by James McAndrew, GCFP

The mere thought of pain can fill us with dread. Actual pain can dominate every part of our lives and prevent us from getting adequate rest. So, if we’re unfortunate enough to suffer from acute or chronic pain, how do we get on with our active lives and find satisfaction?

That was my challenge for four long years. After my mother’s death, in the midst of an ugly, prolonged family drama around her will, my left hip was injured during Tai Chi Push Hands practice. It never recovered; instead, the injury set in motion a steady downward spiral of chronic pain which affected both hips. The pain and its knock-off effects cast a dark and debilitating presence that affected my mood, memory, and concentration. My wife had a lot to bear and this strained our marriage, yet she stood solidly beside me.

An MRI scan revealed moderate arthritis in both hips. The left looked worse for it had a labral cartilage tear in addition to bone spurs, worn out cartilage, and leaking fluid which the right hip also had. Most disturbing was the shape of my left femoral head. Rather than being a smooth cone shape, it was badly flattened; no wonder it hurt! Had a simple injury caused this much damage? Had the flattening occurred over decades? Whatever the actual causes were, I was informed that resurfacing or arthroscopic surgery weren’t options and that I was now on “the long road to hip replacement!” Having lived a very physical life, and being a good athlete, my self-image was shattered!

Being a Feldenkrais® practitioner, I wondered if I could avoid hip replacement, then proceeded to do everything in my power to avoid it. I treated myself to almost daily Awareness through Movement® lessons [these helped me more than anything else did], physical therapy, Rolfing, seven cortisone shots, then spent close to $10,000 having my own stem cells implanted in both hips to regrow the cartilage. Ultimately none of these things could repair the damage and I realized that the quality of my life would improve if the relentless pain were to go away – I’d honestly forgotten what comfort felt like. Having one hip in dreadful shape and the other fast deteriorating, I decided to have both hips replaced at once via anterior approach surgery. It was a massive and scary challenge, yet I preferred to go through the surgical ordeal just once, as my right hip would eventually need replacing anyway.

Does this mean that I gave up on the Feldenkrais Method® of somatic education or that it doesn’t work? –Not at all! The most amazing part of the four year long ordeal was the journey itself. The intelligent, kind, open awareness, willingness to ask for help, and healthy self-love required of me, carry over to this day. Every single day became a living Awareness through Movement lesson–sleeping included. Although I sacrificed jogging and jumping rope, I lived an active life during this time and walked without a limp; no stranger guessed the difficulty I was living with. An active life remained possible because I accepted my predicament and committed to improving my self-use through the Feldenkrais Method. Today, sixteen months after my surgery, that improvement continues.

The awareness required to improve my self-use in walking and all functional movements came at first through practicing the Awareness Through Movement lessons. However, the real challenge was to take what I’d learned in these lessons and apply it to my life –all day long. The keen level of self-sensing developed by Awareness Through Movement lessons gradually transferred over into everything I physically did. I was walking more lightly and skeletally. I shortened my step a little to reduce pain, then became acutely aware of a ground force traveling upwards through my feet, knees, into my aching hips, and lower back. My movement became better organized as my physical self-image became clearer and more skeletal. Increasing my self-awareness is what enabled these changes.

All this time I continued to practice Tai Chi Push Hands and to actively coach boxing. Swimming was a nice low impact activity, and sometimes I rode my bike. The anti-inflammatory drug Aleve helped with pain, and apart from seven short lasting cortisone shots, I never took other steroid based painkillers. Surprisingly, both my boxing and push hands improved! The self-sensing I’d developed during Awareness Through Movement lessons worked to my advantage. The need to shorten my walking step meant that my bases of support [feet] were always under me and I’d uproot push hands partners with ease. There was a feeling of effortless “scooping” which was very smooth. In boxing, I made smaller dodging movements to avoid punches. This enabled me to fire back counter punches instantaneously. My dodges and counter punches were often simultaneous which made them very effective.

We Feldenkrais® people know that the possibility of improvement almost always exists. By improving and perfecting what I could do, I didn’t regret what I could no longer do. I experienced a lot of satisfaction within my “shrunken” universe. This reminds me of an old saying; “it’s not what you’ve got, it’s how you use it that counts.” Yet making my hip arthritis the very center of my life caused harm elsewhere. I was shorter tempered at work and didn’t listen to my wife or anyone else very well; pain is debilitating. I seriously contemplated suicide several times when I saw no way out. Openly sharing my despair with my twelve step fellowship and my wife relieved my burden. After some time, I realized that my job was to love myself through this ordeal and to not give up on myself.

The calming effects of Awareness Through Movement lessons were truly profound for me. My autonomic nervous system (ANS) unwound into a relaxed yet aware state. Oftentimes life demands that we get a lot accomplished. We rush, lose awareness, and the sympathetic branch [“fight or flight” part] of our autonomic nervous system takes over. Awareness Through Movement lessons guide us into the more restful –parasympathetic branch of the ANS. One is very present there, yet calm with a feeling of ease. Doing the lessons had a very significant effect in lowering my pain levels. I became very familiar with the “taste” of this parasympathetic place which I believe is required for healthy self-love. Some seek it through meditation, I sought it through bringing refined awareness to bear on the novel, guided movements of Awareness Through Movement lessons.

My life became better after hip replacement. All the self-care I’d practiced prior to surgery I now apply to my new life with two titanium hips! There are certain things I won’t do [such as jumping rope or sprinting], but I no longer have to “watch my every step” as I did for four long years. By continually seeking to improve the quality and ease of the movements I make, I live with relative comfort and am able to do most of the things I want to do. It’s a Feldenkrais slogan that “there’s no limit to improvement”; there really isn’t!

I left the hospital just one day after hip replacement for several good reasons. One of them was annoyance at being instructed to urinate only when a nurse was watching me [this applied even to sitting on the edge of the bed using a urine receptacle]. They figured out that I’m a determined soul, and secretly programmed my bed’s alarm to sound when I tried to urinate in private. Having tripped the alarm I became very annoyed and proceeded to walk slowly and carefully on my brand new hips, [without a walker or crutches] to the nurse’s station where I told staff to turn off the alarm. They were shocked that I was able to walk and obliged me. Yes, I’m a very determined person, but it was the level of self-organization I’d developed in Awareness Through Movement lessons that enabled me to walk unassisted within hours of hip replacement [as well as the excellent surgeon who operated on me]. Back home, I took no more risks and used crutches for the next three weeks.

Curious? Try this! 

An idea that helped me to walk and climb stairs more comfortably, was to imagine a push coming from the ball of my back foot as I stepped or climbed. In walking, I needed to do this in slow motion at first. It wasn’t a deliberate push, but the clear image of a push that helped me. In climbing stairs, I needed to start at normal speed using this pushing image. Soon there was less work for my front leg to do and I walked with greater lightness and ease. I felt quite tall as the push off the ball of my back foot created a feeling of being completely “over” my front leg, [which naturally straightened like a stick]. Although well-organized walking involves more than this, I’d recommend playing with this idea for a while and see if walking and climbing stairs don’t become a little easier and more enjoyable.

Born and raised in England, Feldenkrais practitioner James McAndrew lives in San Francisco. Working as a public school teacher he also finds time to teach Feldenkrais Awareness through Movement classes to senior citizens and coaches boxing. In his free time, James enjoys practicing Tai Chi Push Hands and taking piano lessons. James seeks to bring Feldenkrais principles to all that he does while acknowledging the need to mess up frequently!