Sports Injuries and Knee Pain

In the chapter titled ‘Diagnosis and Medical Training’ of his 1932 book, The Use of the Self, F.M. Alexander wrote that no diagnosis of a problem could ever be complete unless the way a person ‘used’ himself was investigated. This is because the ways we ‘use’ ourselves affect the functioning and can either directly or indirectly influence a person’s recovery. If you are injured and seem unable to find a cure, this ‘use’ may be the missing factor that, when attended to, could solve the problem. At long last the medical profession are beginning to acknowledge, if not totally accept, this. The recognition of the A.T.’s benefits in the recent 2008 Randomised Controlled Trial, published in the BMJ, was another massive step in getting the A.T. the attention it richly deserves. This report is well worth reading, as are all of F.M. Alexander’s books on the subject.

Unfortunately, not all sports injuries are avoidable. Contact sports, falling awkwardly, and especially accidents happen all too often. However, many sports injuries are avoidable. Repeating a wrong movement over and over is often a cause. Over training, pushing yourself beyond natural limits, allowing adrenalin to blind your awareness to pain, choosing not to seek medical advice in the belief that the injury will sort itself out, believing you are an invincible machine—all of these can lead to disaster. Often, sustaining an injury results in a person being unable to train, and this immobility leads to negative thoughts, feelings of being fed up and a desperation to regain former fitness. Many now turn to the Alexander Technique for recourse.

If you can learn to do your exercises or sport with good use, you can reduce the wear and tear on the body’s joints and eliminate unwanted tension. Consequently, back, neck, shoulder, elbow, wrist, knee, foot and ankle pain are all less likely to happen. After all, a well-designed machine still needs regular maintenance. Learning the A.T. and applying it while playing a sport instils the athlete with a wonderful sense of confidence as well as enabling them to register feelings of ‘wrongness’ almost immediately. This increased sensitivity to wrong actions as they are performed has a ‘nipping things in the bud’ effect while hinting at how to prevent repetition. It is this lack of an accurate register in people which is the cause of most sports injuries, and is therefore something that is established when you come for lessons.

F.M. Alexander called this register the ‘Primary Control’. It is the first and the most vital process and, once re-established, tackling any injury or fault can begin. Without it only temporary relief is possible. Injuries sadly reappear in the original guise or manifest somewhere else. No sooner does the knee pain go than the hips or back or shins flare up. Some are plagued by injury and never recover. If only these people knew it is often what they are doing wrong, not just in the pained area but elsewhere, that is the cause. Of course many do know they are doing harm to themselves; they are ‘over-pronating,’ their pelvis ‘is out of alignment,’ they land ‘too much on their heels,’ their head is ‘way over to the side’ etc. Little wonder people get frustrated that the problem cannot be eliminated. And having tried conventional treatments such as massage, physiotherapy and chiropractics without success, they may look elsewhere. They may come for an Alexander lesson.
Let us discuss knee pain in a general way (though it could easily be any other injury; no body part can be seen in isolation). The way your foot and ankle operates has a huge bearing on the knee. What is happening in the hips and pelvis will also influence it. In turn, how the pelvis moves in relation to the spine and back, these areas to the shoulders and scapula, and most importantly the head in relation to the neck, will all directly and indirectly affect the knee. It is very much like the song says: ‘the thigh bone’s connected to the shin bone’ etc. The effects of wrong use are likely to appear in many parts of the body. The stress on the knee as you hit a squash ball with a wrong position of the foot will be crucial and prompts the question: why do you place the foot incorrectly in the first place? It is you who is doing it, no-one else. It is your habit, and although wrong it has become so familiar, so automatic, that you cannot stop it from happening—especially when you are desperately trying to hit a winning shot. Why can it not happen automatically as it ought to? The answer is because the ‘Primary Control’ has been interfered with; sort that out and the foot will be placed correctly every time. The muscle-memory will be reliable and in the same way you were previously unable to do the right thing, you will now not be able to do the wrong thing. That shooting pain through the knee will be a thing of the past, replaced by a lightness and freedom in the legs; a feeling of floating without effort. When all is co-operating harmony and unity of the body can exist.

But allow one part to do something wrong and it affects the rest. The ‘tail is wagging the dog,’ so to speak, and harmony is destroyed. In this instance we must look elsewhere for a solution; we must turn to the relationship between the head, neck and back. You will remember that F.M. Alexander eliminated his voice difficulties only when he dealt with them indirectly, and not by working directly on the throat. The symptoms of hoarseness disappeared, never to return, only when his overall use was improved. Specific problems are seldom cured by specific treatment. It is almost always the general use that is at fault, and this general wrongness which causes specific problems.

Of course, this general misuse is there even when not playing sport; it is a constant throughout the day. It is merely exaggerated when participating in sport. After a few lessons of the Technique you will see the bigger picture and where the difficulties lie, but more importantly, where the solution is—within you. Knee pain is an indication of wrong use. Conditions in the knee may have become so bad that it would be misleading to say that the A.T. will cure all. However, even knees with arthritis, cartilage damage and those injured from failed operations can be helped if the use of the self can be changed and improved. Learning good use before taking up a sport would preclude bad habits from developing in the first place, but this is only an ideal. Sports people who never get injured? Marvellous!

At present I have run every day since 2006 without any knee problems, and I am looking forward to extending this sequence through 2013. Prior to having lessons in the A.T. in 1982, my right knee would swell after only ten or twelve consecutive days of running. Rest, lower mileage, and running on grass all helped, but only temporarily. The injury-free mountain and hill racing I do now with a body thirty years older is testament to the A.T.’s effect. Tomorrow is another opportunity to apply the principles, for improvement is always possible. Good use gives us all the best opportunity to be injury free and is therefore worth having even if you do not play sport or are inactive. Those couch potatoes who develop runner’s knee, tennis elbow, bad backs or other so-called sports injuries, from watching the football, rugby or golf on TV, or who get repetitive strain from using the remote to switch channels, could all benefit from having a knowledge of the A.T. principles and having a course of lessons to learn it.