Category Archives: Health

‘Core strength and stability’?…but we’re vertebrates!

Skeleton doing plankYou won’t find many Alexander Technique teachers talking about ‘core stability’ or ‘core strength’. This is the notion that a core group of abdominal muscles exists that can be strengthened through specific exercises to provide us with better posture and a ‘strong and stable back’ 😉. The idea arose in the late 1990s and seems to have found a place in mainstream thinking. This place, however, is not deserved as researchers and health practitioners from a range of different disciplines now believe that ‘core stability’ is something of a myth (see the links at the end of this post).

For sure, so-called ‘core strength’ exercises can help you look more ‘streamlined’ if that is what you want, but there is very little evidence to support the idea that targeted ‘core strength and stability’ exercises are particularly good for back pain, or for our general health and well-being. Instead, the focus on bracing and pulling in the stomach may make things worse – encouraging us to hold even more muscular tension and placing destabilising forces on the spine.

It is now well accepted that it’s actually exercise in general and everyday activity that helps people recover from and prevent back pain. Of course, Pilates or yoga can be a great help here; just be aware that in a well-taught class you are unlikely to find a focus on ‘core’ or other specific muscles. There is also good evidence that Alexander Technique lessons are an effective approach for long-term resolution of back pain.

From an Alexander Technique perspective, we are intricate, finely tuned beings that work best when we allow ourselves to function as an integrated mind-body whole. We are also a lot stronger when we use ourselves as an interconnected whole rather than as if we consist of ‘separate parts’, which is a common concept of ourselves. So here’s one example – if I want to push open a heavy door and my underlying, largely subconscious, concept of strength is that it’s my arms that do all the pushing, then I’m going to find it harder work than if I simply put my arms out and use my body weight to send the door out of the way as I walk through it. In an Alexander lesson, we become aware of the countless ways in which we tend to make life harder for ourselves through our habitual ways of doing things. We also discover how everything is a lot less effort when we are shown how we can allow ourselves to work in a more integrated, coordinated and balanced way.

Humans are vertebrates, just like dogs and horses, and so at the physical core of our whole being you’ll find our spine and skull. Alexander teachers are interested in how well a person is working as a whole, and the head / neck / back dynamic relationship is a good indicator of this. Our head and spine constitute our central coordinating axis – and it was FM Alexander who discovered that, in this respect, we’re just like other vertebrates. Think of a deer or cheetah running and you’ll see a beautifully poised head leading the movement and the body seems to just flow along behind. Even though we are on two feet rather than four, the same principle applies. Most of us start out with pretty efficient, well-coordinated movement (think of the free, easy movement and balance of most 2–3 year-olds). However, we tend to lose some of this coordination and balance as we gradually adapt ourselves to our environment, which is usually a largely sedentary world of chairs, tables and computers. We tend to get stuck in habitual ways of doing things, including over-use of our arms and legs, which compromises the natural length and springiness of the spine.

The ideal situation is that all our muscles are doing the appropriate amount of work required for any given task at any given time, so we need to be able to continually adapt according to what we’re doing. In general, however, our muscles tend to be doing too much work, as holding tension is a very common habit. In contrast, the system of deep muscles associated mostly with the spine and head that provide us with postural support is usually in need of a bit of waking up. It’s all a matter of balance and, with such a complex system, there’s no way we can directly bring that balance about through any specific exercises. Alexander lessons provide a practical and effective approach to this problem. Through learning greater self-awareness and from direct experience of guided movement we can re-discover the central coordinating role of our ‘true core’, the healthy dynamic relationship between our head and spine. When this is working better, we’re more able to let go of unwanted muscular tension and discover easier, freer movement.

So, if you’re a vertebrate and would like to discover how you can access your ‘true core strength and stability’, find yourself a registered Alexander Technique teacher – feel free to get in touch if you’re in the Edinburgh / East Lothian area or search find your local teacher here.

Read more about the myth of core stability:

Eyal Lederman: http://www.cpdo.net/Lederman_The_myth_of_core_stability.pdf

Peter O’Sullivan: https://www.youtube.com/watch?v=YezBG_NdLgs&feature=player_embedded

Emma Wightman: http://www.stockbridgeosteopathicpractice.com/the-myth-of-core-stability-part-1.html

https://trustme-ed.com/blog/the-problem-with-core-stability

Prevention is better than cure

Alexander Technique as health and safetyIs it just me, or do you find when looking for car insurance that none of the categories in the online drop-down employment list accurately describe your job? Not surprisingly the category I wanted (‘Alexander Technique teacher’) didn’t exist, but none of the available options seemed even remotely relevant to what I do. When I came across the category of ‘health and safety consultant’ I immediately thought of someone on a building site wearing one of those bright yellow hard hats. But then it dawned on me that ‘health and safety consultant’ is actually quite a good description of our work as Alexander teachers – helping people to look after their health and wellbeing, and prevent injuries and accidents in everyday life.

In a previous post I talked about how I use the Alexander Technique to help keep me safe day-to-day. Here I’ll say a few things about how learning the Alexander Technique can benefit our long-term health.

Although I’ll never be able to prove it, I am convinced that I’d be in a bit of a state by now if 20 years ago I hadn’t decided to take up the Alexander Technique. I do know that at that time I had daily low-level neck ache and the beginnings of RSI linked to extensive computer use and, more worryingly, I had a family history of severe neck and back problems. When I decided to begin Alexander lessons I was seeing it as my attempt at an ‘insurance policy’ for my future heath. It’s very clear to me now that the Alexander Technique is essentially preventative in nature – promoting health in its broadest sense, rather than treating specific issues. At that time, however, I didn’t know much about it and I don’t even remember how I first heard about it – all I remember is that I was scared that I might end up with similar problems to my mum and brother and was willing to try anything that might help me protect my long-term health.

So how can learning and applying the Alexander Technique impact on our health over a lifetime? Anyone who has had a reasonable number of Alexander lessons will be very aware of, and enjoy, how differently they move, sit, stand and even breathe, compared with their previous habitual ways of being and doing. They’re also likely to notice a tendency towards a calmer, more open, and more self-confident attitude to life. Our current physical and mental state is a reflection of the cumulative conditions of our existence/experience leading up to this point. So it’s easy to see that if, for example, we learn to move more effortlessly with less stress and strain on our back, neck and joints, that this might have beneficial consequences over the long term in terms of flexibility, aches & pains and so-called ‘wear and tear’ conditions such as osteoarthritis. One of the more subtle and intangible benefits, however, is the greater understanding and acceptance of oneself that comes from taking on board the Technique. This is accompanied by a growing sense of oneself as a whole, rather than having a concept of ‘self’ as essentially being the mind, which is then carried around by a separate (and not always trustworthy) body.

One evening last week I found my right knee suddenly really jarred when I was going upstairs. I immediately stopped and considered the situation – was it something I’d done in that moment of climbing the stairs? And/or, had I slightly twisted and injured my knee without realising it when I’d been clambering over the rocks at Joppa beach earlier that day? Not knowing the answer to these questions, and certainly not wanting to make the situation worse, I was left with the fact that all I could usefully do in that moment was to apply my usual Alexander thinking and see what happened. So I gave myself a few seconds to bring my awareness back to myself, noticing my contact with the supporting surface of the step beneath me and thinking of the direction upwards, all the way up my spine through the top of my head up towards the ceiling, and the idea of my knees going ‘forwards and away’ (‘classic’ Alexander thoughts – or directions as we like to call them). I reminded myself that I was likely to automatically anticipate another experience of pain with my next step, and so invited myself to put such thoughts aside. Then, mindfully, I took another step – wow, no pain at all, my knee was fine!

We have three flights of stairs in our house so as I gradually continued up towards the top, I had plenty of time to find out what effect my thinking was having. Half way up, my mind wandered onto something else and then suddenly ‘Ouch’ again! So, giving myself a moment to renew my Alexander directions, I set off again and was fine all the way up to the top floor. In the course of that evening I found that each time I went up or down the stairs, or crouched down to pick something up I had no knee pain – but only as long as I remembered to think my Alexander directions; otherwise, each time that I didn’t stay ‘present’, it hurt!

I don’t always have such a clear-cut experience of the power of thought – Alexander-informed thought. It’s usually much more subtle e.g. walking might seem to become slightly easier and smoother when I change my thinking. But it did make me realise how important is the way we respond in that first moment of something going wrong. Our response can significantly influence the longer-term outcome, either aiding a speedy recovery or (unintentionally) predisposing to a worsening of the situation.

Now of course pain is a very useful immediate reaction whenever we encounter anything that is harmful. It’s how from a young age we learn to protect ourselves by knowing what to avoid etc. But a pain response can sometimes become entrenched unnecessarily. An experience of pain makes us anticipate pain again whenever we repeat the same action/are in the same situation. However, pain anticipation results in a whole-body/self response that includes tightening up and this in itself makes it more likely that pain will recur. So we can get stuck in a vicious circle of pain which can become persistent and remain long after any original tissue damage has healed up. There is now a lot of research on persistent (chronic) pain and ‘brain plasticity’, and one helpful and accessible insight into this is Steve Haine’s booklet, Pain is really strange.

My experience of knee pain that day led me back to memories of times prior to learning the Alexander Technique and the way I would react whenever anything went awry. Typically, any experience of unexpected pain or discomfort would unleash a stream of ‘what if’ thinking – for example ‘is this the start of osteoarthritis?’. But now, using the practical thinking skills I’ve learnt, together with a more accepting and curious attitude to the current situation, I was able to work through the present problem. I presumably had some kind of minor injury but preventing my reactions from making it any worse allowed my natural self-healing capacities to do their stuff. After a couple of days I didn’t even have any twinges in my knee.

Of course I can’t ever know for sure if my Alexander thinking had any role in preventing a minor injury potentially turning into something more serious or long-term – but I’ve had enough similar experiences over the years that I’m convinced that the Alexander Technique has had a major impact on protecting my health for the long-term. And of course there are now several clinical trials that back up my own personal experience, with evidence of how learning and applying the Alexander Technique can impact on some long-term health conditions.

If you’d like to find out more about how you can use the Alexander Technique to help protect your long-term health do get in touch if you live in or around Edinburgh, or look for events or teachers in your area.

The Alexander Technique keeps me safe

Stay safe with the Alexander TechniqueThis past month I’ve spent a lot of time driving up and down between Edinburgh and Bristol due to family illness. During this time I often found myself thinking ‘thank goodness for the Alexander Technique, I’m so lucky to have this skill!” – I was able to stay calm, aware and focused throughout, even when I’d had very little sleep and the road conditions were awful.

There have been countless times in my everyday life – for example, picking up something heavy, climbing a ladder, walking on uneven ground – when I’ve used the Alexander Technique to help me stay safe. How does this work? – by becoming more aware of oneself and what is happening moment by moment, and being able to give oneself a little bit of space and time in which to consider how best to respond in any given situation. So, for example, if I’m climbing up a ladder to wash the windows I’m very aware of my changing balance with each step – not trying to control or micro-manage, just staying present and paying attention to what I’m doing with myself rather than solely focusing on cleaning the windows. So if, for example, a rung is slippery I’m more likely to be able to adapt and stay in balance and so stay safe.

Less obvious perhaps but equally as important, is how learning the Alexander Technique is helpful for safety in its broader sense, particularly over the long term. So it’s not just about in-the-moment avoidance of accidents or strain – I’ve also protected my long-term health and well-being through the Technique. I’m convinced that without it I’d be a bit of a wreck now with neck pain and RSI – I was beginning to get signs of these developing before I started Alexander lessons. Through the lessons and my subsequent training to be an Alexander teacher, I’ve integrated the Technique into my daily life for better balance, movement coordination and mindful calm.

“Really uplifted by it, really empowered by it…”

Embodiment and self efficacyThis description of an experience of learning the Alexander Technique comes from one of the participants in a large randomised controlled clinical trial for people with chronic neck pain. It is from a series of in-depth interviews that were carried out with some of the trial participants and which form the basis of a new publication by myself and other members of the ATLAS study team [1]. Our analysis explores the participants’ experiences of learning the Alexander Technique (or of having acupuncture, the second intervention evaluated in the trial) and contrasts these experiences with their previous medical care. The participants’ accounts of their experiences help to explain the basis for the observed clinical benefits in the trial of long-term reduction in neck pain and associated disability following Alexander lessons or acupuncture [2]. They also complement the trial findings of participants developing greater self-efficacy [3].

Here I look at the experiences of the participants who attended Alexander lessons. They reported that learning the Alexander Technique led to greater self-awareness, and they explained how applying the Alexander thinking skills led to a sense of more control over managing and overcoming their neck pain. Participants’ reflections include:

“Really uplifted by it, really empowered by it and really surprised at, at what I had experienced.” (Female)

“…you don’t really have to physically do anything, you’ve just got to think it… So you can be walking down the street and you can put it into practice, I can be at work…I had made my muscles go soft that for ten years hadn’t been, and that was just from my teacher just explaining what to do and just very lightly touching my shoulders and just…talking me through it.” (Female)

“You’re in control, you know.” (Male)

For many participants the increased self-awareness and a sense of interconnectedness and embodiment were integral to the transformative process they experienced. The perception of ‘neck pain’ could no longer be reducible to a ‘body part’.

“She looked at me as [a] whole rather than as a shoulder and a neck … And I’m not just learning to relax certain muscles that were the problem, it was everything, which, I suppose in some respects, just balanced, balanced me a lot better.” (Female, Interview 2)

“I’m a much calmer person, it’s taught me how to take a step back and assess a situation rather than jump straight in … because I’ve learnt how to do it, I’ve learnt how to take a step back, I’ve learnt how to relax my body.” (Female, Interview 1)

Participants described how they continued to use the understanding and skills they had gained, after the Alexander lessons had finished, to sustain and in some cases further improve their reduction in neck pain. For example, one participant said:

”The positive thing about [the Alexander Technique] is you can carry on doing the things that the teacher’s taught yah to help yah, and I do. And gradually it’s just got better and better, you know. And as for life changing, probably the Alexander’s changed me because I never used to realise it, but with being in pain you used to tend to be a bit short tempered and…. grumpy.” (Male, Interview 2)

Find out more

Our article is published in Complementary Therapies in Clinical Practice, read it here.

More on the ATLAS trial

ATLAS was a randomised, controlled trial that recruited 517 patients with chronic neck pain and evaluated one-to-one Alexander Technique lessons with a STAT-registered teacher, or acupuncture, each plus usual care, compared with usual care alone. The main clinical findings of this trial are published in the prestigious Annals of Internal Medicine [2]. The trial demonstrated statistically significant and clinically meaningful reductions in neck pain and associated disability for both interventions compared with usual care alone. Read more about the study here.

  1. Aniela Wenham, Karl Atkin, Julia Woodman, Kathleen Ballard and Hugh MacPherson. Self-efficacy and embodiment associated with Alexander Technique lessons or with acupuncture sessions: A longitudinal qualitative sub-study within the ATLAS trial. Complementary Therapies in Clinical Practice 2018;31:308–14.
  2. Hugh MacPherson, Helen Tilbrook, Stewart Richmond, Julia Woodman, Kathleen Ballard, 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.
  3. Julia Woodman, Kathleen Ballard, Catherine Hewitt, Hugh MacPherson. Self-efficacy and self-care-related outcomes following Alexander Technique lessons for people with chronic neck pain in the ATLAS randomised, controlled trial. European Journal of Integrative Medicine 2018;17:64–71. 

 

Is ‘text neck’ real?

Text neckI saw a recent newspaper article claiming that there is no such thing as ‘text neck’, saying that research has dismissed any link between use of mobile phones and neck pain. As is often the case with mainstream media, the journalist was basing this rather bold statement on the findings of just one small study [1].

The problem with this type of journalism is that large claims are based on small amounts of evidence, without taking into account the bigger picture. Had the journalist taken the trouble to look further, they would have discovered that quite a lot of research has already been done in this area. While the jury is still out, the weight of evidence is pointing towards the likelihood that there is a link between mobile technology use and neck and shoulder pain. For example, research published in 2017 reviewed all the studies to date that had examined a possible relationship between mobile touch screen technology use and musculoskeletal problems such as neck pain [2]. The researchers’ analysis of the 45 studies identified led to their conclusion that there is some (albeit limited) evidence of musculoskeletal problems, particularly neck and shoulder symptoms, associated with mobile technology use. They stressed that the evidence is limited, largely due to the lack of controlled and long-term studies, but they were sufficiently concerned to issue guidance, including reducing excessive time using mobiles [2].

We evolved in an environment very different from that of today. We were, no doubt, well adapted to that environment, moving through it with our heads beautifully ‘supported and suspended’ as part of our whole springy and dynamic upright structure. In this scenario, the considerable weight of our head (4.5kg or so!) did not cause us any undue strain, passing ‘straight down the plumb line’ into the ground rather than pulling the rest of our body down.

However, since the Industrial Revolution our environment has changed beyond recognition. The current world of seats, tables, cars, computers and mobile technology has changed how we spend our time, fundamentally restricting and constraining our everyday (moment-by-moment) movement into an uncomfortable mix of stasis and repetitive actions. We have developed an array of subconscious habits to try and adapt ourselves to this environment, and these are interfering with our natural movement coordination, postural support and balance. If you watch most people using a mobile, reading a book, or just looking down, you’ll see their head hanging forwards from the spine rather than pivoting at the joint at the top (see my article in TalkBack magazine for more on this [3]). With 4.5kg of weight pulling downwards for large parts of the day, it seems foolish to dismiss the possibility that neck and shoulder pain may result over the years.

While there is now a lot of attention paid to the amount of time spent on our mobiles, it may be more important to focus on how we use it – what do we do to ourselves while we are ‘lost’ in our virtual world? Why not conduct a little experiment – pick up your mobile and start reading a text or looking at social media. Ask yourself what gradually happens to your neck and shoulders, to your breathing, and to your awareness of the world around you? My belief is that – without an ability to avoid the usual habits around mobile phone use – it is likely to predispose to neck and shoulder pain over the long term. But it’s not just about biomechanics. Losing awareness of what’s around us and instead focusing our attention narrowly on our mobiles, we tend to become tense and rigid, affecting our breathing, balance and our sense of being ‘grounded’. So paradoxically, even while we are rushing about our busy days, on the move and on our mobiles, we can actually become quite frozen and fixed.

As an Alexander Technique teacher, I help people recognise what’s happening to themselves as they use their mobile, or indeed as they carry out any activity (sitting, lifting, walking etc). I then show them how they can reduce unhelpful habits so that they can lead their daily lives with more poise and freedom, and less effort. Using a mobile well

Consider finding out more about the Alexander Technique if you’d like to be able to look after yourself better and stay grounded in the real world – and not just when you’re using your mobile.

 

  1. Gerson Moreira Damasceno GM, et al. Text neck and neck pain in 18–21-year-old young adults. European Spine Journal, January 2018;1–6.
  2. Toh SH, et al. The associations of mobile touch screen device use with musculoskeletal symptoms and exposures: A systematic review. PLoS One, August 2017;12(8):e0181220.
  3. How the Alexander Technique can help you avoid ‘text neck’, Julia Woodman. TalkBackquarterly magazine of BackCare. Summer 2016 Issue; 20–21 (or click here for PDF; reproduced with kind permission).

How can I change?

Choose change

It’s the beginning of January and some of us may find ourselves struggling to put into practice our New Year’s resolutions. Resolutions usually involve a desire for change – to either achieve or to be something different to now. We start off with good intentions but then find that making change happen can be incredibly difficult, particularly if it’s to be long-lasting. If we fail, it’s very easy to believe that it’s due to a lack of ‘willpower’, or because of factors that are beyond our control. Well, of course we can’t do much about factors beyond our control but we can take a look at ourselves and ask the question of what does it really take in order to be able to change?

The Alexander Technique is a method for self-change. It provides us with the thinking tools to become more aware of ourselves and our habits, and gives us a practical, thoughtful and embodied approach to bringing about change. It works with the way we think, react, act, move and be – and, because we’re dealing with such fundamentals, it gives us a process for getting to the real root of a problem. Instead of fixating on the desired goal, we learn to give ourselves time and to pay attention to how we go about achieving the goal. This also means we are more likely to set realistic goals and so are more likely to achieve them. The approach is to prioritise looking after ourselves throughout the process of working towards our goal. It’s a more sustainable approach than the ‘all or nothing’ attitude that often leads us to give up at the first hurdle.

The Alexander Technique can be applied in every aspect of life, helping us to make the changes that we want to make – from learning how to exercise without injury to reducing postural and movement habits that might be the cause of back or neck pain. Some of the hardest habits to shift can be thinking habits, and learning the Alexander Technique helps us to change our thinking. The American philosopher and educationalist John Dewey found that it enabled him to change his intellectual position on an issue whenever new evidence emerged to challenge it – he contrasted this with other academic thinkers who continued to hold rigidly to one position come what may [1].

If you’d like to find out more about how the Alexander Technique can help you make changes, consider booking an introductory lesson. Be sure to choose a qualified, registered teacher – members of the Society of Teachers of the Alexander Technique (STAT) have undertaken 3 years’ full-time professional training. If you live around Edinburgh you might like to consider myself or one of my colleagues. Visit the STAT directory to find a teacher local to you.

  1. Frank Pierce Jones. Freedom to change. Mouritz, London, 3rd edition, 1997; p97.

Driving home for Christmas

Sitting slumpedIf you usually have to drive to work, you may be looking forward to having a break from your daily commute (even if you’re facing a long drive home for Christmas first). For all too many of us, driving contributes to, or even causes, back, neck or shoulder pain, as well as stress. How can the Alexander Technique make the daily commute a bit easier? Here are some things to think about and try out at home over the festive break.

 

 

Sitting in balance, supportedHow are you sitting?

Car seat design has a lot to answer for but even with the best seat in the world, it’s still easy to end up with aches and pains. The most important factor is not the seat but yourself and your ‘human ergonomics’. This is where the Alexander Technique can be so helpful. An Alexander teacher can enable you to discover how to drive with less effort and stress, sitting easily in balance, holding the steering wheel with less tension, and ‘rising above’ the antics of fellow road users.

If you’re trying to sit up straight or hold yourself upright then you’re not on the right track. Good posture − like that seen in most toddlers − is effortless. It does take time, and Alexander work, to wake up the deep postural muscles that are the hallmark of a ‘strong back’, but a good start is to develop an awareness of your sitting bones and the support coming from underneath. So, find a reasonably firm chair to sit on and slide your hands under your bottom from each side so that you’re briefly sitting on your hands. Can you feel the bony parts of yourself that you’re sitting on? These are our sitting bones, the rocker-shaped bottom of the pelvis (see photos). Now you’ve found them, take your hands away and try gently shifting yourself forwards or backwards to get a sense of how to balance on them, allowing your weight to drop straight down through the chair. Can you get a sense of the support coming up from the ground through the seat and up through your sitting bones? It’s this support that triggers our reflexes that send us upright.

 Balanced on sitting bones

Skeleton driver nicely balanced on its ‘sitting bones’

 

 

 

 

Bottom of pelvis (sitting bones) balanced on supporting surfaceClose-up of the back of the pelvis and lower spine. Note the ‘sitting bones’ in full contact with the supporting surface below and in balance

 

 

 

 

How are you seeing?

Modern lifestyles, particularly the widespread use of mobile technology, are having the effect of narrowing our attention and visual field. Our vision is becoming more like a spotlight that focuses only on the specific object that our attention is currently on. This way of seeing can become a habit, and one which is certainly not helpful when driving! A safe driver is aware of everything around the current focal point, so that while looking at the road ahead, they will still immediately see movement at the periphery of their vision, such as if the door of a parked car they’re about to pass begins to open.

If your visual field seems quite narrow or two-dimensional and you’re interested in improving it, begin by spending a few minutes each day – perhaps looking out the window, or when you’re out on a walk – allow yourself to look at an object with a soft lively gaze, and notice the shapes, colours etc of what’s around it (these won’t be in focus). Don’t experiment with this when driving in case it distracts you – wait till you’ve developed the skill. This more natural, ‘panoramic’ (more three-dimensional) vision will pay dividends in whatever you’re doing through increased awareness and better balance.

How are you thinking?

No doubt, you’ll be familiar with the stress of trying to get to an appointment in time and being delayed by traffic. And as anyone who sufferers from chronic pain knows, stress makes it worse. The Alexander Technique helps us to shift our attention onto prioritising ‘looking after ourselves’ (keeping our poise) rather than over-focussing on the goal of getting there on time.

Another unwelcome aspect of driving is other drivers behaving selfishly or aggressively. The next time another driver does something that annoys you, see if you can take a second and, rather than just reacting unthinkingly, continue to keep your awareness of the road ahead, and at the same time notice the support of the seat coming up through your sitting bones and think of the distance up to the crown of your head and beyond. Then slowly and gently exhale through your lips, as if you were blowing a small feather away. Repeat a couple of times, noticing the in-breath automatically coming in through the nose and the continuous cycle of breath with no holding between the inbreath and the outbreath. Now decide whether or how you’d like to respond.

I hope you’ll enjoy exploring these ideas and discovering a more comfortable, calmer and less effortful way of driving.

Adapted from a previous article for BackCare’s Talkback magazine: Is your daily commute driving you to despair?; read the article for tips on how to adjust your car seat so that you can sit comfortably.

New research: Learn the Alexander Technique to improve how you live and care for yourself, and so reduce pain

Neck pain self efficacy pulicationMy colleagues and I have just published new research from the ATLAS clinical trial of Alexander lessons or acupuncture sessions for people with chronic neck pain [1]. The research concludes that Alexander lessons lead to long-term improvements in the way people live their daily lives and manage their pain. It reports the positive effect of learning the Alexander Technique on people’s self-efficacy and ability for self-care, and the way in which this is linked with long-term reduction in chronic neck pain. These findings illustrate nicely one of my favourite descriptions of the Alexander Technique – a way of looking after yourself better in daily life and for the long term.

 What were the detailed findings?

Compared with the control group (usual care alone), trial participants who had attended Alexander lessons reported significantly greater improvements across eight self-efficacy/self-care measures, including the ability to reduce pain in daily life – and this improvement was maintained at 12 months, several months after the lessons had ended. At 6 months, 81% of the participants who had attended Alexander lessons reported significant improvement in the way they lived and cared for themselves (compared with only 23% of the control group) and this increased to 87% at 12 months (compared with 25% for control). These improvements in self-efficacy and the ability to reduce pain during daily life were found to be related to the long-term clinical outcome of reduced neck pain and associated disability [1].

More on the ATLAS trial

ATLAS was a randomised, controlled trial that recruited 517 patients with chronic neck pain and evaluated one-to-one Alexander Technique lessons with a STAT-registered teacher, or acupuncture, each plus usual care, compared with usual care alone. The main clinical findings of this trial are published in the prestigious Annals of Internal Medicine [2]. The trial demonstrated statistically significant and clinically meaningful reductions in neck pain and associated disability for both interventions compared with usual care alone. Read more about the study here.

What do people say about these new findings?

Professor Hugh MacPherson from the University of York, who was the principal investigator of the ATLAS trial and one of my co-authors on the current publication, says it ‘really does set out the role of self-care and self-efficacy as key components related to the benefits of the Alexander Technique’; and describes it as a ‘landmark study for many years to come’.

 Find out more

Our article is published in the European Journal of Integrative Medicine, read it here.

 

  1. Woodman J, Ballard K, Hewitt C, MacPherson H. Self-efficacy and self-care-related outcomes following Alexander Technique lessons for people with chronic neck pain in the ATLAS randomised, controlled trial. European Journal of Integrative Medicine 2018; doi: 10.1016/j.eujim.2017.11.006
  2. MacPherson H, Tilbrook H, Richmond S, Woodman J, Ballard K, Atkin K, Bland M, Eldred J, Essex H, Hewitt C, Hopton A, Keding A, Lansdown H, Parrott S, Torgerson D, Wenham A, Watt I. Alexander Technique lessons or acupuncture sessions for persons with chronic neck pain: A randomized trial. Annals of Internal Medicine 2015;163:653−62.

“My life’s a mess! I need a counsellor…and a chiropracter…and a coach and a…..”

We have a tendency to split ourselves into different bits. If we want help defining or achieving our goals we visit a life coach, for physical fitness we might go to a personal trainer, for aches and pains it may be a physiotherapist, and for anxiety perhaps a psychotherapist. Of course, if we want to address one specific issue or aspect of ourselves, then seeing one of these professionals could be exactly what is needed. But thinking more widely, what if we’re interested in improving the way we work as a whole (mind-body), to protect and promote our health for the long term, to be able to stay calm and think clearly, and to achieve the best we can? Is there an approach that is truly holistic that will enable us to achieve these goals – and one which we can access at any and every moment we choose?

And why is it that we tend to compartmentalise ourselves into the mind and the body, and to split the body into different discrete parts? Descartes, and even going as far back as Plato, have a lot to answer for! Our whole culture and way of thinking is centred on mind-body dualism. When we think of ‘I’ we often mean the conscious thinking self (the voice in one’s head) and the body is often seen as simply the vehicle that carries us around – a ‘vehicle’ that we often mistrust, sometimes dislike, and even fear when it ‘goes wrong’. You can notice this attitude in everyday expressions such as ‘my back is hurting me’ − this implies the back is an object that I possess, in much the same way as I might say ‘my car has a fault’. Much of our conventional attitude to health and illness is shaped by this assumption. So for example, if my back is hurting I may assume this is exclusively a physical problem, and I might then look for a specific treatment or specific exercises to strengthen certain muscles. But the thing is that we aren’t an assembly of mechanical parts and we operate as a whole; it’s not just that we’re inter-connected, rather we are indivisible mind-bodies. Not recognising this fully, we don’t always consider whether perhaps the root of the problem, and indeed the solution, might lie partially or wholly elsewhere from the immediate symptom. So for example, an ankle problem may result from the overall way that I walk and stand; and pain is always worse if I anticipate pain. If your car develops a problem with its headlights you’d probably be right in not expecting that the actual cause of the problem could be the tyres. A car is a mechanical object but we’re not, we’re highly complex beings where everything about us affects everything else; the mind can’t be separated from the body, or the body split into discrete independent parts.

Perhaps a more helpful idea than Descartes’ ‘I think therefore I am’ would be ‘I am what I think’. I would argue that every thought that we have translates into some kind of physical quality in ourselves – as well as the converse, our physical state affects our mental/emotional state. That’s probably obvious for things like getting stressed about something and feeling tension develop in shoulders, neck etc, and the vicious circle that ensues. But you might think that this would not apply for more abstract things such as, for example, the ‘mental’ activity of reading your emails? Well try it and see whether you notice any of these happening: holding your breathing, eyes staring fixedly or glazing over, brow furrowing, lips pursing. Why would any of these occur if mind and body did operate independently?

The Alexander Technique is a practical, logical and empowering self-care, self-development method that can be learnt with the help of a qualified teacher. The teacher will use both hands-on gentle guidance and dialogue to engage you in a process of learning that is both experiential and cognitive. You will begin to notice those physical and thinking habits that interfere with your natural movement coordination and balance, and also your freedom of choice. You will discover how you can harness your thinking to free yourself of such habits and to exert a strong positive influence on yourself. Being more self-aware and also clear in your intention, you will find that activities of daily life can be carried out in a more considered and mindful way. Being shown how to reduce the habits that interfere, you can begin to allow the natural coordinating mechanism of your dynamic head-neck-back relationship to work as it should, so that movement can occur with minimum effort, fluidity and balance. This natural movement coordination can be seen in most toddlers and also in animals – think of the grace with which a wild horse runs. Through Alexander lessons, you will notice less tendency towards tension, easier breathing, and a greater sense of calm. The Alexander Technique is not a quick fix but as our overall functioning gradually improves, specific problems have a much better chance of resolving. Gradually, we become better able to look after ourselves in everyday life, and for the long term, and we generally find it a bit easier achieving what we want to achieve

So, faced with all the problems and challenges that we encounter through our lives, does it make sense to look for someone else to fix things for us, searching for a different type of professional help each time we encounter a different problem? Or, alternatively, why not find out about a method that can provide life-long skills so that you can own an approach to help you tackle any and every challenge that you face (whether it might be labelled as ‘physical’ or ‘mental’ or both?)

See https://alexandertechnique.co.uk for a directory of teachers in your area who are registered with the Society of Teachers of the Alexander Technique (STAT). STAT is the world’s largest and most long-standing professional body of Alexander teachers. All STAT-registered teachers have successfully completed a 3-year full-time training course and adhere to a published Code of Professional Conduct.

Parkinson’s, balance and the Alexander Technique

Consider the Alexander Technique for people with Parkinson’s disease who are experiencing balance or motor function problems.

These are the new guidelines from NICE (National Institute for Care and Excellence).1

Along with other Alexander teachers, I know from experience how helpful Alexander lessons can be for anyone with balance or movement difficulties, and it is good to see these benefits being recognised more widely. The NICE advice is largely based on the findings of a clinical trial demonstrating that people with Parkinson’s were able to carry out their everyday activities with less difficulty following one-to-one Alexander lessons, compared with a control group.2 The trial also showed that the skills learnt in the lessons stayed with the people long after the lessons had finished.3 Other research suggests that verbal instructions based on Alexander principles can enable people with Parkinson’s to find better balance and mobility when standing or walking.4

The improved balance gained from learning and applying the Alexander Technique goes hand in hand with improvement in movement coordination and postural support. Again there is research to back this up.5,6,7 Studies with older people have also shown improved balance, postural stability and confidence in standing and walking following Alexander lessons or classes.8,9,10 There has even been a study comparing the walking patterns of qualified Alexander teachers with that of people of a similar age; this showed that older Alexander teachers walked more like younger adults.11,12

Benefits for balance and movement are important, not just for people with Parkinson’s but for elderly people who may be afraid of falling, and indeed for anyone engaged in any activity – sport, dance, and yoga may come to mind but we also benefit from good balance and coordination when hanging out the washing, or doing DIY or gardening.

Contact me to discuss how you could benefit from some Alexander lessons, or find out about other research.

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