Alexander Technique Science

Scientific understanding of the Alexander Technique (AT) increases year on year. You can watch the following animation to understand a lot of the recent science in just two minutes!:

I oversaw the above animation project as a trustee of the FM Alexander Trust.

Below is my more detailed snapshot of the most important scientific studies to date. In addition, some of my own publications on AT and science are included in the final section, and you can keep up-to-date with my blog.

Click on a link below to jump to the relevant section.

AT Health Benefits
How AT Works
My AT Publications

AT Health Benefits

In 2008, the NHS and the UK’s Medical Research Council spent over three quarters of a million pounds on a groundbreaking study which concluded that one-to-one lessons in AT had ‘long term benefits for patients with chronic back pain’.

In the study, 579 patients with chronic back pain were randomly assigned four different treatments. These comprised normal GP care (control group), massage and six or 24 AT lessons with a qualified teacher. Below illustrates one of the main findings:

ATEAM results chart
© Guillaume Bourgault

As can be seen, the patients who were assigned AT lessons started from a place of experiencing pain every day. But after 12 months, those who took 6 AT lessons had reduced their pain levels down to 11 in 28 days (about one day in every three); and those who took 24 AT lessons had reduced their pain levels down to only 3 in 28 days (less than once a week). This was a significantly better result than those patients who were assigned massage or normal GP care.

The research was published in the British Medical Journal and a video about the study was also made at the time.

The above research was a Randomised Control Trial (RCT), considered the gold standard for clinical research. There have also been two other RCTs investigating AT. One study found that AT lessons led to ‘significant reductions in neck pain and associated disability compared with usual care’ and the other study found that AT lessons likely lead to ‘sustained benefit for people with Parkinson’s disease‘.

How AT works

A groundbreaking paper published in Kinesiology Review in 2020 provides the clearest scientific explanation to date of how the Alexander Technique (AT) works. The authors put forward a model of AT mechanisms based on evidence from research into AT and related fields. I have summarized this model below.

Introduction

Two aspects of our neurophysiological selves are fundamental to healthy movement and balance. These are postural tone and body schema. There is growing evidence that training in AT has a positive effect on both. The authors propose that these changes in postural tone and body schema are responsible for other effects of AT, including changes to movement, balance, pain and emotional regulation.  

What are Postural Tone and Body Schema?

Postural tone is the continuous low-level activity in our muscles that prevents the body’s collapse against gravity, stabilizes its configuration in space and organizes coordinated movement. This muscle activity must be steady yet adaptable in order to support both stability and movement. It can be conceptualized as a ‘state of readiness’ to manage whatever internal or external forces are acting on the body.

Body schema is our brain’s 3D map of our body parts in space. It is constantly updated as we move around. It can be thought of as a detailed reference manual for our brain to plan and execute movement.

Alexander Technique improves Postural Tone and Body Schema

There is evidence that AT affects postural tone in two ways. 

Firstly, AT improves the adaptability of postural tone. After training in AT, individuals are better able both to resist or yield to external forces (for example, gravity) as circumstances require. 

Secondly, AT improves the distribution of postural tone through the body. Specifically, AT seems to shift axial (neck and torso) muscle activity from superficial to deeper muscles. For example, there is a likely shift from activity in muscles such as sternocleidomastoid and trapezius to semispinalis and deep multifidus. This shift may result in greater efficiency and more precise control of position and movement.

In addition, it is likely that AT improves the accuracy of the body schema, the brain’s 3D map of our body parts in space.  Postural tone and body schema are believed to be deeply intertwined, meaning that improvement in one leads to improvement in the other. AT aids this virtuous circle.

The following video provides a snapshot of changes to postural tone after training in AT. The participant on the left has not had AT training (control), and the participant on the right has had extensive training (AT participant). Note first of all the smooth weight transfer in the AT participant, consisting of a gradual increase in foot force. This demonstrates the ability to match forces precisely, or in other words, adaptability of postural tone. Secondly, note the comparatively lengthened spine in the AT participant. In general, there is evidence to suggest that those who have had AT training have lower thoracic and lumbar curvature than controls, indicating a redistribution of postural tone.

How does training in AT achieve its effects?

Those training in AT become skilled in particular intentional and attentional processes. Specifically, two processes are key. Inhibition involves preventing or undoing unnecessary muscle tension, and Direction involves applying specific intentions to postural tone, body schema and spatial awareness.

AT’s effects on movement, balance, pain and emotional regulation are all considered to be downstream from the changes to postural tone and body schema outlined above.

In conclusion, the following is a simplified version of the model put forward by the authors:

Alexander Technique model

For a discussion of the science of the Alexander Technique and links to the latest research papers visit alexandertechniquescience.com.

My AT Publications

Over the last decade I’ve published a number of papers and chapters on scientific aspects of the Alexander Technique. I was one of the first to suggest links between the Alexander Technique and body schema, hemispheric differences in attention and affordances. Three of my publications on the Alexander Technique are available for download below.

There has been an increased interest in the relationship between AT and body schema. This paper can be seen as the beginnings of a phenomenology of the body schema; in other words, an understanding of the body schema from the subjective point of view.
This is an ambitious article which suggests that the understanding of AT has much to gain from the insights of other disciplines including philosophy, neuroscience, psychology and anthropology.
This article brings together research on hemisphere difference, brain pathways to movement and motor awareness. Many of the phenomena associated with AT resonate with these areas of neuroscience research.