Will the Egoscue Tower help you?

If you’ve read Tim Ferris’ book The Four Hour Body, you probably read about “The Egoscue Tower.” Tim makes it sound like a god-send to help “unlock the pelvis” and eventually relieve hamstring tightness.

As someone who’s been certified as a Posture Alignment Specialist by Egoscue University and someone who’s used it to help clients get over back pain, hip pain, and sciatica, I can tell you that it is, in fact, great for some people. It is not, however, a magical cure for all back and hip pain, and there are times that it can be a bad idea to use. So before you buy a Tower, see if you fall into the good candidates category or the “be careful” category of people.

First the good candidates.

If you’ve got lots of tightness around the hips, the Tower might be helpful. The people I’ve primarily seen get the most bang for the buck are those that are flexed in the hips with lateral rotation of their femurs.

Flexion of the hips basically means your pubic bone is pulled down toward the floor (this could look like a really severe curve in your lower back or as a relatively flat back with your upper body tilted forward).

Lateral rotation of the femurs is when your knees (and very, very likely your feet) point out to the sides in your normal relaxed posture. When you then try to point your feet and knees straight forward, it feels really awkward/tight in your knees and hips.

With the hip flexion and the lateral femur rotation, you just can’t stand up straight and your spinal erectors (and your hip rotator muscles) get burned out from trying so hard all day.  Your lateral hamstrings (hello, biceps femoris) are often quite dysfunctional, contributing to lateral rotation and possibly a bit of knee flexion.

lateral rotation of femurs and feet

Example of extreme lateral rotation of femurs. Note that knee caps and feet are pointing out to the sides instead of straight forward. If you’ve read the Egoscue books, you might recognize this as Condition 1.

So how does the tower help?

As described in the book, positioning your foot for 45 – 60 minutes in the tower helps the hip flexors and all the other muscles around the hip relax. This allows your muscles and brain (neuromuscular system) to get used to having your leg pointing in the direction it’s supposed to point in. Tight, over-facilitated muscles learn to relax when your neuromuscular system realizes that your leg is going to stay in that straight position, regardless of how badly it feels like it wants to rotate to the side.

The position also allows the spinal erectors to relax, which can be nice if you’re always in a hunched position with your back or your erectors are working overtime to keep you from falling over. Just this chance for the muscles to rest, refuel, and reset can make a big difference to your comfort level. As an added bonus, as any kyphosis (upper back rounding) improves, your ability to get your shoulders in the right place also improves.

Using the Tower is like dealing with a naughty kid. Imagine you had a naughty kid who just liked to bang on pots and pans to annoy you. You ask him to stop. You put him on time outs. You bribe him. You cajole him. Nothing works. Finally, one day you just sit there, completely nonplussed for as long as he wants to bang on the pots and pans. Eventually, he tires out and just stops banging on pots and pans and then gives up on it altogether since apparently you are an immovable force.

It’s the same idea with the tower. Your hip joint keeps to rotate and stay flexed, but eventually it gives up and finds a new normal where your leg stops rotating and your lower back can drop to the floor. Your back wants to stay rounded, but eventually it gives in as well.

What’s it feel like?

When I work with clients with the tower, we pay close attention to that sensation of lateral rotation (foot trying to turn out against the pedal strap), and wait for that to dissipate at each level before moving on.  While waiting, you can end up with cramping and what I call “complaining” from your hip muscles; commonly I’ve observed complaining in the quads, the hip flexors (psoas), and the area around the glutes (usually in the deep lateral rotators and not actually in the glutes).  For the lateral hamstrings, usually you’ll get a sense of gentle stretch rather than any cramping, though everyone’s different and it may just happen to lucky you!

Supine groin progressive

Not everyone gets cramps, but for those who do, they can be pretty darn shocking. I clearly remember feeling a primal kind of panic when my hip rotators or lateral hamstrings would release when I first started using the tower years ago. I’ve also had to gently talk many a client through the aches of the tower until their bodies found a new normal and the tension and cramping dissipated. You’re asking muscles to elongate in a way that they probably haven’t done for years if not decades, so it can sometimes be pretty rough going. As you repeat, the cramping may ramp up for a brief period, but once you’ve gone through it a few times, the intensity should taper off. It’s pretty similar to the experience of novice weight lifters feeling crazy soreness after their first few workouts.

Who should be careful?

I do not use the supine groin progressive with anyone who already has hyperextended knees, unless there is some way to bolster the knee and prevent it from going into its locked out position — and even then I’ve not found it to be all that useful. For people who have normal range of motion in the knees, the supine groin progressive can already be stressful on the back of the knee. For someone whose knees hyperextend already, you’re adding 45 minutes of constant pressure to stretch the ligaments of the back of the knee — not exactly a recipe for longterm structural integrity in my estimation.

I’ve heard some postural therapists say that using towels under the lumbar spine and neck can help reduce the strain on the knee, but this adjustment doesn’t seem to change anything. From my perspective, the roll puts the hip flexors into a shortened position, basically ensuring that the only thing in the lower body that’s going to do any lengthening is around the knee (e.g. distal hamstring lengthening = even more hyperextension of the knee). The force of gravity on the knee joint is still there, still stretching out the knee.

no butt disease

This is a butt that is barely there.

Also, if you are someone with NBD (No Butt Disease), the Tower may or may not be helpful — just depends on your unique situation. The thing to look out for is whether lying in the tower actually makes things worse in your back or in your hips. As noted above, the Tower can help over-facilitated muscles relax and reset. When you have poor muscle development in your butt, lying on your back and butt in the Tower can actually allow too many muscles to go limp. In this case, the more you use the Tower, the weaker your butt (AKA hip extensors) get, and the more your spinal muscles may attempt to compensate, which could potentially aggravate your symptoms.

From personal experience with having ridiculously weak hips that caused me all manner of chronic pain (foot pain, calf pain, knee pain, and painful hip snapping), the Tower can be quite helpful for reprogramming the hips initially, but if the Tower makes your hip joints feel weaker and looser (or just the inner thigh much tighter) or your back feel more painful, then some more specific examination of your body’s holding patterns is definitely in order, and some other exercises to activate your hips will likely be better for you and help you get stronger, healthier, and more pain free.

The gentleman in the picture above got absolutely nothing out of using the Tower for his knee and hip pain, but he got a whole heck of a lot out of doing exercises to improve the baseline activation and overall strength of his butt. In a few months’ time, he got back to running half marathons despite having been told by his doctor that his running days were long over. Another bonus: he didn’t have to block out 1.5 hours of time every day to lie on his back.

And that’s it!

Hopefully that gives you a good, realistic idea of what to expect with the Tower. For any other  questions that weren’t answered here, feel free to post in the comments section below. If you’d like to buy a Tower, keep scrolling down!

Where to buy a Tower

If you fall into the good candidate category and want to try a tower based on Tim Ferris’ recommendation and what you’ve read here, you can order one online at Railyard Fitness by clicking their logo below. You don’t really need the full kit unless you really, really want to have all the toys. All you really need is the Tower and a chair to put your leg up on.  Enjoy!


About the Author

Matt Hsu is a trainer and orthopedic massage therapist. He fought a long battle with chronic pain all over his body and won. He blends the principles he learned in his journey, empirical observations with clients, and relevant research to help others get their lives back.

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