General, Women

The cure for bad backs, by royal appointment

THE TIMES – Feburary 11, 2006
Ginny Dougary

Sarah Key’s method of stamping out pain is so successful that the Prince of Wales is a big fan. So is Ginny Dougary, after joining a week-long course that brought tears as well as laughter.

Sarah Key is at it again, in her white skirty-shorts, tanned bare legs and pearls, her trusty plastic spinal cord draped over one shoulder like an outlandish stole, urging her “babies“ (aka middle-aged patients) to: “Dance on your pain, rock ’n’ roll, bend like a willow, crouch like a bushwhacker, curl like a swastika, spread like a blow-fly, and suck that fluid into your discs . . . shhhhhhllleeeeeeeoooough.”

“The world of backs is full of bullshit” is another of the Australian physiotherapist’s pithy sayings but there are many more where that came from, as I discovered when I enrolled as a fully fledged back-sufferer for a week of the Sarah Key Method.

There were 11 of us on the course, of all shapes and sizes, varied professions and nationalities — one woman had flown in from the States — and we were all 40-plus, with the exception of one sporty whippersnapper who, despite being only in his early thirties, seemed to be the worst afflicted of the bunch.

Key worked exclusively in the NHS when she was living in London more than 30 years ago. She went private in 1976 and now travels between Sydney — where she has her own practice — and the Hale Clinic in London. She is best known for using her feet to dig deep into stubborn tissue and for treating the collective back problems of the Royal Family, in particular those of the Prince of Wales, who is one of her staunchest supporters and, indeed, is backing her attempt to extend her treatment farther through his Foundation of Integrated Health.

Key uses her feet because she can feel more with them than with her hands. It’s a technique that she hs been honing for 20 years, since she first learnt it in Switzerland. She has treated thousands of people in that time from all over the world and says her success rate with “simple lower-back pain is astonishingly high, though complex problems have to be viewed over the longer term”.

This time last year I wrote in Body&Soul about my first meeting with Key when I interviewed her at Tresanton, Olga Polizzi’s haven of a hotel in Cornwall. It was on the eve of Key’s first Back-in-a-Week course at Tresanton and there was only a handful of patients. I sat in on the first morning’s meeting and every story of a life half-lived because of debilitating pain was dismaying in its own way.

What struck me most forcibly was how much the back-sufferers had sacrificed to be there. These were not people who were even comfortably off: an unemployed car mechanic who lost his job because of his ongoing back problem, who was funding the week with his redundancy money; a young mother, unable to pick up her toddler, who was risking further credit card debt. There was only one person, a Nike executive, for whom the fee at Tresanton of £ 3,000-odd pounds would not have created considerable financial hardship.

But then over the long years of searching for a cure most of the sufferers had already spent that sort of sum on the endless, dispiriting round of cranial osteopaths, chiropractors, acupuncture, surgery, hypnotists and so on.

At that time, through brisk walking and daily exercises, I considered that my own bad back was pretty well sorted. But then Sarah gave me a couple of sessions with her feet and, on the second one, something unexpected happened. As I sat in one of the rather uncomfortable chairs, I felt an extraordinary whoosh of relief. My posture was suddenly radically different. Instead of the pinched sensation I must have learnt to live with, I was sitting in a way that felt completely new — but with a dim memory of it being familiar from a long, younger time ago — undistorted, relaxed, and at ease.

In the weeks that followed that mini-revelation, I felt more supple and spring-out-of- bedish than I had for years. But to maintain that new sensation of lightness, it was up to me to take charge. She gave me a “back block”, a blue Perspex oblong brick about a foot long, over which one is supposed to lie — stretching out the spine, sucking fluid into those all-important discs dried up from the hours of sitting hunched over a computer — twice a day, for the rest of one’s life. And guess what? I didn’t do it.

Therein lies the strength and the weakness of the Sarah Key Method. Her amazing foot action is only one aspect of her method. There is the aforementioned back block, which is already used in some forms of yoga but which she has modified for her own treatment. There is also Key’s approach, which marks her apart from others in her profession.

She is passionate about demystifying what is wrong with you, encouraging each back sufferer to understand his or her specific problems through straightforward diagrams and using vivid, unobfuscating language. She overturns all the usual shibboleths of the back profession and this sometimes feels scarily counter-intuitive: we are urged to bend down whenever possible; told that it is madness, indeed, to think that we are protecting our backs by avoiding using them; and that it’s actually good for us to lift heavy things, and so on.

Far from feeling alternative (where you tend to be urged to listen to your body), this feels more bracingly Mary Poppins-esque: our backs are naughty, stubborn children who need a good talking to and, when properly handled — with a daily regimen of back block and a spoonful of appeasing exercises to help the medicine go down — they will amaze us with how well behaved they can be. In the real world, however, the key question is whether you are the kind of person who is self-disciplined enough to maintain the eternal vigilance necessary to prevent your back, once it is on the mend, from going again.

When I returned to Trensanton as a particpipant in the Back-in-a-Week course, a fair number of my fellow sufferers were Times readers who had read the original piece in Body&Soul. Before, I had been a detached observer; now I had my own anxieties about feeling raw and vulnerable. The previous month, my only remaining adult relative — my older sister, Anne — had died unexpectedly, at the age of 59.

Almost as soon as I heard the awful news, my back went into spasm. The last occasion I had felt such excruciating pain was when my mother was dying and it seemed uncannily similar, almost as though the body itself had an emotional memory.

So there were tears that week but also a lot of laughter. It was instructive and helpful to hear about other people’s setbacks and to be reminded that one was far from alone in experiencing the frustrations of trying to cope with life when every movement causes pain.
I recalled how I had sat on the floor for an hour and a half for a recent interview with Bob Geldof because there were no suitable chairs. A chief executive talked about how she would sometimes have to lie down in meetings, which may have been awkward but would have been more so if she weren’t the boss.

Each day started at 8am with a slide-show lecture. The room was covered with mattresses, pillows and blankets and we were encouraged to lie, sit, stretch and stand whenever we felt uncomfortable. There were initial individual consultations, with Key scribbling over our backs with a marker pen to pinpoint the problem areas, which were then photographed.

Towards the end of the week, these images were flashed on to a screen as we listened to the diagnosis of one another’s cases and Key’s suggested remedies. The exercises that would strengthen one person’s back, for instance, would be disastrous for someone else. By day three, what with Key dancing on our pain with her feet and us rocking and rolling on our mats, most of us were feeling sore and, in some cases, spectacularly bad-tempered; the atmosphere of cheerful bonhomie replaced by monosyllabic grunts. This, we were told, was entirely to be expected since the work is so intensive.

This time round my back seemed more resistant to Key’s earthy foot action, although I was certainly aware of the different, almost musical notes of “sweet pain” when her heel hit the trouble zone and the dull drone from the surrounding areas.

One of our group was actually sobbing on her mat during an exercise session, although it was unclear whether this was emotional or because the movements were too hard for her. Another member put her back out, mid-stretch, and Key had to whack it in with some force. So although there were many jolly snapshots from the week — I particularly liked the moment when the magazine editor, something of a style icon, said the only way she could be persuaded to wear a pillow strapped to her back was if Prada designed the cover — there were constant reminders that back pain really is no laughing matter.

If anyone had come expecting instant results, they would, we were warned, be disappointed. On the penultimate day, Carmel Neale, who had attended one of the earlier Tresanton courses, addressed our group. For seven years she had felt like a “mouse on a wheel” trying everything from surgery to Pilates in her search for a cure, but with no success.

In the months after being released from Key’s care, progress was literally painfully slow, but she persevered with the daily exercises and the back block and now, a year later, her life was transformed; her only medication a glass or two of sauvignon blanc and occasional anti-inflammatories. She had been on hiking holidays and sailing trips, had moved house, and her back had coped throughout.

As Key said: “You must remember that you are all on a journey. You’ll be able to poke your head out but then you’ll probably need to retreat back into your shell.” Two months on, there are mixed reports from our group. The whippersnapper is on three-months’ sick leave from work at Key’s behest, and a couple of the women say that they feel in worse shape than they did before.

The magazine editor is making terrific progress, however, and I’m fine (my back pain, as I believed, was tied up with the shock of bereavement). Almost everyone speaks highly of Key: she has given them hope; they feel that she really cares and takes them seriously; and for the first time they have a diagnosis that makes sense.

The main obstacle to recovery, it must be said, is that although Key is determined to teach her method to more physiotherapists — her hope is that it will be taken up by the NHS to enable those who can least afford it to benefit — she, herself, cannot be cloned and for most of the year she could hardly be farther away.

Two initiatives are needed to discern whether the Sarah Key Method could and should be made more widely available: thorough ongoing research into why her approach seems to work in many cases where all else has failed and the facility for more physiotherapists to be given the opportunity to observe and be trained by her. Both of these will be taking place soon under the auspices of Prince Charles, who wrote the foreword to her Back Sufferer’s Bible (Vermilion, £9.99). “Visualising what is happening inside the back makes it more logical and easy to see why Sarah Key’s exercises really do work,” he wrote. “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.”

Since HRH has been seeing Key for years, he as much as any back-sufferer would agree that there is one certainty with a problem back: it is sure to be be a long and chequered road ahead. For, as Sarah Key says, and who better to say it: “Backs are buggers.”

General, Women

Back on her feet

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.