posture correction to prevent back pain and others

[Abso88]

don't know if this should be in this area but prevention care kinda fits in the injury pain category. maybe there should be a self care section for therapist separate from injury, pain treatments for clients.

I found a great book that teaches one how to have proper posture. this will fix most people's problems of pain, injury and prevent them. the title is kinda misleading. '8steps t a pain free back' by Esther Gokhale. her site is egwellness.com even though it sounds like a treatment from the title. it's not. it's education of proper posture application in sitting standing, lying,walking, etc.. nowadays the norm posture from medical field is taught wrong not base on how our body naturally function.

it will also help you with doing proper massage too since eventually you'll align your body and lengthen your spine and use proper muscles instead of joints (due to poor posture) to do your everyday activities. I highly suggest all therapist get this book and learn it. it's way better than the body mechanics taught in massage classes. not to mention, it'll help prevent future pain for you by knowing how to use your body correctly the way nature intended. and you will probably not need to go see a chiropractic for adjustment because your body will adjust itself from these healthy natural habits

 

[The Lemur]

I took a brief look at the website and a few things jump right out at me.

"The Gokhale MethodSM addresses the root cause of muscle and joint pain.
Most pain can be attributed to how we hold ourselves and how we move. Since we are born without a user’s manual, we rely on our culture to guide us. "

As bodyworkers, we certainly see how "bad" posture can create imbalances in the body. But, I challenge anyone to show me research that states faulty posture necessarily leads to pain. There are many people out there with very good posture who suffer tremendous pain, while there are just as many out there with dreadful posture who suffer no pain.

I use postural evaluation as part of my evaluation as well as a guide to treatment, but misalignments are not necessarily correlated with pain.

I cringe when I see suggestions for proper sitting lumped into generalizations. The two drawings on the first page of the website are a case in point. The first one, where the model is sitting slumped and sloppy, is designated as "poor alignment", while the second is called "good alignment". Telling everyone to sit, back unsupported (as shown), with a full lumbar lordosis for any length of time can be the worst thing that you can tell a person who suffers from shortening of the hip flexors and resultant back pain.

It is quite possible that the book elaborates on these topics further than I took the time to peruse, but my first reaction was to stay away.

 

[chuckstervandam]

I took a brief look at the website and a few things jump right out at me.

"The Gokhale MethodSM addresses the root cause of muscle and joint pain.
Most pain can be attributed to how we hold ourselves and how we move. Since we are born without a user’s manual, we rely on our culture to guide us. "

As bodyworkers, we certainly see how "bad" posture can create imbalances in the body. But, I challenge anyone to show me research that states faulty posture necessarily leads to pain. There are many people out there with very good posture who suffer tremendous pain, while there are just as many out there with dreadful posture who suffer no pain.

I use postural evaluation as part of my evaluation as well as a guide to treatment, but misalignments are not necessarily correlated with pain.

I cringe when I see suggestions for proper sitting lumped into generalizations. The two drawings on the first page of the website are a case in point. The first one, where the model is sitting slumped and sloppy, is designated as "poor alignment", while the second is called "good alignment". Telling everyone to sit, back unsupported (as shown), with a full lumbar lordosis for any length of time can be the worst thing that you can tell a person who suffers from shortening of the hip flexors and resultant back pain.

It is quite possible that the book elaborates on these topics further than I took the time to peruse, but my first reaction was to stay away.

Most physical therapists that I know categorically dismiss the notion of an ideal posture. So do most of the chiropractors and orthopedists I am familiar with.

Further, research has demonstrated that stiffly holding an "ideal" posture is guaranteed to cause pain. Slumping, slouching, and shifting around are micromovements that enable our bodies to prevent pain from lack of movement.

In performing activities that place significant structural stresses on the body, it is important to utilize proper alignment and movement patterns to minimize risks of injury. Therefore the emphasis should more rightly be placed on learning to improve biomechanical movement patterns rather than arbitrary "ideal postures" that are not task-specific.

From reading the Gokhale site, it is impossible to tell exactly what she is teaching. It does make frequent mention of movement training, but the emphasis is solidly on everyday activities. It is impossible to tell how they would address training appropriate patterning for specific activities, let alone how they address stretching, strengthening, etc. to correct imbalances in muscular development and compensation patterns... I suppose that's what the book is for.

 

[Pompal 09.]

well, I have the book. it goes into details with scientific background supporting it. most chiropractor and physical therapist have the wrong approach to relieving pain such as strengthen this muscle and that muscle or snap the spine back into place. it's not base on how natural our body works. As a therapist, i always go in favor of natural approach of how our body works.

and yup. you made assumptions and generalized. so i say your first reaction is not in your favor without looking at the big picture. if you choose to not check it out. then i say you've let a great resource pass you by that may of help you deal with potential future pain that may or may not come to you or your clients. there is reason that one isn't suppose to slump from sitting. and you do realize posture isn't static right? it's not about holding ideal positions which you assume what posture is about. she goes into how to carry oneself properly in areas of sitting, standing, walking, sleeping, etc... As with posture, it's not about being in this or that posture. it's about looking at the spine and how our body works and use our body base on that, not on what others say this or that is good posture. it's all scientifically base. all the reasons are explained in her book. I would say bio-mechanics is more better discription of intended message. but that word isn't used as general public don't know bio-mechanics.

look at those with good posture who have pain and you realize they don't have good posture base on science. good posture is being in the proper posture of ease and balance that relax your body. the so called 'good posture' that is recommended to everyone isn't good posture. the book goes into detail. she's done a great depth of research on posture. do check out the book without assumptions.

and there is no way to prove such and such cause this. these are one of those that are subjective. and that isn't important. what is important is to prevent pain. if it works use it. why care about the cause? and i do believe most people are in pain due to posture. why? cuz even if it's injuries caused. that injury give them bad posture from compensation that prevent them from healing. why else we do postural assessment before doing massage? to find out tension of muscle and imbalance. and those are all posture related. so that in a way proves posture cause pain or reinforce pain.

just remember. this is preventative care so body function at best and heal itself. not about the so called fix it mentality that you assume in posture cause pain. so let's fix it with posture correction.

the post was to share a great resource not to critic it and tell others to stay away from it base on assumptions without checking it out waltfriz.

and yes, you are correct JasonE. that is what the book is for.

 

[Dirtbag Poser Bot]

Sillypup,

I apologize if you took personal offense to my post. I just ordered the book and will give it a fair reading. You are correct, without reading, there is no way to judge, despite what is presented on the website. Not that my one opinion should matter that much, but I will post again after looking it over.

 

[8 In the corner]

There's a comprehensive preview of this book on google HERE.

 

[Ali]

If you want to read about back problems and assessment of back problems, check out Stuart McGill's Low Back Disorders.

And after you are done with that, do read Shirley Sahrmann's Diagnosis and Treatment of Movement Impairment Syndromes.

And after that Kendall's "Muscles: Testing and Function with Posture and Pain."

And when you are done there, I have a folder full of research I can send you.

No sense in limiting yourself to one single book.

Also, Walt is right - poor posture doesn't necessarily mean pain and proper posture doesn't necessarily mean pain free. And, somewhere lying around my apartment I can find you the research to cite that as well.

Patrick

 

[Ray E]

No offense taken waltfritz. just didn't want your bold post that is so strongly against a great suggested resource book to help therapist prevent pain be overlook by others. the book i suggested was more geared toward the therapist not for the client we work on as it would fall into the somatic movement therapy category. of course i find it useful to them but you and I know they are often lazy to be active and expect us to do our mojo to get rid of their pain.

I think there is a youtube video of her giving an hour lecture to google company. http://www.youtube.com/watch?v=-yYJ4hEYudE

all those books you suggest are great patrick , however, i think they are different perspective then coming from natural body posture habits from re-educating the body. they seem to come from treatment, something wrong with you perspective base on it's title of words like, diagnosing, disorders, testing, and treatment. they seem very familiar so i probably have browse through their table of contents on amazon. they weren't my type of tea meaning not the perspective presentation i was looking for. you know most pain sufferers don't care about why they have pain. they just care to get rid of it. what's the solution they keep asking. hence, my suggestion for this book that focus on solutions rather than problems. do check those book suggested by patrick for those interested in learning more about pain. I myself prefer learning method on how to prevent them so those presentations in those books might not suit my needs. treat the cause not the symptom is my approach. that's the problem i see in health field. still stuck with treating symptom not cause. big pharma keep us like that on purpose as they make billions of bucks keeping people in chronic illness.

with the poor posture causing pain, good posture being pain free debate. they are gray areas. there will never be a definite answer to that. there are so many variables. I'll stay with the good old do whatever works method. i don't care for the scientific belief that you have to have proof in everything to validate it method. research are always bias and often false. "what the prover thinks, the prover proves. " goes the saying. Not to mention the many fake research going on all over the place. if i did go route of only proof are valid (western thinking mainly), i wouldn't be an expert in energy treatments or do great work that clients think are miraculous. nature is the best lesson. just listen to the body and that's what the author did in her research. find those that don't have pain all over different cultures and learn from them. she found out they were using their body naturally. I'll stick with nature methods over any science research especially in medical field that scientist like to be gods messing with dna cloning. etc...

 

[Madeleine Z]

But...you can't have it both ways. If you choose to trust or believe one person's references to science but ignore others, you are walking a slippery slope. You referenced that this book cites research to back up the claims. One must be able to look at all available information, both pro and con, to determine the validity of the premise. You are reading one person's opinion on what is natural and right for human's. If there was one correct path then all of us should be out of business.

 

[stephen raj]

But...you can't have it both ways. If you choose to trust or believe one person's references to science but ignore others, you are walking a slippery slope. You referenced that this book cites research to back up the claims. One must be able to look at all available information, both pro and con, to determine the validity of the premise. You are reading one person's opinion on what is natural and right for human's. If there was one correct path then all of us should be out of business.

Bingo.


Sillypup,

You are right, people don't care why they are in pain they just want to get out of it! BUT, it is your job (or our job) to understand why they are in pain so that we can fix it. Understanding posture and movement and what types of things people present with are critical ways of helping people on the road to recovery.

Part of my disenchantment with most massage therapists is that they just want the protocol or just say "well, the person hurts here so I'll just massage it."

Asking "why" is your job! Why are the people in pain and what can I do about it?

patrick

 

[DCuchillas]

sillypup -

You enthusiasm is admirable, but you wrongly assumed that my initial assessment was negative rather than neutral.

Now tell me if I am wrongly understanding you:

You dismiss scientific research in favor of "natural methods" that cite scientific research.

You seem to think that not knowing the nature of a problem makes it easier to solve.

Then you said:

i don't care for the scientific belief that you have to have proof in everything to validate it method. research are always bias and often false. "what the prover thinks, the prover proves. " goes the saying. Not to mention the many fake research going on all over the place.

Does it bother you that Gokhale's research was based on the methods she learned from a woman who developed a form of movement education based on yoga and observations of India's indigenous peoples? In other words, does it bother you that Gokhale traveled the world observing indigenous cultural movement patterns to expand upon the principles she had already accepted as true? In short, does it bother you that Gokhale's research was biased from the outset?

Personally, I don't have a problem with it. I accept that she is presenting an approach to posture and movement education based on her perspective and research. This doesn't invalidate her methods, but it does indicate a need to compare her work and cited sources with independent and credible alternative sources. This is how we learn to make balanced judgements of materials that cite scientific research for support.

 

[TheAnswerMan]

I agree with you jasonE about her explaining more in the book. i never said your post was negative. it was waltfriz first response that I was referring to as negative.

with all my years in holistic health regarding the scientific research going on, research is not up on my priority influence that so many people think as top priority to make one's decision. And from marketing field studies perspective , they generally aren't that trustworthy. i usually dismiss it due to corruptions and they often are base on false statistics and info or procedure. statistics mean nothing from my years of experience and studies in sociology. research are often used as marketing ploys. it's usually made up and have a tolerance of 80% false marketing info being accepted according to the field in order to not be sued for false marketing. rarely is it done from an honest scientist. And if it's done by honest scientist, the boss will manipulate it. proof is in the widespread false medical info influence by big drug companies and fda. especially with who is in control of the medical field namely big pharma. for a scientific research to be influencial, I would have to look at who fund the research. if it's big company related to big pharma than it's probably corrupt. where the source comes, matter. there are too many experts being bought out or threaten on their life if they become whistle blowers of false research.

look at the aids epidemic. info about it is all lies. scientist right now are trying to retract the info about it. it's all lies and cancer field too. corrupt propaganda just to make money off drugs. using fear and false info to scare people into ways that benefit big corps. scams on the public is what it is for decades. you can do search yourself and you'll find it so.

there is a difference about knowing the cause and the why question of pain. why someone hurts refers to how does the nervous system work to send message that the problem area hurts. why often refers to the reasoning that loops and loops. how one solves the problem is more important. look at the western focus on disease. they want to know about the disease but not on how one gets healthy. this understanding focus on disease is just often waste of time. that's why we are in this drug treatment nonsense and not preventative cure and health focus in the health industry. I don't know if i convey my message correctly but i think it goes along the line of focusing on problems vs. focusing on solutions. focusing on solutions tend to look from perspective of prevention , focusing on problem looks at how do i fix this. so different book have different presentation styles. it's not about quantity in looking at all the books out there but more of quality picking. medical books tend to be more knowledge base of fix the problem site and not look at the whole.

yes, i hate the field educating therapist about massaging the hurt part too without knowing the relationships of the whole body and the cause too. that was my point when i refer to working the cause and solution focus. just massage the pain area refers to fix it working on symptom approach. I guess i differential cause and why being two different things. another analogy would be looking at electricity lights. we still don't know why lights turn on when we turn on switch. all i care about is, turn switch, lights on. good. turn on switch "cause" light. some people would do research to find out "why" that happens. and scientist still haven't figure out how that happens. they just know doing such gets a certain response.

for example, you wouldn't go around trying to understand how our body moves in every single part. we don't have all the time in the world to understand everything. as a time saver, we just have to pick and choose. sometimes understanding isn't necessary to solving problems. a big example is the psychology field. who gives a damn about understanding problem consciously. they keep asking 'why' is such problem so? who gives a damn about why someone is addicted, can't move on a peaceful life due to rape or trauma of sorts, phobia,etc.. or trying to understand all those issues clients have. just give them the solution so that they can move on with life. don't need the BS of reliving it over and over so one can theorize 'why' they have those traumas or why they can't move on.

I hope some of these examples let you folks know what perspective i come from. and asking why isn't my job. asking 'how' is my job. i am not concern with why but more concern with "how" they got those pain so I can get directions to solutions. maybe your why is how. it could just be semantics confusion in our words.

there is no one path but there is path that is most efficient which is determine by one's goal. also there is wisdom of our body that is natural approach. nature is often one's best teacher. i'm not fond of dissecting the body in parts and finding solution that way without looking at the whole body and that is often the case of how western scientist works in understanding the body. of course i'm sure nowadays there are smart scientist who looks at the whole body. not much but getting there as many now see the errors of drug focus for treating everything.

 

[Dogbreath]

I have had a chance to read through Gokhale's book and I have a few observations. First off, it is a beautiful book; well illustrated in all ways. Reading through the first part, where she lays out the groundwork for her ideas for treatment, there are a few glaring problems.

Gokhale speaks interchangeably between "our society" and the USA, with occasional reference to industrialized countries. The bulk of her anthropological comparison and contrasting seems to be between non-industrialized cultures and the USA. (pg 6.) She then goes on to say that "Until the 20th century, debilitating back pain was not common in our society." (no reference was provided for this statement). "Today, back pain is more than twice as common as it was in 1950" with the following reference:

Is musculoskeletal pain more common now than 40 years ago?: Two population-based cross-sectional studies. - Harkness EF - Rheumatology (Oxford) - 01-JUL-2005; 44(7): 890-5 (MEDLINE is the source for the citation and abstract of this record )

Abstract:

OBJECTIVE: To test the hypothesis that the prevalence of specific musculoskeletal pain symptoms has increased over time in the northwest region of England. To meet this objective we have examined the difference in the prevalence of low back, shoulder and widespread pain between the 1950s and today using historical data collected by the Arthritis Research Campaign (arc). METHODS: Two cross-sectional surveys conducted over 40 yr apart in the northwest region of England. The status of two regional pain sites and widespread pain was determined using interview and questionnaire responses, for the earlier and later studies respectively. Subjects were classified positively if they reviewed low back pain, shoulder pain or widespread pain on the day of the survey. Rates were standardized to the Greater Manchester population. RESULTS: There were large differences in the prevalence of musculoskeletal pain between the two surveys. For all three symptoms examined prevalence increased from 2- to 4-fold between the two surveys. In both surveys low back pain was more common in women. Shoulder and widespread pain was less prevalent in women than in men in the earlier survey but by the time of the later survey women reviewed more pain at these sites. CONCLUSIONS: The prevalence of musculoskeletal pain is much higher than that reviewed over 40 yr ago. The change in prevalence is unlikely to be entirely due to the study design; other possible explanations such as the increased reviewing or awareness of these symptoms is discussed.

Noting that the study was done in Manchester, England, not the USA does not show that these statistics will be true in this country. She then goes on to hypothesize that after the 1920's, people tended to "thrust their pelvises and necks forward, and hunch or round their shoulders. It became fashionable to slouch" (pg 11). She then goes on to tell how she feels the fashion industry played a part in these changing views of posture as well as to try to connect a change in our posture with a loss of "kinesthetic tradition" that lapsed when we moved away from more traditional family roles and lacked imitative role models of family. No research or references to support any of this.

Also on pg 11 is a mention she makes that in a 1911 medical text that she viewed, the spine was pictured with quite subtle curves, while a 1990 medical text shows a much more exaggerated set of spinal curves. "The shape of the spine in the 1911 illustration is shared not only by our ancestors, but also by adults in traditional cultures today and young children the world over. The consistency across generations, cultures, geography, and age provides compelling evidence that this is indeed the natural shape of the human spine. Here is a dramatic clue to the cause of our current back pain epidemic." From this point in the book she moves on, as if the facts have been established that our view of normal posture has changed in this country and this is the reason for our problems. OK, so if all medical texts are showing a different shaped spine over the period from 1911-1990, then this might be a point to explore. I opened up my Netter's Atlas of Human Anatomy (2006 edition) and turned to the illustration of the spine. Unfortunately for Gokhale, the 2006 Netter illustration is nearly identical to the 1911 illustration that she shows in her book.

Gokhale appears to have taken a few research citations that apply generally to pain and posture, and ran with them to support her premise. I understand that this book is intended for the general public and is not a scientific paper of book, but with little if any true scientific support for her ideas, how or why should we believe and follow her recommendations for a more "natural" and anthropologically correct posture. The public is often desperate for an easy fix for pain. If it was easy, there would be no need for the all of us. Whether MT, PT, Chiropractor, MD, etc, we all can help some people, but not all. This book may fit into that, providing some with help. But the overstatments as to the "cause" of back pain goes too far.

I will repeat what I have said earlier: I challenge anyone to provide research that shows that "poor" posture is directly correlated with pain. Gokhale runs and runs well with this inaccuracy.

That being said, would the methods to improve posture provided in her book be a detriment? I doubt that they would for many people, although trying to generalize proper posture and the necessary steps to achieve it can in truth be harmful for many. The orthopedic and neurological intricacies of pain do not follow an easy road map to a fix that can be learned by reading one book. I am sure that the people who are quoted in the book truly were helped by these methods. I can produce just as many positive testimonials from my successes. But the failures seldom get printed. (Which is why I refrain from posting testimonials)

If one buys or follows this book, know in advance that you are buying one person's opinion, just as you are reading mine. Take either of them for what they are worth.