Steps to a Healthy Back


October 2, 2015 by Jean

8 Steps to a Pain-Free BackWhen 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.

24 thoughts on “Steps to a Healthy Back

  1. Charlie Emmons says:

    Jean, I think it’s an interesting synchronicity that I read this blog right after getting back from the chiropractor. I went earlier than my usual appointment because of a flare-up of spinal discomfort. She said I had two rotated discs and some inflammation. The current weather might be a factor, but I’ve also been running a lot (setting new personal records). I’m going to lay off running for a while. I found your details interesting, and I have just one possible suggestion to add. I have been helped immensely by doing yoga for a half hour every morning. I used to just take a weekly class, but when I popped my sacroiliac out a few years ago (and had it put back in place), I started doing a set of poses that I thought would help heal it. It was the single best health move I have ever made. The sacroiliac was healed in a few months, but by then I had established a habit. The best poses for me in helping my back are downward-facing dog and rag doll (which involves hip-hinging and just hanging the head down). Chair twists are great in the car when stopped at a traffic light. Maybe some yoga would help you too. Just remember what my yoga teacher says, “If it hurts, it’s not yoga.”

    • Jean says:

      Charlie, You’re the second person who has suggested yoga to me. I’ve been wary because it is so difficult for a novice to understand all the different types of yoga and to know which teachers are adequately trained in physiology and anatomy to be appropriately careful of herniated discs. Last year in my singing class, we did some basic yoga breathing exercises, including the chair twist and a rag-doll type exercise that unfortunately involved bending from the waist. I now know that both of these probably caused more damage to my discs and that i shouldn’t have been doing them. The big problem for me is the things that don’t hurt while I’m doing them but that further aggravate chronic problems.

  2. Jean R says:

    That looks like a book I could use. Thanks for posting about it. My compressed discs are in the lower part of my spine. I know my posture is bad caused, probably, from a life time of bad bone structure in my feet. I got a thing from the chiropractor to give me extra support when I sit in a chair or in the car and it helps a lot. I get the tingling in one foot at night in bed that bugs the heck of of me. Growing older is not a sport for sissies.

    You are such a pragmatic person I know you’ll make the most of the book and your therapy sessions.

    • Jean says:

      Jean, I initially got the book out of the library. After reading through it and trying some of the exercises, I decided that this program was for me and bought my own copy. You might want to try getting it from the library to see if it would work for you.

  3. Sue McPhee says:

    Jean. How interesting that you are talking about this book! I, too, just ordered and received it, on the recommendation of one of my clients who swears by its contents. Having worked with many folks with back issues when I was doing physical therapy, I found that proper posture was tantamount to improvement. And now, as I continue working with clients doing deep tissue massage, I find the same to hold true. I am considering purchasing Gokhale’s DVD. If I do, I’ll let you know how I like it. 🙂

    • Jean says:

      Sue, My copy of the book (I’ve been using a library copy) just arrived today. I’m excited by Gokhale’s methods and am happy to have your positive response to it. Let me know what you think if you get the DVD.

      • Sue says:

        Finally ordered the DVD last month and watched it. I really like it because it brings all the steps to life. Although the pictures in the book are fantastic, this DVD takes the instructional a full step further. She has four clients that she demonstrates the postural corrections with and that is extremely helpful. For example, the stretch sitting is far easier to understand by watching her demonstrations. I am considering getting the cushion. The book is fabulous, too, as I like reading about the background and full explanations which the DVD does not have time to elucidate. Bottom line, both are helpful. The DVD makes it easy to practice while watching her demonstrate. The only thing better than that would be a personal consultation with her or one of her associates. Since the $450 workshop is beyond my means right now, I am content to have the book and DVD.

        • Jean says:

          Sue, Thanks for the update. I may order the DVD, especially for steps that I find mystifying — like positioning my feet in a “kidney-bean shape.” I’m not sure how well I can transfer watching how she corrects clients’ posture to my own body; unlike you, I don’t have a strong kinesthetic sense. That is probably the main reason I’m thinking about signing up for one of the intensive weekend foundations courses in the new year.

  4. pagedogs says:

    I second Charlie’s remarks about yoga. I am 60 and have cervical and lumbar disc degeneration and stenosis. I have done physical therapy exercises at home for years, which strengthened my neck and core muscles and kept things in check. I had always been skeptical of yoga but decided to try it and found that it has helped my back tremendously. I am a convert.

    We have some wonderful yoga teachers in mid-coast Maine and, although I’m not sure where you are, I imagine you have plenty in your area. Yin and gentle yoga are especially good for my back. If you decide to take some yoga classes, be sure to tell your teacher about your back issues and she or he will make modifications for you, if necessary.

    Yoga aside, the Gokhale book looks fascinating and I’m going to give it a look.

  5. Stacy Moore says:

    I hope the book, physical therapy, and yoga give you the buffer you need for those autumn chores, Jean. You will pace yourself sensibly, I’m sure, though the temptation not to must be awfully strong sometimes!

    • Jean says:

      Stacy, Both the book and the physical therapy seem to be helping, as I chip away slowly at my wood pile. I don’t find it difficult to pace myself — because the truth is that I’m happy to have an excuse doing things that are more fun than my chores 🙂 . (Brings back memories of childhood when my mother used to take away my books until my chores were done.)

  6. Amazing what we do to our backs after years of abuse…I have had a few injuries which cause my issues…I love acupuncture and massage for my issues, and I will check out the book too.

  7. The Feldenkrais Method has helped many with back problems, chronic pain and all types of movement. There is a wealth of information on the web that would benefit you. Best wishes to finding what works for you but I wish you well. Remember-it is the body’s mandate to heal. Feldenkrais can help you find YOUR way. All best wishes. Rachel Potasznik, GCFP, CYT-BetterBodyLab, Founder

  8. Teri says:

    Jean, I’m so happy to hear that you have “found” Esther Gokhale’s book and that you are benefitting from the methods and information it offers! I had a similar starting point as you: I had some leg/hip pain that was getting in the way of my lifestyle and, only in my mid-50s at the time, it seemed premature to have a sometimes-debilitating physical problem setting in! I happened to see a Public Broadcasting program on Gokhale’s work, thought it sounded very intriguing, and got the book at my library. I am fortunate to live close to the “headquarters” of the Gokhale Method and ultimately took the Foundations Course for some hands-on experience of the techniques and philosophy presented in the book. I can’t say enough about how much I benefitted from her program. That was close to 5 years ago, and I use the techniques I learned every single day, with gratitude. I never have leg or back or really any other pain now, since I have learned the positions that are natural to our bodies. Hip-hinging, engaging the inner corset, glide-walking, stretch-sitting and -lying, stack-sitting — these are all part of my daily routines and postures, learned from the class and her book, and they have made all the difference in my life. One of the greatest takeaways has been the loss of a subtle fear — that I didn’t even really know was there — of apparently inevitable pains that growing older seemed to promise. Now I realize that I don’t need to dread “mysterious, impending” pains and aches; if something doesn’t feel right in any place in my body, I have the tools now to evaluate what I might be doing wrong in terms of my posture or movement, and I can easily remind myself of what to do differently. Pain averted!

    It’s really been life-changing and I can’t say enough about the benefits of this wonderful and well-researched methodology. I know there is a distance issue in your case, but If it is possible for you at some point, I highly recommend that you make the trek to a location where the Gokhale Method is taught (class schedules are varied and you can take the entire program in one weekend in some cases). I gained an enormous benefit in experiencing a live, hands-on environment, where you can get direct feedback on the techniques and your own body architecture. The class sizes are small and very well-organized. My instructor was Esther Gokhale herself — jackpot! — but all Gokhale Method instructors are well-trained and I’m sure anyone would benefit from a Gokhale class taught by any of their instructors. (No, I am not paid to promote the Gokhale Method 😉 I am just a VERY satisfied student who feels lucky to have crossed paths with this person and her program. And I pretty much tell everyone I encounter who is suffering with back, shoulder, hip, leg pain about the benefits — so simple, so easy, so wise, and so useful — from this program.) Best of luck to you and may the techniques you are learning continue to be of benefit!

  9. Laura says:

    Thank you for sharing the wonderful reminder that in our aging we can continue to give our bodies the chance to find more balance and more ease in our movement and every day life. Gokhale’s approach is incredibly simple and beneficial, and I have had the fortune to work directly with Angelika Thusius (Kentro Body Balance) who was a teacher of Esther’s at one point. I would recommend her book and DVD as well. Both she and Ester have explored the centering mechanism of a resilient sacrum (and thus whole spine) that allows that magnificent responsive J curve about which Esther talks. They both have developed their own slant in how to help us connect and experience the simple movements that bring us into more resilience, and as a movement teacher (and massage therapist) I know of the benefits of finding the approach that inspires us to move. There are also others who have experienced this approach who have written books, again each with their own perspective. May the discovery of your body’s joy in moving continue!

    • Jean says:

      Laura, Thanks for the introduction to Kentro. I can see how this method and the Gokhale method share certain foundational posture elements, but the two approaches seem to appeal to different types of personalities. I’m sharing all this with my sister-in-law who has suffered from life-long back pain.

  10. Sue says:

    Jean: Did you see this notification of a Gokhale workshop in Easthampton, MA, coming up soon?

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I am Jean Potuchek, a professional sociologist who has just stepped into the next phase of my life, retirement, after more than thirty years of college teaching. This blog is about my experience of that new phase of life.

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