Out and About with the Alexander Technique

The Alexander Technique is far more than ‘relaxation’ or stress management, although it can help us in both ways. When we include using the Technique during our everyday activities, it can help us unwind and to avoid slipping back into habitual reactions that create tension, distortion and discomfort in our bodies.

If you keep being aware of your use during activity and regularly practice the lying down procedure, your body- use is likely to improve and your movements will tend to become more free and easy than they have been for some time. It really can increase your wellbeing, so why not reward yourself.

Some people say that they don’t have time to practice this procedure, which is sad. If they allowed the time to do this regularly, they would realise just how enjoyable it can be useful it is as we unwind and come back to ourselves and they would also see just how much we can learn about ourselves in the process. We often work better afterwards, too.

Lying down and working on ourselves can become like a safe haven to return to in the middle of our hectic lives – or when out enjoying yourself but back pain threatens to spoil the day.

The photo was taken in the New Forest, where this man suddenly lay down in semi-supine, right in the middle of the ride, to ease his back pain. He’d only had a couple of AT lessons and was not lying with the ideal height of support under his head, so his neck is still a bit contracted and arched – but we don’t have to be perfect, anyway! It was great to see the Lying Down Procedure being used so naturally – and in such a beautiful setting. It can only improve our health and the quality of our lives.

Now I shall lie down and work on myself……

More Thoughts on the Active Rest Procedure

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Ah the joy of lying down in Semi-supine!

When we lie down in semi-supine with a book under the head and knees bent, this allows our spine to gain maximum support and our nervous system to calm down. This wooden model would not let me bring the feet any closer to its body but for most of us, this position has the feet too far out, so they will tend to slip away. Also, the weight of the legs tends to drag on the pelvis, contributing to creating an arch in the lumbar region, the lower back, which can be uncomfortable, particularly if you have back pain. If the heels are just in front of the knees, this usually works better – unless you have a restriction in your knees in which case bring the feet in as close as is comfortable for you, without forcing the position.

If you place your hands somewhere on your torso, with your elbows easing out away from your body, this allows your shoulders to drop into place more easily. Again this model would not let me put the hands on the ribcage, which is where many people find is a good place for them to be.

A variation on the lying down procedure is to place the feet on a chair, so that the legs are more or less at right angles to the body. This is great if you are finding it hard to balance the legs without using lots of muscular effort, as you just don’t have to worry about balancing them when they are supported on a chair. It can also be good to use this position if your lower back is feeling very contracted and tense. Just make sure that you are not restricting your circulation behind your knees. You can then add this variation on the lying down procedure into your repertoire of tools to use to work on yourself.

Whichever position you use, enjoy the process of unwinding and easing your body into its full length and width and experience being in a quieter, freer and calmer state. Then allow that calmness and expansiveness to still be with you when you get up from the floor and begin your next activity, whatever that is.

One pupil got up from lying down on the AT table and caught site of himself in the mirror and exclaimed “I look taller and broader than I did before my lesson!” It works…..

For more info, you might like to read the notes on the Lying Down Procedure.

Standing with Ease

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Standing with Ease Using the Alexander Technique

In Alexander lessons, we really can learn how to feel comfortable when we stand for long periods of time, rather than ending up with back pain.

When we allow ourselves to balance on our feet in a coordinated manner without bracing and locking our legs and backs, we can support the weight of our upper body whilst using far less effort. In so doing we reduce the downward pull of gravity – and we are less likely to sag.

I often used to have an aching lower back even when a child, as I trailed around shops or art galleries. Despite being trained in ballet, I still used to sink down into myself and put pressure into my lumbar spine. This would be worse when I was tired, or bored, or when I was trying to look shorter than I really was. Thankfully I changed these habits when I learned the AT, so I stopped getting that heavy back ache – and art galleries are far more enjoyable now!

This sinking down into oneself is graphically shown in a sculpture by Francesco Messina. Many people will just see a curvaceous young woman called Maria. I see a familiar, distorted pose, with the body’s weight mainly taken on Maria’s left foot, which throws her off balance and displaces her pelvis. Her weight is pushed down into the lumbar area of her back which over-arches (Lordosis) and cannot properly support her upper back and head. Her neck thrusts forwards and curves her upper back, making a pronounced ‘S’ shape (which could develop into Kyphosis)

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Maria Grazia by Francesco Messina – Lugano

This posture of sinking down onto one hip is frequently used, particularly by women. Standing on one foot may look non-threatening, even vulnerable and is sometimes thought of as feminine. ( But do women want to look vulnerable these days? )

If we just move briefly through this sort of off-balance position, little harm will be done – but if this is a habitual posture, we will probably end up with hip and lower back pain and problems such as Sciatica. By changing our habits in AT lessons, we can often avoid contributing to such conditions.

Maria Grazia by Francesco Messina 1967 front 10-08-2008.jpg

Sinking down on one hip, throws the body off balance

When we have to stand for long periods of time, as I have to as an Alexander teacher, it does make a huge difference to our general well-being to be able to stand freely and easily, sharing the body’s weight on both feet, with the head balanced on the neck, creating an alignment through the whole body from the ears right down to the ankle joints. In this way we can fine tune our balance, adjusting to even small changes in our body as we stand and move.

This balanced way of standing and using the body may be seen in the photo of an artist’s wooden model. I had fun trying to make it stand. It could only do so when everything was in alignment and balanced. It underlined for me just how much we as humans pull ourselves and our skeleton off balance with our poor body-use, so that our muscles have to work extra hard in order to let us stand up at all. When we are poised, our muscles work in a coordinated way and we balance more easily.

Learning the Constructive Rest Procedure

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IWD Workshop ~ Learning how to do the Lying Down Procedure

As part of any Introductory AT Workshop, I always include some time to introduce the Lying Down Procedure to participants. This is performed in a semi-supine position, which allows the back to have maximum support and the spine is as near to being in a straight line as it is likely to get.

In the first photo, you can see some of the women following my instructions and using their hands to gain a sense of their head-neck-back relationship, in order to roughly work out what height books they would need under their heads. Both myself and Deena Newman, who assisted me, then went around and adjusted the books if necessary, as different people need different height books to rest on. If the books are too low, the head drops back and down to the floor and the neck curves into a banana shape, so cannot release and fully lengthen out. However if the books are too high, the throat can be constricted and pressure can be put onto the vertebrae at the base of the neck. So it is worth taking care when choosing the height of books to use under our heads.

Once people were lying appropriately, we then gave everyone another brief experience of some ‘hands-on work’ – as you can see in the second photo, which shows Deena putting her hands on a participant’s head and neck, encouraging her to release any muscle tension and to have a ‘free neck‘. During individual lessons, this usually takes place on a table, which makes life rather easier for the teacher!

Thumbnail image for Deena Newman working with a workshop participant.jpg

Why do we use books?

Soft cushions and pads give way and get compressed under the weight of the head but paperback books give us a firmer support – without being as hard as hardback books! In the same way, we always lie down on the floor, rather than a bed, so that our bodies can have maximum support and more of a chance to let go of contractions and ease out into into a more lengthened and expansive state.

There was a brilliant and relevant quote in a recent Guardian Interview when Jonathan Price, the actor, was asked Which
book changed your life?

‘The one the teacher put under my head during the Alexander Technique sessions at Rada. I grew an inch and a half.’ Jonathan Price Guardian Interview 7 March 2015

Article on Using the Constructive Rest Procedure

If you would like to read more about using this incredibly useful, calming and enjoyable procedure, you might like to read my article on the Lying Down Procedure.

Even without going to Alexander Technique lessons, this procedure can be used for relaxation and to help you de-stress – but with the help and guidance of an AT teacher, you can learn how to make the lying down procedure far more effective! It can help you let go of tensions, calm your nervous system and importantly, can set you up to perform your next activity more freely and easily, whatever that activity may happen to be. It is a valuable tool to use throughout your life.

Introductory Workshop for Men, Women and Teens 25th April

Do You Look After Your Back When you Hold a Baby?

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The Henry Moore exhibition at Kew Gardens in 2007, still leaves me with a wonderful memory. How exciting that Henry Moore returns to Kew this September – I really look forward to that.

Moore’s Mother and Child, although very abstract, evokes a strong sense of calm tenderness. Mother is portrayed holding the baby in a way that allows a safe, intimate connection with her.

I can also see the sculpture from an Alexander Technique perspective, as illustrating a common habit that many men and women have: contracting down on one side of the body and looking down with the head and neck to one side. Such patterns of contraction and mis-use can also develop when breastfeeding, writing, playing the violin or guitar, using a mouse and using a car’s gear stick, for instance.

If people habitually assume lop-sided positions, an imbalance in muscle use occurs, subjecting the vertebrae and intervertebral discs to an uneven, downward compression. This can cause neck and back pain and can eventually result in problems such as scoliosis and sciatica.

So do continue to keep a tender intimacy when you hold your child but remember to look after yourself at the same time. It is possible to learn how to protect your back whilst performing everyday activities and observing how we are using or mis-using our bodies is a good place to start – and if a great work of art can also remind us to be aware of our own body use, that is an unexpected bonus!

Individual AT lessons for both men and women are available on a regular basis.

Next Workshop for Men and Women 25th April 2015

Henry Moore ~ Mother and Child ~ Kew Gardens 2008

Alexander Technique for Women ?

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Why put on an Alexander Technique Workshop just for women?

Well, in the first place, some women just feel more comfortable attending this type of workshop if it is for women only and for some, their cultural background encourages them to attend classes in an all-female environment.

Also, women do have some specific issues such as wearing high heels, pregnancy and childbirth, all of which can be thought about within the context of the Alexander Technique. For instance, many women experience back pain during pregnancy, or as the result of their habits or wearing stilettos – all of these can compress the lower back, which can create an exaggerated lordosis, often leading to pain. By learning and using the Technique, which can help women use and carry their bodies differently, many such problems can often be alleviated.

Childbirth itself can be helped by using the Technique, as can carrying the baby once it is born – although this latter is (hopefully) not exclusively a woman’s activity! One pupil said this:

“I wanted to thank you for all that you taught me over the 9 months of my pregnancy. My weekly Alexander Technique lessons with you were so valuable and I feel contributed hugely to my healthy pregnancy and were so helpful in preparing for the birth”.

A lovely little sculpture I saw in South Africa shows a baby being played with whilst the mother lies in semi-supine position, in a similar manner to how one uses it in the Alexander Technique (although the angle the woman is holding her head would probably be modified in an AT lesson). Lying in this position offers people a chance to let their spines lengthen and for their nervous systems to quieten down and this is a procedure that people are encouraged to practice every day as part of learning the Alexander Technique. (We don’t usually lift babies above out heads during the constructive rest procedure though!)

This position can also be used more casually as in the sculpture, allowing parents an easy way to be in close relationship with baby, whilst looking after one,s back. Older babies will climb all over you but this can add to the joy – and your back is still being supported and protected.

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Andrew Gibson – Woman and Child ~ The Annexe, Kalk Bay S.A.

Would you like to find out more about the Alexander Technique?

Individual lessons ~ for both men and women ~ are available on a regular basis.

Next Workshop for Men and Women 25th April 2015

UEL Wellness Day ’14

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University of East London Wellness Day 18 November

I had an interesting afternoon helping out at UEL’s Wellness Day, on a stall run by STAT (the Society of Teachers of the Alexander Technique). There were three AT teachers promoting the Technique, plus Ilia, STAT’s manager – and of course there was Alex the skeleton!

The young man in the photo was running the next stall and it was good to be able to introduce the Alexander Technique to him, giving him some ‘hands-on work’ whilst he was sitting, standing and walking around. A good number of students, lecturers and staff kept us busy for the whole time we were there, asking questions and having mini AT lessons, which was great.

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Alex was rather tired by the end of the day……

Allow Pain to be Your Teacher

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As I Say to My Pupils – ‘Pain Can be a Good Teacher’

When we understand the significance of pain and recognise the different types of pain we can experience, we can use pain as a teacher and not just see it as negative. This is particularly true of injuries or aches and pains from tension, which we can feel powerless to change. However, when we listen to our bodies (without becoming obsessive about it) and develop an awareness of habit patterns which can contribute to or even be the cause of our pain, we can begin to make choices as to how we act and move, and so begin to reduce pain – which helps us gain some conscious control over the situation..

Of course, some types of pain are an indicator of serious illness or injury and medical attention will be required, but even here we can often use the Alexander Technique to ease the discomfort and to help manage the pain.

Pain from a Broken Toe

Some years back I dropped a heavy piece of wood onto my right big toe and broke the end of it. Although the break was tiny, it was of course, very painful and I walked with a limp for some time, despite my efforts to minimise the distortion in my movements.

After a while, I began to notice that my left knee and right hip joints were beginning to hurt. Thankfully I was already an Alexander teacher and I knew these new pains were developing because of the imbalance created in my body-use from walking with a limp. I realised that I was continuing to limp even after my toe had stopped hurting – how quickly habits form! When I paid attention to stopping this habit, my joints stopped hurting. Any subsequent pain indicated to me that I had gone back into the protective limping habit, which I really did not need any more, so I reminded myself to stop that again.

Fear of Pain

After experiencing pain, we often develop a habit of reacting to the thought of pain by tensing up to protect ourselves ‘in case’ and this tends to be counter-productive. Often these reactions are quite sub-conscious but in Alexander lessons we can learn to recognise them and are then more able to consciously let go of them .

Reacting by tensing up at the thought of a dentist drilling a tooth for instance, just makes the jaw tighter, more sore and harder for the dentist to move. We can also give ourselves neck, back and head ache if we lie rigidly in the dentist’s chair. Going to the dentist’s is a great time to apply the Alexander Technique! Lying in the chair, reminding ourselves not to tighten our jaw, neck and back can make the experience far more comfortable – and it’s also a good distraction from the process in hand!

RSI Pain

One condition that affects many people these days, including computer-users and musicians, is Repetitive Strain Injury (RSI) and this is a condition when people often tense up at the thought of being in pain – which just creates more pain. I have taught various pupils with RSI and one of the most helpful things they can do is attend to the pain they experience, rather than continuing to work through it and to avoid tensing up in reaction to the thought that they will be in pain if they perform a certain action.

By developing an understanding as to which of their actions bring on pain and discovering what it is they do and how they have habitually performed those actions, helps them to realise how they have developed RSI. Then they can learn to avoid unhelpful habits and any pain arising during an activity can show them when they are falling back into the habits that cause problems.

With the help of an Alexander teacher they are then able to learn to:

1) stop a habit and an activity just before any pain kicks in, so that they can avoid creating more pain. Then their bodies can have a chance to recover.

2) learn to modify how they perform tasks in a more free and easy manner, so they are more poised, using less strain and tension.

3) learn to challenge the thoughts and attitudes that underlie the overuse patterns they have habitually fallen into. For instance, thoughts such as ‘I must finish this‘, ‘I must continue until I get it right’ or ‘I’m feeling stressed‘ tend to get us to keep pushing ourselves on until there is, consequently, yet more pain. At this point, the quality of our work often deteriorates, so it is far better to stop before this happens!

Completely stopping and lying down in semi-supine for 10 – 20 minutes can allow our minds and bodies to calm down, unwind and we can let go of our habits of tension that keep driving us on. It also helps injuries to recover and we usually work far better afterwards.

Pain Can be a Valuable Warning Signal

It can be a slow process to learn how to change our reactions and to see pain as a valuable warning signal but this process is one that pays off. It can be used with many conditions such as back and neck pain, many types of headache and a variety of other strains. An elderly lady came to me for AT lessons and she had bad arthritis in her knees, so that it was very painful to move into sitting or standing and her knees rather scarily crunched as she moved. However, when she refused to tense up at the thought of moving, she amazed herself by standing up with very little pain – and virtually no noise! When there is deterioration to our bones, the AT cannot change that but when we allow the joints to move more freely, there can be a reduction in the pain experienced. Pain can help remind us to stop, think and then move thoughtfully, freely and much more easily.

In this way, people find they gain a tool they can use to learn from pain, so that they can avoid those habits that help to create pain, This gives them more choices, helps people to regain some power over the situation and often frees them from some or all of the pain that has been one of their teachers.

Research into Balance and the Alexander Technique

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Study: Can the Alexander Technique Improve Balance and Mobility in Older Adults with Visual Impairments?

Yet another interesting piece of research has been published which provides further evidence as to the effectiveness of the Alexander Technique.

Researchers at the Sydney Medical School, Sydney University, Australia, have investigated the impact of taking Alexander Technique lessons on the mobility and balance of 120 subjects, who were all over 50 years old and had visual impairments. The intervention group were given AT lessons plus their usual care, whilst the control group just received their usual care.

Primary outcome measures of physical performance were taken at 3 months, with secondary outcome measures of postural sway, maximal balance range and the number of falls experienced by the subjects, taken at 12 months.

Conclusion

The results showed that there were no significant changes in the the primary outcome measures. However, the intervention of taking Alexander lessons indicated there was a ‘significant impact’ on the secondary outcome measures one year later.

The results showed benefits in postural sway for the group that had AT lessons, compared to the control group who did not. This group also had a trend towards fewer falls and fewer injurious falls. Some people who had previously experienced multiple falls, also showed an improved level of mobility.

This is very encouraging and, remarkably, these changes in outcome came about after having just 12 weeks worth of half hour long AT lessons. Unfortunately, the research team had to reduce the number of lessons from the recommended 20-25 lessons, down to 12 lessons, because of financial restraints. How much more significant might the outcomes have been, if the subjects had been able to have a greater number of Alexander lessons, possibly of 3/4 hour in length, as I and many AT teachers offer?

The research paper states that the findings ‘suggest further investigation of the Alexander Technique is warranted’. It is good to see that amongst the references cited, there are a number of papers relating to prior research into the Alexander Technique, such as the ATEAM Trial re back pain. Let’s hope more funding is available to develop this research. Further research into this and other relevant topics, will be much welcomed by the Alexander community!

Pub: Sage Journal July 2014

Paracetamol Doesn’t Help Lower Back Pain

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Millions of Days Taken Off Work for Back Pain!

According to the NHS, work-related back pain caused the loss of 7.5 million working days during just one year in 2010 – 2011 ~ and this figure is not unique, it is similar for many other years as well. That is a lot of time off work and must have a big impact on the economy, so treatments for back pain are constantly being researched.

The Lancet has just published the results of a research trial that took place in Australia, which looked at the efficacy of prescribing paracetamol for people with acute lower back pain (24 July 2014). This research was a randomised, controlled trial with over 500 subjects in each group, taken from primary care centres in Sydney and the results show that paracetamol is no more help than taking a placebo at aiding recovery from acute lower back pain!

The findings of this research therefore ‘question the universal endorsement of paracetamol in this patient group’. This traditional way of dealing with acute back pain is shown, for instance, in the NHS Choices website which mainly advocates ‘keeping active and if necessary take over-the-counter painkillers‘. No wonder the pain often lingers.

Causes of Back Pain

Some back pain is caused by illness or an accident but the NHS states that the majority of problems are caused by ‘bad posture while sitting or standing, bending awkwardly, or lifting incorrectly’ – what F M Alexander called ‘habits of mis-use‘. Addressing such habits and learning to improve our body-use is a cornerstone of the Alexander Technique and it is now recommended by the NHS as a method of reducing long-term back pain. This recommendation comes as a result of the major ATEAM Research Trial in 2008 that showed lessons in the Alexander Technique were more helpful for people with chronic lower back pain than were either massage or an exercise regime prescribed by doctors.

Prevention is Surely Better than Cure.

I suggest that it would be far more helpful to use the AT sooner, in order to help reduce acute back pain before the problem becomes chronic and therefore a long-term problem.

Even better is to learn and to use the Alexander Technique in order to let go those habits of mis-use of which we are mainly unaware, until an AT teacher can help us to recognise them, and help ourselves prevent back problems from developing in the first place.

Update

The British Medical Journal, BMJ, have published another paper by the Australian Research Team 31 March 2015. This is an overview of 15 randomised controlled research trials exploring back pain and the effectiveness of using paracetamol.

The outcomes showed that paracetamol did not help back pain, caused liver toxicity and did not improve the quality of people’s lives! – and this is what is usually recommended as the first line of defence to help back pain!

You can read an ouotline of the findings below, as reported in the BMJ. As a result of this research, the medicines safety regulator is assessing the safety of over-the-counter drugs and the National Institute for Health and Care Excellence, NICE, is awaiting the results of the review before making any decisions about whether or not to continue recommending paracetamol for lower back pain and arthritis. It may recommend exercise instead.

Some of this research has been in the public domain for over a year. However the ATEAM Research Trial which showed that the Alexander Technique was more helpful than exercise for lower back pain and improved the quality of people’s lives, was published back in 2008. How long will it take NICE to understand the implications of this research into the effectiveness of the Alexander Technique and to act on it by recommending AT lessons for back pain, instead of toxic drugs?

You may see the outline of the findings below:

Published March 2015 BMJ 2015;350:h1225

‘What is already known on this topic

Clinical guidelines recommend paracetamol as first line a
nalgesic drug for both spinal pain (neck and low back pain) and osteoarthritis of the hip and knee
The evidence base supporting these recommendations has recently been called into question

What this study adds

High quality evidence suggests that paracetamol is ineffective in reducing pain and disability or improving quality of life in patients with low back pain
There is high quality evidence that paracetamol offers a small but not clinically important benefit for pain and disability reduction in patients with hip or knee osteoarthritis
Though high quality evidence shows that patients taking paracetamol are nearly four times more likely to have abnormal results on liver function tests compared with those taking oral placebo, the clinical relevance of this is unclear.’