While physical therapists are known as hands-on, movement specialists, evidence is beginning to suggest their ability to teach can improve outcomes and reduce health care costs as well.
A recent study published in the journal Spine (Preoperative pain neuroscience education for lumbar radiculopathy – August 15, 2014), followed a group of individuals who were undergoing surgery of the lumbar spine. Prior to surgery, half of the participants received the typical pre-surgical care. The other half received specialized education from a physical therapist on the neuroscience of pain. The researchers followed up with the participants 1 year after surgery and found the group who received a single, educational session from a physical therapist, viewed their surgical experience much more favorably, and utilized 45% less health care expenditure following surgery.
What does this mean to me?
Physical therapists are experts in developing strategies to help you better understand and manage pain. Growing research, such as this, is indicating education, focusing on the reconceptualization of pain, can lead to improved function, range of motion and decreased pain. As little as one session with a physical therapist, can result in improved long-term outcomes and lower health care expenditure costs.
The Effectiveness of the Feldenkrais Method: A Systematic Review of the Evidence
By Susan Hillier and Anthea Worley
This review aimed to update the evidence for the benefits of FM, and for which populations. The Feldenkrais Method (FM) has broad application in populations interested in improving awareness, health, and ease of function. The Feldenkrais Method (FM) was developed over a period of decades in the last century by Dr. Moshe Feldenkrais. He claimed the basis of the approach was founded in the human potential for learning how to learn. This review showed 7 studies finding in favor of the FM for improving balance in ageing populations Single studies reported significant positive effects for reduced perceived effort and increased comfort, body image perception, and dexterity. Considered as a body of evidence, effects seem to be generic, supporting the proposal that FM works on a learning paradigm rather than disease-based mechanisms. Clinicians and professionals are encouraged to promote the use of FM in populations interested in efficient physical performance and self-efficacy.
One reason the Feldenkrais method is effective:
Movements are performed very slowly in order to you to learn at your own rate of understanding and doing.
Time is the most important means of learning.
To enable everybody to learn, there should be plenty of time for everybody to assimilate the idea of the movement as well as the leisure to get used to the novelty of the situation.
There should be sufficient time to perceive, and organize oneself. No one can learn when hurried and hustled.
Each movement is, therefore, allotted sufficient time for repeating it a number of times.
Thus, you will repeat the movement as many times as it suits you during the span of time allotted.
When one becomes familiar with an act, speed increases spontaneously, and so does power. This is not so obvious as it is correct.
Efficient movement or performance of any sort is achieved by weeding out, and eliminating, parasitic superfluous exertion. The superfluous is as bad as the insufficient, only it costs more.
No one can learn to ride a bicycle or swim without allowing the time necessary to assimilate the essential, and to reject the unintended and unnecessary efforts that the beginner performs in his ambition not to feel or appear inadequate to himself.
Fast action at the beginning of learning is synonymous with strain and confusion which, together, make learning an unpleasant exertion.
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So, prompt #1 has wholly to do with time; and touches on the role of the teacher, and the role of human insecurity as they pertain to learning.
And the approach to time within a Feldenkrais lesson has to be framed anew for beginners (and reiterated for more familiar folks) because it is so drastically different from everything we have ever been taught about time. If you are someone who grew up in an industrialized society, and attended school, etc. then the way you came to understand the link between learning and time is that you learn x within y minutes. If you don’t do it—or can’t do it— you get an F.
And within this standardized process in which most of our developing minds were ensconced, there is a teacher monitoring your capacity—the person dolling out the F, or the A, or what have you.
And, in a master move, that might easily be missed, Feldenkrais opens this first instruction (urging a reconsideration of time) with a recusal of his own role as the teacher.
He writes,
I do not intend to “teach” you, but to enable you to learn at your own rate of understanding and doing.
He is refusing to be seen as a traditional teacher. Instead he considers himself (or the practitioner at work) someone who is creating a set of environmental conditions IN WHICH a particular kind of learning is likely to happen. In fact, here, the main component of being a teacher that he is refusing is the teacher’s strict control of time, and how fast learning must happen given a particular time constraint.
He even declares that,
No one can learn when hurried and hustled.
Therefore learning cannot even happen when a time constraint is applying pressure on the learning process. The primary goal in a lesson is that a person establishes “his own rate of understanding and doing.”
The challenge here is that a Feldenkrais lesson may be the first context in which a person has ever been given this opportunity. Some may find this liberating, a joy. Others may find it anxiety-producing, boring, or in some other way frustrating. They may not appreciate being asked to have an entirely new concept of themselves and their experience in relation to time. We have mostly all been habituated to the rate of learning prescribed for us in childhood by schools, busy parents, etc. Some may have a more difficult time detaching from that habit and reimagining the possibilities.
Feldenkrais even goes so far as to say that,
No one can learn to ride a bicycle or swim without allowing the time necessary to assimilate the essential, and to reject the unintended and unnecessary efforts that the beginner performs in his ambition not to feel or appear inadequate to himself.
He’s biting off a whole other facet of human experience here. He is acknowledging that we all have an instinct to do well, and perhaps an even stronger instinct to be perceived as doing well.
Therefore when learning a new thing, for example swimming, you can imagine a 4 or 5 year old child flailing her limbs about in the water because she feels herself to be imitating her older sister who can swim. But the younger sister cannot swim yet. However, given her desire to learn, and given an entire summer, or several summers, she will have the time to choose only what is effective and functional movement, and let go of unnecessary efforts that don’t actually help her float or move in a particular direction of her choosing.
He ends with,
Fast action at the beginning of learning is synonymous with strain and confusion which, together, make learning an unpleasant exertion.
Which brings us back to one of the main tenets of the Method, which is that learning should be a pleasant experience. And, in fact, that if the process isn’t pleasant, the learning won’t happen. Step 1: Do things very slowly, especially at the beginning.
