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Back Pain Truths and Solutions

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

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

© 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

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.