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by Laura Tuthall
Life as a hypermobile person can be painful, exhausting, and unpredictable. Many aspects of our health are out of our control, but we do make choices that cumulatively affect our functioning. Most of us know this at some level; from one careless motion to years of repetitive activity, actions big and small contribute to the symptoms of today and tomorrow. Navigating realities like joint instability and reduced proprioception can be daunting, but paying attention to our choices becomes that much more important when our circumstances are so extreme. With consequences of strain ranging from pain and dislocations to serious long-term damage, cultivating physical awareness and control is an essential aspect of EDS/HSD management. We cannot change our given conditions, but we can learn to accept instability, honor injury, and adapt accordingly. The Alexander Technique can serve as a guide for hypermobile individuals seeking to improve the way they use their bodies, and thereby their experiences of living in them.
The Alexander Technique (AT), developed by Frederick Matthias Alexander around the turn of the 20th century, is an educational process that brings our awareness to how we do things, refining the coordination and organization of the whole body. Many other models of care available to hypermobile people treat parts of the body as pieces to be fixed. This can be helpful and necessary, but AT offers an alternative that views the body as an inherently connected structure and cultivates skills from that principle that can be applied to any activity. Because of its comprehensive and adaptive nature, AT can work in tandem with medical care, physical therapy, and exercise, and is appropriate for students of all ages.
AT is now taught widely in many countries in many different ways. It should be noted that not all are suitable for hypermobile bodies, just like not all physical therapy practices are safe. A good teacher, like a good medical professional, will listen to your individual experience and tailor their methods to it. They will educate themselves about hypermobility and use a gentle, noninvasive touch to increase sensory accuracy and encourage more efficient body use patterns.
For those of us with EDS and related conditions, reducing pressure on our joints and spine is an important goal, and one of the biggest benefits of AT. We know from medical professionals that avoiding hyperextension prevents further harm to loose joints, that maintaining good posture is crucial for spinal health, and that strengthening our muscles properly will help support our joints. However, many patients find these recommendations difficult to follow when contending with joint instability, chronic pain, fatigue, and other issues. Hopefully, we have a medical team that helps us approach physicality in a way that works for us, but no matter our situation, increasing awareness of our bodies and developing better movement strategies will help us feel more comfortable in our daily lives.
AT facilitates the growth of self-management skills: progress requires the student’s participation in noticing their habitual patterns, exploring alternatives, and applying that knowledge and curiosity to their physicality in and out of class. Lessons involve open dialogue about the student’s experiences, hands-on guidance to augment their sensory awareness, and the introduction of relevant topics such as anatomy and body mechanics. Common activities include sitting, standing, and walking. However, the focus is not on the type of activity but on how it is being done. Consequently, anything can be explored and improved, from using a computer to playing a musical instrument to working with mobility aids. This contrasts with an exercise class or a physical therapy session, in which participants might complete prescribed sets of movements while engaging specific muscle groups.
For example, an AT teacher might lead a student struggling with low back pain through a variety of activities that explore hip joint articulation. While lying on a table with the teacher’s hands underneath the small of the back and at the fold of the hip, the student might be prompted to release unnecessary tension in the hip and throughout the body. Next, the teacher might gently lift and move the student’s leg to give them a more accurate sensation of articulation. Later on, the student might apply these experiences to standing and walking, fine-tuning their alignment and muscular engagement with touch and verbal cues from the teacher. Throughout, teacher and student would discuss whatever comes up, such as sensations the student notices, effects of habits they may have, and connections between areas of the body.
The active educational component of lessons and the sensory information provided by a teacher’s hands are invaluable. However, AT lessons are not available to everyone (yet). If there are no teachers in your area or you cannot afford lessons, you can still bring about improvement by altering the way you think about your body.
Consider this: in order for alignment to serve us, it must be adaptable. It is not perfection in stillness, but organization that supports us through any activity, from lying in bed doing nothing but breathing to the most complex of movements. Take the spine, with its curves designed to absorb shock, a heavy head at one end and the pelvis at the other – attempting “good posture” by over-straightening the spine and stiffening the muscles of the torso creates pressure and is difficult to maintain. On the other hand, collapsing into hypermobility causes the body’s structure to compress itself. Both extremes are static; neither allows you to adjust your relationship with gravity as you move. Instead, try approaching uprightness with a sense of pliability and balance.
It is important to spread the work of supporting ourselves through the entire body, the parts of its structure readjusting to accommodate the needs of activity. Responding to pain or instability by organizing the rest of the body thoughtfully will take pressure off the local concern and integrate it into the whole. For example, a recently subluxated knee will benefit more from improved articulation of the ankles and hips that recruits the musculature of the legs more evenly and fully than it will from avoiding movement altogether or from tensing around the injury in an effort to protect it.
More than a collection of levers and pulleys that make movement happen, our muscles wrap around our bones and overlap each other like webbing. When working optimally as independent parts of a coordinated whole, they suspend the spine and support the joints. Especially for those of us with compromised connective tissue, imbalance in the musculature – with some areas tight and overworked and others lax and inactive – can cause intense pain and interfere with alignment and joint integrity. For us, treating the body as a movable, balanced whole is paramount.
Whether you are undiagnosed, newly diagnosed, or long aware of your condition, there are many methods of symptom management to experiment with, singly or in combination. By paying attention to how we use our bodies in an informed, consistent way, we can add to the efficacy of all approaches we try. AT is unique: it offers us autonomous control – not over our conditions, but over how we adapt to them. It can give us power to improve our own functioning, live with less pain, and do whatever we do better.
Laura Tuthall is an interdisciplinary artist with hEDS that studies and teaches the Alexander Technique in New York City. In 2016, she co-created Integrating Instability – a project dedicated to bringing AT to the EDS/HSD community. You can find more information at https://www.integratinginstability.com/
Categorized in: Society News