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November 10, 2015

Should Your Spine Be Shaped Like a J?

yoga anatomy workshop lumbar spine, SI joints, and pelvis - sacroiliac stability, alignment

Should we have a J-shaped spine?

NPR aired this story back in June: “Lost Posture: Why Some Indigenous Cultures May Not Have Back Pain,”. It went viral (at least in the Facebook feeds of physical therapists, yoga teachers and the like).

The piece shares the perspective of Esther Gokhale, an acupuncturist who, after suffering severe back pain after spinal surgery, did her own “research”.  Her conclusion, which she describes as based on simple observation of indigenous peoples around the world who have near-absent rates of back pain: We should be aiming for a J-shaped spine rather than an S-Shaped spine.

Is she right?

Should we all be flattening our backs then pushing out our butts?

Esther gave a TEDx talk on the subject, which you can see here:

Yoga Anatomy Academy disagrees with much of this TEDx talk (though Esther G is so amicable!) and here’s a few of our Whys:

  1. There’s no dichotomy between “tucking your tailbone” and maintaining a lumbar curve – it’s not an either-or.
  2. Pronounced firm glutes (tehehehe) or a bumpin’ backside are not the same as an anteriorly tilted pelvis — in fact, a toned backside is more likely a byproduct of muscular use, which is more likely to sustain the pelvis neutrally. (And you simply cannot pronounce the shape of a person’s spine by looking at pictures. Only xrays or possibly palpation could show the actual angles of the spine and pelvis).
  3. Sitting is necessary at times, but not the answer. Though it is true that sitting well can be very relieving for the times that you need to sit, if you sit, we would seek a gorgeously stacked spine, and prefer you NOT be leaning on anything.
  4. An anteriorly tipped pelvis causes just as much back pain as a posteriorly tilted one (uhh. pregnancy anyone? beer bellies?), and with all our backbending, yogis more often have THIS problem (too much lumbar curve) because of that! In fact, an anteriorly tipped pelvis is statistically correlated with greater incidence of femoroacetabular impingement and hip labral tears. You don’t want to trade back pain for hip pain.
  5. More gadgets are not the answer — strengthening and re-patterning is, and there’s not a lot of room to make money off of that.
  6. (this is admittedly quite picky) “Anteverted” is a term used in medicine to refer to organs that have tipped forward in the sagittal plane or a femur bone rotated in the transverse plane. The correct terminology for the movement of the pelvis in the sagittal plane (front-back) is “anteriorly tilted” and “posteriorly tilted”.

Phew!

What we DO like from this video is:

  1. The general advice to lower the front ribs, elongating the thoracolumbar junction (midback) in the back. This action won’t take away your lumbar or your thoracic curves, but it will make it easier for:
    1. Your core muscles to fire and protect your low back
    2. Your head to be centered over the rest of your spine
    3. Your shoulderblades to have access to their fullest range of motion possible, which will reduce glenohumeral impingement
  2. We also like that, even though Esther is recommending products that she sells (which makes it difficult to change one’s mind about their thesis), she admits that a simple towel can help. We have a different location for that towel, but that we’ll save for a different post a different day.

And our biggest message here at Yoga Anatomy Academy: you are perfect just as you are.

You may need to address your habitual postural patterns. That can be a process. But you don’t have to mourn the fact that you chose the wrong profession or were born in the wrong era or to wrong hemisphere or with an S-shaped Spine (which is normal BTW, all over the world!).

Your spine, with all its curves, deserves attention, curiosity, regular healthy movement and muscular stability.

Our thesis: intelligent yoga asana can take us there.

We’d love to know your comments on this body controversy! What do you think about the J Shaped spine? Tell us below!

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5 Comments on “Should Your Spine Be Shaped Like a J?

Erik
July 22, 2018 at 3:33 pm

Where is the towel location you recommend, or the post illuminating that subject?

Reply
Heather Parsons
April 9, 2019 at 11:23 am

I found your article, Yoga Academy, really useful and has some good points. I think its is a shame that Esther Gokale has only 6 mins to explain a very technical area. I have her book, and while I don’t agree with everything in it, it brings a more cohesive explanation than what is presented here. Esther in her book, is not advocating an anterior tipped pelvis at all. ( or here either as I see it) She talks more about the alignment of L5/S1 joint in her book which she also details is not for everyone in her book (something I am aware of personally, particularly (breatstoke) swimmers and yoga/gymnasts can have a problem with. I am, however confused about her tail tucked under comment as that is not how her book explains it. This seated exercise is just that. An exercise for applying self traction of the low back and helping to get that length. It doesn’t put you in an anterior tilt. She explains that when our gluts are working well, ie well defined and prominent it will support your back. She doesn’t detail much or any abdominal stability ( or spinal eg multifidus). I would recommend her book, as there are things to be gained and learnt from. Esther is coming from one place within the Yoga profession we are looking at a much wider scope of healthy movement. It is interesting that many yoga people do struggle with excessive anterior pelvic tilt or lumbar curve, a good reason Pilates adds to the understanding of the stability of the back. Heather ENERGYBODi

Reply
DrFoster
April 10, 2019 at 8:37 pm

Hi Heather, I do appreciate that Gokale’s writing and thinking has been beneficial to you. I am not an expert on her work, but unless someone is looking at a person’s standing direct lateral xray, they do NOT know the position of one’s L5/S1. Additionally you cannot look at someone’s butt and know whether that person has strong gluteal muscles. Period. There are a lot of prominent back sides that are extremely weak. There is a real danger in both 1) presuming appearance = function, and 2) exoticizing other cultures, which in many cases, out of unequal distribution of world resources (aka colonialism) have lives that demand physical labor while many reading this have the capacity to opt out of physical labor “ooh and awe” at their physical form. Both of these mentalities are the foundation of this “method”. If the Gokale Method used coherent anatomic language, spoke about laborers in general, not just from the Global South with anti-colonial language, and could be supported using research from the past two decades, then I would take another look. The reality is she has just trademarked something and gotten lucky with it. Chances are her work has helped people because it simply moved them in novel ways. And that is evidence-based movement science.

Reply
CM
June 28, 2020 at 7:04 pm

At the end of the day, the data speaks for itself. I’m not sure how this posts challenges the salient points of Gokale’s research:

Cultures with j-curves have almost non existent back pain.

Cultures with back pain almost exclusively have s-curves.

S-curve is relatively new. It’s just a sliver in the timeline of humans standing fully upright at least as far as artifacts from ancient civilizations show. And s-curve positively correlates with increase in back pain.

Yogis don’t have j-curves spines. Thus, stating that they still have back issues despite having too much lumbar curve isn’t a logical argument. They’re trying to j-curve the lumbar but while maintaining an s-curve in the thoracic/cervical spine. That’s why they still have a problem.

Experience speaks for itself. I no longer have back pain issues since adhering to Gokale’s methods. Goes to show we can split hairs in an anatomy discussion, but still be wrong in reality.

Reply
DrFoster
June 28, 2020 at 7:39 pm

Human variation is everywhere – within and between cultures. The spine (including the exact curves) of one office worker will look different from another, keeping as many other variables consistent.
And whatever helps you is great. I’m glad you found what helps. Movement — especially trying new movements when your previous ones were not helping, is often the kind of stimulus that reduces pain. There is research behind this statement.
What bothers me about Gokale’s hypothesis that is founded on false assumptions. There is no split between humans with a “J” shaped spine and “S” shaped spine. Ask any radiologist.
Secondly, the way she justifies her hypothesis is through photographs of humans. You cannot see the shape of the spine through NatGeo images.
Thirdly, there is an exoticisation in her work of people from less developed parts of the world. This is a harmful, post-colonial mentality. Speak of the absence of chairs? Sure. Romanticise poverty and the conditions of brown people in developing nations. Nope. Not here for it.
Finally, what Gokale calls research is paltry and on very thin ice.
But again, if her movement ideas help you, that is what matters. Her hypothesis is not acceptable from a scientific point of view.

Reply

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