Small Movements Lead to Big Changes; a Physical Therapists experience with MBS

As a Physical Therapist (PT) with over 15 years of experience my outlook on treating patients has been broadened and enriched through Mind Body Studies (MBS), based on the work of Moshe Feldenkrais. In PT practice, I would primarily treat a patient by focusing on the location of pain, discomfort, or symptoms. But as a Mind Body Practitioner I take a more holistic view of the person.

Using the MBS principle of going slow and doing smaller movements, we can bring attention to how people move, creating an environment in which anyone can learn new possibilities for movements. With new options, and with these small movements that can be done at any time, patients of any age can experience relief from chronic symptoms.

In PT; we tend to ask patients to do similar, repeated movements with a focus on local symptom relief and strength building. In MBS, the emphasis on learning leads to awareness of the whole body and distribution of work or effort throughout the body. Consequently, patients report experiencing a surprising reduction in pain and symptoms.

Case study 1: Recently, I was providing care for an 89 year old female who ℅ lumbo sacral pain. I observed that she had scoliosis to Right (R) in the mid to lower thoracic region, and her left ear was closer to her L (left) shoulder. Her L shoulder and L iliac rest were also observed to be closer together than on the R side. In addition, the patient was also observed to be sitting predominantly on her R ischial tuberosity. A traditional PT approach might include asking the patient to stretch her shortened L torso. Using MBS principles, however, I asked the patient to emphasize her pattern by sitting even more clearly on the R ischial tuberosity, thus exaggerating the shortening of her L torso.

Bringing attention to the weight shift created awareness in the patient’s nervous system of her habitual pattern (shortening the left side). Once she knew how she produced the pattern, she had more options. As Moshe Feldenkrais liked to say, “If you know what you’re doing, you can do what you want.”

The patient noticed that she was sitting more in the middle and reported that her back muscles were not as tight or painful. This allowed the scoliosis to be less pronounced and in turn the patient felt relief from her symptoms.

Case Study 2: Patient 2 ℅ low back pain and wheezing. Upon palpation, soft tissue tightness was observed around the low back region. A traditional PT treatment course would include stretches and strengthening exercises. Applying the principles of MBS, the patient was asked to do movements in a very small range. The first movement was hip External Rotation in sitting (taking one knee laterally) a few times. This was followed by taking hip in Internal Rotation (taking knee medially) a few times. These two movements were then combined, bringing the knee in and out, still in a very small range. During these movements, the patient was asked to bring attention to the low back region and to notice how far up he could feel the movement, i.e. could he feel any involvement of the shoulder and head. The patient reported awareness of movement traversing up to his neck and shoulder. Upon the completion of the movements in both legs the patient reported complete relief of his low back pain. He also reported that he was  no longer wheezing, as his breathing changed with awareness of his chest and ribs.

Both patients independently did these small movements multiple times a day and are now reporting significant decrease in their chronic pain symptoms.

The principles of MBS have both broadened my perspective on PT work and contributed to more satisfying results for my patients.