A good stance and posture reflect a proper state of mind.
MORIHEI UESHIBA
JUST AS OUR GENES EXPECT us to walk upright and to go barefoot, they are also preprogrammed to expect a lifetime of pain-free movement through an almost infinite number of planes under various workloads. We are wired for the effortless attainment of perfect posture, yet poor posture and inefficient biomechanics are now commonplace in the industrialized world. We can blame a sedentary lifestyle, our excessive reliance on modern comforts (such as poorly designed chairs, braces that compensate for functional errors, and elevated shoes that compromise posture), and flawed cultural influences (such as slouching fashion models) for the pain and spinal degeneration that millions suffer from today. But it doesn’t have to be this way. You can easily correct poor posture with a few simple lessons that can pave your way to a lifetime of pain-free activity.
The very obvious downside to poor posture is the chronic and often debilitating physical pain that accompanies it. If you spend your days sitting, standing, and walking with a fundamentally flawed posture, it will catch up with you in the form of pain, increased injury risk, and long-term degeneration. If you want to live a long, active life, a healthy functioning spine is essential. The spinal cord is essentially a high-bandwidth system for the transfer of information between nerves, organs, and other parts of our anatomy. Misalignments of the spine (aka subluxation) can constrict nerve pathways, leading to all sorts of muscle, joint, and circulatory problems.
“One of the most common forms of bad posture is when the head juts forward instead of extending straight up from the shoulders.”
One of the most common forms of bad posture is when the head juts forward instead of extending straight up from the shoulders. According to Rene Cailliet, professor emeritus of University of Southern California’s physical medicine and rehabilitation program, this posture “can add up to 30 pounds of abnormal leverage, pulling the entire spine out of alignment and may result in the loss of 30 percent of vital lung capacity.”10 Think about what that means: a diminished lung capacity will reduce available oxygen to all other parts of the body, including major organs like the brain and heart. Nerves are compressed at multiple sites, and soon you’re experiencing both pain within the head and at the base of the neck. You’re also setting yourself up for later thoracic spine damage, a rounding of the upper spine also known as a “dowager’s hump.”
As the Mark’s Daily Apple community has grown in recent years, I’ve had the good fortune to associate with some of the world’s leading health experts. These are forward-thinking individuals who are pursuing sensible health solutions and exploring beyond the confines and critical-thinking errors of conventional wisdom. One such pioneer is Esther Gokhale, a licensed acupuncturist who specializes in non-invasive cures and prevention for spinal pain and injury.
Gokhale’s quest for a better way to approach posture started over twenty years ago. Her motivation was personal, having suffered from debilitating sciatic pain associated with a pregnancy, followed by an unsuccessful surgery for a herniated disc. Today, she runs the highly acclaimed Gokhale Method Institute in Palo Alto, California, which has been heavily praised by the Mayo Clinic, Stanford Medical Center, and the American Association of Orthopaedic Surgeons.
Straighten your neck Option A: Grab a clump of hair at the base of your skull and gently pull it back and up.
Option B: Grasp the base of your skull with both hands and gently pull toward the top of your head.
Gokhale’s book, 8 Steps to a Pain-Free Back, is filled with images of people from various regions of the developing world. These subjects exhibit efficient posture and biomechanics at rest as well as during arduous physical labor. One in particular shows a mother in the west African nation of Burkina Faso, walking barefoot with impeccable posture … while balancing a large laundry load on her head with one hand, carrying a heavy bucket of supplies with the other hand, and, along for the ride, a baby nestled in a sling along her lower back. Talk about a lasting impression! No braces, no ibuprofen, no couch to collapse in at the end of the day—no problem, no complaints!
Meanwhile, here at home, we overindulge in modern comforts and sedentary lifestyles, and, as a result, suffer from chronic pain, muscle contraction (tightness), and inflammation. Your body initiates these symptoms, known as adaptive protective mechanisms, in an attempt to cope with the constant stress of poor posture and technique. Pain and muscle contraction inhibit your mobility while your immune system sends plasma proteins and leukocytes to the pain site to help accelerate the healing process. The excess fluid at the site of the injury is what produces the inflammatory swelling.
Popping a few pills when these mechanisms kick in overrides the body’s desired effect—to get you to stop the damaging activity—and thus sets in motion a potentially endless cycle of further damage to your discs, nerves, tissues, and muscles. No wonder we see literally millions of folks dealing with chronic back and neck pain, and hundreds of thousands more undergoing major back surgery each year.
The ideal lower back exhibits a mild groove with embedded vertebrae that appear as bumps and soft ridges on either side of the groove. A rounded lower back shows no groove and a swayed lower back displays a deep, exaggerated groove.
The key to avoiding back pain (and achieving a healthy posture) boils down to preserving a straight and elongated spine at all times. This is true in all activities— standing, sitting, walking, sleeping, as well as physical work and complex athletics. Look at photos of weightlifters about to hoist the bar, basketball players in their defensive stance, baseball players awaiting a batted ball, football players in their three-point stance, or sprinters racing for the tape—in all cases they exhibit a straight and elongated spine as a component of correct technique. Millions, actually billions, of folks—physical laborers, current-day hunter-gatherers, repetitive task workers, and stooped-over field hands—in developing countries also exhibit characteristically excellent posture, and avoid injury while bending, lifting, pushing, and pulling.
According to Gokhale, the ideal is represented by a spine that is actually J-shaped if viewed from the side, not the more familiar S-shape we see in medical textbooks, conventional wisdom’s representation of the ideal. Rather than ideal, it’s simply the prevailing shape that has taken hold in modern society. Interestingly enough, Gokhale reports that in early twentieth-century medical textbooks, spinal models were more J-shaped, before the destructive effects of industrialized living and the 1920s’ slouchy flapper fashion became the norm. In a J-shaped spine, the twenty-four bones (vertebrae) of the back are stacked in a straight line from the neck down through the lower back. The bottom of the spine curves slightly inward, forming a J shape from a side view. This is associated with a pelvis that is tipped slightly forward, or anteverted, which is ideal. Gokhale says an easy way to picture this is to imagine a beltline that is angled down towards the front. The result will position the buttocks behind the spine. Ready to try it out? First, slip off your shoes and anchor of your bodyweight on your heels. (Now you know why the calcaneous is such a dense bone!) Stand with feet comfortably shoulder-width apart, pointing forward or only slightly outward. Scrunch your toes inward to engage your arches. Beware the collapsed arch and outward-splaying feet that is both a cause and symptom of poor skeletal alignment. By engaging your arches and rocking your bodyweight back onto your heels, you should feel as though you have a strong, balanced base. Next, roll your shoulder blades, one at a time, into alignment on the same plane as your spine. To ensure your shoulders are positioned properly, turn your palms outward as you stand. This is a handy trigger to keep you honest and reprogram the common tendency to let the shoulders to cave forward and pull the head along too.
The J-shaped spine of an antiverted pelvis (tipped slightly down) helps achieve a healthy posture. Conversely, a retroverted pelvis (tilted forward or tucked under) leads to tense muscles and slouching.
Standing with weight anchored on heels and shoulders aligned with spine, slightly contract only the upper level of your abdominal wall (i.e., the top level of your “six-pack”). This will keep you from collapsing your weight onto your spine and tucking your pelvis. Finally, reach up and grab a clump of hair at the back of your head and gently pull it back and up. This will allow your neck to elongate instead of the common compression that is associated with a protruding head. With neck elongated, your eyesight will project at a slight downward angle.
As you engage with your new, correct posture, your entire body should feel relaxed and balanced. Refrain from the common corrective reaction of jamming the shoulder blades back unnaturally, which usually lasts only for the duration of the family holiday photo. While this overview of the basics can be valuable to overcome the most common error of protruding head, compressed neck, slouched shoulders, and a tucked-in pelvis, do yourself a favor and explore the Gokhale Method and8 Steps to a Pain-Free Back in greater depth—especially if back or neck pain is of particular concern to you.
Stretchsitting Push buttocks to back of chair with your feet hip- width apart. Lengthen your spine, eliminating any sway. Leave buttocks anchored to the chair, and relax the muscles of your torso, allowing the rib cage to separate as much as possible from the pelvis.
For millions of years, our ancestors never actually “went to the bathroom,” because, well, the bathroom was pretty much right where they were. Turns out, our biomechanics evolved for us to defecate in a full squatting position, yet we insist on thwarting that most natural of urges by sitting on a porcelain device that interferes with proper elimination.
Unless you’ve traveled to a variety of Asian countries, you may never have seen nor tried a squatting toilet. (Picture a bowl below ground level for you to straddle—nothing more to it!) Many health and ergonomic experts—particularly in the Evolutionary Health movement—are passionately advocating the benefits of defecating in the squatting position and calling attention to an increasing amount of studies that confirm the health risks of using a sit-down toilet.
The commode came of age in the sixteenth century in the interest of giving royalty a little dignity while they did their private business. Then in the Victorian Age, the heyday of repressed social customs, came the invention of the flush toilet. As ordinary folks were able to utilize the invention across the industrialized British Empire, the “Emperor’s new throne” became yet another symbol of the mother country’s smug superiority over their primitive colonials. Problem is, our bodies were designed for squatting not sitting.
When you defecate from a seated position, you pinch the angle between the rectum and the anus, leading to three times more straining and twice as long a time period to get the job done.11 The inefficiencies and strain of sitting have been shown to increase the risk of constipation, hemorrhoids, hernias, diverticulosis (caused by excessive straining, believed to afflict half of all Americans aged sixty to eighty), uterine prolapse (which affects women during pregnancy and childbirth), and both urinary and anal incontinence.12
Surely all this talk of straining and pinching is unpleasant, but not as unpleasant as the serious health risks of using the everyday toilet. Because sitting inhibits a complete evacuation of the colon, residue can harden in a process known as fecal stagnation. Fecal stagnation causes colonies of harmful bacteria to take root in the contaminated areas, which has been linked to inflammation of the surrounding tissues and increased risk for colon cancer and inflammatory bowel diseases such as appendicitis, diverticulitis, ileitis, ulcerative colitis, irritable bowel syndrome, and Crohn’s Disease. What’s more, many of these bowel diseases are virtually unknown in developing countries, where squatting is used in lieu of the loo.
Squatting opens up the recto-anal angle (one study showed squatting affords an average angle of 132 degrees, and up to a completely straight 180 degrees, while toilet sitting results in an average angle of 92 degrees), offering your waste a path of least resistance for full evacuation.13 Defecating in this position also strengthens the muscle fibers in your pelvic floor and protects the prostate, bladder, and uterine nerves from damage related to straining.
If you are interested in reduced constipation, less straining, and lower risk of inflammatory bowel conditions, squatting to eliminate is a connection with an obvious evolutionary precedent. And you don’t need to move to Asia. There are a number of toilet stools available that will modify the position you adopt on a traditional toilet to enable the benefits of squatting. Visit SquattyPotty.com for a full education on the subject and direct ordering (units start at $35—cheaper than hemorrhoid surgery or colon cancer treatments).
Toilet squatting stools are U-shaped, so they slide around either side of your toilet bowl for easy storage. Slide the stool out a bit and you can rest your feet on elevated platforms, bend your knees, lower your torso between your thighs, and achieve a modified squatting position. After getting over your initial culturally influenced hesitations, you will realize how effortless and natural it feels to assume the squatting position, particularly when you use a specially designed stool.
