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Alexander Technique

 
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Alexander Technique - December 29, 2004 11:47:00 AM   
MikeWW

 

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Does anyone have experience with the Alexander technique and if so, what kind of clinical results were you able to achieve using it?
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Re: Alexander Technique - February 7, 2005 1:24:00 PM   
JLS_PT_OCS

 

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It seems to be method of posture control and body awareness during all activities.
Mostly for neck pain and / or some voice complaints.

Conspicuous lack of outcome studies and failure to utilize some evidence-based treatments such as mobilization procedures or deep neck flexor strengthening makes it difficult to see this as a viable therapy.

Though certainly I have seen LMTs and some (of all things) ballet instructors advertising that they are "Alexander Teachers".

I get clinical results with evidence based therapy, therefore, I do not use this technique.
Though I was fascinated by the claims made by an LMT who utilized it with her clients...very amusing.

_____________________________

Jason Silvernail DPT
Board-Certified in Orthopedic Physical Therapy
Certified Strength and Conditioning Specialist
www.silvernailstudios.com
jasonsilvernail@gmail.com

(in reply to MikeWW)
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Re: Alexander Technique - March 16, 2005 7:24:00 AM   
january

 

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Hi Mike

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15458754

I found a free copy of this paper on another forum (only need registering) but it seems that its name is disallowed on this one? :confused: I can't simply write its name (replaced by *****)?

(in reply to MikeWW)
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Re: Alexander Technique - March 18, 2005 2:41:00 AM   
Randy Dixon

 

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Jason,

I like movement therapies, I think they are about the best thing you can do for your patients to allow them to do for themselves.

I guess I'm going to have to look up some papers, since I know you are a "if it's not on Pubmed it isn't real" type of guy.

That's just a little jibe, I thought I'd beat the rush.

(in reply to MikeWW)
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Re: Alexander Technique - March 18, 2005 2:52:00 AM   
january

 

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Randy,

There is now a lot of evidences on PubMed!
Man was designed to move as a whole, not by parts!

(in reply to MikeWW)
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Re: Alexander Technique - March 18, 2005 12:25:00 PM   
JLS_PT_OCS

 

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Randy-
Thanks for the friendly joke, and you may be right about that statement, generally. Guilty as charged. :)

Part of my intent with that attitude is to draw attention and discuss why PT is different than such exercise programs, namely, that we use things proven by research to be beneficial for people with medical problems, pain, and movement dysfunctions.

Otherwise we might as well be Personal Trainers or Athletic Traners, then. Don't get me wrong, I've nothing against those people (my wife is a personal trainer, I have friends who are ATCs), but with as much transition as is going on in this market and in the health care system, I feel that sort of distinction is key for us.

Much like pilates, there are probably some very good aspects of this technique, but if there is no effort to isolate those aspects or refine the techniques, and excessive emphasis on dogma, theory and certification charges, then it is more a money making gimmick than a medical treatment. I think surely we can all agree on that?

If the theory trumps evidence (or attempts to provide evidence), and there is money to be made with it, I think I am justified in my skepticism of ANY such system or program.

I would agree with you, definitely, that for patients in pain, most any movement is good, and we should be encouraging that, be it Alexander, Pilates, Yoga, Tai Chi, etc.
But that doesn't make it "Physical Therapy". Evidence based treatment techniques by properly trained providers does.
:)
J

ps seen some interesting research recently on attempting to quantify the benefits and procedures in Tai Chi. An interesting start, and an example of how to move a system or art from gimmick or hobby toward it's use as a medical treatment...

_____________________________

Jason Silvernail DPT
Board-Certified in Orthopedic Physical Therapy
Certified Strength and Conditioning Specialist
www.silvernailstudios.com
jasonsilvernail@gmail.com

(in reply to MikeWW)
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Re: Alexander Technique - March 19, 2005 3:09:00 AM   
Randy Dixon

 

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Well I thought I was going to have a good argument with you but I think we are pretty close together on this. The Alexander technique, Feldenkrais and a few others are the beginnings of what PT's do when training neuromuscularly. I would agree with you that there is no need to keep the "name" and philosophy, along with the certifications and CEU charges, intact in order to keep what is worthwhile about them.

(in reply to MikeWW)
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Re: Alexander Technique - March 19, 2005 7:29:00 PM   
srcase

 

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Today, I just gave an eight hour inservice on Pilates for Rehabilitation. We had eight participants and we organized the material by primary focus and muscles used. The exercises are based on form and precision with transverse activation all the time, plus obliques, adductors, lower trap, serratus, and deep neck flexors mostly. Every movement incorporated breathing and alignment. My patients definitely benefit from the breathing and postural awareness, spinal mobility, even some neural gliding from the exercises....and of course, stabilization.
I certainly wouldn't consider myself a Pilates guru, as it does have it's limitations and drawbacks (classic Pilates emphasizes stabilizing the lumbar spine in flexion quite a bit, which is good for higher level patients, but I like to stabilize in neutral first, so I just modify depending on the patient and the condition)
And I think it is this clinical decision making coupled with our intricate knowledge of anatomy and pathology that make PT's the optimal profession to adapt these movement awareness techniques to fit a rehabilitation model. Now, I just have to do the research!
And hey, what's wrong with ballet teachers, Jason ;)
Sarah

(in reply to MikeWW)
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Re: Alexander Technique - March 20, 2005 4:00:00 AM   
nari

 

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Sarah

Go for the research on the so-called 'soft options' like Tai Chi, yoga, dancing etc.

And we are definitely the profession with the background clinical experience / knowledge / development to utilise these specialised movements to their limits.
For chronic/persistent pain people, who have forgotten what is natural for them, and don't want to particularly find out because they cannot visualise natural movement, and are too far from the USA to attend Barrett's course...it is the way to go for them.

Nari

(in reply to MikeWW)
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Re: Alexander Technique - March 21, 2005 12:31:00 PM   
JLS_PT_OCS

 

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Good posts, Randy/Sarah...and agreed, Nari on our preparation.

On ballet teachers... I've been angry ever since they made me wear the pink tutu instead of the blue one in class....
Or maybe it's the truckloads of musculoskeletal dysfunction reported in the population of classical ballet dancers, as well as the encouragement of unrealistic and emotionally-damaging body image issues in young girls...

either way, I'm not a fan.
:)

_____________________________

Jason Silvernail DPT
Board-Certified in Orthopedic Physical Therapy
Certified Strength and Conditioning Specialist
www.silvernailstudios.com
jasonsilvernail@gmail.com

(in reply to MikeWW)
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Re: Alexander Technique - March 25, 2005 4:01:00 PM   
apolipo

 

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Quick thought:

For anyone who has recently attended one of Gary Gray's classes, do you think his principles of functional exer/movement qualify as a movement based therapy?

He is not big on telling people how to move, but in subtly tweaking movements to acheive a desirable or functional goal. His approach takes a great deal of knowledge about biomechanics and motor control to appropriately tweak and adapt movement patterns.

Also, he dislikes active, single joint movements. I get the feeling that, in his mind, they are pointless.

Any thoughts?

Mike t

(in reply to MikeWW)
Post #: 11
Re: Alexander Technique - March 30, 2005 9:57:00 AM   
JLS_PT_OCS

 

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I have to say my approach to exercise and rehab has been totally changed by reading and watching Gary Gray and Gray Cook [both PTs] speak.

They have helped me focus more on movement quality in patients and sharpened my focus and attention about recognizing what is quality movement and what is not quality movement, and how to fix it.
I find I spend less time with patients on an exam table poking and prodding them, and less time "telling" them what to do. I now spend more time watching them perform various movements and cueing their motion with the use of external resistance such as bands or positioning strategies that encourage or force correct movement.

I also spend less time giving patients "stretching" exercises, and have almost completely stopped giving patients stretching exercises for supposed "tight" muscles. I now understand what they mean by the difference between flexibility and mobility, and how to better train that.

This has really changed how I practice and I have enjoyed both of their works immensely. I'll start a separate thread for this also.

J

_____________________________

Jason Silvernail DPT
Board-Certified in Orthopedic Physical Therapy
Certified Strength and Conditioning Specialist
www.silvernailstudios.com
jasonsilvernail@gmail.com

(in reply to MikeWW)
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Re: Alexander Technique - March 30, 2005 9:18:00 PM   
karmzack

 

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Jason,
I can only find one book by Gray Cook - "Athletic Body in Balance". Do you have info/reviews on any of his courses. The Sahrmann text looks like it may go way over my head.

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Zack Solomon MPT, OCS, CSCS

(in reply to MikeWW)
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Re: Alexander Technique - March 31, 2005 7:03:00 AM   
JLS_PT_OCS

 

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Highly recommend Gray's book. I didn't really get it until I went to a PerformBetter course and heard him speak. Great guy, laid back and helpful.
However, I happen to know you personally, Zack, and since you're smarter than me, you might do a lot better. :)
PerformBetter doesn't charge much for their seminars, and if you can hear Gray speak it might really help. Plus CEUs for your CSCS.

I think the Sahrmann text is over my head, too. But I just keep reading the same passages over and over, and sometimes a few things get through my thick skull. It's really opening my eyes and creating a paradigm shift, I think.
More to follow.
J

_____________________________

Jason Silvernail DPT
Board-Certified in Orthopedic Physical Therapy
Certified Strength and Conditioning Specialist
www.silvernailstudios.com
jasonsilvernail@gmail.com

(in reply to MikeWW)
Post #: 14
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