Scoliosis and ideo-motor action

Dear Dr. Dimon,

Based on FM Alexander’s discovery that use affects functioning, I would be interested to receive your comments about whether the onset of scoliosis (lateral curvature of the spine), either from birth or at least from early childhood, would cause someone to be more prone to developing an unbalanced ideo-motor action, or whether the scoliosis itself, which is a shortening of the spine, is a result of the imbalance?”

Best wishes.

Stella Weigel

Hi Stella,

Thanks very much for your very interesting question–it is not an easy one to answer, so let me begin by sorting out a couple of very basic issues, and then I will get to your question.

To begin with, for readers who may not be familiar with the term “ideomotor action,” it refers to the pathway of neuromuscular activity in which an idea triggers a motor act. When, for instance, I am sitting at my desk and I hear the doorbell ring, I may think about whether I want to answer the door, but chances are I will react rather unthinkingly because the ring, which associates with the knowledge that someone is at the door, triggers a motor act or series of act, and I find that I am answering the door before I have even deliberated about it. That’s ideomotor action, which is the basic way that we perform actions during the course of our normal everyday lives.

When ideomotor is unbalanced, this means two things: first, that the action is performed with a harmful degree of tension–what Alexander identified as the harmful pattern of misuse that we are so familiar with (pulling the head back, shortening in stature, and so on); second, that the action is triggered too easily because we are too reactive or hyperactive, which we see if, for instance, someone has decided not to answer the door and is so jumpy that he answers the door anyway. Obviously, if ideomotor action is imbalanced in this way, as it is in virtually all adults, then over time our actions are going to adversely affect our health–use affects functioning.

But what causes ideomotor action to become unbalanced to begin with? Unlike animals, we humans perform many complex actions that we are not instinctively equipped for–sitting for long hours in school, typing at a keyboard, writing with a pen. As a result, the system does not work in a reliable way; we engage muscles that are not meant to be engaged, and often exhibit an outright lack of control. I am convinced, from working with and observing children, that this misdirected or unreliable use of the system, or unbalanced ideomotor action, begins very early and precedes malcoordination of the primary control. What I mean by this is that, even in a child who sits beautifully and seems to be quite well-coordinated, the system will be misdirected so that, when the child stands up, he will pull his head back and arch his back, as if his nervous system is simply not organized properly and is sending the wrong signals to the muscles. This seems to suggest that, if there is any tendency toward twisting or scoliosis, the performance of everyday actions will tend to exacerbate the existing condition.

On the other hand, if the muscular system has become imbalanced from other, more physical causes–say, a period of bed rest, an illness–or from emotional factors–then this will create interference with the ideomotor response, which will tend to become more imbalanced. This is also true if, in learning to stand and walk and to perform other actions, the child’s basic coordination is interfered with: in this case, the pattern of ideomotor action will be disturbed by the existing imbalanced in the working of the postural system.

In answer to your question, then, postural imbalances can cause imbalance in the pattern of ideomotor action, and ideomotor action will also certainly tend to exaggerate and interfere with postural function–it can go both ways.

There is more to say on this issue, but I’ll leave it at that for now and hope this has been helpful!

Best wishes,

Ted