- Physical Therapy and the Alexander Technique

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Physical Therapy and the Alexander Technique:
An Overview

by John A. Macy, PT

Many people interested in the Alexander Technique ask how it is related to Physical Therapy, which often is the only intervention in movement with which they are familiar. The two fields have a number of common concerns, but there are also some important differences. Physical Therapy is a broad field which treats movement dysfunction from a primarily medical approach. The Alexander Technique, however, teaches people to change dysfunctional movement patterns by educating clients in how to change their daily habits of movement and posture.

Physical Therapy works to restore maximal movement abilities and function. These abilities and functions can be lost due to various causes. One cause is the loss of the mechanical ability to generate motion (as when a muscle is torn or a joint has been replaced). Another is the impairment of the ability to control movement (as when person's brain is injured from a stroke). A third cause is the loss of sensation in the limbs due to a nerve injury.

In order to assist clients, Physical Therapists use a variety of methods and techniques. These include the application of heat, ice, electricity, pressure, and traction to change certain characteristics or responses of human tissues, and manual (hands on) techniques to stretch, mobilize and restore the mechanical capabilities of a person's frame. In addition, they place a great emphasis on designing and teaching patient specific exercise programs to develop muscular strength, improve joint function, and increase a client's coordination.

The Alexander Technique is an educational process that focuses on changing the way a person thinks about and performs their activities and improving the way the activities are done. The Technique works by helping people change what they do with the innate mechanisms which permit us to exert fine control over the way we move. The teacher examines how common tasks, such as getting out of a chair and walking, are performed and then directs the client to make changes in select components of the task. These changes usually involve changing the coordination and timing of smaller movements, such as the balance of the head on the neck, or the timing between different joint motions.

Usually a teacher will use gentle touch to help direct a client's movements because often the client being asked to move in a manner that is very unfamiliar. This is a bit like a golf instructor might do in showing someone how to swing a club. Depending on the approach used, the teacher may engage the client in a great deal of discussion about their perceptions and understanding of how they move, or may say nothing at all. Generally, the interaction will fall somewhere between these two extremes.

Training for Physical Therapists and Alexander Technique teachers differs in a way that reflects their differing approaches:

A Physical Therapist must be knowledgeable about the bones, muscles, tendons and ligaments and the specific mechanical arrangements which generate movement as well as the organization and structure of the control systems, i.e., the brain, spinal cord and peripheral nervous system. In addition, they need to be able to recognize and identify medical conditions that can affect movement abilities and human physiological responses to such conditions as well as the normal responses to mechanical injury of the body.

The education required of a PT involves a large amount of time spent on musculoskeletal anatomy with cadaver dissection and separate course work on the anatomy and structure of the brain, spinal cord and nervous system. A great amount of course work also focuses on the medical conditions that can have an impact upon movement abilities, as well as training in techniques for identifying and treating specific dysfunctions.

Physical therapists receive a college degree in their field. In the United States this is often a masters degree. Graduation from a program enables a therapist to sit for a national qualifying exam. If the score is high enough (each state determines what is sufficiently high) they are then eligible for licensure in that state. Each state has further regulations governing the practice of Physical Therapy that a therapist must adhere to. A breach of the regulations is grounds to remove a Therapist from practice.

In contrast an Alexander Teacher needs to be knowledgeable in the basic principles of the Technique and have experience in applying these to their own movement patterns. They also need practice in teaching these principles to others and should have a working knowledge of the writings of F. M. Alexander, the originator of the Technique. Teachers often have had experience in other fields and came to teach the Technique after having had lessons themselves.

Alexander Teachers usually attend formal training programs with specific content and contact hour requirements (usually 1500-1800 hours). Some teachers train in less formal apprenticeship programs. Both methods have produced fine teachers although there is no set of objective standards or test of competency administered by a neutral third party.

Historically there has been relatively little training in the details of anatomy and physiology but these areas are emphasized more today. Alexander teachers refer their students to a medical practitioner if there is any suspicion of a medical problem. They are not, however, trained specifically in disease identification or public health measures.

A good analogy of how they practice can be drawn with teachers in other fields such as instrumental music instructors, personal trainers, or martial arts instructors. Regulation by government bodies is essentially non-existent because the interaction is considered an educational one between informed parties.

In summary, Physical Therapy is a licensed, professional practice working within the medical model with emphasis on the restoration of the components necessary for proper movement generation and the retraining of many different movement patterns. The Alexander Technique is an educational practice with emphasis on teaching principles of optimal movement control and applying these principles to everyday movements. There is an overlap between the two types of practices and both can be of great benefit in helping people attain their greatest potential.

John A. Macy is a physical therapist who has been teaching and incorporating the Alexander Technique in his practice for the last twenty five years. He has extensive training in soft tissue and manual techniques as well as neurological rehabilitation and has taught courses on the Alexander Technique for physical therapists and other healthcare personnel across the country. Currently he provides physical therapy services and teaches Stott Pilates at The Workout Inc. in Omaha, Nebraska. He may contacted at:

For more information about the Alexander Technique visit: The Complete Guide to the Alexander Technique

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