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15/06/2015 Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain : Goats and Soda : NPR
http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain?utm_source=npr_newsletter&utm_ 1/8
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Lost Posture: Why Some IndigenousCultures May Not Have Back PainJUNE 08, 2015 3:25 AM ET
MICHAELEEN DOUCLEFF
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Primal posture: Ubong tribesmen in Borneo (right) display the perfect J-shaped spines. A woman in Burkina Faso
(left) holds her baby so that his spine stays straight. The center image shows the S-shaped spine drawn in a
modern anatomy book (Fig. I) and the J-shaped spine (Fig. II) drawn in the 1897 anatomy book Traite d'Anatomie
Humaine.
Courtesy of Esther Gokhale and Ian Mackenzie/Nomads of the Dawn
15/06/2015 Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain : Goats and Soda : NPR
http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain?utm_source=npr_newsletter&utm_ 2/8
Editor's note, June 10: We have added an acknowledgement of several sources
that Esther Gokhale used while developing her theories on back pain. These include
physiotherapy methods, such as the Alexander Technique and the Feldenkrais
Method, and the work of anthropologist Noelle Perez-Christiaens.
Back pain is a tricky beast. Most Americans will at some point have a problem with
their backs. And for an unlucky third, treatments won't work, and the problem will
become chronic.
Many ancient statues, such as this one from Greece, display a J-shaped spine. The statue's back is nearly flat until
15/06/2015 Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain : Goats and Soda : NPR
http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain?utm_source=npr_newsletter&utm_ 3/8
the bottom, where it curves so the buttocks are behind the spine.
Courtesy of Esther Gokhale/Gerard Mackworth-Young
Believe it or not, there are a few cultures in the world where back pain hardly exists.
One indigenous tribe in central India reported essentially none. And the discs in their
backs showed little signs of degeneration as people aged.
An acupuncturist in Palo Alto, Calif., thinks she has figured out why. She has traveled
around the world studying cultures with low rates of back pain how they stand, sit
and walk. Now she's sharing their secrets with back pain sufferers across the U.S.
About two decades ago, Esther Gokhale started to struggle with her own back after she
had her first child. "I had excruciating pain. I couldn't sleep at night," she says. "I was
walking around the block every two hours. I was just crippled."
Gokhale had a herniated disc. Eventually she had surgery to fix it. But a year later, it
happened again. "They wanted to do another back surgery. You don't want to make a
habit out of back surgery," she says.
This time around, Gokhale wanted to find a permanent fix for her back. And she
wasn't convinced Western medicine could do that. So Gokhale started to think outside
the box. She had an idea: "Go to populations where they don't have these huge
problems and see what they're doing."
Esther Gokhale'sFive Tips ForBetter PostureAnd Less BackPain
Try these exercises while
you're working at your desk,
sitting at the dinner table or
walking around, Esther
Gokhale recommends.
[Added June 10] So Gokhale studied findings from
anthropologists, such as Noelle Perez-Christiaens,
who analyzed postures of indigenous populations.
And she studied physiotherapy methods, such as the
Alexander Technique and the Feldenkrais Method.
And the original post continues ...
Then over the next decade, Gokhale went to cultures
around the world that live far away from modern life.
15/06/2015 Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain : Goats and Soda : NPR
http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain?utm_source=npr_newsletter&utm_ 4/8
1. Do a shoulder roll:
Americans tend to scrunch
their shoulders forward, so our
arms are in front of our bodies.
That's not how people in
indigenous cultures carry their
arms, Gokhale says. To fix
that, gently pull your shoulders
up, push them back and then
let them drop like a shoulder
roll. Now your arms should
dangle by your side, with your
thumbs pointing out. "This is
the way all your ancestors
parked their shoulders," she
says. "This is the natural
architecture for our species."
2. Lengthen your spine:
Adding extra length to your
spine is easy, Gokhale says.
Being careful not to arch your
back, take a deep breath in
and grow tall. Then maintain
that height as you exhale.
Repeat: Breathe in, grow even
taller and maintain that new
height as you exhale. "It takes
some effort, but it really
strengthens your abdominal
muscles," Gokhale says.
3. Squeeze, squeeze your
glute muscles when you
walk: In many indigenous
cultures, people squeeze their
gluteus medius muscles every
time they take a step. That's
one reason they have such
shapely buttocks muscles that
She went to the mountains in Ecuador, tiny fishing
towns in Portugal and remote villages of West Africa.
"I went to villages where every kid under age 4 was
crying because they were frightened to see somebody
with white skin they'd never seen a white person
before," she says.
Gokhale took photos and videos of people who walked
with water buckets on their heads, collected firewood
or sat on the ground weaving, for hours.
"I have a picture in my book of these two women who
spend seven to nine hours everyday, bent over,
gathering water chestnuts," Gokhale says. "They're
quite old. But the truth is they don't have a back
pain."
She tried to figure out what all these different people
had in common. The first thing that popped out was
the shape of their spines. "They have this regal
posture, and it's very compelling."
And it's quite different than American spines.
If you look at an American's spine from the side, or
profile, it's shaped like the letter S. It curves at the top
and then back again at the bottom.
But Gokhale didn't see those two big curves in people
who don't have back pain. "That S shape is actually
not natural," she says. "It's a J-shaped spine that you
want."
In fact, if you look at drawings from Leonardo da
15/06/2015 Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain : Goats and Soda : NPR
http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain?utm_source=npr_newsletter&utm_ 5/8
support their lower backs.
Gokhale says you can start
developing the same type of
derrire by tightening the
buttocks muscles when you
take each step. "The gluteus
medius is the one you're after
here. It's the one high up on
your bum," Gokhale says. "It's
the muscle that keeps you
perky, at any age."
4. Don't put your chin up:
Instead, add length to your
neck by taking a lightweight
object, like a bean bag or
folded washcloth, and balance
it on the top of your crown. Try
to push your head against the
object. "This will lengthen the
back of your neck and allow
your chin to angle down not
in an exaggerated way, but in a
relaxed manner," Gokhale
says.
5. Don't sit up straight!
"That's just arching your back
and getting you into all sorts of
trouble," Gokhale says. Instead
do a shoulder roll to open up
the chest and take a deep
breath to stretch and lengthen
the spine.
Vinci or a Gray's Anatomy book from 1901 the
spine isn't shaped like a sharp, curvy S. It's much
flatter, all the way down the back. Then at the
bottom, it curves to stick the buttocks out. So the
spine looks more like the letter J.
"The J-shaped spine is what you see in Greek statues.
It's what you see in young children. It's good design,"
Gokhale says.
So Gokhale worked to get her spine into the J shape.
And gradually her back pain went away.
15/06/2015 Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain : Goats and Soda : NPR
http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain?utm_source=npr_newsletter&utm_ 6/8
Healthy spines in the Western world: The J-shaped spine is often seen in photographs from the late 19th and early
20th centuries.
Library of Congress
Then Gokhale realized she could help others. She developed a set of exercises, wrote a
book and set up a studio in downtown Palo Alto.
Now her list of clients is impressive. She's helped YouTube CEO Susan Wojcicki and
Matt Drudge of the Drudge Report. She has given classes at Google, Facebook and
companies across the country. In Silicon Valley, she's known as the "posture guru."
Each year, doctors in the Bay Area refer hundreds of patients to Gokhale. One of them
is Dr. Neeta Jain, an internist at the Palo Alto Medical Foundation. She puts Gokhale's
method in the same category as Pilates and yoga for back pain. And it doesn't bother
her that the method hasn't been tested in a clinical trial.
15/06/2015 Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain : Goats and Soda : NPR
http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain?utm_source=npr_newsletter&utm_ 7/8
"If people are finding things that are helpful, and it's not causing any harm, then why
do we have to wait for a trial?" Jain asked.
But there's still a big question looming here: Is Gokhale right? Have people in Western
cultures somehow forgotten the right way to stand?
Scientists don't know yet, says Dr. Praveen Mummaneni, a neurosurgeon at the
University of California, San Francisco's Spine Center. Nobody has done a study on
traditional cultures to see why some have lower rates of back pain, he says. Nobody
has even documented the shape of their spines.
"I'd like to go and take X-rays of indigenous populations and compare it to people in
the Western world," Mummaneni says. "I think that would be helpful."
But there's a whole bunch of reasons why Americans' postures and the shape of
their spines may be different than those of indigenous populations, he says. For
starters, Americans tend to be much heavier.
"If you have a lot of fat built up in the belly, that could pull your weight forward,"
Mummaneni says. "That could curve the spine. And people who are thinner probably
have less curvature" and thus a spine shaped more like J than than an S.
Americans are also much less active than people in traditional cultures, Mummaneni
says. "I think the sedentary lifestyle promotes a lack of muscle tone and a lack of
postural stability because the muscles get weak."
Everyone knows that weak abdominal muscles can cause back pain. In fact,
Mummaneni says, stronger muscles might be the secret to Gokhale's success.
In other words, it's not that the J-shaped spine is the ideal one or the healthiest. It's
what goes into making the J-shaped spine that matters: "You have to use muscle
strength to get your spine to look like a J shape," he says.
So Gokhale has somehow figured out a way to teach people to build up their core
muscles without them even knowing it. "Yes, I think that's correct," Mummaneni says.
15/06/2015 Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain : Goats and Soda : NPR
http://www.npr.org/sections/goatsandsoda/2015/06/08/412314701/lost-posture-why-indigenous-cultures-dont-have-back-pain?utm_source=npr_newsletter&utm_ 8/8
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"You're not going to be able to go from the S- to the J-shaped spine without having
good core muscle strength. And I think that's key here."
So indigenous people around the world don't have a magic bullet for stopping back
pain. They've just got beefy abdominal muscles, and their lifestyle helps to keep them
that way, even as they age.
chronic pain back pain global health
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