Ambidextrous? I'd Give My Right Arm

You’re kidding me? You mean being right-handed is bad for my health?

Well…yes, actually. Back, shoulder, hip, and knee problems are frequently rooted in our everyday right-handed actions. As right-handers we do not give thought to how we pick up objects, open doors, operate technology or even fold our arms. But if you are one of the ninety percent of the world’s population that is a ‘righty’ (source: Max Planck Institute for Psycholinguistics, 2024), you should; your future well-being depends on it.

Life is designed for right-handers. Everyday objects like scissors, notebooks, and can openers are made for righties. Skeptical? Then check-out stores like Lefty’s in San Francisco. You will be surprised by the range of objects specifically designed and marketed for left-handers. Conversely, everyday objects designed for right-handers perpetuate the use of the right side of the body.

Right-handers’ postural holding patterns

The adjacent image shows two spirals of muscle holding, one at the front (anterior) of the body and the other at the rear (posterior). This double-spiral illustration is based on the work of the Australian-born anatomist, Professor Raymond Dart (1893-1988).

Right-handers overwhelmingly twist from the left to the right. The left shoulder, torso, and hip rotate to the right as the head, too, tilts in that direction. The right shoulder drops and the right hip rises, shortening muscles on that side of the body. The right foot sometimes splays out further than the left in response to disproportionate weight being driven through the right leg. These postural features often exhibit themselves in people diagnosed with spinal scoliosis or twist.

While lefties do something similar as a mirror image, these one-in-ten folk are comparatively less left-centric. Their daily requirement to live in a world designed for righties compels, to a degree, the balancing out of their habitual right to left twist.

Dart’s unique contribution was to identify these commonly held muscular spirals. The reasons why we develop these debilitating postural traits was the life’s work of another Australian-born anatomical virtuoso, F.M. Alexander (1869-1955). Alexander discovered that how we sit, stand, and move routinely causes compression and rotational holding. These postural distortions originate from the habitual position of our heads in relation to our neck and back. To prevent and remedy this effect, Alexander developed a practical method. The eponymous Alexander Technique teaches how to lengthen and widen from the head in everyday activity, instead of pulling ourselves down and across. After surprisingly few Alexander Technique sessions, we learn how to release chronic muscle and joint holding. In right-handers, the habitual left to right rotation of the shoulder, torso, and hip becomes less marked. This combination of directional lengthening and widening as well as muscle and joint release, in effect, begins to change a lifetime of learned postural habits. For right-handers, in particular, this results in considerably less pain and greater mobility.

Over the past twenty years a number of clinical trials have sought to assess the efficacy of the Alexander Technique. In 2008 the prestigious medical journal BMJ published the findings of one such 579-subject, randomized clinical trial. Dominating the BMJ’s front page for that edition, its review reported that 24 Alexander Technique sessions resulted in an 86% sustained decrease in participants’ chronic back pain. Other clinical trials of the Alexander Technique suggest efficacy with chronic neck pain and Parkinson’s Disease.

Nadal: left-hander in tennis, right-hander in life

Playing a sport that involves holding a piece of equipment -a racquet, golf club, or bat- accentuates the left to right twist of the body for right handers. Runners, gym rats, and yoga practitioners are not immune either. Profoundly ingrained bodily twists affect how people exercise, favoring their right sides in lifting, stretching, and stepping. With enough practice it is possible for an athlete to become proficient using a traditionally non-dominant side.

Rafael Nadal, the elite Spanish tennis player, is a natural right-hander who was coached to excel on the tennis court using his left. As a result, his inevitable left-handed extreme tennis twist was balanced in part by the opposite twist of his body in the use of his right hand in non-tennis life. By changing his dominant racquet hand, Nadal gained a tactical playing advantage. Additionally, he likely extended the duration of his playing career and aided his well-being.

Michelangelo’s Rebellious Slave from 1513, housed in the Louvre, Paris

Education provides a key to the effective management of musculoskeletal pain and immobility. Right-handers can improve their body balance by learning to use their left hand more for life’s routine activities. This learning should start at an early age. Moreover, it could be reinforced by a much more informed approach to postural health in the training of all physical education teachers, nurses, and physicians. Meantime, there does appear consensus among medical researchers that parts of the right-side of the brain control movement of the left arm and leg. If this relationship is encouraged through the teaching of music, drama, and art -as Betty Edwards’ popular Drawing on the Right Side of the Brain contends- so much the better. Perhaps a middle school study course on Michelangelo’s Renaissance counterpose marble sculpture, Rebellious Slave, might be an interesting introduction to art, anatomy, and postural health!

According to the CDC, in 2021 an estimated almost 52 million Americans experienced chronic pain and over 17 million (7% of all U.S. adults) experienced chronic pain that resulted in substantial restriction of daily activities. These folk were often braced, prescribed powerful pain suppressant drugs, and/or subjected to invasive surgery. A more functional, cost-effective approach lies with information. A practical understanding of how to remedy right-left imbalance, muscle holding, and habitual patterns of sitting, standing, and moving empowers people. For public health, such rudimentary knowledge would help prevent much of the chronic musculoskeletal pain of those 52 million Americans.

Perhaps the last word should go to Professor Raymond Dart. In his last ever interview Dart commented pithily: The future lies with the ambidextrous human.

Alexander Who?

A genius.

Those were the words used to describe Frederick Matthias Alexander in his obituary in The Times of London in October 1955. A posture, anatomy and health rock-star of the previous fifty years, Alexander counted the famous and powerful as devotees. These included writers of the stature of George Bernard Shaw and Aldous Huxley, politicians like British Treasury Secretary Stafford Cripps and academics such as Chicago University’s influential Professor of Philosophy, John Dewey. And yet today, less than seventy years after his death, F.M. Alexander’s eponymous Technique, with its capacity for a revolution in individual and public health, is scandalously low profile. The seeds for this scenario were sown in a fascinating cocktail of world conflict, professional snobbery and personal paranoia.

The eldest of nine children, the sickly Alexander was born in one of the remotest corners of the British Empire - Tasmania, Australia in January 1869. In early adulthood he was an actor. Working in Melbourne, Alexander repeatedly lost his voice during public recitals. Unable to find a physician who understood why and steadily losing his livelihood, Alexander embarked on an intricate process of self-observation in mirrors. Gradually he unearthed a series of remarkable discoveries about his anatomy and its relationship to his previously undiscovered postural habits. Realizing he had stumbled on a finding of worth, he began offering his services to the general public.

By 1904 Alexander had moved from Melbourne to London, then undeniably the world’s greatest city. Over the course of the following fifty years his professional skill, force of personality and penmanship of four books would make Alexander the postural health expert on both sides of the Atlantic. His highly practical method of improving health, mobility and productivity by re-learning how to sit, stand and move habitually became renowned and hugely in demand. Encouraged to recognize the significance of his discoveries, Alexander started a training course for teachers of his technique as well as a school, based on the technique’s principles, in southern England. He even won over certain sections of the medical profession. In May 1937 a letter appeared in the influential British Medical Journal, signed by nineteen eminent doctors, recommending that the Alexander Technique be included in the training curriculum of all physicians.

In July 1940 and with the seemingly imminent invasion of Britain by Hitler’s Nazi Germany, Alexander left for America. He had commuted between Britain and the U.S. regularly in the decade between 1914 and 1924 in order to teach, lecture and market. However, the wartime ship voyage to America and, more importantly, the decision to return across the Atlantic would prove consequential.

Virtually all of the British-based teachers of the technique were involved full-time with that nation’s war effort for almost six years. The few women instructors that were available had scant resources and precious few clients. Austere food rationing, the effects of German blitz bombing and a bankrupted Britain would curtail demand as well as supply for several years after the end of the Second World War. By contrast Britain’s loss turned out to be America’s gain. Many professional Americans in New York, Boston and elsewhere benefited from Alexander’s presence in their country. His services, as well as that of his younger brother A.R. whom Alexander had trained, were much in demand. This rapid and encouraging progress in the U.S. was completely halted in its nascent tracks by Alexander’s curious decision to return to Britain in July 1943. This was a mere three years after arriving in the world’s most affluent and receptive country to his ideas.

An even greater impediment to the development of his technique was Alexander’s educational background. Notwithstanding his status and fame, Alexander was not a qualified physician. The resulting mix of snobbery and fear manifested towards him from the medical establishment, together with his corresponding mistrust of most physicians, would have profound implications for the future of his technique. Despite the encouragement of prominent supporters and benefactors such as Professor Dewey, Alexander ultimately proved unwilling to open up his ideas and methods to independent research and empirical testing. This decision fueled the suspicion among his critics that Alexander was a charlatan. After his death, Alexander’s concepts would be vindicated by Dr. Wilfred Barlow’s 1973 publication, The Alexander Principle, as well as more recent large-scale, randomized medical trials.

Meanwhile, Alexander became sensitive to the point of paranoia, as exemplified by three telling episodes. The first was that he became convinced, without cause, that two of his most loyal and talented lieutenants, the aforementioned Wilfred Barlow M.D. and Patrick Macdonald were conspiring against him. The resulting split from both men resulted in a schism within the Alexander Technique community which lives on to this day. The second manifested itself in Alexander’s deeply injudicious decision to sue a South African government sponsored publication, Manpower, for libel. Despite his legal victory, the case and its appeal consumed copious amounts of Alexander’s time, money and energy in the final decade of his life; precious years which should have been devoted to fostering credibility, succession and legacy. Instead and thirdly, Alexander’s Will left control of his Estate to his last surviving sibling, Beaumont, a rogue whose only interest in the Alexander Technique was how much money it could generate for Beaumont himself.

If ‘genius’ can be defined as someone who alone devises a practical system for materially improving human health and functioning on a mass scale, then Alexander was indeed a rare genius. He was also human and flawed. The strength of character which refused to accept that habitual pain and stress had to be endured, was the same character-strength that refused to believe any research or successors were worthy of his legacy. Sometimes in life our greatest strength is also our most glaring weakness. This truism was never more true than in the remarkable life of Frederick Matthias Alexander.

Lights, Camera...Inaction

Can a person’s destiny be predicted from their posture and body type?

One influential Ivy League college researcher certainly thought so.

From 1880 to 1940, as part of its registration process, Harvard’s male-only Physical Education Department took nude photographs of many new students. In all some 18,000 images of naked Harvard freshmen were captured during this period. Around 1940 Professor E.A. Hooton of Harvard’s Anthropology Department and William Herbert Sheldon, a Harvard researcher, inherited the camerawork. These two academics transformed the predominantly administrative project into a somatotype mapping study. Based on the images, students were ascribed one of three body types - skinny, nervous ‘ectomorphs; fat, jolly ‘endomorphs’ and confident, buffed ‘mesomorphs’. Sheldon, in particular, became a strong advocate for the argument that a person’s body type was the chief determinant of character and eventual levels of success.

Persuasive and seemingly credible, Sheldon convinced many of the Ivy League and Seven Sisters’ colleges in the years between 1940 and 1970 to join the trial. During this roughly 30 year period, all incoming students at Princeton, Mount Holyoke, Radcliffe and the rest were photographed nude or semi-nude from the back, front and side during freshman orientation week. These academically elite young men and women acquiesced to having pins stuck on them while disrobed in order that their spinal curvatures could be highlighted in the resulting images. Those whose pins exhibited excessive curvature were encouraged to attend remedial postural classes.

The likes of George HW Bush at Yale, Meryl Streep at Vassar and Hillary Rodham Clinton at Wellesley as well as many thousands of others comprising the great and good of American society were photographed this way.

By the late 1960s Sheldon’s work had become highly controversial. Accusations were made that his research had its foundations in eugenics and, worse still, was motivated by Nazi sympathies. Under this level of heat, the erstwhile cooperative Ivy League colleges dropped Sheldon as quickly and as furtively as possible. The photographs were either burned (ironically) or gifted to the Smithsonian’s National Anthropological Archives. Little was discussed about the subject until The New York Times published a piece in January 1995 by journalist Ron Rosenbaum, himself a subject of Sheldon’s lens while at Yale in the mid-60s.

With the luxury of hindsight both Sheldon’s methodology and the colleges’ unquestioning acceptance were misguided, to say the least. Nevertheless, the project raises some fascinating issues. For sure, there are hot-button questions concerning the boundaries of privacy, consent and information misuse. There are also important research implications.

A postural trial of the willing and informed is a laudable concept. This is all the more so when many members of the research group comprise the educational, medical and political leaders of tomorrow. Many of Sheldon’s original subjects could have been systematically re-photographed throughout their lives as part of a rigorously controlled tracking study. In order to achieve this, the gathering, storage and use of the images needed to be openly discussed, contractually agreed and rigorously regulated. Had this been done, the findings would have been quite simply invaluable. Instead, a combination of deception, mismanagement and fear resulted in the squandering of a unique opportunity. What was lost was highly valuable information about the relationship between habitual posture, health and performance among several generations of America’s future policy makers.

In our era of pervasive social media, developed political sensibilities and screen-slumped youth, the lessons of Sheldon and his nude Ivy League photos can not be overstated.

Pain's Groundhog Day

Artwork from Professor Osgood's 1930 Report

The jigsaw puzzle of pain in the United States has a whopping piece missing. This piece impacts millions of adults and kids, contributes to costs greater than cancer, heart disease and diabetes combined and has repercussions for every future generation. Now lost, the part was actually in our hands a century ago.

Of American men rejected for military service by the end of the First World War in 1918, some 40 percent were for reasons associated with poor posture. An alarmed President Hoover turned to Harvard Medical School's distinguished Professor of Orthopedic Surgery, Robert Osgood. Osgood’s resulting report to the 1930 White House Conference on Child Health advised that every child in the United States undertake postural education and correction in grades 1 through 7. In order to achieve this ambitious goal, Osgood wanted all physicians, nurses and physical education teachers to have a basic understanding of posture incorporated as a mandatory part of their training.

Bancroft: "Erect carriage in stair climbing."

Osgood's recommendations were built on the work of Jessie Bancroft. Bancroft's 1913 book The Posture of School Children resulted in the establishment of The American Posture League. In schools across the United States, this organization implemented detailed standards for postural education.

Meanwhile, in London around the same time, another remarkable person of a similar vintage had come to parallel conclusions about the relationship between habitual posture and health. F.M. Alexander discovered that how we sit, stand and move throughout our day and throughout our life often causes or worsens bone, muscle and joint pain. His ingenious response was to devise a safe, easy-to-learn and practical method, the Alexander Technique, which stops pain by changing our postural habits.

Few physicians and nurses understand that poor habitual posture fosters back, neck and shoulder problems, migraines as well as hip and knee pain and repetitive strain injuries. To add insult to injury, these health professionals are often ineffectively equipped to respond when they do see the connection. This is not their fault. The blame lies with their training, our myopic obsession with drugs and elective surgery and the breathtaking sterility of the nation’s health protection agency, the CDC.

The pharmaceutical industry’s blindness to the import of habitual posture should surprise no-one. What is astonishing is that US insurance companies do not value the economics of postural pain prevention, in contrast to some European counterparts. These US insurers would do well to follow the money. Lost productivity and medical care from pain is costing corporate America up to $635 billion annually; more than the yearly costs of cancer, heart disease and diabetes combined. If US business only knew that supremely cost-effective ways exist to get people back to work pain-free and more productive than ever.

Slouched kids become slumped adults in chronic pain

A hundred years after Bancroft's work there is no universal postural education of children in American schools. Adults in pain are routinely prescribed fatally addictive opioid medications. Sufferers with eminently treatable and preventable conditions are almost never guided to safe and effective postural health solutions. This scenario is a personal tragedy for many of those 50 million American adults suffering with acute and chronic pain. For our slouched and screen-preoccupied children and grandchildren, it is a catastrophe in the making.

"Those who fail to learn from history are doomed to repeat it", Winston Churchill remarked. People like Bancroft, Osgood and Alexander had a profound understanding of the relationship between posture and health. They appreciated the balance between therapy and education, between prevention and cure and between mind and body. When it comes to the effective treatment of pain in the United States, it is beyond high-time that the jigsaw piece of posture is rediscovered and placed in its rightful position.

We do not have another century to waste.