Feldenkrais And Awareness Through Movement As A Tool For Pain Management With Teresa Miller, PT, PhD

Welcome back to the Healing Pain Podcast with Dr. Teresa Miller, PT, PhD

This was a fun episode for me for lots of different reasons. The first reason, I spent a lot of time over past episodes talking about cognitive-behavioral therapies, in essence, if you will, the more top-down approaches for the treatment of chronic pain as well as other health conditions. Being a physical therapist, I work with both the mind as well as the body. I want to turn some attention toward more of the embodied therapies, more of the bottom-up approaches, and how they can have a very positive influence and impact on someone’s pain and their overall health.

In this episode, we are going to discuss awareness through movement and how the Feldenkrais Method can be used as a tool for pain management. My guest for this episode is Professor Teresa Miller. She is the Founding DPT Program Director at St. John’s University, a graduate of the American Physical Therapy Association Educational Leadership Fellowship, and a Guild Certified Feldenkrais Practitioner.

She is an Associate Professor Emeritus from State University of New York Downstate Medical Center in Brooklyn, New York, where she taught physical therapy for years. Dr. Miller received her PhD in Physical Therapy from Temple University, her MS in School Psychology, a BS in Physical Therapy, and AIS in Physical Therapy Assisting.

In this episode, we discuss what is the Feldenkrais Method, how it is developed, what are the guiding concepts of a Feldenkrais lesson, how Feldenkrais can help those managing chronic pain and how to find a Guild Certified Feldenkrais Practitioner. A little FYI before we begin this episode, Dr. Miller was one of my professors of Physical Therapy at the State University of New York Health Science Center, Brooklyn way back from 1995 to 1997.

I consider her a colleague, a mentor, as well as a friend. It was lots of fun for me to do this episode with her. It takes you back in time a little bit too when I was a student and reviewing some of the work that she did, which is groundbreaking. Feldenkrais was not so popular in 1995 when I went to PT school. She was one of the first people to introduce me to more of the mind-body as well as embodied approaches to treating pain.

I want to thank her for her time and for joining us for this episode. I know you are getting a lot out of it. I especially want to thank her for her leadership and bring some of these mind-body approaches into my personal practice as a PT but also into the profession and providing evidence for it. Without further ado, let’s begin and meet my good friend, Teresa Miller.

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Feldenkrais And Awareness Through Movement As A Tool For Pain Management With Teresa Miller, PT, PhD

Teri, thanks for joining me on the show. It’s a pleasure to have you here.

Thank you, Joe. It’s a pleasure to be here and I appreciate being invited to speak.

We should let people know that you were one of my professors in PT school years ago. Back in PT school in 1995, I clearly remember a class that you gave where we had mats on the floor and you had us line our backs. The first couple of things that you said were, “Observe how you are lying there. Observe where your scapula is on your back and where your pelvis is.” All this was so new and different to us. At that time, we didn’t know what Feldenkrais was. You went on to become Guild Certified in Feldenkrais and you did some research in that area. Part of your PhD work was a little bit of Feldenkrais. As your former student, I don’t know how you became interested in Feldenkrais or where that came from. Can you tell us a little bit about that story?

When I was at Downstate, one of my professors was studying Feldenkrais and a second faculty member went on to study it. I remember we had classes in PT school wherever you had to lie on the floor and do the same body scan noticing where we were in space, and then exploring some movement. All I could remember from it was that I fell asleep every time. I was working in my first hospital-based job and there was somebody else who was doing training. I started to observe him. It was in a rehab center. We have a floor of a hospital.

In my next job, there was somebody else who was doing Feldenkrais so I was meant to do this. When I was at Northwell, it was North Shore Manhasset back then, we had a PT who was doing the formal training with the Feldenkrais Guild. He was working for a physician doing research but he used the same outpatient space that I was running. I was watching and asking questions. I started to say, “Harold, I have this patient and they are not getting better. Do you have any ideas?”

That was pretty much how I’ve got involved. I remember one patient, in particular. I had worked with her for a long time. She had had other therapists before me. She couldn’t bend her knee more than 90 degrees. We tried Iodex. I had to freeze her knee with Iodex. We did slow and prolonged stretching. I put her on a traction machine, weighing on her belly, slow pulling and it wasn’t getting any better.

I said, “Harold, what do I do?” He had her lie on her back in her frog-like position with pillows. He had her moving knee flexion-extension, rolling the knee up towards the ceiling or pressing it down into the table, moving from the hip and doing pelvic tilts. All of a sudden, she had 110 degrees of knee flexion and I was like, “What?” I had done all this soft tissue work on her and I said, “There’s something here that I want to explore because this was so unusual to me.” That’s what piqued my interest.

If my memory serves me right, you are working with more of a neuro-rehab population.

Yes. When I met Harold, I was doing outpatient but I did different rotations at the hospital. Before that, I had been in neuro-rehab. I have always been very interested in movement. I was a gymnast. In my first PT job, I had a lot of patients with chronic pain and the doctors would say, “Do ultrasound in the hip, knee and ankle for five minutes each.” I’m like, “It’s coming from the back most likely if they have pain down the whole leg.”

I started to explore complementary and integrative therapies, craniosacral, acupressure and a few other things. I found Feldenkrais and it answered a lot more for me about regional interdependence like the relationships between different body segments, how you could move one and affect the rest of the body and how you could change function. It was a more whole-body, whole-person, mind-body approach that spoke to me and it changed how I approached my patients a lot.

Mind-body wasn’t a catch term back then the way it was now. It existed but it was so way outside the circle, so to speak. It was beyond alternative at that point.

When we went to treat patients with pain, back then the theory was to exercise them hard first and then give them a treat with some modality, a hot pack, ultrasound or electric stim that you needed to work through the pain. What I have learned over the years of doing Feldenkrais is I don’t doubt anybody’s pain anymore. I don’t question it. I try to figure out, whether it is coming more from the cognitive aspect or the emotional aspect.

I’m not the one to judge that but can I find a way to help that person to get out of pain on their own? How can I empower them? That’s a much more useful way to work with patients because they don’t feel like you are questioning them. You are acknowledging wherever it is that they are at and making it a safe environment for them to learn in.

For those that don’t know, we should probably backtrack a little bit. If you can explain what the Feldenkrais Method is, where it came from and how it started to give people some back story on it?

Moshé Feldenkrais was a physicist and an engineer. He worked on the Manhattan Project and had a knee injury when he was a teenager. They told him he needed surgery or he would never be able to walk right again. He is a very brilliant man. He lay on the floor and started to explore where he was in space, exploring his own movements. He found that if he moved from other places in his body, if he moved in different ways, his pain went away. He started to use that to improve his function, and then people started asking him, “Can you work on my kid?”

HPP 250 | Feldenkrais Method
The Feldenkrais approach helps a person to get out of pain and empower them making it a safe environment for them to learn.

 

I remember watching a video during my Feldenkrais training of him working with a child with cerebral palsy. I had worked in pediatrics, too. In one session, rather than taking months and months to teach a kid how to go from lying on their back to sitting up who had never done it before and some of them were fourteen years old, he did it in one session. I’m sitting there watching the video crying and saying, “How did he do that?” I knew how much it took. He had this one kid lying on his back. He put his foot near his buttocks and he started playing with the kid.

He had the kid pushing up the table backward. I’m saying to myself, “That kid is using an extensor tone. That’s not good.” He would make the kids laugh and the kid would push up the table. He would pull it back down. The kids would push away and pull him back down. He got the kid involved in pulling himself back down. He was doing reversibility of movements so it wasn’t just extension.

When he stood the kid up, he was taking weight on his feet. He was using it functionally. Even his speech changed in that session where he held his head, I was like, “This is amazing.” Over years and years, people asking Feldenkrais how to incorporate this so he started doing training. Another part of his background that helped that I left out was that he was a Martial artist. He was a fifth-degree black belt in Judo so he incorporated Systems Theory and Chaos Theory in Mathematics with the Physics, Judo, and his own discovery of movement to come up with this whole approach, which is learning but it’s not fixing somebody.

The Feldenkrais people don’t like to think of it as fixing somebody or therapy. It’s more about how can I have more options to be a more potent self? How can I have more options to function? If I’m standing there or walking along and somebody scares me, am I going to fall over? What am I going to do? Do I stiffen up? If you think of the elderly people that we might treat, we are all hunched over. They are tightening everything up because they are so afraid of falling.

That’s not a potent self because if they step in a pothole where they step off a curb, they don’t adjust their head and neck. They don’t adjust in their trunk at all, their pelvis, knees or hips so they might be using the ankle strategy to regain their balance. That’s not always enough. It’s about learning what you are already doing and how you can make that even better. If you take a kid with cerebral palsy who walks with a scissoring gait where the legs are turned in and might have a big lordosis, a big arch in their lower back, in the old days in PT, I used to try to fix that.

I would be controlling them maybe from their shoulders or their pelvis and trying to get the legs to face more forward and space the balance a little bit wider apart. What Feldenkrais did was he made it safe to be where somebody was. He said, “It’s okay to function that way.” There were other people after him like Systems Theory, Mark Latash was somebody who wrote a neat article about not taking that away from the kids who had cerebral palsy. What Feldenkrais did was he would have them go into it even more.

Accentuate the posture, arch the back, roll the legs even more and come out of it to where it’s easy. If somebody was slumped, slump even more and return from it instead of, “Stand in front of a mirror and straighten yourself up. That’s fixing or correcting.” Instead, he said, “Turn on even more of what you are doing but make it more complete.” If you are hunched over, what’s your lower back doing? You might still be arched in your lower back, even though you are kyphotic in the upper trunk so make it flexion throughout. Roll that pelvis back, return from there and start to explore other combinations of movement.

When I do that, do I stick my chin out? Can I do it by sticking my chin in? Do I stick my lower ribs out? If I stick them out further, can I start to bring them back as I roll into that ball? It’s an interesting concept because as a PT, my brain was always like, “Somebody’s posture isn’t so good. Their alignment isn’t so good. I want to fix that. I want to teach them how to make it better.” In the end, we get to the same place but how we get there is different when you are a Feldenkrais practitioner. You are still in your mind. You are still saying, “How can I get more of an optimal alignment or posture? How do I get there?” It’s not so easy to straighten up.

For somebody who’s tight because they have been in this position for years, you can’t just straight them up. It’s interesting because I have taken patients who were in their 90s and had them go more into where they were, come out of it and keep repeating that in the easy range. The next thing you know they are upright. It was mind-blowing to me. For years, I would have patients where I was doing mobilization on their trunk trying to get the vertebrae and ribs to move and get that mobility back. I tried so many different ways and you get a little bit right. In one session with Feldenkrais, I have had people who straightened up.

I’m doing some pelvic clocks as we are talking here because I know it’s critical to a lot of the methods in the pelvis. As you are talking, there are a couple of things that resonate with me. The first is it doesn’t seem like Feldenkrais has overly doesn’t look at the body as dysfunctional, which is where traditional PT has been for a long time. Although we are moving away from there knowing that there are other factors to chronic pain besides the structural factors, so to speak, that resonates.

There are somatic therapies out there. There’s a whole family of somatic therapies but when I look at Feldenkrais, they are identified as somatic education, which is different. I’m wondering if you can maybe talk about the distinction or why do you think they call it a somatic education versus therapy. Maybe you don’t know about the evolution of that but it’s interesting.

It’s teaching body awareness. Not just body but your whole self, mind, body spirit and interaction with the environment. It’s all of that. Even in a lot of the other somatic therapies, for example, the Alexander Technique. I’m not as familiar with it but they might be working more from the head and neck. That’s where they tend to start with Alexander or Pilates holding that neutral pelvic tilt and learning to breathe there easily but holding that tilt through everything.

I remember I had different students many years in a row but at lunchtime, I would have them hold that neutral pelvic tilt, which is a lot of the exercises that we see being done in PT. Go to lunch and every time you think of it, go into that neutral pelvic tilt. When they came back from lunch, I said, “How did it go?” They would be like, “We are so exhausted. That’s hard.” It’s hard to think about it all the time but the difference with Feldenkrais is you might do it cognitively in the awareness through movement lessons. There are two types of Feldenkrais.

There’s hand-on, which is called functional integration or there’s awareness through movement where I can talk the person through something or I could do it by myself thinking about movements. When you are doing those movements, that can take energy and concentration but what happens is there’s a shift in the nervous system. The nervous system starts to recognize that, “Where I am now, works. I have been walking or sitting this way for years. That’s where it’s okay to be who we are and we are not fixing.” As you start to work with the person and have them explore, it’s also easy to move almost like a flow of water.

If I sink my pelvis down into my right, I like to sit on my right shield, that’s easy. If I go to my left, it doesn’t want to go. If I don’t try to make a face, it’s like I’m questioning it but here, it’s nice and easy. Help that person to recognize what’s easy and what can be as easy. It might be a slight difference in direction of movement. When I raise my arm over my head, that’s about it, believe it or not, but I’m also sitting with my pelvis very stable.

HPP 250 | Feldenkrais Method
Sometimes we think it’s okay to be who we are and we’re not fixing anything. You have that posture for decades and you’ll be fine. But you have to know when to fix and start to explore other combinations of movement.

 

If I let my pelvis roll with me, there I am and if I sit on that other shield too, it’s free and I didn’t have to do anything to force it there. It’s helping people to find where that flow of movement or flow of almost water when you spill water on the floor and seeks its own path. When we teach people how to do a range of motion, we are trying to have them do a straight plane instead of, “Where is that easy place?” If I keep doing that easy place, it’s like if I drew a butterfly on the board.

This is from Systems Theory. As I draw that butterfly each time, it’s going to be a little bit different. There’s a little bit of variability in movement. Our patients with neurological conditions, especially those with high tone, don’t have that variability or even low tone. They might fix it so they don’t fall over. As you start to vary around what’s easy, there’s an opportunity to start. Each time it’s a little different. You start to fall a little further to one side if you are relaxed.

I like using the analogy of childhood stranger anxiety, a toddler. If mommy or daddy was in the room and there’s a stranger in the room, they cling. They stay close to mommy or daddy and do that for a while. If it feels safe, they might run a couple of feet over and look at the other person. They come back. They go a little further over and a little further over, where eventually they will give them their toy or they will show them their toy. It’s like that with us with movement.

If you are in a safe place, relaxed, and feel safe, you can start to explore different weight shifts, combinations of movements and learn something new. If you don’t feel safe like our elderly patients who are walking and they are afraid of falling over, you have no options. You are not a potent self and you are more likely to fall or to injure something. Our patients who were always here start to get overused at C4, C5 or those patients with shoulder injuries who have a rigid trunk and they are trying to flex their shoulder. It’s all from the shoulder joint itself. Glenohumeral, maybe you get a little scapula or cheating in there but it’s not a flow of movement all the way down to the skeleton.

If I raise my arm over my head, I’m shifting on my ischial tuberosity, on my hip bone and I’m also pushing off a little bit with my left foot. My whole body is involved if I’m relaxed. In Feldenkrais, we talk about an echo of movement through the skeleton. There are times that I want that stability. I might not want differentiation between all the parts. I might not necessarily want a flow of movement through the skeleton, depending on what I’m doing. If I was doing something like opening a jar, I’m probably going to have to fix a little bit with what I’m doing. If I’m reaching to put something up on a shelf, if I’m reaching in my trunk, I’m not going to get as high on that shelf and I’m probably going to do it more from my shoulder and not my whole self.

The idea of safety is an important topic to talk about feeling safe in one’s body, especially if people with chronic pain because oftentimes they don’t want to explore the part of their body that’s painful, whether it’s their arm, their lower back or their leg. They don’t want to bring their awareness to it. They are scared to move it and use it. There’s even some research around there almost being a dissociation effect that’s similar to what happens in things like PTSD and trauma where your brain and nervous system wall that area off and there’s detachment from it.

I like when you said helping people explore their own physical body, movement and working through the entire body. It’s almost like the energy through your body. You can move the energy through your body and with that, you move into different parts and pieces of your body. You are learning that you can feel safe in your own body and exploring your own movement. It’s so important for people with chronic pain where they don’t feel safe in their body and they certainly don’t feel safe exploring movement.

They don’t feel safe when we as PTs come up to them and say, “You have pain in your shoulder. We don’t want to get a frozen shoulder. I have to arrange that shoulder. It’s going to hurt. They have maybe broken their wrist. We want to stretch it and that hurts.” What happens when something hurts and you are trying to get more range? To me, this is what I was saying before about the frog’s leg position. This is why Harold and I thought she got more range.

I still believe this and it makes sense. She had cancer behind the knee and they had irradiated the whole back off her leg and she didn’t have the soft tissue mobility but even after I’ve got that back, I did lots of both soft tissue mobilization. I finally moved the muscle around the bone and the layers of skin but she still only had 90 degrees of flexion. I’m like, “The cancer was behind your knee. It doesn’t make sense.”

What was happening was that she was in this subconscious state of co-contraction that the flexors and extensors were protecting her leg. When she originally had the radiation and she had radiation burns, they put her in a joint splint so her knee would stay straight, at least for walking. That’s why she was flexion. She had the extension. If I’m going to do a hamstring stretch, I do Tai Chi and Kung Fu. What do they do? There are places where they will have you bounce to try to get your hamstrings longer.

You put your legs out to the side and you are trying to reach down or slow prolonged stretch at the end of the range. How? It’s not comfortable. In that position, I will come off of it a little so I might bend my knees a little. I might bring my legs a little closer to each other or not lean as far forward and I start to roll my pelvis and get my body moving around my legs, in essence. I’m turning off the co-contraction because I’m moving other parts. I’m doing it where it feels safe and comfortable. Within minutes, I could reach down way below the sole of my foot. If I tried to do this slow, prolonged stretch, I’m not able to do that.

You are talking about the subconscious. There’s a subconscious holding that happens in the body. It’s interesting because when we talk about the subconscious mind, people think about subconscious thoughts. We can go in that direction to a pure cognitive direction but you are talking about using the body somatically as a way to influence the mind almost, which is counter-current with what’s happening. Psychologically informed PT is all about taking traditional cognitive behavioral therapy and putting it into PT.

As you know, I do a lot of work with pain management. It’s important and there’s a role but people who know me, like yourself, know that my background is influenced by someone like you from early on in PT. I studied yoga and Pilates. I have a gymnast background as well. The movement has never left me. I still will fiercely argue with anyone that you can’t rehabilitate or help someone become more resilient to chronic pain if you don’t help them gain an awareness of their body. I love what you said about the subconscious part. It starts to put what we do as PTs as far as movement goes that doesn’t just influence the body, your frontal lobe, the conscious mind but it also has an influence on the subconscious mind.

The muscle co-contraction doesn’t have to be coming top-down from the brain. It could be coming from the sensory part of the system and coming up the other way. In Feldenkrais, we talk about habit patterns. How do we hold ourselves? What are those habit patterns? What’s familiar? What feels safe? What feels like being home in your body?

As you start to explore in other directions, what also feels safe? Putting somebody in front of a mirror and saying, “Line yourself up here.” I have had women patients sometimes that have much larger breasts than I do. They have to counterbalance that excess in front. They are going to move their upper trunk back so they are not going to fall over. Other women have a lot more curves so they push this back subconsciously to accommodate for that extra weight. You can get that person to find what feels safe for them. Each of us has a different body type and nervous system.

HPP 250 | Feldenkrais Method
The muscle contraction doesn’t have to come top-down from the brain. It could be coming from the sensory part of the system and coming up the other way.

 

My nervous system happens to be pretty hyper. If you test my reflexes, I’m probably a 3-plus or 4-plus bilaterally. I’m hyper but that’s typical for me. What are my habit patterns? How do I use myself functionally? How can I do better with that? How can I move more easily, fluidly and efficiently? That’s what you help the person to explore. The interesting thing is it’s not what I impose on them. It’s what I see as I observe them if I’m doing the awareness through movement where I’m talking them through a lesson and an exploration of movement.

I’m observing what’s happening in them and I might give them different movements to explore with the support surface that they are on, their relation to gravity or one body segment on another based on what I’m observing. If I’m doing it hands-on, it might be, “Where is that flow of water?” If I’m supporting their arm, bringing it over their head, and feel resistance, I’m not going to plow through it. I’m going to say, “What if I externally rotate their arm a little bit? What if I flex the wrist as I do it?” Change something about the movement or give a cue in the rib cage for the ribs or pelvis to come along then all of a sudden, they have that additional movement and it’s easy.

You mentioned the subconscious mind. I’m curious as you are working with people and I know that Feldenkrais is not necessarily targeting emotion but have there been any emotional experiences, emotional releases that you have noticed in people as you are working with them and they are starting to explore parts of their body that have been walled off by their subconscious mind?

It’s a little different. I have done craniosacral therapy and I have had patients who have had SomatoEmotional Releases. They might start crying. Their body might twitch or something. I haven’t seen that so much in Feldenkrais. Sometimes as people are relaxing it’s like when you go to fall asleep, you are going off into dreamland and all of a sudden you jump. There are certain people that I have worked with, that do that. My husband is one. I used to get mad at him. I’m like, “Why are you doing that?” I realized that it was totally unconscious. He had no control over it. From an emotional aspect, I have had people connect with their bodies who had never done it before.

One person, in particular, was in her early 60s. She had cerebral palsy since birth. She walked with more of a crouch gait because she had had the tendon release. She didn’t flex her hips at all when she was walking. It was more of a whole-body turning as she would walk. It wasn’t even counter-rotation anywhere. I was working with her lying on her back. I was moving her lower extremity and I had probably started from her foot playing with some plantar flexion, dorsiflexion, rolling the leg in and out, and seeing how I can get her knee up towards your chest easily where there’s no resistance.

You feel for the direction and get the resistance. You might change the direction or you might go back and keep repeating it. At one point, she looked at me and said, “Where’s my hip joint?” I was like, “Where do you think your hip joint is?” She pointed to the top of her iliac crest. I went and I’ve got an anatomy book. I showed her the hip joint and she said, “That’s why I was asking. I have never felt my hip move before.”

That was a very emotional response because here she was in her 60s. She didn’t know what her hip joint was because she had never moved it except to sit down in a chair but her way of sitting down was still in her whole body back, reach with her hands, and eventually, she would get her trunk forward. It’s not so much a SomatoEmotional release that I have seen. It’s more of the emotions of discovering something new, feeling freer and able.

I remember having an emotional thing myself during a Feldenkrais weekend that I took. I have some eye coordination issues. When I was a kid, they didn’t know about dyslexia. I remember doing some lessons around the coordination of the eyes with the jaw, the trunk, the different ribs and the pelvis. After the session, it was in Manhattan, I wanted to catch the train because otherwise, it was a weekend, I would have to wait an hour.

I ran and normally when I would run, I would run up and down, pounding the ground and I couldn’t breathe. I felt like I ran a gazelle after the lesson. I’m sitting on that train reading. I didn’t have to read word for word. I was reading 1 mile a minute. The tears were flowing. It was like, “I can’t believe I could do this.” It was something I fought my whole life. Those are more the kinds of emotional responses where it’s something people have never been able to do and now, they can.

We should never forget about the somatic nervous system. We talked about the nervous system so much with pain. We talked about the autonomic nervous system when we try to relax the nervous system but the somatic nervous system is a lot of things you are talking about. It is visual input, our ears, what’s happening in our joints and our muscles, proprioception, and kinesthetic sense are important for living a vibrant life.

As a culture, we tend to be so much in our heads.

I tell people, “It’s time to get out of your head and get into your body.”

I might work with that person and start down on their hands or their feet, for example. By gently touching and exploring movement, sometimes supporting, taking over the work of a limb, and working the nervous system, this somatic sensory system from the peripheral up towards the brain or the core.

We think about how our thoughts and emotions affect our behaviors, so to speak, our thoughts and emotions affect our bodies. I’m like, “There’s also a whole other route going the opposite direction that’s so important to try, especially for PTs to not forget that and to also reinforce that in our roles, whether it’s working with a patient or talking with our colleagues in interdisciplinary education or practice. Instead of straight plain movement, let me give you a different exploration and a somatic sense of what the entire body is like.”

If I have a patient lying on the floor and I ask them to roll, they might roll by swinging the whole leg over, for example. That might be influenced by, do they have broad shoulders or like me, do they have wider hips? I’m going to need to initiate differently than somebody who has broad shoulders. If I use that Somatosensory System, I could have that person initiate from different places and get a totally different movement.

HPP 250 | Feldenkrais Method
Inviting people to move in different ways is just so important because that’s where we have our body. Our body was meant to move and explore our environment.

 

If I want somebody to bring their toes towards their nose when they are lying on their back and they can do that because maybe they have had a foot drop, I might have them slide their foot down towards the foot of the table. I might have them do something during gait where I’m getting a rotation of the trunk. Even though I can’t get any dorsiflexion from them in sitting or lying down but if I get it in phase with gait, all of a sudden, they have dorsiflexion. How did those central pattern generators happen? Is there a different way of using our mind and feedback that we have from the somatosensory system to get a totally different response? We can ask for it differently and get a different pattern of movement.

Inviting people to move in different ways is so important. That’s why we have a body. Our body was meant to explore, move, explore our environments, and feel our environment through all the different areas and aspects of our body. If someone wants to find a Feldenkrais practitioner, how would they go about doing that?

If they go to Feldenkrais.com, they can put in their ZIP code or state and they can look and see who’s near them. We have had COVID and Telehealth so there may be people who are doing some of the classes online, too. There are books and journal articles on it. In fact, there was a very nice systematic review that was done in 2015. There are resources. There are lots of videos on YouTube but I caution people who are going to go and look at a video or read it in the book.

If it’s one of Moshé’s books, he totally stresses, “Pain-free discomfort-free movement only, not where you have to hold your breath.” If I turn my head, that’s easy. Do you see the difference? I don’t want to go there. I don’t want to plow through that because I’m taking my nervous system and I’m tweaking it. It’s going to get that response of fight or flight or co-contraction.

If I do the easy direction over and over, and then maybe do something different with my shoulders or my eyes, they could go in the same or opposite direction, I can start to get a change in those habit patterns and a change in my system. Anybody could go online and find resources but I would caution them to only work where it’s easy. Don’t push. Go slow.

In fact, the slower you go, at least initially, the more you can pay attention to that somatosensory system, the more feedback you will get and the more likely you are to be able to recognize some differences. They call that the Weber-Fechner Principle. If I move by pushing through something, I’m not paying attention and I’m not going to learn anything new. I’m going to hold my breath the same way and do what I have always done. There are plenty of resources out there but if you can find a practitioner, if it’s somebody who has a more sensitive type of system, it behooves them to go to Feldenkrais.com and try to find somebody who’s Guild certified.

Everyone can check out Feldenkrais.com to find a Guild certified practitioner. Teri, it has been wonderful talking to you about all the things I know about you.

You too. They are great questions. I love talking about them.

I have known you for so many years and you are an expert in this. It’s so refreshing to see you again in this role.

I don’t know if I’m an expert. I always feel like I’m always dabbling but it’s something that has fascinated me along the way and it changed how I practiced. I don’t stretch people anymore. I do lengthening. I think about how I can turn the nervous system on and off in different directions to get more length than a muscle rather than having to sit on it and try to get more range and that causes pain.

Tell us how people can learn more about you and everything that you are up to.

I am at St. John’s University. They could always email me at [email protected]. I’m happy to speak with people and help them find a practitioner if they are having trouble finding somebody that they can identify with or that’s local to them. We are not everywhere in the country but there are a lot of us out there and in the New York, New Jersey region because there are training in Manhattan. I did training in Montclair, New Jersey. I’m not really the first. There was one at Sarah Lawrence College Upstate New York too but there weren’t many of us on the East Coast and now there are a lot.

At the end of every episode, I asked you to share this with your friends, family, and colleagues on Facebook, LinkedIn, Twitter, and a Facebook group or wherever anyone is talking about somatic therapies and movement therapy for the treatment of chronic pain and other conditions. I want to thank Teri for joining me. I will see you soon.

Thank you for having me.

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About Dr. Teresa Miller, PT, PhD

HPP 250 | Feldenkrais MethodTeresa Miller, PT, PhD is the founding DPT Program Director at St. John’s University.  She is an Associate Professor Emerita from SUNY Downstate Medical Center in Brooklyn, NY where she taught physical therapy for almost 25 years. Dr. Miller received her PhD in Physical Therapy from Temple University in 2007, a Master of Science Degree in School Psychology from St. John’s University (1993), a BS in Physical Therapy from SUNY Downstate Medical Center (1981), an AAS in Physical Therapy Assisting from Nassau Community College (1975). She is currently a student in the American Physical Therapy Association Educational Leadership Fellowship and has served and continues to serve in leadership roles in the profession. Dr. Miller is a Guild Certified Feldenkrais Practitioner. CM

Her clinical practice experience spans a wide gamut and includes areas such as orthopedics, neurology, geriatrics, pediatrics, pain management, and complementary and integrative therapies. She has worked in school-based, acute care, rehabilitation, and private practice settings. She is passionate about learning and teaching wholistic, mind-body, systems-based, patient-centered, evidence-based approaches to maximizing function and improving quality of life. Dr. Miller’s vision for the program is to graduate compassionate, competent, entry-level practitioners of physical therapy who will serve as leaders and advocates for the local, regional, and global health care communities, and as leaders and innovators in the physical therapy profession. In her spare time, Dr. Miller loves to read, cook, garden, sail, practice martial arts and spend time with family and friends.

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