Most of us realize that we pay a dear price in many ways for the comforts and conveniences of our modern lifestyle. Some, such as environmental pollution and processed food are more obvious whereas others are not quite as obvious. The change to “off the floor” living is a good example. As chairs, couches, recliners and beds replace floor-level living where sitting cross-legged or squatting are the norm, we have lost not only one of the most simple ways of maintaining our flexibility and suppleness but also a crucial means of maintaining healthy elimination and digestion.
   
          In my early years as a doctor I had the great privilege of working with the indigenous peoples of the Palliar tribes in the lower Palani hills in South India. A simple hunter-gatherer tribe living in thatched bamboo huts deep in the jungle, these wonderful people lived in good health well into their old age aided by a great knowledge of herbs and foods from the forest and the extreme simplicity of their lifestyle. In the years that I lived and worked with them I never once saw a chair or even a stool in their dwellings. They either squatted on the ground or sat cross-legged on the floor. In the evenings as they gathered around a fire to tell stories, sing songs or chat I noted that even the elderly could sit in the squatting position for several hours at length without the slightest semblance of discomfort. I noted that this was an important factor contributing to their astonishing litheness, agility and prowess but it was some years later that I came to a deeper understanding of the many ways in which squatting benefits health. Below is a list.

1.          Mimics the fetal position. More than any other posture squatting mimics the fetal posture and is an ideal position of rest when one is comfortable in it.
2.          Stretches the spine. The entire spine is stretched in the squatting position except for the neck, which too can be stretched in this position by simply dropping the head between the knees.
3.          Opens the pelvis. The lumbosacral and sacro-iliac articulations are eased open while maintaining the tone of the pelvic floor. The squatting position therefore has great advantages in birthing as well.
4.          Increases intra-abdominal pressure. The abdomen gets a good squeeze in this position, which increases pressure within, aiding elimination.
5.          Increases pressure on the colon. The thighs come in contact with the abdomen along the flanks and apply pressure to the ascending colon and the descending colon on the right and left side respectively.
6.          Stretches the Achilles. The area on either side of the Achilles tendon carries important reflex points for the bowels and rectum. Squatting provides a great stretch to the Achilles.
7.          Stretches the peronei. The peronei are a group of muscles on the outer aspect of the lower legs adjoining the shin. These muscles also carry important reflexes to the bowels and digestive tract.
8.          Stretches the plantar fascia. The mid-section of the soles of the feet carry important reflexes to the digestive tract and this area gets a beneficial stretch in the squatting position.
9.          Stimulates reflex points on the chin. Cupping the chin in the hands while in the squatting position stimulates points on the chin that reflex to the bowels.
10. Stimulates reflex points in the hands. In the same position the cupped hands also receive the pressure from the chin in the area that reflex to the bowels.

While most of us use modern seated toilets we could still benefit from squatting by simply practicing the posture on the floor for 5 to 10 minutes prior to a bowel movement. We could also make this a more common practice in our daily lives by practicing it more often during the day. Gently rocking forwards and backwards and from side to side can enhance squatting and can benefit the knees and spine.
 
Begin your practice of squatting gently and with caution if you are unfamiliar with it. For those unable to do so it is best begun by leaning back against a wall for support. It is important that the heels rest firmly on the floor to prevent injury to the feet and ankles.
 
Chronic knee problems such as meniscus tears and arthritis, spine problems as well as ankle issues can be aggravated initially, so it is best to consult your doctor beforehand. In pregnancy, a history of miscarriage and cervical incompetence in particular can be a contraindication and professional opinion must be sought prior to commencing practice.
 
 
 
 
   
    
  

My clients often ask me why I chose to switch over from conventional modern medicine to alternative medicine. The truth is I haven’t really switched over. I still use my training in conventional medicine on a daily basis, be it in diagnosing an endocrine imbalance or narrowing down the differential diagnosis in a patient with peripheral neuropathy. A fairly recent example is a client with a history of severe excruciating one-sided headaches that would appear several times a day for about half an hour even waking her from sleep. These episodes would last for a month or two and then vanish only to reappear a few months later. This pattern of intermittent headaches had persisted for several years. No medication had made any significant difference. She had reached the point where she could take it no longer and had contemplated suicide many times. A well-known neurologist had diagnosed cluster headaches but she had not responded to treatment. When I saw her she was in great distress and had an episode of headache in my office that was obviously agonizing. The temporal pattern of the headaches, the timing, the frequency and the severity strongly suggested a variant known as Chronic Paroxysmal Hemicrania. The good news with this particular diagnosis is that a specific drug, Indomethacin, not only elicits a favorable response that is diagnostic but can also be used to terminate these attacks and in small maintenance doses can prevent them from recurring. Her headaches stopped completely within 3 days of starting Indomethacin. She has successfully prevented further attacks of headache in the past year and a half with a small maintenance dose of Indomethacin.

    I have related this story simply to highlight the fact that basic clinical skills such as history taking and clinical examination should always be the bedrock of medical practice and should not be usurped by technological advances in imaging and laboratory testing. The process of reasoning and logical deduction based on thorough history taking and clinical methods that enables a trained physician to arrive at a final diagnosis is honed over many years of practice. Modern medical practice ignores these skills at it's own peril. It is time to go back to the basics.

  There is no question that Modern medicine has an indispensable role to play in many situations; major trauma, congenital disorders, severe infectious diseases and more. In many of these there are complementary modalities of therapy that could be of great help if used wisely. However, to my mind, in the ever-increasing number of lifestyle related diseases that are rampant in modern society, Holistic Integrative Medicine should take over that central role and Modern Medicine should serve a secondary function and be used only when necessary. Better still, someday in the not so distant future, I am hopeful that the distinction between the two will blur sufficiently and there will be a seamless integration of all modalities of treatment into one medical system. This will no doubt require major changes in medical education, research, health care legislation, insurance and so forth but such change is inevitable. The current system is simply not sustainable as is painfully evident to many patients, health care providers and governments. Change will come but the polarization of so-called scientific medicine and the various traditional systems of medicine has been so extreme that such change could likely be tumultuous. Meanwhile insidious change is already under way. Many well-known institutions such as the Mayo Clinic have established departments of Integrative Medicine as have some prestigious universities and medical schools. Many conventional physicians are beginning to overcome their inbred bias and are seeking to explore and understand other systems of medicine. This can be troubling and disquieting at first since these systems are often so contrary to each other philosophically. As medical students we are trained to think “scientifically”, to seek “evidence”.

    But what constitutes evidence? Modern Medical science uses statistical methods such as randomized controlled studies to evaluate evidence. However such methods don’t lend themselves easily to the study of many of the traditional systems of medicine. New research methods are needed. Often the argument “there is no proof”, or that “these methods have no scientific basis” is used to dismiss entire systems of medicine some of which have been in place and served peoples and cultures for thousands of years. The fact is there has been little interest until recently in investigating them for their true worth. There has been a lack of inquiry and of genuine research that has been equated to a lack of evidence.

Until next week…