October 2, 2015 by Jean
When I had my annual check-up with my primary care practitioner this summer, I decided it was time to do something about my problematic spine. I’ve been living with these problems for over fifteen years. They are chronic, but flare up periodically into disabling pain in my arm or leg. In the past few years, the flare-ups have become more frequent; and I’ve become concerned about how they might affect my ability to continue living in my house. I live alone, and the care and feeding of my rural house requires that I be able to do some fairly heavy work.
After a series of x-rays of my neck and lower back, followed by a series of MRIs (which showed degenerated discs up and down my spine), I opted for a course of physical therapy that would focus on my most disabling symptoms, leg pain from a degenerated lumbar disc. I should say that I’m a true believer in physical therapy. In the past, I’ve found that physical therapy gives me almost immediate relief from pain, and that I’m then taught stretching and strengthening exercises that help to prevent future episodes of pain. I’m a very good physical therapy “student” and was still doing the stretching exercises for my lower back that I had been taught during a course of physical therapy ten years ago. My only disappointing experience with physical therapy occurred last summer, when my primary care practitioner and the physical therapist disagreed about the cause of my leg symptoms and the resulting treatment did not provide much pain relief or prevention. This time, I asked around and got lots of glowing recommendations for a different local physical therapy practice, where I have been getting therapy for the past four weeks.
My main concerns in physical therapy were to get relief from the pain in my leg that I have been experiencing daily for over a year and to learn some strategies for slowing down or preventing further deterioration of my spinal discs. During my first visit, the physical therapist read over my MRI reports and asked me when, where and how I experience pain. He then watched me carry out a number of daily activities like walking across the room and bending over. His conclusion was that we could accomplish a lot by teaching me new ways to move my body, and he recommended a book, 8 Steps to a Pain-Free Back by Esther Gokhale (Pendo Press, 2008).
The premise of Gokhale’s book is that most of our back problems are caused by poor posture habits that developed during the 20th century. By studying societies in which back pain is rare, she developed a series of exercises for restoring us to “natural, healthy posture.” At my first physical therapy session, the physical therapist showed me a full-page photo from Gokhale’s book of an elderly African woman who is bent over gathering water chestnuts, which she does for many hours at a time without back pain. The therapist pointed out that she is bending from the hips (what Gokhale calls “hip-hinging”) with her back straight, rather than bending from the waist with a rounded back as most Americans do.
So far, I have browsed Gokhale’s book and tried to implement some of her principles as I move through the day. I’ve paid particular attention to hip-hinging, which I have been practicing as part of my stretching routine and have tried to use when I’m working in the garden. (It’s not easy, because I have 60+ years of muscle memory to overcome.) I’ve also tried to practice her sitting postures, which has included changing the position of my seat when I drive, her strategies for stretching my spine as I sleep, and “tightening my inner corset” to elongate my spine when I’m doing certain types of strenuous activity.
My next step is to go through the book systematically, starting with step 1 (stretch sitting) and focusing on one step a week through step 8 (glide walking). It is possible to take classes with practitioners trained in Gokhale’s methods, but the nearest is 200 miles away from me. Fortunately the book is designed as a self-help guide, with every posture correction broken down into a sequence of small steps, with each illustrated by both photographs and diagrams, and with cautions about common mistakes and signs of improvement to watch for. I’ve been wanting to improve my posture for decades, but I’ve never found the available advice worked for me. I’m excited about this new strategy.
Anyone who would like more information about Esther Gokhale’s method or book can find it here.