The 'Posture Guru' Shares Her Tips to Relieve Back Pain

Back pain is an epidemic. It could be caused by our more sedentary lifestyle, a few extra pounds around the middle or looking at the phone for hours each day. But Silicon Valley posture guru Esther Gokhale says in non-industrial cultures, back pain is practically non-existent. Why?

She thinks is because our spines have recently changed shape, so she has created an entire method to change that shape and reduce pain. Gohkale says it's a method for sustainable posture that could lead to a reduction in back pain. Her fans are legion and the medical community has taken note as it searches for alternatives to pain pills, surgery and braces.

The problem, Gokhale says, is that modern life takes the top part of our back and curves it forward, creating an "S" of "C" shaped spine. Plus, she says, we're told to tuck our pelvis and push out our chests, to create a perfectly straight spine. That differs from non-industrial cultures like Burkina Faso, Borneo and in remote parts of Brazil, where Gokhale says she observed "J" shaped spines; the base of the spine curved out to the buttocks, while the rest of the spine stacked vertically straight up to the shoulders.

She says children natively have this posture and before the industrial age, so did our great-great-grandparents. But then something changed: Activity lessened, our gaze moved to small tasks with our hands and our idea of sitting and standing properly morphed to something more erect. Gokhale channels my grandmother: "'Sit up straight.' That's what moms have been telling their kids for decades; usually in a frustrated way, because it clearly doesn't work. Maybe for 10 seconds and then the kid goes back to slumping."

So Gokhale says "Sit up smart." She has seminars, videos and books that espouse her techniques and the traditional medical community is taking note. Dr. Praveen Mummaneni, neurosurgeon and co-director of the UCSF Spinal Center says that while no studies of non-industrial populations have been done to directly support Esther Gokhale's research, the techniques resonate. "It's a very good visual. The J-shape is a very good visual that I think a lot of people will recognize, looking at that from the side and in thinking about their own posture, and it's straight forward to remember," Mummaneni says.

In our posture session, Gokhale taught me some basic ideas that have helped me focus on my posture. As she says, "My methods are simple, but not easy." I agree: in the days following our session, I try to put her ideas into practice; posture is a discipline!

How to sit in a chair: the behind goes behind

Gokhale says we were taught to tuck our pelvis when we sit, "imagine you have a tail. The way we've been instructed to sit is to tuck that tail under our behinds. But I want you to push the tail out and let it go out the back of the chair." I find this pelvic tilt is freeing, and Gokhale says you can reinforce it if you sit for long periods by using a pillow to wedge your pelvis forward and force your behind, behind.

Power your posture from the rear

Gokhale coaches her students to access the muscles of the gluteus maximus to hold the "J" shape in their backs and stack their spine in vertically. "Make every step a rep."

Gokhale says strengthening the posterior chain of muscles in the gym is good, but if you can recruit those muscles with every step, clenching the upper outside quadrant of your backside as you walk, you will do much more for your overall posture and pain reduction.

Lengthen the spine and hook your mid-back on a support

Whether it's typing at a keyboard or holding the steering wheel of a car, when our arms go forward, our shoulders follow and we end up in a "C" shape. Gokhale says to use a towel, a jacket or she sells tethered pillows that fasten on. She says lean forward, use your arms to push down and lengthen the spine as you then lean back and hook your mid-back onto that cushion.

This move was enlightening for me. I felt like it created a stacked spine that rested comfortably. More than traditional good posture, I found this easier to maintain over time.

Roll the shoulders back

As I spoke with Gokhale the first thing I noticed was that every five minutes or so she would roll her shoulders back, one at a time. In the past I thought of good posture as lifting the entire rib cage and pushing it forward.

In truth, my posture came slouching down seconds later when my attention turned elsewhere. But if I just focus on my shoulders, I find that I have a little more hold time before they drop forward again.

Gokhale has free videos on her website demonstrating some of these techniques and she also sells her book, pillows and chairs there.

If there's one thing I learned doing this assignment on posture, it's that improper posture can lead to pain, but the feedback loop is delayed: The pain occurs too long after the bad posture happens to truly influence our behavior. So I also tried a few devices that provide more immediate feedback for bad posture.

Posture Shirt Alignmed: $95

The Posture Shirt looks like a cycling jersey: fitted to the body with short, tight sleeves. It costs $95 and it's a biofeedback device to help you sit up straight. One of the biggest problems of poor posture is we lose focus, slouch and forget our goals. I wore the posture shirt for three days and this was a consistent cycle:

Sit properly, unconsciously slouch, wonder why my shirt felt tight on my shoulders and arms, remember that it feels good when I sit up straight, correct posture. If you suffer from pain and have been trained in proper posture, I found this to be a helpful biofeedback mechanism to remind you of your goals. That said, I would have to be in serious pain to want to wear this shirt habitually. Alignmed also has a bra version if the shirt is too much to wear under tailored clothing.

Lumo Lift: $79.95

This wearable device snaps magnetically onto your lapel, T-shirt or bra. You need to calibrate the Lumo, telling it what you deem proper posture. Then when you slouch, the device on your clothing vibrates.

You can dial its sensitivity up or down, basically making it more forgiving or more strict when you deviate from your upright position Simultaneously, the Lumo connects via Bluetooth to your phone and uses an app to track your posture. It creates detailed reports about your total time in correct posture, then offers goals and coaching points to help you improve.


My Kingdom for a Chair

Last Updated Jul 31, 2009 5:25 PM EDT

I've decided that pain can't possibly be good for productivity.

How did I arrive at this shocking conclusion, you ask? Simple. My back is killing me and it's making it really hard for me to sit at my desk and work -- a prerequisite for productivity when you're a writer.

My chiropractor is helping, but he's made it clear that he won't tolerate any more of my whining until I invest in a good chair. See, he believes that where and how I sit for eight hours a day (or more) has a lot to do with my aches.

So it's time for me to retire the bought-on-sale, Office-Depot-clearance-item chair I picked up about six years ago. But let me tell you, there are a LOT of choices out there. And I don't know where to start, or what's hype and what isn't.

Of course the Aeron chair comes highly recommended, but have you seen the price tag? $629 for the basic model would pay for a lot of chiropractic adjustments.

The kneeling chair is supposedly good for taking pressure of your back, but it looks kind of silly. And I imagine getting up and down several times an hour, which I do, would be a little annoying if I had to extricate myself every time.

I have a great exercise ball at home and suggested to my chiropractor that I just perch on that. But while he said it would be fine for short stints at my desk, he insisted I should still alternate that with sitting in a proper chair. (Drat. There goes my no-cost solution.)

There's the Swopper, a colorful stool on a spring. Seems like it'd be fun, albeit possibly distracting; I have a tendency to jiggle my leg when I'm writing under deadline, and I can imagine the effect that'd have (boing boing boing). But $499 is a pretty penny to pay for a souped-up toadstool.

One other option might be to change to a stand-up workstation. I consult with Cisco, and some of the folks there swear by them. They have high swivel chairs as a backup but spend most of their time working on their feet. I'll bet it's good for their backs (not to mention it must help combat that 3 p.m. urge to doze off). But I'm afraid my feet would hurt after a while.


So I'm stumped! And I'm turning this one over to you, my loyal readers. I'm sure many of you have been through this yourselves and have recommendations galore. So share your vote in the poll, and please add any detailed suggestions or warnings in the comments section. Thanks!

© 2009 CBS Interactive Inc.. All Rights Reserved.


Shoulder Area Tendinitis Aka Supra Spinatus Tendinitis

The Shoulder, Rotator Cuff, and Tears

The shoulder area is the target for a multiplicity of tendinitis and other problems.

Rotator cuff problems such as strain and tears, labrum (Cartilage), long head of the biceps tendinitis, muscle strains and tears, neuritis, arthritis, narrowing acromial-clavicular joint.

Tendinitis (supra spinatus tendinitis) benefits from in-home physical therapy, special supplementation, and non-muscle building exercises. The book "Cure Yourself of Tendinitis (At Home Now)." Can be of great assistance!

What the book, by Dr. Edward G. Holtman D.C. reveals:

1.Discusses each and every area of the body where tendinitis can occur, and how to locate and treat each area.

2.The all-important role that the body's muscles play in the onset and the treatment of tendinitis.

3.What most physical therapists are doing to hurt or impede your progress with tendinitis!

4.The basic theory, or principals, for treating tendinitis anywhere in the body!

5.The reasons all health professionals have, thus far, failed to deliver lasting results with tendinitis (This should be embarrassing!)

6.Why seniors develop tendinitis.

7.How to treat your tendinitis yourself at home with lasting results and at a low cost.

Severe Tears

Severe tears will probably be best handled surgically. But rotator cuff strain or weakness can be rectified by in-home exercises.

What Causes the Various Shoulder Problems to Erupt?

The causes of tendinitis are most often caused by repetitive movement or over-use of the involved body part. Strains and tears from severe use or injury, neuritis from subluxated (slightly out of place) neck and upper thoracic vertebrae, arthritis from injury, 'normal' wear and tear, Vitamin D Deficiency, and hormonal imbalance.

Bursitis (inflammation of the sack that holds the joint fluid) may also be caused by: Sudden arm jerks, Karate, Baseball, and cross-country skiing.

What are some activities that can initiate shoulder Tendinitis?

Þ Tennis

Þ Golf

Þ Factory Jobs

Þ Chin-ups/Pull-ups

Þ Weight Lifting

Þ Squash

Þ Rock Climbing/Mountaineering

Þ Mechanic Work (Auto)

And many other everyday activities

What Should Be Avoided (If Possible)

Any activity that is listed above should be avoided or considerably reduced until the tendinitis is nearly well. Avoid most physical therapists because they will "encourage" you to do muscle-work exercises and muscle work is the main cause of most tendinitis. The exception to this rule is, opposing muscle work exercises!

What Can Be Done?

Neuritis: Hands on chiropractic, because the cause is most often in the spine.

Arthritis: Shoulder joint manipulation, calcium and vitamin D Supplementation, heat or cold applications.

Bursitis: Cold pack applications for 10 minutes twice daily. Guided movement (Your chiropractor may help you with this procedure)

More Information and About The Author:

Dr. Edward G. Holtman, D.C. has over 40 years experience in treating chiropractic patients and 10 years experience in the field of tendinitis treatment.

The NEW published book, "Cure Yourself of Tendinitis (At Home Now)." Can be ordered by calling our office.

Office hours are 10:30 A.M.- 10:00 P.M. Monday through Saturday Central Standard Time. Office phone: 262-673-5650.

By: Dr. Edward Holtman, D.C.

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Winter Back Pain - See A Chiropractor

With the onset of cold weather, a brand new danger lurks it's ugly head for those with underlying structural problems associated with their spine. The drop in temperature can affect our hydration levels and the overall tone of our muscles, but more importantly ice is everywhere and can lead to lots of back problems from the trauma... even if you don't actually fall down.

How can this be? Let's start with the fall. It's pretty obvious that if you fall down, you will likely affect your spine. The impact and shock of hitting the ground can move things out of place. It's that movement of vertebrae out of place that can cause spinal problems. The effect may not occur right away. You may just notice that "something's not right," but not enough that you decide you absolutely must do something about it right away.

It's these warnings that are the easiest to ignore. Many times people will ignore the warning signs and simply wait until they are bending down to do a simple task like picking up socks when they unexpectedly cannot move. They are doing something "dangerous" like throwing a small pillow when their back seizes up. These are the types of stories I hear everyday.

The overlooked trauma is when you don't actually fall. You come close, maybe grab on to something nearby. Still, your muscles tense up, you get scared, and then thank your lucky stars that you didn't actually fall on to the ground. It's these "near misses" that can still affect your spine.

That sudden seizing up of the muscles can also throw things out of place. The muscles attach to the spine and when they tense up, knot up, or spasm they will cause the joint to stop functioning as it is designed. Time to see the chiropractor.

The chiropractor will find the areas of your spine that have moved out of place, help move them back into place, and restore the body's normal function. The relief happens pretty quickly in most cases. A problem caught early is always easier to take care of before the crisis occurs. Not to mention how much a frozen back can ruin your entire week.

By: Philip V. Cordova, D.C.

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Dr. Philip Cordova is a chiropractor in Houston, Texas. More information about this seeing a local chiropractor in Southington, CT can be found on at


Neck Pain Can Las Vegas Chiropractic Really Help? by Dr. Michael Reiss

Neck Pain Can Las Vegas Chiropractic Really Help?

 by: Dr. Michael Reiss

Neck pain is a very common problem affecting up to 70% of the adult population at some point in life. Though there are specific causes of neck pain such as arising from a sports injury, a car accident or sleeping crooked, the vast majority of the time, no direct cause can be identified and thus the term nonspecific is applied. There are many symptoms associated with patients complaining of neck pain and many of these symptoms can be confused with other conditions. Wouldnt it be nice to know what neck related symptoms are most likely to respond to chiropractic manipulation before the treatment has started? This issue has been investigated with very favorable results!

The ability to predict a favorable response to treatment has been termed, clinical prediction rules which in general, are usually made up of combinations of things the patient says and findings from exams. In a large study, data from about 20,000 patients receiving about 29,000 treatments, was collected and analyzed to find out what complaints responded well to chiropractic treatment. The results showed that the presence of any 4 of these 7 presenting complaints predicted an immediate improvement in 70-95% of the patients: 1. Neck pain; 2. Shoulder, arm pain; 3. Reduced neck, shoulder, arm movement; 4. Stiffness; 5. Headache; 6. Upper, mid back pain, and 7. None or one presenting symptom. Items not associated with a favorable immediate response included numbness, tingling upper limbs, and fainting, dizziness and light-headedness in 4-12% of the patients. The take-home message here is that was far more common to see a favorable response (70-95%) of the patients compared to an unfavorable response (4-12%), supporting the observation that most patients with neck complaints will respond favorably to chiropractic treatment.

So, what do we do as Las Vegas chiropractors when a patient presents with neck pain? First, after gathering preliminary information such as name, address and insurance information, a history of the presenting complaint is taken. This consists of information including what started the neck complaint (if you know), when it started, what makes it worse, what makes it better, the quality of pain (aches, stiff, numb, etc.), the location and if there is radiating complaints, the severity (0-10 pain scale), timing (such as worse in the morning, evening, etc.), and if there have been prior episodes. Various questionnaires are included that are scored so improvement down the road can be tracked and a past history that includes a medication list, past injuries or illnesses, family history and a systems review are standard. The exam includes vital signs (BP, pulse, height, weight, temperature and respiration), palpation, range of motion, orthopedic and neurological examination. X-ray and/or other special tests may also be included, when needed. A review of all the findings are discussed and after permission to treat is granted, a chiropractic adjustment may then be rendered. A list treatment options may include: 1. Adjustments; 2. Soft tissue therapy (trigger point stimulation, myofascial release); 3. Physical therapy modalities; 3. Posture correction exercises and other exercises/home self-administered therapies; 4. Education about job modifications; 5. Co-management with other health care providers if/when needed.

We realize you have a choice in Las Vegas Chiropractic offices. If you, a friend or family member requires care for low back pain, we sincerely appreciate the trust and confidence shown by choosing our services and look forward in serving you and your family presently and, in the future.




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