Alexander Technique and Physical Therapy
The Alexander Technique


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

"Oh, my aching back!" laments 70-90% of men and women in the U.S. at some point in their lives. Whether generating from muscular strain, trauma, structural or disease origins, finding an effective, lasting solution to neck or back pain can baffle even the most conscientious sufferer.

As a physical therapist, I observe a cyclical pain-spasm-pain pattern in my patients with neck and back pain - whether pain originates gradually or suddenly, with or without an obvious precipitating event or disease process. The muscular holding in response to pain becomes habitual, perpetuating a cycle of muscular pain and spasm, delaying resolution.

In addition, habits of posture and movement cause or exacerbate neck and back pain. The manner in which you sit, stand, bend and reach may set back the healing process or be the initial cause of pain.

The solution to the neck/back pain dilemma is education: an examination of postural and muscular habit, the way we perceive our bodies, how we execute movement, and how we respond to stress. Lessons in the Alexander Technique provide this educational component, complementing physical therapy and other treatment modalities.

Distinguished from body mechanics or posture education, the Alexander Technique involves a progression of information and skills. In early lessons, the student with back pain is typically looking for pain relief, and depends on the teacher's manual guidance to release excess muscular tension.

Subsequent lessons, however, focus on the repetition of coordinating head, neck, trunk, and limbs in activity, again with the guidance of the teacher's words and light touch. Finally, movement principles and postural skills are integrated into daily activities such as using the computer, weeding the garden, playing an instrument, or driving a car.

The Technique's founder, Frederick Matthias Alexander, developed his work at the turn of the last century in order to solve a recurrent laryngitis-like affliction that threatened to end his acting career. Through observation and experimentation in front of a 3-way mirror, he was able to identify specific muscular and postural patterns that caused his malady.

Only when he discovered that optimal breath support and voice reproduction depended on the correct use of his head, neck, back, and limbs, was he able to restore his voice. In other words, one body part cannot improve until the total self is corrected.

This principle is particularly true regarding neck and back pain. The way we use the head, arms, legs, and breathe affects the muscles of the neck and back. By correcting use of the entire body, compressive forces down the spine are reversed; habitual muscular tension and associated pain alleviated.

The Alexander Technique demands conscious awareness and cultivates the ability to recognize and inhibit a harmful pattern. Conscious control is valuable for all of us, but for those in pain, it is the key for regaining control and renewed comfort.

As I write, I have modified my seat back with a firm rectangular pillow. I am releasing my neck, allowing the poise of my head to allow easy length in my spine. I am breathing fully. My habitual shoulder tension is at bay.

Initiate self-examination right now! Give yourself a few minutes each day to increase awareness and alleviate muscular tension:

  1. Breathe. I have placed this word on my computer's screen saver where it rotates slowly as a reminder.
  2. Notice how you're moving and holding yourself. Quietly command yourself to 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. Notice any changes in muscular engagement and fullness of breath.
  3. Slow down a hurried state of mind. Take time. Deepen your breathing. Notice your body and how you are moving; inhibit the mental pattern associated with rushing.
  4. Increase awareness and decrease muscular tension. Lie supine for 15 minutes with a 1-3 inch book under your head, feet on the floor, knees bent. Breathe easily and tune into your body. Unwind. Pay particular attention to your neck and jaw, the general expansion of the inhale, the easy softening of the exhale.

Beware! Alexander also discovered that perceptions can be deceiving. We may think we are moving well when, in fact, we are engaging unnecessary muscular effort. I recommend a certified teacher to illuminate the more subtle patterns of muscular tension that perpetuate neck or back pain - patterns you may not realize are harmful.

Once the new way of thinking and moving becomes familiar, you have choice: disengage the old pattern; employ the new pattern! Therapeutic exercise is more effective. Habitual slumping is replaced with an easy, upright torso. If your back or neck pain is caused or exacerbated by poor posture and excessive muscular tension, an Alexander education can be profound and lasting: decreasing or eliminating your pain.

This article appeared in Rapid River Magazine, volume six, issue six, February, 2003

British Medical Journal Study on back pain and the Alexander Technique
Oprah Magazine's March article on Back Pain and the Alexander Technique.