Saturday, August 8, 2015

How I Help My Back With Esther Gokhale's Postural Techniques

Since I discovered I had spondylolytic spondylolisthesis, I've followed a posture program for my back that has changed my life, but it is not the usual kind of posture program.

For over four decades, I had typical American posture. At worst, I slumped. At best, I followed the standard medical wisdom for how to move and stand, doing just what my orthopedist, chiropractor, and physical therapists said I should.

I made sure to keep any weights I lifted close to my abdomen and bent my knees deeply while lifting. I tucked in my butt almost every moment of the day. I used cervical pillows to deepen the curve in my neck. I thrust my shoulders back. I did knee-to-chin stretches and literally hundreds of other standard back stretches and isometric exercises.

I did so many core exercises I should have had abs of steel, but they only got weaker over the years. I tried not to slump, but couldn't seem to maintain it. And my back pain, which had been with me since childhood, got continually worse.

Then I heard of a posture program developed by a woman called Esther Gokhale. I watched this video of a presentation she gave to employees of Google:


Her lecture made sense. It described an ideal spinal profile different from the one I'd been taught to maintain for so many years, using pictorial examples from history and other cultures.

I was sold - kind of. I'm a cynic to beat all cynics, so of course my enthusiasm was tempered with some healthy negativity.  But I bought her book, 8 Steps to a Pain Free Back, to give it a shot. And I read it.

Honestly, it wasn't the best self-help book I'd ever read. It was too generalized. It left me with a number of questions. And the section on walking was confusing. But it also presented a strong case for her program and a (mostly) easy-to-follow posture program that was unique in one important way.

I started following the program, starting with changing my sitting posture. I watched another video. I even wrote a couple of fairly critical reviews and posted them online. I was startled when Esther Gokhale contacted me, expressing concern about some of my points of criticism. She spoke with me on the phone, answering some of my questions.

And I continued to apply the program. It got easier and easier, and my back got better and better.

That was three years ago. Since that time, I have reduced the instances of my back going "out" to virtually nil. (When it does go "out," I use trigger point therapy, which reduces my bedridden recovery time to at most a day instead of a week.)

At one point after applying what I still saw as a weird, counterintuitive posture program, I realized my plantar fasciitis had stopped flaring even a little bit. My sciatic pain, which had previously gotten so bad I could hardly stand, stopped being a daily issue.

These are, I guess I should say here, not typical results. Don't expect miracles. Many people are NOT helped by Gokhale's program. It helped me, though...in conjunction with trigger point therapy and the moist hot packs.

How Gokhale's posture program differs from other programs, besides answering to a different spinal profile, is that special exercises and stretches, while helpful, are not the focus of the program. Changing the way you move, every day, all the time, is. Gradually, of course. Not changing all at once. As I learned to my detriment, it's too easy to try to change everything abruptly. I went too fast at the beginning and effected an increase in my headaches.

Progressing more slowly, over the course of a year I changed the way I slept, sat, stood, walked, bent, and exercised. That means I changed most of my movements in the course of normal daily living.

Here are some key highlights of changes I made:

Bending


  • I stopped bending at the waist; now I bend at the hips.
  • I stopped bending deeply at the knees while lifting; now there is only a slight bend.
  • I stopped tucking my butt as I bend; now I stick my "tail" out.


Standing


  • I stopped resting my weight primarily on my forefoot; now my weight goes on my heels.
  • I stopped locking my legs; now they're kept bent a bit, at the knees and at the hips.
  • I stopped trying to move my knees inward in a ladylike fashion. They flare outward, and so do my feet.
  • I stopped shoving my shoulders back; I started rolling them gently back as shown in Gokhale's video above.
  • I stopped tucking my butt in - the biggest and most important change of all.


Walking


  • I stopped pushing off with my quadriceps and started using my gluteal (butt) muscles.
  • I stopped trying to keep my feet parallel; now I keep them slightly flared outward.
  • I stopped tucking my butt in.


Sitting


  • I stopped tucking my butt in.
  • I stopped trying to fit myself to the chair; now I modify the chair to fit me.
  • I stopped using lumbar support cushions; I now use towels for support and they're placed elsewhere.
  • I stopped resting my legs up high while sitting.


Lying Down


  • I put my whole spine - lumbar, thoracic, and cervical - in traction whenever I lie on my back.
  • When I use a pillow while lying on my back, I position it lower down, so it's under the tops of my shoulders, too.
  • I keep my head in a neutral position while lying on my side by using more pillows.
  • I keep an anteverted pelvis while lying on my side.
  • I rarely lie on my stomach, and when I do, I always use a pillow under my abdomen.
I can't say I follow Gokhale's program precisely. She and her colleagues travel around giving classes and I've never been to one of the classes. With no personal feedback, I'm not sure I've correctly mastered all of the movements.

Instead, I use the book as a guide and my newly revised sense of what's right for my body. The paradigm shift of her posture program seemed major at first, but it's now automatic for me to sit, bend, and lie down differently. 

Walking and standing still require more conscious awareness. Walking tends to be repetitive, and it's easy to slip back into old patterns. Standing is even harder; rarely is my focus on the act of standing, itself - rather, I'm focused on the chores I'm doing or the people I'm with.

And despite the fact that my back condition is not going away - I'm still trying to avoid surgery - I'm functional in a way that I was not a few years ago.

I hope you will ask me any questions you have about my experiences. I'm not a Gokhale program expert or a healthcare worker, but I've learned some things about my own back and would like to help lead others to success with minimally invasive solutions to their back pain.

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