Alexander Technique and Physical Therapy
The Alexander Technique



a resource for reversing back pain and continued self-care

By Idelle Packer, MS, PT, CTAT
certified teacher of the Alexander Technique

Back pain is often debilitating, insidious in its gradual onset or arbitrary in its sudden occurrence with no obvious precipitating event. Lessons in the Alexander Technique can illuminate postural or muscular patterns that cause cumulative stress on the neck or back. With this knowledge, the person with back pain is equipped to recognize and prevent these harmful patterns and learn to move in harmony with the body's design.

In the early lessons, the student with back pain is typically looking for relief, and depends on the teacher's manual guidance to release excess muscular tension. The goal of the study, however, is to become independent in applying the operational principles to daily activities as diverse as sitting at the computer, weeding the garden, playing an instrument, or driving a car.

When does the Alexander Technique improve or eliminate back pain?
When back pain is caused or exacerbated by general postural and muscular malcoordination, Alexander skills will reduce or eliminate back strain by increasing proficiency at "conscious inhibition".

In other words, you will become aware of movement patterns that tend to compress the spine and limit movement potential, and learn to replace these patterns with an easy upright posture in sitting and standing and a "lengthening spine" in all activities.

The student of the Alexander Technique learns a preferable balance and coordination that improves posture, reduces stress to the neck and back, and refines kinesthetic and proprioceptive skills.

Is the Alexander Technique the same as posture education and body mechanics?
There is a distinction between the Alexander Technique and body mechanics or posture education. The Alexander Technique teaches you to think in a new way.

Your perception of what is actually happening to your muscles and joints is clarified. You gain a new understanding of how your pattern of thinking may be affecting the state of your muscles and joints.

You become aware of harmful habitual movement patterns and faulty thinking. Once familiar with an alternative freer experience in movement, you can choose it!

When posture and movement mechanics improve after lessons in the Alexander Technique, the change is a by-product of a new way of thinking about movement. The student of the Alexander Technique's new general coordination is a result of consistently utilizing a particular thought process and a particular relationship of head, neck, back and limbs in activity.

The profound connection between the mind and muscular response is unique to the Alexander Technique and is the basis for a practical and lasting solution to the dilemma of back pain.

What can I do on my own right now?

YOU CAN BEGIN TO WORK ON YOURSELF RIGHT NOW! As you read these words, make a decision to lesson the tension in your neck and shoulders and allow the head to balance easily on the end of the spine.

Try to find a way to sit that places the torso's weight evenly on the two "sit bones" of the pelvis (the ischial tuberosities). Place feet on the floor, weight balanced between the heels and the forefoot, toes easy.

Take a moment to notice how the muscles of the neck and back have changed. You may be able to notice a change in your breathing, as well.

Here are some other ways you can begin to identify unnecessary muscular tension and improve your general body use. These suggestions are designed for you to use as a springboard for your awareness and experimentation. Give yourself a few minutes each day to see how much relief and change you can effect in your own body!

  1. Breathe.
  2. Notice how you're moving and holding yourself. Quietly command yourself: Let go of excess neck tension. Allow the neck to be free to allow the head to be easily poised on the end of the spine. Allow the weight to be balanced between the heel and forefoot if standing or on the "sit bones" if sitting. Purpose: connect conscious thought to body use.
  3. Try to slow down a hurried state of mind by thinking: "I know where I am, and I have all the time in the world." Purpose: associate a new mental attitude with your movements; become more aware of how you are moving; practice saying "no" to the old pattern of rushing.
  4. Lie down for 15 minutes each day: rest your back with a 1-3 inch book under your head, feet on the floor, knees bent (hook-lying). Rest your hands on your lower ribs; rest your elbows out to your sides. Breathe easily and tune into your body. Unwind. Pay particular attention to your neck and jaw; the general expansion of the torso while inhaling; the easy softening of the rib cage while exhaling. Purpose: to increase awareness and decrease muscular tension.
  5. Try standing with your feet 3-6 inches from a wall, hip width apart or wider. Lean against the wall. Let the head be poised on the neck free of the wall. Imagine your body lengthening and widening. Notice your breathing. If your back is tight, bend your knees slightly and focus on releasing tension in both the back and neck. Give yourself time to slow down and become quietly observant. Purpose: to increase awareness and decrease muscular tension while in an upright activity.
  6. Try these ideas when sitting:
    Find a chair with good upper and lower back support, and move your hips to the back of the seat. Try improving your chair design by experimenting with use of a pillow. Some people prefer placing the pillow behind the waist and upper back; others may get adequate support by placing a small rectangular pillow just above the waist for thoracic support.
    Keep your feet flat on the floor or use a footrest.
    Without slumping, allow the back of the chair to support you.
    Without stiffening, lean into the chair back and envision your back lengthening and widening.
    Pay attention to neck and jaw tension.
    Notice your breathing.
    Sit at a comfortable distance from your work surface.
    When you have to reach or bend forward, do so from the hip joints (the bend at the top of your thigh) rather than the waist.
    When you look down to read or write, allow your eyes to lower while maintaining the ease of the neck and the poise of the head. Avoid rounding your neck or collapsing the upper chest.
    Get up periodically to walk around or stretch.
  7. Try these thoughts while walking:
    Think of your body expanding and releasing into length; neck free; head directed lightly upward.
    Allow your legs to swing freely from your hip joints by leading with the knees.
    Allow the arms to swing.

Note: It is possible to follow the above eight practices while still engaging your old habitual pattern of utilizing excess muscle tension. For this reason I recommend working with a certified teacher as you explore the material in this section. While good body mechanics are extremely important, a study of the Alexander Technique will teach you to recognize the more subtle patterns of muscular tension that interfere with optimal performance. Ultimately, the healing course of your back will depend on your ability to integrate the operational principles of the Alexander Technique into movement patterns of everyday activities, work efforts, therapeutic exercise, and recreational sports and activities. If your back pain is caused or exacerbated by general postural and muscular malcoordination, I believe you will be rewarded with success in decreasing or eliminating your pain.

British Medical Journal Study on back pain and the Alexander Technique
Economic value of the Alexander Technique in Randomized Controlled Trial published by British Medical Journal with a short u-tube film of participants in the study.
Oprah Magazine's March article on Back Pain and the Alexander Technique.
Self-Care: Skills for Life
Caplan, D. The Alexander Technique: Education for the Aching Back
Packer, I., Reversing Back Pain (Rapid River Magazine full text article)
Kinesio Taping for back pain
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"The Alexander Technique stresses unification in an era of greater and greater medical specialization. Its educational system teaches
people how to best use their bodies in ordinary action to avoid or reduce unnecessary stress and pain. It enables clients to get better faster
and stay better longer. This is undoubtedly the best way to take care of the back and alleviate back pain."
Jack Stern, MD, PhD, Neurosurgical Group of Westchester White Plains, NY