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

Are You Sitting Comfortably?

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Are You Sitting Comfortably? No?

Then your first step is to make friends with your Sitting Bones.

I had some fun setting up and taking these photos of Skelly, who usually hangs on a stand but I wanted him to sit, without an Xmas hat on this time. Interestingly, the easiest way for me to set him up was balancing him right over his sitting bones, just the way I wanted him to be – which is the way our bodies are designed to sit. When Skelly was not put in an upright position, he just overbalanced. OK he’s only a plastic skeleton without muscles but he gives us a good idea about our bony structure and the way our bodies are designed to work. ( Not many arms will bend backwards like his though! )

However you can see the chunky rockers of the sit bones at the base of the pelvis, which are planted firmly on the surface so they can take the weight of the skeleton above. You can create an imaginary line through the skeleton from where the ear would be (near the hinge of the jaw), which is aligned above the shoulder and top of the arm, which in turn is lined up with the sitting bones. In this way the large weight of the head is balanced centrally and is supported, because it gets transferred through the spine and skeleton, right down into the sit bones.

An average adult human head weighs about 4.5 kg – 5 kg (9.14oz – 11lbs). It is heavy and it needs proper support!

I thought I would also try getting Skelly to lean – he cannot slump and collapse as real people do because he is too rigid but I did eventually get him to balance briefly, as if leaning backwards. One of the interesting things about this image is that it not only shows the sitting bones but clearly shows the tiny bone of the Coccyx at the tail end of the spine – which is not designed to take any weight but often is forced to do so because of the way the pelvis tilts when someone slumps in a chair. When this happens, the Coccyx is put under too much pressure and can be damaged, along with some of the vertebrae and discs. Also, the skull is left unsupported and the neck muscles end up by overworking in order to maintain some sort of balance and the breathing will be restricted….. and people wonder why they get problems such as neck and lower back pain!

This is a good example of how our ‘use‘ or ‘mis-use‘ affects the way our body can function.

So balancing over our sitting bones as we sit, allows our bodies to function more efficiently. One of the great things about Alexander work is that people usually do end up by sitting more comfortably, as they let go of habitual actions and reactions and learn a new way of using their bodies.

This pupil quoted below was very grateful for her AT lessons but her rather sad words illustrate how many people experience being taught how to sit as a child. However, they do at least have the option of learning the AT, and rediscovering the joy of sitting comfortably as an adult:

“I wish I’d been told about my sitting bones as a child instead of being hit and told to ‘sit up straight’. It’s so much more comfortable!”

Next Step?

If you would like to find out more about how the Alexander Technique can help you to sit, walk and move around more comfortably, individual lessons 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

Pregnancy, Childbirth and the Alexander Technique

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Pregnancy and Back Pain

Women’s bodies go through dramatic changes during pregnancy and, as the NHS Choices website states, many women experience back pain, particularly during the last weeks of pregnancy. As the baby grows, the woman’s ligaments become more stretchy and the extra weight of the baby tends to drop forwards and down, tilting the pelvis, so that the pregnant mother often loses the length and strength in her lower back, increasing the lordosis and compressing the lumbar vertebrae. This extra tilting of the pelvis can also contribute to pain in the pelvic area, as in Symphysis Pubis Dysfunction (SPD).

However, as can be seen in the photos of this young women at 271/2 weeks pregnant, using the Alexander Technique can help women to maintain the length in the lower back. This AT student had virtually no back pain despite the large size of her baby and she was still able to practice lying on her back in semi-supine, right up until childbirth. She was also riding her bike throughout her pregnancy!

Childbirth and After

Practicing ‘monkey position‘ was one of the ways the AT helped Erica to maintain the length in her lower back during pregnancy and it was particularly useful both during labour and after giving birth. The photo below shows Erica using a very ‘shallow’ monkey position but in her AT lessons, we also explored how she could use a deeper monkey with her knees more bent, which helps encourage the baby to move into a good position for giving birth and will be useful when bending to pick up baby from the cot or floor, for instance. Bending the knees still further takes the movement down into a squat, which can be great to use during labour.

Erica kindly allowed me to share her experience of using the Alexander Technique to help her during labour, childbirth and after. She gave birth in hospital and ended up by needing a C Section, as her baby was very large for her small frame.

“During the time I was labouring naturally (before it was clear I would need an epidural and caesarean) my husband and I used a lot of AT techniques, such as always coming back to a free neck, using the exercise ball to relax my hips through contractions, watching out for tension in the jaw and shoulders and accepting the sensations and contractions rather than fighting them. These were invaluable tools for the long hours of labour and I had to use lots of ‘whispered ahs‘ in theatre, as the drugs made me feel very shaky.”

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Monkey Position can also be Used During Recovery

“My recovery has been very speedy. After the caesarean I was up and about the next day as monkey helped me to be mobile around the ward – so the hospital were happy to discharge me the next day. The doctors said I was a great advertisement for having a caesarean and the body bouncing back!

Using monkey is absolutely vital for recovering from a caesarean, given the pain and weakness of the tummy muscles. It is the only way to get up from a chair! Thank you for all your guidance as monkey is saving me a lot of pain throughout the day.”

Of course Erica had worked hard at learning and practicing the Technique and she used it in her daily life, even before she became pregnant. This meant that she could call on her understanding of the AT and use it effectively when she really needed extra help.

Many thanks to Erica for sharing her experience and these photos, which were taken on the spur of the moment. I am glad to say both Mother and baby are doing well.

Next Introductory Workshop for Women and Teenage Girls ~ 7 March 2015

An International Women’s Day event

Booking and Info

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.’

Chilling Out in the Garden

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After the Work – Enjoy your Garden

Now this is dedication to using the Alexander Technique Lying Down Procedure!

This AT pupil kindly sent me a photo (Aug 2012) which was taken whilst he lay in semi-supine up his garden. He specifically built the little jetty over his pond, so that he can use it as a quiet place to practise the Lying Down or Constructive Rest Procedure outdoors.

Whilst he is lying there he can see the fish and other wildlife living in the pond and garden – and he can also look up into a big tree above him, with sky and clouds as a backdrop. He has a beautiful view which is continuously moving, which helps him not to fix his eyes on just one point as he lies there. This will also help him to remain alert yet quietly ‘working on himself’.

What a great way to unwind after periods of work, sports or gardening – or just to return to a quiet place in oneself. You can find more info about using the lying down procedure here.

Now I wonder if I can create a special outdoor space for myself, where I can practise the lying down procedure with even more pleasure….

Mindfulness and the Alexander Technique

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Mindfulness

Mindfulness is a topic that has been explored in the media of late. For instance, an article in the Sunday Times, ‘Breathe deep and mind how you go’ discussed the value of using mindfulness training as a way of helping school children who find it hard to cope with their various experiences of stress, including exams and “body image” pressures. Heads of high-performing schools are concerned at the ‘alarming rise in (pupils) suffering from mental health disorders’ and there is a move to build more resilience in children. This is admirable – but hopefully people are also addressing ways to reduce some of the pressures put upon these youngsters?

Some aspects of mindfulness training have similarities with aspects of the Alexander Technique. The Times article states that a number of schools use mindfulness training as a way of helping children ‘to act consciously and thoughtfully… rather than react with a kneejerk reaction’ and mindfulness ‘has proved effective in ameliorating young people’s mental and emotional difficulties’. This is something that is part and parcel of Alexander lessons, where we learn to inhibit unhelpful habitual reactions, so gaining more conscious control and more choice as to how we respond to situations.

Mindfulness training in classrooms helps children learn to notice their thoughts and feelings as they sit quietly and breathe deeply. Anthony Seldon suggests that ‘Every school in Britain could begin this journey back to sanity and self control by introducing two minutes of stillness every day’. Whilst this is a great beginning, just two minutes a day does sound somewhat minimal.

Mindfulness in Movement – Including Breathing

One of the beauties of the Alexander Technique is that part of the work is learning to develop what could be called ‘mindfulness in movement’, so that we aim to live our lives and perform everyday activities, including breathing, with more awareness. Becoming aware of our breathing and just observing it, as in some mindfulness training and in the AT is one thing. Being asked to make ourselves ‘breathe deeply’, as some people advocate, is another. It very much depends on HOW we breathe, as to whether or not this is helpful or, possibly, even harmful.

F. M. Alexander known as F.M.) was aware of how schools and the army used to advocate deep breathing exercises and he wrote extensively about the pitfalls of following any routine which used ‘end-gaining principles‘ to force the breath. For instance his paper ”The Dangers of Deep Breathing’ (1908) outlines how this frequently results in distortions and patterns of mis-use such as ‘lifting the chest and collapsing’ whilst trying to breathe deeply, which usually ’cause an exaggeration of the defective muscular co-ordination already present, so that even if one bad habit is eradicated, many others – often more harmful – are cultivated’ .

F. M. himself had breathing problems as a young man, which contributed to him losing his voice when he was reciting on stage. He described himself as breathing through his mouth so that he made audible ‘sucking and gasping noises‘. In learning how to change these habits, F.M. began to develop the Technique as we know it today. Alexander was known by many as ‘The Breathing Man’ and he helped many people become better poised, with a coordinated use of their muscular mechanisms, so that their breathing could work smoothly and naturally. This is still a central part of Alexander lessons today.

Attention v Concentration

William James, an early and influential psychologist is quoted, as having stated that an education that taught people how to focus their attention would be “the education par excellence” – whilst he could perhaps be describing mindfulness training, this could also describe the Alexander Technique as well. F.M. was very keen to apply his methods to the general education of children, so that they could avoid developing bad habits that might stay with them all their lives. In 1924 the ‘Little School’ was started with
the help of Irene Tasker, a Montessori and AT teacher and the children were given Alexander Technique lessons alongside ordinary schoolwork, so that they were taught how to be aware of their psychophysical functioning – that is, their thinking and body use – throughout their school day. Unfortunately the second World War interrupted the work of this school and it was not able to be re-started after the war ended. Today, a number of schools incorporate the Technique into the curriculum to great effect, as do music and drama colleges.

FM Alexander wrote of the problems of ‘mind-wandering’ and old habits which result in ‘thought-grooves’ but suggested that while we need to gain control of our thought processes we should ‘beware of so-called concentration‘ as it denotes conflict and leads to physical tension.

Instead, Alexander says:

‘We must cultivate… the deliberate habit of taking up every occupation with the whole mind… which necessitates bringing into play every faculty of the attention’. (The Alexander Technique – Essential Writings of F M Alexander selected by Edward Maisel 1974)

Now this, surely, is mindfulness in action and it enriches our lives.