Richard

A case study by David Hall

Richard was a thoughtful ten year old who looked politely bemused as he sat curled up on the chair opposite me. He was with his mother who was telling me about pains he suffered in his right heel after playing sport and a tendency for his knees to collapse if he ran on uneven ground.

He was a talented sportsman, she said, but had a lot of difficulty running. His coaches were at a loss to explain this discrepancy. It was as if he had the mind of a sportsman but a body with other plans.

I asked him why he was here and he shrugged. A problem like this is no drama for a ten year old. I mentioned that the work I did enabled people to use their body more efficiently, which could make them run faster or make it easier to swim. He looked a little more interested.

He was sitting rather impassively on the chair with his back rounded. I asked him to stand and walk. In standing he seemed to be alert, centred and aligned but when walking, his left hip appeared stuck and his right foot turned in awkwardly. These conditions were exaggerated when he ran. It was as if his left hip could not participate in the action and had to be dragged along by the rest of his body.

I asked him to sit on a stool and began to tap lightly on his back, neck and shoulders. I did this in a way that made him more aware of his body as a three dimensional structure. Prior to tapping, I turned his head left and right. The movement was jerky and stiff. After my initial round of tapping I turned his head again. The movement was smoother and the comfortable range had increased. Making changes to the way a person carries their head can affect their whole body, so I asked him to walk again. He looked a lot more even, though his left hip still did not rotate.

A Feldenkrais or Alexander teacher rarely focuses on problem areas in isolation. They are more interested in how that problem area is a result of a whole body organization. So rather than trying to free the hip directly, I began to look further afield.

I picked up his left wrist and lifted it above his head. This movement was also restricted. Many people think of their arm as something that attaches at the side of their shoulder rather than as an extension of the whole torso. This often means that the person holds their shoulders as if they were a part of their ribcage, which greatly limits their flexibility.

I began to tap on his left side, lifting his arm up and down occasionally. He could feel the difference in quality and range of movement as his image of his arm changed. I repeated the process on his other side so both arms could move freely, then turned his head from side to side. This time it was much easier. His whole torso participated in the movement.

I asked him to lie on a low table and for the remainder of the lesson we explored the connection between his head and pelvis by rolling them side to side, whilst lying on his back and stomach.

He returned for his second lesson walking more fluidly though his mother said that running was still the same. We worked with the movement of going from sitting to standing as this is a good way to improve the way we prepare ourselves to exert force or move suddenly. Consider the way a tennis player stands when about to receive a serve, or a basketball player stands when confronted by a defender.

This was not an easy movement for Richard. He seemed unable to move his pelvis back when bending his knees forward. He also tightened the muscles at the back of his neck, each time he got out of the chair. This had the effect of pulling his head back and down as he stood. Excessive neck tension like this is usually habitual and often at the heart of many movement difficulties. After showing him how to maintain the delicate balance of his head on top of his spine, getting up and down became much easier.

He worked with this during the week and said on his next visit that running was easier. I asked him to run. It did look better but I could see that he did not know how to use his feet to drive him forward. There is a moment in running where a person’s leg extends behind them and they drive themselves forward from the ball of the big toe. Richard’s feet did not extend back. It was as if he were driving himself forward from his calves.

I have a skeleton in my room, so I showed Richard the structure of our limbs and the way they move as an extension of our centre. We explored leaping one step at a time and he was able to experience the power that could be gained if he used his foot as an extension of his leg. We did it as he maintained the length of his spine, the freedom of his neck and shoulders and allowed himself to rotate.

Running was a little self-conscious but he could feel what was possible and went home to experiment. He returned the next week saying that running was again easier. We explored his feet in more detail. He sat on my table with his feet on a small roller. I rolled his feet, one at a time, explaining how a quarter of the bones in our body are below our ankles and about the importance of the pressure receptors in the soles of our feet for things like posture. As I rolled his feet, I moved his knees this way and that, and changed the position of his foot to bring his attention to the way his feet connected through his legs into his torso.

As I did this, his hips began to relax and the next time he walked his pelvis rotated evenly. It was a big difference, everything was moving together. The following weekend his coaches began to comment on his improved performance. He said he could run much more quickly and was clearly satisfied with the result.

There were a few more lessons that focussed on the relationship between his head and pelvis along with how to continue the exploration on his own.

His mother told me that he had gone from being the slowest person in the basketball team to one of the quickest. It is very satisfying working with young people like Richard, not only because I can help them become more able to reach their potential, but also because I know I have helped them avoid a lifetime of unnecessary aches and pains.