Posts in Alexander & Health
Archer's Bow and Shortened Hamstrings: More Markers of Occupation

Yesterday I wrote about the markers of occupation, the way our activities can shape our bodies over time. My friend Todd sent me a dramatic example from the military history of the middle ages: a lifetime of drawing the longbow was visible in the long dead bodies of archers.

We can actually identify a longbowman’s skeleton by the damage they have done to their bones; otherwise rare defects show up along the shoulder blades, wrists, and elbows. The act of drawing back hundreds of pounds of force every day, hundreds of times per day, strained ligaments and bones to such an extent that some skeletons even started growing extra bone to compensate. Their devotion to their skill permanently changed their bodies enough that we can still identify them hundreds of years later.

Our modern markers of occupation are quite different from the English archers. We are much more likely to be changed by the extreme sedentariness of our modern work environments.

The solution, of course, is to move more, and so people exercise. As important as exercise is, there’s new research that suggests that sitting all day is so detrimental to our health that all the exercise in the world isn’t enough to undo the damage—if we continue to sit all day.

This point was reinforced by a recent piece by Brook Thomas on stretching. Sitting all day shortens the hamstrings and so people try to stretch them to increase their length. Why does this often have so little effect? Thomas argues that it’s not just that the physical substrate of the muscle needs to be stretched. The nervous system needs to reset its expectations about what is possible:

While working on the Liberated Body Short Hamstrings Guide, I kept coming back to the issue of how the hamstrings function, in some chronically short-hamstringed people, as an emergency brake. This kind of compensatory pattern happens for plenty of reasons, but top among them might be under active deep core musculature, too rigid core musculature (yes, underactive and too rigid can come together), weakened adductors, and more. If these or other key stability structures can’t fully do their job, the hamstrings are at the ready. They sub in for a lack of support elsewhere by battening down the hatches...

If your car were parked on the edge of a cliff and was held there only by its emergency brake, would you release it? Not if you are sane. This is the same decision your nervous system is making when you attempt a forward fold and are stopped prematurely.

To bring about a change in the structure of the musculature, both mind and muscle have to be taken into account. The best way to do this? Change what we do each day.

The way to approach rehabilitating [short hamstrings] would be to move with more normal hamstrings length more frequently. For example: to use a standing desk for all or part of the day, to sit on the floor with our legs outstretched in front of us (if we can accomplish that without rounding our backs, another symptom of short hamstrings), wearing neutral-heeled shoes, and to walk and to take frequent movement breaks, among other things.

The road to rehabilitation would not look like stretching the bejeezus out of your hamstrings at their absolute maximum end range for somewhere in the neighborhood of thirty and ninety seconds per day.

We have to stop dividing our lives between sedentary work and vigorous exercise. Alexander lessons can certainly help us unlearn the unfortunate habits that our work lives encourage. But work also needs to become more dynamic. Most tasks do not actually require us to sit for 8 hours a day. The same problems can be solved and the same projects completed using a variety of positions and actions. Ultimately, if the work environment changes, it will be easier for employees to take responsibility for their own health.

This is starting to happen, but it can be frustratingly slow. My sister recently injured her knees in a fall. After getting reassurance from her doctor that nothing was torn or broken (she received a diagonsis of patellofemoral pain syndrome), we talked about how she could modify her activities to help her heal. We had two priorities: cultivate length in the back to take weight out of her knees, and prevent the kind of distorted, compensatory patterns that creep in to the rest of the body after a knee injury.

She found sitting and standing still to be the hardest activities to maintain. So we talked about her options at work. Could she get up and walk around? To a limited extent, yes. If she perched on a stool with her feet on the floor, her knees would be at a wider angle than when sitting. This might provide some relief. Was there a high desk and stool that she could use to experiment and see? No, that wasn’t possible. Could she find a place to lie on her back for 10 minutes or so every couple of hours? It would help prevent compensatory patterns. No, there was no place that she could lie down.

We both were a little frustrated. My sister’s workplace is very intellectually stimulating, but it’s very physically restrictive. This is the norm in many work environments, not the exception.  At some point, our office places will have to change. The archers of the middle ages had no choice about practicing with the longbow—it was demanded by the king. But we don’t owe such fealty to our employers. We owe our work work. We don’t owe work our health.






Bottom the Weaver and Weaver's Bottom: Markers of Occupation

When I first moved to Chicago, a flutist friend told me about visiting the chiropractor and seeing an x-ray of her back. Though she had left her flute at home, she was shocked to see that the twist of how she held her flute was visible in the structure of her spine. Tom Myers, the Rolfer and author of Anatomy Trains, writes,

Musicians the world over are among those who deal in intense concentration around an object which cannot change shape. The tendency for the body to shape itself around the solid instrument is very strong in all types of music. So strong in fact, that, during a time when I enjoyed a vogue among London’s orchestral musicians, I could often accurately anticipate the player’s instrument before being told, just on the basis of body posture. The accommodation to the flute, or violin (or guitar or saxophone) was so clear that the instrument could almost be ’seen’ still shaping the body, even when it was in its case.

Musicians aren’t the only ones altered by their vocation. A while ago I read Michael Ondaatje’s novel, Anil’s Ghost, about a forensic anthropologist searching for the remains of victims of the Sri Lankan civil war in the 1980s. In the novel, Ondaatje’s fictional heroine, Anil Tissera, received her education in the United States from a real-life forensic anthropologist, Lawrence Angel. Ondaatje describes what I assume to be true stories about Angel:

Anil had worked with teachers who could take a seven-hundred-year-old skeleton and discover through evidence of physical stress or trauma in those bones what the person’s profession had been. Lawrence Angel, her mentor at the Smithsonian, could, from just the curvature of a spine to the right, recognize a stonemason from Pisa, and from thumb fractures among dead Texans tell that they had spent long evenings gripping the saddle on mechanical barroom bulls. Kenneth Kennedy at Cornell University remembered Angel identifying a trumpet player from the scattered remains in a bus crash. And Kennedy himself, studying a first-millennium mummy of Thebes, discovered marked lines on the flexor ligaments of the phalanges and theorized the man was a scribe, the marks attributed to his constantly holding a stylus.

Ramazzini in his treatise on the diseases of tradesmen had begun it all, talking of metal poisoning among painters. Later the Englishman Thackrah spoke of pelvic deformations among weavers who sat for hours at their looms...

These were the markers of occupation.

Kennedy speculated that “Weaver’s Bottom” gave us Nick Bottom, the Weaver, in Shakespeare’s A Midsummer Night’s Dream—turned into an ass by Puck. Weaver’s bottom is still a diagnosis, called ischial bursitis.

Our careers shape us slowly. An act is repeated and becomes a habit. With enough time, habit affects our health.

We know this. And many of us exercise to combat the sedentariness of our work. But work tends to stay with us during our workouts. I often see runners jog past my studio window. It’s pretty easy to see which runners work at a computer all day. You can still see the office slump: head forward, shoulders rounded, arms up towards the computer that isn’t there. This is not to say that exercise doesn't have many wonderful health benefits. But if, for example, someone has neck or shoulder pain exacerbated by sitting at work all day, they will get limited relief if they unwittingly stay rounded forward on their run.

It can be startling to discover that the contours of an activity have stayed with us, hours after we’ve moved on to something else. And it takes time to reverse the pattern.

I started studying the Alexander Technique right after graduating from conservatory as a violinist. The violin is held on the left, and as I became more aware of my habits at the violin, I began to realize just how much of my life was spent looking to the left. When parallel parking, I would look over my shoulder to the left. When swimming the front crawl, I would breathe only to the left. I would wait for the train—which would be arriving from my right—facing the left. And I fell asleep on my stomach facing left with my left arm raised. It was as if in my sleep, I would still be practicing the violin.

One night I decided to change and lay down on my stomach turned to the right. You would think that this would be a simple matter, but I felt like the mattress itself was pushing up towards me, straining my head to the right. After a minute or so, I gave up and turned back to the left and fell asleep.

But each night I tried again. And each night facing the right became more and more familiar, less and less of a strain. Eventually, it became so comfortable that I began to prefer facing the right. It was a small thing, but a welcome change. Now I know that if I’ve been rehearsing all day or performing at night, I can go home and in at least one little way, undo a mark of being a violinist while I sleep.




That's Right: Nothing is the Solution to "Text Neck."

Recently my Facebook feed has blown up with articles and news segments about the dangers of “text neck.” It turns out that spending hours a day hunched over your smartphone texting is a bad idea and leads to all sorts of neck and upper back issues. Who knew? The news stories have given some good counsel—like limiting the amount of time you spend on your phone and moving your body in ways that are different than hunching over a phone. But as I’ve read the advice about preventing “text neck,” I keep wondering, do we give ourselves any choice in the matter?

I was reminded of a student who came to me for Alexander Technique lessons several years ago, just before the smartphone revolution. He was a doctor complaining of neck pain. He tried to set up regular lessons, but like many doctors, his schedule was not entirely his own. Even when we managed consistent lessons, he was always on call. With most of my students, I ask that they leave their phones off so that we can work without interruption. But he had to leave his pager on, just in case he had to respond to an emergency at the hospital.

I have to admit, he was a challenging student. At the start of each lesson, he would fill me in with a detailed report on his neck symptoms at work. He monitored himself ceaselessly to see if there was any improvement. He was obsessed with finding the “correct way to move” and gave himself detailed instructions using his voluminous knowledge of human anatomy. He would inform me, “I need to tone up through the erector spinae group, widen through the trapezius and release into the quads.” I suggested that he not micro-manage his movements, and told him the parable of the centipede who tried to control all one hundred legs consciously and ceased to be able to walk at all.  I tried to convince him that the first step was to leave himself alone. He needed to practice “non-doing:” it would give him a chance to observe himself and see if he could discover if his movement habits contributed to his neck problem.

One lesson I finally succeeded in getting him to stand quietly, leaving himself alone. I had just placed my hand where his head meets his neck and was helping him experience a “free neck”—moving his head gently back and forth in the “no” direction—when his pager went off. At the sound of the buzzing, his neck tensed dramatically, the back of his head pulled back, and his shoulders went up around his ears.

He duly checked his pager—it was not an emergency. We looked at each other. “I think we know why you have some neck tension,” I said.

‘Push notifications’ inform us not only of texts or phone calls, they alert us to e-mail, Facebook status updates, tweets, breaking news, traffic reports, weather alerts, and the latest available level on Angry Birds Star Wars II. Our response becomes habitual. The alert sounds and we jump into action. If that habit includes pushing our head forward 30 degrees, we may not even notice our necks tense to carry the 40 lbs of functional weight. That’s the thing about habits: they are unconscious and automatic.

The head is a heavy object. The average head weighs about 10 pounds. When your neck is free and the head is poised on a lengthening spine, it has a functional weight of 10 pounds. But for every degree the head is held forward—whether towards a cell phone, a computer, a book, a music stand, or a musical instrument—its functional weight increases dramatically. As this study by Kenneth K. Hansraj found, a 10 pound head held 30 degrees forward has a functional weight of 40 pounds.

So what we do with our heads has an enormous impact on the health of our necks, shoulders and backs. With my doctor student, the anxiety around the insistent and unbidden summons of his pager caused a spasm of tension in his neck, jerking his head back into his spine. The action was particularly dramatic in his Alexander lesson because it happened right after I had helped him find length in the neck and freedom at the head-neck joints. In his everyday life, though, he rarely freed his neck and it became increasingly tense and painful throughout the week.

Smartphones and doctors' pagers are similar in one important respect: they are stimulus response-machines. And smart phones are even more stimulating: "push notifications” inform us not only of texts or phone calls, they alert us to e-mail, Facebook status updates, tweets, breaking news, traffic reports, weather alerts, and the latest available level on Angry Birds Star Wars II. Our response becomes habitual. The alert sounds and we jump into action. If that habit includes pushing our head forward 30 degrees, we may not even notice our necks tense to carry the 40 lbs of functional weight. That’s the thing about habits: they are unconscious and automatic.

But there’s a key difference between doctors' pagers and our smartphones. Doctors are required to have a pager and may even, like my former student, resent its constant thrall. But if you’re anything like me, you love your smartphone. In fact, you could say that the stimulus from within—”I wonder what my friends think of that cat photo I just posted on Facebook,” for example—is as strong as the push notification from without.

Understanding the power of habit is as important in preventing “text neck” as limiting our time on our phones—maybe more so, since so many of us enjoy the time we spend on our phones and don't have any intention of reducing it down. With my doctor student, we practiced a different response to his pager: when it sounded, he would remind himself to pause, take his time in responding, free his neck. We can do the same thing with our phones. The next time in pings, we can give our necks a break. We can take a moment, however fleeting, and do nothing.