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Therapies

Feldenkrais

What Is It?
How Does It Work?

What You Can Expect
Health Benefits
How To Choose a Practitioner

Cautions
References

Evidence-Based Rating System

What Is It?

The Feldenkrais Method is a form of "body education" that teaches students how to move their bodies more efficiently, improve coordination, expand range of motion, reduce stress on joints, and increase flexibility.(1) It is often referred to as "Bodywork,"(2) but this is a misnomer because the intention of the Feldenkrais instructor is to teach rather than perform direct manipulation of the body tissues and structure.

Often sought out by those who have movement dysfunction and pain, the Feldenkrais Method is also very popular with dancers, actors, musicians, and athletes who regularly challenge their bodies with repetitive motion.

Russian-born physicist Moshe Feldenkrais (1904-1984) developed the method after he suffered a knee injury that was expected to prevent him from walking. A student of physics, psychology, and biology (with a black belt in judo), Feldenkrais melded his diverse interests and knowledge to create his method, which he actually conceived as he taught himself to walk again without pain. (1)

How Does It Work?

The Feldenkrais Method utilizes many strategies in teaching students to listen to what their bodies are telling them.

Based on the idea that the central nervous system plays an enormous role in a person's comfort, the method encourages awareness of one's skeleton, muscles, and joints, and also draws attention to negative patterns of posture and movement.

The intent of the Feldenkrais practitioner is to enable students to refine their body awareness, so that each body part participates more fully in every action and no one body part is stressed more than any other. According to Feldenkrais, when a student unconsciously allows the skeleton to provide the support for which it was intended, the muscles begin to feel more relaxed and less tense, allowing for expanded range of motion and flexibility.

In teaching the method, the Feldenkrais instructor may ask the student to repeat simple movements many times with slight variations. Doing so offers fine sensory cues to the central nervous system and aids in shifting the patterns of automatic movement and posture so they're more efficient and comfortable.

Recent advances in the scientific study of the nervous system recognize that "neural plasticity," or the ability of the nervous system to learn and adapt, has been a previously underestimated factor in conventional health care and rehabilitation. The Feldenkrais Method is one way to access this ability of people to "self-improve."

What You Can Expect

The Feldenkrais Method has two components. Students may use one or both.

In Awareness Through Movement® (ATM) classes, which are taught to groups in a classroom, students explore basic movement themes to improve movement quality, awareness, and function. The themes utilize ordinary body positions, such as lying on the back, stomach, or side; standing up; or sitting in a chair. In a typical hour-long ATM class, the students focus on one movement theme, guided verbally by the instructor. Often the instruction will cue into the potential mobility in forgotten parts of the body, such as the thoracic spine or ribs of the chest area.(1,3)

Functional Integration® (FI) individualizes the Feldenkrais method with a one-on-one learning process that usually takes place in a Feldenkrais instructor's office.. Sessions are tailored to meet a student's individual needs and generally last 45 minutes to an hour. The student frequently lies fully clothed on a padded table while the instructor uses slow, gentle touch, and sometimes verbal suggestions, to introduce movement relationships among the various body parts. Positions such as sitting, kneeling, or standing may also be used. (1,4)

In all cases, touch is used to communicate, not to correct, and there is no therapeutic pressing or stroking. The instructor's goal is to bring sensory attention to habitual patterns, while also suggesting new options. Through exploration and experimentation, the student seeks an optimal, individualized style of movement. Changes occur spontaneously rather than through willful determination.

ATM classes are typically offered in a series of four to six sessions, meeting once a week. The schedule and frequency of the individual FI sessions is determined by a student's goals and the recommendations of the practitioner.

Health Benefits

Better body awareness, easier movement, and a sense of relaxation and well-being have all been credited to the Feldenkrais Method. For those who come to classes experiencing pain, the sessions often reduce it; those with movement dysfunction can improve strength and coordination.

While students of Feldenkrais always emphasize that the focus is on individual learning rather than on the treatment of a particular condition, they often report success with specific ailments such as chronic low back pain and neck and shoulder pain. (5,6)

Some Feldenkrais instructors specialize in working with people with orthopedic and neurologic conditions that cause pain or limit movement, such as sports injuries, arthritis, stroke, and multiple sclerosis. (1-3,7-10) Others work specifically with performers or athletes in order to relieve pain, recover lost functions, or refine specific functions.

Because most medical research measures isolated parameters rather than overall function, designing research specific to the Feldenkrais method continues to be challenging. While there have been a few studies evaluating Feldenkrais for those with multiple sclerosis, rheumatoid arthritis, and chronic pain, most health claims for the method are based on anecdotal evidence.  (2-4,7)  In one ten-week study involving twelve multiple sclerosis patients, the patients were divided into an ATM group and a control group. When compared to the control group, the ATM group showed improvement in the outcome measures used including improved balance confidence. (3)

The Feldenkrais method has shown some improvement in patients with fibromyalgia, a disorder characterized by chronic muscle pain and fatigue.  In a Swedish pilot study 39 fibromyalgia patients underwent Feldenkrais intervention for 15 weeks. At the end of the study, the patients reported small improvements in balance and lower-extremity muscle function; however, these improvements were not maintained over time. (11) Another study showed moderate improvements in muscle function and pain reduction and concluded Feldenkrais has potential as an adjunct to physical therapy in fibromyalgia patients. (12)

How To Choose a Practitioner

The certified training programs for Feldenkrais practitioners involve putting in 800 to 1,000 hours over a three- to four-year period. Graduates are qualified to give group ATM lessons after the first two years of training and individual FI lessons after the full four years. In the United States, look for a practitioner who is certified by the Feldenkrais Guild of North America (the professional association for the discipline), located in Portland, Oregon.

It is not necessary to have medical training to be a Feldenkrais instructor. However, many physical therapists, massage therapists, and other health practitioners are Guild-certified Feldenkrais practitioners. Insurance rarely covers Feldenkrais sessions unless they are performed by a professional licensed in another health profession such as physical therapy.(1)

Cautions

The Feldenkrais method is considered to be safe for everyone, not as a medical treatment, but as movement education.

References

1. The Feldenkrais Method of Somatic Education. Web page. Available at: http://www.feldenkrais.com/method/the_feldenkrais_method_of_somatic_education/. Accessed April 11, 2009.
2. Johnson SK, Frederick J, Kaufman M, Mountjoy B. A controlled investigation of bodywork in multiple sclerosis. J Altern Complement Med. 1999 Jun;5(3):237-43.
3. Stephens, James, DuShuttle, Dominique, Hatcher, Carla, Shmunes, Jenifer, Slaninka, Christine. Use of awareness through movement improves balance and balance confidence in people with multiple sclerosis: A randomized controlled study. Neurology Report, Jun 2001;25:39-49.
4. D.Bearman & S.Shaffarman. American Journal of Pain ManagementAJPM Vol. no. 1 January 1999. The Feldenkrais Method in the Treatment of Chronic Pain: a study of efficacy and cost effectiveness.
5. Lake, Bernard. Photoanalysis of Standing Posture in Controls and Low Back Pain: Effects of Kinesthetic Processing (Feldenkrais Method) in Posture and Gait: Control Mechanisms VII. eds. M Woollocott and F Horak, U of Oregon Press, 1992, pp 400- 403.
6. Lundblad, I., Elert, J., Gerdle, B. Randomized controlled trial of physiotherapy and feldenkrais interventions in female workers with neck-shoulder complaints. J. Occupat Rehab 9(3): 179-94, 1999.
7. Malmgren-Olsson EB, Bränholm IB. A comparison between three physiotherapy approaches with regard to health-related factors in patients with non-specific musculoskeletal disorders. Disabil Rehabil. 2002 Apr 15;24(6):308-17.
8. Narula M, Jackson O, Kulig K. The Effects of Six Weeks of Feldenkrais Method on Selected Functional Parameters in a Subject with Rheumatoid Arthritis. Phys Ther. 1992;72 (suppl.):S86.
9. Narula M. Effect of Six Weeks of Awareness Through Movement Lessons on Selected Functional Movements Parameters in Individuals with Rheumatoid Arthritis (A Pilot Study Using Single Subject Case Study Design). Thesis submitted in partial fulfillment of the requirements for the degree of Masters of Science in Exercise Science, Oakland University, Rochester, MI: 1993.
10. Glenna Batson, PT, MA. Effects of Feldenkrais Awareness Through Movement on Balance in Adults With Chronic Neurological Deficits Following Stroke: A Preliminary Study. Complementary Health Practice Review, Vol. 10, No. 3, 203-210 (2005).
11. Aspegren Kendall S, Ekselius L, Gerdle B et al. Feldenkrais intervention in fibromyalgia patients: a pilot study. J Musculoskeletal Pain 2001; 9: 25–35.
12. Barrows, Stacy, PT, GCFP. The Effects of Feldenkrais "Awareness Through Movement" Sequence on FM Patients. FMOnline, vol. 7, no. 9.

 

Evidence Based Rating Scale 

The Evidence Based Rating Scale is a tool that helps consumers translate the findings of medical research studies with what our clinical advisors have found to be efficacious in their personal practice. This tool is meant to simplify which supplements and therapies demonstrate promise in the treatment of certain conditions. This scale does not take into account any possible interactions with any medication/ condition/ or therapy which you may be currently undertaking. It is therefore advisable to ask your doctor before starting any new treatment regimen.

Condition

Rating

Explanation

 

Chronic pain 

   

Studies indicate significant improvements in pain; more studies needed. (4,5) 

 Fibromyalgia  



 Few studies indicating small to moderate improvements in pain and muscle function; more studies needed. (11,12)
Multiple Sclerosis  


Studies indicate improvement in balance and anxiety. (2,3)

Rheumatoid  Arthritis   


Preliminary evidence indicates efficacy. More research is needed. (7-9)
 Sports Injuries

 

Favorable consensus for improvement in pain and range of motion. (1)


 Stroke  


Preliminary study indicates improvement in functional mobility. (10)



Date Published: 04/19/2005
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