For the past 16 years or so I've had a "bad back". I originally strained something doing deadlifts and there have been repeated bouts of back spasms ever since. Sometimes they have been severe, leaving me on the floor and almost unable to move. On other occasions it is more of a continual minor ache. Sometimes I'll be OK for months on end and capable of some relatively good athletic performances - big walks in the hills, demanding met con circuits even - when I did more lifting - some heavy deadlifts.
That is context for this post. You see I'm always on the look out for thoughts about back health. I get a regular sports massage and have learned that trigger point therapy and stretching the glutes and psoas is really important for me - just to relieve the effects of sitting all day at a desk. I have learned much from Rif for example.
In addition to the physical side, I must also say that I believe that there is a big psychological element to my back spasms - when I'm stressed my back pain is always worse. In fact I have a lot of sympathy for Dr Sarno's approach to and understanding of back pain. He talks about TMS - effectively back pain being a tactic that your mind/body uses to divert your attention from the things that are really bothering you subconsciously.
While I think stress has a big role, I also think there are physical measures to employ to attack the symptoms and also simply to maintain health.
Esther Gokhale
With this in view, you'll understand that I was interested to read a post on Matt's blog recently about a book he was reading. The post was called Best Back Book and was about a book by Esther Gokhale: 8 Steps to a Pain Free Back
This post is not intended to be a review of the book, but I would agree with Matt that this is a superb volume. He explains:
Judged by the title, you might think is just another back pain book. However, this book is much, much more. It is really an anthropological and evolutionary study of how the human back is supposed to work. Why do traditional cultures have low levels of back pain, yet the rate is skyrocketing in the U.S.? What is the proper way to sit, stand, and walk? These are the questions the author attempts to answer.
I am only part-way through this book, and I learning something new almost every page. For example, many fitness experts state that a "neutral" or flat pelvis is correct posture. Instead, the author makes the case that the natural alignment for the pelvis is to be "tipped forward". She supports this with pictures of babies, young children, and people in traditional cultures who all exhibit a tipped-forward pelvis and none of whom suffer from back pain.
The photographs in the book are fascinating and show just how poor the posture of the average Westerner is. The book is worth buying simply for these photographs which are an indictment of the way so many of us stand, walk, sit and lie.
It is an excellent and challenging book that I wholly recommend. Easy to read and inspiring too.
The Asian / Third World Squat
Basing so much of her argument on trying to what is "natural" I was surprised that Esther did not talk about the squat.
People in developing countries seem to squat all the time. In the absence of chairs it seems the natural way to rest / eat.....and defecate.
Surely if we are to use our backs in their natural positions, we should be squatting lots? Indeed I'd come across this recommended a couple of times as a healthy stretch. Remember Mark Sissons stretching his sprint video? Then the "latrine squat" was recommended here as a glute stretch.
T nation even had an article on this - talking of the Third World Squat
You'll notice that in third-world countries, there will be a lot of situations where people are hanging out or working, and rather than sitting or kneeling down, they squat. They can sit like this comfortably for hours. It seems like a simple thing and can be easily overlooked, but try it some time. The average North American adult can't even get into this position, let alone stay there for any length of time.
There was even the comedy video - with serious points - about the "Asian Squat"
So why did Esther not like the squat?
I emailed her and asked!
Here is her response - basically if you have not grown up squatting like this, it is probably too late to start - you bones will not be built for it. They will have settled into structures which do not easily accommodate the Asian squat.
Here are my musings on squatting.
1. At birth, many of our joints (including the ankles, knees and hips) are not ossified. Instead of bone, we have cartilage in those areas.
2. Each of the above joints has a timetable for when the cartilage ossifies. The hip joint, for example, is made of three parts - the ischeum, ileum and pubis - each pair of which ossifies at a different age (first pair at age 2; last pair at age 16).
3. Once your joints have ossified, they are relatively immutable. Bone does change shape depending on the stresses on it, but it does not change drastically and in particular, the above ossifications are irreversible.
4. If you grow up squatting (on pit toilets, eating on the floor, etc) then the joints ossify differently than if you grew up sitting on chairs and using commodes for toilets. In particular, if you grew up squatting, your joints will ossify in a way that allow you to continue to squat in adulthood. If you did not squat through the years that your ankles, knees, and hips were ossifying, you will probably not be able to do a healthy full squat in adulthood.
5. People who force squats without having he joint architecture to do them tend to round their backs (compressing their spinal discs), pronate their ankles, and stress their knees.
6. Recommendation: don't try to force a squat. In most situations you can do the job equally well with a modified squat (on foot flat on the floor, the other on the ball of the foot). The times squatting does help are childbirth and evacuating your bowels. In these situations I recommend using some extra support under your heels - this makes squatting easy on the ankles and back. For other situations like certain squatting Yoga poses, I recommend not going all the way into the pose.
There you have it! The interesting thing to me though was her recommendation:
In most situations you can do the job equally well with a modified squat (on foot flat on the floor, the other on the ball of the foot).
I'd seen this before! My friend Bryce Lane wrote a piece a few years ago about his experience with this stance of squat.
The B Squat
Bryce came up with this stance while experimenting with positions to get more stability in lifts. The leverage is better apparently. You can read his thoughts here: The B Squat
So there you are.
I like it when different people come up with the same idea from different directions. I'm going to start using the b Squat more myself - the body weight one and maybe even as a goblet squat - hopefully to keep my posture more healthy and efficient.
15 comments:
Great blog !
As a parallel to Ms. Gokhale's work, (sharing similar origins/influences, ie; "Aplomb" from France, etc.,) you may enjoy:
http://www.agelessspine.com/
All the best,
Eddie
I really love your blog - check it everyday.
Why not just do one-legged squats? For me they eliminate the problem entirely.
I am a big fan of your blog, and check it every day for new research. As for the squat, everything I read suggests that people who can't squat are limited not by bone structure, but by inflexibility, which forces an anterior tilt to the pelvis. I am a testament to the fact that repeated stretching of the hamstrings and glutes, and practicing the squat, works! I couldn't squat without support a year ago, but now I can squat with comfort, and I still work on it every work out! It just takes time. Keep the great posts coming!
one leg squats are fine - I like them as a good functional movement.
But I think the Third world squat I was talking about is more about a long term resting position. I think the modified / B squat is half way to a single leg squat anyway.
Bryce
Thanks for the kind words.
I too had read a lot about the need for stretching to develop the flexibility necessary to squat and I have done so myself. I'm pretty good at squatting flat footed, but I think Esther's point it that you can only go so far by stretching - there are structural issues that can't be solved by stretching.
I'm not sure that I agree with her, but I am coming to that position. Even though I am pretty flexible in the squat at the bottom my pelvis still tucks under too much.
Hi Chris,
I've been checking out the reviews of Stuart McGill's "Low Back Disorders" on Amazon. Looks interesting.
http://tiny.cc/IczoD
Mari
I've been meaning to get McGill's book for a while.
Eddie
I've just ordered Agless Spine from Amazon - it looks very interesting. Thanks for the heads up.
I follow your blog and quite enjoy it. Thanks. The link I've added (hopefully)is quite good. The money thing turns people off but it's a great summary of "back problems". The whole web site is worth looking at.
old dude
http://saveyourself.ca/tutorials/low-back-pain.php
I would like to see some real research on the development of the bones. It sounds like a far fetched idea to me.
The reason many have trouble squating is motor pattern reasons and lack of flexibility. Re-patterning movement can easily and quickly retrain the body to squat. It is an ability we all are born with and becomes lost due to lack of use and other bad habits that creates core malfunction and instability.
Check out the functional movement screen by Gray Cook or his book Athletic Body in Balance. I have literally seen people improve their squat by re-patterning in minutes using his techniques.
It should also be noted the squating for long periods in individuals may be uncomfortable due to tendon and ligament fatigue and the relative lack of blood supply to the connective tissues.
People in third world countries who squat many times a daily there whole lives would not have such issues. We know that high rep body weight exercises will increase the vascular networks of the joints and connective tissues and that isometric holds increase connective tissue strength and health.
The idea that bones have something to do with joint function is strange to me. Unless you are talking about deformities or calcium build ups such as bone spurs. The bones have little to do with the function of the joint.
Bone length has an effect on leverage and muscular strength, but this is less a matter of usage and development and more of an issue of an individuals height, bone girth and density based on genetics and nutrition.
Thanks Bill. I've got Gray Cook's book but i need to go through it in a bit more detail.
I will maybe email Gokhale and ask more about this.
I do not completely agree that if you did not squat when you were younger that your bones are permanently ossified so that you can't ever do it. I thought this was the case with me, but as I was taught by Kathleen Porter, if I rolled a towel and put it under my heels and squatted like that for a while, then eventually, my hips would release enough to make the towel a little lower. Then I'd stay like that for a while, and then after awhile, the towel could get lower. I used to be really stiff but as I worked like this over a long period of time (months, and a few years even) my body gradually changed. Now the full squat is really easy for me to do when I couldn't even get close once upon a time. I think its a mistake to tell people their bones are ossified beyond change because that will just discourage them from believing they can change in ways that they really can. Kathleen's main theme that she stresses over and over again in her classes is that you NEVER strain, but RELAX into the change. If it feels like a stretch, it's too much. She always says, "stay THIS SIDE of the stretch, and just let go in your mind. Your muscles will follow." It takes a while for the change to come, so if anyone is feeling impaitient, forget it. But it really works. So don't give up. Support yourself with pillows, towels, whatever helps you to feel safe. Put your body in as close a position to where your headed (which is natural) Kathleen's book shows you how and then keep letting go in your mind and your b ody WILL change. Sure some people are really too old and maybe too far past the point of reversing certain things but for a lot of folks this will work. i know cause it worked for me.
I decided to start doing the Asian squat after we incorporated squats into my martial arts class this year. The "Western Squat," as it's been dubbed, kills my joints. I've been working on the Asian squat for about a month now, trying to do a few every day and trying to increase the length of time I can hold that position. It took a few tries, but I think I've almost got the posture down. Fortunately, I have average flexibility; it's my back that's the problem. I don't feel that my back is nearly as flexible as it should be at 25 years; I have to lean forward slightly so it doesn't hurt. But when I rise to get out of the squat, that hurts my back. Is my back just stiff or am I doing it wrong?
Anon
without watching you it is impossible to know what you are doing wrong. However, as Dan John has said it is generally not squatting that hurts your knees, but what you are doing (and calling it squatting)
Try the Goblet squat as in the article
http://www.t-nation.com/free_online_article/most_recent/goblet_squats_101
or
http://danjohn.net/wp-content/uploads/cpkb2.pdf
All the best
Chris
Post a Comment