How can one approach have such diverse benefits?

I was asked the other day how it is that learning the Alexander Technique can have such a wide range of different benefits. People want to learn the Technique for all sorts of reasons, from helping manage chronic health problems through to enhancing sporting performance. A recent national research survey found that the most common reason for beginning Alexander lessons is musculoskeletal pain but there were also many other reasons (Figure).1

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So how can one approach help across such a wide range of areas? And why is it that people may begin lessons for one reason but often then discover additional unanticipated benefits?

Learning the Alexander Technique acts at a fundamental level − enabling us to change the way in which we react, move, stand, sit etc, and so to carry out our daily activities with less effort, less stress and more poise. With the help of an Alexander Technique teacher, we can become more aware of ourselves (mind-body) and our habits, quietening an over-active mind and discovering how to have more choice over how we respond in any situation. In parallel, through the practical experience gained in one-to-one lessons, including hands-on guidance, our natural movement coordination, balance and posture are gradually restored.

It’s easy to see how something like sporting performance could improve as a result of better movement coordination and balance. Perhaps it’s less obvious how certain health problems could also be helped. Let’s take the example of someone who develops back pain. If they then continue to go about their daily activities with the same habitual ways of moving, sitting, lifting etc − all of which are likely to put extra stress and strain on their back (and which, may have contributed to the problem in the first place), then in some cases their pain may take quite a while to resolve. If, instead, they are enabled to reduce their habitual interference in their natural movement and postural patterns, then the problem will have a greater opportunity to resolve itself (through the body’s natural healing processes). And, indeed, two large randomised controlled clinical trials have demonstrated significant long-term reductions in pain and associated disability for people with chronic back or neck pain who took one-to-one Alexander lessons. Other research has reported lessons leading to a reduction in performance-related anxiety in musicians, and improvements in psychological well-being, mood and confidence.4−6

More information: back pain trial, neck pain trial, other research.


  1. Eldred J, Hopton A, Donnison E, Woodman J, MacPherson H. Teachers of the Alexander Technique in the UK and the people who take their lessons: A national cross-sectional survey. Complementary Therapies in Medicine 2015;23:451−61.
  2. Little P, Lewith G, Webley F, Evans M, Beattie A, Middleton K, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. British Medical Journal 2008;337:a884.
  3. MacPherson H, Tilbrook H, Richmond S, Woodman J, Ballard K, et al. Alexander Technique lessons or acupuncture sessions for persons with chronic neck pain: A randomized trial. Annals of Internal Medicine 2015;163:653−62.
  4. Armitage J. Psychological change and the Alexander Technique. Unpublished doctoral dissertation 2009, University of Hull.
  5. Jones T and Glover L. Exploring the psychological processes underlying touch: Lessons from the Alexander Technique. Clinical Psychology and Psychotherapy 2012;10.1002/cpp.1824.
  6. Klein SD, Bayard C, Wolf U. The Alexander Technique and musicians: a systematic review of controlled trials. BMC Complementary and Alternative Medicine 2014;14:414. doi: 10.1186/1472-6882-14-414.


Embodying mindfulness

I’ve sometimes heard the Alexander Technique described as ‘Zen for the Western World’. With the help of an Alexander teacher we can learn to become more present and mindful as we go about our daily life.

It’s not just about ‘being in the moment’ though − we are, after all, embodied beings. Being more present is incredibly important but is not enough on its own to allow free and easy movement, and a better quality of life without the so-very common back, neck and joint aches and pains. Alexander lessons engage us as a whole (mind-body) in an experiential learning process in which we begin to think, move (and be) differently; over time it becomes a truly transformative process. The lessons guide us to continue to apply the skills we’ve learnt to our everyday activities, and gradually our postural support, balance and movement coordination improve. I always remember the time while I was having lessons and before I trained to be a teacher, when I suddenly realised one day sitting at my desk at work that I was comfortable for the first time, sitting effortlessly. After many years of the continual ‘yo-yo of habitual slouching / trying to sit up straight’, my postural muscle support system had gradually ‘woken up’ through the lessons and started working well again, while I was also letting go of the excessive muscle tension that I’d been using to try and hold myself up. During this period my colleagues were also commenting on how I was the one who always remained calm when our work became particularly stressful.

Through the Alexander Technique we become more aware of ourselves and how we’re responding, moment by moment, to what life presents; it enables us to discover how to lessen the habitual interferences with our natural movement coordination, balance and postural support. So yes, I think that the term ’embodying mindfulness’ is a good way of describing what the Alexander Technique is and what it achieves.

New study on knee osteoarthritis suggests Alexander Technique lessons can help reduce pain and disability

My involvement in research on the Alexander Technique means that I’m a keen follower of what other researchers are doing. Here I describe the findings of an interesting and promising study that has just been published. The study suggests that Alexander Technique lessons can help people with knee osteoarthritis reduce their pain and disability, and that restoring the normal pattern of leg muscle function may play a role.

Background: Knee osteoarthritis is a common condition affecting more than one in ten people in the UK, and causing considerable pain and disability. It has become clear that people with this condition have an abnormal pattern of leg muscle function when walking and moving in general. Instead of the normal pattern in which one set of leg muscles relaxes as another set contracts, in people with knee osteoarthritis, opposing sets of muscles contract at the same time and this puts a lot of stress on the joint.

What the study set out to investigate: The aims of the study were to find out whether learning the Alexander Technique could help reduce the pain and disability associated with knee osteoarthritis, and whether a more normal pattern of leg muscle function could be restored.

What the study did: 21 people with diagnosed osteoarthritis in their knees were recruited to the study and attended 20 one-to-one Alexander lessons with a STAT-registered teacher. Knee pain, as well as stiffness and functioning, were assessed by the well-established self-report measure called WOMAC. The researchers also studied the pattern of leg muscle activation in these 21 individuals and compared this with a control group of healthy individuals of similar age and weight.

What the study showed: On average, knee pain decreased by half (56% reduction) following the lessons, and this benefit was maintained longer term, as shown at the 15 month follow-up. A similar reduction was observed in the overall score of pain, stiffness and functioning. An interesting additional observation was that most people who were taking painkillers at the beginning of the study, were able to stop or reduce this following the Alexander lessons (10 out of the 15 taking painkillers at the start). The study also showed an abnormal pattern of leg muscle function, in which both sets of muscles contracted at the same time when these individuals began to walk. This abnormal pattern improved following the Alexander lessons, and became more similar to the pattern seen in the healthy control group. Furthermore, greater improvements in the pattern of muscle function were found to be associated with larger reductions in pain. Interestingly, leg muscle strength did not change as a result of the lessons, instead the improvement was associated with a reduction in excessive muscle activation.

What the results mean: The study demonstrates the potential of Alexander lessons to enable people with knee osteoarthritis to reduce inappropriate muscle activation and therefore reduce their pain and disability. These results need to be followed up with a larger, controlled clinical trial but suggest that Alexander lessons may be an appropriate alternative approach for knee osteoarthritis to the usual one of muscle strengthening exercises.

Reference: Preece SJ, et al. Reductions in co-contraction following neuromuscular re-education in people with knee osteoarthritis. BMC Musculoskeletal Disorders 2016;17:372.

Read the full paper here.