The Alexander Technique – An Introduction for Physical Therapists

This article was written by Peter Bloch, BA Hons, MSTAT, a qualified teacher of the Alexander Technique based in Manchester, England. Peter Bloch has taught the Alexander Technique for 25 years and his career has included running a large private practice, teaching and lecturing at music conservatoires and training and supervising teachers of the Alexander Technique. You can read more about Peter Bloch and his work on his website, The Alexander Technique with Peter Bloch.

What is the Alexander Technique (AT)?

The Alexander Technique was originally developed in order to bring about the best conditions for skilled performance. It is a practical method for changing the way people use themselves in everyday activities, both in terms of patterns of movement and in terms of how people think about movement. The AT is not a therapy: it is a sophisticated method of re-education with therapeutic consequences. It does not aim to treat a particular symptom, but instead addresses a person’s entire way of approaching movement in a course of practical lessons.

How does it work?

The Alexander Technique works by helping people to identify and prevent the harmful postural and movement habits that aggravate, or may be the cause of, stress, pain and under-performance. Working to its principles enables students to become aware of disadvantageous responses to stimuli, particularly with regard to physical movements and the intentions that precede them, and then to learn to complete an action without those aspects that are inefficient. These include any unnecessary stiffening or shortening in stature.

What do students learn?

Students learn how to release tension and rediscover better balance, both mentally and physically. With increased awareness they can learn how to be poised without stiffness in a way that can be commonly seen in small children, gifted athletes, dancers, etc, but in a way that is not very commonly seen in normal adults. Students learn to move gracefully and powerfully with less effort, to be alert and focused with less strain, to breathe and speak more easily and freely and to be calmer and more confident.

How is it taught?

Lessons in the Alexander Technique are usually given on a one-to-one basis. The teacher uses their hands together with verbal explanation in order to guide the pupil through everyday movements such as sitting, standing, walking, bending and lying down. Early in his teaching career F.M. Alexander, the originator of the AT, discovered that assisting a pupil to experience moving in a more refined way, relatively free from habitual interferences was, rather as “a picture is worth a thousand words”, a faster and clearer way of learning a skill than almost any amount of verbal explanation. The method of hands-on work that he developed is remarkable in that the teacher does not actually do something to the pupil, but instead uses his or her hands for gentle guidance in movement. Almost anyone who has experienced the hands-on method of the AT is struck by the power and effectiveness of this way of learning.

The Alexander Technique involves no specific exercises, requires no special clothing or equipment and can be applied to any activity. No clothing is removed for lessons.

What are the benefits of the Alexander Technique?

The AT may help relieve back pain, neck pain, joint pain and stiffness, stress, tension, breathing difficulties, performance anxiety and more. It promotes improved posture, mobility, balance, agility, confidence, poise and vocal performance.

What is the evidence for the effectiveness of the Alexander Technique?

The AT has long been accepted as a powerful tool for skilled performance and it is an important part of the curriculum at the most prestigious music conservatoires and acting academies. It is less well-known by doctors as a way to help patients with relevant health conditions. This is due to a lack of major studies, a situation that is likely to change in the near future due to important recent and upcoming publications.

The results of a large, randomised, well-designed clinical trial, recently published in the British Medical Journal (1) evaluating the effectiveness of the Alexander Technique compared with other health interventions for chronic low back pain, found that one year after lessons, individuals with back pain who had undertaken 24 Alexander lessons had only 3 days of pain per month compared with 21 days for similar patients who were receiving the usual standard-of-care from their family doctor, as well as reporting much less incapacity and a striking number of other ‘quality of life’ benefits. Even participants who had only 6 lessons had less than half the number of days of pain. No adverse effects were reported.

Smaller but well-designed studies have shown the Technique to be of benefit in Parkinson’s disease (2-4), balance in elderly people (5,6), breathing disorders (7), and in a number of other conditions where the way that a person uses themselves in activity has an effect of how well they function. The evidence for the effectiveness of AT lessons across different health-related conditions has recently been evaluated and the findings published in the International Journal of Clinical Practice (8). The review found strong evidence for the effectiveness of AT lessons for people with chronic back pain and moderate evidence in helping to alleviate the disability associated with Parkinson’s. Preliminary evidence was found across a diverse range of other health-related conditions. In the UK, a major clinical trial is currently investigating the effectiveness of the AT for chronic neck pain.

How many lessons do students need?

Alexander Technique teachers generally recommend that students aim to have an introductory course of about 20-30 lessons. This is the number of lessons needed by the average student in order to resolve the most common presenting symptoms, and to have a sufficient grounding in the principles in order to continue to progress without assistance. It is generally an advantage, but not essential, for students to have lessons twice or even three times weekly for the first few weeks, after which weekly lessons are usual.

Who can be helped by the Alexander Technique?

The Alexander Technique can benefit people of any age, at almost any level of physical fitness, and from all backgrounds. For the more common types of neck, back and other muscle and joint pain, the AT is likely to help where the problem is either caused or exacerbated by errors in coordination, including posture and balance. Even in conditions with systemic causes, or as a result of injury, better posture, balance and regulation of forces in movement may go some way towards alleviating symptoms.

Like all educational processes, AT lessons are essentially a partnership between teacher and student. In the case of the AT this does not require a high intellectual ability, since it is essentially practical, but it does require an interest in participating and in learning something new. Most people find a course of AT lessons an interesting and enjoyable experience (1).

Finding a teacher

Most, but not all, teachers in the US are members of AmSAT, which is affiliated with most of the major international representative bodies. Membership requires the successful completion of a comprehensive three year full time training at an approved course as well as continuing education and adherence to a code of conduct. You can visit the AmSat website for more information and for a list of international affiliates.

REFERENCES:

  1. Little P; Lewith G; Webley F; 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.
  2. Stallibrass C; Frank C; Wentworth K. Retention of skills learnt in Alexander Technique lessons: 28 people with idiopathic Parkinson’s disease. Journal of Bodywork and Movement Therapies 2005;9:150-7
  3. Stallibrass C; Sissons P; Chalmers C. Randomized; controlled trial of the Alexander Technique for idopathic Parkinson’s disease. Clinical Rehabilitation 2002;16:695-708.
  4. Stallibrass C. An evaluation of the Alexander Technique for the management of disability in Parkinson’s disease – a preliminary study. Clinical Rehabilitation 1997;11: 8-12.
  5. Dennis RJ. Functional reach improvement in normal older women after Alexander Technique instruction. Journals of Gerontology Series A: Biological Sciences and Medical Sciences 1999;54:M8-M11.
  6. Batson G, Barker S. Feasibility of group delivery of the Alexander Technique on balance in the community-dwelling elderly: preliminary findings. Activities Adaptation and Aging 2008;32:103-119.
  7. Austin JHM and Ausubel P. Enhanced respiratory muscular function in normal adults after lessons in proprioceptive musculoskeletal education without exercises. Chest 1992;102:486-90.
  8. Woodman JP and Moore NR. Evidence for the effectiveness of Alexander Technique lessons in medical and health-related conditions: a systematic review. International Journal of Clinical Practice 2012;66:98-112.

This article was submitted by Peter Bloch, MSTAT. On his website you can find more information about Peter Bloch, about The Alexander Technique and about Research on the Alexander Technique.

 

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