Prehabilitation and Rehabilitation and the Alexander Technique – 7th June 2018

Alexander Technique is becoming contagious in my family! Firstly my mother raised my interest in Alexander Technique after having lessons andknee-1406964_1920 this was the reason I gave it a go, now it’s my Dad’s turn. He has seen the changes Mum and I have made over the years, observed the benefits we have experienced (some of which are explained in my May blog; Sciatica, a pain in the butt…and one of the reasons I came to the Alexander Technique – 9th May 2018), but never quite understood what AT was. Dad thought it was a bit like physiotherapy and although he listened when I explained, somewhere along the way the full nature of the beast never really made a connection. Not feeling the needed to convert everyone I knew into AT lovers I left it that!
Over the last year however, my Dad, who injured his knee quite badly in his twenties playing rugby, has been experiencing more and more problems with that joint. His knee became painful, its mobility much reduced and it was having a significant effect on the way he was standing, walking and moving in general. It began to have a knock on effect on his hip and lower back too, creating pain and discomfort in those areas too. He thought it might help to give AT a go, so I started giving him a few lessons to see if it could make things a little more comfortable while he was having his knee assessed by the doctors to see what might be the best way forward. Dad recently commented ‘Now I get it’, fantastic! There is nothing like experiencing Alexander Technique to really understand what it offers.

Pain creates muscular tension, tension and pain produce habits of movement and body use that are trying to avoid further pain, but often inadvertently produce more or exasperate the situation. The body gets pulled out of balance and different muscles try to compensate for all the inbalances throughout the body. If, for example, our knee had pain, we may transfer our weight onto the other leg, but this then causes the upper body to try and re-balance and produces a pulling down towards the injured side. This pattern was very visible in my Dad, however he was unaware of this habit. Through the gentle hands-on teaching and mirror work of AT however, he has become more aware of this habit, amongst others, and is able to pause and direct into a more poised stature. He is also learning to recognise and reduce some of the excess tension he was using to stand up ‘straight’, and has found a more soft and tall option, which is less effort.
IMG_2735As it happens Dad is going to have a knee replacement soon, so in the mean time we are working with AT as a prehabilitation (a process of optimising physical functionality preoperatively to enable the individual to maintain a normal level of function during and after surgery). If, due to pain we have created habits of use that are leading to less coordinated and balanced movement, then (as these habits are often strongly held and unconscious), even after a knee replacement and a cessation of pain the same habits may persist and hamper the rehabilitation process.
Dad and I are working with the habits, creating more embodied awareness of them and I am teaching him skills to pause, and choose a more balanced approach to moving and being, so that he can stay as mobile as possible now and post operatively he has the best chance of a full and healthy recovery, which will help reduce the strain on the rest of his body. (He is certainly staying very mobile and regularly beats my steps per day on our fitbits!)

This embodied learning process can help with many injuries and problems and its worth thinking about learning Alexander Technique’s empowering skills to help reduce stress through the rest of your body if you are suffering with specific joint problems (not just for the joint itself), or as a way of getting ahead of the game with prehab before an operation. Then use it as part of the rehab afterwards.

For more information on the Alexander Technique and the way I teach go to or call or email me on the links at the top of the page.


Author: Esther Miltiadous

Alexander Technique Teacher, North London, U.K.

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