Back pain can literally break your day. Judging by how many thousands suffer, and many for years at a time, it is clear that spinal care is often inconsistent or even misguided.
HealthySteps to Wellness spoke with author, speaker and advisor Esther Gokhale, creator of the Gokhale Method, to “straighten out” the spinal facts from the fictions.
You are clearly passionate about the topic of spinal health. What ignited your passion?
Like many people, I came to my passion through my own misfortune. In the ninth month of pregnancy with my first child, I had a very large L5/S1 disk herniation — and it brought me to my knees. Life as I knew it came to an end. The ailment did not respond to conventional or alternative measures. I was unable to sleep through the night, hold my child after she was born, and I was even recommended to not have any more kids since I had bulging disks all through my spine.
So, I researched, traveled, and cast a wider and wider net to find a solution to my problems. This journey was not easy, but I stayed with it because it provided a solution to my problems — and my patients’ problems. In time, a wider swath of people were being helped.
What is the biggest challenge we currently face concerning back health?
The way the financial invectives are set up makes spinal care very challenging. Individuals have good intentions; however, institutions depend upon income from conventional interventions — and many professionals are compensated according to each and every intervention.
This is changing with the growth of HMOs and self-insured companies; but still, too often, systems are set up to shepherd people toward surgery, injections, and other expensive, ongoing treatments. Finding more appropriate solutions for back problems suffers as a result.
What can we do to overcome back pain?
First, it’s important to realize that many of the things we do for our posture are counterproductive. Such practices as “standing up straight with chin up, chest out, S-shaped curve in spine and tucked pelvis,” and doing crunches and sit-ups for ab strength, can actually do damage.
The first step is to learn what actually constitutes good posture; then, find an effective way to get there. You need to develop a reminder system, and one of the best tips is to take note of people around you with good posture, which can remind you to raise your bar. It’s uplifting, both literally and figuratively.
We also need to do better with our implements — our chairs, shoes, and clothing, which unfortunately are designed to fit our current posture, reflecting and perpetuating the distortions.
Thirdly, a cohesive set of inputs from fitness instructors and computers applications can be beneficial. Some are not: when our students use Fitbits, they do not register the low impact landings that we teach; Fitbits are only designed to measure steps with impact.
In short, we have a whole culture — devices, furniture, clothing — calibrated around poor posture. We need to re-seed this culture with healthy postural guidelines.
What are some practical skills we can use to prevent back pain?
Lengthening the spine is where I like to start with all my students. It’s like preparing the clay; it makes the flesh more malleable. Try to “grow your height,” which may have declined over the years due to increased curvature of the spine. The average height increase for our students, who are age 50-60, is ½-2/3 inch. This height increase allows nerves more room to function without inflammation, disks to better hydrate, organs to gain more space. On every level, it’s healthier.
It just so happens that two of the easiest techniques we teach foster additional length in the spine. We teach stretchsitting and stretchlying, which covers 16 hours of the day (approximately 8 hours a day at work and 8 hours per night while sleeping) when you could be introducing gentle traction in the spine. Even a day of this stretching can make a difference in pain.
The second measure is to reposition the shoulders. Especially in an academic setting, where people are typing all day, we tend to roll shoulders forward. This compromises the pectoralis (in the neighborhood of all the blood vessels going to and from the arms), which leads to tendonitis and other problems with the hands.
While it is relatively easy and risk-free to reposition the shoulders, the way people do it is often ineffective. We teach people how to roll shoulders a little forward, a little up, a little down and back, taking advantage of craggy architecture in the shoulders to ratchet soft tissue back a notch, making us more stable. By using this technique, you are not tensing up some helpless muscle all day long. You can enjoy the benefits of better circulation in the arms, better breathing, less rounding of the back, and better appearance. We have a video clip of this technique on our website.
Pay attention also to your neck, which tends to come forward in an unhealthy way. I advise people to come in very close to their keyboard, almost having the feeling of being in a cockpit, which results in less temptation to come forward. Armrests can harm your ability to get closer to your keyboard; they can cause your arms to come forward, compromising the shoulder architecture and causing the head to lean forward — creating stress all through the fragile neck.
Here’s a maneuver that helps your neck: grasp a clump of your hair or the back of your head, gently pull back and up on the skull, allowing the chin to relax and the gaze to focus at a slightly downward angle.
What about sitting too much … isn’t that a big issue?
Sitting is overly maligned. I think it’s a healthy position if done well and with half-decent furniture and some variety in routine. Done in moderation and skillfully, sitting is beneficial, and one of the easier challenges for the body to navigate. People with manual work have worse statistics for back pain than do people who sit much of the time at work.
Computer culture is the least of our troubles. In fact, some focused thought and reflection is better done sitting instead of standing. Certainly, to be done well, sitting should be switched up with breaks for standing and walking around. I also think that lying down is something we should do, despite some people’s fear of falling asleep! Be creative with movement breaks: when I do Skype calls with students, I do a little bit of samba. Try creative movement when waiting in line at the food store! I want to see our culture advance to where posture pauses are well accepted.
Can our mental/emotional health affect our spinal health, or vice versa?
An increasing body of research shows a connection between posture and emotional state. We know that sustained grief correlates with a shoulders-forward posture. We know that open upper body posture correlates with higher testosterone levels and lower cortisol levels, which is more oomph and less stress.
For any individual, it is useful to periodically check in and ask oneself, “What is my posture and what is my state of mind?” Or, “When I change my body does it lead to a change in my feeling in the world?”
… any final thoughts?
If you have an ache or pain, welcome it. Don’t try to banish it with various band aid approaches. In other words, don’t kill the messenger — it’s trying to tell you something. Do your best to understand why it came about, why you have this ache or pain, and what you might do about it at a root level. Only after you’ve exhausted that search do you want to go to band aid measures to quell that pain. Pain is your friend. It’s trying to tell you something. Listen before you quash it.
Esther Gokhale’s upcoming class: The Gokhale Method: No More Aches and Pains
Sat 10/6 – 9:30 a.m. to 4:30 p.m.
Location: Li Ka Shing Learning Center, Rm 308 (291 Campus Drive)
Interview by Mia Primeau
April 2018