Clare Chapman is a postural health and Yoga teacher here in Bristol. I’ve invited her to write a number of features around postural issues because of her innovative work over the past 5 years with Californian, natural posture teacher, Esther Gokhale, whose inspirational book ‘8 Steps to a Pain-Free Back’ recently reached No.2 on Amazon.com. Starting the series off, Clare talks to us about child development and posture, a look back to where it all begins.
Every new parent asks, “How can I best hold, carry and transport my baby?” After all, babies don’t come with instructions! Yet, for thousands of years it was simple… everyone just adopted the traditions and the role models around them.
Today, we raise our children in a very different context. We live in an industrialized, high-tech, consumer society. We have an unprecedented range of products such as slings, car seats and pushchairs to choose from, and can consider how each brand shapes up on safety, budget, ease of use, style, multi-functionality, etc. But there is another key factor for modern parents to consider, and its effect on our children will literally last a lifetime.
Since the industrial revolution we have tended to raise smaller families often many miles away from grandparents and other extended family. This has led to changes in what we hand down to the younger generation, including tried and tested traditions around how we use our bodies, such as in traditional dance, working skills and child rearing. Esther Gokhale found compelling evidence that our loss of traditional body wisdom has resulted in a much diminished level of musculo-skeletal health in modern, industrialized societies. Traditional communities, which she researched extensively in parts of Africa, India, Brazil and Southern Europe, report an astoundingly low (5% – 7%) incidence of back and joint pain despite long hours of manual or sedentary labour. In the UK the rate is over 80% with back, hip, knee, neck, shoulder and foot problems affecting people at an increasingly young age.
How did this come about?
One of the most significant shifts in how we use our bodies occurred in the 1920s as the new
generation abandoned what they saw as the rather formal uprightness of the pre World War I era in favour of a more casual, slouched body language. A position reflected in furniture such as the Mies van der Rohe chair and the ‘flapper-girl’ fashions.
Over the decades this tucked posture has increasingly come to be viewed as normal. Open any fashion magazine or people-watch from the coffee shop, and in all probability, that’s what you’ll see. We now, often unwittingly, undermine the healthy instincts that our infants are born with because of these modern misconceptions about the human form. For example, because we now think it is normal to tuck the pelvis under, you see babies held with the parent’s forearm tucking baby’s bottom under – this prevents the baby from stacking their spine on her own. Or we prop them up on curvy bean-bags. We don’t realize we are ‘wiring in’ poor habits for our children.
But, if you observe almost any one or two year-old left to their own devices and you will see a natural, healthy posture in action. When seated on the floor for example, babies will automatically sit right on their sitting bones without slumping or slouching. Gokhale Method™ teachers describe this as having the pelvis positioned in “anteversion”, that is, not tucked under, but rather, slightly tipped forward, rested on the sitting bones. From this foundation babies and young children align themselves in gravity, with their spine straight, right on through to their necks, so that the head is beautifully balanced. Because they do this naturally when ready to sit up unaided, there is no strain. The head does not have to be ‘held up’ and is free to turn effortlessly. So, as baby becomes able to sit on their own, let them sit on your forearm with their pelvis tipped forward in this way. Notice that they will naturally stack up without any difficulty.
As for carrying infants for longer periods, in most parts of Africa, for example, young babies are wrapped onto their mother’s backs, held securely with fabric. Their bottoms are supported and their backs are stretched in a lengthened position. Larger infants will be carried with their legs out at to each side. Allowing their legs to externally rotate in this way helps prevent hip dysplasia and allows the immature hip sockets to develop in a healthy way. This contrasts with some modern pushchairs, where concave bucket-style seats and saggy footrests encourage the hips and legs to internally rotate, setting children up to have knock-knees and fallen arches.
To help promote a long and healthy spine with proper pelvic positioning, ideally you would carry your baby on your body as much as possible. If you are looking for a modern body carrier for a baby/toddler, find one where the baby/toddler’s bottom has space to remain behind her, such as the Moby or Ergo Baby, for example. It is well worth visiting specialist retailers such as Born, on the Gloucester Road, Bristol, or Googling for a local ‘babywearing’ group, where you can try out, get advice, buy second hand or rent a sling.
Parents in our culture often find that their own structure can’t sustain this degree of load comfortably (that’s another article!), and of course slings and carriers are not always practical in British weather. Sooner or later, it is important to know what to look for in a pushchair or buggy.
Unfortunately, some pushchairs and car seats available today still have an element of the ‘C’ shape, which will then be the position recreated in the baby’s back. This curve will collapse a baby’s spine, tuck the pelvis under, and bend their neck forward. Slumping like this will squash and inhibit the functioning and development of baby’s lungs and digestive organs. In addition to forcing baby to sit poorly, consider also that they may be in these carriers for hour after hour, sometimes from the car, out, and back in to the car again. Such furniture effectively trains kids in to poor sitting patterns and sets them up for slouching posture and poor bending habits.
The more traditional pram is great in that it gives baby the chance to stretch out on his back or to be angled up towards sitting with a straight, not curved, spine. Try and avoid sole use of pushchairs where you just click in a curvy car seat. Almost all infant car seats are slightly curved, and for safety reasons, you must use them – nor is it advisable to modify them. Rather, try to minimize the time your baby spends in car seats, and of course, leave the seat in the car rather than restricting your little one to this compromised position.
As your babe grows and can sit upright, find a car seat with a 90-degree angled seat:
- Watch out for protective side panels that will push a child’s shoulders forward as they outgrow the seat.
- Watch for deep, padded side panels to the seat that prevent children from resting with their knees naturally apart.
- Avoid soft, dish-shaped seats and foot rests (like in umbrella strollers) that encourage the child’s legs to rotate internally. You want to give the child room to scoot their rear end back, keep their knees apart and then stack the spine long – just like they naturally sit. Sometimes you can help this along with strategically placed folded towels, for example.
As your toddler begins to walk, they will use a natural reflex that allows their feet to play an active part in this new skill. The grab reflex babies are born with remains in place for the first 20 months of life, and this ability to use their arches and foot muscles will give them the power and control to walk in balance. If shoes are put on babies’ and toddlers’ feet this foot coordination can become inhibited or lost altogether. Whenever possible, let your toddler walk barefoot. If the floor is cold, find flexible socks/slippers that have some non-slip finish on the sole. Whenever possible, let your baby work his feet in sand, soil and against contoured surfaces when crawling to build up his foot action for walking.
Another thing to mention here is that the synchronization of arm and leg movement in crawling is also instrumental in proper
gait development, so it is important not to by-pass this stage by putting babies in any type of walker. Though well-intentioned, these contraptions may also encourage infants to feel the ground from a slumped, semi-seated position, which completely interferes with their natural ability to find their balance by aligning their body weight perfectly over the heel bone.
If an infant is fortunate enough to be carried well, given plenty of opportunity to move and stretch out and uses good furniture, they are likely to do what comes naturally and no teaching will be necessary. They may even choose to stack well, perched on the edge of a bad chair, rather than slouch. Children, who have been less fortunate as babies will more often need help, but avoid the instruction to “sit up straight”. Though well intentioned, this instruction can in fact lead to further problems! If a child, or adult, has tucked in the pelvis and therefore slumped, (sitting on the tail bone and sacrum rather than having these behind them) they will be unable to sit upright in a relaxed way. They will need to arch their spines to pull themselves up, introducing tension and compression in the lower back. Instead, use child-friendly and fun cues such as “do a ducky bottom, not a tucky bottom”, or “imagine you have a fine tail. You want it be out behind you, you don’t want to sit on it.”
Creating a posture-friendly environment as your child grows can help them to retain their natural posture into toddler and school-age years. Notice their positions. When reading books or playing, let your child sit on the floor. If you catch them slumping and tucking their pelvis, gently re-position their body. Offer a cushion and encourage them to sit on the edge of it to help keep their pelvis
anteverted (tipped forward). Any infant or adult who sits on their tail with the spine rounded is likely to replicate that shape in standing and bending. This dysfunctional pattern reduces the range of motion in the hip joint, shortens the hamstrings, overstretches the ligaments and muscles in the back and compresses the chest, abdomen and back of the neck and spinal discs. It is the cause of many adult back problems.
Finally, a word about Parent Power – our children will benefit from well-informed consumer choices, but, like our ancestors and the traditional peoples of today, they also learn best by example. If we are constantly slouching on our sofas, sitting hunched over our laptops, or straining to ‘sit up straight’, then they will soon do the same. By improving our own posture we not only reap the benefits of an active, pain-free life but we create the positive role model for our children that grants them their birthright. Let’s show them how to do the right thing in as many ways as we can.
Clare teaches the Gokhale Method to groups and individuals, and offers free workshops to companies and organizations: http://gokhalemethod.com/clare_chapman
Professional Member of BackCare, the charity for healthier backs
Having suffered agonizing back pain when pregnant with her first child, Esther Gokhale is a leading educator on the benefits of natural posture. After unsuccessful surgery and medical advice not to have any more children, she dedicated herself to addressing the causes of so much back pain and structural problems in our culture. Now with three grown-up children, Esther is author of ‘8 Steps to a Pain-Free Back’ and has established the Gokhale MethodÔ to share her research, understanding, and eminently practical approach.