Back Pain

"In all honesty, I can’t really think of one client where the back itself was the problem – as most every back-pain person tends to think. In every case, their back pain or pathology was being caused by chronic habits which almost always was unconscious.” -SH


Can Feldenkrais® Cure Back Pain?

I set myself a challenge early in my private practice; I was resolved to make a living doing private Feldenkrais® session (called “FI” or Functional Integration®). I had no other financial resources with which to pay my rent or meet my other expenses. That meant that when a person walked into my office, I had to either be effective, or not make a living. This did force me to get smarter, quick, about how to be effective with back pain, one of the most common complaints.

So I usually would see back pain go away very quickly. I often thought, in wonderment, why do the MD’s and PTs and yoga teachers make such a big deal about treating back pain? It is the easiest thing to fix, in my experience.  The only exception to that was in cases where there was a surgery on the back – I never had success with those clients. There are those who do get results there, but I did not have the right skill set for that.

I could share dozens of stories about curing back pain. Most of them involve – first and foremost – assessing the client (giving them a “soft-global” Feldenkrais look as they sit, stand and walk and gesture) to see what kind of habits he or she is using to perpetuate back pain. Almost always it is one or all of several things.

For years I thought back pain was extremely simple to cure, and wondered why nobody else was using my approach. One day I sat down and wrote out all the many things I was looking for or evaluating. I had thought the list would be 3-4 items. But surprisingly, over the years I had learned more than I had realized. It is from this list, which I have well memorized, or internalized you might say, that I evaluate people relative to back pain:


  • Tucking the tail habitually, especially while sitting.
  • Tucking the tail while bending to pick up boxes or objects from the floor.
  • Too much fixity and tension in the abs and belly, with zero coordination of those muscles with the antagonistic low back muscles (such coordination is easily and quickly taught – especially with an ATM lesson called The Pelvic Clock).
  • A tailbone that is completely gone from their self-image both in movement and resting. There is intelligence in the tailbone, if we listen for it, it will tell us what to do to keep the low back healthy and happy. I tell all my clients, “you should be able to sense your tailbone at any instant, just like the tip of your little finger.”
  • Feeling too self-conscious to ever let the butt stick out behind when bending knees. That has to go, if they want to cure their back pain (I tell them). This is a guaranteed major problem in all western women who have ever worn short skirts or pants, where it is forbidden to stick out the butt when bending the knees.
  • Sitting with knees together instead of shoulder-width apart. Knees-together is what all-western women do, who wear the usual kind of clothing. It makes the top of the pelvis go back, destroying the lumbar arch. That is just the geometry of the pelvis and hip joints. It is how they are built. The only alternative then is to stiffen to sit up straight, or else become dependent on a lumbar support (even worse, in the big picture). Traditional cultural dress, long and flowing, enables women to sit with knees shoulder width apart with no stigma, as in the west.
  • Harmful sleeping positions. Usually, too much extension, not enough primal flexion. I teach them to side-lie while tucking the chin slightly, and drawing knees farther towards the chest, with the feet in front of them, not below their torso. For back sleeping, pillows under the knees, and lower pelvis (to reduce lumbar extension).
  • If they were meditators, they often would be creating tremendous back pain or neck pain by sitting while tucking the tail under, stiffening the spine to be erect, while pulling in the gut, lifting the chest and pulling shoulders back – and doing this unrelentingly for hours a day, years on end. Those things may be good to establish an initial erect posture (except for tucking the tail under), but then there has to be nearly complete relaxation. Without that, all those other things become a compulsive collection of self-abuse tools. There also needs to be some basic knowledge about the skill of chair sitting, as I teach on this website.
  • Keeping chin too high while talking or working (often seen in shorter people).
  • Not giving themselves permission to stand tall (seen often in tall people).
  • Not shifting weight either in standing or walking, so that neither leg can ever relax. That means both legs get tighter and tenser as the years go by. That’s a prescription for low back pain.
  • Staring and downward trending eyes. Staring makes the whole body tighten down. Looking down, for most folks, also (unfortunately) involves tilting the head down, destroying erect posture. Especially the habit of looking down, and tilting head down, while walking is a way to abuse the neck and back and create pain. There is usually no good reason to look down while walking, it is just a neurotic or obsessive habit. 
  • An over-active head and neck while speaking and listening. Some people think this is how to be social. No it is how to create tremendous neck and back pain. The head is as heavy as a bowling ball and we are not meant to gesture conversationally with the head; instead use the eyes and hands (like the Italians).
  • Never – ever- allowing themselves to “slump” or even get near to that, because they think it is REALLY bad posture. I have to explain that flexion is the only time the back can relax. Slumping is how we were born. It is how we were in the womb for 9 months. We call it the “primal C-curve” in the Feldenkrais Method. It is HOME BASE NOT A BAD THING for the spine. Did Nature make a mistake? There is a natural T-curve like that a chest level. The chest is NOT meant to be stiffened and lifted 24/7 for a lifetime, as these people think.
  • From an early age they have never spoken one word without over-tensing the neck. They think that is what it means to be responsive and communicate. It takes skill and patience to show them how to vocalize without doing this. Then and only then the whole back can relax. When the neck is always tight, so is the back. When I see this, for sure, it is priority #1 to correct the situation.
  • Drawing up the pelvic floor, as likewise the abdomen and belly, while lifting the shoulders when under any kind of stress. This is perhaps a relic of too-early toilet training, where the entire pelvic floor had to be tensed instead of individual sphincters.
  • Never sensing quiet and restful skeletal support of the head on the top of the neck, half-way between the ears. Without this, the neck is always too tense and hyper-reactive, and this “neck-neurosis” will for sure communicate the same idea to the entire back and pelvis. Most people with back pain, in fact, do not even know where the top of the neck is located. They think it is about at chin level. NO – it is at the level of the nose, or ears, or cheekbones! A little basic anatomy would have saved them from this problem.
  • Too many years of using a bucket seat swivel office chair with a lumbar support. That is one of the main causes of chronic back pain, but for sure, it is a tough sell to convince such people to gradually transition to hard flat-top wooden stools.
  • Too many year of using a soft sofa, and bucket seats in cars (old fashioned bench seats were much more friendly to the back and posture), which compresses the tailbone, immobilizing it, and also takes away any hope of perceived skeletal support in sitting. Lumbar supports are then mandatory. Such postural incompetence can easily become a habit; then they blame their back when it hurts. It takes lots of patience to convince people on this one, too.
  • Too much weight, too big a belly, creating an exaggerated lumbar curve

 

In all honesty, I can’t really think of one client where the back itself was the problem – as most every back-pain person tends to think. In every case, their back pain or pathology was being caused by chronic habits, from the above list, which almost always was unconscious. I took this a point of faith and I always got wonderful results this way.

How would I know which of these was the main issue for a client? I had to find that out, and quickly, since that would be the only true path, the easiest and quickest way, to give them palpable release from their torturing back pain. It has to do with that “soft-global” Feldenkrais “look” that we all are taught in our Feldenkrais Trainings. It is a rather a meditative frame of mind, where the intellect is held very loosely – quiet.  Touching base with that silent place inside, when I go there, with a client in the room, what is supposed to happen will just appear on the surface of my mind. That is how I was able to quickly sort out what to do with each client. It is not an intellectual process at all. I would imagine that my many years of meditation practice has helped me refine that skill.

Then there is also the psychology. Each client requires different handling. But one of several preferred methods was to treat the chosen bad habit as a harmful “toy” to which they are very attached, and I am going to take away that toy. I’d expect the same kind of stubborn resistance that a child might give, but in adult format. For instance, as soon as they speak a word and grab the neck or jerk the head, I’ll say “Stop. Say that again with a relaxed neck. Try it now! Put your hands on your neck to be sure you are not tensing there” Or if they stand up fixedly on two legs, I will insist they start gently, slowly side-shifting, with a relaxation response on the non-weight bearing leg. I will continue to do that each time I see them, until when they even think of me they automatically remember how to shift weight in standing.  And then I keep doing like that, unrelentingly, and maybe for many weeks,  until both of us are well tired of that game. I drill them, I play act with great dramatic flair and often a loud voice and large gestures, I play the role of father or mother, I nag them, I interrupt them and I patiently repeat why it is harmful, what they are doing so compulsively. This kind of intervention gets results, where kind words, soft explanations and gentle hints simply don’t have any impact. It is rather like crisis intervention, I imagine, but I have had stunning results in curing back pain this way.


Four years ago I did a workshop on back pain. One man, from France, had been going to India 6 weeks every year to treat his back pain with a special kind of hatha yoga. I told him the usual things about curing back pain (mainly how to not do those bad habits listed above). A week later he stopped by to greet me. He was full of gratitude and wonderment, and he looked at me like I was somebody from another planet as in who ARE you, really? He was looking at me as if I was some kind of god. He said:

“I have been doing like you told me, and ALL my back pain is COMPLETELY gone. I would not have believed such a thing was possible. It was so simple, what you told me. Now, I do not need to go to India for 6 weeks every year to do yoga! THANK YOU SO MUCH.”

I remembered, in the workshop, that I had a moment of personal interaction with him, and I told him what I was intuitively sensing, as to the main, real cause of his back pain. I said it with confidence, briefly and some bluntness. He was a little surprised, and he obviously took me seriously, but for me this was no big deal, as I had been doing the same thing with dozens of private clients for many years.

It has been from such feedback, multiplied many (dozens or more) times, that I have come to trust those intuitive hunches that come from that silent place. It took me many years to finally trust those (almost imaginary) feelings, and give them voice (no matter how inelegantly or bluntly). But it has been well proven and I no longer doubt.

© Copyright 2015 Steve Hamlin  www.mybodycanlearn.com