"They tell you what to do... but not HOW!"

With this cry of despair Jenny sunk onto the chair in my practice. On her doctor's recommendation she had just seen a physiotherapist for help with a frozen right shoulder, a real handicap for a right-handed person. Jenny described in great detail how a nice physio-student had spent endless time measuring the degree of mobility in her shoulder-joint, making her lift and move the injured arm in all sorts of ways until it was "burning with pain". By the time Jenny put on her coat the pain was so severe that she burst into tears. She was given a list of five exercises which she was supposed to do every day (moving the 'bad' shoulder and lifting the affected arm in different directions). After she had left feeling utterly dispirited, the physio's final words kept ringing in her ears: "Stop if it hurts".

Jenny quickly decided to follow that advice when she found the pain was spreading into the neck and even into the left shoulder and arm whenever she attempted to do her exercises. Then she made an appointment with me in the hope that the holistic Feldenkrais approach would make a difference in a more desirable direction.

We pursued only one aim as we began the typically subtle, largely tacit hands-on process known as Functional Integration (FI), a kind of 'dialogue' or 'dance' involving two nervous systems: to test mobility while avoiding even the slightest pain. Compared to what had happened during the mechanical exercise programme ("No gain without pain") Jenny never once flinched as she carefully initiated tiny movements from all parts of her anatomy except the affected shoulder - occasionally just in her imagination, a very effective way of engaging sensory-motor pathways without landing in "pain territory". Exploring first in sitting, then in standing - with the injured part always softly and securely supported - Jenny soon enjoyed moving her entire body with diminishing fear of hurting herself. At the end of the session Jenny looked much happier. She was breathing more deeply and found that the mobility in her neck and both shoulders had improved.

When she had finished putting on her coat - slowly and carefully - she exclaimed with surprise: "It didn't hurt at all!"

The same evening Jenny rang to ask whether it was a coincidence that she hadn't felt any pain for the rest of the day "even though I took off my jacket and put it on again several times in the course of the afternoon." We decided to leave that question unanswered and 'wait and see'. However, she had not the slightest doubt about the soundness of her newly-found guiding maxim: "Much gain without pain".

(See also the case study of a little boy with paraplegia + visual and orientation disturbances due to hydrocephalus in the article "Feldenkrais Learning and David Bohm's Dialogue Model," Resources)

All Feldenkrais-inspired physical rehabilitation involves intelligent provision of appropriate experience. This allows people to school their power of differentiation and thereby discover for themselves the most essential thing of all: how to avoid doing violence to themselves by focusing more on viable ways and means than on a doggedly pursued (occasionally quite unrealistic) goal. Physiotherapists who have come to understand the Feldenkrais Method tend to agree with its originator's assertion: "It is the most difficult make people who don't know what the end is just attend to the means". However if this understanding has the kind of depth only personal learning-experience can supply, the practitioner will intuitively find the right way of arousing a client's interest in the means she or he actually have at their disposal.

Frozen shoulder