back pain

No more back pain!

“Carrying a baby is hard work and sometimes it causes back problems. With all that weight in front, how could you not develop a swayback? Having a pronounced swayback can cause back pain. So you might think the thing to do is to tell the person to straighten their lower back. Unfortunately this doesn’t work.”

“Connecting your heels to the ground by bringing your weight backwards and allowing the pelvis to naturally rotate to align the spine are the key points of ‘standing as sitting’. It takes a little bit of getting used to, not only because your thigh muscles may work a little bit more, but because your balancing mechanism must also become more refined.”

Carrying a baby is hard work and sometimes it causes back problems. With all that weight in front, how could you not develop a swayback? Indeed, many people have a tendency to have excess curvature in their lower back anyway. Having a pronounced swayback can cause back pain. So you might think the thing to do is to tell the person to straighten their lower back. Unfortunately this doesn’t work. A quick review of the neurology of how we learn to move will explain why.

Any neurology book will tell you that the brain controls the body. The sequence is that nerve impulses go from the brain down to the muscles. These impulses make the muscles contract, which of course moves the bones. That is how we manifest our intent in the world: we effect the world with our bones. Our muscles are the engines; our brain is the control centre.

The specific part of the brain that organises voluntary movement is called the motor cortex. Every part of the body is represented on the motor cortex. The parts of the body that are used the most have the most cells assigned to them. The different parts of the body all have to coordinate together, of course. Now here is the key point: the coordination is learned.

A newborn foal can walk within two hours of being born. It takes a human infant from nine to 18 months to learn to walk. The difference is that the patterns of coordination for walking are already ‘built in’ to the foal’s nervous system. The foal does not need much practice. The human infant, in contrast, goes through a long exploratory process of learning how to crawl, stand awkwardly and finally walk. You went through this process yourself. During this exploratory process the brain is forming new and useful patterns of connection among the nerves in the motor cortex. It reinforces and strengthens the patterns of coordination that work.

Our movement  indeed all of our skilled performance  is self-taught. We may imitate other people or we may have good coaching, but ultimately we work it out for ourselves. This is good news and bad news. The good news is that since our movement options are not fixed at birth we can develop all sorts of skills, such as doing sensitive surgery, playing music or building rockets. Our brains are very flexible. The bad news is that since our movement is self-taught, some of us learn how to move in ways that stress our muscles without our even realizing it. Our movement is inefficient because we do not develop an accurate understanding of where the joints are in our body, and how to coordinate the body for efficient movement. We are unable to sense our body well enough to make our movement smooth. So we may say that ignorance is the cause of most body pain.

Now we are in a position to understand why simply telling a person to straighten her back doesn’t help. It is because she does not know how to do the movement. She will understand your words well enough. But several things must change simultaneously for her to straighten her lower back.

Moshe Feldenkrais, the originator of the Feldenkrais method of body education, understood this thoroughly. More importantly, he knew how to make use of this understanding. The brain controls the body. If you want the body to work better, you need to make the brain work better. When we were infants our learning was stupendous. However, except for those of us who pursued sports, dance or martial arts, our movement stopped improving by the end of adolescence. But it didn’t have to  we can refine our skill and develop new understanding at any age. Feldenkrais devised a series of movement explorations that enable us to recommence the discovery process.

Learning to stand better

To illustrate the Feldenkrais learning process, let’s review what I did with a patient, Carole, to help her understand how to organise her body so that her swayback was not so pronounced. I’ll start by telling you one of the things I tried that did not work. I asked Carole to sit on the bed and roll her pelvis forward and back. She should have been able to move the crest of her hip arcing forward and back but instead, she moved her whole torso forward and back, with no independent movement of the pelvis.

Normally Carole would be able to move her pelvis independently. She is a very aware person. But her body changed so much with the pregnancy that she wasn’t as clear as before. So my next step was to help her remember how to move her pelvis independently. The easiest way to move your pelvis independently is to lie on your back and rock it. Your lower back arches as your pelvis rolls away from your head  so even though we call it an ‘independent’ movement in fact the vertebrae near the pelvis adjust of necessity. Going in the other direction, your pelvis rolls towards your head but does not lift off of the surface you are lying on.

We then went through a series of easy transitions, with our final goal being for Carole to be able to move her pelvis forward and back independently when she is standing. This movement will help her to be able to undo her swayback. We started with Carole rocking her pelvis while leaning back on her elbows. Then I asked her to rock her pelvis while leaning back with her arms extended. Finally she was able to rock her pelvis forward and back in the sitting position  a movement she couldn’t do when we first started.

When Carole sits, she sits beautifully. Her pelvis is aligned in a way that allows the spine to be straight and comfortable with her back muscles at ease. And now she was better able to adjust her pelvis to support her lower spine. Yet when she stood she still had a swayback!

Next I looked at Carole’s entire body pattern when she stands. Details always take their place in the context of a larger whole. Looking at Carole from the side, I could see that her body assumes a sort of "C" shape, with the weight of her pelvis forward relative to her ankles, and with her shoulders leaning back to counterbalance the weight. Her "swayback" is the angle her lower back makes when her pelvis forward and her shoulders are back. Now because she sits so beautifully, we know that the problem isn’t with her lower back. Her lower back works fine. The question becomes what can we do so that when Carole stands her body from her pelvis to her head will be aligned as well as it is when she sits?

Standing as sitting

There is something you can do, and you can try this yourself. I asked Carole to explore bringing the weight of her body back just to the point where she was almost off-balance. Most people, when they do this, find that they tend to lift the front of their feet.

Lifting the feet in this position serves a useful purpose. Our ankle joints pivot slightly backwards, coming slightly more under the weight of the pelvis, and this helps us maintain our balance. However, there is another response possible at this point that exactly sits our purpose. Instead of lifting our feet, we could let the pelvis rotate under, thus straightening the lower back and aligning the whole torso.

Try it yourself. Try bringing your torso back almost to the point where your toes would lift to keep balance. At this point your heels are supporting most of your weight, and it is easy for your pelvis to rotate under so that your spine is relatively straight. Even though you are standing, it is almost as though you are sitting. Indeed I call this ‘standing as sitting’, and it can feel a little bit as though you are riding a horse.

Connecting your heels to the ground by bringing your weight backwards and allowing the pelvis to naturally rotate to align the spine are the key points of ‘standing as sitting’. It takes a little bit of getting used to, not only because your thigh muscles may work a little bit more, but because your balancing mechanism must also become more refined. Standing in this way is actually easier, but it requires that your brain becomes a little more fine tuned.

I commented at the beginning that I couldn’t just tell Carole what to do, because she would not be able to understand my instructions in a way that she could use. I had to help her make some discoveries first. I believe this is simple observation as profound implications for learning in general.

Many people, including some teachers and school administrators, seem to believe that you can just tell people things and they will learn. You yourself may have experienced this in your own schooling. Often this leads to students memorising words, but not really understanding.

The first scientific researcher to strongly articulate that people learn by doing was the great French psychologist Jean Piaget. Feldenkrais showed how this applies to any skilled behaviour and he understood that the best learning occurs non-coercively, when people feel free to explore and try things out for themselves. Feldenkrais was able to create this atmosphere in his workshops, even though everybody was doing the same sequence of exploratory movements under his guidance. I try to relate everything to the question what will it take for us to evolve a world that works? I believe that part of the answer is raising children in a way that they learn to think and feel for themselves, even though they need guidance in learning.

The WellBeing Team

The WellBeing Team

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