THE TIMES – February 19, 2005
Ginny Dougary

Prince Charles is a fan; so is the Queen but physiotherapist Sarah Key’s approach to backs is thoroughly down to earth.

Twang. Ke-dung . . . a sudden lurching sensation in your spine, like a lift crashing through 30 floors, accompanied by the unshakeable belief that if you try to stand up your body will snap in two, several long moments of blind panic, then days drawing into months of different and ultimately ineffective treatments.

That was my first experience of what is commonly referred to as a back problem: one which seems to have afflicted, at some point, and to differing degrees of pain, almost everyone I know regardless of how active or sedentary they are, slim or overweight, up-tight or relaxed.

My own journey round my back took place all over the country when staying with various friends my back would go and, naturally, they knew just the person I should see in Ludlow, a cranial osteopath; in Aldeburgh, where my host had taken to lying on a book before bedtime to straighten his spine, a remedial masseuse; a physio here, a physio there; and in one particularly ghastly episode where I stumbled and completely seized up in a busy street in Wales, an injection in the bottom.

The only thing that seemed to work for me in the end was a daily regime, suggested by a trainer, which combined a lively walk with a set of yoga-cum-Pilates floor exercises.

Then Sarah Key came along. A few months ago I had the opportunity to witness the Australian globetrotting physiotherapist and her legendary feet legendary, that is, in elevated back-sufferers’ circles do her stuff on a handful of patients who had booked into the Hotel Tresanton, in the Cornish village of St Mawes. Since my back was sorted, or so I thought, I was to be an observer for part of the week-long programme rather than an active participant.

Key has been the Royal Family’s physiotherapist since 1983 a detail which appears in all her literature and the Prince of Wales has written forewords to her books. In her Back Sufferers’ Bible (2001), he concludes: Visualising what is happening inside the back makes it much more logical and easy to see why Sarah Key’s exercises really do work. After all, I should know. As one of her guinea pigs over the years I can vouch for their effectiveness, if not claim some credit for honing the final product.

What with this royal imprimatur, the quietly luxurious setting at wonderful Tresanton and the £3,200 price tag for a four-and-a-half day course, I had assumed that my fellow guests would be captains of industry and the generally well-heeled. But on this count, as on several others, my expectations were to be confounded.

Despite her Harley Street credentials (she is, incidentally, a registered member of the UK Health Professionals Council) and regal connections, Key worked for years in the National Health Service and is very much an Aussie in her meritocratic approach. On the day of my arrival, for instance, I found her on her hands and knees applying herself energetically to a team of 20 to 30 staff. This was partly to prepare them for dealing with her patients but also to encourage them to address their own back problems.

Later, on a one-to-one session, she demonstates how she uses her feet which I note are impeccably smooth and clean standing with the full (but, mercifully, light) weight of her body on the manager’s bare back, delving and digging around to release what she calls the sweet pain.

Key learnt to use her feet when she went on a course in Switzerland in 1982. The fellow who taught me was a hugely fat Israeli man who got the smallest girl in the group, put her down on the floor and sort of danced along her back like Yogi Bear, she says. When he came to my back, I was stunned by how natural and earthy it felt.

But where her teachers restricted the use of their feet for patients suffering from failed back surgery syndrome, Key found that she could actually feel more with her feet than her hands and began to adjust her treatment for all her patients, although I did feel a bit outlandish at first I knew it would raise eyebrows.

A year later, after treating a succession of ladies-in-waiting, the Keeper of the Privy Purse and private secretaries from the Royal Household, Key laid her feet on the Queen for the first time. How on earth did Her Royal Highness cope? Oh, she’s quite pragmatic, Key says.

There’s no one I haven’t put my feet on with the exception of the Queen Mother. And Prince Charles has been your most abiding patient, why? Well, he alternates between extremely active phases and then an awful lot of travel which is hopeless for backs. He’s sleeping in a lot of strange beds and sits in helicopters, and he had tried a lot of things before I came along. I think he did have a breakthrough but it’s a matter of maintenance really.

Her hope is that the Sarah Key Method, as it were, will eventually be taken up by hospitals and, with this in mind, she has started giving master classes to physios who are interested in her work. The proceeds from these sessions go to the Prince of Wales’s Foundation for Integrated Health, which Prince Charles set up in 1998 to spread the word about non-mainstream medicine with predictably negative responses from conventional health workers.

Key, like the Prince, is scoffed at for not being professional enough. Her critics, she says, think it’s slightly ludicrous that I use my feet because it breaks the barriers of what’s accepted as normal.

They also criticise non-mainstream medicine for not being evidence-based. People trot that out as a reason for doing nothing, she says. The only evidence a patient is going to care about, is the evidence that his back is feeling better. The following morning, Key’s group assembles and the tears start to flow almost immediately. There are three men and two women, only one of whom fits my preconceptions: Ian, 57, a senior executive who, as he puts it, flies around the world persuading athletes to wear Nike.

Dave, a Royal Mail accountant from Derbyshire, has had a bad back since 1991 when he slipped a disc. He has had surgery and every sort of treatment, and has been off work for three months. He’s worried that he won’t be able to fly again or drive because of the pain. The pain that has been stalking you every minute like a gremlin, Key mutters sympathetically.

While Ian tells his story, a young woman to his left starts weeping silently. He may be sporty he skis, cycles and plays golf but he’s so weak that he can hardly push a door. All my life I’ve been afraid of having children because I wouldn’t be able to play with them, he says. Now he has young twins. There’s nothing more important to me than to sort this back out and enjoy the next 20 years, he says.

Andrew is 32, single, unemployed and lives at home with his mother in Kent. He used to be a car mechanic and that’s when his troubles started. He took painkillers and anti-inflammatory medicine but there was no improvement. He bought Key’s first book and did some of the exercises but was unable to gain long-term relief.

His doctor and the other practioners said there was nothing wrong with him. Did that make you feel mad, Andrew? Key asks. Pretty much so; I felt that I was wasting their time. She asks him who paid for him to come on her course. My last employer, he replies. My redundancy money. All the women are now in tears. It’s been a long, lonely vigil for you, Key says, as her own eyes begin to well and she goes off to grab a tissue, saying: Dear me, I didn’t expect this. Ian asks, Are you going to be able to fix him? Yes, Key whispers. I think so.

Nathalie, 31 from the West Midlands, works in local government and has two young children. She turns to Ian: What made me upset was when you said that you didn’t like getting down on the floor and playing with your children and I long to be able to do that, she says. Her back pain is aggravated by a pubic dysfunction which makes her feel as though she’s been kicked between the legs by a donkey. She apologises for the brutality of the description. Now she’s frightened of doing anything, to the extent that she daren’t even have her daughter sit on her lap. I feel I’ve lost my belief to get it right by instinct and self-management, she says. Only because you’ve had it humiliated out of you, Key says.

Evelyn, 47, from West Yorkshire, has had a serious back problem for 17 years. She’s tried massage, exercise, osteopathy, acupuncture, a corset with metal rods (Dickensian! Key snorts), bed rest in a specially designed bed, and sugar injections allegedly to strengthen ligaments. At one point in this saga, she didn’t sit down for a whole year. She works on a production line rather than an office job specificially so that she can stand all day. She and her partner have cashed in their savings for this course and put their house renovations on hold.

So with the exception of Mr Nike, Key’s patients are ordinary people, on quite low or no income, dealing with unbearable pain. Key told me that she gets people who are at the end of the line, who have been given up on everywhere else. Dave said that when he went to see her for the first time, she did more for him in a couple of hours than he has experienced in years of treatment.

I left Key’s back sufferers, fairly confident that at least some of them would experience a breakthrough, since the previous day I had undergone one of my own. The first time that she balanced on my back, I was rather distracted by the unfamiliar sensation and, yes, the thought that these feet had made contact with all those Royal backs. But the next day, as her toes and heels found what they were looking for, the sense of release a wooshing, almost electrifying expulsion was so powerful that it made me feel giddy with relief.
Afterwards, I found myself sitting back in a chair in a position that felt so wonderfully relaxed and right I am usually perched on the edge, poised to take flight or twisted awkwardly that it made me cry to realise how much I had been adjusting my body for so long to cheat the pain. As Key would say, I had been letting my back become like an alter-ego or a spoilt child that you let get its own way. I’ve promised her and myself that next time, I’ll take my spoilt child in hand and check it in to her Back In A Week programme, as a participant this time, not an observer.