- Physical Therapy and the Alexander Technique

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Balance, For Safety Sake
by Idelle Packer, MS, PT, CTAT
and Certified Teacher of the Alexander Technique

Balance is such an integral, ever-present aspect of life experience that most people take it for granted. That is, unless you have experienced the unnerving moment of slipping, losing control of balance, and falling down.

What you may not realize is that balance is a skill - the ability to control and maintain the body's position as it moves through space - a skill you can develop and maintain with practice.

Mobility and balance depend upon three types of sensory information to your brain: 1.) visual input from your eyes, 2.) head positioning information from the inner ear mechanism, and 3.) a sense of spatial orientation and organization from specialized receptor cells found in the skin, muscles, joints and tendons.

Each sensory input is independent of the other. For instance, your sense of spatial orientation (proprioception) is independent of vision. Proprioception allows you to close your eyes and lift your arm and still know which way your palm is turned. It informs you of where you are and where you belong in space. Postural deterioration and clumsiness are associated with decreased proprioception.

Many experts assert that a reduced sense of proprioception is the primary cause of age-related falls that result each year in serious hip and spine fractures. Sensitivity to the receptor cells (which tell the brain where you are in space) decreases as you age. The brain misses these messages about our posture and positioning causing loss of balance.

Slower reflexes, decreased muscle strength, loss of eyesight and depth perception, and onset of conditions such as Parkinsonism, Meuniere's Disease, and arthritis also contribute to a diminished sense of equilibrium.

If you are over the age of 65, you may wonder how you can decrease your risk of falling and improve your general health and mobility. The good news is that we need not succumb to being accident-prone! Movement, posture, vision, and balance can improve with training, and various movement techniques offer help.

First, I recommend a consultation with your physician to discuss and assess your health and potential balance concerns. Next, I strongly recommend a balance assessment by a physical therapist. Statistics demonstrate that older adults improve balance and prevent falls through physical therapy programs that identify a specific balance deficit and design an appropriate progression of exercises to address that deficit.

Vision contributes to balance by informing you of your proximity to obstacles or potential dangers in the environment. Vision or depth perception loss can be improved with vision exercises. I recommend a consultation with a qualified natural vision educator who can guide you in a progressive program such as the Bates Method for maximizing vision and related balance skills.

For older adults, consistent participation in a variety of proven fitness/wellness programs and complementary techniques can restore and improve proprioception: body control and postural stability. Alexander Technique, Body Recall, Feldenkrais Method, Pilates Method, NIA, Tai Chi, and Yoga demand body awareness and optimal posture while performing specific movement tasks.

The interplay of postural and muscular habit, body awareness, and movement skills is highlighted in the Alexander Technique, the discipline I have taught for 23 years. The Alexander Technique develops the skill of proprioception by identifying harmful habits that compromise optimal posture and balance and offering an experience of preferred coordination. Subtle nuances of body posture and movement are addressed one on one, for many, a preferable learning format to group classes.

Attention expands from body coordination in sitting and standing and walking to awareness of the relationship of the body to the environment: how to hold or lift objects, sit down or get up from chairs, climb or descend curbs and stairways, or negotiate uneven surfaces. Stair-climbing, for instance, can be performed with confidence and without back or neck strain, simply by applying the Alexander postural principles to the task.

Skills learned in Alexander Technique lessons offer a safe approach to increasing activity. Sensory input becomes more reliable; posture more upright; dynamic balance more consistent. The movement knowledge is basic and easily applied to other movement techniques or specialized activities. When you feel safer, you will desire more activity, which in turn builds the strength, flexibility, and endurance needed to maintain balance and prevent falls.

In my weekly exercise class at the Deerfield Episcopal Retirement Community I have based the program on the principles of the Alexander Technique and therapeutic exercise. I have observed my students, ages 65-90, greatly improve dynamic balance with consistent repetition of balance activities. In my experience as a physical therapist I have learned that even a person frail with severe osteoporosis or limited by Parkinson's Disease can learn safe ways to re-engage in dynamic activity without fear of falling. 2003, Idelle Packer, Published April, '03, Rapid River Magazine


In support of Alexander's hypotheses, Frank Pierce Jones used methods derived from experimental psychology to conclude:

The reflex response of the organism to gravity is a fundamental feedback mechanism which integrates other reflex systems.
Under civilized conditions the mechanism is commonly interfered with by habitual, learned responses which disturb the tonic relation between head, neck, and trunk.
When this interference is perceived kinesthetically, it can be inhibited. By this means the antigravity response is facilitated and its integrative effect on the organism is restored.
"I submit that these hypotheses have face validity and are consistent with established principles of physiology and psychology."
- Frank Pierce Jones, A Study of the Alexander Technique (earlier published as Body Awareness in Action)

Idelle Packer received her M.S. in physical therapy from Columbia University and has taught the Alexander Technique for 25 years. Her practice, Body Sense, Inc., includes both physical therapy services and the Alexander Technique. She can be contacted through her website,

For more information about the Alexander Technique visit: The Complete Guide to the Alexander Technique

Go Back to Home is a service of Alexander Technique of Lincoln, Nebraska and Toronto, Canada and Life Bridge Coaching.