The Alexander Technique: An Educational Resource for People with Scoliosis                                                                        By N. Brooke Lieb, Nationally Certified Teacher of the Alexander Technique                                                                          Director, Teacher Certification Program, American Center for the Alexander Technique, Inc.

The Alexander Technique teaches you how to identify and change muscular patterns that may interfere with your body’s optimal functioning, helping you to access greater ease in thought and movement.  The Alexander Technique is an educational tool, and is unlike exercise, which seeks to strengthen and stretch the muscular system, or manual therapies (ex: Massage Therapy, Rolfing), which seek to change tissue through external, mechanical manipulation.  Instead, the Alexander Technique teaches you to strategically observe and retrain your habitual muscle patterns in order to perform the activities of life with maximum efficiency and minimum stress on your musculoskeletal system.

Habits/Classical Conditioning:
Every time you brush your teeth, take a step or lift your arm to touch your face, you are relying on your own classical conditioning.  You do not have to think about how far to lift your foot, or how far to swing your leg.  The Alexander Technique is based on the appreciation that our habitual way of performing our daily tasks often involves excess muscle tension, imbalance and inefficiency. Whether it is how you sit, stand, concentrate, or even hold a pen, you do not need to think about how to do each of these activities.  We take our body’s coordination when performing these simple tasks for granted.  However, we tend to perform these activities with excess tension, and with increased pressure on joints, nerves or discs, which can contribute to imbalance, pain and even injury.  Observe yourself next time you are writing with pencil or pen.  Do you really need to grip the writing instrument as tightly as you are?  And yet, if you do not think about it, you will use more energy than is necessary.
Startle Response:
The Alexander Technique recognizes that with the overwhelming amount of stimulus in our daily environment, we live in a chronic state of startle response.  Some of the observable elements of the startle response include raised shoulders; held breath; the head pulled back and down; and an increase in adrenaline and other stress chemicals in the bloodstream.  Also known as the "fight or flight" response, we are ever vigilant, at the ready to respond to a ringing telephone; someone’s question; a traffic light changing from green to yellow; or a foreign object coming at us with great speed.  From early on in childhood, we have been in a state of startle pattern, going on to learn lessons in school, athletics and other motor skills, including handwriting, while in a compromised state.

Unreliable Sensory Appreciation:
If you have ever bitten down on sand or a stray piece of aluminum foil, you will appreciate how much more muscle power you are using to chew your food than in necessary.  As you are reading this, see if you can allow your jaw to relax, and your shoulders to drop.  Perhaps you were carrying some excess tension there, but it didn’t feel like too much until you began to observe it.  Throughout the day, we use more energy and more force than in actually needed to get things done.  Because we have always done it this way, it rarely occurs to us to question how we’re doing things, until we begin to feel pain or fatigue.  The Alexander Technique recognizes that our sensory feedback is inaccurate and seeks to re-educate us to a more reliable feedback.

Thinking to your body can create change.  The Alexander Technique helps students to develop and refine this skill to relieve habitual tension.  Imagine you have a fifty-pound concrete block sitting on the top of your head.  Now imagine that the weight is removed. Think of your arms being heavy and raise your arms.  Now imagine they are filled with helium and raise them again.  Perhaps you notice there is a difference, merely as a result of thinking.

How Alexander Technique can Benefit People with Scoliosis:  
The Alexander Technique is an educational process, and is to be used in conjunction with your on-going medical supervision.  In no way is it intended to replace proper medical care.

Adult patients often see deterioration in their posture, though on x-ray, the curves are stabilized.  This is due to postural habits, and the flexibility of the muscles and ligaments of shoulder girdle, rib cage and torso.  The Alexander Technique is highly effective in giving student’s tools to maintain and even increase the length and balance of postural muscles.  This in turn relieves compression on discs, nerves and joints throughout the body.  Think of a muscle like a rubber band, which can change it’s length and tension. While muscles can habitually shorten and pull asymmetrically on the skeleton, it is possible to educate the muscles to lengthen and thus reduce those pulls on the body.

With partial fusion, there is still movement in other areas of the spine, and maximum lengthening can help reduce pain and improve alignment.  With a total fusion, the concepts of good use can reduce tension  which can cause pain - and increase ease of movement through other joints in the body.

Observing Yourself:
Watch for symmetry, and watch for habits that feed into the curves and possible rotations you may have within the curve.  Observe yourself in a mirror to begin to recognize your curves.  Be aware which side you carry a briefcase or shoulder bag on. If you have one shoulder that tends to be higher, you may want to carry bags on that side of your body, in order to avoid feeding into the curve that already exists.  Explore the option of  using a backpack, which distributes the weight more evenly over the torso. Notice which ear you tend hold the telephone up to.  Try using both ears or getting a headset.

How The Alexander Technique has been effective with scoliosis:
In her book, Back Trouble (Triad Publishing), Debby Caplan, P.T. and Certified Teacher of the Alexander Technique, includes anecdotes from her work with some of her student’s who had scoliosis.  
One student, Anne, had measurements taken by her dressmaker a year apart while studying the Alexander Technique.  She gained 2 inches in length from her shoulder to waist, both on the front and back of her torso; 1 inch width across her shoulders; lost 2 inches around her waist; gained 1 1/2 inches from waist to floor, and gained 1/2 inch in length in her left arm, making it equal in length with her left right arm.
Another student, Judy, began lessons at age 48.  At that time, she was experiencing disabling back spasms, at increasing frequency. With lessons, she found relief from her muscle spasms and over ten years of study, she was able to keep her back pain free, and began studying tennis at 55 and golf at 57 with no recurrence of back pain.
Ms. Caplan’s book includes photos of two adolescent students she worked with.  In both sets of photos, improved symmetry and balance are visible after a course of lessons.

During the Winter and Spring of 2005, I worked with a student who had a curve which had progressed from 51 degrees to 58 degrees.   His Orthodpedic Surgeon referred him for lessons.  While we do not know if there is any change in his degree of curvature after 18 lessons, his curve appears less pronounced.  He has greater range of motion in his ribs, there is less muscle build up on his back, and he has reported neck his neck tension has disappeared.  His wife, an Occupational Therapist, is delighted with the cosmetic change in his appearance, as is he.

Learning the Alexander Technique
Most traditionally, when you study the Alexander Technique, you will work individually with an Alexander Teacher.  Group classes are also offered.  Most Certified Teachers of the Alexander Technique have completed an extensive 3-year, 1600-hour Nationally Certified Training Program, and are familiar with the writings of F. M. Alexander.  
When teachers work with you, they will explore activities, such as sitting down and standing up from a chair, walking, speaking and bending, to help you recognize your habits of movement.  With gentle verbal and hands-on guidance, your teacher will help you achieve a more efficient balance between your head, neck and back.  This change can release excess muscle effort, strain and compression on joints and help your body1s innate reflexes for balance work better.  Teachers also work with you lying on a table, where you can practice releasing muscle patterns without the added challenge of maintaining upright posture and balance.
Part of your lessons may include developing strategies to avoid feeding into your curves and rotations.  Your teacher may have you observe the effect of sitting with one leg crossed, then the other. Often our habits have felt familiar and balanced, and even though we achieve greater balance in a lesson, it may feel odd or even askew. You may use the mirror in this case to help you compare the sensations of balance or imbalance as your teacher helps you move into greater alignment and symmetry.

N. Brooke Lieb is a Nationally Certified Teacher of the Alexander Technique. She received her certification in 1989 from the American Center for the Alexander Technique, where she is Director of the Teacher Certification Program and a Senior Faculty Member.  She teaches in New York City and Doylestown, PA and can be reached at (212) 866-0679; or by e-mail  at, or through her website at

To order a copy of "Back Trouble" by Debby Caplan contact American Society for the Alexander Technique (AmSAT), at (800) 473-0620; or visit their website at