Heel Pain – Mystery Solved!

My friend, a one-time avid tango dancer and current expat in Germany, has been staying with me for a few weeks. She burst into the living room one evening and said she was having persistent heel pain. She thought she was landing harder on her left (non-dominant) heel because every time she took a step on her left foot, the heel hurt. Worse, every morning her feet froze into stiffness. The morning walk to the bathroom was closer to the arthritic shuffle of an elder than a fit 42-year old. “Can you help me Ms. Alexander Technique Reembody Expert?” she asked.

“Why yes,” I thought, “I probably can.”

Usually we tend to be a bit ginger with our non-dominant leg*, so I was curious to watch her walk.

By Connexions – http://cnx.org, CC BY 3.0, https://commons.wikimedia.org/w/index.php?curid=29624326

I observed that she was not landing harder on her left heel. Instead, she had a habit that almost everyone has with their non-dominant ankle: weak plantar flexion. Plantar flexion looks like pointing the foot, but the movement happens at the ankle joint, not the forefoot or toes. The result of weak plantar flexion is that you end up pushing down on the ground with your forefoot, the same way you push down on a gas pedal. This pushing action can cause hammer toes, which she was starting to develop, and tight plantar fascia.

Dare I say the terrible word that we all fear…plantar fasciitis? In a way, my friend was lucky that she hadn’t diagnosed herself with a case of this. There is little doubt that if she had thought she had something as dreaded as plantar fasciitis, the pain, the inflammation and the physical compensation patterns would have all multiplied due to a sense of bodily threat.

I had her sit down on the carpet and we compared her ability to plantar flex the right and left ankles. Sure enough, the movement was smooth as butter on the right side, but feeble and hard to organize on the left. After some trial and error, and a little Alexander Technique hands-on  help, the left side got the hang of it.

She got up and walked. The left leg was behaving differently.

“I don’t want to give you too much cueing,” I said. “Too much thinking will interfere with coordination.”** But then I gave her one cue. I couldn’t resist. “Notice if you are pushing down with your left forefoot. Don’t do that. No gas pedal foot.”

Two days later she came in, excitedly waving her shoes. “I have a story to tell,” she said. “See! Look,” and she pointed at the shoe wear. The right sole had a dark indent from hard heel strikes, the left none at all. She reported that in just two day of practicing plantar flexion, the heel pain was gone, and she was no longer waking up with stiff feet. The absence of the morning hobble felt strange. She had grown so used to it.

How is it possible to change a habit and come out of pain so quickly? We are taught in all disciplines that changing habits takes repetition, practice, attention and a lot of time.

Sometimes, when we discover efficient ways of moving, it’s as if the new pattern already existed, perhaps as something we did when we were children, before tight shoes or tango shoes and life’s pressures caused us to grip. Perhaps this is an issue of neuroplasticity, which turns out to be faster, more flexible and more adaptive than one could ever imagine.

“Plasticity happens rapidly…too fast for the brain to grow new connections. It’s more likely that unused pathways are unmasked when sensory inputs are changed, as from wearing a blindfold for five days. Over time, such plasticity changes can become permanent.”
(p.86, The Body Has a Mind of It’s Own, Blakeslee & Blakeslee, 2007)

Still, how could two years of chronic pain dissipate in two days? Researchers know that pain can diminish long before tissues fully heal, and debilitating pain can occur in the absence of injury due to an over sensitized nervous system (p. 71 Explain Pain, Bulter & Mosely, 2013). Reduction in threat mediates both the experience of pain and tissue inflammation. If the new way of moving provided more security than the old way, a feeling of safety may have been enough to reduce the pain and inflammation. Maybe.

I admit that the above paragraphs are speculative, but instant sticky change has been my experience learning and now teaching aspects of the Reembody Method alongside Alexander Technique. Admittedly, quick lasting change doesn’t always happen. This is not a problem. The slow method, which include mindful awareness, steady practice, concentrated thinking about causes and conditions, and artful contingency plans when triggers trigger, well, that’s great stuff. It works. As a teacher, I like to have a variety of tools in my box

 

*Imagine having to step up on to a high a ledge. What if you were also carrying a bag of groceries? Which leg would you use to step up? Most people would choose their dominant leg because it feels stronger and more secure. We tend to push with our dominant leg and baby our non-dominant leg.

 

**If you try and swing your arms in opposition to your legs as should happen naturally when walking, you will probably find that you have no idea how to walk.

 

 

Analyzing the Ads

Sometimes my students bring me photos and news stories to discuss. The above snap was part of a Marc Jacobs ad in the Sunday Times. We couldn’t quite believe that post #MeToo, this Dickensian image was being used to sell clothes. What happens to our unconscious when the mere turn of a newspaper page primes us to equate cowering with something as desirable as high fashion?

Sure the slouch has been used since at least the 1900’s to portray hip nonchalance.  I don’t have any negative judgement about relaxed posture. I encourage my students to employ the full range of physical gestures – the key is to have choice. We need not be ram rod straight at all times. There’s no moral benefit, and modern pain science shows there’s no equivalency between “good posture,” and a pain free body. “Good posture” is in quotes because there’s no agreed upon criteria for what this means, although certainly as an Alexander Technique teacher I have my views about more beneficial ways we can counterbalance our bones, and how we can learn from studying child development and the movement habits of  people in non-industrial cultures. As it turns out, the geometry for ease is less about the angle of the spine and more about calibrating threat level, accuracy in body maps, and kinesthetic skill, but I digress. Regardless of whether you are poising with a long spine or lounging like a cool cat, this Marc Jacobs ad suggests a life that lacks free will and conscious choice..

Photo snap of Sunday Times article about actress Regina Hall – Enjoy the accompanying  video

To counter the depressing ad, my student also brought me this image of actress Regina Hall also cut from the Sunday Times. We admired  her dancer’s line, her pointed toes and her abandon. We exhaled.

Being an Alexander Student means learning about your habits of movement, your self-image and how self-image impacts the way you move. It becomes impossible not to notice what culture is saying about bodies. Remember you have a choice .

 

 

 

Pelvic Float

Let your pelvis float and roll around the round femur heads.

By Henry Vandyke Carter - Henry Gray (1918) Anatomy of the Human Body (See "Book" section below)Bartleby.com: Gray's Anatomy, Plate 237, Public Domain, https://commons.wikimedia.org/w/index.php?curid=792151

By Henry Vandyke Carter – Henry Gray (1918) Anatomy of the Human Body

How many angles of rotation are possible between the two sides?

Which quadrants feel free and loose, and which feel blocked?

This movement might feel like a tilting ship in a storm.

Or a sexy dance move.

Or something much smaller and subtler that will free you up for walking, standing and sitting.

 

 

 

 

Some Sitting Help

By Bjoertvedt - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=27198216

By Bjoertvedt – Own work, CC BY-SA 3.0

Stand up. Find your hip joints. Locate your “bikini” line, and find the place where, if you press into it, your pelvis will shoot back in space. That’s where your hip joint is. Note that this is just the frontal plane. Your hip joint is a 3D structure, and exists on the side and backplane of your pelvis also.

Place your thumbs in your hips joints and your hands around your leg bones, so that you can feel for the rotation of your thighs (femurs) as you flex and extend your pelvis. When you send your pelvis back in space, notice that your femurs internally rotate. You might be able to feel a slight widening in the sit bones. When you extend your hip joints, you will feel external rotation of the femurs, coupled with a narrowing of the sit bones.

You can also practice sitting in a chair. Explore a gentle motion of rocking forwards and backwards on your sit bones. Sense the widening of your sit bones as your rock forward, coupled with internal rotation of the femurs. Sense the narrowing of your sit bones as you rock backwards, coupled with external rotation of the thighs. Find a balance point with the pelvis slightly tilted forward (sit bones widening). This helps to establish the lumbar curve of your back and will make sitting upright feel much easier. The slight lumbar curve will also help to release the shoulders as the fascia of the back will tend to tug the shoulder blades down a bit.

How does this differ from how you ordinarily sit?

Most people have a hard time finding and moving from the hip joints. Do you bend your head forward or extend your chest instead of moving at the hip joint? To isolate the movement to your hip joints, it’s helpful to imagine a marble sliding down the chute of the spine. When it reaches the tailbone, that’s the moment to lean forward.

As a final note, this type of mechanical guidance does not sum up the Alexander technique, which I would frame as a holistic method for enhancing our conscious lived experience of being embodied. I offer this mechanical exploration, because so many of my students have discomfort sitting.

Knowing a little bit about the geometry of your bones can make a tiresome daily activity easier.

Shoe talk

Getting minimalist shoes is something to think about – but certainly not a requirement.

I wrote this for a student with osteoarthritic knees. We’ve been working on correcting the way her leg bones spiral when bending and straightening. The correct direction of spiral removes the pain completely. This has been going well, so I felt it was time to address the subject of her so called “healthy shoes”, ultra padded running shoes replete with motion control, arch support and a hidden 1.5-inch heel lift.

To get the knees to work better, it’s going to help if the feet and ankles can do their job in the most unfettered manner possible. When we go barefoot, the foot can change shape and adapt more flexibly to different surfaces and different physical demands. The intrinsic muscles of the foot get strong and flexible. The forefoot and rear foot have the freedom to counter twists appropriately between inversion/pronation and eversion/supination, depending on the stage of the gait cycle. This means that ground reaction force moves up through the body in a way that creates powerful stored elastic tension and spares the joints from pain and wear. Restrictive shoes might jack up the heel, limit foot motion via arch support, control pronation, squeeze the toes, among a few of the  impositions on natural movement.

We tend to think of our hands as sensitive intelligent instruments and our feet as bricks that we shove into padded casing. Your foot has 26 bones and 33 joints. The sole of the foot is a rich landscape of sensory receptors. Our feet have evolved to move in a myriad of directions and relay a rich schema of environmental data to our brain. In shoes with very padded soles, our sensory feedback is diminished. In the absence of good data, the brain protects the body by tensing the feet, ankles, knees, and everything above.

You can test this out. Wear only one sock and have one barefoot foot. Walk around your house. Notice the difference in how your two legs move. Which leg is freer and more fluid? Which foot feels secure? Which leg do you trust? Which limb feels pleasurable to use? If your answer is the side that’s barefoot, you have just discovered the impact of better proprioceptive data on physical movement.

You can assist this process by using a foot roller or other implement to wake up the sensory receptors in the skin of your feet. If you google wooden foot roller, you’ll get dozen’s of results.

Minimalist shoes offer less support and protection to the foot, and can take a while to get used to. I recommend starting with only an hour or two at a time to help the intrinsic muscles of the foot adapt to the new level of work demand.

Personally, I like
Vivobarefoot
Earthrunners
Softstarshoes
Xero

Flip flops, although they appear minimal, can be a problem because it’s necessary to squeeze the toes to keep the shoe on. Same thing with clogs. You want your toes to only have to do the work they were meant to do.

And hey, summer is coming. Time to go to the beach and feel the sand between your toes.

P.S. As a final note, it is possible to use your feet well, or at least better, while wearing fashionable shoes. This is the sort of thing that I help my acting students work with. It’s reasonable to choose aesthetics over function to survive in our culture from time to time. I tend to save my fashionable shoe time for tango or the occasional date night. The rest of my life, I like to let my feet roam free.

Photo by Jordan Whitt on Unsplash

 

rest. do less. rest. play. do less. rest.

How do you handle the need to rest when ill, injured or mentally burnt out?

Try out the idea of allowing rest and play time, but not making it bigger than that. You don’t need to create a story about why you got sick or injured and how you could have done better. I like the phrase, “No need to make it bigger than it is.” You can say this to yourself when you start to freak out about not feeling up to par. Yes, your body needs rest to heal. This doesn’t have to to mean anything more than that.

Illness can be metaphorical, and often is, but sometimes we hang on to the illusion that if we did everything perfectly, between nutrition and mental ecology, we would never get sick. This is untrue, and creates so much pressure. What does it cost you to accept that part of living in a body is not having total control?

Take care of yourself with kindness. No need to over indulge in binge like behaviors that mask as self-care. No need to make it into a big story. Just rest and move on when you are done.

Body Project Blog ~ Where thought is the active ingredient, by Elyse Shafarman

Transform anger and powerlessness into the positive energy of participation

Body Project Blog ~ Where Thought is the Active Ingredient, by Elyse Shafarman

Body Project Blog ~ Where Thought is the Active Ingredient, by Elyse Shafarman

Ordinarily I don’t share my political views on my professional page. The healing touch of Alexander Technique is for everyone regardless of political affiliations. That said, many of my clients are traumatized, angry and fearful months after the elections. A recent article on PBS’s news hour attests that these anxious emotions are so widespread they’ve been dubbed “Post Election Stress Disorder.”

I have two remedies to suggest. The first is to prioritize self care. Unplug, get out in nature, move your body, cook a nice meal, play music, hug a friend, gaze at the sky. Give yourself permission to rest.  Consciously cultivate gratitude for everything that is not wrong.

Then, once you are recharged chose one small achievable political action that you can take. It will help you to transform anger and powerlessness into the positive energy of participation. There is even positive psychology research to back this up.

If you like to write, write letters to your congresspeople. Their addresses are a simple google search away. If you find making calls expedient, get the free Five Calls App. According to Michael Moore, contacting your representatives matters even if you live in a blue state. If you have more time and energy read the Indivisible Guide and then participate in face-to-face activism.

If you have less time and energy to participate, redirect some of your spending habits and give more money. For example, I quit drinking a daily Kombucha ($4/bottle), and donated my projected savings to the ACLU, Planned Parenthood and the Union of Concerned Scientists, among others.

As Obama reminded us, local actions matter, whether it’s formal volunteering, subscribing to a green power plan, or simply being kind to the people around you. Whatever you decide you can do, it will matter. If all of us do something, we have a movement.

But remember, all of this action will best serve the world if it stems from awareness and self care. You will not be effective if you are seething with anger and stumbling from stress. So remember, it’s OK to take some time to breathe and catch up with your life. Let your neck be free and then play your part.

Quick tips for unpacking complicated scientific articles

Body Project Blog ~ Where Thought is The Active Ingredient

Body Project Blog ~ Where Thought is The Active Ingredient

Someone commented that the article I referenced in my last blog post looked interesting, but not easy to understand. Here’s the article. Proactive selective inhibition targeted at the neck muscles: this proximal constraint facilitates learning and regulates global control, Loram et al. 2016 Decide for yourself.

The good news is that even if you don’t have a background in statistics or knowledge of specific laboratory procedures, you can read selectively, which will give you a feel for the content of the research, and you can ask questions which will give you a sense of the quality of the study.

(Side note, if this post reads like a primer for an undergraduate course – you are correct – it is).

Start with the Abstract. That may be all you need.

If you want to know a bit more, read the Introduction and Discussion sections. The authors will outline their main research question (hypothesis) and cite supporting background information. At the end of the paper, the authors will explain all the complex mathematical results, elaborate on findings, provide alternate explanations and may even speculate on ways to improve the study/field in the future.

In general, you can skip the Methods and Results sections unless you want to evaluate how good the study actually was. If that’s the case, the first thing to look at is the sub-section labeled “participants”. A rule of thumb is that any conclusions drawn from studies with less than 30 participants in each comparison group can be categorized as preliminary. A large data pool ensures that results are not due to random chance. Often complex power analyses are conducted to assess the adequacy of the sample size, but, as a casual reader, the question, “Is the sample size (n) greater or less than 30?” will get you pretty far.  Ask yourself how the subjects were selected. Random selection is nearly impossible in social science and psychology research. It’s likely that the subjects selected will be from a specific demographic group. This may bias findings. Check also that the subjects were randomly assigned to test conditions and order of tests. Check if there was a control group. It’s amazing how many studies are published that don’t actually have this. In some study designs the same set of subjects serves as their own control.

Continue on through the Methods section looking at the study design and measurement techniques. Was double-blinding used? Again, blinding is difficult in research with humans. If not, think about how this may have affected results. For example, participants will often try to deliver the results they assume the researcher wants  Glance at the Results section and ask yourself how many tests were done. Were the tests based on the initial hypothesis, or did the researchers conduct hundreds of tests in an attempt to fish for patterns? The more tests conducted, the more likely that results are a fluke. Even if all these criteria are met, results are still often unrepeatable. Currently, there’s a crisis in psychological research. Many of the foundational studies don’t bear fruit upon replication. Usually this is ascribed to problems such as regression to the mean (i.e. extreme findings tending to return to average when measurements are repeated), and a publication bias (i.e. failed research doesn’t get published).

It gets easier from here on out. Look at the actual journal that the study was published in. Is it a peer reviewed journal? Was there an editorial board. Look for conflicts of interest. Who funded the study? Who were the researchers? All of this information should be clearly stated.

If, after all of this, you really want to go deep, go back to the Results. Look at all the diagrams, tables and charts. Do the charts depict what they say they are depicting? Can you make sense of the results even without a background in statistics? If you are still feeling hungry, go back to the Methods section. How were the variables measured and manipulated? What kind of data was collected? Were the instruments used to collect the data reliable? Does the data relate to the original questions being asked?

Finally, my favorite part: Comb through the Bibliography. What sources were cited? Sometimes quotes and facts are cherry picked, and if you are really interested, it’s a good idea to try and read the original studies that were used as background sources.

I’m sure you can come up with many questions that I haven’t thought of! Happy digging…

 

 

Building resilience with loving kindness meditation

IMG_0330

Body Project Blog, Where Thought is the Active Ingredient, by Elyse Shafarman

The Buddhist practice of Metta (Loving Kindness) can nourish, strengthen and energize you during difficult times.

In the Alexander technique we use directional thoughts to expand and open the body (Neck to be free, to allow my head to move forward and up, to allow my back to lengthen and widen…etc). These directions can be viewed as a physical embodiment of the energy of Metta. I’ve written more about this here:

metta-meditation-alexander-technique/
the-eleven-benefits-of-loving-kindness-meditation/

To practice Metta let your mind descend into your heart. Repeat the following four phrases to your self. Imagine radiating the messages from your heart through your whole body. Observe the physical manifestations of these thoughts. Allow the phrases to become personal. If an image or sense memory comes up go with that.

  • May I be safe and protected from inner and outer harm (neck to be free)
  • May I be peaceful and happy (head floating up)
  • May I be healthy and strong (back lengthening and widening)
  • May I navigate the world with skill. May I take care of myself with skill. (Arms and Legs release away from torso)

Note that these phrases are wishes not affirmations. Insisting that you are safe in a dangerous world might bring up disbelief. If negative feelings are triggered, that’s also normal. You can either note the emotions and return to the phrases, or apply R.A.I.N. That is (R = recognize what is going on and name it. A = allow the emotions to be without amplifying or suppressing. I = investigate the story lines around the emotions. N = nurture your self and non-identify.)

It’s very beneficial to spend a long time practicing loving kindness directed towards your self – something our culture does not encourage. Self compassion is often confused with narcissism. You may also send the loving kindness energy to a mentor, a friend, an acquaintance and a difficult person (don’t start with your biggest enemy, choose someone who is mildly annoying at first), and then expand the loving kindness to all beings everywhere.

If you enjoyed the practices, some other names to look for are Thich Nhat Hanh, Pema Chodrun and Tara Brach among many many others. Or, find an Alexander Technique teacher in your area, and experience what it’s like to move in the world with more energy, resilience and strength.

Q & A: Should I take your next group class at Berkeley Rep, or should I sign up for a private lesson?

Next group class starts May 7, at Berkeley Rep School of Theatre ($140)

Q: I’m currently a dancer, and am also a graduate student. I have trouble breathing when dancing, trouble with alignment (chronic low back pain), and extra (fidgety-type) movement habits.

Since I am a student, and budget is important at this point, I’m curious if you might recommend signing up for your 5-week class at Berkeley Rep? Or would it be better to come see you for a private lesson?

A: I think the class at Berkeley Rep would be a really good option for you. Alexander Technique is about changing habits. It takes time to form habits, and it takes some time to unlearn habits. A single lesson might be eye-opening, but I think you would improve more by studying consistently for 5-weeks in the group class.

As a dancer myself, I know how critical it is to address alignment and tension in order to have clear and beautiful technique. Also, I think you might find the stress management component of the Alexander Technique helpful as you move through a challenging graduate program.

I do offer 1/2 hour lessons which is another lower cost option, but again, I think you would gain a lot by attending the group class.

Don’t hesitate to contact me if if you have any questions!

With love and lightness,
Elyse

Body Project Blog: Where Thought is the Active Ingredient.