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.

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.

An Experience of Alexander Lessons

Towards the end of 2012, I realised that I was struggling to find ways to deal with harmful levels of stress that were leaving me prone to panic attacks and fearing chronic exhaustion. I recalled having tried Alexander Technique lessons in the past and, although I had not been convinced at the time, I thought I should try again. Once I searched on the internet I noticed that there were a number of teachers practising in and around this area of North London, but Hilary King’s website inspired confidence.

Coping Strategies and a New Vocabulary

Arriving for a session with a practitioner that you have never met in person, be it an osteopath, a psychotherapist or an Alexander Teacher, can be a daunting experience. But on first meeting Hilary for one to one lessons, she struck me as someone who was calm and understanding, as well as a perceptive listener. Over a year on, it is reasonably difficult to recall how strange it is to have a lesson for the first time. I will have felt self-conscious on first experiencing gentle hands-on work, standing still as Hilary explained what she was doing and what I had to (not) do. As when an Alexander Teacher takes hold of your left hand and lightly lifts it and pulls it away from the body, the student is to do nothing: not anticipate, not assist, and not resist. Not-doing is a remarkably difficult concept to grasp and, more importantly, it relies on trust: that your teacher is there for you and that this repetitive and somewhat banal movement will change you. Your teacher will encourage you to talk about your daily activities and show you how you can apply AT to perform these without unnecessary tension and paying more attention to the moment. ‘Why not use a slight monkey position when chopping vegetables’, for example, is one of Hilary’s favourite suggestions. A new vocabulary will also be acquired, and whilst doing a monkey is self-explanatory, there are other terms that are quite baffling initially: to have a loose and free neck, inhibition, end-gaining, and more.

Mindfulness in Action

As the weeks went by though, I found Hilary was teaching me so much more than just how to sit, how to actively rest, how to walk, how to breathe. Alongside this process of repetition, I began to cultivate patience and being in the moment, and this allowed me to understand how I had been living life at an odd pace. Inevitably so, as such is the demand of modern life, to be drawn out of your present self and instead become caught up with what took place yesterday, what will need to be done tomorrow and what might happen next year. Therefore, you are standing in the kitchen hunched over the chopping board with one foot pointing outwards, in the direction of the hallway, should the phone ring, whilst fretting about when to complete that overdue report and, all the time, trying to ignore a regular pain niggling in the middle of your back. Instead, you could be doing a monkey and chopping leeks in your kitchen one April evening, taking pleasure in the task and stopping, perhaps, to notice that the days are now lighter for longer and you feel at ease. The report is still over due, the phone might ring, but this is the here and now.

Connecting With My Body

Whilst regularly attending AT lessons, Hilary was enabling me to connect with my body and the way I use and (mis)use it, encouraging me in the exploration of issues of trust in a safe environment, and gently showing me how to engage in the present. Hilary’s amiable sense of humour was part of the process from the start, a welcome quality because taking a close look at our self (body, personality, mind and habits) can be unnerving in its moments of revelation. Whilst I was initially anxious when being asked to consider an activity I found difficult, such as standing on the wobble board, I eventually realised that Hilary was not actually asking me to master the art of ‘monkeying’ on a small circular and unstable bit of plastic! Rather, Hilary was getting me to notice where and how I was stiffening in anxious anticipation of not accomplishing a task to perfection and, one day, instead of feeling that sharp sense of irritation with myself, I started to laugh. And my laughter had changed, it was no longer self-conscious or tightly nesting in my upper chest, but formed part of the release of tension – specifically from the belly. It was not like learning to laugh, as if for the first time, but remembering how to laugh with my whole being again.

Conscious Choices and Change

To conclude, learning the AT has not only allowed me to develop the necessary strategies and inner strength to cope with what life can unexpectedly throw at us, but it has been instrumental in helping me find the courage to pursue the changes I wanted but found difficult to acknowledge. It has allowed me to appreciate through simple exercises, like catching (or not catching) the ball, that I have a conscious choice over how I sit and where I sit, how I stand and when I stand, what I do and why I do it (or do not do it). AT, if embraced and practised, can be empowering. If you live locally, you will find that Hilary is an empathetic, thoughtful and reliable Alexander Technique teacher, and she will help you work towards letting go of unnecessary tension and set you up with your own toolbox, so to speak, of AT skills so that you can go onwards and upwards.

JCH April 2014

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. Back pain and high heels tend to go together. High heels produce so many back and foot problems for their wearers that many of them come for Alexander lessons. One way lower back pain can develop, is because of habitually wearing high heels. Also, the bones in their feet can become very distorted. So it could be said that high heels help to keep us in work! ( Very cynical! ) But of course I do encourage women not to wear them.

I actually feel very concerned when I see 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, various sorts of distorted toes and body use. Sometimes women are required to dress that way for their work, even though it is illegal in the UK to make women do that. (Altogether another debate about sexism and expected dress codes at work…)

It is obvious to most people that women wearing very high heels are creating and storing up trouble in their bodies. They are also ensuring that many wearers will end up visiting doctors, Alexander teachers, osteopaths, podiatrists and others for years to come about the problems they experience in their bodies as a result. Those shoes could work out very expensive in the long run!

Photo: X-Ray of foot in high heeled shoe 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 bunions, because of their high heels.

Sadly, these pupils preferred to keep their high heels, rather than allow their bodies to become less distorted. They had very few lessons. 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 permanently 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’. Wollstonecraft complained 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, despite 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.

The Alexander Technique and How it Helped Me

Alexander Technique – My Experience

I worked in a college where a colleague told me that Alexander Technique had changed his life. He managed a congenital skeletal problem through Alexander Technique. I was moaning about my bad back – I was spending more time at the computer than in the classroom at this time, and despite having a good chair, I could hardly get out of my car at the end of some days without eye-watering pain. I had seen osteopaths for years for my back (a car accident injury ) but only got short-term relief. Then my legs began to ache …

So I thought AT couldn’t hurt. Compared to osteopathy or chiropractic, it seemed a very minimal approach involving almost tiny adjustments of muscles. But this is what worked. Over a few weeks my back hurt less and less until I could sit at a meal in an ordinary chair and not notice my back. I practised at home: easy to lie on my back, listening to music for 20 minutes or so. Not every day – my life was packed – but great before an evening out or after a long difficult day. I no longer had back ache. At all.

My aching legs, though, were the precursors of a more serious, long-term endocrine condition. My energy, memory, and stamina were affected and I had constant muscle pain. I continued with AT which helped me to cope with the worst. Lying in the AT position made it less necessary to take pain-killers and helped me to be more calm and not to panic about the future of this illness. Hilary helped with tips for finding rest and respite in difficult situations. For instance, in hospitals, concentrating on having a free neck really helps in avoiding getting sucked in to the chaos and frustration evident all around in staff and patients …

I am better than I was, though had to leave work and live a reduced life. AT sees me through difficult days and is a pleasure in the not so difficult days. I still leave Hilary’s house feeling lighter and freer and am so grateful to her for her insights and practical care she has given me over all these years.

Try it. It can’t hurt!

Maggie

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? It’s time to free yourself from the mousetrap! Don’t feel trapped by RSI. The Alexander Technique can help you

Research

Unfortunately, there is little research into RSI and how the Alexander Technique can help with the condition. Hopefully this will change. However, RSI Awareness states that ‘many RSI sufferers have found the Alexander Technique beneficial in promoting recovery and preventing relapse’.

What is your desk set-up like?

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, keyboard, 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, ergonomic 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?

Voice activated software can be a great help to RSI sufferers. However, they are not suitable for all types of work and some people find them hard to use. People do still have to use their hands a bit, so it is important to think about how you are doing that.

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)