Three and a-half decades ago I was a young physical therapist trying to help people improve their functional abilities. The number one reason people came to see me was back pain. Some were helped with the physical therapy interventions I was taught to apply, but many weren’t. A colleague recommended I attend a continuing education program on The Feldenkrais Method®, an approach completely unfamiliar to me at the time. Given that my colleague was also my employer, I decided to act on his recommendation!
The memory of one particular person referred for physical therapy to address years of persistent back pain remains fresh. I had been working with “G” for quite some time and significant improvement remained elusive. As a last resort, I taught him one of the Feldenkrais Awareness Through Movement® (ATM®) patterns I learned at the course I had recently attended. At the subsequent visit, he shared that he had experienced a remarkable absence of back pain, a surprisingly positive response. The gentle, exploratory movements enhanced “G’s” body awareness, helping him discover more efficient ways of moving. He learned how excess muscle recruitment prevented him from moving easily and how insufficient muscle recruitment caused excessive effort elsewhere. He learned about the relationship between his elbow and his hip, his breathing and his neck, his back and his shoulders, etc.
However, the crucial question remains: what happened to the persistent pain, and how did the ATM pattern, taught by a practitioner with very limited experience in its application, manage to alleviate pain that had persisted for years, proving resistant to so many other treatment approaches?
The answer to this question helps illuminate the elegance inherent in the principles of the Feldenkrais Method, a somatic educational approach that aims to enhance self-awareness and movement efficiency. One central idea is that by refining one’s awareness of movement and exploring alternative patterns, individuals can reduce pain, enhance flexibility, and improve overall function. The Feldenkrais Method promotes the exploration of movement variability, and it’s this exploratory process believed to be a key to what Feldenkrais described as “organic learning”. Engaging in diverse and novel movement patterns creates new sensory inputs to the brain which stimulate new brain processing and signaling. These inputs help individuals develop a larger movement repertoire resulting in more movement output options than the habitual ones that may contribute to muscular imbalances, overuse, and pain. This exemplifies the “sensory-motor loop” commonly referred to in body awareness training as well as motor control and motor learning science (which should be referred to as sensory-motor control and sensory-motor learning). The movement variability principle described by Feldenkrais aligns perfectly with current pain science research elucidating how alternate movement strategies and the associated sensory experiences often lead to reduced pain and discomfort.
True or False? The eyes see.
True or False? The ears hear.
True or False? The tongue tastes.
True or False? The back hurts.
The answer to all four statements above is indeed false.
The eyes, ears, tongue, and back all contain sensory receptors that receive information from the environment and from within the body. The eye receptors are stimulated by the light spectrum, wind, and temperature; the ears by sound waves; the tongue by various types of chemicals; and the back by movement, tension, and touch. Once stimulated, these receptors send electrical signals to the brain where the information is integrated and processed leading to brain outputs.
Sight, sound, taste and pain are all brain outputs that help us survive, grow, and function in the world. Our brains create pain to protect us. Imagine what life would be like if we didn’t know when a hot stove was burning our tissues or if we couldn’t feel pain when stepping on a rusty nail! Though not feeling pain may sound appealing, the inability to perceive physical pain is an extraordinarily rare condition called congenital analgesia, or congenital insensitivity to pain, and the life expectancy of people afflicted with it is only 20-25 years. Thus, pain is a lifesaver when it is serving its intended purpose. It functions as a signal prompting us to take actions that safeguard our well-being. For example, this might include muscular splinting to protect an injured body region, running away from a threat, or curling up in the fetal position to protect our vital internal organs.
When “G” performed the ATM lesson, he learned through curious exploration that movement of his back could be pleasant and not threatening. Therefore, the brain no longer needed to create pain and the associated muscle splinting. In addition, his habitual muscular overuse was inhibited by the motions he was instructed to perform within the lesson that included moving without strain or breath holding, and avoiding the unnecessary associated muscle contractions he had learned previously.
The Feldenkrais Method reframes the movement context, eliminating perceived threats of injury or anticipated pain. In the absence of such threats, the need for the brain to generate pain as a protective response ceases, preventing its unnecessary manifestation. That is, without a threat, the brain no longer needs to create pain as an output to protect us, so it doesn’t, leaving us perceiving no pain as we move toward normal homeostasis. Thus, the Feldenkrais Method trains body awareness by “rewiring” the input-output loop through mindful movements, helps us move more efficiently, and function more effectively. Feldenkrais summarized this by stating his method “makes the impossible possible, the possible easy, and the easy elegant.”
Within The Feldenkrais Method, improved body awareness is accomplished through learning with the practitioner in the role of educator. The instructional design takes two forms: 1) Awareness Through Movement lessons, which are verbally guided intentional movement sequences, and 2) Functional Integration, which involves one-on-one sessions in which a practitioner uses hands-on strategies. The goals of both forms are the same – to guide a client toward discovering enhanced body awareness, improved coordination, more efficient and easier motion, reduced pain, enriched function and quality of life.
As is typical of most advances in science and society, The Feldenkrais Method has been introduced and applied for decades, and researchers are now catching up. Moshe Feldenkrais was a genius well ahead of his time with incredible analytical skills and sensitivity to perceive what others before him had missed. His approach is unique and not widely accepted by several disciplines. It has been satisfying to see recent pain neuroscience advancements support Feldenkrais’ theories about movement, motor learning, pain, and the human experience.
A 2015 study published in the Journal of Bodywork and Movement Therapies found that participants who engaged in Feldenkrais sessions experienced significant improvements in pain intensity, disability, and overall function compared to a control group. Another study published in the European Journal of Integrative Medicine in 2017 reported positive outcomes for participants with chronic low back pain who underwent a series of Feldenkrais sessions. These studies align with a plethora of anecdotal evidence from individuals who have integrated the Feldenkrais Method into their pain management strategies. Many clients report a reduction in the frequency and intensity of back pain, improved mobility, increased functional abilities, a heightened sense of overall well-being, and enriched living.
In the 35 years since I met “G”, I continue to be amazed and inspired by the outcomes achieved through The Feldenkrais Method. Socrates’ assertion, “Wisdom begins in wonder,” finds resonance in the principles of Feldenkrais’ methods, which prioritize guided self-discovery through heightened awareness of one’s actions. Feldenkrais’ perspective, encapsulated in the statement, “It’s not to ask ‘what are you doing?’ It’s to ask, ‘what are you doing, how?’” underscores the method’s emphasis on a nuanced understanding of one’s movements. The Feldenkrais Method presents a promising avenue for addressing back pain by tackling its root causes such as the aberrant nervous system signaling and muscle guarding which helps reduce the brain outputs of anxiety, fear, as well as pain. Through heightened awareness, gentle movements, and a focus on efficient patterns, individuals can attain significant relief, improved health, enhanced functionality, and an overall heightened quality of life.
On a personal note, one of the most memorable recollections from my training was how I felt after we were guided through an “ankle lesson.” Prior to the lesson we performed a body scan while lying on our backs, checking the status of our legs, arms, trunk and neck. One of the directives was to feel (internally) how much space there was between the back of our neck and the floor. From my physical therapy training I knew it was normal to have some space behind our necks due to its skeletal curvature, referred to as the cervical spine lordosis. I was pleased my internal perception matched “normal”. Still lying on our backs, we proceeded with the lesson which included numerous ankle, knee and hip movements, and combinations of coordination challenges at these joints. We did not move our spine, arms, head or neck throughout the lesson.
We concluded the lesson by repeating the body scan. As we proceeded from feet toward head, I felt all the typical and wonderful responses one usually does after an ATM lesson. My legs felt more relaxed, longer, larger and I generally felt more complete in my lower extremities. I was shocked when we got to the neck re-scan. My perception was that the back of my neck was touching the floor. This was discombobulating. What about my very normal lordosis? Were they lying to me in PT school? Was my ability to perceive lost? Was I not…..normal? So I investigated by feeling, with my hands, for the space between the back of my neck and the floor expecting to find my very normal lordosis and, subsequently, internal peace. There was neither space nor peace. The muscles in my upper back and neck were so relaxed that the back of my neck was touching the floor. I could not initially make sense of this reaction since we hadn’t done any neck motions throughout the entire lesson. I was amazed at how an “ankle lesson” could create such dramatic change in a body region so distant from the movements performed. I’ve come to understand that there are no “ankle lessons” or “back lessons”, etc. There are only brain-body lessons and learner responses are very individual and very normal. I’m grateful for that lesson on many levels – neck muscles relaxed, an incredibly deep learning moment that changed my life, a broadened “normal”. Peace.
Dr. Mark Erickson is a self-described “recovering physical therapist” since being introduced to The Feldenkrais Method in 1985 and becoming a GCFP in 1992. He credits Feldenkrais with inspiring him to pursue a career teaching in physical therapy programs with the intent of introducing students to more holistic models of practice, especially The Feldenkrais Method. Mark has fully integrated The Feldenkrais Method into his physical therapy practice and educational pedagogy helping learners discover their inner wisdom and opening new ways of moving and thinking and being. Witnessing learners gain insight, confidence, authenticity, and heightened self-efficacy through Feldenkrais-based approaches is particularly gratifying for him.
Contact him at [email protected]