How to Correct Your Posture

How to Correct Your Posture

How to Correct Your Posture

Sitting is not the new smoking, says Esther Gokhale, the author of 8 Steps to a Pain-Free Back.

An acupuncturist who now teaches people how to sit, stand, and move, Gokhale got curious about the root causes of back pain when she was dealing with it herself over twenty years ago. She started studying posture across cultures and times, in real life and in the research. And she developed a method—the Gokhale Method—that helps people return to what she thinks is our innate posture. A lot of her work is about busting myths. But mostly we like her advice because it’s actionable and simple to incorporate into your daily routine.

A Q&A with Esther Gokhale

What are some of the most surprising things you’ve seen while studying posture and back health?

I studied Aplomb—a French movement reeducation technique—and became inspired by the idea that there is an immense amount of bodily wisdom in some parts of the world that we could learn from. I looked at the medical literature, which showed that some cultures have a lower incidence of back pain. I decided to travel—I went to remote villages in West Africa, India, Brazil, Ecuador, and Portugal. I took photographs, filmed, and interviewed people to learn more about how they use their bodies.

What I learned destroyed a lot of common myths for me. For example, the idea that we aren’t adapted to be upright. I often hear people say, “Human beings haven’t really adapted to being bipedal yet. That’s why we have so much back pain.” We’ve been upright for 5,500,000 years—which is a long time even by evolutionary standards—and we have figured it out. The people I met are pain-free.

Another thing I learned: Sitting is not evil. We often hear that sitting kills you or that it’s the new smoking, etc. Yet when I observed people, I saw that many sit for a great deal of the day. They’re weaving baskets, they are making pots, they are preparing pelts, and they navigate sitting just fine. Now, it’s true that they punctuate it with breaks. They don’t sit like a lump on a log for eight hours straight, which is problematic.

We also blame heavy labor. Yet people in these cultures are doing heavy labor and they don’t suffer from a lot of back pain.

It’s not our lot to suffer pain. It’s not that sitting is evil, and it’s not that with old age you are going to be bent over. There are a lot of older people in these cultures who are in their eighties or nineties and are still functioning extremely well. It’s the way that many of us sit and put strain on our backs that makes the difference.

What to Do If You Sit. A Lot.

In Gokhale’s experience, the key to mitigating the effects of sitting all day is walking well. “When you sit for a long time, the psoas muscle begins to adapt to a short resting length,” she says. “So it’s critical to walk in a way that resets the psoas so that it doesn’t become short and tight.” (The psoas muscle runs from the front of the lumbar spine to the upper inside of the thigh. It’s responsible for flexing your hip joints and lifting the upper leg.)

Gokhale recommends this kind of stride as a psoas stretch: “With your leg straight and back at an angle, place your heel down on the floor. Your butt should be squeezed, and you should allow for your psoas muscle to lengthen and stretch. Make sure to leave your heel down. If you lift your heel up, the psoas, which attaches to the inside of the leg, won’t get a full stretch. The goal is to incorporate this with every step that you take, keeping your back heel down, so that the psoas is always getting its natural stretch.”

Gokhale also recommends switching back and forth between “stretchsitting” and “stacksitting.” Stretchsitting, she explains, is a technique that introduces traction—using a folded towel or cushion—into the arch of your mid-back and beneath your shoulder blades—which allows for your shoulders to relax, while you gently lengthen and decompress your spine. In stacksitting, you place a wedge—a folded towel or cushion—at the base of your chair, and then sit on the front edge of the wedge, which will help to tilt your pelvis forward. This, she explains, “allows you to be in an upright, relaxed, seated position while your pelvis is well-positioned and your back stacks easily.”

Last, Gokhale says we should mix it up by standing and moving regularly and avoiding staying in any one position for hours. “I don’t think sitting is evil, but it is important to change it up,” she says.

What does good posture look like?

Upright and relaxed. This requires a well-positioned pelvis—or a pelvis that is tipped or anteverted so that the front of the pelvis is lower than the back and the vertebral column can stack easily on top of that. Both the pelvis and feet work as your foundation. Well-shaped feet have a kidney-bean-shaped footprint, with an external rotation in the leg. All of this helps prevent your muscles from being strained as they try to hold you upright.

People mistake upright and tense for good posture. They arch their back or pull their shoulders back and imagine that that is good posture. Oftentimes doing so strains the back. That exaggerated posture is not sustainable, and it is also not healthy. Toned muscles are very helpful, but there shouldn’t be strain.

It’s important to have good muscle tone in your deep abdominal muscles and deep back postural muscles, which are the muscles closest to your spine. Developing these muscles and building what I call an “inner corset” will help stabilize your trunk. You can do this with any kind of strenuous activity from jogging, swimming, biking, dancing, etc. Your inner corset is not to be mistaken with your core. When people talk about the core, it’s typically used to describe patterns of engagement, which tuck the pelvis and can be problematic.

It’s also important to have strong glutes, which grow stronger when you walk properly. We teach people to walk in an erect way, activating the glutes and making sure that every landing is soft, so you’re not jarring the body. This is a key characteristic of my approach, which is that a lot of the work is done through your everyday activities versus a set of specialized exercises. It’s not that you have to take time out of life to strengthen and stretch these muscles. Rather, if you do everyday life in a skillful way, a lot of the strengthening and stretching is taken care of in the process.

When it comes to the baseline postural support, superficial muscles, like the six-pack (rectus abdominis) and the erector spinae, are not as important. They are used for larger movements, such as bending over or arching your back, and they should not be the main group of muscles responsible for keeping your spine upright. The superficial muscles tend to get overused, while the deeper, stabilizing postural muscles get underused.

You talk about S- and J-curved spines. What do they look like, and is one better than the other?

Conventional wisdom says that it’s healthiest to have an S-shaped spine. But we are teaching people that the healthier paradigm is a J-shaped spine, which has your back more stacked.

There is a lot of research supporting the claim that a J-shaped spine correlates with less back pain and that an S-shaped spine correlates with having more back pain. There was a controlled clinical study on one hundred volunteers with back pain and one hundred volunteers without back pain. The researchers compared the volunteers’ upper lumbar curve with their lower lumbar curve. They found that with those who had back pain, their spine was more curved at the higher end and less down below, like an S spine.

How do you approach healing back pain?

The first step is to decompress. Most people struggle with a lot of compression in their spine. So I begin with decompressing, lengthening, relaxing, and stretching. When the spine’s normal architecture is restored, the stress on the discs and bones is relieved, the nerves are not impinged, and the muscles are lengthened. When the discs and bones are compressed, it leads to degeneration, and when the muscles are tight in the lower back, it constricts blood supply to the muscles. I start with decompressing since it’s relatively simple, and after you learn how to do it, it doesn’t take constant reminding and remembering or a lot of effort. This simple step gives people the encouragement and motivation to do the subsequent steps, which involve a bit more work.

The second step is to strengthen the relevant muscles—the inner corset—and activate the deep abdominal and back muscles that support good posture. Every time your back is challenged, you activate your deep abdominal and back muscles, which helps spare your discs and nerves all at once.

The third step is to shape the trunk and the torso and to work on positioning your behind—behind you. We do this by making sure that the upper lumbar area is straight and stacked.

The Gokhale Method does not involve interventions that someone does to you, like a chiropractic adjustment. With the method, you just need to invest in learning. Once you learn and understand how to do things the correct way, it slowly becomes a habit. All of the work is integrating new ways of doing things in your everyday life. From the way you sit to the way you walk, all of these changes work to remodel your body.

Are there other techniques or movements you focus on to alleviate and prevent back pain?

Learn how to properly hinge at the hips to preserve the spine. Hinging at the hips is the natural way to bend, rather than arching or rounding the back, which is very common.

We also teach people how to properly lie down. And how to elongate your back so that the bed, in a way, becomes a traction device. If you lie on your side, we show you how to lie down with the J-spine, with your behind behind you and the rest of the back elongated and relatively straight. This helps to reshape your back as you sleep, and your brain can get used to that shape.

A Few Simple Exercises from Gokhale

Shoulder rolls:
These are easy and effective and a really good first measure. Do these one at a time. With small movements, simply move one shoulder forward, then up, then back, and down. Repeat on the other side, and then relax.

Now your arms are hanging in a different place, and you’ve ratcheted the soft tissue of the shoulder back a notch. You don’t have to remember anything, just one roll. Now you’ll find the shoulders stay in a different place. This does wonders for the circulation in your arms and back. You won’t be hunching forward as much, and your breathing pattern will improve.

Glute exercise:
Another one that is simple is becoming aware of your glutes. Start by taking a look at your glutes, or your butt muscle, in the rear leg. Begin by squeezing your glutes with every step you take. Being aware of your glutes and remembering to squeeze them with every step will give your walk more power and also help improve glute muscle tone. Since we spend a lot of time walking, it’s worth trying to implement.

Where is the method offered?

We have a six-lesson course, which can be done in an intensive format over a weekend, or it can be done once a week for six weeks, or something in between. It’s been crafted to be efficient, so that at the end of the six-lesson course, people are sitting, standing, walking, bending, lifting differently, lying down differently. I also cover the course in my book, 8 Steps to a Pain-Free Back.

Currently, we have more than fifty trained teachers who travel and teach around the world. The eight-person group courses are usually done in studios and the teachers also do one-on-one home private sessions.

What results have you seen?

Most people come to us for help with their back, neck, knees, hips, or feet. But the method has potential far-reaching benefits. In addition to alleviating neck and back pain, many people begin to look better from being properly aligned, which gives them an emotional boost. By relaxing and activating certain muscles, there can be increased blood supply to the body, organs, and muscles. We have also seen that physiologically, people breathe better. People have also reported improved digestion, increased energy, and better sleep. Their bodies are not complaining all night long anymore.

Esther Gokhale is a licensed acupuncturist and the creator of the Gokhale Method. She is the author of 8 Steps to a Pain-Free Back. She studied biochemistry at Harvard and Princeton and later studied acupuncture at the San Francisco School of Oriental Medicine. She is based in Palo Alto—where she practices acupuncture and teaches dance, yoga, and posture—and travels around the world teaching people about her method.

This article is for informational purposes only, even if and to the extent that it features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice. The views expressed in this article are the views of the expert and do not necessarily represent the views of goop.