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The Jigsaw Challenge

So Why am I Talking About Jigsaws?

It’s Christmas (2020). Out comes my new jigsaw and now I have some challenges. The most important one, I realised a bit late, was how to do the jigsaw and avoid getting neck pain! The next was to decide if the table should be covered with jigsaw pieces. With the Covid 19 lockdown in place there will be no visitors, so yes, the table can hold the jigsaw.

Another challenge is to find all the edges and line them up where they might fit. I’ve started hunting and I gently rummage around in the box. I explore carefully, so I don’t break any of the jigsaw pieces.  I’m already confused because the corner pieces are different colours from the image on the box! Unfortunately, I’ve not being paying enough attention to my body use.

 

How do We do Jigsaws and Avoid getting Neck Pain?

I’ve not done a jigsaw for a long time and I need to get my eye in. It’s hard to find what I’m looking for. I notice my shoulders and upper back are beginning to ache a little – that didn’t take long to happen! So what was I doing to cause that?

I had got lost in the activity and I had begun curl down over the table to see the jigsaw. So I’d started getting a bit tense and then achy. How easy it is to lose awareness of our body use when we get engrossed! It’s not surprising I was a bit achy, when you remember that our heads weigh approx 5 kg or 11 pounds. Our heads are so heavy, if we don’t support them with an easy poise and balance, the weight will drag us down. Then we can get neck pain and stiff shoulders.

My grandson is a good teacher! See how freely and easily he looks down

My grandson is a good teacher for me and when I see how he moves, it reminds me to come back to myself and think of my own body use. He has such a lovely easy way of moving. Here he is looking down, yet he is not dropping his head and neck forwards as I had just done. He is folding forwards from his hip joints and his muscles are working together in a quiet and balanced way – just as I teach people to do in Alexander lessons.  (Teacher teach thyself!) You can sense the connection from the top of his head, along his spine and down to his coccyx and sitting bones.

So my most important challenge is that when I do jigsaws, I will to do so with more awareness. I will avoid getting neck pain by using the Alexander Technique.  I’ll hinge forwards from my hip joints so that I can see what I’m doing and take frequent breaks – as I do when I’m working at my computer. Maybe I don’t need to play so intensely (in-tensely – got it?).  Just because I’m having fun and supposedly relaxing, it doesn’t mean that I don’t need to look after myself.

If you would like to discover ways of looking after yourself whilst performing daily activities, contact me here and try an Introductory Alexander Lesson. This can be face to face in Harringay, or online if you live far afield.

Contact Hilary King

The Developing Self

The Developing Self  is a pioneering organisation that actively promotes the Alexander Technique in education.  The Developing Self team offer specialised Postgraduate Training in the UK and USA, for qualified Alexander teachers who want to bring the Alexander Technique to children and into into schools and colleges. There is now a growing number of primary, secondary and tertiary colleges that include the Alexander Technique in the curriculum.

The Little School – where the Alexander Technique was embedded into Education

The Developing Self movement found its inspiration from F M Alexander’s work with children. Alexander believed it was essential to help children avoid developing poor psychophysical habits and misuse. To this end he ran The Little School from 1924 until the Second World War, when it was transferred to the US. At this  school, they applied the principles of the AT to all lessons and activities.  Today, Educare Small School in Kingston -upon Thames, is run in a similar way. It ensures that ‘principles of the Alexander Technique are woven seamlessly into each school day’.

The Developing Self Resources

There are several excellent books on aspects of the Alexander Technique in Education. These have been written by the Developing Self team, particularly Judith Kleinman and Sue Merry.

The Developing Self website offers a number of free resources, including some lively and informative videos of presentations at the 2021 and 2020 Conferences .  If you are interested in  bringing the Alexander Technique to children and into educational settings, the videos are a great way to explore the topic.

Torticollis or Wryneck

Torticollis – Wryneck is a form of Cervical Dystonia

Torticollis is a condition where a person’s head and neck are constantly twisted by spasms in their neck muscles. These contract down towards one side all the time, often with abnormal rigidity. This old Private Eye cartoon says it all! Torticollis may develop gradually or suddenly and babies may be born with Congenital Muscular Torticollis.

Acute Torticollis or Wryneck

This is the term given when the condition arrives suddenly. For instance a person may wake up to find they slept in a distorted position and have such a stiff neck that they cannot move their head from side to side. This problem often resolves itself fairly quickly.  But a wise person would ask themselves what they might have been doing to bring it on and then find a way of avoiding it happening again.

Diagnosis

When severe, torticollis may be associated with damage to the cervical vertebrae and discs. Diagnosis is essential when there are symptoms such as chronic neck pain with numbness in the hands and arms. This numbness not only poses a threat to many careers but indicates an underlying problem where the nerves are being irritated.  The cause needs to be known, to check for a prolapsed disc and to rule out illnesses such as meningitis, particularly if the person has a fever.

Causes and Development of Neck Pain

Torticollis can be caused by accidents, injuries, tissue scarring and shrinkage.  It can also be brought about by mental states such as anxiety and habitual patterns of poor body use, as in the image above.

Poor posture and long-term mis-use of the body, that disturbs the natural muscle balance in the neck, can lead to the gradual development of torticollis. Unfortunately, many children hunch over school books, holding the pen in a contracted, twisted manner whilst writing. This is a habit they often take into adulthood and then gradually develop neck pain – unless they learn to let go of the habit. Also babies whose heads are left lolling down to one side as they sleep in pushchairs, must be vulnerable to wryneck developing. Over time the neck muscles can get used to being contracted in this way and they become fixed so that torticollis can develop.

There are also work situations which require a person to incline their head and body in one direction constantly. Radiologists for instance, or violinists, often resort to pulling their heads down to one side quite tensely in order to work or hold the violin in place. Dentists often lean down over patients at an angle and a twist – for hours on end all their working lives! If such activities are performed without looking after the head-neck-back relationship and general body use, then problems such as torticollis and neck pain are likely to develop.

Treatment 

In extreme cases, botulism can be injected into the muscle to stop the spasm for a few months. Surgery to partially cut and release the contracted muscle is sometimes used as a last resort.  Physiotherapy to help stretch out the muscles can be helpful.

Can the Alexander Technique help Torticollis?

Fortunately, it is possible to improve one’s body use by learning the Alexander Technique so we can avoid the habits of twisting and contracting that contribute to torticollis. Through the gentle guidance of the Alexander Teacher, it is possible to re-educate muscles so that they can relax and ease out of the neck spasm.  This puts less pressure onto vulnerable discs and nerves and begins to re-establish the natural head neck back relationship.

Many violinists for instance, have been saved from constant pain which could threaten their careers, by applying the Alexander Technique to playing.  They can learn to hold and play their instrument in a manner which does not cause them harm. When they learn how to maintain a freedom and resilient lengthening of their muscles, they can avoid going into spasm whilst playing.

Research into the Alexander Technique and Neck Pain

More generally, a major research study, the ATLAS Research Trial (2015) has shown that the Alexander Technique produced “clinically relevant reductions in neck pain and associated disability” for people with chronic non-specific neck pain.

http://annals.org/article.aspx?articleid=2467961 

If you would like to discover how the Alexander Technique can help you with neck pain and other conditions, you can contact me to arrange an Introductory Alexander Lesson:

Contact Hilary King

Kyphosis

Kyphosis

Kyphosis is the term given to an exaggerated dorsal curvature of the thoracic region of the spine. It can be a congenital condition that is present at birth.  Kyphosis can also develop, for instance, through curling over a screen for long periods of time, or by constantly bending down towards small children or work surfaces.  This curvature causes the heavy head (approx 5kg) to drag downwards, which eventually tends to hurt.  The more off balance the head becomes, the more the spine curves.  This compression tends to restrict the functioning of the lungs and other internal organs. The curvature of the upper back and chest can also put pressure on the nerves of the upper arms and contribute to problems such as RSI.

The imbalance created by this curvature in the upper body, is often compensated for by the spine which develops lordosis, an exaggeration of the lumbar curve in the lower back. This results in an obvious ‘S’ shaped appearance of the spine.

Prevention is Easier than Cure

It is often possible to prevent kyphosis from developing, if we learn Alexander Technique early enough.  Later on in the condition’s development, the AT can help free up the musculature and improve kyphosis and, importantly, reduce further degeneration.  Avoiding habits that cause compression can help enormously.

Kyphosis Shown in Art

I love this sculpture called ‘The Scholar’ by Tapfuma Gusta, which I discovered in Cape Town, South Africa. It clearly shows the upper spine and body curving forwards and down, with the head pulled off balance. The Scholar presumably bent over towards his desk for years whilst writing and reading many many books. Fortunately, with the AT, we can learn how to read without putting such pressure on our bodies.

Alexander Technique Can Help Neck Pain and Headaches

Neck Pain Research

The NHS website states that for long-term neck pain

‘lessons in the Alexander technique may lead to reduced neck pain and associated disability for up to a year or more’

This statement is supported by a major research trial into the Alexander Technique which was undertaken by York University, funded by Arthritis Research UK.  ATLAS was a randomised controlled trial, which  compared the Alexander Technique, acupuncture and regular GP care in the treatment of 450 people who had chronic neck pain for at least three months.
The findings showed that both Alexander Technique lessons and acupuncture sessions led to statistically significant and clinically relevant reductions in neck pain and associated disability, compared with usual care alone, at one year. Also shown, were improvements in mental health and self-efficacy, for both the Alexander and acupuncture groups.
You may read full details of the ATLAS Trial here:

An Alexander pupil’s experience of neck pain and headaches

The article below was written by one of my pupils. It is about her experience of reducing neck pain and headaches through having AT lessons with me.

Six Years of Suffering Regular Headaches

I went to see Hilary because of a long standing problem with my neck and shoulder. I have had occasional flair ups of shoulder pain for about 30 years. For the past 5 or 6 years I have been waking up in the morning with a headache a couple of times a month. At first I put it down to hypertension and stress but even when my blood pressure was controlled the headaches continued, occasionally developing into full blown migraines.

Last summer I went sailing in the Mediterranean. I had a wonderful time, swimming several times a day, though I was aware that holding my head out of the salty water whilst doing breast stroke wasn’t good for my neck. The morning after an uncomfortable night sail to Corsica I lay on my bunk in agony whilst the others swam. I had a migraine and pain extending down my arm past my elbow. When I returned to the UK there was some improvement but the morning headaches were now happening nearly every day and usually woke me about 3 or 4am. Gentle yoga eased the pain, but I was having to do it at 4am.

Just how DO I sit and stand?

My GP sent me to a pain management consultant who told me my shoulder blades were “winged” and should be tucked flatter against my back, and my spine was too straight, it should have more curve. I left the clinic feeling I no longer knew how I should sit or stand or hold myself.

A friend suggested the Alexander Technique. At my first lesson I found it hard to believe Hilary when she told me that I didn’t need to force myself into a different shape. If I relaxed and let my body do its own thing it would naturally fall into position. Her recommended 20 minutes lying on the floor in semi supine seemed to me like a very long time doing nothing much! However I was so exhausted with the 4am headaches I decided to give it a try.

Pain fades away with Semi-Supine Procedure and awareness during activity

When I woke in the night with a headache, instead of doing yoga I tried lying in semi supine. I began to realise that if I concentrated on releasing my neck and shoulders the pain faded. Soon I was managing to go back to bed and get a few more hours sleep. That spurred me on and I read everything I could find on the Alexander Technique, practised lying down at least twice a day and tried to remember what I learned about inhibition and use in the rest of my day. At first that seemed impossible but with Hilary’s encouragement I know now that it is gradually seeping into the rest of my life.

Swimming and sailing again

I’m swimming again, remembering to lengthen and straighten my back. I’m sailing again too, though I still need to work on remembering what I’ve learned when I’m out in a boat. I’m generally much more aware of how I’m using my back and if I’ve been giving my neck a hard time I can usually sort it out with spending a while in semi supine when I get home.

Now Headache Free!

Best of all I’m headache free – they just faded away. Thank you

Pat – June 2017

Alexander Technique Can Help With Hypermobility

Shoulder Pain and Tension

I came to Hilary two years ago when I developed an intense shoulder pain playing the violin. I simply had not noticed how much tension I was putting into my playing. Hilary also helped me to notice other postural quirks and tensions that were affecting my sitting posture, computer use and many basic daily activities. Like many people I have a tendency to “power through” any problem by redoubling effort – my body was finally rebelling at age 40!

Since taking lessons with Hilary (initially regular weekly lessons, then occasional) I have noticed improvements in many areas:

  • Almost immediately my ability to sit still in meditation for 45 minutes improved noticeably – I became able to release aches and pains as they developed, without having to change position 
  • I learnt to approach the violin with patience, whereas before I had been “rushing” at it and tensing up
  • In my running club I improved my pace, core stability and breath coordination
  • I became aware of unhelpful posture habits: twisting my body at the computer, collapsing onto the sofa, clenching my right hand whilst texting, or leaning my hips against the kitchen sink whilst washing up.

Body Awareness and Co-ordination

Even more than these specifics though, the greatest benefit has been the overall improvement in body awareness and coordination. This has been sorely lacking all my life (pun intended) as I have always had hyper-mobility in several joints. I had not previously realised how much it affected me and limited my choices. Since working with Hilary on improving my proprioception and kinesthesia, I am now much more confident in how I use my body and am constantly improving my basic coordination skills, leading to stability and strength rather than frustration and injury. I feel like my mind and body are friends again now.

The New Family Game: ‘Posture Police’!

Lessons with Hilary have always been fun and relaxing, she listens every carefully and adapts her lessons to give precisely what is needed that week. I always leave her beautiful house feeling refreshed and buoyant. The only down-side is that I’m afraid I am a bit of an Alexander-evangelist now, and have roped my whole family in as “posture police” – with noticeable improvements in all of us!  By “posture police” I mean my kids are now in the excellent habit of saying “nice straight back, Mummy!” to me (or “ooh, your back is really curved when you’re putting your shoes on, you should bend your knees!” Also to each other, and they are more easily aware of their own movements and postures. (They do know it’s not supposed to be a stiffly-held straight back.) I have the feeling they are so much more aware of their bodies than before.

Having done plenty of martial arts, my husband Marco has better posture and balance in movement than I do generally, but he is not immune to “laptop and couch slouch” – now he has three pairs of eyes ready to remind him. It’s become quite a family game. We’re all helping each other take care of our bodies better.

Pascale (Architect and Mother of Twins)

International Alexander Awareness Week

The first International Alexander Awareness Week (IAAW) took place in June 2004, when the Society of Teachers of the Alexander Technique, STAT, decided to inaugurate IAAW week, in order to celebrate the fact that the Alexander Technique had been taught in the UK for 100 years. In 2018 the name’s been changed to ‘Alexander Technique Week’ and it now takes place in October each year.

Photograph of F.M. Alexander (c) 2002, the society of Teachers of the Alexander Technique, London

F M Alexander came to live in London at the age of thirty five, in 1904, and began to teach his eponymous Technique here. Initially, Alexander and his work were unknown in London but he was recommended to various eminent doctors and his teaching practice soon grew. Alexander developed a reputation for teaching children and actors how to improve their general use so that they could breathe properly. By 1910, F.M. as he was known by his pupils, published his first book in the UK, ‘Man’s Supreme Inheritance’. In 1931 Alexander began the first Teacher Training Course in London and although he also taught in the USA and South Africa, Alexander continued to work in the UK until he died in 1955, shortly before his 87th birthday. His work is recognised the world over and he has been rated as one of the top ‘200 people who made Australia great’. So it’s well worth celebrating his work!

F M Alexander plaque

 

Centennial Celebrations

The 2004 Centennial celebrations were held in the UK, Australia and the USA, with a week full of activities and classes in the Alexander Technique. This first IAAW week was so successful that it has now become an annual event promoted by the International Affiliated Societies of Teachers of the Alexander Technique. ATAS is made up of the fifteen national Alexander Technique Societies that uphold the standards of Alexander Technique teacher training and practice around the world. ATAS also acts as an umbrella body for the many teachers who live in countries that have not created their own A/T Society as yet.

IAAW is celebrated in the fifteen countries represented by ATAS, with a variety of events such as Introductory Workshops and talks, that focus each year on a different theme to do with the experience of learning and teaching the Alexander Technique,  For instance, the 2008 theme was linked to the publication of the major ATEAM research trial, published in the BMJ in August 2008, which shows that the Alexander Technique can offer those who learn it, the chance to find an end to back pain. Other themes have been coping with stress and avoiding the problems associated with ‘text neck’.  Each year, so far, there have also been special IAAW Discount Vouchers available, which entitle people to one reduced rate lesson with participating teachers such as myself.

2008 saw another important anniversary for STAT, which was formed in 1958 by a group of Alexander Technique teachers. All had been trained by F M Alexander himself, who had died in 1955. The formation of STAT brought together most of the existing Alexander teachers and the Society began the process of regulating the profession. STAT is the oldest and largest professional organisation devoted to the Alexander Technique. Currently, there are over 2,500 registered teaching members within STAT and its Affiliated Societies worldwide.

STAT aims to ensure that a high level of Teacher Training and teaching practice are maintained throughout the profession. STAT is the professional body to which I belong and in order to become a teaching member of the Society, we are obliged to train at one of the STAT recognised 3 year Teacher Training Courses. Each STAT registered teacher is required to adhere to the Society’s published Code of Professional Conduct and Competence, and to be covered by professional indemnity insurance.

Back Pain and High Heels

Are High Heels an Alexander Technique Teacher’s friend?

Now you might think this a strange question for an Alexander teacher to ask and in many ways I would agree with you. High heels produce so many back and foot problems for their wearers and many of them come for Alexander lessons – so it could be said that high heels help to keep us in work! But of course I do encourage women not to wear them.

I actually feel very concerned when I see all these fashionable young women teetering around on stilettos, often wearing a restricting tight skirt, sometimes holding a toddler and pushing a push chair; I also see their exaggeratedly-arching lower backs and various other sorts of distorted body use and crippled toes. It is obvious to see that women wearing very high heels are creating and storing up trouble in their bodies – and they are creating work for doctors, Alexander teachers, osteopaths, podiatrists and others for years to come. This may be helpful to Alexander Teachers during a recession but that gives me no pleasure – those shoes could work out to be very expensive for the wearers in the long run!

Killer heels

Photo: Wysokie Obcasy

‘Invasion of the Killer Heels’

This was the name of an excellent article ‘on a very modern torture’ by Polly Vernon in The Times Magazine (22.10.11). Heel heights were rated for pain and discomfort and the 6 1/2 inch high heels were give a 10/10 pain rating! Why do women agree to suffer in this way? The article discusses back and foot pain and a podiatrist states that he has treated women whose tendons ‘were so retracted they can’t put their foot on the floor any more’. An exaggerated claim? Unfortunately, no.

I had two Alexander pupils who always wore high heels – even their slippers had high heels! The result? Neither of them could put their heels down on the floor because it was too painful to do so! Their muscles and tendons had shortened so much from wearing high heels. Both women had a lot of lower back pain and when they lay down there was a gap of several inches between their lower back and the Alexander table (far more than most people). Some other pupils have had grossly distorted toes and painful bunyons, because of their high heels.

Sadly,they preferred to keep their high heels, rather than allow their bodies to become less distorted. However it is possible, through having AT lessons, to undo some of the damage, if women are willing to make some changes in their footwear and in their habitual way of using their bodies.

Why are high heels so damaging?

When such high heels are worn, the pelvis gets thrust too far forwards and extra weight is pushed down into the hip joints, and weight goes too far forwards over the toes. The higher the heels, the stronger the imbalance that is created. In order to be able to stand upright, the upper body then has to pull backwards, creating an exaggerated curvature in the lower back – lordosis – which compresses the vertebrae and frequently ends up damaging the discs and in particular the lumbar spine, which causes lower back pain. These downward thrusts interfere with the way the body naturally functions and can also distort the woman’s natural poise.

The women’s poor feet in these high heels are also damaged. The higher the heel and the more pointed the shoes, the more damage is caused. The toes are kept in a dancer’s demi pointe position with the weight of the body thrust onto the ball of the foot – for hours on end, often with the toes crumpled up in order to fit into the narrow shoe. These increasingly painful feet now begin to create their own problems and also interfere with the way the woman stands, walks and generally uses her body.

So what can happen by wearing high heels is:

  • Bunions and hammer toes can develop and the feet are distorted
  • Tendons shorten so the heels will not go down to the floor
  • The feet and ankles become over stretched and painful
  • Calf muscles are strained
  • Knees are damaged
  • The hip joints can get damaged
  • The spine is damaged and over-curved
  • The neck can also get damaged
  • The woman’s posture can become permanently distorted

Are high heels really worth this risk and high cost?

As for the woman’s ability to run if she so chooses, or more importantly needs to run, forget it. Fashionable women today are almost as packaged up and hobbled as Chinese women used to be in centuries past, when they had their feet bound-up so they were permenantly damaged. And whatever happened to Women’s Lib?

Mary Wollstonecraft, writing back in the eighteenth century would probably despair if she saw that many women in the twenty first century still display similar habits to most women in her time. How little things seem to have changed:

‘To preserve personal beauty, women’s glory! the limbs and faculties are cramped with worse than Chinese bands, and the sedentary life which they are condemned to live…. weakens the muscles and relaxes the nerves’. Wollstonecraftcomplained women were ‘slaves to their bodies, and glory in their subjection… Taught from infancy that beauty is woman’s sceptre, the mind shapes itself to the body, and roaming round its gilt cage, only seeks to adorn its prison’.

How can the Alexander Technique help?

It is an interesting challenge to an Alexander teacher to work with such problems and to help women to feel good about themselves just as they are, so the urge to wear such attire, depite the risk they pose for the wearer, can gradually lessen. Women gradually understand that they can only lose their various aches and pains when they are willing to make changes in the way they habitually dress, as well as the way they habitually use their bodies.

However, with a willingness to learn the Alexander Technique and apply it in their daily life, people can gradually learn to ease the discomfort in their backs and legs and avoid such problems in the future. During lessons, women can learn how to let their tightly-arching lower backs to release and lengthen out again, so that less pressure in put on that area. With the teacher’s guidance, they will be able to re-align their bodies and regain their natural body balance. For women who are very conscious of the way they look, a good incentive for them to make such changes is that they will also help themselves regain their natural poise and elegance during Alexander Lessons.

Save your high heels for parties!

So please inhibit and say ‘no’ to wearing such high heels regularly. If you really love to wear them, save them for extra-special occasions and resist the temptation to wear them all the time. If you sense that aches and pains are starting to arrive in your body, address the problems now and learn the Alexander Technique before the problems build up and create real pain.

You will soon be grateful if you learn to look after yourself – but do it sooner, rather than later.

Free Yourself from the Mousetrap

Does Your Mouse Frighten You?

I mean, of course, the mouse that lives on your desk! When you look at your mouse, mobile phone, or musical instrument, or you have to perform an activity regularly such as pushing a baby buggy, do you get a sinking feeling and feel afraid that it is gradually causing you to have repetitive strain injury, RSI, carpal tunnel syndrome (CTS) or some other form of occupational overuse syndrome (OOS)?  Do you fear you will experience increasing and continuous pain as you work?

At this point, many people decide to seek help to re-organise their desk set-up and buy an ergonomic mouse, new keyboard, new mobile phone, violin chin rest or new whatever, and hope these will solve the problem. It is certainly important to adjust equipment to be in the best position for us in relation to our bodies and to use the most suitable tools for the task at hand. This also applies to people that hot desk at work (or share cars), who need to make sure they adjust the VDU, keyboad, mouse and seat to suit themselves – not to leave them in the position that suited the person who used them previously. That’s a good start.

New equipment may also help them and the market is now full of lots of different types of mice and keyboards, many of which are ergonomically designed and marketed as being the best way to prevent RSI.  Some of these can indeed help reduce RSI pain, at least for a while and they do require us to use our hands and muscles differently, so are worth considering. However, many sufferers who have invested in ergonomic equipment are disappointed to find that the RSI returns again. They are naturally baffled and ask ‘Why?’

Why Don’t Ergonomic Mice and Keyboards Solve the Problem Long Term?

Well, if you think about it, the mouse and keyboard may change if you buy a new design but, importantly, the manner in which they are being used almost certainly hasn’t changed – often the user just gets more tense with worry and is in yet more pain. This is a distressing situation to be in but there can be a way out of the mousetrap.

RSI sufferers (and indeed many people who experience pain such as headaches and backache whilst working), need to get to the point of recognising that a new mouse, new desk, phone, erganomic chair, or some other new piece of equipment, is only one part of the answer. HOW you use your equipment is the next important question to address.

Hand holding a computer mouse

So What Can be Done?

Make a start by taking frequent breaks and do less! Stop before the pain builds up and refuse to get into a ‘driven’ or superwoman mode. Choose to work in a calm, balanced, freely relaxed and thoughtful manner. It is very different to work freely and quickly, rather than being driven and rushed, full of tension. Alexander Technique lessons can help you achieve this. 

Explore learning to do some actions and jobs with your non-dominant hand, to help us be aware of how you perform these actions and to help balance your body-use. For instance, do you always open doors and turn lights on off with your dominant hand? It can be fun doing it differently and gradually trying more complicated activities such as being able to use a mouse with either hand.  This can be particularly helpful if you have RSI – but take care, sometimes people end up with both hands hurting, if they perform actions in the same old habitual way that they have done for years!

When someone is in severe pain Doctors often say that it’s necessary to rest and immobilise the hand as much as possible, helped by wearing a firm wrist support that restricts wrist movements and over flexion.  If you wear a support for too long, it is possible to lose strength in the muscles but using one for a while can often help, if we learn from the process. Investing in a computer programme that limits the time you spend working before you take a rest, or using a voice-activated programme can also help people change the way they work and minimising the time they need to use their damaged hands. These measures allow the muscles and tendons to calm down and begin to heal. However, at some stage the sore hands and arms will need to be used again but, if something hasn’t changed in the way they are being used, the pain is likely to come back again.

Essential to getting better is to begin to understand what we personally do when we work that contributes to our problems. This is not about blame but about practicalities. For instance working when feeling stressed, exhausted, angry, miserable or afraid, or driving ourselves towards a deadline, or over-practising playing a musical instrument, usually gets us tensing, winding ourselves up and contracting down into ourselves. This hinders the free use of our hands and arms as we work and tends to create discomfort which can, if it happens continually, build up into the pain associated with RSI. Recognising our habitual patterns means that we can learn to let go of them and can therefore make different choices about how we act (or not act) so that our bodies have a chance to heal.

Don’t feel trapped by RSI – Learning Alexander Technique Can Help

Many clients come to Alexander Technique lessons at the point when they just don’t know what to do and feel trapped by RSI. In AT lessons, you willl be helped to recognise your patterns of movement, attitudes and reactions that you habitually get into when you go about your activities and, with the help of the teacher, you can learn to let go of those that don’t serve you. For example, many people needlessly tighten their neck muscles as they sit down and stand up. Many clients tense their hands as they reach out towards the keyboard and mouse, particularly if they expect to get pain when they use them – but they are not aware of the fact that they are reacting to this little mouse as if it has become a monster, so don’t at first recognise that they tighten up their muscles and defend themselves against it. Very often, people begin to tighten their muscles at the mere thought of working, let alone touching the monster mouse!

Ask yourself ‘what do I think and feel about using a mouse/ violin; do I react to the mouse/phone by tensing my hands;  do I notice any other bodily tension as I begin to work?’ Questions such as these, and their answers, can be very revealing about how we use ourselves as we work, so our subtle habits and reactions are revealed and are well worth thinking about. These subtle but continual patterns of reacting to situations with tension all build up and are the sort of thing that can make using a mouse more and more uncomfortable, so that muscles and tendons are continually irritated, which gradually causes pain.

In order to change such habits, the Alexander teacher’s hands gently touch pupils as they make simple movements, so that the teacher can guide them and help them become aware of how they react to the thought of moving, how they move and what they are doing whilst they move.

As F M Alexander put it You are not here to do exercises or to learn to do something right, but to get able to meet a stimulus that always puts you wrong and to learn to deal with it…… It is what you have been doing in preparation that counts when it comes to making movements’ (Aphorisms)

The teacher will, for instance, gently touch a pupil’s neck muscles whilst she is moving to sit down, so she can recognise her habit of tightening and shortening her muscles and gradually, she can learn to stop doing this. Similarly, once a basic understanding of the Technique has been obtained by the pupil, habits such as tightening the hands whilst using a mouse or musical instrument can be worked on in lessons, so the the pupil can begin to approach those activities in a quieter manner that allows the hands to be used more freely and easily, which reduces or even stops the pain.

However, we tend to keep going back to our old habits because they are familiar to us, so we have to keep reminding ourselves to use ourselves in the new, freer manner. Pain is a good teacher too! It will soon remind RSI sufferers if old habits are creeping back in and causing problems. If this happens, it is important to use all the Alexander Technique that has been learned and to consciously think about our use whilst working.  In this way, we can usually stop the pain again – but the main aim is to say ‘no‘ to reacting in our old way, so that we avoid getting back into our old habits that damage us and then we have a chance to move and act differently and avoid pain returning in the future.

Lessons and Workshops

Individual lessons for men and women are regularly available.

Research: Alexander Technique Helps Low Back Pain

The Alexander Technique has been shown to help low back pain in a randomised clinical research trial

Over the last hundred years, many people have found that learning the Alexander Technique is an effective method to use in order to reduce chronic and recurrent back pain and to enhance other aspects of musculoskeletal health. However, there were no major research projects on the topic until recently.

In August 2008, a major research paper was published in the British Medical Journal, the BMJ, that supports this theory. The results of the ATEAM trial have been heralded in the media and the implications of the research have been discussed by many eminent medical professionals, by Alexander Technique teachers and by various health organisations.

I will only outline the main findings of the research here but if you are interested, you may find the full research article via the link to the BMJ.

ATEAM Research Trial

Randomised controlled trial of Alexander Technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain

Published 19 August 2008, doi:10.1136/bmj.a884        BMJ 2008;337:a884

The ATEAM research trial was funded by the UK Medical Research Council (MRC) and the NHS Research and Development Fund.

Professor Paul Little, an MRC research fellow in Primary Care, lead the research trial from Southampton University along with Professor Debbie Sharp, Professor of Primary Care at Bristol University. The Society of Teachers of the Alexander Technique, STAT, were represented by Kathleen Ballard and Frances Oxford.  They were involved in the ten years it took to plan and complete the research and were part of the trial’s management team, which included a Professor of Health Psychology amongst others.

Details of the Research Trial

The research compared the effectiveness of different treatments for low back pain. The Alexander component was taught by 59 STAT registered teachers, including myself, all of whom had been teaching for three years or more. The teachers used  gentle hands-on guidance and verbal instructions in 1:1 lessons. These were designed to help the participants recognise and then avoid movements and behaviours that resulted in back pain, as they sat stood and walked around. Participants were also taught a lying down procedure which they were asked to practice daily.

The participants taking part in the trial were 579 NHS patients from 64 GP surgeries around the UK, all of whom had chronic or recurrent, non-specific low back pain. These participants were allocated groups: 144 received normal GP care and advice and formed the Control Group; 147 were given 6 massage sessions; 144 had six Alexander lessons; 144 had 24 Alexander lessons.

Half of the participants in each of these groups were allocated, on a randomised basis, a GP prescribed prescription for aerobic exercise.  This took the form of 30 minutes brisk walking per day, or something similar, plus some behavioural counselling from a practice nurse.

Main Outcome Measures

The Roland-Morris Disability Scale was used at three months and one year, to establish the number of activities that participants found impaired by the levels of back pain they experienced. This scale is the ‘industry standard’ outcome measure, used to establish levels for back functioning and the levels of disability that chronic back pain creates.  The number of days each person experienced pain was also recorded.

Results 

The results of the ATEAM trial are exciting for both Alexander teachers and for the many people who suffer from lower back pain but have not known how to help themselves effectively. As one of the STAT registered teachers selected to take part in this research, I was delighted to read the outcome of the Trial.

  • Of the various groups in the trial, the greatest statistically significant long-term improvements were shown in those patients who took 1:1 Alexander Technique lessons, compared to those who were allocated either 6 sessions of classical massage, or standard GP treatment.
  • The group who received massage showed some level of improvement for three months but did not sustain this at one year. The group that were prescribed exercise alone did show a slight improvement at one year but this was significantly less that the groups that took Alexander Technique lessons.
  • Just six 1:1 lessons in the Alexander Technique from a STAT registered teacher, followed by a prescribed exercise programme, resulted in some improvements that were maintained one year later. This improvement level was 70% of that shown in the group who took 24 A/T lessons. It is of interest that the exercise was prescribed after patients had already taken some A/T lessons, so they could apply their A/T learning and improve the way they used their bodies during exercising, which would also have helped their backs and their overall body use 
  • The group that showed the greatest long term improvements were the people allocated 24 Alexander Technique lessons. This group, one year later, showed the most reduction in days they experienced back pain, along with the greatest improvements in functioning and in the quality of their life. The average number of days per month they experienced back pain dropped from 21 days to 3 days per month, whilst the average number of activities that were limited by their low back pain dropped by 42%.
  • Interestingly, the participants’ quality of life improved significantly as a result of having Alexander lessons.

Improvements in Back Pain Levels

That is good news for anyone with chronic back pain! The addition of some prescribed exercise, to be taken after the Alexander lessons, made no significant improvement to this group’s level of back pain. This suggests that their general level of use and co-ordination, after having 24 AT lessons, had improved so much that exercise could offer no extra benefit to them.

Importantly, there were no adverse effects reported during the research trial by the 288 subjects who were allocated AT lessons. Between them, these participants had 2,400 lessons.

Another significant result was that the long-term improvements in back pain, functioning and quality of life shown in these AT groups, is unlikely to be due to any placebo effects resulting from the subjects receiving individual attention and touch, with the hands-on work they received in their lessons. The researchers concluded that the statistically significant improvements that were shown after one year, came about because people had learned the Alexander Technique and had applied it in their lives.

Conclusions

Professor Little said that “This is a significant step forward in the long-term management of low back pain. The results of this study reveal that the Alexander Technique can help back pain. It probably does this by limiting muscle spasm, strengthening postural muscles, improving co-ordination and flexibility and decompressing the spine. This means that patients could have fewer activities or functions limited by back pain.”

The conclusions, as set out in the research paper were:

One to one lessons in the Alexander technique from registered teachers have long term benefits for patients with chronic back pain. Six lessons followed by exercise prescription were nearly as effective as 24 lessons‘.

Simply, to quote the author Roald Dahl (who was not part of the research programme):          ‘The Alexander Technique works… I recommend it enthusiastically to anyone who has neck pains or back pain’                                                                                                                                               

Alexander Technique Lessons during the ATEAM Research Trial

Teachers were asked to give verbal instructions to the patients, alongside their hands-on teaching, which is something I always do when I teach. We taught the patients on a 1:1 basis, so they had our undivided attention, which is the standard and best way to learn the Technique. Teachers completed report sheets about the range of AT procedures included in each lesson and about the progress of the pupil. The reports were analysed by the research team and included in the research data.

Pain is a good motivator and I found the patients on the ATEAM research trial were keen to learn the Technique and to take it on board, in order to relieve their back pain. However, it is strange to refer to participants as ‘patients’ as we normally refer to the people we teach as ‘pupils’. The Alexander Technique is a learning procedure of psychophysical re-education, not a treatment as such. The learning process is a partnership between teacher and pupil, requiring the pupil’s active participation in lessons. The aim is for them to use what they learn during everyday activities.

Active Involvement Brings About Changes

Traditionally, STAT has recommended that a course of at least 20 Alexander lessons is required, for people to bring about significant changes to their body use and to develop a tool that can be used throughout their lives. Interestingly, the ATEAM research makes it evident that even just six lessons can be worthwhile and people can find a significant level of relief from back pain if they learn, practice and apply the AT during their activities.

If a pupil comes for AT lessons and just wants us to ‘make them feel better’, they don’t progress in their learning. This is unfortunate, because they never really learn AT work properly and therefore see few changes taking place in themselves. However, when pupils become actively involved in their learning and apply the AT to everyday activities, they frequently make profound changes to the way they act and move in the world and are able to reduce the number of days they have back pain. Importantly, Alexander pupils can also learn to avoid the recurrence of such pain.

Future Research

It is gratifying that the improvements in low back pain that teachers have frequently seen in Alexander pupils over the years, has now been given some scientific validation. It is to be hoped that the ATEAM Trial will encourage further research into areas where experience has shown that the Alexander Technique can also be used. For instance to help people with conditions such as acute back pain, RSI and breathing problems.

Dr Stephen Vogel, head of research at the British School of Osteopathy and a member of the NICE guideline development group, said the ATEAM research was an “unusually good piece of work”, which is praise indeed. Dr Vogel suggested that the Alexander Technique might be considered in the NICE guidelines on back pain, which will be published in 2009, if it fell within the scope of the NICE guidance. (Pulse ~ 21 August ’08)

If the Alexander Technique could become available through the NHS and if more insurance companies would cover the cost of lessons, this would be very much welcomed.

Testimonial

“I started Alexander Technique lessons with Hilary during a very stressful period at work when I was experiencing low back pain and sore shoulders. Now, nine months later, I attend only once a month and have no back pain. More importantly, I feel I have learnt to use my body in a different way and one in which I have greatly decreased my chances of developing immobilizing disability as I get older. I have found Hilary to be a sensitive, conscientious and effective teacher”.

Frankie (Journalist and Singer)