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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 (she claims) 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 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.
  3. You simply cannot pronounce the shape of a person’s spine by looking at pictures. Only x-rays would show the accurate angles of the spine and pelvis).
  4. Movement, how one moves, and whether one moves efficiently, matters significantly more than a snapshot of posture.
  5. 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, seek a stacked spine, and only lean on something to reduce fatigue.
  6. 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.
  7. 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.
  8. (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!

Aside from being poorly evidenced scientifically, there is a layer of romanticising, over-simplifying and assumptions about indigenous humans.

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 shoulder blades 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 — if you are making your living by selling something — it makes it difficult to change your mind about the basis for it), 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.

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

Love yoga anatomy? We do too!

13 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?

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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

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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.

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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.

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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.

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Johnnyboyo
May 16, 2022 at 4:35 am

I agree with most of your points, but I don’t see why you’re bringing in anti-colonialism. It is known modern lifestyle, diet and environment harms people in basically countless ways, causing problems unknown in more natural lifestyles. It has also been observed in literature and elsewhere that third world people, especially those in traditional lifestyles, do not have these problems – whether they be depression, obesity, asthma, or apparently postural problems. Why would a mouthbreathing, tooth rotting, chin receding, back crooking, asthmatic obese person NOT ogle at and go “ooh aah” when seeing a healthy person that actually feels comfortable in their skin? And mind you, that person would most likely NOT trade their lifestyle for “modern comforts”.

To be clear, there’s a difference between people living in natural lifestyles and those simply suffering from poverty in overcrowded slums. Not all third world people belong in the latter and of those who do, most probably suffer from the same problems as first world nations. You could go around in a US ghetto or trailer park and not see anyone healthy to ogle at, so it’s not about poverty.

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Dr. Ariele Foster
May 16, 2022 at 10:30 am

You are free to focus on the remarks I made about romanticising and assumptions made about indigenous people.

Most readers and myself here all agree: living as naturally as we can, in harmony with the natural world is ideal. Simultaneously many of us are grateful for / would not be here without modern medicine, thick soled shoes, and year round access to fresh food.

Yet an evidence-based lens is going to bring up many questions about Gokhale’s presumptions:
Where is the data, and what is the quality of the data that indigenous peoples don’t have back pain? Has she distinguished between simply muscle hypertrophy from use vs. skeletal shape? Is it a matter of how one holds themselves (her theory that this can be taught) or is it a matter of whether one spends a meaningful part of their day sitting in chairs or not?

Gokhale’s lack of rigor, racial othering, and a sort of neo-body dysmorphia that she promotes, it is not ok. It is not ok to be promoting or supporting this if you care about evidence.

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Kate
May 14, 2021 at 8:10 pm

Your spine needs to be able to absorb shock like a coiled spring and if the springs are overly compressed breathing will be inefficient, you will be fighting yourself to move and you will fatigue very easily. The stiffness and suppleness of the spine needs to be the right match for whatever task you are doing, I.e., appropriately strong and supple. The optimally performing spine is versatile and can adapt appropriately to many different tasks. Posture is not something to hold rigidly to protect the back, it’s a start position to move in and out of that is specific to different tasks. There is lots of diversity in the natural shapes of the thorax or rib cages that will affect a person’s resting posture. Walking around stiffly with a flattened spine and pushing your buttocks out is an absurd strategy.

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Dr. Ariele Foster
May 16, 2021 at 4:30 pm

Yes! I hope I conveyed as much in the blog post above (your summary here is stellar), but the fact that this woman has capitalized on, and spread in the halls of Google and the platform of TED Talks, her unscientifically supported, anti-common sense, exotification of natural physical human diversity is maddening.

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Kaye
May 14, 2021 at 8:14 pm

A naturally shaped S curve with the head aligned over the thorax and pelvis does not equal a crossed postural syndrome, I.e. a head forward posture with the head plus neck shifted forward from the trunk.

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Dr. Ariele Foster
May 16, 2021 at 4:26 pm

exactly.

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Arletta
May 15, 2022 at 8:22 am

My thoughts are :Where IS your towel, then? (and, I am thinking of Douglas Adams when I ask it, but also what you said in the article above).

I tried her advice and along with something a different person said about “push your spine forward” it really helped me to have better posture and ability to walk when I was coming from a place of having been so ill I could barely sit or stand for any length of time. When I take her advice, I am better able to have good posture. I don’t care if that gives me a J-spine or not.

But, recently I saw a terrible ad for following what this person claimed was their own method for awakening the spine, wherein they told a tale that seemed to be a mix between the yoga lady who died in 1999 at 91 years of age, I think, who wrote a book called Awakening the Spine and a women who became a successful body builder when she was in her 40’s. This ad was about getting that “peach butt” and being sexy and a contortionist for fun and how you should want these things, so pay lots of money – with “proof” of women that don’t show you what they looked like or could do “before” and which you mostly only see from the shoulders up “now” and still don’t see how flexible they got. But …

Terrible as the ad was it led me to look up the key phrases “awaken the spine” and “awakening the spine” and I learned that what that lady who wrote the book was talking about was a solid concentration on moving from your natural waistline, which went right along with something a belly dance instructor said, which is that it is called belly dance for the reason that you are moving from your waist, so when you are told “slide your left hip to the side” what you are not told, but should be,is that the movement is done by moving your spine at the waist to guide your hip into position.

And, you know what happens when I do that? When I try walking, bending, sitting more while concentrating on my natural waist as that woman told me to do? I end up sitting and walking much like the instructor of J-Spine living says to do.

This kind of thing is why I cannot fully embrace any one philosophy on physical movement. Usually there is something in the instruction that is too hard, too expensive, too unnatural or which leaves something else out.

So, I will do my best to push my spine forward, stack my spine as both yoga and J-Spine tell me to do, while concentrating on making movements through concentration on my natural waistline which leads to the build up of muscles that both are trying to achieve and maybe do some ballet exercises for my feet and be happy to have learned to help me be better.

For me, that is the best way to learn- like Ayurveda (the health/science side) teaches: treat the symptoms, but in a good, natural way.

I feel like with your what you do/don’t like approach, you are kind of looking at it the same way. Only from a point of view of being more firmly entrenched in a specific other lifestyle.

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Dr. Ariele Foster
May 15, 2022 at 5:06 pm

I’m glad you have found something that works for you. Whether the method does or doesn’t work for an individual doesn’t change the fundamental flaws in Gokhale’s approach. The approach itself is scientifically, clinically, and culturally problematic.

Science is not about being “firmly entrenched” in an opinion, but requiring high quality evidence behind one’s statements.

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