Sitting Rolfing SI back workI was recently interviewed by reporter Marissa Capodanno for an article about bodywork modalities she wrote for http://www.iVillage.com. The slideshow turned out well with Rolfing SI being featured in its very own slide. However, due to space limitations, much of the interview was not included in the piece. I thought I would publish the full interview here on http://www.RolfingJourney.com because many of the questions I answered are of interest to people who are unfamiliar with Rolfing SI. It seems like a good thing to make this information available to the public.

What is Rolfing SI? What is the underlying philosophy behind it?

This is the simplest analogy I can give you. You know how when you get in a car accident, bend the frame on your car, and have to take it to the auto body shop to get it straightened out? That’s what Rolfing practitioners do for the human body.

Rolfing SI is somatic education the main purpose of which is to improve the structure and alignment of the body. It is not a form of massage therapy. Rather, Rolfing practitioners are the structural experts of the human body. We use skillful hands-on techniques as well as movement education to empower clients to take charge of their own physical and emotional health.

How specifically does it differ from massage therapy? What is the process like? What can someone trying Rolfing SI for the first time expect?

Ida Rolf, Ph.D. created a 10 step process whereby the practitioner systematically works through the entire body to bring it to a higher level of order both structurally and functionally. Rolfers address whole body patterns. A client may come in with an issue in a specific area, but instead of just focusing on “the problem” intelligent evaluation is done to figure out what is happening structurally the may have caused the issue.

For example, in repetitive strain injuries of the wrist, evaluating and educating the client on how to sit in a supported way is essential. Looking at what is happening higher up the muscular chain of connection to the elbow, shoulder, neck and indeed the entire ribcage and spine is essential to create lasting change for the client.

Rolfing SI Before and After PhotoSome specific differences with massage therapy are that a structural evaluation is done at the beginning of every session to observe structural patterns and set goals for the session. Usually this is done with the client in their underclothes, but it can also be done in a bathing suit or shorts. This allows the practitioner to clearly see the structure of the body. I personally also take time during this part of the session to educate my clients about their patterns so we can begin to create awareness which ultimately leads to long-term change.

Rolfing practitioners do not use a lot of oil or lotion to glide over the skin as in massage therapy. To access and effect change in the deeper layers of connective tissue it is necessary to have a little traction on the skin.

Rolfers work with clients in different positions than you would see in a typical massage. Practitioners will frequently work with the client in a sidelying position. We will also work with the client “in gravity” which means while sitting on an adjustable height Rolfing bench or even while standing.

In general, Rolfers ask clients to more actively participate in a session than you would see in typical massage which is passively received. We will ask the client to change positions more frequently, stand up for more structural and functional evaluation, or make slow precise movements while we manipulate their tissues. These things helps facilitate the change and awareness process for the client.

What are the benefits? Are there any risks? What precautions should someone take who is considering Rolfing SI?

Rolfing SI has the ability to dramatically alter a person’s posture and structure. Rolfing SI can potentially resolve discomfort, release tension and alleviate pain. Rolfing SI aims to restore flexibility, revitalize your energy and leave you feeling more comfortable in your body.

Athletes, dancers, children, business professionals, and people from all walks of life have benefited from Rolfing SI. People seek Rolfing SI as a way to ease pain and chronic stress, and improve performance in their professional and daily activities. It is estimated that more than 1 million people have received Rolfing SI.

Research has demonstrated that Rolfing SI creates a more efficient use of the muscles, allows the body to conserve energy, and creates more economical and refined patterns of movement. Research also shows that Rolfing SI significantly reduces chronic stress and changes in the body structure. For example, a study showed that Rolfing SI significantly reduced the spinal curvature of subjects with lordosis (sway back); it also showed that Rolfing SI enhances neurological functioning.

Make sure you see a qualified practitioner. That means someone who is trained and certified through The Rolf Institute® of Structural Integration, or a Board Certified Structural Integrator(CM), or at least a professional active member of the International Association of Structural Integrators. Watch this video demo of a Rolfing session with Hubert Ritter from Berlin. You can really get a sense of what a session is like without getting distracted by focusing on language.

The usual precautions apply as with any form of hands-on manual therapy. Care should be taken with people at risk of embolism or thrombi from atherosclerosis or varicose veins, and certain autoimmune diseases if in an active phase such as lupus, scleroderma and psoriatic arthritis. People with loss of sensation from diabetic neuropathy or other nerve damage need special attention from the practitioner when receiving work. The same holds true for people with blood clotting issues or who are taking anti-coagulants. There is much research being done on whether it is safe to work with someone when they have cancer. This is a big discussion which I will not delve into here. It is generally a good idea if someone is actively working with an oncologist that they receive approval from their physician.

When would you recommend Rolfing SI?

For relief of musculoskeletal pain which can come from many different causes. For people who are worried about their posture and recognize they would like to have better posture. For people who are on a path of personal development and want to increase their self-awareness. To enhance athletic performance and support yoga, pilates and other mindful movement practices. See also the benefits listed above.

When should someone avoid it?

Acute intervertebral disc problems, during the first trimester of pregnancy, no active work on broken bones, and post-surgery after approval from the attending physician.

Note: As a resource for the precautions and contraindications listed in this article I used Contraindications and Cautions for Deep Bodywork 9th edition, May 2008. This article is written by Robert Schleip, Ph.D., Til Luchau and John Schewe all of whom are Rolf Institute Faculty.

© Carole LaRochelle, 2010.

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Sitting back workThere seems to be a lot of confusion in the public’s awareness of the difference between Rolfing Structural Integration and deep tissue massage therapy. Instead of writing one more article explaining Rolfing SI and how it can benefit you, I have decided to take a different approach. I recently had a new client come into my practice who is the perfect example of why Rolfing SI can be so powerful a method for resolving postural/structural issues and musculoskeletal pain patterns. I have John’s permission to share his story with you.

John is a healthy, active male in his late 40s. He came to see me with the stated goal of alleviating structural imbalances in his right hip and thereby hopefully avoid hip replacement surgery in the future. (One doctor had suggested to him it might be necessary at some point.) He had also been experiencing a significant amount of pain and stiffness on the right side of his pelvis and low back and was hoping I could give him relief from it.

John had originally sought medical attention because he had been experiencing right knee pain. An x-ray of his knee could find no source for the cause of his pain so the orthopedist suggested exploratory surgery to see if anything could be found. John chose to opt out of that offer. He continued to pursue a probable cause for his knee pain and another doctor suggested a leg length difference might be the culprit. An x-ray was eventually performed in a supine (lying down) position at the local medical facility and it was determined John’s right leg was shorter than his left. That information was passed on to John’s podiatrist who made orthotics with the appropriate amount of lift for the right leg based on the x-ray results.

In my office I examined John standing in his shoes and orthotics. I found his right iliac crest and greater trochanter to be higher than his left. That would be an initial indication his left leg was short, not his right. I had him take his shoes and orthotics off and looked at him again. I found his iliac crests now even as well as the greater trochanters.

Next I had John lay down on my table so I could check his supine legPelvic Torsion length. Indeed, his right leg was now shorter than his left. That meant something was going on in his back and pelvis that was causing his leg length to go off when non-weightbearing. I had him stand again and checked his pelvis and found a pelvic torsion. His right innominate was anteriorly rotated and his left posterior in relation to the coronal plane. I also examined his spine and noticed he has a mild curvature causing a right side bend and left rotation in his lumbar area. I inquired of John if anyone else in his family had a scoliosis and he affirmed that was indeed the case.

I set to work manipulating the soft tissues around John’s pelvis and back in a way that would resolve the structural imbalance in his pelvis, and hopefully ease off some of the curvature in his spine. The details of how I accomplished that are beyond the scope of this article. After completing the soft tissue manipulation I checked John’s leg length again with him lying supine. His legs were now the same length and the pelvic torsion was resolved. I had him stand barefoot and the iliac crests of his pelvis were still even.

I asked John to spend a little time walking barefoot to feel this new change for himself, and then suggested he put his shoes and orthotics back on. His response upon first standing in the shoes and orthotics was telling. It appeared to me like he had just stepped in something disgusting with his right foot, and the look on his face told the story that the lift felt wrong. I checked his iliac crest and greater trochanter height again and now the right side was higher than the left. I suggested to him to stop wearing the orthotics; they were throwing his structure off. He would need to get them altered.

I have completed three sessions with John and he is amazed at how much more balanced his pelvis feels and indeed his whole body. He reports much more mobility in his pelvis and back and significantly reduced hip pain. In John’s own words:

There is no question that the high level of comfort that I feel today is directly attributable to the three sessions of work you’ve done with me. I feel a freedom of motion in my hips that I have not felt in at least ten years.

My theory on what happened with John is that no one practitioner was looking at his entire body. One doctor was only looking at John’s knee. The knee hurt so the problem must be in the knee. Considering that the knee pain could be coming from a leg length discrepancy was a good idea. However, measuring leg length with the client supine is not considered a very accurate method, precisely for the reason I found with John. He had a pelvic torsion which created a functional leg length difference when lying supine, not a true bony leg length difference when standing.

Measuring leg length difference

Best way to x-ray leg length differences

Radiographic evidence that measures the actual height of the femoral heads when standing is considered the best way to measure true bony leg length differences. And finally, because the measurement of John’s leg length difference was not accurate he was fitted for an orthotic lift that he didn’t actually need. It precipitated and aggravated his right hip problem. I was the first practitioner John saw who actually looked at his entire body to see how he was structurally organized in gravity. I was the first practitioner to notice what was happening in his lumbar spine that could be throwing his pelvis off.

Rolfing® practitioners are the structural experts on the human body. For John, deep tissue massage therapy around his right hip would not have been enough to give him the relief he was seeking. He needed someone with a structural evaluation skill set as well as soft tissue manipulation skills to figure out the cause of his problem and implement the appropriate treatment.

© Carole LaRochelle, 2009.

I have been involved with Pilates more or less since the late 1980s. I was first introduced to Pilates principles while studying dance with Mercy Sidbury at Sonoma State University. My curiosity piqued, I went to the SSU Library and checked out The Pilates Method of Physical and Mental Conditioning by Philip Friedman and Gail Eisen. This was a hardcover book, originally published in 1980, and the first of its kind to bring Pilates out of private studios and present it to the general public. I studied the book and began practicing on my own both at home and before ballet class to strengthen my awareness of and build my ability to move from and stabilize my core.

The Art of Dance MedicineIn the spring of 1989 I attended The Art of Dance Medicine presented in San Francisco at Saint Francis Memorial Hospital’s Dancemedicine Center. Alan Herdman presented “Floorbarre for the Dancer” which for me, at the time, was synonymous with Pilates mat work.  A couple of years later, after I injured my left hamstring dancing, I ended up rehabbing at St. Francis Memorial Hospital’s Dancemedicine Center where I was exposed to Pilates in more depth. At that time, Pilates was not readily available in Sonoma County, and traveling to San Francisco for one hour of therapy was a bit of a burden to me. I decided to treat my hamstring injury with hands-on manual therapy, rather than through corrective exercise. That choice led me down the path to become a Rolfing® practitioner which I have written about previously.

I drifted away from Pilates after I moved to Washington state in 1992. I was busy preparing to train as a Rolfer and it was difficult to be present with ballet and Rolfing and Pilates all at the same time. I had to focus on one or two things. Through dance, however, I continued to do some mat exercises, in particular with Marcia Quigley at the Maple Valley School of Ballet.

Many of my colleagues in the Rolfing community are quite drawn to the Gyrotonic Expansion System® and that type of non-linear, undulating movement began to appeal to me. By early 2000 I had experienced a couple of unpleasant episodes doing Pilates mat work classes at the local gym. One in particular stands out in my mind. The instructor had us stand at the wall and attempt to flatten our backs against the wall, trying to “imprint” the lumbar spine. That had the effect of putting my sacrum “out” and lead to several days if not weeks of an intense low back pain episode. I began to become a fan of what is known as the “neutral spine” in Pilates and decided to check out Gyrotonic as soon as I had the chance.

When I moved back to California in 2002 I contacted local Master Gyrotonic Instructor Manisha Holzwarth, and I did months of private work with her. Also, percolating through the Rolfing community, primarily through the World Congress on Low Back & Pelvic Pain, came much discussion about low back pain and spinal stability. The Rolfing community was talking about physical therapist Diane Lee and Australian researchers Carolyn Richardson, Paul Hodges and Julie Hides. Their research has shown that anticipatory recruitment of the transversus abdominis and multifidus is absent or delayed in patients with low back pain or a history of low back pain episodes. Why is this important? Because these muscles stabilize the spine so that other muscles can move the trunk without compromising the integrity of the spinal joints. I started researching co-contraction, the simultaneous activation of the transversus abdominis, multifidus, pelvic floor, and diaphragm. I found out that physical therapy had, so to speak, incorporated Pilates into their own body of knowledge.

As a Rolfing® practitioner I see many clients with low back pain. I believe it is not enough to correct motion restrictions and structural imbalances in people’s spines and pelvises without educating and re-training them in the correct use of their bodies as well. The research has shown this essential. And so I find myself in 2009 having come full circle from 20 years ago. I just became a Certified Mat Trainer in ITT Pilates. My desire is to become a better teacher and resource to my clients who suffer with back pain and stability issues. I also would like to bring all my knowledge to bear in teaching groups and in general improve the quality of what’s out there and available to the general public. Having worked one on one with people for so many years now I feel the impulse to share my knowledge in a bigger way.

© Carole LaRochelle, 2009.