Questions about dancers and low back problems


Back pain can affect anyone of any age, even young dancers!

A young dancer who attended an introductory workshop of mine is writing his thesis on the subject of low back problems amongst dancers. As part of his research he sent me the following 5 questions:

  1. Can you describe what the Alexander technique is in approximately 100 words?

    The Alexander Technique is a systematic approach to organizing and improving one’s proprioception in order to gain more conscious control of habitual thoughts and behaviors that interfere with health, balance, well-being and performance. It is based on the discoveries of F.M. Alexander (1869-1955) regarding the use of the head and neck in relation to the trunk and its effect on overall coordination and functioning. It is usually learned with the hands-on guidance of a teacher, although its basic principles can be effectively communicated in a group setting.

  2. What is your opinion, thinking from the Alexander Technique, on the cause of low back problems with dancers?

    I would say that almost all low back problems are the result of faulty habits in one’s postural behavior, and that there is no fundamental difference between dancers and non-dancers in that regard. Common to most low back pain sufferers is the habit of habitually hyper extending the knees, thus causing more strain on the low back. If a dancer uses too much effort to obtain “stretched knees”, combined with too much effort to “pull up”, then the result will be a shortened, narrowed back with increased pressure on the lumbar spine, a hollow back and ribs that are pushed forward. The dancer then tries to correct all this by increasing tension throughout the abdominals and intercostals, thus adding yet more pressure and stiffness to the trunk. This tendency to do more (tighten this, hold that, strengthen this) rather than do less (stop distorting yourself) is a very strong contributing factor to low back problems.

    Another common source of low back pain is using the lumbar spine as a bending joint rather than using the hip joints, which are considerably lower. This habit results in the feeling that the legs begin at the top of the pelvis, rather than below the pelvis, and so causes excess strain on the low back in all movements involving the legs. Many dancers first get this mistaken idea from a dance teacher who tells them to “feel as if your legs begin in the middle of your back”, or similar. These types of instructions in which the teacher asks the student to “try to feel something like” are almost always anatomically incorrect and can therefore lead to rather severe distortions of healthy coordination.

  3. What can the Alexander technique generally do for dancers with low back problems?

    The Alexander Technique works first to release unnecessary tension in order to free the postural reflexes to a more neutral state. From this neutral state the student then learns a new and easier way to initiate movement using conscious direction rather than habit or imitation. It is in the initial undoing process that most people stop experiencing pain.

  4. How would you treat a dancer that has low back problems?

    I don’t treat dancers differently just because they are dancers. Nor do I treat those with back problems very differently from someone with, say, neck pain or RSI. I first work with a student to notice how they tense the neck unconsciously when initiating movement, even though that tension is not necessary and often hinders the desired movement. Changing this use of the neck in relation to the head and back is recognized in the Alexander Technique as a fundamental misuse. As the head-neck-back relationship improves, all types of problems are resolved automatically, including low back problems in most cases. If a student is in severe pain, I will focus lessons more on how to perform daily movements in an easier way.

  5. What advice would you give a dancer to prevent low back problems?

    Learn to stop tensing your neck so that you can stop shortening and narrowing your back so that you can stop hyper extending your knees so that you can stop pressing down. That is easier said than done, but it really is that simple.

The importance of appearance in musical performance

To all musicians, take heed: if you look more involved and passionate while playing, you will be judged to sound better also!

Classical music competitions pit performers against each other. Obviously, the most important criterion for judges is sound. But that assumption needs a new…hearing. Because a player’s passion may be the best predictor of victory.

In a new study, nearly 200 novices had to choose the winners of 10 classical music competitions. Some heard a music clip of the top three performances. Others saw a video with sound. Still others watched a silent video. And the participants were more likely to choose the winner if they watched the silent video, in all 10 of the competitions.

Then professional musicians gave it a try. These judges also only reliably selected the winners from the silent video. Musicians selected the winner more frequently even when all they saw was an outline of the motion of the performers.

The researchers say the findings show that novices and experts make quick judgments about musical performances based on visual cues conveying involvement and passion. The study was published in the Proceedings of the National Academy of Sciences. [Chia-Jung Tsay, Sight over sound in the judgment of music]

So what does this have to do with the Alexander Technique? If you are tensed and pulled down while playing an instrument, you look tensed and pulled down, which is a far cry from looking involved and passionate. As anyone who has attended a group class in Alexander Technique will have noticed, people look better and more expressive, more involved and more passionate, when they free their necks and lengthen upwards.

New 3D scan reveals foot damage from high heels

The Royal National Orthopaedic Hospital has a new scanner that allows doctors to view the foot and ankle in 3D in a full weight bearing position. That means they can even view the foot when the patient is wearing shoes. The scan they released yesterday shows clearly why high heels are problematic when it comes to foot health.

Women who regularly wear high heels often suffer from foot and ankle problems as body weight is transferred to the ball of the foot, adding pressure to sesamoids (the tiny pea sized bones under the big toe). Frequent wearing of high heels also squashes the toes, forcing the foot into an unnatural shape, which can cause intense pain and possible long-term damage such as clawing of the toes.

I have always encouraged my students to minimize their use of high heels, but I also have given them instruction in how to walk in them. I think most of the damage can be minimized by wearing heels in moderation, as the doctors in the study suggested, but also by learning how to direct the body in movement in ways that avoid undue pressure on any one point. Most women in my experience tend to avoid using the heel in high heels, and that leads to problems. Simply turning out very slightly in the hip joints while walking in heels helps to distribute the weight more evenly across the whole ball of the foot, and so might lessen the damage to the big toe shown in the video.

GoMulti sports magazine on why athletes should use Alexander Technique

GoMulti is a New Zealand based sports magazine. In the May/June 2013 issue they included a short article on the Alexander Technique and what it has to offer athletes. What appears to be an edited version is now available on their web site. It includes some expert tips for both cyclists and runners:

Expert tips for cyclists by Barry Collin

  1. Don’t collapse your back into a C- curve, because it restricts breathing. Collapsing the back produces in turn a collapse in the front, which restricts rib movement and breathing. One gets the most oxygen for the least effort from the floating ribs at the bottom of the rib cage. Collapsing forward restricts their freedom and much more effort is needed to use inappropriate upper ribs, and accessory breathing muscles.
  2. Don’t tilt your chin up so that you break the line extending from your spine. Feel how the balance of your head (which depends upon correct muscle tone), is very important in the overall balance of the bike; the more you can allow the weight of the head to be transmitted down through the column of the neck and the length of the spine into the saddle, the more stable the bike will feel. The head, neck and back are now working as one integrated unit.
  3. Let your legs do the work. Finally, keeping this sense of relationship between head, neck and back, allow yourself to pivot forward from the hip joints and then allow the heels of the hands to just support your weight on the bars. This is a poised cycling position. You soon appreciate that it is the legs that really must do the work. If the legs don’t do the work, the effort is passed upwards through the body. This will produce unproductive tension and tightness around the shoulders and arms, in the neck and jaw, and of course in the rib cage and the breathing.

Expert tips for runners by Malcolm Balk

  1. The head leads and the body follows: RUN TALL, not military tall but an easy up. The spine should lengthen in the body, not bend forward in the direction of movement. The forward lean should come from the ankles not from the waist. Thinking up helps the athlete breathe more naturally as well as preventing back issues.
  2. Lead with the knees not the feet. Alexander’s direction “let the knees go forward and away” is perfect for runners who want to reduce over-striding. Thinking of the knee leading, rather than reaching with the foot, encourages the runner to land more underneath the hip which helps to reduce braking and slowing momentum.
  3. Avoid ‘end gaining’! Focusing too much on results is a great way to kill the joy of running and competing. Learning to run well, train intelligently and compete with courage and passion will bring results and enrich you as a human being in the process.

From Law Partner to Alexander Technique Teacher

Bloomberg News is not exactly the first place I would expect to see a video featuring an interview with an Alexander Technique teacher, but here it is!

Stealth Lawyer: Karen Krueger, Alexander Technique Instructor

I noticed that Krueger trained at the same school I did, the American Center for the Alexander Technique, or ACAT as we call it. And that means she was trained by my former classmates who now are the head teachers at the school.

OK! Magazine on A-list students of Alexander Technique

The current issue of OK! magazine has another article about Alexander Technique, this one focused on the A-list celebraties who use it. Madonna, Hilary Swank, Hugh Jackman, Richard Gere, Joanna Lumley, Sir Paul McCartney, William Hurt, Pierce Brosnan, Sting, Julia Sawalha, Jamie Lee Curtis, Jennifer Saunders, Ruby Wax, John Cleese, Robin Williams… the list goes on and on.

Click the picture for a larger view.
OK! on AT

Let's celebrate! 1% off for every year

30 years ago today my life changed completely. At 6:15 in the evening, on the upper West Side in New York, I had my very first lesson in the Alexander Technique. My teacher, Molly Schnoll, was a very sweet, short woman with a charming Brooklyn accent who showed me in just 45 minutes that I didn’t have to live with constant back pain. I walked out of that first lesson thinking, “This is it! This is what I have to master. And the only way to master a technique is to teach it to others, so I guess I have to become an Alexander teacher.”

I have never regretted that decision, not even for one moment. So now, to celebrate, I am offering a one-day discount for a single lesson: 1% off for every year I’ve lived with the Technique, for a grand total of 30%! That means you pay only €34,99 instead of the usual €50.

Update: This offer has now expired. Thanks everyone!

30 years and and half my life!

On 15 January 1983 I had my very first Alexander Technique lesson. I realized the other day that means I’ve been working with AT for half my life! In honor of the occasion, I have decided to make a very special offer on that day only, Tuesday 15 January 2013, for all current and former students. Be sure to check back here then to get the details!

On Seeing and Feeling

In my teaching practice I often say things like, “See the world”, and “If you learn to see what is happening, you’re halfway there”, and “link what you’re seeing in the mirror with what you are feeling.” Now two new studies looking at our ability to copy facial expressions offer some evidence that seems to support this. And one of those showed that relying only on feeling leads to worse results.

Monkey See, Monkey Do: Visual Feedback Is Necessary for Imitating Facial Expressions

Research using new technology shows that our ability to imitate facial expressions depends on learning that occurs through visual feedback.

Studies of the chameleon effect confirm what salespeople, tricksters, and Lotharios have long known: Imitating another person’s postures and expressions is an important social lubricant.

But how do we learn to imitate with any accuracy when we can’t see our own facial expressions and we can’t feel the facial expressions of others?

Richard Cook of City University London, Alan Johnston of University College London, and Cecilia Heyes of the University of Oxford investigate possible mechanisms underlying our ability to imitate in two studies published in Psychological Science, a journal of the Association for Psychological Science.

In the first experiment, the researchers videotaped participants as they recited jokes and then asked them to imitate four randomly selected facial expressions from their videos. When they achieved what they perceived to be the target expression, the participants recorded the attempt with the click of a computer mouse.

A computer program evaluated the accuracy of participants’ imitation attempts against a map of the target expression. In contrast to previous studies that relied on subjective assessments, this new technology allowed for automated and objective measurement of imitative accuracy.

In one experiment, the researchers found that participants who were able to see their imitation attempts through visual feedback improved over successive attempts. But participants who had to rely solely on proprioception – sensing the relative position of their facial features – got progressively worse. [emphasis added]

These results are consistent with the associative sequence-learning model, which holds that our ability to imitate accurately depends on learned associations between what we see (in the mirror or through feedback from others) and what we feel.

Cook and colleagues conclude that contingent visual feedback may be a useful component of rehabilitation and skill-training programs that are designed to improve individuals’ ability to imitate facial gestures.

I would go further and say visual feedback, such as using mirrors or live video, is a useful component of rehabilitation and skill-training programs that are designed to improve individuals’ ability to imitate anything humans do