Egoscue Supine Groin Progressive Tower

The Power of the Egoscue Tower

12/9/2013

When clients of Oregon Exercise Therapy first see the Egoscue Multi-Positioning Tower and are told it is going to be in their new menu their response is typically one of these two:

Wow! I’ve heard so much about this and have been wondering when you’d have me do it. My friend said the Tower helped her so much!
I don't feel anything. How is this helping me? Why do I have to lie here so long?

I thought I would take a minute an explain a little about how the Tower works, why it works, why it can take a long time, why you might not feel anything during it, and what postural imbalances it can have a positive effect on. Whether you have done the Tower before or not, hopefully this will help you get a better understanding of this powerful E-cise and encourage you to try it for the first time or continue to commit to it if you are already doing it.

The Supine Groin Progressive is the most common E-cise that the Egoscue Tower is used for and Pete Egoscue in his book Pain Free describes that:

"This E-cise is designed to allow flexion and extension of the leg, rather than rotation through adduction and abduction (side-to-side movement).”

Let’s break this down to a very simple terms that you will understand and then explain why it can take an hour (or longer) for that to happen. In Pain Free, Pete Egoscue first introduces the Progressive Supine Groin in the knee pain chapter when talking about “external rotation”. External rotation of the femur can be seen when looking at your knees in a mirror from the front and the knee caps are pointing outward (instead of straight ahead).

The femur is being rotated out by strong tight muscles in the hip (psoas, iliacus, etc) that usually are also holding the pelvis in extension (anterior pelvic tilt).

This posture is a common dysfunctional posture that we call Condition 1 Posture. What is happening in the body in a Condition 1 Posture is described in the Egoscue University P3 (Posture, Pain, and Performance) workshop material:

"Keep in mind that the body is a unit and that the body is linked functionally from head to toe. The anterior tilt of the pelvis is caused by the strong, tight hip flexor muscles and puts excessive arching into the low back. The more a person walks with the tight hip flexors, the more they pull down on the spine and exacerbate the problem. To relieve the tension on the spine, the upper back rounds – taking the shoulders forward – and the head tilts downward. To relieve the tension in the hips, the femurs externally rotate, taking the knees and feet outward. This is a formula for pain up and down the body."

Going back to the knee chapter of Pain Free, Pete Egoscue talks about how this constant rotational torque coming from the hip is transferred into the knee joint. The knee is a hinge joint (think door hinge) and is designed to flex and extend (the door opening and closing) not rotate. That rotational torque is what can cause knee pain and wear and tear over time. The Tower is designed to unlock the tight hip flexors which will allow the pelvis to return to neutral, the spine to come out of lordosis and return to normal and the femur to return to neutral and point straight again.This will cause a chain reaction up the body allowing upper back to come out of excessive spinal flexion, the shoulders to move back into position and the head to center itself over the torso once again. The Tower also helps to reconnect the kinetic chain from your ankle to knee to hip and get them functioning as a unit once again. Your hips will move through their design range of motion taking the stress of the feet, ankles, knees, lower back, upper back, shoulders, and neck.

(BTW just because I’m talking about knee pain here, that doesn’t mean that’s the only thing the Tower addresses. The Tower will help with: low back pain, shoulder pain, neck pain, sprained ankle, degenerative knee pain, degenerative hip pain, degenerative disc disease, spondylolisthesis, spondylosis, herniated discs, carpal tunnel, plantar fasciitis, and many other problems. I’ll outline how the Tower effects some of these in future posts – stay tuned.)

Watch this video to learn how to do the Tower:

How long it takes each person to do the Tower will depend on their unique postural imbalances, but for most people it takes around an hour. As the video explains, you start with your leg in the top level and stay there until your low back relaxes completely flat to the floor (typically 5 minutes). At that point you can lower your leg down one notch and then wait for your back to relax to the floor again. Since there are six levels of the Tower, it will take on average 30 minutes per leg or 1 hour for both legs.

If you are in chronic pain and have tried everything, but not the Tower, it is worth a try. This is the one e-cise that is easy to do and will make a huge impact on your posture and pain. Set up a free posture evaluation with me at Oregon Exercise Therapy and I'll walk you through how to do the Tower. I'll explain what is going on in your body and why the Tower will help you.

You can purchase the Tower and other products recommended by me and Oregon Exercise Therapy here.

35 Comments

David Kartuzinski

5/19/2014 07:00:02 pm

My girlfriend has Hip Dysplasia. The type where the socket for the joint is under developed. She is in chronic pain. We just started trying to address this as she has felt hopeless about it. We purchased a special belt, she is taking now supplements that are anti inflammatory, and looking to get a new job where she is not on her feet all the time. Other than a hip replacement surgery, per more than a few doctors, the only other thing I can think of is exercises. Do you think this tower is going to be useful for her condition? I can imagine how it could not be. Thanks.
-dk

Matt Whitehead link

5/20/2014 04:30:13 am

Hi David, I think it is great you are helping your girlfriend try to find things that will help with her chronic pain and hip condition. My short answer is yes I think the Tower would be helpful for her as I have seen it help many other clients with hip dysplasia and chronic pain related to it. I always start looking at situations like this by asking more questions to get a full understanding of what is going on. Things like:
Is her dysplasia acquired or congenital? Is it one hip or both? If she's had the condition for a long time or possibly her whole life, has she always had pain? If not, we cannot blame the pain 100% on the dysplasia but rather there is something else going on. What does her posture and movement patterns look like? Postural and muscle imbalances that develop throughout our lives are often the reason why pain and limitation show up, but the pain is blamed on things like hip dysplasia because that can be seen on X-rays and MRIs. The reality in many cases is the hip dysplasia has always been there and not caused a problem but the postural imbalances have gotten worse over time and they are the reason why the hip has now become painful and often degenerative.

I hope that makes sense. If your girlfriend is interested, I'd be happy to do a free consultation in person or over Skype where you both can ask questions and I can take a look at her posture and movement and see what I think is going on. Also feel free to call or email with any further questions. [email protected] 971-279-2189

Matt

Dr Zendop

5/30/2022 11:34:52 am

Look at the titles of the videoso the Upright Health YouTube channel and choose your tpic. If you dont find it, write them.
I know hm and that he as covered that.
All the best.

Douglas Gray

10/30/2014 11:27:33 am

Hi,

I have a sort of typical lower back spasm thing right now that I am getting over; a friend had an Egoscue tower and let me use it; wow! after just one session (took 48 minutes) I felt way better!! Thank you, this thing is good!!

Matt Whitehead link

10/31/2014 01:10:58 am

Hi Douglas,

Thanks for the comment. I am glad the Tower worked so well for you and that your friend introduced you to it! Now you have to pass it on by sharing it with the next person you run into with back pain. :) Keep up the great work.

Patricia Bobo

11/7/2014 09:00:27 am

I have abone spur in my hip. Lately sciatica
Been bothering me. I have the Egoscue tower and the book. I've been doing it a few times. Haven't seen improvement yet. How many days of the week shall I do the tower and will it help my condition or just aggravate it.

Matt Whitehead link

11/7/2014 12:45:50 pm

Hi Patricia, Thanks for the question, hopefully I can give you some insight that is helpful. Bone spurs and sciatica are two very common symptoms that my clients have and it is important to remember that they both are caused by postural imbalances and incorrect movement patterns. In most cases, these imbalances started years or even decades ago which means these patterns are very ingrained in your body. Changing them is possible - and the only way to get lasting pain relief - but will take consistency and time. I would recommend doing an e-cise menu daily and if possible the Tower, so you give your body the best chance to change quickly. You and only you will be able to tell if the e-cises you are doing are helping because your body will tell you by either feeling better or not. If you don't start feeling positive changes and improvement in a week or two that probably means those e-cises aren't impacting the dysfunctions and you'd want to get a routine specific to your imbalances. If you'd like a free posture evaluation and consultation let me know. - Matt

Patricia bobo

12/24/2014 09:34:59 am

I had one by Marta Olson and my posture and gait was pretty much normal. Have done some hip Ecises n tower but not every day.

Matt Whitehead link

12/29/2014 01:21:33 am

Hi Patricia, If you are having symptoms and sciatica, there is something going on in your posture and movement that is creating it. If you had your posture and gait analyzed by someone else and they didn't find the cause then you are chasing a symptom with everything you do which won't lead to long lasting pain relief. Finding the cause of the problem is the key to getting a long term solution. I would be happy to take a look at your posture and let you know what I see. Give me a call at the office to set up a time: 971-279-2189

Nancy

12/2/2015 01:34:04 am

Hi Matt: I appreciate your Egoscue Tower insights. For someone with no hip "pain" but slight pain/ discomfort quite often and definitely extreme tightness of the right quadricep, my intuition is that I should be using the tower. I have had one for years and never used it judiciously. In the past, I have used it with an Egoscue menu, but only for about 15 minutes on each side. I want to start using it for a full hour at a time. How many days per week would you suggest that someone use the tower? I don't want to see my hip imbalance get worse, and I am hopeful that perhaps it can help my low grade chronic headache. Thank you.

Matt Whitehead link

2/8/2017 12:12:13 pm

Hi Nancy,

I recommend using the Tower 1-2 days per week for maintenance for most people without any pain or major posture issues. Doing the Tower that often with a regular daily menu and active lifestyle should work well for most people. If you notice tightness in your hip flexors or low back, your posture getting worse, or any pain starting doing the Tower more often would be recommend. Also with high intensity athletic training or working out doing the Tower more often or after hard workouts really helps.

The Tower can help with headaches but you also want to make sure you're doing something to directly address any thoracic spine and shoulder imbalances you might have. Let me know if you need help figuring out what to do. :-)

angi bloom link

5/25/2017 04:49:55 am

I ordered this and tried it out yesterday. I have had 10 years of chronic knee pain and inflammation which has improved since I have been focusing more on strengthening the hamstring and gluts. I felt the back of my knee was hyperextending and my knee is more sensitive today. Can I bend the knee of my extended leg slightly or support it so that I reduce the sensation at the back of my knee? I do find the tower very relaxing and it was recommended by a therapist I see. Would appreciate recommendations for people with weak hamstrings.

Matt Whitehead link

10/21/2017 10:32:37 pm

Hi Angi,

I can't believe I missed your comment and I feel really bad about replying to your questions so late! Sorry!

Yes you can support the back of your knee enough that it does not hurt when doing the Tower. Also bending your knee several times between levels can help also.

Do you have an anterior pelvis? If not, you might be better off doing the Supine Groin Stretch with Towels. I'm happy to evaluate your posture for you and let you know. Email me if interested.

It sounds like you are on the right track with strengthening your hamstrings - that is really important to balance your leg muscle strength and function.

Janet Molchan

11/11/2017 10:34:03 am

How or with what would you support the back of your knee while using the tower? What is the supine groin stretch with towels? I feel my knee is a little hyperextended and now sore.

Thanks. Janet

Reenie Matthews

10/21/2017 07:30:11 am

If I have pain on my right side does it make any difference which leg is put into the tower first when doing the supine groin stretch

Matt Whitehead link

10/21/2017 10:27:34 pm

Hi Reenie,

Do you have hip pain? Back pain? Somewhere else?

If I were to evaluation your posture I would be able to tell you for sure which side makes more sense to do first...but I would do the painful side first as a general rule.

Matt Whitehead link

11/16/2017 12:01:20 pm

Janet,

I have clients support the back of their knee with the small Egoscue block at the higher levels of the Tower and with a small pillow or towel on the lower levels. You can use anything that will support the back of your knee enough to take the pressure off it so it does not hurt or get uncomfortable. If you feel your knee hyperextending, it might be worth having your posture evaluated to make sure you are doing the correct version of the Supine Groin Stretch for your posture. I'd be happy to do a free posture evaluation for you - just contact me through my website or call. Hope that helps. :)

Janet Molchan

11/26/2017 09:37:43 am

Thanks for the info Matt. It does help!

Matt Whitehead link

11/27/2017 03:18:11 pm

I'm glad that helped Janet. :)
If you have any other questions feel free to ask.

Neal Scheider link

1/7/2018 03:41:19 pm

What is the difference between using the tower with a towel underneath your lumber versus with out the towel? Thank you!

Matt Whitehead link

1/8/2018 03:21:49 pm

Hi Neal,

You can read about the differences between using a towel or no towel under your back when doing Supine Groin Stretch in this article I wrote:

http://www.oregonexercisetherapy.com/blog/egoscue-supine-groin-stretch

Let me know if you have any questions after reading that.
-Matt

June Olson link

1/23/2019 09:33:27 am

Will using the tower straighten my bent right knee. I am using tower and also using the half dome to loosen the back of my legs which will hopefully allow my knee to straighten. Is there anything else you can suggest. It's been over 2 years. I need to get an unloader knee brace but don't want to get the brace until my knee is straight. I'm so worried this will be permanent and it really impacts my life.

Thanks for any suggestions and help you can provide

June

Jessie Baiter

6/10/2019 10:18:46 pm

Hi Matt!

I dont seem to understand where the contraction should be after contracting my thigh to know that its done. The blog says the middle of the thigh and next to the hip, but is it really supposed to be that far up?

Also Im using the egoscue tower but my extended leg is 1 or 2 inches off the floor. Is that fine or should my leg be touching the floor?

Thank you!

Matt Whitehead link

5/11/2022 09:20:02 pm

Hi Jessie, Yes eventually the contraction should be felt either in the upper thigh or the entire thigh evenly.

If you are using the Egoscue Tower and your leg when in the bottom level of the Tower isn't touching the floor, that is totally ok.

Devon Plumley

12/6/2019 11:54:32 am

Hi there I have a couple of bulging disc’s in my lumbar spine and sitting seems to aggravate the compressed nerve on the right side. I have been thinking about why hip flexion can irritate the L5 dermatome for a while now. Then it occurred to me that psoas muscle tight could easily be pulling on my lower back every time I sit aggravating the bulging disc and not letting it heal. Now I have arrived at the tower and in general the idea of restoring flexibility to the psoas. Do you think I’m on the right track here?

Matt Whitehead link

5/11/2022 09:23:19 pm

Hi Devon,

There can be many reason's why sitting aggravates your nerve pain - the only way to really figure it out is getting an assessment (free posture evaluation). But I agree with you that the Tower could be an important piece of the correction puzzle. Not only does the Tower address psoas tightness, but also psoas imbalance left to right. And knowing you have nerve pain on your right side and not your left, we know you have an imbalance left to right in your psoas.

Karin Gluth

10/24/2020 01:24:11 pm

I’ve been using the tower to help with hip disfunction caused by tight hip flexors. I find I really don’t have an issue flattening my back, but the out side of my lower leg (whichever one is in the tower) really is very uncomfortable. Like the muscles are fighting the position. Any insight into why this is?

Tammy Hoover

1/10/2021 09:48:51 am

I have the same

Matt Whitehead link

5/11/2022 09:26:02 pm

Hi Karin,

This is most likely because your upper leg (femur) is trying to rotate outward (external rotation) and is creating a torque on your lower leg muscles. The longer you are in the Tower the less the femur will externally rotate and it should feel better. But you should also be doing some different ecises to address the femur rotation. Contact me and I'll help you figure out which ones to do.

Ludco

7/22/2021 02:28:25 pm

Can the Supine progressive cause pain in the beginning? I’ve done it a few times, and yesterday I’ve noticed pain and a burning sensation in my knee. I only did it on the lowest level with the foot holder and now I have pain on the inner and outer part of the knee around the kneecap. The pain is on non-injured knee. I’m now worried I may have done something to it.

Matt Whitehead link

5/11/2022 09:27:57 pm

Hi Ludco,

There can be several reasons why your knee hurts after doing the Tower...and the only way to know for sure is for me to look at your posture. Feel free to contact me for a free posture evaluation.

David Kartuzinski

5/31/2022 03:26:11 pm

I have been following this post for some years now and have recommended people to the tower. I still think the egoscue tower is one of the best way to resolve hip and lower back problems.

Joe Lavecchia

9/2/2022 09:08:39 pm

Matt,
Can the tower be used if someone (myself) already has a hip replacement?
Thanks.

Jeff Danielewicz link

6/8/2023 06:46:26 pm

Hello Matt, I'm interested in purchasing a tower and leg support bag or tower to go with it. How much for both and I'm 5 11, what size do I need on the leg support bag. Small, medium, or large. Thanks

Gertrude Slick

7/24/2024 12:54:45 pm

Thank you Matt for being the first one to explain and show me how to use the tower. Kit really has done wonders for my hip, groin and lower back pain. I am looking to purchase another one because the one I have got wet with a water problem I had in my basement. Could you tell me where to put jade another one. Thank you SOOOO very much

The Power of the Egoscue Tower

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