New Study: Alexander Technique Lessons Reduce Knee Pain and Co-Contraction in Subjects with Knee Osteoarthritis

A new study on the Alexander Technique and knee pain was published last month in the journal BMC Musculoskeletal Disorders. 21 subjects with knee osteoarthritis were each given 20 Alexander Technique (AT) lessons. After their lessons, they not only reported a 50% reduction in pain, but showed significantly less co-contraction in their leg muscles during walking. The entire study is available online to read here.

When I first read the study, I was struck by its size. 21 subjects (the study also used 20 healthy individuals as a control) didn’t seem to be that many. I’ve grown used to reading the larger randomized control trials, like the ATEAM back pain study published in the British Journal of Medicine in 2008. The ATEAM study involved 579 subjects. My assumption was that the larger the study, the more robust the findings. What could a study of 21 people really tell us?

The design of a study, however, depends on its purpose. The ATEAM back pain study—or last year’s ATLAS Annals of Internal Medicine study of whether AT or acupuncture are effective in treating chronic neck pain—is an example of a clinical trial, and such trials need to be large for a number of reasons. Subjects are divided into multiple groups. For example, the ATEAM back pain study randomly assigned subjects to groups that took 6 AT lessons, 24 AT lessons, 6 massages, or a control. Such large trials also deal with conditions that tend to have nebulous causes. The idiopathic back pain diagnosis studied in the ATEAM trial is just the technical way of saying, “your back hurts and we don’t know why.” The measurements in clinical trials—like self-report—are often subjective, and the clinical effects of an intervention are usually small. So a clinical trial needs to be large to show statistical significance.

Such large studies, though, can shift clinical practice—what doctors’ prescribe when they’ve diagnosed a patient with idiopathic back pain or chronic neck pain. As such, they also tend to generate headlines in the popular press. Last year’s ATLAS neck pain study was reported on by Time, NPR, Fox News Health, and Harvard Health, among others.

The current study of subjects with knee osteoarthritis is not a clinical randomized control trial. It is basic research, in a laboratory environment that is more controlled than usually possible in large clinical trials. It also uses more concrete measurement. As such, it can establish robust findings with many fewer subjects. And the purpose of such basic research is not only to establish whether the Alexander Technique might be an effective way to treat knee pain, but why. It’s an exciting window into researchers at work. Let’s unpack the study.

Why do we hurt?

Chronic pain is a surprisingly mysterious thing.

Take knee osteoarthritis. Knee osteoarthritis is a condition where the cartilage that cushions the bones of the knee joint starts the wear down. In this study, the 21 participants all had received an x-ray diagnosis of knee osteoarthritis. An x-ray doesn’t show cartilage: but it will show that the space between bones has narrowed, indicating osteoarthritis. Blood work can further confirm that the condition isn’t systematic (as in rheumatoid arthritis).

It sounds obvious, but if you have knee osteoarthritis, your knees usually hurt. But why? It has long been assumed that the pain that accompanies knee osteoarthritis is the result of the breakdown of cartilage in the joint. Less cushioning equals more pain. But researchers have been unable to show a relationship between the severity of pain and the degree of cartilage loss. Some people with minor cartilage loss in the joint suffer a great deal of pain. Others with major cartilage loss experience little discomfort—they may not even know they have the condition. The same is true in some forms of chronic back pain: there are individuals with significant damage to their vertebrae or intervertebral discs, yet experience little pain, and vice versa.

This new study explores two possible explanations for the pain that accompanies knee osteoarthritis.

1. Is pain a self-fulfilling prophecy?

One possibility is that the patients with knee osteoarthritis become more sensitive to pain. You might call this the “self-fulfilling prophecy” explanation of pain. The idea is that people with chronic pain begin to anticipate that pain, and therefore experience more pain. Previous research has found that Cognitive Behavioral Therapy or mindfulness meditation can reduce a heightened sensitivity to pain in subjects with osteoarthritis or fibromyalgia.

While the subjects in this new study reported a significant reduction in pain after their Alexander Technique lessons, the researchers didn’t find evidence that their Alexander Technique lessons had reduced their sensitivity to pain. The research didn’t disprove the idea that subjects with osteoarthritis might have a heightened sensitivity to pain, just that the benefits of AT didn’t seem to function along those lines. (The authors caution that the study might be too small to know for sure.)

2. Is pain the result of how you move?

The other possible explanation for knee pain that this study explores is that the patients with knee osteoarthritis use excessive co-contraction of their leg muscles during walking and other everyday activities. To understand co-contraction, it helps to know a bit about how muscles work.

Muscles often work in pairs. The muscle that’s doing the work is called the agonist. The muscle that is allowing the work is called the antagonist. Take a simple action like the biceps curl. When your biceps works to close the elbow joint, its antagonist, the triceps, releases. When the triceps works to open the arm at the elbow, the biceps releases. The biceps and triceps are an antagonistic pair.

Your hamstrings and quads muscles in your legs are an antagonistic pair as well. Check out this animation of the muscles that are active during walking. While walking is a much more complicated movement than a biceps curl (this animation also includes the iliopsoas, the glutes, and muscles of the lower leg called the tibialis anterior and calf) you can see the quads and hamstrings taking turns during the gait cycle. If you find the action of the muscles hard to follow, watch the bars of activity on either side of the walking figure.

[This animation was done for Aberystwyth University in Wales. It is not associated with the AT and Knee Osteoarthritis study that is the subject of this blog post.]

Co-contraction is when muscles that are usually antagonistic activate simultaneously. In everyday activity, co-contraction functions to brace a joint and isn’t necessarily unhealthy. But previous research has found that individuals with knee osteoarthritis often use excessive co-contraction in their leg muscles during walking and other everyday activities. In this study, the subjects with knee osteoarthritis showed significantly higher levels of co-contraction in their leg muscles than the healthy control group as measured by EMG at the start of the study.

After Alexander

In the study, the 21 participants with knee osteoarthritis had 20 Alexander Technique lessons. The lessons were spaced out over 12 weeks: they had lessons twice a week for 8 weeks and then once a week for the final four weeks.

After their Alexander lessons, the participants showed a dramatic reduction in pain: 56% less pain than at the start of the study. 15 of the study participants regularly took pain killers (analgesia) at the start of the study. 10 stopped taking medication after their Alexander lessons ended. 11 of the participants also reported experiencing less pain in other areas, including neck, shoulder and back.

The subjects also exhibited significantly less co-contraction during walking than at the start of the study. Interestingly enough, the patients did not show an increase in strength over the course of the study—the measurements of leg strength were the same before and after their Alexander lessons.

None of the subjects used any other therapy during their Alexander Technique study. When the researchers followed up 15 months after the start of the study, the subjects had retained the reductions in pain, reporting 51% less pain than before their Alexander lessons.

Evidence & Measurement

We are living in an increasingly “evidence-based” world. Evidence depends on valid and reliable measurement. Alexander teachers have learned that their experience and the experience of their students isn’t considered very robust evidence for scientists studying health and movement. However compelling the anecdote—of pain diminished, increased ease, health restored—saying, “I saw it happen” or “It happened to me,” doesn’t really count.

Most studies of the effectiveness of a particular health intervention use some kind of self-report. For the current study, the subjects filled out the WOMAC questionnaire—a common tool used to evaluate knee and hip pain, stiffness and functioning—before and after their Alexander lessons. It’s on the basis of that self-report that we can say that pain was reduced 56% by Alexander Technique lessons. This kind of self-report is quite a bit more reliable than anecdotal data, but researchers are always looking for other sources to corroborate self-report. Bias too easily creeps in.

The advantage of basic research is the chance to experiment with different types of measurement. With only 21 subjects, the researchers can hook them up to EEG to try to measure the anticipation of pain. They can measure muscle activity with EMG and put the subjects on a force platform to assess joint loading. This kind of laboratory research is much more time intensive and expensive than having someone fill out a questionnaire.

The results of the study suggest that this kind of EMG measurement is worth it in studying the effects of AT on knee pain and osteoarthritis. The researchers found that the self-reported reduction in pain was correlated with a measurable change in the subjects movement coordination—a physiological change in the activity of their musculature. It points in a promising direction, both for scientists who study human motor control and the causes of musculoskeletal pain, as well as doctors who treat knee osteoarthritis. And it might even inspire one of those large randomized control trials to see if the findings hold up in the messy world of clinical medicine.

Many thanks to Tim Cacciatore, one of the authors of the current study, for his feedback on an earlier draft of this post.

 

New Study: Alexander Technique Lessons Alleviate Chronic Neck Pain

A new study published in the Annals of Internal Medicine shows a significant reduction in chronic neck pain after lessons in the Alexander Technique.

517 patient with chronic neck pain were assigned to one of three groups. The control group received the usual care: physical therapy and prescription drugs. A second group was assigned 20 one-on-one, 30-minute Alexander Technique lessons (600 minutes total) with a certified teacher. The third group was assigned to 12 acupuncture sessions (also 600 minutes total).  On average, patients made it to 14 of their 20 Alexander lessons and 10 of their 12 acupuncture sessions. 

Patients taking Alexander Technique lessons and those receiving acupuncture both experienced more than a 30% reduction in their chronic neck pain. A 25% reduction in pain is considered clinically significant. As Time points out in their coverage of the study, physical therapy and exercise lead to only about a 9% reduction in pain.

The most important result from the study is that the benefits of Alexander lessons persisted after lessons had ended. Patients completed their Alexander lessons in about 4 to 5 months after the start of the study. A year after the beginning of the study the patients were still experiencing a reduction in pain. 

Stuart McClean at the University of the West of England in Bristol discussed the study with Reuters Health and suggested that the Alexander Technique helps “patients change past behaviors and habits and lead towards improved coping strategies and self-care.”

The lead author of the study, Hugh McPherson, explained that the results of the study were too robust to be the result of the placebo effect. And none of the participants in either Alexander Technique lessons or acupuncture sessions experienced adverse effects of any kind. “No other single treatment is known to provide long-term benefits,” Hugh McPherson told Reuters.

These kind of large, randomized studies of the Alexander Technique are rare. This is the first study of its kind to be published since the ATEAM study of back pain published in the British Medical Journal in 2008. That study found that back pain sufferers experienced significant relief from as few as 6 Alexander Technique lessons.

Such studies are confirming what Alexander Technique teachers have been teaching for 100 years: learning to improve your posture and movement habits can have a significant impact on your health.

See also: "Lighten Up" or "Pull Up"? A New Study about the Alexander Technique and Parkinson's Disease. And: That's Right: Nothing is the Solution to "Text Neck"

Body Learning Podcast: Violinist and Alexander teacher Andrew McCann on his early experience studying the Alexander Technique.

I had the pleasure of talking with Robert Rickover on his Body Learning podcast about my first experience studying the Alexander Technique. We talked about what inspired me to take Alexander lessons, some of the things I learned in those early lessons, how my Alexander lessons helped me as an aspiring violinist, and the ways in which those first lessons continue to influence me as an Alexander teacher today. 

My conversation with Robert was partly inspired by a series of posts I wrote about my lessons with my first Alexander teacher, Carol McCullough. I studied with her for a year-and-a-half before deciding to train as an Alexander teacher.  You can read the series here: http://www.alexanderand.com/blog/2014/11/18/my-first-alexander-lessons

Visit bodylearningcast.com for more conversations about all things Alexander. Robert Rickover also runs the Complete Guide to the Alexander Technique at alexandertechnique.com.

Announcing the Publication of Alexander's Way by Alexander D. Murray

This week we are celebrating the publication of Alexander Murray’s book, Alexander’s Way: Frederick Matthias Alexander In His Own Words and in the Words of Those Who Knew Him.

Alexander’s Way explores the development of Alexander’s method, using Alexander’s own writings and the remembrances of those who knew him best. It begins with Alexander’s earliest days as an actor and teacher of elocution and the Delsarte Method of Dramatic Expression in 1890s Australia. We follow Alexander to London in 1904 and the maturation of his unique, hands-on teaching in the years leading up to World War I. We observe his travels to the United States, where he wins the influential support of the philosopher and educator, John Dewey. And we witness Alexander’s remarkable skill in his final decades through the eyes of Marjory Barlow, Walter Carrington, Aldous Huxley, Margaret Naumburg, Irene Tasker and many others. Alexander’s Way is an invitation to deeply explore Alexander’s fascinating history, and a rich resource for all serious students of the Alexander Technique.

The title Alexander's Way comes from Lao Tzu, often quoted by Patrick Macdonald: "A way that can be walked/is not The Way/A way that can be named/is not The Name." As Alex writes in the Preface, "At least we have Alexander's own written words as signposts on his journey. They point the way for us, which we are free to find as best we can."

Alex and Joan Murray in their teaching studio in Urbana, IL. Photo by Philip Johnston.

Alex and Joan Murray in their teaching studio in Urbana, IL. Photo by Philip Johnston.

Author Alexander D. Murray began his study of the Alexander Technique in 1955. He and his wife, Joan Murray, trained as teachers with Walter Carrington in the 1960s and were close with many first-generation teachers, including Marjorie Barstow, Walter and Dilys Carrington, Frank and Helen Jones, Patrick Macdonald, John Skinner, Peter Scott, Tony Spawforth, Richard and Elizabeth Walker, Lulie Westfeldt, Kitty Wielopolska, and Peggy Williams. In 1967, the Murrays met anthropologist Raymond Dart, and he inspired and cooperated in their development of the Dart Procedures, an ongoing exploration of human developmental movement that has influenced Alexander teaching throughout the world. Alex and Joan have trained Alexander Technique teachers at the Alexander Technique Center Urbana since 1977. Alex is professor emeritus of flute at the University of Illinois at Urbana-Champaign and former principal flute of the London Symphony Orchestra. The National Flute Association has honored him with the 2015 Lifetime Achievement Award.

Alexander’s Way was originally published in 2010 as FM Alexander, In his Own Words, and in the Words of Those Who Knew Him. Philip Johnston edited the original edition and Katie Enders was instrumental in starting the process towards this new edition. A team of editors worked with the author to complete Alexander's Way, including Rose Bronec, Andrew McCann, and managing editor and designer, Evelyn Shapiro. We also benefited from the comments and close reading of Karen DeWig, Margie Marrs, and Malcolm Williamson. The reprints of Alexander's writings in Alexander’s Way were made possible with the generous permission of the Alexander Estate, Jean Fischer and Mouritz Press. It is the author’s hope that Alexander’s Way will inspire readers to explore Mouritz’s rich catalogue and read the excerpted works in their fuller context. 

Alexander’s Way is being sold through the Seattle Book Company for $10 US. It can be purchased on line: http://www.seattlebookcompany.com/alexanders-way/

Andrew McCannComment
Why Do I Have to Wear So Much Plaid? Habit, Change and Why Alexander Lessons Are the Way They Are

This introductory essay on the Alexander Technique and the nature of habit was originally published on the "learning" page, before a recent redesign. Rather than delete it, I thought I would post it here on the blog. Plus, any chance to show a picture of my sister wearing plaid should not be missed.

The Alexander Technique is an education in movement. It teaches us to attend to movements that are so fundamental to us that we largely take them for granted. We don't think, "This is my habit." We think, "This is who I am."

HABITS: WHY WE HAVE THEM

Our basic coordination is automatic and unconscious. A three year-old thinks about what she has to say, not how she’s standing, beginning, perhaps, with, "Why do I have to wear so much plaid?"

Our basic coordination is automatic and unconscious. A three year-old thinks about what she has to say, not how she’s standing, beginning, perhaps, with, "Why do I have to wear so much plaid?"

Most movement is habitual, meaning it is automatic and unconscious. Past the age of two, we usually don’t think about how we are moving. We don’t attend to the particulars of our gait or how we’re balancing in the chair. We simply walk or sit.

Habits free us to think about other things. My sister at three isn’t thinking about how she is standing, she’s thinking about everything she has to say—beginning perhaps with why she has to wear so much plaid.

This habitual coordination becomes the basis for later skill.

My sister at ten shows a poise at the softball plate that would make an Alexander teacher rejoice: free neck, relaxed shoulders, a lengthening back, bending at the hips and knees, not the waist—and a smile to boot. Moreover, her coordination is at the service of her larger goals. When she goes to slug the ball out of the park, she doesn’t have to micromanage her coordination. It happens for her.

This is the ideal for skilled movement—automatic and goal-oriented. And it is an ideal experienced by almost everyone: when driving, typing, riding a bike, or playing an instrument.

THE PROBLEM OF CHANGE

Poised and goal-oriented, a ten year old relies on her movement habits to slug the ball out of the park.

Poised and goal-oriented, a ten year old relies on her movement habits to slug the ball out of the park.

Unfortunately, the same learning process that gives us fluid, effective movement can leave us oblivious to the causes of our discomfort or pain. My experience as a violinist is a case in point.

The violin is a notoriously awkward instrument to hold, and by the age of thirteen, I had made it more awkward still.

I pushed my chin forward to hold the instrument, tensed my neck, rounded my shoulders, and pushed my hips forward. By college, the pattern was set. I was playing four or more hours a day and experiencing regular tightness in my wrists and forearms and more mysteriously to me, spasms around my shoulder blades.

In spite of my discomfort, I was unaware of the fact that I was doing anything wrong.

My self-image was of the heroic school of violin playing—standing nobly, violin raised. I remember being surprised to see myself hunched over the instrument in photographs. I assumed that the photographer had caught me at a bad angle. I didn’t make the connection between how I engaged the instrument and my discomfort after a day of practicing.

This lack of awareness is typical when we try to change a deeply ingrained habit.

A bad habit is still a habit. It is still automatic and unconscious. We feel pain, but don’t notice the actions that are causing the pain. We may be frustrated by our inability to perform our best, but we do not perceive the habits that undermine that performance.

An Alexander lesson is foremost an opportunity to attend to the subtleties of coordination, and learn to accurately interpret what you notice. Developing this awareness lays the foundation for lasting change.

WHAT AN ALEXANDER LESSON IS LIKE

An awkward instrument made more awkward by how it’s held: a thirteen year old contorts his body to play the violin.

An awkward instrument made more awkward by how it’s held: a thirteen year old contorts his body to play the violin.

Like many, if not most Alexander teachers, I teach the Technique out of my home, in the same room where I teach violin lessons. Because you can apply the Alexander Technique anywhere, you can teach it almost anywhere, and my studio is a familiar, comfortable learning environment. 

You don’t need to buy special exercise clothes to learn the Alexander Technique and for heaven’s sakes, you should keep your clothes on. You could learn the Alexander Technique in formal clothes, if you had to, but most students choose to wear normal, everyday casual clothing. Because we’re working with movement, wearing something that is unrestricting is a good idea. (Avoid skirts or anything too tight to move easily.)

EVERYDAY MOVEMENT

A classic Alexander lesson often begins with sitting and standing. This is not because Alexander teachers are obsessed with perfect chair comportment, but because sitting and standing are deeply habitual. When you start to notice how unconscious and automatic your habits are in sitting and standing, you gain insight into all your habits.

Sitting and standing are also relatively low stakes activities and simple. People aren't very emotionally invested in how they sit and stand, so they have more of chance of seeing their patterns objectively. Plus, when you go home from your lesson, you’ll be sitting and standing all the time—so you can start to apply what you’ve learned right away.

GUIDED MOVEMENT: PUTTING THE FOCUS ON THINKING

By 22, the pattern is set and pain problems start to emerge. Now the unconsciousness of habit masks the cause of the problem and makes change more difficult.

By 22, the pattern is set and pain problems start to emerge. Now the unconsciousness of habit masks the cause of the problem and makes change more difficult.

An Alexander lesson is hands-on, but it doesn’t involve direct manipulation of the body in the way that a massage or chiropractic adjustment does. The teacher’s hands are designed to put your focus on your thinking—on your moment-by-moment awareness and your intention to move.

One of the most important roles of the teacher’s hands is to give you feedback. Because our habits are largely unconscious, we need to raise the level of our basic awareness. This is one of the most fundamental things you will gain through lessons: calibrated, accurate awareness—that you are doing what you think you are doing.

Another important feature of an Alexander lesson is that movement is guided. For example, if you’re working on sitting and standing, the teacher will actually sit and stand you.  This is an unusual experience, but one that you rapidly get used to. The guided nature of the movement puts the focus on your thinking. You can practice noticing how you react and experimenting with different intentions, rather than worrying about translating a teacher's instructions into action. Ultimately this practice helps you change your habitual reactions to a real sense of poise and purposeful, healthy action.

APPLYING THE TECHNIQUE

Alexander lessons begin with sitting and standing, but we will ultimately work on whatever unique challenges you face in your activities. Maybe you’re a photographer and want to learn how to stop tensing your neck when you bring the camera up to your eye. Or you’re a pianist who collapses your shoulders forward towards the keys when you play. Or you’re a graphics designer who grips in your shoulder when you use the mouse. Or you’re a chef who rounds your back when you bend down to take a sheet pan out of the oven.

Whatever your habits, we will spend time in your lessons learning what  triggers these habits and how you can overcome them. By overcoming such habits, you develop a true skill for life— the ability to care for yourself, whatever challenges you face in the future.

Walk Like A Penguin

Tablet Infographic's intermittently viral advice on How to Walk on Ice:  www.tabletinfographics.com/#/ice/

After a month of record-cold temperatures here in Chicago, we’re finally beginning to thaw out. Almost as if to celebrate, an infographic appeared on one of the Alexander Technique Facebook groups with advice on how to walk on ice. On the left, the graphic shows how walking on ice with the front foot forward increases the risk of falling. Whereas on the right, there’s a penguin. Wait a second: a penguin? We’re supposed to learn how to walk on ice from a PENGUIN?

Since seeing this infographic, I’ve been doing almost nothing else but reading about penguins and watching penguin videos. Maybe I shouldn’t be taking a penguin image so seriously. But I’ve become obsessed with what it says about the state of modern humanity that an infographic about walking on ice takes cues from a penguin.

Ladies and gentlemen, Exhibit A:

This is not to diss penguins. Penguins are wonderful creatures. They have, unlike other birds, evolved to swim with extraordinary agility. Emperor penguins, to give one example, will launch themselves from the water onto the ice to avoid predators (like the truly terrifying leopard seal).

But on land, penguins are TERRIBLE at walking—penguins expend twice as much energy on land as any other terrestrial animal of the same size. Penguin legs are short and their feet are big. While longer legs would help a penguin walk more easily, it’s thought that long legs would also lose heat too quickly in the harshly cold environment in which many penguin species live. Waddling looks comical, but it turns out to be the best way to walk if you have really short legs.

In contrast, almost every aspect of the human body has evolved to facilitate efficient walking. Our long necks and tall narrow waists allow the head, ribs and hips to move independently from each other, facilitating the pleasing spiral swing of a healthy walk. The curve of our lower backs—the lumbar spine—positions the torso directly above our pelvis and legs, rather than pitching our torso forward, like in our closest cousin, the chimpanzee. Our human pelvis—the illium—faces sideways and our knees are angled underneath our hips. This allows us to balance our weight on one leg while keeping our trunk upright. And we have a large heel bone—the calcaneus—and well-supported arches, that allow us to roll through the foot and push off the front toes.

Human beings as a species may not be as adept at swimming as penguins, but we are much, much better at walking.

Human adaptations for efficient walking. This image has been modified from Lieberman's The Story of the Human Body to include, um, a penguin.

It’s particularly bizarre to look to penguins for help with staying stable on ice because there’s so little consequence for a penguin when they slip. It’s one of the delights of watching penguin blooper reels that they fall without injury—even from a significant height. And a penguin falling on its belly introduces another form of locomotion—tobogganing

In turns out that an animal’s size and its danger of injury in a fall are linked. An animal the size of a mouse, amazingly enough, can fall any distance without risk of significant injury. My 15 lb cat has swiped a bug off the ceiling from a high shelf and then leapt the 10 feet to the ground with little concern. A 40 to 80 pound emperor penguin can trip without fear. But adult humans aren’t so lucky. Any animal above 100 kg (220 lbs) will be at serious risk for injury from a fall of just its own height—picture a horse, cow or elephant. While adult humans weigh less on average than 100 kg, we are quite tall for our weight. Adults can break bones just from tripping, and falls are the leading cause of fatal and non-fatal injuries in seniors above the age of 65. 

To help keep us from falling, we have rescue (or righting) reactions. These are automatic—though most likely learned—reactions to keep an animal from overbalancing. Rescue reactions have been studied in many animals—cats and dogs seem to be the popular laboratory preparations. (Even bats have been studied—though since they sleep upside down, they do not share the same righting reactions common in other mammals.) Rescue reactions in humans are very robust, triggered by information from multiple senses: not just the inner ear (vestibular system), but from the eyes, head balance, sense of body position (proprioception) and touch (such as the contact of the feet on the floor). There are many rescue reactions, from staggering and bracing the legs, to sweeping the arms. “If the limbs are trapped, the trunk will be moved so as to take the impact on the shoulders,” balance researcher TDM Roberts tells us. “The movements are organized as though to avoid impact with the skull at almost any cost.” 

Rescue and righting reactions are studied in the laboratory in many ways, including putting subjects on a "tilt-table." The image is from TDM Roberts Understanding Balance, p. 163.

In December of last year, I experienced my rescue reactions when I stepped on a sheet of black ice walking home from a gig. At the moment my foot began to slip, I felt my arms shoot out and my legs brace of their own accord. I stayed on my feet. I felt particularly lucky because I was more encumbered than usual. I was carrying my violin on my back, my courier bag over my shoulder with my girlfriend’s laptop in it, and a grocery bag with a pyrex that had contained my dinner. Disaster averted.

So if we’ve evolved to walk well and we have well-ingrained rescue reactions, why do we need a tutorial on how to walk on ice? Obviously, winter is dangerous and ice is slippery. But winter is dangerous partly because our built environment is so safe.

Two winters ago, Kyra was leaving the morning after one of those wintry-mix storms that leaves equal parts snow, slush and ice on the ground. She strapped her cello to her back and stepped out on to the front porch with extra caution. But when she reached the stairs, she went flying, not because she wasn’t prepared for the slippery stairs, but because she didn’t expect the hand-rail to be covered in ice as well. She was lucky. Though she landed on her chin, she suffered only minor bruises. She also provided another instance towards a possible hypothesis: that musicians modify their rescue reactions to protect their instrument first, their own heads second.

My near slip in December was a similar point. The black ice was hidden in the shadow of a street lamp. The rest of the sidewalk was clear. The situation was only half-safe, but I expected it to be completely safe, so I nearly fell. This is true of much of our modern environment: an expectation of safety brings with it inattention and complacency. (There’s a similar effect in roadway construction—boring flat roads are more dangerous than dangerous swervy roads because people drive more safely on dangerous swervy roads.) 

Is there one best way to walk on ice? Tutorials on the ‘correct way to move’ are a byproduct of standardization, only sensible in a manufactured landscape. Better to think of unlearning our habits—trading the one wrong way not for the one right way, but for the ability to choose from many possibilities.

With enough time, such modern conveniences can actually change our bodies and our reactions. Researchers in Europe have found that seniors who have lived their lives in cities with cobblestone streets are less likely to fall than seniors who live in cities with smoothly paved streets. Cobblestones are more precarious, they demand attention and adaptability.

Our habitats create our habits. Before studying Alexander, I walked as if still slumped in a classroom chair: head forward, upper-back leaned back, hips forward as if about to “limbo.” Many people walk like this, or in some other strained way. 

The problem with such habits is that they it become our default way of moving, whether the sidewalks are icy or the sidewalks are clear. Looking back on my near fall in December, I wonder: If I still walked with my hips pushed forward, would I have slipped on the ice? It's hard to say. But walking with your hips forward—already out from under you—is a fall waiting to happen.

So is there one best way to walk on ice? Tutorials on the “correct way to move” are a byproduct of standardization, only sensible in a manufactured landscape. Better to think of unlearning our habits—trading the one wrong way not for the one right way, but for the ability to choose from many possibilities.

I went for a walk this morning down to Lake Michigan, about a mile from my apartment. For most of the way I had little choice but to follow the sidewalk. Trucking along the cement ground, I could experience simple walking, my bipedal inheritance in action: the free balance of my head on my spine, the swing of arms and torso over my hips. I could experiment with walking that was a gentle fall forward, or mix it up and bring my attention to the thrust of my toes from behind.

When I got to the lake, though, I left the sidewalk. Even in flat Chicago, the parkland is gently rolling. The ground is uneven. Most all of the snow had melted from the slight rise overlooking the lake. My feet sank into the muddy ground at odd angles. Though I was still walking, my gait was as changeable as the terrain—here stepping around a puddle, here high-stepping my knees over an unmelted chunk of snow, and once, yes, swaying from foot to foot over a patch of ice, like a penguin.


Thanks to Alexander Technique teacher Jennifer Roig-Francolí for sharing the How to Walk on Ice infographic. I turned to Daniel Lieberman's The Story of the Human Body for a guide to human adaptations for walking. The relationship between animal size and risk of injury in a fall comes from Steven Vogel's Life's Devices: The Physical World of Plants and Animals. Rescue reactions are described in TDM Robert's Understanding Balance. Studies on falling on the cobblestone streets of Europe came from the Blakeslee's The Body Has a Mind of Its Own. And the tidbit about drivers driving more safely on more dangerous roads is found in Tom Vanderbilt's Traffic.

Start with Meaning: A Conversation with Adam Marks about Teaching Public Speaking to Musicians

Adam Marks' public speaking class was one of the highlights for me of last summer’s Music in the Mountain’s Conservatory. I was teaching the Alexander Technique to the festival students, and Adam not only invited me to sit in on his class, but encouraged me to help the students apply the Alexander Technique when they practiced speaking in front of the class. Since Adam and I are both returning to teach at the 2015 Music in the Mountains Conservatory, I asked him to talk with me about how he developed his public speaking program and how it can help musicians enhance their performances.

Pianist Adam Marks, practicing what he preaches.

Pianist Adam Marks, practicing what he preaches.

Adam: We were raised in an era of very strict conventions around concerts. This is how to begin a concert. This is how to transition between pieces. And we entered our professional lives just as things were changing quite a bit. We’re at the fulcrum of a very interesting shift.

Andrew: Especially in chamber music, it’s rare to see a group perform without one of the performers speaking from the stage. It seems like one of the things that you’re trying to do in your public speaking classes is to really enhance the entire performance.

Adam: If you start by saying to a group of musicians, "Who here has been to a concert where somebody talked and it was awful?” Everyone will raise their hand. And the bottom line is that if you have nothing to say, you shouldn’t say it. Speaking shouldn’t just fill time or check off a box.There’s an opportunity to bridge a gap here. To share some of your self.

Andrew: What drew you to explore the public speaking aspect of being a musician?

Adam: I had trained in speaking. I did competitive speech and debate starting in middle school. And then I took courses and was competing pretty regularly in speech and debate in high school. And when I was at Brandeis for my undergraduate, trying to make myself a legitimate pianist—whatever that means—I was also getting a minor in theater.

At the end of my college time, I started to play contemporary music. And I realized that it required a bridge to the audience if you wanted it to appeal to anyone but a “new music audience.” And they didn’t necessarily need help to understand, but permission to engage.

Andrew: It’s so common to go to a new music concert and have a performer give a semi-technical description of, say, metric modulation in the Elliott Carter piece they’re about to play. But you seem to steer away from technical explanations.

I started to map out the experience that I wanted to have on stage. I would think about the performance as a whole: how I wanted my time to be. I’m responsible for that time. And I realized, the more you put these things together—speaking and performing—the stronger they both are.

Adam: There’s never a completely homogenous audience. So I always say: “Figure out things that will actually make sense to everyone.” And usually that means starting with your journey, your engagement with what makes Carter Carter, whether in that metric-modulational way or not. Because for the person who knows everything about metric modulation, you can give them a new way to listen and engage. And for the person who has no understanding of metric modulation, you can suggest where to put their ear and how to think about the music.

Andrew: What do you find among the students you’ve worked with: is there a sense of buy-in to the idea of talking from the stage or is there resistance?

Adam: People have so much fear surrounding public speaking. I try to remove some of those fears as early as possible. I like to start from the place of: “You don’t have to do this in public.” You have to learn how to do this for yourself and for this room. And we take some of the pressure off of the performance aspect of it.

I mean, if somebody were coming in to study violin for the first time you wouldn’t begin with, “Let’s start by imagining a recital in which you play all of the Bach partitas.” You wouldn’t. You would say, “Let’s start with some fundamentals and build some skills you can eventually take to the stage.”

Andrew: One of the things that interested me in watching the class was that you didn’t start with techniques like, say, voice projection or diction. You started with meaning.

Adam: If you start very technically, everyone gets stuck thinking, “Here’s the mechanism I must engage with.” But if you start with meaning, you connect to the musical work we inspire students to do. If we’re being good musicians, good chamber musicians in particular, we have to be able to articulate our ideas. And if we start with what we already have, use those skills first and learn how to adapt them for an audience, it’s far more empowering. The chance of success goes way up.

And I also find that people will forgive style if the content is meaningful, and not the other way around.

Andrew: When I’ve watched you speak at a concert, it seems clear to me that you know what you want to say, but it still sounds extemporaneous. In the class, the students were developing very short and succinct statements or stories—maybe 30 seconds. But you didn’t have most of them speak extemporaneously—most of them memorized their talks. Is that a distinction between being a beginner at public speaking and being more experienced?

Adam. Yes, I think so. Actually, with anyone—at any level—knowing how you end is crucial. So I’ll usually memorize how I want to end and really practice that, because it’s so crucial to know how to stop. I think that’s where a lot of people fail. Knowing how to stop and how to transition is the most important thing to anchor.

We speak every day. It’s our primary means of communication. We get nervous when it becomes performance. So when we figure out everything around the presentation before dealing with the technical, we tap into that everyday experience as opposed to creating an artifice. And that’s a perfect connection to Alexander. Alexander is about finding the natural movement and releasing the unnecessary things that we have built up to create a more natural flow in your body.

In terms of what we’re doing with students, when you’re dealing with something that is so brief and so short, the beginning and the end are the same. It’s something that is doable. It’s concrete. You can rehearse it and they can deliver it.

They’re also developing their identities of self at that age. So as their voice gets stronger, as their persona on stage becomes more vivid, there’s more room for flexibility. So if a student were doing something longer, and they had maybe three points they wanted to get out, I would focus them on learning the three points, and then memorizing the last sentence.

Andrew: Something that had never occurred to me until I sat in on your classes was that talking from the stage could transition into the performance itself. You really emphasized that the ending of the talk could match the energy of the next piece on the program.

Adam: That came from my own exploration. When I first started speaking at my concerts, I would have all this energy. I really like talking spontaneously. And I would have all of these ideas and my mind would be racing and then I would sit down at the piano and I would think, “Wait, I have to be calm and still now.” It would be very very difficult.

So I started to map out the experience that I wanted to have on stage. I would think about the performance as a whole: how I wanted my time to be. I’m responsible for that time. And I realized, the more you put these things together—speaking and performing—the stronger they both are.

Andrew: As much as you start with meaning, that doesn’t mean that you neglect technique. And I think that this is one of the connections between how you teach public speaking and how I approach teaching Alexander, that the physical coordination is there in support of the meaning, the need to express something.

Adam: Yes, I mean, we speak every day. It’s our primary means of communication. We get nervous when it becomes performance. So when we figure out everything around the presentation before dealing with the technical, we tap into that everyday experience as opposed to creating an artifice. And that’s a perfect connection to Alexander. Alexander is about finding the natural movement and releasing the unnecessary things that we have built up to create a more natural flow in your body. Am I right?

Andrew: Yes. And just as there’s a widespread fear of public speaking, there’s also a widespread policing of posture. So it was exciting to be able to address how the students were, as Alexander teachers like to say, “using themselves” when they were up speaking before the class. And make that a hopefully more positive experience.

Adam: You brought a vocabulary to the classroom that I’ve never gotten to work with in real time with students. I do address the physical on a very basic level. For you to have your laser-cat eyes on that kind of stuff and to help people release in a very physical way, it just changes things so much. And I felt that what you were doing was so complementary.

Andrew: Yes, there was this basic compatibility of approach. I mean, if you take a student standing in front of the classroom, preparing to speak: head forward, shoulders rounded, and hips cocked at an angle. This is clearly not a great place to connect with people as a speaker or as a performer.

Well, why do they have that pattern? The typical way that people talk about it is that there’s apathy, they’re checked out as a teenager. It’s this typical teenage angst.

But it’s not really: It’s a lack of organization in the body, and it’s a lack of organization that comes from sitting all day, and becoming the shape of the furniture that you sit in—or even the shape of the instrument that you play.

You can’t really change the shape that you see by just “standing up straight.” They need to really perceive where their support is coming from. They need to notice how they might be interfering with their breath, that when they let the breath recover, now they have the air they need to speak. But it’s not something that’s put on. It’s an experience of the coordination that supports what they have to say.

Adam: It’s supporting something greater. I think that everybody needs a reason to do something new or to do something different. And in a classroom setting, they can get feedback about what’s changing about their presentation. Physically, verbally, musically. The more we unite all of those things, the better.

People aren’t going to a festival to learn how to have better posture, or learn how to speak in public. They’re learning how to be better musicians. And these things help you be better musicians. When they realize that, that’s where the buy-in comes from. But it takes time. It’s a luxury to have a couple weeks.

Andrew: Yes, and like you said at the beginning, the speaking connects the performers to the audience. I can’t even tell you how many audience members came up to me after the final concert at Music in the Mountains last summer—I think one literally had a tear in her eye—and said, “The students! They’re so well-spoken!”

Praised as an “excellent pianist” with “titanic force” (New York Times), Adam Marks is an active soloist, chamber musician, and educator. He has appeared as soloist with the Mission Chamber Orchestra, Manchester Symphony Orchestra, the National Repertory Orchestra, and at notable venues including Salle Cortot, Carnegie Hall, Miller Theatre, Logan Center for the Arts, Millennium Park, Ravinia, and the New World Symphony Stage. He was a laureate of the 2008 Orleans Competition for contemporary music in Orleans, France. Recent performances include recitals in Brazil, Singapore, and Croatia. Highlights of the 2014-2015 season include a residency with Yale University composers, appearances with the Pittsburgh New Music Ensemble, and a return to the Dame Myra Hess Recital Series and live broadcast on WFMT. Adam is currently appearing on stage in Fiasco Theatre’s critically-acclaimed revival of Into The Woods at Roundabout Theatre off-Broadway. To learn more about Adam, visit adammarks.com.

The Music in the Mountains Conservatory is a summer festival for high school and college-aged classical musicians. It runs from July 12 to August 1, 2015. The application deadline is March 16, 2015.

Related posts from the Alexander & blog: Finding the Story and When a Slump Becomes a Slouch: How Much Should We Read Into Posture?

Sometimes Not Breathing Is Believing

Technically, this pigeon is playing the English horn. [Artist unknown]

Technically, this pigeon is playing the English horn. [Artist unknown]

When I was training as an Alexander Technique teacher, Vivien Mackie—the well-known Alexander teacher and cellist—came to Urbana to visit the Murray’s training course. While in town, she gave a master class to undergraduate musicians at one of the local universities. I had never seen an Alexander teacher teach a master class, so I decided to sit in and watch.

One of the students was an oboist. The oboe can be richly beautiful. But this young man would puff himself up like a pouter pigeon before he began playing, and the sound that emerged from his instrument was harsh and laser-like—I imagined it peeling the varnish off the floor of the stage.

Vivien Mackie let him play for a bit and then had him stop. “I want you to try something, just as an experiment,” she said. (I’m paraphrasing.) “Just try once to begin playing without taking a breath.”

He looked a little confused, but nodded congenially. He turned back to his instrument, puffed himself up with a big breath once again, and resumed sandblasting the stage to a smooth sheen.

Vivien stopped him again. “Just try once playing without taking a big breath.”

He nodded, turned again to his instrument, puffed himself up with a big breath, and started power-washing the grooves in the floor with his sound.

Vivien interrupted him again. “I know it sounds crazy,” she said. “But just once, for me, try playing without taking a big breath.”

He nodded, and this time, he finally took no noticeable breath before beginning to play. The most beautiful sound poured from his instrument. I don’t know who was more astonished: him or me.

Many years later I had a similar experience with a professional flutist. She had taken a series of Alexander lessons with me before and was back for a refresher. This time she was in the midst of preparing for an orchestra audition.

She had to prepare a long list of orchestral excerpts—20 second to 1 minute long selections of some of the most difficult music written for her instrument. Each lesson would begin with some classic Alexander—reminders to find her length and freedom of movement in relatively simple activities. And then she would take out her piccolo and we would look to find the same freedom of movement when she was playing through each excerpt.

I remember one lesson in particular. She decided to play through a piccolo excerpt from the Lieutenant Kije Suite by the Russian composer, Sergei Prokofiev. It’s a jaunty little melody that begins in a reasonable register and then suddenly leaps up an octave and is very, very high.

When she reached the octave leap, several things happened at once: she pushed her chin forward towards the piccolo, tensed her neck, and blew about twice as much air through her instrument as she had before.

The first half of the melody sounded great. After the octave leap, it wasn’t as good. The notes either sounded shrill or didn’t really speak. She told me that the piece had never been a problem for her when she was playing with full orchestra in concert. But as an audition excerpt, it had become her bete noire.

The first thing I asked her to do was pay attention to her head balance when she played through the excerpt. It is often the case that releasing tension at the head and neck will make a difficult moment much easier. She was surprised to discover that she had been pushing her chin forward and tensing her neck at the moment the music leapt an octave. But the awareness didn’t help her much. Even with some practice, she couldn’t really do anything about it. The Prokofiev was already giving her plenty to think about it—adding the thought of a free neck was one thought too many.

A lot of musicians assume that learning the Alexander Technique means playing their instrument with perfect posture. And if you want to police these musicians’ posture, you could have faulted the oboist for puffing up his chest, or the flutist for tensing her neck. But these actions were really symptoms of their beliefs about what was necessary to play their instrument in that moment.

While we had been working on her head balance, I noticed that she was still pushing a ton of air through the instrument when she got to the octave leap. Now this is a tricky moment in teaching. I don’t know how to play the piccolo. And I don’t know if you need a lot more air to leap an octave on the piccolo. But I figured it was worth exploring.

So I said, “Just as an experiment: this time, when you play through Mr Prokofiev here, don’t change anything when you get to the octave leap. Just use the same amount of air.”

And she did. And when she got to the moment, the music leapt out of her instrument: the higher octave was just as clear and just as musically jaunty as the lower octave. And without the drive to push so much air through the instrument, she didn’t push her chin forward or tense her neck.

A lot of musicians assume that learning the Alexander Technique means playing their instrument with perfect posture. And if you want to police these musicians’ posture, you could have faulted the oboist for puffing up his chest, or the flutist for tensing her neck. But these actions were really symptoms of their beliefs about what was necessary to play their instrument in that moment.

The oboist was young and relatively inexperienced. He believed that he needed a ton of air to play the oboe. With Vivien Mackie’s help, he was surprised to discover that he not only didn’t need to take a big breath to play, but that his sound quality improved enormously when he took no noticeable breath at all.

My flutist student was a much more experienced player. She knew how much air was required to play the Prokofiev and could play it without much concern in a full orchestra. The tension in that moment came from the pressure of preparing for an audition—the need to nail the part, get it right the first time.

Both of these experiences are satisfying as a teacher. Look, the experiment worked! And it's tempting to say that such magic moments are enough. Now and forever more, these musicians will play with their new found ease! What complicates (and also enriches) the process, is that it's not just a matter of changing a movement pattern, but of changing a belief about what is possible. It's one thing to experience that you can get more from doing less. It's another thing to believe it.

 

If Evolution is to Blame for Back Pain, Why Do We Even Bother?

Alexander Technique students often experience relief from back pain through lessons. But if evolution is to blame for back pain, are we just deluding ourselves?

One day in the spring of my final semester in college I was in a hurry to check my mail between classes. I started running from the conservatory to the mailroom and after barely half a block, had to stop because my lower back hurt. I am tall and slim, much like my dad. When I was growing up, he suffered from periods of lower back pain, so even though I wasn’t particularly active or fit in college, I didn’t think, “Boy, I need to get in shape.” I thought instead, “Well, I guess it’s my build.”

This way of thinking about pain and discomfort is pretty common: my problem isn’t because of how I do things, but because of who I am. When it comes to back pain, this way of thinking has gotten a boost from some evolutionary biologists. They argue that evolution is to blame for back pain.

I’m glad I didn’t know about this line of thinking back in college. If I had, I wouldn’t have just thought: “My back hurts because of my build.” I would have thought, “My back hurts because I’m human.”

What do evolutionary biologists mean when they say that evolution is to blame for back pain?

In popular culture, it’s common to think of evolution as a perfecting process, where our species just keeps getting better and better all the time. But evolution—at least the natural selection kind—is a blind process. Species don’t get better or worse: they adapt to what is. When the environment changes, species either evolve over time to fit it or don’t. Most importantly, new adaptations in a species are constrained by what has come before.

For example, in the recent Cosmos series, Neil deGrasse Tyson explains that eyes originally evolved in water. When animals emerged on land some 375 million years ago, evolution couldn’t start over and “design” eyes for the land. Terrestrial eyes had to evolve from aquatic eyes: and so humans, to give one example, can’t focus on something that is held up right in front of our face. Who knew?

Such constraints on evolution explain the origins of back pain in humans. Our primate ancestors were quadrupeds. Our upright stance and bipedal locomotion are recent adaptations. There just hasn’t been enough time for our backs to have adapted to being upright.

Bruce Latimer, an anthropologist and anatomist at Case Western University, makes this argument to LiveScience. "We're the only mammals that spontaneously fracture vertebra," he says, comparing the spine to a stack of cups and saucers (the cups are the vertebrae and the saucers are the intervertebral disks). He continues:

Then take a book like a dictionary and put it on top. This is the head. If you are really careful, you can balance it — otherwise there's a lot of porcelain on the ground… Then imagine taking this and putting in all the curves that you naturally have in the spine. I could give you all the duct tape in the world, and you still couldn't possibly balance it.

Latimer is featured on Neil Shubin's wonderful PBS series Your Inner Fish. (It is currently streaming on Netflix.) PBS has made a three minute clip featuring Latimer available on youtube:

If our backs are an "engineering nightmare" (strong words!), does this mean we can’t do anything about back pain? If my Alexander students experience relief from back pain in their lessons, are they just deluding themselves?

In his 2013 book, The Story of the Human Body: Evolution, Health, and Disease, Harvard evolutionary biologist Daniel Lieberman suggests that back pain might not be as inevitable as it seems.

Bipedalism first evolved some 6 million years ago, when our hominid ancestors, Ardipithecus and Australopithecus, first stood upright. Approximately 2 million years ago, the earliest human-like hunter-gatherers emerged, including Homo erectus. Modern humans, Homo sapiens, evolved some 200,000 years ago. Lieberman notes that there are important anatomical differences in the spines of Homo sapiens and Homo erectus, specifically one less lumbar vertebra in Homo sapiens, which implies that there was evolutionary pressure selecting for stronger spines in modern humans.

To Lieberman, two predominantly cultural changes help explain the high incidence of modern back pain: the agricultural revolution, 11,000 years ago, and the industrial revolution, some 200 years ago. Lieberman argues that back pain is a “mismatch disease” that results when our evolved adaptations fail to match the demands of our modern, cultural environment. Our hunter-gatherer ancestor’s lives were neither as rigorous as early farmers nor as sedentary as our contemporary lifestyle:

He writes:

No one has yet quantified the incidence of lower back pain among hunter-gatherers, but foragers rarely sit in chairs, they never sleep on soft mattresses, they often walk while carrying moderate loads, and they also dig, climb, prepare food, and run. They also don’t engage in hours of strenuous work such as hoeing or lifting that repetitively load the back. In other words, hunter-gatherers use their backs moderately—neither as intensively as subsistence farmers nor as minimally as sedentary office workers…

He refers readers to Michael Adams' model of lower back pain risk, then continues:

A healthy back requires an appropriate balance between how much you use your back and how well your back functions. A normal, fit back needs to have a considerable degree of flexibility, strength, and endurance, as well as some degree of coordination and balance. Since people who are mostly sitters tend to have weak and inflexible backs, they are more likely to experience muscle strains, torn ligaments, stressed joints, bulging disks, and other causes of pain if and when they subject their backs to unusual, stressful movements.

Lieberman’s account fits with my experience of back pain at the end of college. Like many college-aged Americans, I had been sitting everyday for hours upon a time for a decade and a half. When I sat in class I leaned back with my weight resting on my tail bone and my lower spine in a c-curve. Yes, my back hurt, but not enough to send me to a doctor. Even so, years later, Joan Murray (the co-director of the Alexander Technique Center Urbana where I trained as an Alexander teacher) would tell me that when we met, my lumbar spine was almost kyphotic (that is, the normal curve of the lower back had been reversed).

First in my Alexander Technique lessons with Carol McCullough and later during my training with the Murrays, I re-learned my basic coordination. In the process, my lower back strengthened and my shoulders broadened. I developed greater comfort in a wider range of positions. I still remember the excitement when I developed enough mobility in my hips and knees and length in my back to squat with my heels on the ground. And the lower back pain went away. I’m more comfortable in my body now as I approach forty than I was at twenty-two, about to graduate from college.

The process wasn’t magic. I relearned how to move and gradually reversed a condition brought about by neglect. And my renewed coordination requires maintenance. But since I make my living from teaching the Alexander Technique and performing on the violin, I'm not tied to a chair the way I was in school. That said, certain situations are more challenging than others.  As I learned the hard way, when I’m performing eight shows a week as a violinist in a pit orchestra, I need to make sure that my setup (my chair, my stand, my violin chin rest, etc) makes healthy coordination possible.  

The evidence from evolutionary biology does suggest that humans have a risk for back pain. But Bruce Latimer and others overstate their case when they blame evolution for back pain and call the spine an “engineering nightmare.” A risk of pain doesn’t mean that we are destined for pain. If we let it, our modern school and work environments will leave our backs uncoordinated and weak. But we don’t have to become victims of sitting all day. With practice, we sedentary moderns can relearn how to move so that we not only avoid pain, but experience real joy in movement. After all, something else evolved along with our dodgy backs—our minds.

Daniel Lieberman discusses back pain as a mismatch disease in the chapter 12, "The Hidden Dangers of Novelty and Comfort" in The Story of the Human Body. The PBS series Your Inner Fish was originally a book, also by Neil Shubin. The most significant study of the Alexander Technique and back pain was published in the British Medical Journal in 2008 and has been summarized here.
 

Tone Poem

I’ve been struggling for the last few days to write about muscle tone. Muscle tone is all important in the Alexander Technique—but how to evoke it? Make it palpable in writing?

Technical writing is technical. From Tim Cacciatore, et al’s “Improvement in Automatic Postural Coordination Following Alexander Technique lessons in a Person with Low Back Pain.”

The AT aims to improve the “use of the self” by teaching conscious control of tonic muscular activity in relation to actions and events through 2 main principles: (1) the prevention of undesirable increases in tonic muscular activity that are triggered by actions and events (“inhibition”) and (2) the use of conscious, spatially directed motor commands to influence tonic muscular activity (“direction”). Alexander claimed that these principles, when integrated, achieve and maintain a definite, balanced organization of tonic muscle activity that underlies efficient coordination.

Tonic muscle activity. Muscle tone.

What is muscle tone? Here's a trick from chefs for judging the doneness of steak: find the fleshy place between your thumb and first finger. Relax your hand and touch the spot. Rare. Bring your thumb against the side of your palm so that the muscle tones. Medium rare. Grip tightly until the muscle bulges. Well done.

Is muscle tone like musical tone? E. Geoffrey Walsh tells us:

The word ‘tone’ has the same root as the word ‘tune’, and the tension in the tendon of a muscle can be likened to that in the string of a guitar. Based on these considerations, muscle tone in the resting state can be measured by applying rhythmic forces and observing at which rate of application the motion is the greatest. This is the ‘resonant frequency.’ Tone is related to the square of the resonant frequency.

Though I am a musician, I don’t really know what to make of this. Each day I take the violin out if its case. I tighten the hair on the bow—not too tight, not too loose. I check the A against the tuner, then tune the other strings, each a perfect fifth. Two strings vibrate together in a ratio of 3:2. When perfectly in tune—not too slack, not too taut—the resonance should fill the air. No audible beats.

Muscle tone has a history. Kyra was a competitive gymnast for five years. Watch a gymnast dismount: feet driving into the mat, knees locked, hips pitching forward, lower back arched more than it seems possible to be arched. Not just muscle toned—muscle taut. It has been 18 years since Kyra last competed, but the pattern is still there. Yesterday she practiced letting the pattern go. She asked her legs to let go of her low back, to stop pulling it forward into an arch. Somewhat surprisingly they agreed. They let go. Enormous relief, but very disorienting. She both felt more stable and like she might not be able to stand. She went to bed but her legs wouldn’t let her sleep. They felt underemployed. They were looking for something to do. Something to hold on to.

Muscle tone is a state of being. Awake. Asleep. It was the fall of my first year training to become an Alexander Technique teacher. Brinn was only a few months old. His mother, Katie, was in her third year of training and he often came with her to class. I was twenty-five and clueless about babies. One day it was time for Katie to get some work from Joan, so Katie passed Brinn to me. He started out alert, looking around, springy in his body. Where had his mom gone? He could still see her so he started to relax. It was late in the morning. I felt his body start to soften. He rested his head on my shoulder and fell asleep. What chemical is released by the feel of a sleeping baby against your shoulder? I wondered. I was soothed as well. (Stacy came in the room, whispered to Joan: “I’ve never seen Andrew so quiet.”)

Muscle tone is mind. There are so many possible stories. Here's a simple one: I’m visiting the Murrays for a teacher refresher course last June—continuing education, as it’s called. I’m receiving a table turn: I’m lying on my back, head supported on a book, knees up. I’m happy to be a student again—get some work, not just give it. Margie lifts my right leg off the table and I let her have it. It’s relaxed in her hands. Then Joan calls from downstairs. In five minutes we’ll be assembling for the morning demonstration. Margie laughs. Though my leg still rests in her hands, though I haven’t moved it an inch, I’ve taken it back. My leg has filled with sudden purpose. It is all readiness: Time to get up. Time to go to work.

Muscle tone is all of these things. Working with my Alexander students, we discover muscle toned to tautness, hard coils of rope from years of working too hard. We find muscle so underused it has grown slack. Above all, we find muscle without mind. Muscle that is a mystery to its mover. And so we work to wake up. Ask the necessary questions. Give instruction. Redistribute the load.

Do you see the importance of muscle tone? How the work is more than posture and positioning? More than a collection of parts in the right relationship: 90° from here to here, 135° from here to here. More than alignment? It is about fully inhabiting your being. It is about being completely alive.

Tim Cacciatore study, "Improvement in Automatic Postural Coordination Following Alexander Technique Lessons in a Person with Low Back Pain," was published in the journal Physical Therapy, June 2005. E. Geoffrey Walsh's thoughts on muscle tone come from the Oxford Companion to the Body, 2003.

Transformers: What Changes when Our Words Change?
"Bump, bump, bump, on the back of his head..." Original decoration by Ernest H Shepard from A.A. Milne's Winnie-the-Pooh.

"Bump, bump, bump, on the back of his head..." Original decoration by Ernest H Shepard from A.A. Milne's Winnie-the-Pooh.

My sister has been having a series of refresher Alexander lessons with me and after the holidays, she told me this story. For Christmas, her four year-old son, Griffin, was given a Transformer. I grew up with Transformers, but if you don’t know, they’re a line of toys that change from a robot to, say, an airplane and back again. I didn’t realize that they made Transformers for four year-olds, but apparently they do. Even so, the first time Griffin tried to transform his Transformer, he got stuck, tried to force a part, and then broke it. This was quite traumatic and after my sister consoled him (and his dad fixed it), she said to him, “Okay, next time, when you feel yourself trying to force it, just pause, and we can help you work it out.” As soon as she said this, she later told me, a light bulb went on in her head and she thought, “Wait a second, that’s what we’ve been working on in my Alexander lessons!”

It is often the case that the stories that help clarify the Alexander Technique are either about four year-olds or for four year-olds. This is probably because four year-olds are wrestling with impulse control for the first time and when we’re trying to change our habits in an Alexander Technique lesson, we, too, need to wield some control over our impulses. Our habits of mind and movement usually just have their way with us and it’s only by pausing and taking some time that we have any hope of experiencing positive change.

I’ve been dwelling recently about the language we use to explain the Alexander Technique. Stories about children and children’s stories are very helpful in teaching, but I also feel a contrary impulse, which is to communicate the significance of the work. To that end, a more technical language might have more impact, at least to a certain audience. “Stopping and thinking to change our habits” doesn’t sound nearly as rigorous as “Practicing executive attention to facilitate change in automatic postural coordination.”

I think this desire to communicate the importance of the Alexander Technique has been there since the beginning.

Stories about children and children’s stories are very helpful in teaching, but I also feel a contrary impulse, which is to communicate the significance of the work. And to that end, a more technical language might have more impact, at least to a certain audience. ‘Stopping and thinking to change our habits’ doesn’t sound nearly as rigorous as ‘Practicing executive attention to facilitate change in automatic postural coordination.’

For example, when my sister counseled Griffin to “pause,” she was asking him to practice what Alexander teachers call “inhibition.” F.M. Alexander first began using the term shortly after he had moved to London from his native Australia in 1904. Before then Alexander had been primarily known as an actor and a teacher of elocution and the Delsarte Method of dramatic expression. His work gradually came to the attention of a series of medical doctors, first in Sydney, then in London, who would send their patients for lessons with Alexander. It was after meeting Dr Robert H Scanes Spicer in London that Alexander began using a more technical language to describe his work, such as “antagonistic action,” “mechanical advantage,” “kinaesthesia,” and “inhibition.”

Alexander’s use of the term inhibition has something in common with the great American psychologist, William James (see the chapter on Will in his Principles of Psychology). Yet it's Sigmund Freud’s psychoanalytic conception of inhibition that has gained ascendency in our culture. Even though Freud has been out of fashion for the last several decades, many people still associate the idea of inhibition with lack of spontaneity, repressed emotion, and sexual dysfunction, none of which are in any way goals of studying the Alexander Technique.

Alexander may have been uniquely unlucky with the term inhibition. It is both one of the most important concepts in the Alexander Technique and perhaps the most easily misunderstood—and not just in the Freudian sense.

When I was first starting out as a teacher over a decade ago, I loved using the more technical terms. Since I didn’t really know what I was doing, I hoped that my erudite language would impress my students. I had one student who became particularly enamored with the idea of inhibition, which he misconstrued to be a general state of disassociation. And while I was trying to work with him on staying aware and light in his body, he would just check out, growing more and more disconnected, and heavier and heavier in his body.

It’s likely, of course, that if I had had more practical skill as a teacher I could have avoided the problem. But I sometimes wonder how much my language encouraged the misunderstanding. It’s easy to think that to inhibit means to repress or disassociate. It’s harder to misunderstand more colloquial phrases, like “take time,” “leave yourself alone,” or simply, “pause.”

This doesn’t mean that I think we should ignore more technical language. I recently spent time working through a new study about the Alexander Technique and Parkinson’s Disease. One of the things I appreciate about scientific writing is the attempt to speak very precisely. Since I’m a teacher and not a trained scientist, a lot of the writing can be above my head, but when I am successful in making sense of it, I find it clarifies my thinking. And it helps me connect the act of teaching with the research enterprise of understanding how we think and move.

It may very well be that as the sciences progress, we will develop a shared language that is both precise and accessible. Until then, I will continue to collect children’s stories, since they can be so helpful in keeping my students from wandering down the wrong path. Like this, the very beginning of Winnie the Pooh:

Here is Edward Bear, coming downstairs now, bump, bump, bump, on the back of his head, behind Christopher Robin. It is, as far as he knows, the only way of coming downstairs, but sometimes he feels that there really is another way, if only he could stop bumping for a moment and think of it.

 

This post was revised and expanded on Sunday, Feb 22. To learn more about Alexander's early history, refer to Alexander's Articles & Lectures, edited by Jean Fischer, and Michael Bloch's biography, F.M.: The Life of Frederick Matthias Alexander, Founder of the Alexander Technique. I also gained insight into Alexander's development from the manuscript of a forthcoming book by Alexander Murray. Many thanks and credit to the Alexander Technique teacher—I wish I could remember her name—who first mentioned the Alexander Technique connection to Winnie the Pooh.

"Lighten Up" or "Pull Up?"; A new study about the Alexander Technique and Parkinson's Disease.

Word came last week about a new study published in the journal Neurorehabilitation and Neural Repair about the Alexander Technique and patients with Parkinson’s Disease.

Parkinson’s Disease is a progressive neurological condition affecting movement. Progressive in this sense means that symptoms worsens over time. The condition often begins with slight tremors and reduced facial expressions and may eventually lead to a stiffening and slowing of all movement. Parkinson’s is largely treated with medication, though Parkinson’s patients and their doctors often explore methods that can improve a patient’s quality of life while coping with the disease.

The Alexander Technique and Parkinson’s has been studied before. In 2002, a randomized control trial published in Clinical Rehabilitation assigned 98 Parkinson’s patients either to 24 individual Alexander Technique lessons, 24 individual massage sessions, or no intervention beyond their normal drug treatment. The study showed that Alexander lessons significantly increased the ability of patients to carry out everyday activities (there was no significant change in the massage group). The benefits remained when patients followed up 6 months after their lessons ended. The Parkinson’s patients who took Alexander Technique lessons also had less change in their Parkinson’s medication than either of the other groups (this is notable since medication dose usually increases with time as the disease worsens). The patients themselves reported improvements in balance, posture, walking, and increased coping with the disease and reduced stress.

One of the challenges in a randomized control trial like the 2002 study is to explain why a particular intervention is effective. In the 2002 study, massage was used to control for the effects of touch. Though massage and the Alexander Technique use touch quite differently, they use an equivalent amount of touch in a session. Since the Alexander Technique had a beneficial effect but massage did not, the researchers could conclude that touch alone wasn’t enough to benefit the Parkinson’s patients. The patients who took Alexander Technique lessons clearly learned something, but what?

Enter the most recent study: “Lighten Up: Specific Postural Instructions Affect Axial Rigidity and Step Initiation in Patients with Parkinson’s Disease,” by lead author, Dr Rajal Cohen. (You can read it in full here)

This was a smaller study and deceptively simple: 20 patients with mild to moderate Parkinson’s Disease practiced two contrasting postural instructions for all of ten minutes each. One set of instructions, called “Pull Up,” was based on effortful conceptions of posture. The other set of instructions, “Lighten Up,” were based on the Alexander Technique of releasing into length.

The research team then measured axial rigidity (increased axial rigidity interferes with movement), postural sway (sway can increase the risk of falling in Parkinson’s patients), and the smoothness and efficiency of initiating movement.

The study is fascinating to anyone who is interested in movement and posture because it shows that how we think about posture can make a measurable difference in the quality of our posture and movement.

During the study, the Parkinson’s patients read contrasting explanations for the two separate set of instructions. The “Pull Up” instructions were based on familiar conceptions of posture:

Parkinson’s makes you weaker, so it is important to activate your core muscles to pull yourself up to your full height. For the next few minutes I would like you to focus on feeling your neck and trunk muscles work strongly to pull you up.

The patients then practiced these specific “Pull Up” instructions (which might be familiar to anyone who has worked with either a personal trainer or a drill sergeant):

Use your core muscles to pull yourself up to your fullest height; engage the muscles in your abdomen and lower back; feel your neck and trunk muscles working to pull you up; pull your stomach in, your head and chest up, and your shoulders back.

“Lighten Up” instructions were based on the Alexander Technique. The researchers had the subjects read this explanation:

Whatever our condition, we make matters worse by pulling ourselves down, and especially by tightening the neck and pulling the head down. For the next few minutes I would like you to focus on allowing an upward direction.

Then the patients practiced the following instruction:

Notice that you are pulling yourself down and give yourself permission to stop doing it; let your head balance easily at the top of your spine; allow your spine to be uncompressed and your torso to open effortlessly; let your shoulders and chest be open and light.

As a control, the researchers had the patients practice a “relaxed” condition:

Imagine that it is the end of a long day and you feel tired and lazy; allow your head to feel heavy and sink slightly forward and down; relax your shoulders and allow them to hang heavily.

The researchers varied the order in which the patients practiced “Pull Up,” “Lighten Up,” and “Relaxed,” to control for possible carryover effects from the different instructions. What did they find? When patients practiced “Lighten Up,” they showed less axial rigidity, less postural sway, and increased smoothness of initiating movement than when they practiced “Pull Up” or “Relaxed.”

There are a couple of surprising things about these results. The authors note that since Parkinson’s Disease has such a detrimental effect on motor control, they did not expect the patients to show a measurable difference when practicing something so subtle as differing postural intentions. Most remarkable to me is that such brief instructions, given without the hands-on guidance found in a traditional Alexander lesson, would have a beneficial result. The study gives some inkling of why a course of lessons—like the 24 lessons in the 2002 study of Parkinson’s patients—might be so positive.

One of the things that excites me about this study is the way in which it clearly articulates the difference between how Alexander Technique teachers approach posture—lightening up to make things easier—versus more familiar approaches to posture—pulling up to make you stronger. We Alexander teachers often feel like we are in danger of getting swept away in the great wave of “core conditioning,” struggling to prove the benefits of a gentler approach to movement than “power through” and “no pain no gain.” If this study can help convince people that lightening into length has proven benefits, it might help not only Parkinson’s patients, but anyone who wants to move more easily and effectively.

Thirty Posts in Thirty Days

On Nov 10, I launched a new website for my Alexander Technique teaching practice and on a whim decided to blog every day for the first 30 days. Writing once a day was a somewhat arbitrary decision—why not every other day? But I figured that overkill in the beginning would get me in the rhythm of writing. And it was refreshing to be forced to produce something everyday, whether I was in the mood or not.

I soon discovered that certain rules seemed to apply. Each post took at least three drafts before I could stand the idea of someone else reading it. Writing filled the available time. If I had all day, it would take the whole day. If I had two hours, I could finish up in two hours. And there was no relationship between how inspired I was to write and the quality of the final product, let alone the popularity of an individual post. The most popular single post was written at the last minute, after spending all day casting about desperately for an idea.

Writing about the Alexander Technique is challenging—you can’t really capture the experience of a lesson in words. So I found myself mostly telling stories. Some of these stories I had been waiting to tell for 15 years or more. Others I had used over and over again when working with students. And each time I tried to write down a story, at some point, I would get blocked.

When you’re writing each day, you can’t really afford to stall out on a post. It was at this point that I would show a draft to Kyra—she's an amazingly astute editor—and she often revealed one of two things. Either I had changed the subject, and the post had suddenly gotten way too complicated for a 500 to 1,000 word blog post. Or I had stopped telling the truth.

It wasn’t that I was lying, but when telling stories about studying the Alexander Technique or the violin or even cooking, I would sometimes find myself recasting that experience in a way that I hoped would be most appealing to readers or would seem to prove the point I thought I was making. And when that happened, the draft wouldn’t hold together. Only when I really thought through the story, examined how I had felt at the time and wrote from the truth of that experience, that the writing would find its shape. Telling stories became a way of testing the truth of what I had to say.

Thirty days into this blog it’s time to change up the schedule a bit. Tomorrow night I’ll be in the pit for the first performance of the musical Newsies, and with eight shows a week, I’ll have much less time to write until after the first week of January. But I’ll keep posting, catch-as-catch-can, and might even have a guest post or two. There’s much more to say and much more to explore. Thanks for reading!

 

Andrew McCannComment
Soft Focus

For several summers in a row during college and just after, I was a student at the International Festival Institute in Round Top, Texas. During my time at Round Top, several of the faculty sat in with the student orchestra, including the concertmaster. Her standards were high and she was unabashed in insisting on them. For example, she would turn around in soft passages to make sure all the violins were in exactly the same part of the bow and yell, “AT THE POINT” at any stragglers. Playing in her section was somewhat traumatizing but also rewarding—by the end of the summer we sounded great, and we knew that her ferocity was one reason why.

The violin sections rotated seating, and for one concert cycle I found myself sitting next to her. There was a private drama to sharing a stand with her. She would whisper heated instructions to me during rehearsals: Count! Don’t rush! I remember one moment in particular. We were in the midst of a passage—the whole orchestra playing around us—and she hissed at me, “Who are we playing with?” I was confused. Who are we playing with? The Round Top Festival Orchestra? I didn’t say anything. “Who are we playing we?” she asked again. We were still playing. I looked blankly at her. “WHO ARE WE PLAYING WITH?” I found it difficult to play and talk at the same time. So I just shook my head. “THE BASSOONS!” She was definitely no longer whispering. “WE’RE PLAYING WITH THE %$*& BASSONS!” And I suddenly realized that for this entire time, we—the violins—and the bassoons had been playing the same melody together and I was too busy playing my own part to notice.

Playing a musical instrument in an ensemble requires intense focus on the task of playing that instrument. But if we focus so much on our own part that we become oblivious to the musicians around us, then we will no longer be much service to our section, the orchestra, or the music.

This is not just true for musicians. Before scrolling down further, I want you to watch the video embedded below this paragraph. It’s very short. In it you will see two teams of three players each, passing basketballs. One team is wearing white shirts. One team is wearing black shirts. When you watch the video, count the number of passes made by the white-shirted team. This is very important. You must count the number of passes made between members of the white-shirted team. The future of the Republic hangs in the balance.

Did you notice anything unusual? Many thousands of people have watched the video and about half of them don’t notice anything out of the ordinary. Daniel Kahneman writes about this experiment in Thinking, Fast and Slow:

Intense focusing on a task can make people effectively blind, even to stimuli that normally attract attention… The most remarkable observation of the study is that people find its results very surprising. Indeed, the viewers who fail to see the gorilla are initially sure that it was not there—they cannot imagine missing such a striking event.

My teacher at Oberlin, Greg Fulkerson, used the terms hard focus vs soft focus. With hard focus, we’re so oriented to the task in front of us that we’re not in the room. With soft focus, we are able to both attend to our part and be aware of what is going around us at the same time.

Since our attention is inherently limited, you can use soft focus to know whether or not you’re prepared for rehearsal. If you can play your part, but it requires so much concentration that you became oblivious to your surroundings, then you need to practice it more. One way to practice soft focus on your own is to use your body as a focus of attention. If you can play through your part while attending to your whole self—from the dynamic balance of your head on your spine all the way down to the contact of your feet on the floor—then you are probably fluent enough on the part to use soft focus in rehearsal with others.

Of course, there are always exceptions. Some composers write music of such intense difficulty that it overwhelms your ability to broaden your attention—you just hang on for dear life, switching your attention as the next crisis demands. But in most music, it is possible to be prepared. Being able to choose where you place your attention is one of the most important ways you can contribute as a musician. It puts you in the room, not only with the music and your peers, but ultimately your audience.

 

Repetition without Repetition

Odin demonstrates the use of the metronome as a sleep aid.

 

I remember when my high school violin teacher first showed me how to work up a passage gradually using a metronome. I thought it was a bit magical. You started slowly and just by moving the metronome up one click at a time, you could get a passage up to tempo!

When I got to Oberlin, I was surprised to find that my violin professor wasn’t quite so keen on working up with a metronome. He thought it was a useful tool, sure, but he had some questions first: was I playing in tune with every repetition? How was my sound? Was it warm and round or harsh and scratchy? Was I thinking of the phrase? It hadn’t really occurred to me to be that careful. I just assumed that as I got more facile in the passage that my intonation and sound would improve as well.

Violinist Simon Fischer writes in Practice:

Because repetition practice is effective it can also be the most dangerous. You have to be very aware of what you want and what to avoid—and listen very carefully—to avoid strengthening mistakes.

Repetition is also a great way to get injured—sometimes in surprising ways. I got a glimmer of this danger one day in college when I had been drilling a passage with the metronome for about 45 minutes. For some reason that day, I had decided to stand with my weight pushed into my left hip and down my left leg. This wasn’t a normal way of standing for me, but it had a sort of jaunty insouciance that I liked when I saw myself in the mirror. When after 45 minutes of practicing I decided to take a break, I straightened up and felt a shooting pain in my left hip. I packed up, grimacing, hobbled out of the practice room and limped off to class. It took the rest of the afternoon for the discomfort in my hip to ease.

Awareness is essential in repetitive practice. As a young player, I usually focused my attention on what I intended to practice, not on everything that was actually happening at the same time. Whatever we repeat, we are potentially learning. When I began taking Alexander Technique lessons, I started to include a larger awareness of my body when I practiced. I realized that if I tensed my neck or rounded my shoulders while practicing, I was drilling these harmful habits just as much as the notes I was supposed to be learning.

So how to we get the benefits of repetition without succumbing to the dangers? Recently I came upon an intriguing approach advocated by Christine Carter, a clarinetist and researcher at Manhattan School of Music. She points out that one of the reasons that it’s so hard to stay aware and attentive during repetitive practice is, well, it’s dull.

We are hardwired to pay attention to change, not repetition. This hardwiring can already be observed in preverbal infants. Show a baby the same object over and over again and they will gradually stop paying attention through a process called habituation. Change the object, and the attention returns full force. The same goes for adults… The fact is, repeated information does not receive the same amount of processing as new information. And on some level, we all know this. Constant repetition is boring and our boredom is telling us that our brains are not engaged.

Carter recommends that we replace “blocked practice”—where we practice all the repetitions at once—with “random practice”—where the repetitions are sprinkled throughout the practice session.

For example, say want to practice three passages—A, B, and C—15 times each. A blocked practice schedule would look like this:

  1. A, 15 times
  2. B, 15 times    
  3. C, 15 times

In contrast, a random practice schedule would look like this:

  1. ABC
  2. BCA
  3. CAB
  4. BAC
  5. ACB
  6. CBA
  7. etc.

Each passage still gets practiced 15 times, but by alternating among passages, we make it easier to stay alert and attentive.

Different practice methods are better at different stages of learning. In Practice, Simon Fischer suggests that highly repetitive practice is most effective towards the end of the process of learning a piece. In the beginning, it’s tempting to repeat a passage we can't play over and over again. But more exploratory practice methods—designed to understand the choreography of the passage from different angles—are better at such an early stage. Only when you can play a piece well at a conscious level—really know the story you want to tell—do you risk “grooving” the piece into your system through repetition. 

 

 

Finding the Story

I was just out of grad school and still living in Urbana, finishing up my Alexander Technique training. I was playing in the violin section of the Peoria Symphony and Yo-Yo Ma was the featured guest for the symphony’s end-of-season gala. He came in for the dress rehearsal on the same day as the concert. I assumed that he would disappear after the rehearsal like some of the other soloists that had played in Peoria. But he was incredibly generous with his time. After rehearsal he stuck around backstage, shaking hands with the musicians and signing CDs. Before the concert, he hung out backstage, shaking hands with musicians and signing CDs. And after the concert, he hung out backstage, shaking hands with the musicians and signing CDs.

I didn’t have anything for him to sign but I did have a question. A few years before, the New Yorker had published an article by Malcolm Gladwell about “The Physical Genius,” which profiled masters of skill: the neurosurgeon, Charlie Wilson, hockey great Wayne Gretsky and Yo-Yo Ma. One quote in particular had really stuck out at me: “Ma says he spends ninety per cent of his time ‘looking at the score, figuring it out—who's saying this, who wrote this and why,’...and only ten per cent on the instrument itself.” I was a bit flabbergasted by this idea. So I got in line and when I got up to him, I mentioned the article and then said, “Do you really only spend a 10th of your time on your instrument?”

And he got super excited. I don’t have an exact quote, but the gist of what he said is this: You have to figure out what the story is before you go to your instrument. So you study the score. And you try to figure out the story. And once you have an idea, you go to the instrument and try out the story. And then you decide, no, that’s not quite it. And you go back to the score to figure out the story. Then you come back to the instrument and try out the story. But no, that’s not quite it. And then you go back to the score until the story is clear to you. And then you tell that story at your instrument. But you have to find the story to tell the story! If I remember correctly, he may have started waving his arms and gesticulating enthusiastically.

When I was coming up, I was often told by teachers that if I wanted to make it as a musician I had to put in 6 to 8 hours a day on the violin. It never occurred to me that I could get as much accomplished—let alone more—if I dedicated most of those hours to score study and mental practice.

If you have never mentally practiced before, it can be hard to know where to start. Choose a short passage: maybe four measures. Completely imagine what you want it to sound like: dynamics, tone quality, phrasing. Imagine the physical sensations of playing. If you’re a string player, imagine the fingering and bowing patterns, the contact of the bow hair on the string, the bow’s speed and contact point. If you’re not a string player imagine the sensations that come with your instrument or voice. To this long list, add your whole body. Feel your feet against the floor and the delicate balance of your legs. Include your breath, the subtle movements of your torso, and the balance of your head on top of your spine. You don’t have to tell your body to do anything, just expand your awareness to include your whole body. Then play the passage.

When I was coming up, I was often told by teachers that if I wanted to make it as a musician I had to put in 6 to 8 hours a day on the violin. It never occurred to me that I could get as much accomplished—let alone more—if I dedicated most of those hours to score study and mental practice.

One advantage of mental practice is a sense of fluency in your body. The Alexander Technique teacher Walter Carrington once said, “People imagine that their bodies are disobedient and unreliable in carrying out their wishes, whereas nothing could be further from the truth. Our bodies get terribly confused because of the conflicting demands that we make of them all the time in our muddled, confused, contradictory wishes.” This is especially true in practicing. When a piece of music is hard, it is hard because a lot of things are going on at once. If you notice your body getting tense or tight, start with your mind. Is your intention clear? Or are you sending muddled, confused, even contradictory directions?

In that old Malcolm Gladwell article, Yo-Yo Ma says that he remembers riding on the bus when he was seven and solving a difficult musical passage by imagining himself playing it on his cello. That’s so precocious that I kind of hate him. But it’s also inspiring. There’s so much that can be accomplished if we just use our brains.


 

Embracing Incompetence

I was working with a violinist in his Alexander Technique lesson last week. Like many violinists, he has the tendency to push his hips slightly forward and lean back when he holds the violin. In his lesson, I helped him find a more neutral way of standing, with his shoulders aligned with his hips. “I can’t stand like this!” he declared. “I’m bending forward!” It was only when I had him look at himself in the mirror that he saw that he wasn’t bending forward at all, he was standing normally.

Alexander called this, “unreliable sensory appreciation.” It turns out our proprioception—our sense of where our bodies are in space—is based on our habits. It’s not objective. When we try to change, we feel weird, even if the new way of moving is more coordinated and even free of pain. Making progress in the Alexander Technique begins when we recognize that the way we feel isn’t necessarily accurate.

When you are learning anything, whether the Alexander Technique or a musical instrument, you go through four stages:

  1. unconscious incompetence
  2. conscious incompetence
  3. conscious competence
  4. unconscious competence

That first step, going from unconscious to conscious incompetence, can be a little rough. No matter what you’re learning, it can be disconcerting when you realize that you don’t know what you’re doing.

What’s true in the Alexander Technique is also true in practicing music. In my last two posts, I have recommended that you mentally practice a passage before physically playing it. The combination of mental and physical practice turns out to be more effective than physical practice alone.

The downside of mental practice is that you will become much more conscious of the difference between how you want to sound and how you actually sound. If you are not used to practicing so consciously—if you are in the habit of running through pieces before you’ve really learned them, all the while imagining you are at Carnegie Hall—you may find that your newly effective practicing is demoralizing. As the violinist James Buswell has written,

  • As your ear is hearing more, you will think you are getting worse instead of better.
  • As you think more clearly, you will feel stupid.
  • As you identify more problems, you will think that there are an infinite number of them.

This feeling of incompetence is actually a sign of progress.

The psychologist David Dunning has researched incompetence by having his subjects both take a test and say how well they thought they did on the test. Those who did most poorly were also most likely to overestimate how well they’d done. He explains:

When you’re incompetent you suffer a double burden, first you’re going to make a lot of mistakes. But second, the same skills that allow a person to make correct decisions are the same skills that allow you to accurately assess whether you’re doing well… For example, the skills that allow you to write a grammatical sentence are exactly the same set of skills that you need to recognize whether you’re writing grammatically or whether another person is writing grammatically. So almost by definition, the incompetent are not going to be able to recognize that they’re incompetent. If they could recognize that they were incompetent, they would probably have some skill that would make them more competent than they are.

No one wants to feel incompetent. And many students will give up when they’re faced with their own inadequacies. But this is the very stage when persistence is the most necessary: regular practice of comparing what you think you are doing with what you’re actually doing until the two converge. So the next time that you suddenly recognize your own incompetence, celebrate the feeling: it shows that you are learning something. Keep practicing. You’re on your way.

Meet Your Startle Response

I first started studying the Alexander Technique the year after I graduated from Oberlin. I was living in Minneapolis, studying violin with Jorja Fleezanis and taking Alexander lessons twice a week with Carol McCullough. In my early Alexander lessons, Carol was teaching me to “free my neck,” to find the delicate balance of my head on top of my spine. She suggested that a free neck was essential to experiencing ease and coordination of my whole body. I was skeptical. A free neck was pleasant enough, but as a musician, I was pretty concerned about my hands and arms. What did the neck have to do with all of that?

Then one day I was driving over to Jorja’s house for a violin lesson. As I was exiting the highway, I was nearly sideswiped by a car getting on. I had to swerve out of his way—we barely missed each other at 60 miles an hour. As I rounded the exit ramp and joined slower-moving traffic, I noticed my head was jammed back into my neck and my shoulders were up by my ears. Oh! I thought. Neck tension! When I got to my lesson it took me a few minutes to relax enough to play. I used what Carol had taught me: I freed up my neck at the nodding joint, found an easy length up my spine, and relaxed my shoulders. It helped me settle down.

Meet Your Startle Response:

What I had experienced that day in the car is the startle response. Many of us have heard of the fight-or-flight response: it’s the burst of adrenalin that sends the heart racing, increases our breathing, and makes our palms sweaty. In that moment of alarm, there is also a tensing of the entire musculature. Frank Pierce Jones, an Alexander Technique teacher and professor of experimental psychology, first described the startle response in his research in the 1960’s.

The pattern of startle is remarkably regular. It begins with an eye-blink; the head is thrust forward; the shoulders are raised and the arms stiffened; abdominal muscles shorten; breathing stops and the knees are flexed. The pattern permits minor variations but its primary features are the same.

The startle response is very fast. As Jones goes on to say:

It is difficult to observe and more difficult to control. Its chief interest here lies in the fact that it is a model of other, slower response patterns: fear, anxiety, fatigue, and pain all show postural changes from the norm which are similar to those that are seen in startle.

A full blown startle response—as when you narrowly avoid a car accident—is almost impossible to control. There is one case study that showed a buddhist monk with decades of experience meditating could suppress his startle response to a gun shot while meditating. Musicians rarely experience as dramatic a stimulus as a gun shot while rehearsing or performing, but they will experience a slower version of startle often. It may seem paradoxical, but knowing about your own startle response can be a crucial tool in cultivating greater freedom and ease in your music-making.

Startle In the Practice Room:

The startle response is especially helpful in the practice room. When you are overwhelmed by the technical demands of a piece, it can be hard to figure out what is causing the tension. Assuming that the piece isn’t completely beyond you, it’s often the case that there are one or two moments that are causing the problem, but they are masked by a general feeling of difficulty.

I was nearly sideswiped by a car getting on the highway. I had to swerve out of his way—we barely missed each other at 60 miles an hour. As I rounded the exit ramp and joined slower-moving traffic, I noticed my head was jammed back into my neck and my shoulders were up by my ears. Oh! I thought. Neck tension!

Yesterday I wrote about practicing at the speed of thought. Try this approach first: before beginning to play, think through the passage in your head. By imagining the passage completely before you begin, you are less likely to be surprised by its hurdles and therefore less likely to go into startle.

If you still tense up and can’t identify the reason, you can video yourself—many phones now even video in slow-motion, which is especially helpful. Try the following: set up your phone/camera and before hitting record, think through the passage. Press record and play through the passage uninterrupted.

When you play back the video, look for the moment when you start to tense up. Use the list that Frank Pierce Jones provides: Do your eyes tense—either blinking or bugging out like deer in the headlights? Does your head brace and neck tense? Do your shoulders lift? It's going to be subtle. When you identify the moment of startle, look at what is happening in the music in that moment. Is it a leap? A tricky fingering or string crossing? A difficult rhythm? A dramatic dynamic change?

When you have identified the problem, practice it in the way you know best—though a good bet would be to practice it slowly. As you work on the technical challenge, cultivate ease: soften your eyes (rather than staring unblinkingly at the music), release at the head-neck joint and shoulders and think of an easy length along your spine. Remember to allow your breath to flow uninterrupted. With time and attention, you may find that you are detoxifying the passage. When you meet the challenging moment, you’ve rehearsed a sense of ease and can greet it with the energy of the musical moment, not with the tension of what could go wrong.

Startle On Stage:

Speaking of what could go wrong, when I was a student, I was often perplexed by why some performances would go off the rails. I would make a mistake and then things would get worse and worse.

None of us are perfect. Mistakes are inevitable in performance, whether by our own error or others in our ensembles. When mistakes happen, we are likely to go into startle. As a student, I even remember amplifying the moment by grimacing, as if trying to show my teacher or studio-mates that I knew I'd made a mistake! If we don't release out of startle, we will stay tight, making it more and more likely for more mistakes to happen. 

Just after that moment of startle, we can notice the pattern, and without breaking the flow of the music, remind ourselves to soften the eyes, free up at the neck, lengthen along the spine, relax the shoulders, release the belly and breathe. This seems like a long list to think while playing music, but it’s all one state change: from startled to released again. It's a practical way to let our mistakes go.

We’re used to thinking that negative emotions should be avoided. But since it’s difficult to control the startle response—after all, you would have to guarantee that nothing unexpected ever happened to you—it’s better to embrace it. The startle response is a wonderful teacher. By showing us how we tense up, the startle response points the way to greater freedom and ease.

Practicing at the Speed of Thought

Walter Carrington, one of the great Alexander Technique teachers, told a story once about the Imperial Riding Academy in Berlin. When the chief riding instructor took the cadets out on horseback at the school, he would say to them, “Now, gentleman, when I give the order ‘ride canter,’ what do you say?” And the assembled cadets, each sitting astride their own horse, would answer, “I have time.”

As Walter explains it, when you have an entire class of cadets on horseback and an order is given, it’s very important that everyone not react immediately. The cadets are, after all, learning how to ride on horseback. They don’t yet know what they’re doing. If their first priority is to execute the command as quickly as possible, then suddenly you have a room full of horses on the move and it could get dangerous very quickly.

Taking time is just as important to musicians as it is to novice cadets at a riding academy. When musicians take time, it usually means practicing slowly. The great violin pedagogue, Ivan Galamian, was once asked to pick just one practice strategy. “Playing through at half speed,” he said, “because it gives you time to think.”

There’s another way to practice slowly, and that is to take time before you begin. Before raising the instrument to play or putting your hands on the piano keys or beginning to sing, you pause. In that time, you fully imagine how you want the music to sound before you’re preoccupied with actually making it.

One advantage of practicing this way is that when you’ve fully imagined how you want to play something and then you actually play it, it’s as if you’ve practiced it twice. Another advantage is that you can discover how well you actually know the piece. It’s much easier to barrel through a piece than to imagine yourself playing it in every dimension. It’s a good rule of thumb that if you can’t imagine yourself playing a piece at tempo, you probably can’t actually play it at tempo—even if you can “get through it.” You may also find that by imagining yourself playing a piece slowly, you can then play through it in smaller chunks at tempo.

In the Alexander Technique, taking time is the secret to undoing the power our habits have over us. Many people assume that they can change a habit by “doing the right thing”. But our habits are triggered automatically. You can truly want to do the “right thing,” but when the time comes the old habit takes over. One secret in changing a habit is identifying that trigger to act and then choosing not to act at all. To take time. Then you have a chance to imagine what you’d rather do.

Not all music making requires such slow thinking. By the time we get to the stage for a performance, we want to get the point where the music happens without us being so deliberate about it. But we can make more progress if we take time in the beginning, if we practice at the speed of thought.

The Alexander Technique @ The 2015 Music in the Mountains Conservatory

I have some exciting news!

Last summer, I had the pleasure of teaching the Alexander Technique at the Music in the Mountains Conservatory, a program for high school and college musicians in Durango, CO. The Alexander program was popular with the students, and with the support of the Artistic Director, Matt Albert, the festival administration and faculty, the Alexander Technique program is not only returning to the 2015 Music in the Mountains Conservatory, it’s expanding!

Last summer, we offered an Alexander Technique group class, private Alexander lessons, and an unexpected and wonderful collaboration with Adam Marks in his public speaking class. While the details are still being worked out for next summer, we'll be adding two Alexander Technique assistants and the the program will include regular small group classes, private lessons, and workshops on all aspects of applying Alexander to practicing and performing.

The Music in the Mountains Alexander Technique program will be organized around four big topics:

  • Your Instrument & You
  • Habit & Change
  • Practicing Effectively & Sustainably
  • The Joy of Performing

For the rest of this week, I will be posting short essays that touch on these topics and which I hope will be useful to high school and college music students.

The Conservatory will run from July 12 to August 1, 2015. It is rare for students to have the opportunity to study the Alexander Technique so intensively at a summer festival and I am grateful to Matt and the festival administration for supporting this program. Help us spread the word: if you’re a teacher of high school or college musicians, send them to the Music in the Mountains website and download this brochure for a complete list of programs and the stellar teaching faculty. The early application deadline—with a discounted fee—is January 16, 2015.

And stay tuned to this space for the latest developments!