Back Pain Truths and Solutions

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After a feet-focussed Awareness through Movement® class this term one of my students said to me that she wished she had done some of this before she had had surgery on her toes – surgery which has unfortunately left her worse off than before.

This kind of failed surgery story is not an isolated case but is documented in two recent books written by highly respected and acclaimed authors:

Ramin’s account of her own search of a solution to her chronic back pain issue exposes the false promises and money driven exploitation of back pain sufferers by the back pain industry (worth an eye-watering US$100 billion a year). She exposes the scandal of money-driven approaches including surgery, drugs and therapies such as chiropractic and ineffective forms of gym training.

Ian Harris’s message is not so much to accuse surgeons of exploitation but of the very limited research evidence available to help them decide how effective an operation is going to be. What evidence there is suggests that surgery and related procedures often do not live up expectations. In many cases the improvements reported by patients owe as much to a short term placebo/feel good effect as to the surgery itself. With the result that 6 months down the track, the patient may be no better off – or even worse off as my student was – than before the operation. Which makes surgery a very expensive option! (NZ Listener review of Harris’ book.)

Both Ramin and Harris are not saying surgery is never successful but that its success is much more limited than the pharma and medical “industries” would lead us to believe.

Ramin came to realise that there are no quick fixes for most back pain sufferers and that taking responsibility for your own health means putting in the effort to learn ways of helping yourself. Part of this personal responsibility is becoming fully informed of the benefits and limitations of surgery, drug therapy and other body-related practices.

One of the body-related practices Ramin looks at is the Feldenkrais Method®. It receives her big tick in addressing her back pain issues. This gentle, curiosity engendering approach to uncovering your personal habits of daily functioning provides a relatively low cost way of taking of responsibility for yourself. It requires “work” on your part (i.e “learning”) but without the over emphasis on muscles and outward appearance that many popular body practice regimes promote. (On Ramin’s advice, fellow journalist and back pain sufferer Jane Brody tried out the Feldenkrais Method and with great results.)

In my Feldenkrais® classes and individual work my aim is to enable the “learner” to discover how to improve themselves. I am working through the nervous system utilising its “neuroplasticity” to improve the neuro-muscular connections. This enables better coordination of the body in movement through the bony structure of your interconnected skeleton. Using the inherent flexibility of your brain this approach emphasises efficiency of your movements and reducing over-work or “efforting” that stresses the joints. It enables you to learn how to increase your options for easier functioning in all activities. This “intelligent” awareness approach is quite different from the practice of hours of mind-less and unnecessary muscle strengthening that doesn’t address serious functional issues such as chronic back-pain.

It is only through an awareness based approach such as Feldenkrais® that you will be able to address the underlying poor habits that are at the root of obstacles to pain free movement.  You will rediscover the pleasure and enjoyment in daily work and leisure activities.

 

  • Alan Cameron, November 2017

Book your movement re-education session with Alan now: 027 697 3854 / 04 476 6532 or alan@movewell-livewell.nz

THE ROAD TO NEW YORK

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Linda Sutherland at Tile Trends on Marion St is ticking off the days to the 5th of November and the New York Marathon. It’s been on her bucket list for ever, she says. Linda’s determined to be FIT and FIFTY. You may have guessed it – Linda turns 50 on the 9th of November so the Marathon is her early birthday party and all New York is invited!

Linda’s had lots of back and ankle issues. It was painful getting up first thing in the mornings and walking downstairs. Frustrating for someone who’s a competitive sportsperson and loves a challenge.

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“I needed a big picture solution,” Linda says. “Something that dealt with my whole body, not just the bits that hurt”. And that’s what most appealed to her about the Feldenkrais Method® – that it does look at the big picture and involves the brain.

In preparation for New York, Linda’s already had several individual sessions with Alan, a Certified Feldenkrais Practitioner.®  “I feel a difference within 24 hours of each session with Alan. It takes a week to process the change. Then the following week it settles in and I’m wow-ed by the difference it makes.”

Linda is delighted with the results of working with Alan. “It’s now easier to run, bend, pick up things, lean over and get something. My muscles are not as tight and my lower leg feels stronger. I feel a whole lot straighter! And I don’t have that deep ache anymore.”

She’s so looking forward to her Big Day in the Big Apple. And we’re delighted and excited too. You go girl! We’ll be cheering for you here in Wellington.

  • Gillian Cameron, October 2017

Book your movement re-education session with Alan now: 027 697 3854 / 04 476 6532 or alan@movewell-livewell.nz

THE MUSCLE MYTH

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© International Feldenkrais® Federation Archive, Robert Golden

Feldenkrais® practitioners like myself are accustomed to having clients coming for individual lessons saying something like: “I’ve been to a physio (or other physical treatment provider) who says my back/knee/shoulder/neck/ problem is because I have (this or that) weak muscle or set of muscles. So they told me to do these exercises to strengthen them so the problem can be fixed. I’ve done exactly what they said but it’s not improved, and actually I strained something else!”

Now the treatment provider maybe quite correct in identifying that certain muscles are not performing and need improvement. But in nine cases out of ten – and in my own experience 100% of cases –  both the root of the problem and its resolution is a matter of coordination (of muscles) NOT weak muscles. Another way of viewing the root cause in muscular terms is that it is both weak (under-used) and strong (over-used) muscles that are the issue. That is just another way of saying the real problem is one of poor coordination. Poor, or even less-than-optimal, coordination is what leads to slow burn injuries. They are rarely pure accidents but the result of the sufferer’s own habitual patterns of movement. At some point the body expresses its inability any longer to tolerate poor self use and the slow burn flares into a painful hip or knee or shoulder or neck etc. It is your habitual neuromuscular patterns that determine the relative efficiency or inefficiency of your coordinated movements.

So here it is: merely doing exercises or having muscular manipulation that is directed solely to strengthening any or all of the under-performing muscles will not address the underlying issue of coordination that is the root cause of your problem.

The genius of the Feldenkrais Method® of somatic movement (re-)education is that it provides an accessible and effective way of addressing the root problem of poor coordination.  It enables those less-than-efficient habits to be re-formed through awareness in movement. Movement is used to bring about an awareness that alerts the nervous system to its existing patterns and to enable newer, better options to be embedded. This awareness-based learning utilises the inherent flexibility of the brain (neuroplasticity). When you learn to improve your coordination then your overworked muscles stop overworking and the “weak” underused muscles now miraculously (!) become stronger without any need for a special regime of muscle strengthening exercises. It is not magic. A 100-metre sprinter may need to do muscle building but the skill required for improving performance comes from repetitions of constantly improving the coordination in running – and not from muscle building in the gym. Without improving your coordination, muscle strengthening is basically a waste of time.

I invite you to come and find out how you can learn to improve your co-ordination and performance in any activity. I offer a free, no obligation, 30-minute in-person consultation. I will explain how you can learn to improve your health and well-being using the Feldenkrais Method® and suggest ways in which individual lessons can be tailored to your particular needs.

  • Alan Cameron, August 2017

Book your movement re-education session with Alan now: 027 697 3854 / 04 476 6532 or alan@movewell-livewell.nz

Felden-WHAT? – “No pain, MORE gain” movement re-education

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Feldenkrais® trainer Larry Goldfarb tells an amusing story about the time he was asked at a party what he did for a living. “Felden-What?” was the surprised response. I can certainly relate to that! His explanation to the party goer has become so popular it has since been translated into 8 languages.

– Alan Cameron, © 2017

 

Larry’s story:

It was about to happen; that moment, that dreaded moment. I was at my friend Marcello’s birthday party, enjoying the Brazilian music when one of the other guests engaged me in a friendly conversation. We discussed the usual things, such as the weather and how we each knew the guest of honor. Peter had just finished telling me about his research in engineering when it happened:

“What do you do for a living?”

“I’m a Feldenkrais® teacher.”

“Felden-what?”

“Feldenkrais. It is a method of movement re-education, named after the man who developed it, Moshe Feldenkrais.”

“Felden-Christ?”

“Close, but not quite. It’s Feldenkrais: F — E — L — D — E — N — K — R — A — I — S. It rhymes with rice.”

“Feldenkrais?”

“Exactly. The Feldenkrais Method® is a way to teach movement. I work with people who have physical limitations, such as chronic pain or neurological problems, or with people who want to improve their performance, like actors, musicians, or athletes. I also teach classes in the physical education program at the University.”

“What do you teach?”

“Usually students come to me because they are experiencing some kind of limitation, something that is interfering with their daily life or obstructing progress or performance. My job is to figure out how they are moving, how that relates to the problem they are experiencing, and how they could move differently enough so that the problem can’t continue.”

“Sounds interesting. Is it some kind of exercise? Or do you show people how to correct their posture?”

“Well, it’s not that easy to answer, mostly because what I teach, and how I teach, is pretty different from exercise or posture. Both of these are based on similar assumptions: If you are weak, then you should exercise to strengthen your muscles. If, on the other hand you think bad posture causes your problem, then you should correct it and stand up straight. Both assume that the body is something that must be molded, reshaped, put in its proper place. Neither gives you the chance to see that what you are doing might contribute to the problem you face. Neither approach looks at how you move and how that could relate to the problem you’re experiencing.”

“Are you saying that people shouldn’t exercise?”

“No. I’m not saying that. I am saying that exercise alone isn’t enough. The idea behind exercise is that you are not strong enough, that your muscles need to be in better condition. So an exercise program is designed to increase the ability of muscles to work. I think this is often a mistaken view, because the problems that I deal with—chronic pain, neurological difficulties, obstacles to performance—do not have to do with how strong the person is, they all have to do with the way someone moves. I guess you could say, I am interested in people moving smarter, not stronger.”

“Are you saying that movement can cause problems?”

“Yes, that’s close to what I am saying. The way you move can lead to problems. What’s more interesting is that you can be unaware that the movement is at the root of the problem.”

“Oh, so people might think that their problems are caused by not being strong enough or by being damaged, when actually it is a result of how they are moving? And we are not aware of this?”

“Yes, most of us are unaware of how we move. We pay attention to where we’re going or what we are doing, not to how we move. For example, think about how you stand up from sitting. How do you do it? What happens? What moves when?”

Peter stands up and sits back down a few times, saying, “I see what you mean. It is more complex than I expected. Usually, I think of standing up and then, next thing I know, I am standing. I guess I have never thought much about it before.”

“That’s what I mean. Most of us don’t think about our bodies until we experience pain or some kind of problem. But that means that we could have been moving in an inefficient or dangerous way for a long time by the time we notice something is wrong. This is one place where the saying ‘If it works, don’t fix it’ doesn’t apply.”

“But why is that? Why don’t we notice?”

“Because our movements become habitual, automatic. We repeat the same movements over and over, without thinking or noticing. When something happens repeatedly, it drops from our consciousness. This isn’t necessarily bad, it is a part of the process of learning.”

“Does that mean we learn to move in inefficient ways?”

“Yes.”

“Why?”

“Well, because we move only as well as we’ve learned to move and that learning process is pretty haphazard. There are many things that influence how we move: childhood development, accommodations to previous injuries, and the requirements of specialized activities we engage in (such as sports, musical instruments, or work motions). Finally, since we don’t really understand how our bodies move, we often move in ways that don’t fit with the way we are put together.”

“Can you give me an example?”

“Sure. People think that the body hinges at the waist and they move as if that were so. Unfortunately, the lower back does not allow for that kind of motion; the design of hip joints is what allows the torso to bend forward and back. The muscles of the back are not designed for that movement. Interestingly enough, this is the region where most people hurt their backs.”

“I see. Moving as if your back were made to hinge at the waist can lead to back strain and pain.”

“That’s it; you understand. But, anyway, I have taken enough of your time with this. Sorry, I can get carried away talking about my work.”

“Not at all, this is very interesting. It sure beats the normal party chatter. My mom has had chronic back pain for years, so I’m curious about your work. I was going to ask you what you could do for her.”

“It’s not easy to say because I would have to see how she moves.”

“Can you say generally what you do when you start working with someone?”

“Yes, I can describe what would happen if your mom were to come to see me. I would begin by looking at her move, asking her to turn right and left, bend forward, back and to each side. I would put my hands on her to feel which muscles were working, which muscles weren’t engaging, and which ones weren’t letting go. I would look for some kind of habit or pattern that interferes with other movements.”

“You lost me there. What do you mean when you say a pattern that interferes with other movements?”

“I mean that it often seems as if people have gotten stuck doing a movement or holding themselves, unconsciously, in certain way. For instance, if you injure your leg, you change how you walk and you begin to limp. The limp may be appropriate immediately after an injury, but it can last much longer than the injury. If it continues longer than it’s needed, it can lead directly to pain, stiffness, and other problems. But that’s just one example; you can limp with your shoulder, your neck, or your back. Indeed, you don’t have to injure yourself to develop this kind of movement. You can acquire a similar habit playing a musical instrument, repeating work movements day in and day out, playing certain sports, and so on. The key is that you develop a movement pattern you get stuck with, a pattern that underlies every movement and interferes with any activity that runs counter to it.”

“Go on.”

“For instance, I was recently working with a bus driver who had recurring back pain. When I looked at her movement, it became quite clear that the muscles of the lower trunk were chronically contracted and that her back was locked stiff. Even when she tried to stretch, she could not get her lower back to let go. It was as if she had lost control of those muscles. She thought her back was supposed to be straight, so after her first bout of back pain, many years earlier, she taught herself to keep her back flat. When she moved her trunk, she overused the muscles of her upper back, so they had begun to hurt constantly. Though the doctor could find no disease, the bus driver still thought something was wrong with her spine. I could help her see that it was her movement that was causing the problem.”

“Once she saw that, could she change what she was doing?”

“Not immediately. You see, over the years, she had lost touch with what those muscles were doing. It was as if she was on automatic pilot and she had forgotten how to regain manual control.”

“So what do you do about that? I think it would be incredibly frustrating to understand the cause of the problem and not be able to do anything about it.”

“That’s where the method comes into play. There are two ways in which I work with people: in hands-on individual lessons and in group lessons. Both ways of working are based on the idea of teaching people to be aware of how they are moving, how they can move, and to increase their options and comfort. During the group lessons, I talk people through a sequence of gentle movements; during the individual lessons, I use my hands to move the student.”

“Does it hurt?”

“Not at all. Feldenkrais is gentle. The idea is that you will change most easily if the new movements are more comfortable than the old ones. I like to say that our motto is ‘No pain, MORE gain.’”

“Is this like massage or chiropractic?”

“No. The one similarity is that we touch people, but beyond that the Feldenkrais Method® is very different. In massage, the practitioner is working directly with the muscles, in chiropractic, with the bones. Feldenkrais is about working with your ability to regulate and coordinate your movement; that means that Feldenkrais is about working with the nervous system and the coordination of movement.”

“What do you mean?”

“Well, remember the bus driver I mentioned. Her muscles were tight because her nervous system told them to contract. They didn’t decide to tighten on their own, muscles don’t think for themselves. The brain tells them what to do. So my job is to help my student learn to control her or his muscles again. I do that using very gentle guided movements, staying in the range of ease at all times.”

“Pretty amazing. You really think people can change without hurting?”

“Absolutely. That’s one of the reasons I love what I do.”

“But wait, my mom has some kind of problem with her discs. Would Feldenkrais cure her?”

“Feldenkrais isn’t about curing or fixing people. It isn’t a medical treatment, it’s an educational approach. It’s about helping people get control back into their lives by understanding why they feel the way they do and by learning how to move differently so that they don’t have to keep feeling that way. Even when people have an organic problem or disease, I can often help them deal with how they respond to the problem. For instance, when I work with people who have arthritis, my job isn’t to get rid of the disease. In this case, my job is to help them move so that they don’t stress the affected joints and so that they can find more comfortable, safer, ways to do what they want to do. Same thing applies to disc problems—even when there is a structural problem—the question is how can the person move in a better way, so that they increase their comfort and avoid or minimize future problems.”

“Oh, oh. They are lighting the candles. Can we talk more after the festivities . . .”

Book your movement re-education session with Alan now: 027 697 3854 / 04 476 6532 or alan@movewell-livewell.nz

Or take advantage of a free 30-minute consultation with Alan to find out how Feldenkrais® movement education can help you.

Len Lye and Human Movement

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Len Lye Grass 1961-1965, Len Lye Foundation Collection, Govett-Brewster Art Gallery/Len Lye Centre. Photo by Bryan James.

As an artist – an acclaimed practitioner of the aesthetic – the late Len Lye  has become internationally known for his “figures of motion”. Like Moshe Feldenkrais he was not interested merely in movement for movement’s sake. He was interested in expressing movement, a universal phenomenon in all things and events, as something experienced in the human body.

It was not only the motion of what he could observe around him that he found aesthetically interesting but especially its connection to human life and movement. You see and feel the human element of movement in his kinetic works, for example his renowned wind wands – large long pieces of tubular steel that allow for free movement in all directions with different patterns and tempos. These are on a fixed base that in the ambitiously large scale of his installations are required to take an enormous physical load.

I was especially taken by his much smaller work “Grass” at the Govett Brewster Gallery in New Plymouth. It consists of  slender, tubular, flexible, steel rods, resembling species of New Zealand native grasses, fixed into a flat wooden moving base – as you can see here. I was intrigued by the effect of gently waving grass with an accompanying humming sound. What particularly interested me was how these effects resulted from the movement of the wooden base that not only tilted up and down but moved across from side to side horizontally, left and right, when looking at the base lengthways.

The theme for my regular Awareness Through Movement classes this term is the pelvis and its functional connections in the human body.  In Lye’s “Grass” I could see and feel the “embodiment” of human movement. The wooden base for the “blades” grass evoked the functional movement of the human pelvis in a way that his other works with a stationary base do not.

It reminded me of how the pelvis supports a flexible upright spine and the parts of the body directly or indirectly attached to it. A functional pelvis is able to move freely between the hip joints in a way the allows easy use of the legs aligned to the up force of gravity from the ground through the feet and ankles that reciprocally support the legs and connected pelvis and everything above the pelvis.  At the same time the pelvis as an intermediate base supports flexible functional movements in the back chest head shoulders and arms above itself.

Below the wooden base of “Grass” was the mechanism that allowed movement of that base which in turn promoted moment of the metal grass. You could say the mechanism was the “ankles” of the sculpture  connected to its “feet” the, stationary base, resting on the “ground” (shelf) where the kinetic work was displayed.

This playful and highly imaginative work of art made me realise how wonderfully complex is our functioning body in movement. The real human feet are themselves a feat of extraordinary architectural engineering. Each foot is composed of a flexible bony structure of many pieces with multiple arches connected through the ankle joints to articulating jointed legs. The legs in turn are connected to the intermediate base of the pelvis, a moving “platform” for all kinds of activities involving the moving  connected parts above.

Lye undoubtedly was well aware that the human body is so much more richly complex than any work of art can fully express. But “Grass” and his other artistic creations are fascinating and engaging evocations of that universal, human, functional richness.

– Alan Cameron, © 2017

 

Kinaesthetic learning – the key to learning how to function in the world at any age

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In my last blog I talked about what is required for getting down to the ground and rising up from the floor to standing with minimum effort – actions that seem to become difficult as we age. I introduced the idea of spiralling as an essential element of good human action and how this is part of getting down to and up from the floor or ground. Here I am connecting what is involved in the spiralling movement to our somatic (whole person) learning applicable from infancy to old age.

Human Somatic Learning
Everything a human does as a matter of habit is learnt and not purely instinctively as a matter of survival. We have a tremendous capacity for learning. Infants are “hard wired” with the desire to learn. However, this human learning takes time and is highly social and cultural.

It’s social because for a child to learn to walk, for example, requires interaction with other humans, normally the parents. Though the child does much of its learning on its own through exploring what interests him or her, yet the conditions for effective and healthy learning is dependent on other humans.

Learning to Function in the World – Kinaesthetic Learning
The Feldenkrais Method® uses the early childhood way of learning – kinaesthetic learning. Feldenkrais practitioners say we do not directly teach people how to do this or that. Rather, through our verbal instructions in classes and by hands-on movement of individuals in our one to one lessons (functional integration®), we set up the conditions for each person to learn for themselves what is good and effective somatic (whole person) functioning.

A developing child from the outset is learning for itself not by obeying someone else’s instructions or by rote learning. Kinaesthetic learning means learning by attending to one’s sensory experiencing in movement, directly engaging the sensorimotor cortex of the brain and nervous system which connects to muscles that do the moving work for us.

But human learning is also cultural. For an individual child this means how the child learns – the manner and style of learning that embeds itself as acquired habits – is a reflection of her context, the total environment including the social environment of its immediate family. If a child’s parents themselves never learnt to embody well the elements of spiralling movement neither may the child – influenced as it is by the example of its parents’ own habits of moving.

Losing childhood kinaesthetic learning
But even when we did learn to move and function well in our youth, as we age, under social and cultural influences, we lose those abilities to function in that easy flexible way. The most serious loss however is our ability to learn kinaesthetically as a child does – even while our conceptual and analytical skills have developed. We have lost the somatic awareness that enables us to retain or regain these abilities.

To a great extent in our society loss of this effective functioning is due to our own neglect, a failure to avail ourselves of the somatic awareness that we had as a child.

Spiralling movements that are found in young people then are lost for many as they age. But this is not an inevitable process. My Feldenkrais® teachers in their 70s and 80s demonstrate this truth. Through embodying this way of learning I walk more easily and powerfully at 64 than I did in my 30s and probably than I ever did!

Recovering the ability to learn kinaesthetically
So what is the key to adult learning that enables us to recapture the ability for easy effective spiralling movement?

Firstly it is not by relying on our developed analytical and theoretical thinking disconnected from kinaesthetic experience.

Instead, like a child, we must once again recover the kinaesthetic way of learning. But unlike a child, for us adults it has to be with conscious awareness that we are doing this. Studying anatomy or the discipline of kinetics and then directly attempting to imitate what they seem to show is needed is not effective somatic learning (though such somatic learning is enhanced by such knowledge).

This is because our systems cannot embody directly such analytical conceptual learning. The amazing complexity of our bodies and human functioning in movement far exceeds our capacities to analytically comprehend that complexity in a functionally self-applied way.

Spiralling is complex
Spiralling like all completed human actions involves three essential elements of timing, orientation, and coordination. But when it comes to normal functioning in our own environment, unlike animals, we are not “wired” to carry out actions embodying these three elements in an effective or efficient way.

So how can we learn to embody the principles of timing, orientation, and coordination for spiralling movements – an amazingly complex achievement for a human being – following the childlike way of kinaesthetic learning?

In my previous blog I explained how good action involves spiralling movement and how this this is required for easy getting down and up. This is very complex movement, firstly, because spiralling requires constant shifting of weight over the two feet and also over the bottom of the pelvis when in the sitting position on the ground or floor. This in turn involves constant changing of one’s anatomical orientation. If you just consider your head movements in spiralling up and down. Your head is constantly changing its orientation as you move your body through different planes of action. So moving the whole body and its parts required for spiralling movement up and down must be coordinated – there is a connected sequence of bodily movements. But effective coordination depends upon a precise timing throughout the action in order to effortlessly go down to and reverse back up from the floor without a break or jerkiness in movement. This is only learnt by paying attention to what one is experiencing through the internal kinaesthetic sense – through proprioception.

Spiralling is embodied through kinaesthetic learning
One must embody this way of learning to identify your current less-than-effective patterns of movement and to re-form them into new more functional habits. Embodying is the key concept here.

The young child does not analytically comprehend, or may not even have heard of, the three principles or of spiralling or any of the concepts I have discussed. Yet she has learnt to practise kinaesthetic learning at a very early age and embodies these somatic principles without that kind of conscious analytical knowledge.

In the end the same kind of kinaesthetic embodying must be practised by us as adults if we wish to recover, or even discover for the first time, really effective functioning in movement. But for us, unlike the young child, acknowledging the theoretical and scientific basis of such learning may be required to lead us back to that way of learning.

The process of learning to spiral in getting down and up has many more benefits than just getting up and down. It can be life changing for all of your movement based activities and more besides!!

– © Alan Cameron, 2017