Zeena: Hello everyone, it’s Zeena Dhalla, your VerticAlign posture coach and I’m super excited today cause I am doing an interview with the world renowned posture and pain expert, Esther Gokhale. Hi Esther, thank you for being with us today.
Esther: It’s a pleasure being with you.
Zeena: Before we go into some questions, I wanted to read a couple lines from your bio, and just to give the audience a little bit of an idea where you came from and how you got into what you are doing. So Esther Gokhale has been involved in integrative therapies all her life. Her early interest in healing lead her to study biochemistry at Harvard and Princeton, and later Acupuncture at the San Francisco school of Oriental medicine. After experiencing crippling back pain during her first pregnancy and unsuccessful back surgery, which I think is important, she began her lifelong crusade to vanquish back pain. This led her to develop the Gokhale method which is a unique systematic approach to help people find the bodies way back to pain free living. Her book, Eight Steps to Pain free Back, which I have right here in my little hand has sold over a 100 thousand copy and has been translated into 8 language. Gokhale has been a speaker teacher at corporations such as Google. She’s spoken at conferences such as TedX Stanford. She speaks with medical physician groups including doctors from Stanford and has worked with trainers such as the San Francisco 49ers and several other Stanford teams. So that gives you an idea of how credential she is and very I am happy to have her with me today so again thank you for joining us.
Zeena: Alright, I want to start about the Google talk that you gave in 2008, I watched it few times and that talk you addressed posture problem that we had back then and I am sure we still have today, and I think we can all agree that sitting is one of the biggest contributors to posture issues facing our society today. So can you tell us what you think the number one problem with our sitting position today and how it causes poor posture and as a result, pain.
Esther: So I think people use one of two bad postures when sitting them either slumps it or they arch sit and most people go back and forth between them. They tug their pelvis and then it results in a kind of hunched position and occasionally they remember oh’ dear supposed to do something else and then they popped their ribs and that what actually no better and I think it’s because these are the only two sitting positions that people know. I actually think it’s a perfectly healthy position to do in moderation if you have decent furniture and you’re not sitting there like a lump on a log for hour after hour. I think it’s restful and research shows that you can have deeper cognitive processes when you are sitting and that’s why meditation is usually a sitting practice and there is also a research showing that if you stand all day you have a different set of problems. For example more hospitalizations due to varicose veins, higher risk of atherosclerosis and it used to be on the assembly line days that standing were thought to be the problem. So the blame gets kind of shifted around and really yes, we need to change it up and we need to do each of those positions well so that we are not just escaping from one position to the next bad position and even making little phrases like “the best position is the next position” which is a real copout in my view, to force someone to move constantly is crazy. You want to move and change it up a lot that being peaceful being comfortable in a seated position like we both are right now is also helpful and has advantages.
Zeena: And do you think for based on the work you have done with the corporations, do you think the length between these sitting issues and posture and pain people been more awareness now or is it getting better or worse since 2008 pacifically.
Esther: So the people who touch our work are doing better and we have testimonials coming out of our ears, including from physicians and celebrities and so on but we still haven’t touched by the small percentage of the population and I would say on the whole pain is continues to rage rampant and is one of the biggest like the global disability survey shows it to be one of the biggest problems that were facing today. I don’t think we are getting any better. There is research there is a website called healthoutcome.org that is the world’s first crowd sourcing website for rating different interventions for medical conditions, and for lower back pain, postural modification comes head and shoulders above the next one which is yoga, which has a lead on the next ones. The things that come up at the bottom of the list and this is from 40,000 ratings are the things that everybody’s doing, you know the cortisone shot, surgery, physical therapy comes at the very lowest rungs of the ladder and that shocked me actually to see just how badly rated it is and so I think you know, there is research now showing that there is a connection that when you change your posture or improve your posture, this actually is the most effective way of getting rid of pain, and certainly we have tons of anecdotal evidence and common sense arguments why that would be.
Zeena: Are you seeing more interest in the medical community to do more clinical tests and research studies and that kind of thing to help prove the link between posture and pain?
Esther: Yes but you know the clinical study is world so constrained. Big pharma isn’t running around to fund this kind of study so where is the money coming from on this? So I’m gratified that we are getting large numbers of people reporting their experiences, you can’t fudge 40,000 ratings.
Zeena: Oh yes you can’t fudge a 100,000 copies of your book sold and people following your methods.
Esther: 150,000 copies sold by the way.
Zeena: Oh it is? I apologize!
Esther: We should edit our biography copy.
Zeena: That’s fantastic, congratulations. I want to shift a little bit to smart phones. I don’t know about you but I walk around the universe just appalled at sometimes what people what do with their smart phones and I actually have a tip on my blog I give some tips to my clients about certain ways to use your smart phones to help that make them more effective for your body. I wanted to get your recommendations. Do you have recommendations for how people can use their smart phone better and be aware?
Esther: So the important thing is to have a baseline that is comfortable and healthy and once you have that and you have a pretty good awareness around that then you don’t distort that very easily for any implement. Like right now I’m talking to a webcam, I have come in close enough, I am sitting on my chair my Gokhale pain-free chair, I am extremely comfortable my shoulders are rolled back, I am not having to remember anything or do anything so here is a really good baseline that I am not tempted to leave just because the webcam is there. This would be the same as I was working with my cell phone so here is where parents directions are right, you know when it you to eat, they tell you to bring your food to you and not go to your plate. It’s the same for the cell phone, like you’d like to bring this, you can establish a really good baseline for your shoulders for your back and there is a place to lean forward from naturally it’s where the neck meets the back but you want to do that on a good baseline. You want have the back of the neck elongated and then it’s slightly slanted, just at that one juncture and your arms are in a good place with good circulation thanks to the healthy positioning of the shoulders so that you can hold your cell phone easily.
You don’t get fatigued because you’re cutting off the circulation from having your shoulders forward. So shoulders are back and now everything is going to be close into the body including his cell phone and your eyes are really designed to do a lot of work and then to the extent that it’s not satisfactory there is a place to bend forward but for cell phones you don’t even have to do that. You can just use your eyes and there’s no reason to have it be unhealthy. I have a picture of a gorilla holding a cell phone admirable posture you know, gorilla does it beautifully and we can learn from them.
Zeena: That was a really great tip that I was just practicing and it actually felt great and I have similar tips for sitting positions that I give my client so yes that’s great thank you. So in your book you talk a lot about sitting and standing and lying and bending and all those important positons.
Esther: Talking about which I am gonna change it up right this minute, so taking about changing it up so here I go for a break.
Esther: And my favourite break is actually samba, you know because here I am moving and enjoying myself and there’s no reason I can’t be doing this while I’m talking to you.
Zeena: So I wanted to talk about exercise because you know exercise is always important for us and in the back of your book you have some exercises that you recommend. I wanted to drill down in some of these exercise modalities, the popular ones specifically let’s start with Pilates. I believe you have some Pilates training, I come from a Pilates background, I would love your feedback on what you think about Pilates.
Esther: I really like the emphasis on strengthening and muscular tone and I think modern people can stand more tone in their bodies so that part is great. The objections come in the baseline position of having a tucked pelvis and that’s half of Pilates teaches including Joe Pilates himself, you know super super tucked and then you have the other half of teachers roughly half. As you know Pilates lost their trademark so people under the name of Pilates can do whatever they want and so some Pilates teachers do what they call neutral pelvis but by my standards it’s still a little tucked and you have this S-shaped curve that’s described as natural and neutral and that’s not what I describe as natural as you know from my book what I call natural is actually a J-shaped spine very different from the standard S-shape spine.
I’ll just hold it up for your audience and you can see the S-shape there and then to the left side of the book is the J-shaped spine which and so that’s different from what most almost any Pilates teachers I have run across or doing. And the other objection I have is there is a popular exercise like the Pilates 100 where there is a lot of neck strain, like the neck coming forward and people are fragile in their necks. They already have problematic strain and disc bulges and sometimes herniation and arthritic changes so for sustained period to hold this forward neck position I am not a fan of. But you know these things can be modified, and really I mean what I’m looking for someone who is excited enough about both Pilates and Gokhale method to make a new sort of variant of Pilates that would be correct, I mean that what’s really needed for people who want and exercise based class.
So we have STOTT Pilates and Fletcher Pilates and all of those are quite tucked at the baseline which is for me having an antiverted pelvis is a key ingredient, it’s almost the central ingredient in the Gokhale method and without it doesn’t facilitate the bum working and walking and you get this kind of forward head lean.
Oh here’s another thing that I object to is parallel feet. I don’t think parallel feet is natural for our species so we modify things to be more anthropologically and historically and species correct but that said you know for people who like to go to a class and be trained or go to a personal trainer and Pilates reformer type machines and much can be done if it was slightly modified, I would be really happy with it.
Zeena: I wanna hug you right now because you said all the things I’ve been preaching for a long time about the Pilates community and at this excessive thoracic flexion, and how can it possible be so good for us and a tucked pelvis is just not natural. So instead of what I have done in my own work is that I take the beautiful principles of Pilates which is the control, the slow movement, and the precision, the alignment work, the breathing work, you know the rib cage work, all that beautiful stuff that I know you have talked about too. But get rid of the tucking, get rid of the thoracic flexion and focus more opening up the body and working the glutes and working the back side and all that stuff is so great, thank you for confirming ever thing that I have found that past few years.
Let’s talk about yoga, I think in one of your bios you mentioned something about you were doing yoga back when you had crippling back pain, is that correct?
Esther: So yes I was doing yoga after a fashion, you know uncorrected severely swayed, extremely good at back bends in the wrong place. I was a model in Bombay and people would clap and sign up for the presenter’s yoga classes. I was a cute teenager who could do cool tricks you know. But that’s in part I think got me into trouble when I had my L5 S1 herniation and so on. So yoga is an amazing discipline, you know it was designed by yogis for yogis. These are people who sit on the floor to eat, they squat on toilets, they do yoga for hours every day in a traditional fashion that handed down and now for modern Western person to just jump in and try to approximate the poses doesn’t always work.
It takes sophistication to tweak it for a modern practitioner, I think it’s done a lot of improvements in terms of the blocks and the little aids you know. I think there’s even more that needs to be understood about how the modern frame is different from Indian yogis frame because when you were born we have all these areas that are cartilage, and if you squat on toilets and sit on the floor to eat that’s going to ossify one way and if you’re sitting on a chair and on a Western commode that’s going to ossify a very different way and then once it’s ossified you can’t force the structure except by hyper extending ligaments and damaging joints to then try to approximate what you used to do easily as a two-year-old.
So I love yoga, I teach yoga but every pose is modified, the choice of poses is very well-crafted to support modern living because I think yoga should serve life. I don’t think life should sort of get sucked into a sort of a theoretical existence apart, you know away from life you know people need to be brought back to life and live life richly rather than get to drawn away from everyday life.
Zeena: You make a great point on the modification issue because I’ve had clients that come in and say they got injured in a yoga class because they have been sitting at their desk for hours at a time having no knowledge about how to hip hinge or how to extend from the right part in their spine or vhow to bring their arms above their head properly and then from there they walk in a yoga class and injure themselves.
Esther: It happens frequently and especially for the more serious yogis ironically people are doing hours and hours can develop some pretty unfortunate arthritic changes in their neck from doing shoulder stands excessively and poorly, so yeah.
Zeena: So let’s talk about CrossFIt, what is your experience of CrossFit I know it’s becoming a really big trend and everyone has a different opinion on it, I have chiropractors who have opinions on it and you are an acupuncturist so tell me about your thoughts are.
Esther: So I love the approach of doing functional exercise many things happening at the same time for a busy modern person that’s efficient it’s also a natural you know we used to haul animals, home, enemies to chase animals and be chased and climb up trees and this is normal for our species to do several things. It’s not normal to just flex one muscle at a time so that’s the part I like, but you know before you do that you have a whole bunch of things going on, you would like to patterned in how to do that well and that is not the case for the average crossfitter. They go in there and they are going to do it or began you know and it’s heavy weights. So the heavier more challenging your routine and the more things that are going on the more you need to have prepared for it or face risks of herniated disk.
I know chiropractors say oh yeah they are our business model and that’s just sad because here you put effort and then you doing damage rather than good. It is a big problem and doing some good and some damage is still a pity. You could be doing just good and should be and that’s not trivial to pattern the body well but it’s not rocket science either everyone can do it. We teach it in a six lesson course, Gokhale method foundation course available across the planet by teachers I have trained and the textbook is our book and everyone can do it because we are not teaching people weird stuff. We are teaching people how to sit and stand and bend and walk and lift. Things that every human can do and can find in themselves again and to do in a nuanced way not just higgledy-piggledy damaging things along the way.
Zeena: What about cycling, running, swimming some of those cardiovascular sports that people enjoy.
Esther: I like those things, anything that has been around over a 100 years is likely to be able to be done with good form. So that’s certainly running and I actually think it’s normal and desirable for everybody to do some running. However if your structure is dilapidated then you have to come at it slowly. First learn how to walk really well and then build it up. Cycling obviously is not a natural thing. There were no cycles in prehistoric times but it can be done well. People really need to learn how to hip hinge well so they are not rounding their back especially not in the lumbar spine, not tucking their pelvis and not kind of hunching their shoulders. So it’s a little tricky to do well but has benefits you know, we are in modern times we have to get from one place to another so much better away than just getting in the car all the time. So it’s a balance you know and everything can be done well and be constructive or done poorly and be destructive. Accounts for everything you’ve mentioned so far.
Zeena: Sometimes in a spin class I’ll look at all the people with a rounded shoulders and their rounded lumbar spine and I watch them get off their bike and walk out of class without stretching. I was like oh’ you just did double damage. I think you’re right we need to really be emphasising the flat back hip hinge position when people are on their bike and that’s really important.
Okay I want to move off from exercise and talk about some devices that have come on the market recently. I know you have some things that the Gokhale method sells like your cushion and your chair that you are probably sitting on as we speak. What about these braces that are hot on the market these days that you wear on your shoulder? I think there is a company that sells shirts that bring your shoulders. What do are your thoughts on those kinds of things?
Esther: So I actually like the simpler ones of the devices that brings your shoulders back just to train your brain and where your shoulders are meant to. I sometimes will do a crude version of tying a sheet. I have it in my book you can tie the arms behind you just to give you an experience of how that might feel and get your brain computing but as a device to be worn for an extended period of time and to depend on it. It should be used like a safety net, like you know to keep it somewhat back and then as a training device.
But they think is there is no substitute for education like you don’t want to pull your shoulders back. That will just tense up the muscle the rhomboids and get the origin, points of origin the attachment points inflamed. So I don’t like people to be pulling the shoulders and if that’s what they are getting using those braces to train them to do, it’s counterproductive.
The same goes for you had asked me in your email about Lumo Lift and other devices that buzz when you’re crunching and what almost everybody does with this reminder is to pop their ribs up and now they got two problems instead of one. They haven’t really addressed their hunch and they have just added a sway down below and then that gets tiring or sore and then they go back to hunching the thing that buzz them and then they pop up. So now you are trading one poor posture for another and that’s a problem. So trying to do this without a really nuanced education, I think is just trading one problem for another.
Zeena: Interesting I love that. So let’s talk back about smart phones and tablets and the youth. So I have a 9 year old daughter and I hand her my phone what do you think we need to be doing as a society to help the youth because I literally walk around and I just feel sad because I see the curving and the slumping, so what can we do to capture the younger audience and help prevent them in having back pains at age 20.
Esther: It’s getting worse, the hunches are getting more and more crazy and I think it begins with very poorly designed kid furniture, infant furniture. Like I think no parent should buy an umbrella stroller if they can possibly do without one because that curve shape is just training a small young child to be tucked in the pelvis and to be in this sort of a C-shaped that you don’t want to be. The same with the car seats. Often their first experience to come home from the hospital and they are put in a car seat safety shaped like this which is really a shame so we start them very early, we also carry them poorly so what we need to do first of all is learn good posture for themselves because otherwise there is no way to transmit it. You’re just going to say things like sit up straight, stand up straight which will do more harm than good and also you need to give them the message that this is something you value that you are willing to spend time and energy on otherwise how you expecting them to.
So for the know-how for the values, demonstrating the values parents need to learn this and then they need to band with each other’s what I’ve seen needs to happen so that you can pass it on effectively. Otherwise it’s just hard to do this in isolation is hard to validated, it’s like learning a foreign language. There’s some depth and breadth to it and to expect someone to do it on their own and just you know don’t go to class and learn French and then talk French on your own you need other people to talk.
So when we teach kids we teach very differently you know we say ducky but not tucky you know we say stack your blocks we don’t use the same medical terminology and so there are ways to teach. We do teach all our teachers are trained to work with people of different ages. Hundred year olds, infants and you know we teach parents how to follow through and how to advise them that we do insist that parents learn for themselves. I’ve tried very hard to approach kids through schools. It’s a really difficult uphill endeavour because the teachers are not very empowered they are feeling encumbered. They have to you know do increasing number of jumping hoops with scores and writing this and writing that and adding requirements and so on so they are not particularly in the mood to add yet another thing into their day. Kids are over scheduled so this is a problem I’ve tried to crack for a long time. I have some ideas coming up, we inform people of what our offerings are in our newsletter positive stance in a people can sign up and be posted and I’ve tried a lot of ideas that don’t work like approaching through the teachers. Parents are a really good way but it needs to be more than that.
Zeena: Great this is wonderful I really appreciate you answering all these questions. I have learned a lot I hope the readers have learnt something too. I want to give you an opportunity to let us and the readers know how to engage in your methods and how to buy your book and your cushion and all that stuff so please take a moment and let up know.
Esther: Sure the website is http://www.Gokhalemethod.comand that’s spell GOKHALE method.com and that’s a hard one to remember so if people look up posture guru that the New York Times called me then you get led to the book and the site. On Amazon if you look up back pain under books it’s one of the top books that comes up and it’s called Eight Steps to Pain-Free Back and then the rest of the things we sell on our website the cushion the chair I have a little head cushion that I find very handy to know which way up.
Zeena: Oh’ fantastic.
Esther: It’s simple but it has a good amount of weight and friction and it stays on there and then we have our DVD that’s on our website. This is also on Amazon and so we don’t sell many things but these things I found to be useful and if people are in the market for a chair, the chair is really, if I say so myself, pretty awesome because it allows you to stretch sit and it allows you to stack sit on the front half, it has a built-in wedge and so that’s very handy.
Zeena: I have seen some devices that you can put on your chair that kinda give you that tilt that it seems like your chair has both the ability to do your stack sitting and your stretch sitting, correct?
Esther: Yes which is a whole lot better than slum sitting and arch sitting.
Zeena: You have a YouTube channel?
Esther: We do have a YouTube channel and we offer online free online workshop so if you go to the homepage of the website you can just sign up for one and out teachers who are all over the planet. We do free workshops as well as teach our course and do initial consultation and all sorts of things to try to do as you are doing Zeena, help the planet’s posture improve.
Zeena: Well I call myself a posture geek, I call my newsletter the posture geek newsletters, so from a posture geek to the posture guru thank you so much for being with us today.
Esther: My pleasure, thank you so much.