Here is an outline of Clinical Somatic Education written in response to a third year student on the BA (Hons) dance degree at Hull College. She approached us for information to help her with writing her final year dissertation. Her dissertation was focused on dance injuries specifically ankle sprains and the rehabilitation process.

Although focused towards dancers this may offer an insight into how Clinical Somatics may be of assistance

“In terms of rehabilitation from ankle sprains, I’ve had one or two dancers who I have worked with. I’ve worked with them after the swelling has gone down post-injury. My work is neuromuscular focused, so although the injury could be in the ankle, I’d be observing for whole body patterns of limited connection between the brain and musculature. These patterns show up as asymmetries in structure and functioning, i.e. one hip higher than other, one shoulder further forwards than the other or left leg having a different stride length from the right. Often with dancers I also observe differences in turn out of one foot compared to the other where the dancer could internally sense both feet pointing directly forwards whilst, when viewed from the outside, there would a turning out of one foot. This discrepancy between internal self-sensing and external self-organisation is what I would focus on addressing. For dancers this discrepancy could be an underlying cause of bodily injuries due to the difference between internal directed action and external manifested action. My work addresses Sensory Motor Amnesia (SMA) which relates to decreased functional connection between the brain and the body. If there is a reduction in sensory connection there is a reduction in motor efficiency.

For dancers with ankle sprains I’d particularly observe for lack of functional control in the sides of the body – including obliques, latissimus dorsi and rectus abdominus. If there was a distortion in the functional control of one side of the body this could lead to lack of effective coordination in the muscles down into the pelvis, hip, leg and foot on one side of the body. Often when there is turnout in one foot but not in the other there is a difference in muscle tonus in the glutes. On a deeper level there may also be a difference in functioning of the psoas and the muscle tonus in the illiacus on one side. Shortening in the obliques on one side may contribute to one hip being higher than the other, a shortening in the rectus abdmoninus or latissimus dorsi, a rotation of the pelvis, forwards or backwards. There may also be a difference in the functioning of the abductors and the adductors ie one tighter, the other slacker than optimal.

I primarily work with three neural reflex patterns: startle, landau and trauma reflexes which operate at the subcortical level of the brain: one addresses the muscles through the posterior chain of muscles, one the anterior and the other, the sides. I’ve primarily focused on trauma reflex so far and how it may impact the sides of the body. The other two reflexes also have large scale impacts on the body, and kyphosis and lordosis are often the results of the brain getting stuck in a pattern of contraction of muscles in the back of the body or muscles through the front. In terms of ankles these can further contribute to weight being more into the heel or more into the toes and balls of the feet, which may also be contributory factors in ankle injuries.

As a Clinical Somatic Educator my focus isn’t on therapy as such but rather on education. My focus is on educating my clients how to sense and move in better ways based on expanding the sensory information received in their neocortex so that they can engage better movement options. I’m assisting them to develop a better, fuller sense of self  – one that is enriched and enhanced to provide access to more effective, efficient movement choices.  For ankles specifically I’d probably have a general flow working from the centre of the body to the periphery, enabling adjustments in the front, back and sides of the torso, to reset muscle functioning from the centre outwards. From the centre I’d move out down the leg to assist change in muscle functioning all the way into the feet. I may also focus on a lateral connection across to the opposite shoulder which may have become engaged in compensatory contractions.

Specific techniques I’d be using would be – Means Whereby to explore the movement currently available and to prepare the brain by guiding attention to a specific area for learning/change to take place. Another is Kinetic Mirroring which would involve me contracting an area of musculature, drawing origin and insertion points closer together so the brain can have a heightened sense of contraction in the musculature without being engaged in producing the contraction. Then I’d guide a client through pandiculating the musculature which involves them contracting the muscle themselves to the point where the awareness of contraction is highlighted by the use of gentle hands-on pressure from myself, they then slowly release the muscle with conscious awareness, at a slower rate that normal to raise the action from the automatic unconscious level to the level of conscious voluntary control. At the end of the release, the third phase of the pandiculation is then allowing a complete letting go and relaxing. In the slow controlled release phase I observe for jumps and judders which are indicators of lack of full connection between the brain and the musculature. If jumps and judders show up I invite the client to smooth the movement out, I can ask them to contract back to just before the judder began and then have them release again and smooth the motion. We can work in this way to improve sensory-motor control working with the neuromuscular system. This allows resetting of the resting and contracted muscle lengths at the level of the brain so the functional possibilities within the brain to muscle are expanded and enhanced. We also use particular movements for integration of changes that send the newly learnt ranges of muscle functioning from the cortex into the subcortex ie. where the automatic subconscious behaviour choices reside.

Beyond hands-on work I’d also offer verbally guided movements which they learn to practise at home. These would compliment hands on movement lessons so that can cross-contextualise new learning after the 1-2-1 session into their wider development as a dancer.”

My experience with dancers came from offering Clinical Somatics for two years at Northern School Of Contemporary Dance (NSCD) when I lived in Leeds. Whilst there I taught weekly classes of Hanna Somatics, took part in bi-annual Healthy Dancer Days and provided 1-2-1 Clinical Somatics with degree dancers attending NSCD. I currently teach workshops around the UK and abroad and offer private 1-2-1 Clinical Somatic sessions in and around South and Mid Wales.

David Fleming

Certified Clinical Somatic Educator (CCSE)