Here's a little quickie: From time to time, we Hanna somatic educators get a client whose pattern of tension is so unusual that we have a hard time knowing where to start. This entry cuts to the bone, and quickly.
Although Trauma Reflex has a universal core pattern, all injuries are idiosyncratic -- meaning odd and unusual, unique. They always come from some direction other than from straight ahead or straight behind and always involve postural and movement asymmetries.
The universal core pattern of Trauma Reflex involves pulling the injured part toward the somatic center (hara, dan tien, core, etc.). Tightness always appears more on one side, usually the injured side, than the other (though not always); there's always a twist along the vertical/longitudinal line of the person. One hip is pulled up and its shoulder, pulled down (usually, but not always).
That universal pattern is what the Trauma Reflex lesson/session addresses: freeing the retraction toward center and undoing side-tilt and the twist.
The idiosyncratic part has to do with the injured part, itself. Hurt ribs involve clamping the arm down against the hurt side. A whiplash injury involves raised shoulders. The standard Trauma Reflex lesson is inadequate to deal with either, and other idiosyncratic patterns because the involved regions are outside the movement patterns employed in the Trauma Reflex lesson.
So, we may feel, "What do I do with that?"
It's a two part answer -- and simple.
"A good man, before he can help a bad man, first finds in himselfthe matter with the bad man."
~~ Lao Tzu, The Tao Teh Ching
Witter Bynner translation
Here are the two parts:
Use yourself as the guinea-pig to understand your client's predicament. Replicate your client's pattern in yourself. Assume his or her shape and movement pattern. Feel it and understand from the inside, out.
Whatever the client is doing "wrong" (i.e., contracting
in Trauma Reflex) have him or her do it MORE, and then, LESS. Those are his or her needed pandiculation patterns.
In this entry, I present some combinations of somatic exercises that have special potency in changing tension-and-movement patterns -- preceded by a bit of explanation.
EXPLANATION
Anyone practicing somatic education should be familiar with -- and use -- the power of synergy.
"Synergy" isn't some New Age froo-froo concept; it's the way "a whole is more than the sum of its parts" -- it's organization. It's what makes a system a 'system' and not just a collection of unassembled parts. It's coordination. It's integration. For more on Thomas Hanna's take on coordination, read his book, The Body of Life. He also referred to synergy in his published Wave 1 lectures; whether you are a student-in-training or a certified practitioner, if you don't have those lectures or haven't listened to them, get them and listen to them. They are a major part of his functional legacy and will boost your effectiveness.
Synergy is part of what makes the standard lessons of Hanna somatic education so powerful. In those lessons, multiple movement elements, e.g., the steps of Lesson 1 / the Green Light Reflex lesson, combine into an overall action pattern. Those movement elements are "the parts"; the action pattern you are addressing -- Landau Reaction, Startle Reflex, or Trauma Reflex in its multifarious forms (see The Handbook of Assisted Pandiculation) -- is the 'whole'.
Piecework -- going straight for the painful location to "get at the problem" right away, is never as effective as dealing with whole patterns, in the long run and often in the short run. Sometimes, when a client is insistent that we work in the painful region immediately, I'll do it. I call this form of client placation, "Kiss boo-boo." But then I get straight away to the overall pattern and I explain to the client, why, if necessary to his or her wholehearted participation in the way I want to proceed with sessions.
By the same token, combining somatic exercises to address a single location is more potent than addressing it with one somatic exercise, only. Thomas Hanna's comment on afternoon, leading us in somatic kinesiology -- that using more than one somatic exercise to reach a problem region is more potent than using only one exercise (because learning the same thing multiple ways is more potent) -- may have slipped by unnoticed by many, but it's worth noting -- and acting upon.
So here are some collections of somatic exercises that are synergistic in this way. You'll notice two things. That I:
start with gentler somatic exercise and progress to more demanding ones
combine somatic exercises published in different sources
A certain class of somatic educators continually explores for ways to improve his/her own functioning and well-being. Such people have an advantage over those who go only with the basic material conveyed during training: they can understand more forms of Sensory-Motor Amnesia (from the inside) and deal effectively with them, unlike those with less-developed somatic competency.
If, in yourself, you can find new and effective somatic exercise patterns, that's best; if not so much, various programs exist that can give you a leg-up.
Centering the Sacrum (End Your Own Sacro-iliac Pain)
This is a fairly "minimum" collection of exercises -- enough for you to test to feel their synergy. People with sacro-iliac pain almost certainly need more -- and I've published an entry that explains why and gives access to a complete regimen here.
You notice that this collection of movements is fairly large. That's because our necks are mobile (and can become restricted) in so many directions. Gotta do it. Neck issues are a big deal (and often involve TMJ issues); a person with pain in the spine, low back or pelvis that doesn't resolve as expected is likely to be tight in the neck, with the distant pains reflexively caused.
That's quite enough to get you started. If you have the ambition, it's an eye-opener.
There is a way about somatic education that can be seen as a kind of ethic or approach to life. By that same token, there is a way of seeing how the way someone participates in somatic education is the way they participate in life.
For one thing, we're dealing with matters of relationship, where relationship isn't a static thing like an abstract concept, but a dynamic of play -- how we do things.
For our first example, let's take the case of how a somatic educator may conduct a session of somatic education with someone. In general, our way is to observe and understand, from within, the predicament of our client. We may look at him or her standing full length, and by observing the stance of that person, replicate its feeling in ourselves. There's a feel to what we see. We kind of get inside you like a hand in a glove and, aided by our theoretical understanding of the behavior of the three major reflexes of stress and our recognition of interconnected movement patterns, we discern what's going on in you. Of course, we cross-verify those findings with your history of injuries, palpation (manual assessment) and your current sensations.
So, here's the first ethic: We get information from both inside and outside, in feeling and in understanding.
Having done that, we choose and guide you into the easiest, most accessible, and generally, most direct route into what you're already doing habitually. We have you make it more. To do so, you must first recognize it as something you can do -- and then do it. So, we guide you, we direct you, into replicating elements of the action you are habitually doing (differentiation) then guide you into assembling all those elements into an integrated pattern -- the more integrated and complete, the better. You go in; you come out. You learn the path into and the path out-of. We help you find it.
You see what I mean about relationship, yet? There's are patterns in us formed by the physical, emotional, mental and intuitive stresses of experience, patterns of remembered tension in our musculature and arrested-but-held impulses to action. We guide you to awaken to what each one is -- and generally, no sooner has that awakening occurred then you are already at least partially, if not largely, out of that pattern. It happens before you know it, actually (although we feel it). Then we have you move about so that you can feel what's changed. Then we do some more.
Into . . . . . out of
The Rule of Thumb, here, is "Whatever they are doing 'wrong', have them do it MORE, and then less -- alternately. Imagine the liberation. "Destination -- Jello" -- but Jello with an attitude!
Now, I suppose there are various ways of going into and out of -- some of which look like going around the problem. So there are degrees of relationship -- degrees of directness -- degrees of relevance -- degrees of comprehensiveness. See?
Now, consider that language: relationship, directness, relevance, comprehensiveness. Those four terms are sufficient to define an ethic.
Here's where some variation can creep in. An additional "point on a continuum" is "more and less", "consistent and inconsistent".
"More or less" may be more or less force, more or less speed, more or less intensity, more or less subtlety.
"Consistent and inconsistent" are terms having to do with times and occurrences and also with changes of rules.
Do we change the rules in the middle of the game or do we change the rules between games?
In the case of somatic education, since we are showing a person how to go into and come out-of, some consistency is "desirable". We want to make enough of an imprint in a person's memory that they can find it at will, and then they have also found the way out. In general, "The way it goes in is the way it comes out - and "The way it comes out is the way it goes in."
That's a high-speed strategy because it makes the greatest imprint with the least effort. Another ethic: A case of "get more result with even less effort". Targeted, rhythmic repetition helps a bit.
That kind of high-speed strategy makes even lesser efforts cumulatively effective.
But of course, the point is to get the result -- not to reduce effort.
Another ethic: The way to conserve effort is to get the result very efficiently -- at least as efficiently, and perhaps even more subtly than by less focussed, less specific, less intent, less attentive efforts.
Those are just of few of the ethics we may see in the process of somatic education.
I have observed other variations on ethics among clients.
COMMON ETHICS
There are some interesting ones. I gave them names.
The Cooperative Helper
The Wooden Man
Half-Hearted Participation
The Really Hard Worker
It's Over Before It's Really Over
"Doesn't Know When to Quit"
All-or-Nothing
Criss Cross
Cooperative Helpers go right along with you but never really relax at the core: they've learned to be in control in your groove -- they-re very cooperative -- but if they get into anticipating too much, they get jumpy and never relax.
The Wooden Man appears, to others, to change slowly, if at all, but he reports how much change he is feeling. This is a really sensitive individual because (s)he feels so much change when so little is happening.
Half-Hearted Participants don't really put much into it. They don't "ramp up" enough really to engage. You've got to ask them. Repeatedly. They may say one thing and do another -- or promise something and not do what they say.
The Really Hard Worker on the other hand, never quits! (S)he springs into action, sometimes ahead of you so it's a little like reigning in a horse. Thoroughbred. Jumpy. A bit high strung. Tends to hurt him or herself by excessive effort or by never taking rest. We repeatedly have to remind him or her to use less effort and to go more slowly. Be more leisurely.
It's Over Before It's Really Over is the person who, somewhere near the middle or three quarters through a movement, suddenly gives way and quits. Understand, this is a movement for which the person set the effort-force level to begin with -- and (s)he gives way, feeling overpowered by someone who matched her example at the beginning! Misconstruing that she is resisting being overpowered by them, rather than they that are respectfully resisting her, she feels overpowered. Pacing, follow-through -- and recognition of responsibility -- are the teaching, here.
Doesn't Know When to Quit never takes a vacation. This is a person who is a bit slow to enter the relaxation from a "movement into tension" and a bit slow to relax faster. Even after a move to complete relaxation, this person also springs into action at a moment's notice -- even when you want him to relax and have said so. It's a learning thing. We take such a person down in stages, having him/her use progressively less effort with each repetition. We sneak up on the relaxation state. (Shhhhhhhhh.)
All or Nothing -- such a person in a high-powered sports car would be dangerous. (S)he knows only "all on" and "all off". It's "pedal to the metal" or "hit the brakes!" Fitful. Sudden. Not much gradation of control. Can you imagine? Workaholics. Such people may look forceful, but tend to cave in a bit more suddenly than you might expect. They just need practice floating in the mid-range of things -- the so-called "Middle Way" -- which is not mediocrity or "centered balance", but variable, floating self-regulation with capacity for the extremes.
and Chris Cross -- this is a very interesting person. Confuses right and left. Ask him to lift his left arm and he lifts his right, for a moment. Sometimes a long moment. You ask him to look right, he looks left, for a moment, then looks right. Catches himself. Feels dumb. This typically happens with new, non-habitual movements. Here's the news: four (4) out of five (5) people do this a few times during a session. It's very confusing for the person when I bring it to his attention -- and it is for that eventuality that the sayings, "the other right" and "the other left" were framed. This is a person who means to do one thing and does the opposite. Which can be handy -- if we're engaged in learning the way in and the way out. But also amusing.
Anyhow, you can see that these types together define a kind of ethic and more types could be added to make a more complex ethic.
But let's look again at what we have, here.
The Cooperative Helper MEETS Chris Cross
The Half-Hearted Participant MEETS Wooden Man
All-or-Nothing : It's Over Before It's Really Over
The Really Hard Worker : "Doesn't Know When to Quit"
Looks like we've defined some ethics, here, doesn' it?
Here's the last somersault: We contrast/relate the sets of ethics:
The Cooperative Helper MEETS Chris Cross | Directness OF Relationship
All-or-Nothing : It's Over Before It's Really Over | Staying Related
The Really Hard Worker : "Doesn't Know When to Quit" | Getting More with Less
Half-Hearted Participants MEET Wooden Men | Focus with Consistency
The Gyroscopic Walk is a form of "super-walking" -- a high-efficiency walking pattern that gives you more walking speed at less effort and that integrates your whole-body movements so you feel more free in movement, better balanced and better put together.
The Gyroscopic Walk is very good to do after any other somatic exercise or after a clinical somatic education session, to rapidly integrate (absorb and reinforce) the improvements in physical comfort and movement.
Walking is a peerless organizer. -- Ida P. Rolf
The four people who attended my training day, "Trauma Lesson Calibration and Pandiculation Extravaganza", saw me demonstrate and then learned and practiced a walking pattern I call, The Gyroscopic Walk (which I first called, "The Magnetic Walk").
This walk integrates beautifully with Thomas Hanna's walking lesson in his "Myth of Aging" program (lesson 8, in his book, Somatics) and with my program, Superwalking.
The Gyroscopic Walk efficiently conserves and recycles the kinetic (movement) energy of walking in a way that increases walking speed with the same amount of walking effort -- or -- that reduces the effort of walking at any speed.
My students of that training day learned the basic pattern of that walk in a four-step process:
See.
Prepare yourself.
Do.
Refine.
The basic pattern of The Gyroscopic Walk involves arm movements (while walking ) of a stylized kind. You keep the palms of your hands facing your hip joints while your arms swing forward and backward. The motion involves a swiveling motion of your forearms. Try it; you'll understand.
The movement of your arms swinging with your palms continuously facing your hip joints produces a sensation in the hands and arms of containing and moving a mass around a central point -- which is, of course, is what sets up a gyroscopic force. With a bicycle, the gyroscopic force of the wheels keeps us up; in walking, it keeps us balanced as we pivot around our "spinal axis". In both cases, gyroscopic force conserves and recycles kinetic energy (movement).
Now, there are three developments of the Gyroscopic Walk, maybe more, that come after this one.
NOTE: Click here for an audio overview of, and instruction in, these and more developments.
Here's the first:
bouncing that 'ball of mass' contained in the palms of the hands forward and backward with each step
As your arms swing, you keep your palms facing your hip joints; your forearms turn forward and backward with each step.
You contain or restrain your forward-backward arm movement (reduce the amount of swing), while maintaining your walking speed, enough that you can feel the force transmitted to your legs. That's the experience of recycling kinetic energy.
Your walk will spontaneously accelerate with the same amount of effort as before and you'll feel your feet anchor to the ground, better.
Another is
exploring the Gyroscopic Walk at different speeds
There's something to be discovered, there. I need not say more.
and a Third is
adjusting the location of twist you feel in your trunk up or down.
You do this action by feel, once you have understood and can do the basic Gyrosopic Walk.
a Fourth is
alternating Gyroscopic and ordinary walking
Do the Gyroscopic Walk only until you can feel the force transmitted to your legs, then revert to ordinary walking. We're talking a few seconds, here. You repeat the action many times.
You'll feel things connect and relax in a new way, leading to smoother, more powerful walking.
And there are more -- but I think that's quite enough to chew on, for now.
Lawrence
PS: Oh, here's an afterthought ..... just a little happenstance one.
Listen: We can use the Gyroscopic Walk, when alternated with the
Scottish Geezer's walk, to re-set our idling speed and to tune up our
walking movements, whole-bodily.
Just in case you don't know what I mean by, 'idling speed': the higher the idling speed in an automobile, the faster the engine turns over, when stopped at a traffic light; the higher the "idling speed" of a person, the higher the tension level -- also known as "stress level", when supposedly at rest. Another term for "stress level" is "state of readiness for anything," a state of "being somewhat wound up".
The two walking patterns, the Gyroscopic Walk and the Old Scottish Geezer's walk are, in a sense, opposite and complementary; when you alternate between them, they provide contracting sensations that heighten perception and the ability to relax.
We can use the Gyroscopic Walk, when combined with the Old Scottish Geezer's walk, to re-set our idling speed so that we can explore and find the "idling speed" and/or "tone" we like best.
The "tuning up your walking, whole-bodily" part is something for which you need satisfactory experience with the Gyroscopic Walk to understand this discussion.
PPS: I wrote this message for Hanna somatic educator colleagues and clients with experience.
If you are not a Hanna somatic educator, these words may be "helpful": To do the Gyroscopic walk, you must already be free and well-coordinated enough to get into a movement rhythm; stiff places and pains interfere, so if you're stiff, get some somatic education to get free.
To free tight hamstrings, it's important to understand their four movement functions.
leg extension at the hip joint
leg flexion at the knee
rotation of the lower leg at the knee joint
stabilization of the pelvis when bending forward
To free hamstrings, we must free them (gain control of tension and relaxation) in all four movement functions.
If we do not gain (or improve) control in all four movement functions, one or more of those movement habits will dominate control of the other movement(s).
In addition, the hamstrings of one leg work alternately with those of the other -- as in walking; when the hamstrings of one leg are bending or stabilizing the knee, the hamstrings of the other leg are extending or stabilizing the other leg at the hip. In those movements, the hamstrings coordinate with the hip flexors and psoas muscles. (Co-contraction of hamstrings and hip flexors/psoas muscles leads to hip joint and ilio-sacral (SI) joint compression.) So our approach (being movement-based) must take those relationships into account. Otherwise, we never develop the feeling of free hamstrings in their familiar movements.
LEG EXTENSION AT THE HIP JOINT
That's the "leg backward" movement of walking. The hamstrings are aided by the gluteal (butt) muscles, but only in a stabilizing capacity. The major work is done by the hamstrings. In this movement, the hamstrings, inner and outer, work together in tandem.
LEG FLEXION AT THE KNEE JOINT
That's the "getting ready to kick" movement and also the "pawing the ground" movement. In these movements, the hamstrings, inner and outer, also work together in tandem (same movement).
To the anatomist and kinesiologist, it may seem incomprehensible ("paradoxical") that the hamstrings are involved in both movements -- leg forward and leg backward -- but that's how it is. Though the hamstrings are involved in both cases, different movements cause a different feel.
LOWER LEG ROTATION AT THE KNEE
That's the turning movement used in skating and in turning a corner. In this movement, the inner hamstrings (semi-membranosis and semi-tendinosis) relax and lengthen as the outer hamstring (biceps femoris) tighten to turn toes-out and the inner hamstrings tighten to turn toes-in as the outer hamstring relaxes and lengthens.
STABILIZATION OF THE PELVIS WHEN BENDING FORWARD
The hamstrings anchor the pelvis at the sitbones (ischial tuberosities) deep to the 'smile' creases beneath the buttocks (not the crack), so one can bend forward in a controlled way, instead of flopping forward at the hips like a marionette. In this movement, the hamstrings coordinate with the front belly muscles (rectus abdominis).
In most people, either the rectus or hamstrings dominates the other in a chronic state of excessive tension, so freeing and coordinating the hamstrings involves coordinating and matching the efforts of the two muscle groups. When the hamstrings dominate, we see swayback; when the rectus muscles dominate, we see flat ribs.
TRAINING HAMSTRING CONTROL
In training hamstring control, it's convenient to start with the less complicated movement, first. That's the anchoring movement that stabilizes bowing in a standing position. (See first video, above.)
After we cultivate control of "in tandem" hamstring movements, we cultivate control of "alternating" hamstring movements. (See second video, above.)
By cultivating control of "in tandem" and "alternating" movements, we fulfill the requirements of functions (1.), (2.), and (4.). The exercise linked in the paragraph above indirectly addresses function (3.) (lower leg rotation at the knee). Other exercises that have this effect exist in the somatic exercise programs, "The Cat Stretch" and "Free Your Psoas", for which previews exist through the preceding links.
If you have back pain, then the first thing to consider is that you don't "have" back pain; back pain "has you" in its grip. That way of describing it would seem to be more true to your experience, wouldn't it? This video, below, shows how you can get control of the back pain that has you in its grip and then get rid of it, while recovering the comfortable and secure use of your back.
Although some people believe that standard procedures are "time-tested" and inherently more reliable, in this case, the opposite is true. Faster, more complete, and longer-lasting relief can be obtained with a less invasive, "high-touch" procedure that hits "the mark" than by standard procedures that miss "the mark". What is "the mark"? What to do, right now?
This video shows what you can do to relieve your own back pain and restore freedom of movement. The procedure has helped thousands of people who have already had back surgery or other invasive procedures.
For a clear understanding of a new, more effective approach to back pain than stretching, strengthening, adjustments or massage, please see this page.
For chronic back pain, please see this page, which also contrasts conventional back pain methods (including spinal decompression devices) with an entirely new, more effective approach.
This entry contrasts standard therapeutics for pain with clinical somatic education, for relief of pain. It explains the origins of pain and how therapeutic approaches work (or don't work).
THERAPY, BODYWORK, and SOMATIC EDUCATION
To begin, I'll state my bias: I am a clinical somatic educator trained in methods of mind-brain-body training that addresses chronic, non-malignant, musculo-skeletal pain (e.g., back pain) and stress-related disorders (breathing difficulty, headaches).
When pain from injuries lingers beyond the expected few weeks of tissue healing, it generally comes from residual muscular tension triggered by the injury. Tight muscles cause muscle pain, joint compression (leading to osteoarthritis) and nerve impingement (e.g., sciatica, Thoracic Outlet Syndrome).
Conventional therapeutics and alternative therapies (e.g., bodywork of all kinds) generally produce temporary and partial relief from moderate-to-severe injuries and may be slow to produce durable improvements.
Clinical somatic education, in the tradition of Thomas Hanna, generally produces rapid, durable, and complete relief from moderate-to-severe injuries. That distinction makes it a better choice, in general, than both conventional and other manipulative therapies.
This article contrasts those methods to an approach that deals with many musculo-skeletal problems, including back pain, more effectively.
How Chronic Muscular Tension Forms
In the viewpoint of somatic education, muscular activity comes either from voluntary behavior, from habitual (involuntary) learned behavior, or from involuntary reflexes. That means that movement, posture, and muscular tension come conditioning of our nervous system.
It seems obvious that stress and trauma leave impressions in memory and that those impressions might be associated with tension of one sort or another. The piece I'm adding, here, is that the memory of injury, if intense enough, can displace the familiar, healthy awareness of movement, position and self-control. That displacement creates a kind of amnesia of the body; we forget how we were before injury and get trapped in tension.
It's this kind of tension that conventional medicine tries to "cure" by means of manipulative therapeutics (including chiropractic, bodywork and acupuncture), drugs, and surgery.
That this approach works better than the methods this article critiques remains for you, the reader, to see for yourself. I can't convince you, here (any more than I could be convinced before seeing for myself), but can only offer you a line of reasoning and ... at the bottom of this page, a bit of evidence -- a link to a candid, two-minute video clip that shows the first moments of a client after a one-hour session of clinical somatic education.
So, I must appeal to your capacity to reason and to your intelligence and you must seek out the experience, for yourself.
We begin.
OVERVIEW OF THERAPEUTIC MODALITIES FOR BACK PAIN
First, I'll comment on drugs, then manipulative techniques in general, then surgery, then clinical somatic education.
Two of these three approaches, drugs and manipulation, are best for temporary relief or for relief of new or momentary muscle spasms (cramp), not for long-term or severe problems.
The third, surgery, is a last resort and is appropriate for only the most severe of degenerative conditions beyond the reach of therapy.
You can get a comparison chart of common modalities here.
DRUGS
Drugs can provide temporary relief or for relief of new or momentary muscle spasms (cramp), but can't provide a satisfactory solution for long-term or severe problems. They generally consist of muscle relaxants, anti-inflammatories, and analgesics (pain meds).
Muscle relaxants have the side-effect of inducing stupor, as you have found if you've used them; they're a temporary measure because as soon as one discontinues use, muscular contractions return.
Anti-inflammatories (such as cortisone or "NSAIDS" - non-steroidal anti-inflammatory drugs) reduce pain, swelling and redness, and they have their proper applications (tissue damage).
Cortisone, in particular, has a side effect of breaking down collagen (of which all tissues of the body are made). When pain results from muscular contractions (muscle fatigue/soreness) or nerve impingement (generally caused by muscular contractions), anti-inflammatories are the wrong approach because these conditions are not cases of tissue damage.
Nonetheless, people confuse pain with inflammation, or assume that if there's pain, there's inflammation or tissue damage, and use anti-inflammatories to combat the wrong problem.
Analgesics (pain meds) tend to be inadequate to relieve back pain or the pain of trapped nerves and, in any case, only hide that something is going on, something that needs correction to avoid more serious spine damage.
MANIPULATIVE TECHNIQUES
Manipulative techniques consist of chiropractic, massage, stretching and strengthening (which includes most yoga and Pilates), most physical therapy, inversion, and other forms of traction such as DRS Spine Decompression.
Most back pain consists of muscular contractions maintained reflexively by the brain, the master control center for muscular activity and movement (except for momentary reflexes like the stretch reflex or Golgi Tendon Organ inhibitory response, which are spinal reflexes). I put the last comment in for people who are more technically versed in these matters; if these terms are unfamiliar to you, don't worry. My point is that manipulative techniques can be only temporarily effective (as you have probably already found) because they don't change muscular function at the level of brain conditioning, which controls tension and movement, and which causes the back muscle spasms.
Nonetheless, people commonly resort to manipulative techniques because it's what they know -- and manipulation is the most common approach, other than muscle relaxant drugs or analgesics, to pain of muscular origin.
SURGERY
Surgery includes laminectomy, discectomy, implantation of Harrington Rods, and surgical spine stabilization (spinal fusion).
Surgery is the resort of the desperate, although surgery has a poor track record for back pain.
There are situations where surgery is necessary and appropriate -- torn or ruptured discs, fractures, spinal stenosis, rare cases of congenital scoliosis. There are situations where surgery is inappropriate -- bulging discs, undiagnosable pain, muscular nerve impingement.
Severity of pain is not the proper criterion for determining which approach to take. The proper criterion is recognition of the underlying cause of the problem and dealing with that.
A NON-MANIPULATIVE APPROACH that RELIABLY GETS RESULTS when THERAPY LEAVES SYMPTOMS IN PLACE: CLINICAL SOMATIC EDUCATION
Working with Brain-Level Control
Most back disorders are conditioning problems - correctable by clinical somatic education.
Clinical somatic education is not about convincing people that 'things are not so bad, and live with it' or 'understanding their condition better' or instructions for maintaining good posture. It's a procedure to eliminate the underlying cause of pain symptoms and to improve function by retraining an aspect of brain function that can readily be retrained (with the correct approach): movement memory (a.k.a., "muscle memory").
In the case of back pain, the underlying cause -- chronic back tension -- causes muscular pain (muscle fatigue and spasm), disc compression, nerve root compression, facet joint irritation, and the catch-all term, arthritis.
Degenerative Disc Disease, for example, though called a disease, is no more a disease of the discs than is excessive wear of tires on an overloaded vehicle with wheels out of alignment. Over a long period of time, accelerated wear accumulates. With discs, they call that a disease. There is no such thing as Degenerative Disc "Disease"; it's breakdown caused by bad movement-memory conditioning.
Clinical Somatic Education
Clinical somatic education is a discipline distinct from osteopathy, physical therapy, chiropractic, massage therapy, and other similar modalities.
It isn't a "brand" of therapy or treatment, but a category or discipline within which various somatic "brands" or approaches exist. Examples of "brands" include Trager Psychophysical Integration®, Aston Patterning®, Rolfing Movement®, Orthobionomy®, Somatic Experiencing®, The Alexander Technique®, Feldenkrais Functional Integration®, Hanna Somatic Education® and others.
The prime approach of somatic education, through whatever method or "school", is to retrain the nervous system to free muscles from an excessively contracted state and to enhance control of movement, function, and physical comfort.
One key difference of clinical somatic education from manipulative practices is the active participation in learning by the client. It's not just strengthening or stretching, but gaining the ability to relax completely, to exercise full strength, and control of every strength level in between. The added freedom and control that a client learns during sessions, and not what a practitioner does to the client, per se, causes the improvements. In clinical somatic education, the instruction comes from outside; the improvement comes from within.
As education, clinical somatic education deals with memory patterns -- the memories of incidents of injury, of stressful situations and of how to move and how to relax. Memory patterns show up as habitual muscular tension and changes of movement (e.g., limping) and posture (e.g., uneven hips or shoulders).
Deeper-acting somatic disciplines, such as Feldenkrais Functional Integration and Hanna somatic education, deal with more deeply ingrained and unconscious habit patterns formed by injuries and stress.
How it Works
Clinical somatic education uses movement and positioning to enable the client, by combining sensation and improving control of movement, to recapture control of out-of-control muscles. As muscles come under voluntary control, they relax and become responsive, again.
The "how" of it is that the brain learns control of muscular tension and movement -- both in the formation of pain patterns and in the formation of healthy functioning -- through the feelings of movement -- slowly or quickly, depending on the kind of technique used.
The Distinction: "Clinical" vs. "Enriching" Somatic Education
Most forms of somatic education are not "clinical" somatic education; they are "enriching" somatic education that gradually improves movement and sensory awareness. They have limited predictability about when a specific outcome, such as pain-free movement, will occur.
The distinction of a clinical approach to somatic education is the speed with which improvements occur and the ability of its practitioners to predict with a high degree of reliability how many sessions will be required to resolve a specific malady, without further need for medication or treatment by a health professional -- "how long before I can have my lifestyle back".
Even "enriching" somatic education (such as Feldenkrais Somatic Integration or Aston Patterning) alleviates pain, given enough time -- even where more conventional therapeutic methods -- manipulation, adjustments, stretching, strengthening, drugs, acupuncture, surgery -- are less successful or fail altogether.
The specific advantage seen in clinical somatic education by referring physicians is that clinical somatic education, while being effective in the relief of muscular pain and spasticity, has the specific virtue of teaching the client an ability to improve control the muscular complaint (i.e., pain) to the point that there is little chance of a future return of the problem.
For a technical comparison between somatic education and chiropractic (as an example of a manipulative approach), you may click here
For a discussion of back pain and clinical somatic education, you may click here. For a discussion of clinical somatic education and recovery from injury, in general, you may click here.
~~~~~~~~~~~~~ Lawrence Gold is a certified clinical (Hanna) somatic educator who has served a world-wide clientele of people with chronic (long-term), non-malignant pain (i.e., caused by injury) -- in practice since 1990. Contact him at https://somatics.com/wordpress/contact.
