Physical Therapy And The Alexander Technique

John Macy is an Alexander Technique teacher, Physical Therapist and Pilates instructor in Omaha, Nebraska. He talks with Robert Rickover about the relationship of the Technique to Physical Therapy.

Robert: [With Alexander Technique], it sounds like a lot of thinking is going to have to take place. How I move this leg. How I move that arm.”

John: “The beauty of the Alexander Technique is that it is simple. It has to do with that one first movement we make. We have an idea to move in our head. To do that, we send signals from our brain to our body to move on your joints. The first joint you can move on is the atlanto-occipital joint, where your head sits on your spine. When you change the quality of that movement, all the other movements can work more easily. You don’t have to worry about moving all the other parts or adjusting them. Just take care of the first things and the other follow because that’s how we’re wired as vertebrates.”

According to Wikipedia: “The Atlanto-occipital joint features predominantly in the symptom of tension-like headaches as a result of prolonged inappropriate posture from poor ergonomic adaptation.
In such cases, patients typically report cracking of the neck, discomfort when sitting, continuous migraine-like headaches, dullness, dizziness, tingling in the fingers, sensitivity to light and a feeling the head is expanding.”

John: “Athletes have known for years that the head leads and the body follows. Watch high-jumpers. They will run up to that bar and turn and you can see their head lengthen away from the body and the rest of the body goes up in the air after that.”

F.M. Alexander‘s insight was that if you influence that little event, you can influence everything else you want to change.”

Robert: “Unless the head-neck relationship is working well, you’re not going to get far with adjustments further down.”

“You don’t meet many old physical therapists.”

John: “I heard today that the ten-year burnout rate for physical therapists is 75%.”

Robert: “I wouldn’t be surprised if it was not also high for massage therapists and other body workers.”

“What is the difference in the approach of physical therapists and Alexander Technique teachers for, say, someone with back pain?”

John: “The perspective. The Alexander Technique teacher will say, you’ve got pain in your lower back. What are you doing with the rest of you that is leading you to do things that injure this area and can we change those to take stress off your system, to take pressure off there, so it can function better?

“Most physical therapists will say, oh, you’re lower back is hurting. What is wrong with the tissue right there? Let’s see what we can do to speed its repair. And not take the step to see what is it you are doing with your lower back to cause pain and damage.”

“The major idea in the Alexander Technique is the concept of use. How are you using yourself? I love it sometimes when patients come in and say, I’m hurting right there. And I will say, ‘That’s great. When you are moving that way, you are supposed to hurt right there. I’d be concerned if you came in and told me, ‘My back doesn’t hurt any more even though I walk around like this.’ Then I’d know you’d such serious damage that the nerves don’t work right any more.'”

“A lot of the Western medical model says, if you are hurting here, that’s what we treat, instead of stepping back and saying, what are you doing that led to the injury. Sometimes you do need to intervene. If you tore up cartilage in your knee, you need to fix that. But you also have to do something about what they did in the first place to tear up that cartilage.”

Robert: “An Alexander Technique teacher is going to want you to think differently about movement. A person in pain is not going to be in a good place to think differently about movement.”

“Your mental physical state is transferred through your hands. If you have a tight neck or tight shoulders and you put your hands on someone, you are conveying that information to them. When you don’t, you’re conveying a greater sense of ease to them.”

John: “We’ve all been in a room where someone walks in very depressed and grumpy and you feel everybody get slumpy about it. Or somebody energetic comes in and everyone lightens up. The communication follows what that person is doing.”

About Luke Ford

I've written five books (see My work has been covered in the New York Times, the Los Angeles Times, and on 60 Minutes. I teach Alexander Technique in Beverly Hills (
This entry was posted in Alexander Technique and tagged , , , , , , , , , . Bookmark the permalink.