“Knee bone con-nect-ed to the…”?

Can you sing “Dem Dry Bones“? If you don’t know the spiritual by name, I bet you can intone at least some of the lyrics:

…the foot bone’s connected to the leg bone, the leg bone’s connected to the knee bone, the knee bone’s connected to the thigh bone…

Josephine Baker dances the Charleston

Josephine Baker dances the Charleston

Beyond the direct structural connection between the “knee bone,” or patella, and the “thigh bone,” or femur, is another connection that will be of particular interest to athletes and other individuals afflicted with or susceptible to patellar femoral pain syndrome (PFPS), a disorder often referred to as “runner’s knee.” And this is the connection between the knee and the gluteus medius, the muscles situated above and toward the outer sides of the much larger gluteus maximus muscles.

The knee bone is 'connected' to the gluteus medius

The knee bone is ‘connected’ to the gluteus medius

If you read my Samba Your Way to Beautiful Glutes post or joined my Samba webinar in October, you’ll know how to locate these paired muscles, and you’ll appreciate at least some of what they do.

How to locate the gluteus medius

How to locate the gluteus medius

Gluteus medius muscles, pelvic anteversion, and knee health

According to modern conventional wisdom, it’s considered normal for young children to have inward-turning knees, which are expected to straighten out by about age 7. What I’ve observed in village Africa and other nonindustrial cultures is that because children are carried on their caregivers’ hips and backs, children’s legs are externally rotated from the very youngest ages.

This Burkina baby was patterned to externally rotate his legs as he was carried on his mother's back

This Burkina baby was patterned to externally rotate his legs as he was carried on his mother’s back

In contrast, in the US and other modern industrial cultures, the  internal rotation of the legs is often maintained into adulthood.

Internally rotated legs are common in modern industrial cultures, even in adulthood

Internally rotated legs are common in modern industrial cultures, even in adulthood

Because the gluteus medius muscles are external leg rotators, strengthening these muscles can counter internal leg rotation, helping  the kneecaps to align and track better. (To check the tracking of your patella, sit down, place your palm over one of your knees, and then flex your leg to feel and follow the triangular kneecap glide up and down along the end of your femur.)

Strong gluteus medius muscles are important because people whose “glute mēds” are underdeveloped are at increased risk of knee and other lower-limb injuries, including patellafemoral pain syndrome. Preventing PFPS, or managing its painful symptoms if the problem has already occurred, are just a couple of reasons why–when you stand, walk, and run–you want to use your glute meds and externally rotate your legs. 

In addition to promoting knee health, external leg rotation facilitates an anteverted pelvic position and a well-stacked spine

In addition to promoting knee health, external leg rotation facilitates an anteverted pelvic position and a well-stacked spine

Gluteal muscle activity and patellofemoral pain syndrome (PFPS)

If you’ve ever felt a dull, aching pain under or around your kneecap where it connects with the lower end of your femur, you may have experienced patellar femoral pain, especially if the pain occurred when you were sitting for a long stretch of time with your knees bent, or you were kneeling, squatting, or walking up or down stairs.


Knee pain is nothing new; this Greek votive relief for the cure of an injured knee dates back to 100-200 AD

And, if you have been diagnosed with PFPS, you’re not alone. Gluteal Muscle Activity and Patellofemoral Pain Syndrome–A Systematic Review, which was published earlier this year in the British Journal of Sports Medicine, confirms the connection between the knee and the gluteus medius. By synthesizing electromyography (EMG) measurements of the gluteus medius muscles during a range of functional tasks as reported in 10 case-controlled studies, all of which evaluated EMG activity of the gluteus medius, the authors strove to elucidate the relationship between gluteal muscle activity and PFPS. Among their observations and conclusions:

  • Patellofemoral pain syndrome is one of the most common presentations to sports medicine practitioners; of 2500 presentations to sports medicine clinics 25% of all injuries were PFPS
  • Individuals with PFPS exhibit reduced gluteus medius and gluteus maximus muscle strength
  • Growing evidence supports the efficacy of gluteal muscle strengthening for PFPS and gluteal-muscle strengthening programs have been associated with positive clinical outcomes
In a nutshell, if you have good strength in your gluteus medius muscles, your knees will be in better shape.

In a nutshell, if you have good strength in your gluteus medius muscles, your knees will be in better shape.

Walking is connected to healthy knees

Think about it: Walking is something most of us do a lot, although according to the 2010 study Pedometer-Measured Physical Activity and Health Behaviors in US Adultsthe 5,117 steps Americans typically take each day are not enough–and in fact represent thousands fewer steps than those taken by our counterparts in Australia (9,695 steps), Switzerland (9,650 steps), and Japan (7,168 steps). But even if  we step just 5,000 times a day, if we engage our gluteus medius muscles with each step, that’s still a lot of repetitions to help “re-architecture” our legs and minimize the risk of PFPS. 

The pelvis serves as our postural foundation, and one of the keystones for healthy postures is to allow the pelvis to be anteverted. When your pelvis is anteverted and your “behind is out behind you,” then the whole pack of muscles that includes the hamstrings, the gluteus maximus, and the gluteus medias can work to advantage, strengthening themselves, inducing circulation in the appropriate places, and bearing stress.

Ancient coin features Apollo (with anteverted pelvis!)

Ancient coin from Caulonia features Apollo with anteverted (ie, tipped forward) pelvis

Beyond this, the relationship between external leg rotation, pelvic anteversion, and the action of the gluteus medius is cyclic. In order for the gluteus medius to be in a position of mechanical advantage, some degree of pelvic anteversion is required. And, if we are to believe the observations summarized in the British Journal of Sports Medicine review, strong gluteus medius action relates to a diminished risk of PFPS.

Eadweard Muybridge's 'human male walking' demonstrates strong gluteal action in the rear leg

Eadweard Muybridge’s ‘human male walking’ demonstrates strong gluteal action in the rear leg



The interconnectedness between external leg rotation, pelvic anteversion, and strong gluteus medius action is beautifully illustrated in the detail of Muybridge’s “animal locomotion” photo and “film” above.

“Dem Dry Bones”

Bottom line, the knee bone is connected to the thigh bone, but it’s also connected to the gluteus medius, and this is a fairly direct connection because these paired muscles externally rotate the legs.

Finally–not just because the lyrics are right on point with this lesson, but because he plays and sings so artfully and with such a great sense of fun–I hope you’ll listen to Fats Waller’s wonderful take on “Dem Dry Bones.”


Image Credits:
Josephine Baker Dances the Charleston, Wikimedia Commons
The Bath, Charles Degas, Wikimedia Commons, Public Domain
How to Locate the Gluteus Medius, Esther Gokhale
Burkina Baby, Esther Gokhale
X-ray of “Knock Knee,” Biomed Central, Wikipedia
The Spinal Cord, Bruce Blaus, Wikimedia Commons
Greek Votive Relief Knee Injury, Marie-Lan Nguyen, Blacas Collection, Wikimedia Commons
Female Jogger, Mike Baird, Creative Commons
Human Male Walking (animation), Eadweard Muybridge, Wikimedia Commons
Animal Locomotion, Eadward Muybridge, Wikimedia Commons
Ancient Coin from Caulonia: Classical Numismatic Group, Inc, Wikimedia Commons


Mike King’s Incredible Journey

A quote from one of my cherished Gokhale Method students captures the before of his posture-improving, pain-eliminating journey with me:

“I was a managing director at a telecommunications company supervising a lot of people, but there would be days when I’d put in my time lying on the floor in my office–to take pressure off my spine. At first colleagues would walk in and do a double-take, but gradually they become accustomed to my having to stretch out the floor while I worked. This had become my new normal.”

Another quote offers a glimpse of the happy hereafter, in particular, the adventurous life this man has been leading since we concluded our regularly scheduled, one-on-one work together, in 2008. 

“My wife and I just came back from a trip to Machu Picchu and the Galapagos. All the climbing of the Inca ruins and the walking over the lava fields of the islands went so very smoothly I never had even one issue of back trouble. Believe me, I could not be happier.”

The remarkable fellow is Mike King of San Ramon, California, and I was thrilled when he agreed to share his dramatic journey into and out of debilitating back pain.

What follows is Mike’s “travelogue.”

"Esther, I never thought I would ever again be able to do something like this. Thank you, thank you, thank you."

“Esther, I never thought I would ever again be able to do something like this. Thank you!”

The “back story” to my back story

“I’m 75 now, and if I look at the kinds of things I did in my life that contributed to what turned out to be debilitating back pain, it includes putting myself through college by working in a truck service station, working on very large and very heavy tires, using pneumatic wrenches to take them off and put them on. It was physically awkward and very taxing work. I also played football in high school and college and was involved in several car accidents. These were among the contributing factors.

“The first signs of trouble appeared in 1974. Especially when I did yard work or any other manual labor I would be very achey; I would really feel it. But it wasn’t a big deal back then, because I could get through these episodes by popping anti-inflammatories and easing up on the manual labor. The pain wasn’t yet chronic.

“But by the late 1980s my back problems intensified. The pain would last longer, and it would be more restrictive in terms of what I could do. For example: I’ve always been someone who’s been in the gym; I enjoyed working out, and I ran. But when back pain began to catch up with me, I had to quit running and cut back on working out. My life began to change.”

From bad back to worse

“In the 1990s I was doing a lot of international business travel, which meant frequent long flights and hotels with strange beds. This was at a time when I was becoming severely physically limited–when not only  was something like yard work out of the question, but walking had become a chore.

“Yet another issue was pain-related sleep deprivation, which of course exacerbates the difficulties of any challenging situation. And when my back problem became chronic–when I saw how much of my lifestyle I was having to let go–I became terribly discouraged. Feeling uncomfortable after a workout is one thing, but when disabling pain comes at you all at once it’s pretty hard to take. So, out of desperation, in June 1998, I saw my first neurosurgeon.”

The diagnosis

“Long story short, the neurosurgeon ran a number of tests and did a number of scans and diagnosed extensive sciatica due primarily to damaged L4 and L5 discs impinging upon nerves radiating out from my spinal cord. And his recommendation was surgery on my lumbar spine.

Contrast the herniated lumbar disc impinging upon the spinal nerve, at bottom, with the healthy disc, at top

Contrast the herniated lumbar disc impinging upon the spinal nerve, at bottom, with the healthy disc, at top

“By this time I was in serious pain and walking with a cane, and in desperation I agreed to have surgery–a laminectomy and a discectomy, which basically involve the carving out of some bone to get to the damaged discs that were protruding out and pressing in on spinal nerve roots.

Two surgeries: the good–and the bad & ugly

The bad

“When I came out of the first surgery–even after a longer than normal period of recovery–it became apparent that I was in worse shape than when I went in. It’s not like I was looking for a miracle, but I was expecting some relief because the neurosurgeon had painted a rosy scenario of a positive outcome. Instead, the surgery was a failure.”

The ugly

“At one post-op visit my wife, who was extremely concerned, explained to the neurosurgeon that I was feeling discouraged because I was still in terrible pain and still so debilitated. And the neurosurgeon turned to her and said, ‘Well, that explains why he’s not getting better. He’s not getting better, because of his attitude.’

“Jan looked at him and said, ‘No. He’s discouraged because the surgery didn’t work, and you’re not taking responsibility for it.’

"In desperation, I agreed to have surgery."

“In desperation, I agreed to have surgery.”

“So we quickly moved on, but of course by that time the damage had been done.”

The good

“Nine months later, in April 1999, I had a second back surgery, basically to clean up the results of the first failed surgery. And though I came out of that with the usual post-back surgery kinds of issues, I felt sufficiently well to travel on business to Hungary just one month later. And I got eight good years out of that second procedure, because it was done well and because I was very careful about what I did and got better at reading the warning signs. Once again, I was able to travel, work out in the gym, enjoy my life. So that second surgery turned out to be a really good thing–for a while.”

Back surgery number 3?

“In late 2006, early 2007, my back pain returned, but this time I now had foot drop, a condition that can occur when herniated spinal discs in the lower back impinge on spinal nerve roots. Because foot drop made it hard for me to walk and keep my balance, it prompted a visit to a third neurosurgeon, who–as he showed me X-rays and MRIs–identified a number of discs causing my problems, specifically: L3-L4, L4-L5, and L5-S1. But when he said, ‘You’re looking at major spinal fusion,’ I said to myself, ‘I’m not going to have a third back surgery. I’m not going to put my body through this. I’ve got to find another way.”

"Adriaen Brouwer's 'The Back Operation,' 1636, captures only some of the pain of my surgical interventions."

“Adriaen Brouwer’s ‘The Back Operation,’ 1636, captures only some of the pain of my surgeries.”

Identifying with the man from la Mancha

An impossible dream?

“To say I became preoccupied with a need to feel better is an understatement, because when you’re in pain and desperate for relief, you will find all sorts of people who claim they can heal you. For me, the experience was like going through a smorgasbord line, trying countless alternatives, none of which worked and some of which actually hurt me. And I began to view my quest as a sort of impossible dream to find a way to take care of my problem, without submitting to spinal fusion. 

“I’m not a student of Cervantes, but as I got deeper into my quest the classic tale of Don Quixote began to resonate. As you no doubt know, the story centers on an idealistic but confused man’s wanderings to do good works.  An indomitable inner will and extraordinary determination propelled him on his journey, despite real and imagined obstacles he encountered at every turn. And it occurred to me that people who suffer from debilitating back pain follow a similar path. While perhaps not as delusional as Don Quixote, we’re forever searching the Internet, gathering the latest information on surgical and nonsurgical approaches; we’re able to recite the definition of chronic pain; we try heat and then we try cold; we try pain blockers, anti-inflammatories, and muscle-spasm medications. We visit neurosurgeons, orthopedic surgeons, chiropractors, naturopaths, homeopaths–every imaginable alternative practitioner.  We seek second opinions and third opinions, and then, because we’re still hurting, we seek more.

"Don Quixote's indomitable spirit inspired me."

“Don Quixote’s indomitable spirit inspired me.”

“I put a lot of miles on my car and paid a lot of fees, in search of a solution, but my quest was really wearing on me because I was beginning to believe there wasn’t an answer. And as the prospect of fusion surgery loomed ever larger, and as I could see life as I once knew it slipping away from me, I grew more concerned.  Until one night, I plucked up a copy of Costco’s magazine.”

A serendipitous discovery

“Deep inside the magazine, I found a small article linking posture to back pain. It was very brief, with almost no detail, but after I read it I thought, ‘Hey, this something I haven’t tried!’ Of course I was more than a little skeptical that the approach developed by Esther Gokhale, with its focus on posture, could have a significant effect on my back pain, but I was determined to check it out. So I gave Esther’s office a call and signed up for a 1-hour free session.”

"It was just incredibly serendipitous how I came to discover the Gokhale Method."

“It was just incredibly serendipitous how I came to discover the Gokhale Method.”

“Later, when I got to know Esther, I asked, ‘Was Costco selling  your book?’ It wasn’t. The story just kind of appeared, and the fact that I would find it–and jump on it–was just incredibly serendipitous.”

What’s posture going to do for me?

“By the time I met Esther I was walking with a cane and getting through the day on a heavy-duty dose of Vicodin; I was not in good shape. So when my wife and I attended the one-hour introductory session, my mindset was: ‘This is kind of weird. What’s posture going to do for me?’ But when the session concluded and a man in the back of the room stood up and said, ‘I just have to tell you something, Esther. I’m a neurosurgeon, and you’ve done more for a number of my patients than I could ever do with surgery,’ I thought, ‘Bingo, this is what I needed to hear.’

Esther_Gokhale_Mike_King“On the spot I signed up for the Gokhale Methods course, opting for six private sessions with Esther. And I bought a copy of her book, 8 Steps to a Pain-Free Back. The amazing thing—and even I have trouble believing this–was that  I literally could feel a positive change after each session. At our first meeting, I learned how to sit. Now that may seem like a very simple thing to do. (I know I certainly thought it was,  because I’d been sitting for a lot of years and it never occurred to me that I should be doing this any differently.) But it soon became apparent that I had a lot to learn, and that I was going to have to do some serious reprogramming of old habits. And for six weeks I worked really hard, learning and practicing Esther’s techniques.

“As I progressed through the six classes, Esther helped me understand the big picture of her program. One of the nice aspects of the Gokhale Method, I should add, is that it’s not something you need to go back and re-enroll in every month–or even every six months (although for a while, I greatly benefited from quarterly ‘tune-ups’). Instead, you learn techniques that you can easily practice in the course of your daily life.”

Reclaiming my life

“I finished the course in 2008, so it’s been five years. And at age 75  I’m enjoying life and doing everything I want to do. One thing I hugely enjoy is being out and about with my camera, finding things to photograph, and–since working with Esther–I’ve done wonderfully well when I travel. My wife and I are just back from China; last year we hiked around Machu Picchu and the Galapagos; the year before we explored southern Africa–and next year I’m returning to Africa. We’ve seen so many amazing things and I’m grateful to the Gokhale Method for helping me regain the mobility I need to do all this–I’m grateful to Esther and her method for enabling me to (quite literally) reclaim my life.


"Freedom from back pain means freedom to travel. Here I am in Tiananmen Square."

“Freedom from back pain means freedom to travel. Here I am in Tiananmen Square.”


Photo Credits:
Mike King, Machu Picchu, 2012:  Jan King
Herniated lumbar discs: Wikimedia Commons
Surgeon: Wikimedia Commons
“The Back Operation,” Adriaen Brouwer: Wikimedia Commons
“Don Quixote,” Honoré Daumier: Wikipedia
“Getting Back to Our Roots”: Screen shot from The Costco Connection
Esther Gokhale and Mike King from
Back Pain: The Primal Posture Solution video:
Mike King, Beijing: Jan King

Exercise to reinforce primal posture?

The 2012 study A Single Bout of Exercise Improves Motor Memory published by scientists in Copenhagen found that exercise impacts the development and consolidation of physical memories. What particularly caught my eye were the findings that:

“A single bout of intense exercise performed immediately before or after practicing a motor task was sufficient to improve motor skill learning through a better long-term retention of the skill.”

“The positive effects of acute exercise on motor memory are maximized when exercise is performed immediately after practice, during the early stages of memory consolidation.”

These discoveries gave me pause. What if I were to incorporate acute exercise–that is, exercise of sudden onset and short duration–into the teaching of my 8-Steps posture techniques? By so doing might I improve learners’ long-term retention of individual components of each posture lesson and–ultimately–speed up and perpetuate their recovery of primal posture?


Because the study authors note that the effects of acute exercise might have important practical implications in rehabilitation, as well as in sports, and because helping people in pain rehabilitate primal posture is my life’s work, the notion of exercising to reinforce primal posture is a topic worth exploring.

What is motor memory?

Often referred to as “muscle memory,” motor memory, or motor learning, underlies the expression: “Once you learn how to ride a bike, you never forget.”


Motor memory is what’s involved as my fingers rapidly type this sentence on my laptop keyboard and what my husband unconsciously employs when he sits down at the piano and plays Scott Joplin’s “Maple Leaf Rag.” Of course “muscle memory” has nothing to do with muscles actually creating and storing memories of how to type or play keyboards. Instead, muscle memory is a sort of procedural memory that consolidates specific motor tasks into memory via repetition and files them away for future reference. It’s the form of memory that enables a middle-aged woman who hasn’t ridden a bicycle in decades, to climb aboard, wobble for just a moment, and then confidently pedal away.


The study


It’s well accepted that physical activity positively impacts cognition and brain function, and that aerobic exercise promotes adaptations in the human brain, among them: an increase in brain activation, blood flow, connectivity, as well as brain volume in the hippocampus, the part of the brain involved with spacial navigation and the consolidation of information from both short- and long-term memory. Until now, only a few studies focused on the effects of acute exercise on specific types of memory, and no studies investigated the long-term effects of acute exercise on motor memory consolidation and motor skill learning.

In the Copenhagen study, the men who exercised after practicing the motor skill showed improved long-term retention of the computer motor skill

In the Copenhagen study, the men who exercised after practicing the motor skill showed improved long-term retention of the computer motor skill

Study design

Two key questions Marc Roig and his colleagues set out to answer were:
  • Can an intense bout of cycling optimize the acquisition and retention of a motor skill?
  • Does the timing of the exercise in relation to the practice of the motor skill influence motor memory and skill learning?
Here’s how they set about their task: Three groups of  healthy young men attempted to master a visuomotor computer task–that is, a task that challenged both their muscles and their minds. Specifically, the men were asked to track with a joystick–as closely as possible–a red, squiggling line with a white cursor.
Tracking task graphic from Copenhagen study

Tracking task graphic from Copenhagen study

The men repeated the task many times until tracking the red line became almost automatic. One group engaged in 20 minutes of intense cycling on a stationary bicycle before the task, another group intensely cycled for 20 minutes after the task, while the third quietly rested after practice. Motor skill acquisition was measured 1 hour, 24 hours, and 7 days after practice.


The researchers hypothesized that the performance of a single bout of exercise before motor practice would improve acquisition of the motor skill and that exercise after practice would mainly optimize its retention.  The results surprised them:
  • Whether the men vigorously cycled before or after practice didn’t significantly impact the rate of skill acquisition.
  • Regardless of when they exercised, the men who cycled showed a better long-term retention of the computer motor skill, compared to the group that did not exercise.
  • The group that exercised after practicing the motor skill showed better long-term retention than the group that exercised before practicing the motor skill.

What’s the ‘takeaway’?

The timing of the exercise is important. To maximize long-term retention of motor memory, acute exercise must be done right after the memory is learned. The researchers conjecture that short bursts of intense exercise before practicing the motor skill may leave the brain overstimulated, making it less able to zero in on and access new memories. Note that the improvement doesn’t show up in the first hour, but rather when tested 24 hours or 7 days later, perhaps because after just one hour the memory is still being encoded and moving from short- to long-term storage.

Eager to explore how these study results might be applied to the teaching of Gokhale Method posture techniques, I invite you to participate in a simple, not quite rigorous experiment to test the notion that by exercising briefly and intensely after repeatedly practicing a single movement, you can cement this motor memory and better retain it over the long term. And I propose that we center our visuomotor-memory practice on a neck stretching and strengthening technique–neck-shearing (or head-gliding) from side to side.

Head gliding–a forgotten primal skill

Although we all share a fine blueprint for physical well-being, it takes cultural support and repeated visual cueing, especially in the formative years, to pass body wisdom from one generation to the next. Unfortunately, many in 21st-century industrial society have lost touch with the sort of  kinesthetic traditions our ancestors performed for thousands of years. One of these losses is the primal ability to balance substantial weights on our heads. 

Kinesthetic tradition is alive and well in Burkina Faso

Kinesthetic tradition is alive and well in Burkina Faso

While most of us are not prepared to transport a load of bananas atop our heads, we can practice and learn to stretch and strengthen our neck muscles, without stressing the cervical spine.

Take a look:

How to head glide

The best and most natural way to practice this visuomotor skill is to:

  1. Sit or stand before a mirror.
  2. With your palms facing in, hold each hand several inches from the side of each ear.
  3. Keeping your body still, slide your head from side to side, aiming to touch each ear to the corresponding hand.
  4. To ensure that you are translating this motor task horizontally and not moving your body, keep looking at yourself in the mirror.
  5. Practice this head-gliding movement from side to side, again and again, until you think you’ve got it.
  6. Then, on a scale of 0 to 10, self-evaluate how successful you were in head-gliding.
  7. Jot down this number for future reference.

Speeding up learning headgliding TeleSeminars

To very loosely test whether engaging in a short bout of vigorous exercise after practicing a visuomotor skill will enhance long-term retention of this skill–I invite you to join me for two 30-minute online meetings:

Saturday, August 10th, 10:30am PT

Sunday, August 11th, 10:30am PT

To register, click here.

As a preview, please view the above 2-minute video clip at least once.

While the protocol we’ll follow is not rigorously scientific, it will be fun and–with practice–may leave you with a new and useful skill. Beyond all this, our experiment may lead to interesting results you can apply to other motor skills you’d like to learn and retain.

We look forward to seeing you!

What would Copenhagen researchers say about this?

Finally, just for fun: Is the motor memory being reinforced by vigorous hammering before and after “the pause that refreshes” a memory of how to grasp and raise a glass? (The video runs for just 39 seconds.)


Photo and Video Credits:
Left-Right Brain, Creative Commons

Child on a Bicycle, Jacob and Marlies, Wikimedia Commons
Bike Rider, Josh Bluntschli, Wikimedia Commons
Stationary Bike Riding, Wikimedia Commons
Visuomotor Tracking Task Graphic, M Roig et al. PLoS One. 2012; 7(9): e44594
Burkina Faso Wo
man Carrying Bananas, Esther Gokhale

Neck Shearing/Head Gliding Video, Gokhale Method Institute
Blacksmiths, 1893, Thomas Edison, YouTube uploaded by cpenter





Posture focus and ping pong is a win-win combination

An explosive sport with everyday applications

Many people in the US think of ping-pong as a somewhat lackadaisical sport, but it’s actually a very active game that requires a great deal of fine motor control, hand-eye coordination, and athleticism. It takes explosive power, in addition to strength and flexibility, to get to the ball in time. In fact, one of the benefits of playing table tennis is that it allows you to develop an explosive power that is helpful for building bones and strengthening muscles.

Professional table-tennis player Timo Boll, below left, illustrates these truths. His form is superb. Not only are his legs externally rotated, but he’s doing a perfect hip-hinge, his shoulders are back and low, and his left wrist is in good alignment. The pivot of his head on his neck, which enables him to look up without scrunching cervical vertebrae, also serves him well.

German table tennis players Timo Boll and Christian Suss are laser-focused on the ball

German table tennis players Timo Boll and Christian Suss are laser-focused on the ball

If, after studying this photo, you still have any doubts about ping pong being an exciting and athletic sport, take a look at at this video billed as “one of the best table tennis points ever.”

Clearly, table tennis isn’t just about standing close to the table and hitting one kind of shot. The game is all about swiftness, power, balance, coordination, precision, and stamina–and healthy posture is a driver for all of these things.

Posture and sustained use of healthy limbs

While our focus here is table-tennis readiness and using posture to improve play, ping-pong posture pointers can be extrapolated to everyday uses of the shoulders and arms—for example, when driving, typing, or washing dishes.

Woman_Pauses_At_Laptop_Kirill Kedrinski_Flickr_PhotoPSharing

While the precision and explosive power required to play table tennis are less relevant to most routine activities, underlying posture fundamentals apply, especially those pertaining to the healthy positioning of the shoulders and arms. This is because when the shoulders aren’t drawn into a hunch, when the nerves that arise in the thoracic spine are not impinged, when there’s no tightening of the pectoral muscles, and when natural movement in the opened-up chest is free to provide a natural massage, breathing and circulation are improved.


Ping pong and posture is not just a sports story. It’s a story about the sustained use and continued health of the limbs–enabling the limbs to  do their everyday thing long-term.

Table tennis is my game

Childhood play

When I was about eight, my Indian father taught me to play table tennis at one of the two tables at the Breach Candy swimming pool in Bombay. Ping pong was popular in India when I was growing up, and I played quite a lot, mostly at school. Over time, I developed what was thought to be a mean backhand, but I did this without developing any sort of forehand. While the standards for play weren’t as high as they were in East Asia or Sweden, I participated in tournaments of middling quality, and had some success.

Ping pong paddle with badminton shuttlecock in Mumbai (formerly Bombay), where I learned to play table tennis

Ping pong paddle with badminton shuttlecock in Mumbai (formerly Bombay), where I learned to play table tennis

Later, as a high-school-senior exchange-student in New Jersey, I won a local table tennis tournament in what, again, may have been a tournament of questionable competitive caliber.

Still, by local standards of that time, I had a pretty wicked backhand, together with a winning record. All this without having yet developed a good forehand.

A ping-pong courtship

I was a freshman at Harvard when I met my husband Brian over a ping pong table in Princeton’s “Debasement,” now called the D-Bar. I was visiting my then-boyfriend, a very discerning person, who shared my view that Brian was a very likable fellow.

What first struck Brian about me was that I was an authentic person. And what struck me about Brian was that he was beatable at table tennis! Actually, what struck me even more was that my handily beating him at ping pong didn’t bother him. Whereas some guys’ enthusiasm for playing would be dampened by regularly losing to a woman, Brian remained engaged, alert, and dedicated to improving his game. Accepting of pulling up from behind, he worked his way to the point where he handily beats me now, as he has for some time.

My husband and I met playing table tennis

My husband and I met playing table tennis

Stories abound about how Hillary met Bill

Stories abound about how Hillary met Bill

Ping pong courtships are dynamic!

Ping pong courtships are dynamic!

Table tennis hiatus, then a family of players

After Brian and I married and had kids, there was quite a long stretch where table tennis was no longer a part of our lives. Then, about 10 years ago, we purchased a table and ping pong became a family game.

The kids are mostly out of the house now, but Brian and I play frequently, sometimes as often as several times a day. This is in part because the table is usually parked right in the center of our living room. While this is somewhat unusual decor, it aligns with our priorities. And when the living room is required for other activities we either move the folded table to the side, or outside on the patio (it’s an outdoor table).

Plucking up paddles and playing a quick game of ping pong is one of the ways Brian and I take pick-me-up breaks. Because we talk when we play, it’s also an opportunity for us to visit together.

Voila!–a forehand!

When Brian and I first met and began to play in 1977 I was not yet focused on posture. But when, after about 20 years, we resumed play, I was very surprised to discover that in the complete absence of playing I had developed an effective forehand! I attribute this “gift” to my (at that time) 5-year commitment to healthy posture. My body may have been older, but its essential architecture was much healthier, which meant that more than ever I was poised to play a more complete game.

The posture-sport connection

Improving at ping pong in the absence of playing really interests me, in part because it prompts the impulse to connect the dots between posture improvement and improvement in sports–not just table tennis, but any number of athletic activities, whether this be fly fishing, cycling, tennis, or golf.

Poised to play

Because healthy posture provides mechanical, physiological, and even psychological advantage, focusing on posture while engaged in sport makes good sense. After all, the body is an intricate system involving not only the bones, the joints, and the muscles of the mechanical system–the “pulleys and levers”–but the complex physiology of circulation and innervation, together with sports psychology and sports performance anxiety. In table tennis–as with every sport–anatomy, physiology, psychology–and posture–are intricately entwined.

Anchoring strokes to posture points

When I play table tennis I put my “body-as-human-machine” at mechanical advantage by focusing on key elements of my posture. Doing so helps all aspects of my physical game, including my oft-used backhand, my ever-improving forehand, and my ability to rally. (Posture-focus also serves me psychologically and emotionally, but more about these aspects of play in just a bit.)

A ready position and a posture-focused state of mind

Before any game and between rallies (but not between strokes), I focus my attention on:
  • Lengthening my neck
  • Depressing and pulling back my shoulders
  • Anchoring my ribs
  • Hinging at my hip joints
  • Keeping my behind behind me
  • Externally rotating my legs and “kidney-bean”-shaping my feet
While visualizing and executing these posture points once required a conscious effort, focusing on them now has become a natural part of my game.
Neck and shoulders. The ping-pong posture habits most helpful to me may be super-correcting when pulling back and lowering my shoulders, and lengthening my neck with extra muscular force. I exaggerate simply because doing so makes my swings more effective. Optimally positioning my shoulders helps with my range of motion, my power, and precision. It also helps prevent injury of my shoulder joints, joints that have craggy, complex interfaces, and are vulnerable to inflammation and wear and tear.

Ribs and hips. When playing table tennis, I’m also aware of rib-anchoring and hip-hinging. Keep in mind that most of the posture-tracking I do happens between games, or between rallies. It’s too much to consciously focus on posture points during active play.

Buttocks, legs, and feet. Pouncing in ping pong is essential and fun. In order to do this well, I remind myself to keep my behind behind me. Neglect this posture point, and my ability to speedily reach the ball on less than a moment’s notice will be compromised. And, although the leg and buttock muscles do the bulk of the work in table tennis, having the feet turned out and shaped like kidney-beans also helps with speed and power.

Backhand, forehand, and rally


It is in the nature of the game to get more backhand than forehand practice, and this is especially true when I stay in one spot. When preparing for backhand strokes, I think about my shoulders staying down and and my neck going tall in a slightly exaggerated way.


Despite marked and continuing improvement, I still feel a bit disconnected from my forehand and am sometimes surprised when a shot that comes off my paddle actually lands on the table! But, because of the posture work I’ve done and because my shoulders are now “closer to home,” I now have a bigger range of motion and a more precise stroke. I suspect that shoulder positioning was at least part of the missing piece that prevented me from predictably hitting smooth forehand shots in days gone by.

Posture focus as an antidote to performance anxiety

If there’s any kind of emotional flutter when I play table tennis, focusing on posture takes the worries out of my head and places them into the act of play. A posture-point review offers sufficient material to displace anxiety; there is no longer any room for it.

Similarly, because table tennis is so quick and labile, so sensitive to little fluctuations in the psyche, it’s counterproductive to think, “Oh I’m really going to smash that ball!” To do so is to pretty much ensure that the ball goes flying off the table.

Bottom line? Focusing on posture is an instrument for greater mindfulness. By making myself fully available to the physical reality of a ball coming at me, sports-performance anxiety–all anxiety–is displaced. Anchoring posture habits to particular aspects of play helps both the physical and emotional components of my game.

Forrest Gump rallies

In the following video clip, Forrest Gump faces the (un)reality of an approaching ping pong ball…the “movie magic” that underlies actor Tom Hanks’ game is enlightening, but not so much his style of play. While it’s obvious Tom is a limber and athletic fellow, his ping-pong posture could be improved. Because he raises and pulls forward his shoulders with almost every stroke, his “pecs,” “traps,” and shoulder joints take a heavy toll.

Of course Forrest Gump is a character who would never complain of pain. But he does point to his shoulder and observe that play was exhausting. Here’s a suggestion, Forrest: One shoulder at a time – a little forward, a little up, and a lot back!

Brian and I rally

Finally, without the benefit of “movie magic,” my husband and I briefly rally to close out this post.

Of course our game is a work in progress–as are we! This is part of what makes applying posture points to a sport like table tennis so much fun.

Image Credits:
Timo Boll and Christian Suss, Creative Commons
Woman with Laptop, Kirill Kedrinkski, Flickr PhotoSharing
Brazilian Woman Washing Dishes, Christian De Vries, Flickr PhotoSharing
Mumbai Street Ping Pong, Roshan Pajwani, Flickr PhotoSharing
A Game At Which Both Win, 痞客邦 PIXNET 留言(0) 引用(0) 人氣
Bill and Hillary Clinton Play Ping Pong, Blazing Paddles, Larry Hodges
Ping Pong Courtships, JCC Youth Conference, 1947, Flickr PhotoSharing
Ping Pong Videos, Gokhale Method Institute