, ensuring students are always best equipped to efficiently learn to stacksit. Our students don’t hesitate to let us know what is working well for them…

…and what can still be improved. We have listened to user suggestions and recently applied a few innovations that we hope will make you like our wedge even more.

New features of the Gokhale Wedge 2.0

The original wedge (left) and its updated version (right) perform the same functions, assisting your pelvis and spine to be optimally positioned in sitting. The new Gokhale® Wedge has some innovations that we think you will like even better.

Sitting on the flat side: Our wedge has both a flat and a convex, rounded side. Using it flat side up, as shown below, it behaves like a teeter totter and gives varied options for the angle of its slope. This enables lighter people, and people with less L5-S1 angle, to tilt the wedge forward only as much as they want, and to sit on it higher or lower down, to find just the right amount of angle for them. It can give a gentle introduction to pelvic anteversion for those with sciatic pain, sacroiliac joint issues, or stiffness at the L5-S1 junction. As I already have a good bit of built in wedge in my third decade of stacksitting, glidewalking, etc.), this way around also suits me just fine. 

Sitting on the flat side of your wedge gives you a wide choice of height and angle.

To make sitting on the flat side smoother and even more comfortable, we have moved the zip of the washable cover from the center of the flat side to the edge of the new wedge.

Sitting on the convex side: We have introduced a new non-slip PU leather on the flat side, giving users a non-slip base on slippery surfaces such as some wooden chairs and benches. As before, one of its rounded edges is slightly lower and less steep than the other, giving you nuanced choices of angle whichever way around you choose to use your wedge.

This wedge is positioned ready for stacksitting, rounded side up. This way around can give the most anteversion by encouraging the pelvis to drop forward. The front edge as it is positioned here is slightly lower and has a gentler curve than the back edge. 

A change of fabric: The wedge is now in the same, slightly darker burgundy fabric that we use for our Gokhale® Head Cushion. It’s not only a nice aesthetic match, but its slightly coarser weave fabric also gives a better grip.

A well-designed wedge helps you to rediscover sitting comfort. It helps create healthy J-spine muscle memory for standing and walking too.

If you want to find out more about using our wedge, you can read our introductory blog post The Gokhale® Wedge for Relaxed, Upright Sitting, and view a video of me using it:

Here I am demonstrating how to sit on the Gokhale Wedge. Several postural principles combine to make stacksitting especially beneficial for our structure.

Your Gokhale® Wedge is backed up with know-how

No matter how well-designed, a wedge for sitting is best supported by training. This is true of all  our products, but perhaps especially so for our wedge, because stacksitting is a big departure from most people’s sitting form. You can learn about stacksitting in our in-person Foundations course, one-day Pop-up course, our online Elements course, plus our Gokhale Exercise program. These offerings, along with our DVD Secrets to Pain-Free Sitting, all teach the skills that enable you to enjoy your wedge optimally in daily life. 

Our students also appreciate being able to integrate using the wedge with our wearable PostureTracker™, which has settings that can track the degree of your L5-S1 angle, and the stack of your spine. Consider the Gokhale® Wedge a part of your toolkit as you improve your posture, and musculoskeletal health. 

Best next action steps for newcomers

If you would like insight on your sitting posture, consider scheduling an Initial Consultation, online, or in person.

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

In January and February this year I took the Gokhale Method Elements course, which consists of 18 brief (13 minute) but potent lessons. I would like to share my experience of the Gokhale Method with you in this blog post.

My goals were to find out how to sit, stand, and walk well, so that I don’t overstress the scoliotic parts of my back. I was also in search of more comfortable and beneficial sleeping positions. I felt I needed guidance to help me develop a better sense of my body posture and alignment. To be able to do a one-on-one course online made this possible for me. 

It was only when I saw the difference between my “Before” and “After” pictures that I realized just how much change it was possible to make to my posture in such a relatively short period. 

Learning to stand well has been transformational for me. You can see that I used to park my hips forward and sway back, pressuring on my lower spine and sending my neck forward—little wonder I was in so much pain. Though still a work in progress, I know how to align my weight better throughout my whole body.

I have always enjoyed exercise, movement, and body work, including hiking, Qigong, and yoga. I now have a healthy standing point from which to do all these activities.

When walking, for the first few steps I might omit to squeeze my glutes and check through the other things I know to do…but it is becoming more habitual so my muscle memory soon kicks in. Or I recall my favorite prompt of Esther’s, “if your glutes snooze, you lose.” 

The J-spine concept was entirely new to me. I had tucked my pelvis under (as you saw in the above “Before” photo) all my life as far as I can recall. Consequently, I believe, the place that hurts for me is around L5-S1 at the very bottom of my spine, so I have to be accurate to squeeze my glutes from a relaxed pelvic position and not to sway and compress my lower back trying to make it happen with the wrong muscles. A single follow-up lesson on this was really useful to help me relax my pelvis back even more.

A healthy L5-S1 angle (J-spine) permits the wedge-space disc there the space that it needs (a.). Learning the Gokhale Method finally enabled me to stop tucking my pelvis and sacrum, and damaging my L5-S1 disc (b.).

Due to my scoliosis I have to be extra careful about how I do things, and with poor bending form, I would always ache—or have a more acute disaster. Now I understand why. I use the hip-hinging technique as I’ve been taught (plus putting my hands on my hips) and I can bend comfortably—it amazes me! I don’t straighten my legs like some of the pictures we see, as I don’t have the hamstring length, but I can follow the principles involved. 

Since learning to hip-hinge I can bend without distorting my back and without pain. There are many principles to learn that contribute to healthy bending, which comes later in the course, but it has been well worth it.

Since 2005 I have been playing the harp, for which being in the right position is important. I pull the harp towards me more now, and when I bend, I bend at the hips, not rounding my back. When sitting with a backrest I have found using the Stretchsit® Cushion makes a good deal of difference to my comfort—I have one in the car, and in fact I’m sitting with one in this interview right now to reduce the pressure on my lower back.

The gentle traction you can get in your lumbar area by using a Stretchsit® Cushion reduces compression and asymmetry in your spine.  

Since a hysterectomy in 1995, I have lost bone density and three inches in height. I am working nightly with stretchlying to lengthen my spine and reduce my scoliosis. I am confident that stretchlying at night and using my inner corset to support my spine during the day will prevent any further height loss and increase in my scoliosis, as I have already seen such improvement in my posture. These two measures may well enable me to regain some of the height in my spine that I have lost.

In October I had an eye surgery, a partial cornea transplant, and to make sure that it stayed in place, for three days following the operation I had to keep my head still and remain on my back. I practiced stretchlying carefully leading up to the operation and found I could lie there all night comfortably; stretchlying is the best!

Come morning I have the option of switching to stretchlying on my side, which I also learned in the course. Again, I found a follow-up lesson on stretchlying on the side helpful as it involves a little more technical precision, especially with anteverting the pelvis, to work its magic.

For me the biggest help for my upper body was learning the shoulder roll…and I feel like my neck automatically gets into the right place after I’ve positioned my shoulders well. It also positions me better in sitting and standing, and helps me do more of the things I care deeply about.

One of those things is artwork, and I am now much more aware of my body while I’m doing it. For example, I’m standing straighter, and if I start to slouch—oops—I can feel it. 

I love the poetry of combining imagery and words in my artwork.

I’m also at the computer writing books, including a biography, children’s books, and poetry. As I spend a good deal of time sitting, it’s important to do it well. 

These are four of the numerous books I've published. I have illustrated the three books shown along the top here. Seven Meditations for Children I have recorded as an audiobook—see how the child is sitting with a nice straight back!

My husband had an eminent career in public health which took us all over the world. Rather than take a lucrative post as an Obstetrics and Gynecology trained MD, he chose instead to work for the poor and underserved of the world, becoming Founder-Director of the Center for Population and Family Health, 1975–86. He was then Dean of the Mailman School of Public Health at Columbia University, 1986–2008, and honored while alive with the naming of the Allan Rosenfield Building and after his passing by the Tribute Wall I fundraised for. The first year of our marriage was spent in Nigeria, and we were in Thailand for six years. I must have seen a lot of examples of elegant posture in the rural areas of those countries, but back then I didn’t recognize how important it was.

Here is a photo of the Tribute Wall to my husband—there we are together, bottom left. My husband served in Korea as an Air Force doctor. You can see people headloading in Nigeria (left hand panel, photo top right).

I have six grandchildren, three boys and three girls, aged 12–23. When I’m with them I try to help them with their posture—they spend so much time hunched over. I guess it’s hard for children to envisage they are statistically likely to have back pain down the line, but at least I can sow the seeds for them to think about posture, and set as healthy an example as I can. I’m so glad that the Gokhale Method is there to help all generations—and especially the young—to rediscover their healthy posture heritage.

I’m known to my grandchildren as “the Nana who raps instead of naps!” Here is a rap I would like to share with you:

IT'S TIME WE VOW TO SPEAK RIGHT NOW
 

It's time we vow to speak right now

our vow to share a peace we dare

to live and keep and not let sleep

In mere intentions while old conventions

Toot horns of war. No more, no more,

We shout out loud, no more to shroud

Our depths of heart. It's time to start,

Yes, twenty-four seven, on Earth bring Heaven,

So one, two, three, it's you and me

To take a dive in what's alive,

Our YES to fate before too late

To emanate our LOVE not wait,

to one and all, the world enthrall

So they will see that all we be

One family! Yes all we be

One FAMILY!

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. . .

Do you suffer from neck tension, muscle knots, or tingling in your fingers? Do you get frequent headaches?

Or maybe your neck is fine most of the time, but seizes up periodically, leaving you unable to function normally in your job, family life, and recreational activities.

A soft cervical collar is a common prescription to alleviate neck pain. It can give welcome support in the short term, but doesn’t help to strengthen your neck or get to the source of the problem. Wikimedia Commons

Most neck pain involves compression. 

In modern cultures, the head often drifts forward as we slouch and crane our necks towards our computer screens. The weight of the head, (typically 11 lb. or 5 kg—think bowling ball), then requires the muscles at the back of the neck to contract strongly to keep the head up. This contraction compresses the relatively delicate tissues in the area. Not a recipe for a healthy, happy neck. If you have forward head carriage but are symptom-free so far, keep reading for tips that will prevent future problems with the discs, nerves, blood vessels, and bones in your neck.

In our culture slumped desk work posture and a degree of forward head carriage is common. Pexels

Restoring the natural length and position of your neck

Young children, ancestral populations, and people living in traditional societies around the world preserve a natural head carriage that stacks the neck well as part of a healthy J-spine. This allows the head to be balanced with only appropriate muscular effort, and the neck to be tall and free from compression. 

As young children we instinctively align our neck well over our body. Pexels

Restoring mobility in your neck

Perhaps you have experienced increased stiffness and reduced mobility in your neck over the years? Or unpleasant gritty sounds when you turn your head? Beware of exercises that include extreme flexion, extension, or head circles. These movements, taken to the end of your range of motion, can damage your discs and pinch your cervical nerves. If they are a part of your exercise regimen, consider reducing their range. 

There are many delicate and vital structures within the neck, so we first want to align it well. (front view). Wikipedia

In our experience it is best to focus on restoring the neck to a healthy baseline length and shape that centers your head well on your spine. The video below shows you how to proceed:

This gentle movement will help you to find a safe, natural trajectory to get started on gliding your head up and back.

If you have areas of long-standing rigidity or curvature in your neck, it is likely linked to your postural distortions elsewhere in your body, for example thoracic rigidity or a tucked pelvis. 

Expect this to take more time and training to change, for which you will be rewarded with additional benefits including comfort, improved circulation, and increased energy.

Finding your neck strength 

While many of the neck’s structures are delicate, they can also be strong. The deep muscles that are intended to support the neck and keep it tall tend not to get used very much in modern industrial culture and are often weak. Besides doing strengthening exercises, as is common in conventional approaches to neck problems, learning to carry weight on the head is extremely valuable. 

People in traditional societies preserve a taller, straighter neck, and more functional head posture. (Odisha, India)

Cultures that headload suffer much less neck pain than we do and can teach us much about how, where, and why to headload. Not only do these people have excellent neck health, but they also have excellent posture throughout their bodies, and move with elegance and efficiency. Students in our classes begin with light weights to sense the axis along which they need to stack their bones. Over time, the weight can be increased to further strengthen the longus colli, inner corset, and other muscles. 

The small extra weight of the Gokhale™Head Cushion enables students not only to strengthen the deep neck muscles and lengthen the neck, but also to better orient their entire skeleton. 

My book 8 Steps to a Pain-Free Back has many images of people throughout the world headloading. Healthy head carriage, as opposed to forward head carriage, is an important starting point for this activity. It is not possible to carry significant weight without both the healthy neck alignment and strength to avoid compressive forces.

A well-aligned head and neck is both highly functional—and elegant. 

Because about one in three adults are affected by neck pain every year¹, we introduce techniques for the neck early on in our in-person Foundations course (Lesson 1 of 6), in our one-day Pop-up course, and our online Elements course (Lesson 4 of 18). Here students learn in detail the gentle techniques that gradually return the neck towards the length and pain-free position we all enjoyed as infants. Whatever your age, your neck is something you can learn to once again stack in your favor.

References: 

1. Institute for Quality and Efficiency in Health Care (IQWiG), “Neck Pain: Overview,” InformedHealth.org, last modified February 14, 2019, https://www.ncbi.nlm.nih.gov/books/NBK338120/.

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. . .

Before I settle in to recount my back pain story, let me fetch my Gokhale Pain-Free™Chair. This is the chair I now use for all my writing, and that’s important, as I am an author of mystery short stories, and spend many hours composing at my desk. Pain-free, I’m now glad to say.

Since retiring from over four decades as a trial lawyer, I write about The Sleuthing Silvers, Barb and Bernie. This image is from my website, sporting my detective shades. www.thesleuthingsilvers.com

I’ve had back problems for many years and coped with it by going to any number of orthopedists, chiropractors, physical therapists, and neurologists. In my experience, doctors (general physicians) can’t do much for ordinary mechanical back pain, other than advise on painkillers.

That management worked for some 25 years, and then I started having chronic pain that wouldn’t respond to my usual formula and go away. I was becoming somewhat desperate as it affected my whole life. I was grumpy enough by nature before the pain started, but became much more grumpy after! 

My rheumatologist, who I’d seen many times, said, “Well, you might want to read this book.” I had never read a self-help book for my health—I just generally don’t believe in them—but I was so desperate that I went ahead and bought Esther’s book, 8 Steps to a Pain-Free Back. 

I actually liked the subtitle, “Remember When It Didn’t Hurt.”  You do remember how when you were younger, even if you had back pain, it would be a little bit better each day. You could count on it being better tomorrow, and then soon you would be fine. That certainly wasn’t happening.

Esther’s Book was the only self-help book I ever bought—reluctantly.

I was cynical going into this work, and admit I had a very negative attitude. I had already made some of the arguments against working with my posture that were anticipated in the book—you’re too old for this, it’s too far gone…Yet I have come around to endorsing all the amazing testimonials I read in the book. Because I live in the same location as Esther, I actually know many of the doctors and patients quoted in the book who experienced transformational results with the Gokhale Method.

So I read the introduction. That’s what really did it for me—it’s so persuasive, and it’s so simple—it’s something you then want to do. So I started to antevert my pelvis. After months of pain, I woke up the next day and felt noticeably better. I thought, well, this must be a mistake. The following day I was substantially better, and the next day after that I was pain-free and have been ever since. 

I was just blown away by this, and so read the whole book that explains the Gokhale Method. Esther focuses on her subject like a laser beam. I got the impression she knows the spine as well as anyone on earth. I wanted to meet Esther Gokhale, and as we both live in Palo Alto, I was able to do that and take the six Gokhale Method Foundation's Course lessons. 

The in-person  Gokhale Method Foundations' Course originated in Palo Alto and is now taught by teachers in many parts of the globe. Our online Elements course makes the Gokhale Method accessible to students the world over. www.maps.google.com

When we met, even Esther was surprised by my body’s rapid positive response to the Gokhale Method. She explained to me that I had actually been lucky to have gotten positive results having immediately anteverted my pelvis. Attempting to antevert the pelvis to start with is not recommended as most people have some stiffness at the L5-S1 joint and are therefore likely to sway higher in their lumbar spine as they try to get their behinds behind them, creating even more compression in that area. Alternative techniques, designed to first bring healthy length into the lower spine, are advised as an initial phase. It seems I was lucky—one of a small percentage of people with sufficient protective stiffness in my lumbar area to avoid any sway and additional damage.

(a.)                                           (b.)

Most people will inadvertently sway their backs when trying to stand or sit upright with their behinds behind them (a.). This tightens lower back muscles and compresses the lumbar vertebrae and discs. To avoid this, the Gokhale Method first teaches techniques to elongate and stabilize the spine (b.). 

Anteverting my pelvis made a huge difference to me. I had been doing all the wrong things to my spine, such as sleeping in a fetal position, but soon I learned how to sleep, sit, stand, and walk without compressing my spine. In fact, I could now decompress my problematic area around L5-S1. I came to understand how much of our modern furniture puts us into compressive shapes that tuck the pelvis under, pinching the L5-S1 disc and causing it to bulge back toward the nerves. 

An anteverted pelvis preserves the wedge-shaped L5-S1 disc (a.). A tucked pelvis cannot accommodate this and the lower discs will suffer undue pressure and bulge toward the nerve roots (b.).

When I first showed up for the lessons, I explained that I thought the introductory chapters said it all, and that the rest of it was somewhat repetitive. But I was wrong. Every chapter will give you a little something that may look inconsequential, but the magic is in the detail! And even though I was doing very well with the book, the precision adjustments and personal coaching I got from having the lessons made a huge difference.

These things were so simple, made such sense, and worked. Even while I was so thrilled to have found this work, I also felt very angry that nobody else had been able to tell me these things. I have seen umpteen specialists over the years, and no one ever mentioned the Gokhale Method. The upcoming Randomized Control Trial that has apparently been funded entirely by satisfied students will hopefully put the Gokhale Method on their radar. I would like to see the Gokhale Method become a prominent part of every doctor’s prescription for back pain.

It makes sense that changing your posture can make a huge difference to structures as sensitive as your spinal nerves. Just a millimeter either way can determine whether you get agony, or relief from back pain. I also appreciate the wider health benefits of making these posture shifts. I’ve noticed that my organs work better, and my breathing is better. 

I now realize it’s not sitting that’s the problem. The issue is the furniture you choose and how you sit. The Gokhale Pain-Free Chair helps me to stretchsit, decompressing my lower spine.

My understanding of the relationship between breathing and the inner corset is much clearer from having had the lessons. Reading the book did not make it clear to me how muscle tone in the abdominal wall would act to resist any ballooning outward when breathing, and translate into healthy movement in my back with every breath. What Esther calls our “inner massage therapist.” Lessons enabled me to get that. 

I used to get tired and sore standing in line for just a few minutes. More recently, after about 10 minutes in that situation I thought, “Hey, something’s different, I should be tired by now,” and I realized that standing with my weight in my heels, my body aligned as I learned from the Gokhale Method, I felt fine! Cumulatively these details really work. 

Enjoying pain-free time with my granddaughter and her American Girl Tea Party puzzle.

When I first read the chapter on glidewalking, I thought I needed a PhD in mechanical engineering to understand it! But in the lessons, you get it bit by bit, and the teacher gives exactly what the student is ready for. When I was younger, before I had had so much back pain, I loved to walk—I would walk 40 minutes every day. Then I had a hip replacement in 2018, and since then I have had problems. Esther showed me how my left gluteus medius was weak, and had likely caused my piriformis (a deeper external hip rotator) to overwork and cause other problems. 

I’ve been keen to improve my walking. Here I am hiking in the Tahoe National Forest, California.

This is a quote I can relate to: “Nature has placed mankind under the governance of two sovereign masters, pain and pleasure. It is for them alone to point out what we ought to do, as well as to determine what we shall do.” Anglo-American philosopher of law and social reformer Jeremy Bentham, 1748–1832. Portrait by Henry William Pickersgill (d. 1875). Wikipedia

I’m in the early days of my journey and I’ve only finished the course recently. I’m tempted to declare myself “cured” and move on—I can bike ride, swim, and ski without any pain. I’m hopeful that I’ve mastered and internalized what I need to know and keep doing to get on with my life. But I will stay in communication—I can set up an appointment anytime if I need to—all I want is to remain pain-free. I’m so grateful to the Gokhale Method and all who are associated with it. It has changed my life. 

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. . .

This is our third blog post in the series where we put popular exercises under scrutiny to examine how they stack up—or not—against the principles of healthy posture. Here we are looking at “Cat-Cow,” a common exercise for mobilizing the spine.

Cow is one of the “holy cows” of conventional exercise. Done on all fours, it puts the spine into extension (swaying). It is paired with Cat, which puts the spine into flexion (rounding). Alternating between these postures is widely considered to be a good or even necessary exercise for mobilizing the spine.

Cat-Cow is widely considered to be a good mobilizing exercise for the spine—but there is a big downside. Pixahive

Alternating between extreme extension and flexion stresses the joints of the spine, which then sustain wear and tear. It also results in the surrounding muscles stiffening to protect the spine. True, it can feel good to stretch out tight muscles in this way, but rather than relying exclusively on repeated extension and flexion, it’s better to address the underlying cause of the stiffness, which is usually poor posture. People with good posture are not compelled to do this sort of exercise. 

Arching the back (above) and slumping (below) are common but damaging postural habits 
that we do not want to reinforce in our exercises. Freepik

In addition to the real-time wear and tear in the spine, Cat-Cow reinforces the poor postural patterns of arching and slumping that are common in our culture. 

Many of us arch the lumbar spine to be “upright.” This compresses the discs, nerves, and soft tissues of the lower back which leads to degeneration, pain, and dysfunction. It is also common to slump the upper back when sitting or standing. This progressively overstretches the spinal ligaments, increasing kyphosis. Cat-Cow augments both these common characteristics of modern posture. 

Cow (above) can deepen and compress an already tight lumbar curve. Cat (below) will then overstretch an already rounded upper back.
Both movements compound common posture problems.

If the chin is lifted and the neck is swayed in Cow, this will additionally put pressure on the cervical joints.

Due to its horizontal orientation, without an awareness of healthy posture, this is an exercise that encourages the abdominal muscles to “switch off” rather than retain a healthy baseline tone. Hanging the abdomen from the lumbar area like a deadweight encourages exaggerated distortion of the lumbar spine.   

After compressing the lower back in Cow pose, most people then round into Cat to stretch it out. Training the upper back to hunch in Cat will then send the shoulders and head further forward in daily posture. Rather than mobilizing the spine, Cat-Cow can create a destructive spiral of a tight lower back and an overstretched upper back. 

Rather than encouraging even length throughout the spine, Cat-Cow pushes deeper into the existing curves. Freepik 

If you are concerned that the yoga or exercises you do could be exacerbating a habit of arching and/or slumping, we recommend exploring how to modify your regimen in an Initial Consultation. You can arrange an Online Initial Consultation or an in-person Initial Consultation if you have a Gokhale Method® Teacher near you.

The 1-2-3 program on Monday, August 9 will show you how to do a modified Cat-Cow. In Cat you will learn to stretch the upper back without overdoing it, and how and why not to round the lower back in the process. In Cow I will teach how to restrict the concave sway in the lower back while giving a satisfying stretch through the thoracic spine where it will do no harm. You will learn how to invite the right amount of movement in the right parts of your spine.

If you would like to join the Cat-Cow class but have not yet subscribed to the 1-2-3 program, sign up now for your 7-day Gokhale Exercise Free Trial.

1-2-3 Move happens daily with Esther at 9:45 a.m. (Pacific Time)
Gokhale Fitness with Eric runs Mondays, Wednesdays, Fridays from 7–7:25 a.m.
(Pacific Time), and Tuesdays, Thursdays, Saturdays from 3–3:25 p.m. (Pacific Time)

   A four-year study involving 276 spine patients ages 53 to 75 published in the journal Spine suggests that we should--at the very least--take a deep breath and think twice before choosing epidural steroid injections to relieve the pain of lumbar spinal stenosis, not only because this oft-used treatment may not work, but also because it may cause more harm than good. Better yet and instead it might make sense to simply get in the habit of breathing deeply, which naturally lengthens the spine and helps relieve unhealthy stress on the vertebrae.... But more about Gokhale Method solutions in just a bit!

While the authors of "Epidural steroid injections are associated with less improvement in patients with lumbar spinal stenosis" caution that the unexpected results of this small, retrospective study warrant further investigation, a couple of findings leap out:

• Using well-established scales for measuring leg and lower back pain, the researchers found significantly less improvement among patients who had the steroid injections than among those who did not; this was true even among those patients who went on to have surgery. 
• Despite conflicting reports about the efficacy of epidural steroid injections in lumbar spinal stenosis, 69% of spinal surgeons consider ESIs to be the first-line invasive treatment when exercise and physical therapy have failed.

The Spine study—together with recent alarming reports of fungal meningitis, paralysis, and other risks associated with epidural injections—prompted me to tackle this topic today.

What is lumbar spinal stenosis?

Spinal stenosis is a narrowing of the open spaces in the spine that can compress nerve roots and cause pain and numbness in the neck, limbs and back. Lumbar spinal stenosis is the narrowing of the spinal canal in the lower back--that is, in the five vertebrae that run between the rib cage and the pelvis. If we dig a little deeper and consider the anatomy of the spine, itself, we find that stenosis can happen in a couple of places:

• The space at the center of the spine (central stenosis)
• The canals (or vertebral foramina) through which the spinal nerves pass (lateral stenosis)

Visualize it

I believe in the therapeutic value of mental imaging, but in order to visualize solutions to a problem, it helps to see and understand the problem, itself. Take a look at this information video.

No wonder lumbar spinal stenosis hurts! As we just saw, a number of factors can contribute to the narrowing of space in the spinal cord:

• Bulging discs
• Bone spurs (also called osteophytes)
• Thickened spinal ligaments
• Enlarged joints near the spinal canal

Not only do these bulges, spurs and hypertrophied ligaments and joints pinch nerves and cause pain in individual people, they represent a burden on our healthcare system and society at large.

"The growing epidemic"

In 2010, The American Academy of Orthopaedic Surgeons described lumbar spinal stenosis as "the growing epidemic," noting that with the aging of the population this already costly problem will only get worse:

• 8% to 11% of Americans are thought to be impacted by lumbar spinal stenosis.
• 2.4 million Americans are likely to be affected by 2021.
• As "boomers" increasingly qualify for Medicare benefits, government spending on lumbar spinal stenosis will no doubt increase.

Additional evidence was provided by the Chairman of the American Society of Interventional Pain Physicians, who, in a 2012 review of Medicare records, found that the number of  spine injections from 2000 to 2010 increased 159%. And the Centers for Medicare and Medicaid Services reported that in 2011 it paid providers $106.4 million for 252,288 injections, which averages out to $422 each. All of which raises the question: What can we do to prevent or manage lumber spinal stenosis apart from relying on costly epidural steroid injections, which may not work as well as people had hoped and which are now also associated with contamination and infection and other risks?

Gokhale Method solutions

If you'd rather not count yourself among the the 2.4 million Americans (and untold numbers of others outside the US) likely to be afflicted by lumbar spinal stenosis between now and the year 2021—or if you are currently experiencing pain from spinal stenosis and would prefer a non-interventional approach—then I recommend the following Gokhale Method techniques:

• Stretchsitting
• Stretchlying on your back
• Stretchlying on your side
• Using your inner corset

All of these techniques involve lengthening the spine, which—by increasing the space between the vertebrae, as well as the open spaces in the spinal canal where the nerves exit—take stress off the places where stenosis occurs. One way to enhance these powerful techniques is to use imagery, a method known to promote all kinds of healing, together with deep breathing, which will improve movement of macro- and micro- elements of the spine. To begin to test this out you might now take a very deep breath and, as you feel your spine naturally lengthen, imagine what it feels like to naturally stand like the beautiful kouros figure, just below.

The benefits of reestablishing good length in the spine cannot be overstated

Stretchsitting and stretchlying on back and sides

As noted above, Gokhale Method stretching techniques involve lengthening the spine (including, of course, the lumbar spine). Reestablishing natural length creates space and helps relieve unnatural stress by decompressing nerve roots as they branch away from the spinal cord via the spinal foramina. Spine-lengthening techniques also take pressure off bulging discs that can cause pain when they press in against spinal nerves. Relieving unnatural stress on the vertebrae via spine-lengthening and reshaping may also confer benefits by slowing or even halting the formation of unhealthy calcium deposits, which, when they form bone spurs, can poke into the spinal column, compress nerves, and cause pain.

Using your inner corset

Bracing the torso is also really important in preventing or managing lumbar spinal stenosis, and this can be accomplished by strengthening the deep abdominal and back muscles and making good use of what I call the "inner corset." We can actually relieve compression on the spine by transfering it to these strong central muscles, which are ideally placed to help carry the weight of the upper body. It follows that engaging the inner corset may also help minimize the pain that occurs when bone spurs intrude on the spinal cord or spinal nerves, as well as when spine instability (spondylolisthesis) narrows the spinal canal by allowing one vertebra to slip forward on another.

Complementary techniques

Breathing and mental imaging

Only when the body is in correct alignment can the natural action of breathing massage the tissues of the spinal area and confer its own therapeutic value in relieving the pain of lumbar spinal stenosis. And because mental imaging is known to help reduce stress and relieve back pain, it may be beneficial to consciously envision what's going on inside your body, every time you take a deep breath:

• With each inhalation, the spine lengthens and massages tissues in the back while relieving stress on entrapped spinal nerve roots.
• With the settling back that occurs with each exhalation, the natural massage-like action continues, and this goes on and on, with every breath.
• With the natural massage that occurs with each inhalation and exhalation, blood is pumped through the tissues around the spine, normalizing circulation in the area.
• Good circulation presumably normalizes related physiologic processes that might include calcium deposition and calcium reabsorption.
• Good circulation also promotes the flushing away of waste products.

To sum up, stimulating circulation in the lumbar region—both of which are achieved through the Gokhale Method—are invaluable in the prevention and amelioration of stress on the vertebrae.

Imagery can help relieve stress and minimize pain

Secondary benefits of Gokhale Method techniques

Lengthening your spine and using your inner corset are things you want to be doing anyway, in the course of your usual activities—not only to clear up pain stemming from lumbar spinal stenosis, but to make you look and feel better, overall. Added perks of learning and practicing low-cost, no-hassle Gokhale Method techniques include zero risk of infection and other adverse effects, and—beyond the initial learning—no expenditure of precious time.

Where to learn more?

You will learn to lengthen your spine and use your inner corset in Sessions 1, 2, and 3 of the Gokhale Method Foundations course, and in Lessons 1, 2, 4, and 5 of the book 8 Steps to a Pain-Free Back, as well as in Scenes 1, 2, 3, and 6 of the Back Pain: The Primal Posture Solution DVD.

Image and Video Credits: Spinal Stenosis: Wikimedia Commons Journal Cover: Spine Lumbar Spine: Wikimedia Commons Spinal Stenosis YouTube Video: DuPuy Kouros, Archaic Greek Youth: Gerard Mackworth-Young Feather collected in Washington State: Kevmin, Wikimedia Commons