These columns, written by Carolyn Nicholls, first appeared in the Brighton Evening Argus Women’s section 'Body and Soul' and are reproduced by permission.

Working styles have changed dramatically and now it is common to work either totally or part time from home. This brings its own tensions and problems as well as freedoms. Most people who work from home put in more hours than they would do at an office and work very intensively, often finding the day has flown past and they are still in their pajamas because they sat down ‘just to check a few emails’ when they got up and it all went pear shaped from there!

My pupil Katie does exactly that and is now finding she is very stressed and developing a variety of computer related problems. She has neck pain and mild RSI in her wrists from constant typing, she has noticed her breathing is very poor and she feels very stiff and tired after sitting at her desk.

As there is no one to distract her by suggesting a coffee break or a lunch outing, Katie tends to ignore her own symptoms and simply carry in working. A lack of social contact means she can’t chat about what seem trivial problems to work mates because all her work contacts are very intense and deadline driven.

Stress made Katie seek out Alexander lessons and untangling her mass of problems was intriguing. When Katie talked about what her day was like she hunched her shoulders right up round her ears, stuck her hands in her packets and flapped her elbows about. One foot was tapping and she was jigging about. She simply couldn’t keep still. When I pointed that out she asked me what it had to do with her tension. I put Katie on my teaching table, lying on her back with her knees bent, and got her to stop wiggling. Gradually she realized her stress and tension was at a very high level and she did everything in such a hurry that her whole body was on constant red alert. Learning to break this vicious cycle by releasing neck muscles was the start of Katie understanding the effect stress had on her body and spirit. She learned to take more time to do things and to notice when tension was building up in her. Regular practice of semi-supine throughout her working day enabled her to keep releasing muscles that would other wise got tighter and tighter.

Over a course of lessons Katie noticed big changes in the way she sat at her computer and the way she walked. She felt as if her life was less rushed and her anxiety levels dropped too. She told me that the most important thing she learned was to take time.

Feb 07 - Elastic Riding

James is a keen rider. He competes in cross country and dressage competitions, trains horses and is totally immersed in the horse world. Suddenly at the age of 35, James started to get back pain when riding and afterwards when doing stable work. This was a real shock to him as he hadn’t injured himself in any way and was totally accustomed to the hard physical labour that goes with riding and caring for horses. James came for lessons because of his back pain, but continued long after the pain abated because the Alexander Technique made so much sense to him. Lessons clearly demonstrated to him how tense he was, and how he had mistaken tension for strength. Re-learning how to use his muscles differently was a revelation in economy of effort. In retrospect James wondered why his back had not hurt before, but I explained that was one of the great unknowns! Some people can seem to get away with mistreating their bodies and some cant. Sometimes something we have been able to do for years starts to cause problems and there seems to be no reason for it. All we can do is look carefully at how we are using our bodies and make the necessary changes. Apart from the relief of his pain, James got excited about how much the Alexander Technique was improving his riding, particularly his dressage skills. He realised riding is about the meeting of two minds, the riders and the horse; and of two muscular suits cladding two quite different skeletal structures.

James spent a lot of time schooling his horse, attending to its balance and co-ordination whilst ignoring his own. His co-ordination and postural support were not as good as his horses!

Improving the way he used his whole body influenced the way his horse uses its whole body. Lesson helped James realize what he did on his horse was totally dominated by what he did off it. The way he supported himself to walk, talk, eat, dance or slob on the sofa all has one force to content with, and that is gravity. If his response to gravity is effortful and tense, then that is how he rides.

We are all slaves to our habits, and find it very hard to change things. Habits of postural misuse are embedded so strongly in our nervous systems that we don't realise we've got them. It took time for James to make changes but he considers it time well spent. His back is painfree, his riding better than ever and he says his horses are happier too.

March 07 - Hiatus hernia

My pupil Ester wanted lessons to help cope with her hiatus hernia. Ester is in her early 60’s and has been suffering from this condition for some time. Although surgery is an option, and indeed may be the best thing for her, Ester is keen to do all she can to help herself. Her posture and the way she uses her body are very important factors for her self management.

A hiatus hernia is when the upper part of your stomach pushes upwards into the opening in your diaphragm through which your gullet passes. Your gullet carries food into your stomach.
When the top of your stomach pokes through the hiatus, it prevents the muscle fibres of the diaphragm from closing the lower end of your gullet and the result is stomach acid is able to move up into your gullet causing extreme heartburn and pain.

Ester can no longer sleep flat, she sleeps semi-inclined so that acid will drain down with gravity. This is not a comfortable way to sleep and Ester developed neck and back ache as a result.

Putting my hands on Ester I began to help her work out the compensation tension patterns she had developed. Whenever our health and wellbeing is challenged in some way, we work out ways of coping. Mostly this involves a muscular response to the situation and often it is not the best response. Often we are unaware of how we have responded and excessive tension can seem normal to us. We all need muscle tone to support us in our daily activities, but it needs to be evenly balanced throughout our bodies. When muscle tone increases into muscle tension we get problems. Excessive tension distorts our bodies and creates pressure in joints and organs, interfering with our natural functions of breathing and digestion.

In Esters case she was unconsciously pressing her chest wall down by depressing her sternum, particularly when she swallowed, which was an uncomfortable activity. She was tightening her hips and leg muscles which was contributing to the general downwards drag through her body. At first Ester couldn’t understand why leg tension might affect her hiatus hernia, but I explained our bodies work in harmony throughout our muscles and tension in the legs affects other parts of us. Over a period of 30 lessons Ester learned to support herself differently, she no longer pressed herself down, instead she allowed her body to freely move.

Ester’s symptoms became more manageable and although she will have surgery for her condition she felt much more positive in her ability to help herself. That is what the Alexander Technique is all about, learning to help yourself.

April 07 - Whiplash

Anyone who has suffered even a minor whiplash will know that it can give you a very stiff neck and back and headaches. Usually symptoms clear up in a week or so. When Charlotte, a long standing pupil, rang up to say she’d had a slight shunt in her car and thought she might have a bit of whiplash I advised her to check it out with her doctor and then come for a lesson. Charlotte’s doctor examined her and gave her painkillers and she came for a lesson the following week.

Although she had no pain, Charlotte was aware that she was holding herself differently. The accident had made her nervous and she was still bracing her body as a result. As part of the bracing pattern she had tightened her legs and lower back and was experiencing low back pain of the kind that brought her for Alexander lessons two years ago. In her lesson we worked with encouraging a general release of tension throughout the length of her body.

This helped her to recognize excessive tension in her shoulders and to let it go. Releasing her shoulders allowed her to breathe more freely and she commented that she hadn’t realized that she was holding her breath quite so much until she had let her tension go. “I feel as if I’m breathing properly for the first time since the accident.” she said. During the next few lessons we worked with making sure Charlotte unraveled any compensatory tension she had created. When someone suffers whiplash, they think they have recovered only to run into problems weeks or months later. This can be due to the development of tension in other parts of the body to support the original injury.

These tensions can stay fixed in muscles long after the injury and become a bit of a habit. Stiffness in the neck and back can make it difficult to turn the head in a particular way and so you might unwittingly avoid doing so. This in turn builds a layer of tension in the shoulders so that you hunch very slightly when turning. This can spread on to the upper back and on throughout the body so that little by little things stiffen up and suddenly there seems to be a problem. In fact the compensation has become the problem and has to be undone. For Charlotte this did not happen. She was diligent in practicing her semi-supine procedure and making sure she didn’t stiffen her neck muscles and scrunch her body downwards. She said she felt the Alexander technique had taught her skills to manage this and other problems she encountered.

May 07 - It’s ME/CFS awareness week

May 6th-12th is ME/CFS awareness week and as I have given Alexander lessons to people coping with this chronic illness I thought it would be useful to talk about how the Alexander Technique can help people manage conditions of low energy, muscle and joint pain and extreme fatigue.

ME affects people of all ages, socio economic classes and gender. It is classified by the world health organization as a neurological disease and ranges in severity from mild, to severe where the condition keeps a person housebound or even bed bound, constantly feeling extremely ill and exhausted. It is a disease that disrupts education for young people and causes others to loose jobs, homes and become isolated and broke!

There is no cure for ME but there is a lot of benefit to be gained in managing the condition and that is where the Alexander Technique can help. My pupil Eleanor got ME in her early 30’s following a viral infection. Basically she got flu and just didn’t seem to recover. She was unable to work and was housebound for 5 years, relying on her husband to do everything for her. Eleanor found she inevitably became very unfit, which didn’t help, but couldn’t exercise as she was too tired and any exercise inflamed her muscles for days afterwards. She had heard about The Alexander Technique and decided to give it a try. By this time Eleanor was well enough to get into a taxi and could walk a little if she took it slowly.

Our lessons first addressed the strange notion that Eleanor, like so many other people, with or without ME, was creating a lot of tension in her body by holding her muscles stiffly. She was not at all aware of this and literally cried with relief when she experienced a release in her shoulders as she lay on the teaching table in semi-supine. She was thrilled that finally here was something that gave her autonomy. She could learn to think about her body and herself in a different way. She could learn how to release and direct her body to lengthen and widen. Most importantly it didn’t require any physical effort and could be practiced in small doses so mental fatigue was not a problem.

We adjusted the lessons to suit her situation, making them shorter and more spaced out that usual. This helped stabilse her available energy and gently build better muscle co-ordination and confidence. She was particularly interested in non end-gaining, a concept that recognizes that if you go directly for your goal, whatever it is, without careful consideration of how you might achieve it, you are liable to run into problems. In Eleanor’s case this meant she began to recognize how much automatic tension she brought to simple activities such as raising her own arm to pick up a cup of tea. The Alexander Technique was one of a number of ways Eleanor used to improve her health and mange her condition. After 6 months of lessons she is more stable, able to walk more without fatigue and simply feeling a lot better.

There are no quick fixes for ME, but thoughtful management can go a long way to make things better.

For more information about ME/CFS log on to www.measussex.org.uk or www.ayme.org.uk (for young people with ME)

June 07 - In the garden

Despite the recent rain, longer lighter days have tempted many of my clients out into their gardens and a flurry of activity results. This flurry brings with it complaints of sore backs, sore shoulders and sore knees from all that pruning, lifting and kneeling to weed.

Apart from the obvious precaution of not going form being a couch potato to suddenly doing a full days heavy digging, what can the Alexander Technique offer a dedicated gardener?

Sue is a dedicated gardener; she likes to undertake big projects, which often involve heaving stones and paving slabs around to be placed to her design. She is petite and although wiry, not able to manhandle materials about like an experienced builder. Instead she works out different ways of doing things. Sue recognized that she simply couldn’t lift heavy paving stones and so didn’t hurt herself trying.

She approached her problem indirectly, not trying to get the result done at all costs, but thinking through the best approach. In her Alexander lessons she had noticed her strong tendency to want to rush things, even standing up was done in a rush, and it resulted in Sue stiffening all over her body, so that although she stood up quickly, she locked her body as she did so and gave herself back pain. Lessons taught her not to think about the end of her project, even if the project was simply standing up out of a chair, but to consider instead what tension pitfalls she wanted to avoid on the way.

When it came to standing up, she clearly wanted to avoid creating tension in her neck and back that pulled her down again. When it came to paving stones, Sue learned to ‘walk’ them on their edge, keeping them in balance, and not to rush over the job, but to take her time and keep her own tension levels low. To her surprise she moved the slabs without exhausting herself and got them where she wanted.

Another task she enjoyed was kneeling to weed, but, even with a kneeling pad she found it hard on her knees. She realized that she used a lot of unnecessary force when weeding and this created compression in her back and a lot of pressure on her knees. Letting herself lengthen and allowing her ribs to move freely so she could breath easily, took the pressure off both her back and her knees. The Alexander technique is a tool, or more acutely, a series of tools, that you can use to monitor and release your own tension and create a greater degree of flexibility and balance in your body. If you are a gardener it will help you manage your weeding and digging.

July 07 - Rigid Posture

My new pupil George is an academic, and, like a lot of brainy people, treats his body as a way of carrying his brain around. He has no interest in exercise, often forgets to eat because he’s so involved with research and is a typical absent minded professor who looks as if he’s just about managed to change out of his pyjamas.

Unhappily for George, there comes a time when the body, uncomplaining for years, decides enough is enough and suddenly George is paying for years of misuse and neglect. Sitting like a sack of potatoes in front of a computer screen for years on end is not conducive to good breathing and Georges ribcage long gave up the unequal struggle to move so his breathing is very shallow and mostly takes place in his abdomen. His shoulders have permanently migrated up to his ears and his neck all but disappeared. His shoulders are also very stiff and he has problems getting his jacket on and off. Basically all his joints have stiffened up and he is aware of moving with increasing difficulty, beginning to struggle getting in and out of a chair and having problems turning his head when driving.

During his first few lessons we talked a lot about balance and I asked George to consider how he balanced himself when sitting at his desk. He had no idea! He just sat there, hunched up tapping away. Learning where his sitting bones where (in the middle of your buttocks) and how to sit on them, not behind them so you slouch, or in front of them so you over arch your back, was one step towards a more lengthened balance of Georges entire body. He enjoyed practicing semi-supine and found it gave him a sense of how his back worked, where his shoulders were and how to release excessive tension around his shoulder girdle and chest.

Over a course of some 30 lessons, Georges shape changed completely, he no longer shambled as he walked but had a more springy upright back, which he said was effortless. He realized he was exerting a lot of energy in his previous slumping and now he had changed habit he felt lighter and freer. He could get his jacket on easily, had to adjust the driving mirror of his car to accommodate his new lengthened back and generally felt much more energetic.

Although the Alexander Technique is a gentle process, it can help to rehabilitate lazy postural muscles to support us better. This can have a hugely beneficial effect on breathing, digestion and circulation. After all, if you squash a hot water bottle, it will change shape and distort. If you squash yourself, you can expect similar trouble!

August 07 - Alexander Tips for Travelers

Many of my clients who suffer from back pain are apprehensive about traveling, particularly flying. Most forms of travel involve sitting for extended periods of time and this can give rise to additional stiffness, and cramp and aggravate back pain. There are skills you can use from the Alexander Technique to help in these situations.

First of all you have to be realistic, if you have severe back problems a long haul flight is best avoided unless you have no choice, but preparing physically for a shorter journey can decrease the problems. Making sure that you start your journey in a good state. Doing some semi-supine before you leave the house helps you be more aware of when you are starting to slump and cause compression in your back and joints. Breathing is another consideration. Travel is stressful even if you enjoy it and when you are stressed, you will tend to hold your breath and breath very shallowly. This will make it more likely that you will compress your ribcage and so put pressure on your digestive organs. Combine this internal pressure with plane food and you can end up with indigestion as well as back pain.

When my client Rebecca decided she would take a holiday in Spain her biggest concern was her delicate back so between us we devised a list of tips to help her cope.

• Take advantage of any opportunity to lie down in semi-supine, so wear loose clothing, and choose a good book you can read on the plane or put under your head when you lie down. People do all sorts of things in airports so no one will notice.
• Do get up from your seat at any and every opportunity, which will annoy the air stewards, but they don’t have your back pain!
• Give your self an Alexander workout for five minutes every hour. This means attending to your back and asking it to lengthen, ask your neck to release any residual tension and let your head go up to the roof of the plane. Check your breathing and enjoy moving your ribs.
• Don’t sit still; wriggling will help keep you from getting cramp. Wriggle ankles, knees and your pelvis.
• Drink water. Dehydration affects your back as well as making you feel sluggish. Your discs need fluid to maintain their cushioning abilities, if your body lacks water the discs will tend to compress and add to back ache.

Rebecca followed the list to the letter, and was free from pain and actually enjoyed the flight. She used the skills she learned in her lessons to keep herself from collapsing unintentionally. The experience gave her confidence and she is planning a trip to New York, knowing she can manage her back.

September 07- Easy Driving

Many of my pupils find driving frustrating. The constant traffic, the road works, the unfair speed cameras; all contribute to a stressful experience.  My pupil Sally summed it up “I find myself gripping the steering wheel so tightly my fingers go white. And since having my lessons I notice that I arch my back away from the seat, I’m so tense.” I got Sally to mimic holding the steering wheel whilst she was having her lesson and she bought her hands up and immediately stiffened her neck so much I was surprised it didn’t cause her immediate pain, but she hadn’t noticed. Along with the stiff neck Sally clenched her jaw and held her breath. When I gently pointed these things out to her she was shocked “And I’m only pretending, it will be much worse when I’m really driving won’t it? she cried.

Fortunately for Sally there are ways you can help yourself. The first is to acknowledge that you are one of those people who find driving stressful, the second is to accept that you can’t change the traffic, the road works or the speed camera, but you can change the tension levels that build up in you. It doesn’t matter what has caused you to get tense, it will always affect you in your neck and reveal itself in your breathing. These two elements together will make you stiffen your back as well, which is why some people get back pain from driving.

Releasing tension in your neck muscles is a matter of practice, and you won’t be able to do it whilst driving if you don’t practice outside the car! Sally realized that she already had skills she could use. She practiced semi-supine on a daily basis and could encourage her back to lengthen and her neck to release when she was lying on her back in this position with her head supported by books and her knees bent. She then transferred her skill of release to her driving and was very pleased with the result.

She felt much less tense, less anxious and more confident. She told me that she had been changing her route home from work to avoid a difficult right turn. She had been nervous and often got beeped by impatient drivers behind her, which made her even more tense. Now she was able to patiently wait until the traffic permitted her to turn right without getting anxious, and when other drivers honked their horn she simply ignored it and didn’t let it make her rush out into the fast moving traffic.

After each lesson Sally had to adjust her driving mirror because she had lengthened so much, then gradually over the next week she pulled down again. When she realized this, she recognized the amount of tension she bought to driving and was able to stop it.

Nov 07 - Skiing

This time of year, several of my pupils are looking forward to winter skiing. Balance is important at any time but when you are sliding over snow it is even more important to have the right balance in your body.

Excessive tension interferes with balance and if you are afraid you will fall over you are likely to tense up even more. Understanding the pattern of tension that is likely to occur gives you the chance to change it. Neck tension is the most common interference with easy balance. If your neck is tense and tight then the muscles of your back and legs are affected in a domino effect. This usually makes your back muscles short and tight and your legs stiff. In this way your whole body has lost the sense of fluidity you need to glide over the snow. Asking your neck muscles to unlock so that your head is not dragged into your shoulders can reverse the tension cycle and let your whole back become more flexible. In Alexander lessons we work a lot with the movement you make when you stand up from sitting in a chair. This may not seem to have much to do with skiing, but the transition form sitting to standing, and visa versa, requires you to bend your hips, your knees and your ankles. If you can’t do this freely and easily when you get in and out of a chair, then you won’t be comfortable in the flexed position needed to ski.

Learning not to tense your hip joints or your ankles when you move and walk will pay dividends on the ski slopes where balance depends on your ability to flex easily and feel what is going on under your feet.
Tense feet are less sensitive to the terrain underneath them and you need to be able to ‘read’ the snow and the ground under your feet. For many people the fear of falling makes them tense up in their feet as well as in their neck. Tense muscles don’t respond to movement as easily as released muscles. Learning to release your ankles and allow your heels to rest properly on your skis and your toes to lengthen away from your heels gives your feet and legs the chance to support you properly. At the other end of your body you want to keep your neck free from tension and aim (don’t push) your head up towards the sky. In this way you set up a gentle elastic stretch through your body-with your head going up and your feet going down. All you need now is good snow and you’re off!