Whole-Body Integration

Dancing Santa - Merry Christmas!

Hmmm. Wish I could claim that Rolfing® Structural Integration could make you dance like this! It will put more spring in your step and lube those joints, but ya gotta go elsewhere to learn to dance.

Merry Christmas to All!

 

Save Costs on Rolfing and Craniosacral Work with a Flexible Spending Account

This very useful article from The New York Times explains how you can use a flexible spending account to save significantly on the cost of getting bodywork – one-third or more in some cases. First you need to set up and fund a flexible spending account:  you contribute to the account from your income, and this money is not taxable but must be used the same year. You then get a doctor's prescription for the bodywork, and submit a receipt to your plan. In effect, you are paying for bodywork with pre-tax dollars.

The article also offers useful guidance on navigating this with plan administrators by pointing to a study showing the beneficial effective of massage and noting that the government's flexible spending account will approve reimbursement for massage that doctors prescribe as medically necessary. Most doctors will recognize the value of Rolfing® Structural Integration, craniosacral work, massage, and other well-known forms of bodywork as treatment for pain, scoliosis, injuries, stress, TMJ, headaches, repetitive motion injuries, postural problems, and the like.

In many states, including Washington state where I'm located, Rolfing® Structural Integration is grouped in with massage for licensing, so I can work under massage prescriptions.

How Rolfing® Sessions and Movement Work Can Help Musicians

Today I want to expand on the topic of Rolfing® Structural Integration and other bodywork modalities for musicians. (Yesterday I posted about Leon Fleisher, the renowned pianist whose career was truncated by focal dystonia until he found a way to manage the disorder through Rolfing® Structural Integration and botox injections to the affected muscles; you can read that here.)

The positioning of the body to play many musical instruments is asymmetrical. For example, playing a guitar or double bass, one arm is up, and one is down, and each does something different – fretting versus plucking, strumming, or bowing. Or the violin, where the head and chin tuck to the instrument. While playing the piano seems symmetrical, I found it interesting that in Fleisher's interview he attributed his focal dystonia to the fact that the affected fingers – the fourth and fifth fingers of his right hand – play the keys that hit the piano lyre's shorter strings. Shorter strings have less resonance, and the fourth and fifth fingers are generally weaker, so Fleisher says you have to work harder to play these keys.

Focal Dystonia

Fleisher's ailment is focal dystonia, a neurological movement disorder that has no cure but can be managed by a regimen that includes botox injections and Rolfing sessions. Fleisher reports that 10,000 musicians around the world suffer from focal dystonia. 

Repetitive Motion Injuries / Tendonitis

More typically with musicians I see issues akin to repetitive motion injuries and tendonitis. Practicing and playing hours a day will use the same muscle groups over and over, with the potential for contracted muscles, localized fascial shortening around them, and entrapped/inflamed nerves. This type of situation responds well to hands-on Rolfing Structural Integration sessions, as well as manual therapy for the nerves. This work is best done in conjunction with movement therapies for reasons discussed below.

Rolf Movement® and Other Movement Modalities

In an article in Structural Integration: The Journal of the Rolf Institute, Rolfer™ Elmar Abram reported working with a few musicians who had the diagnosis of focal dystonia, but whose limitations disappeared when they were coached to play their instruments differently using Rolf Movement® Integration techniques. In some cases it had to do with how they played their instruments in terms of posture and alignment, in other cases there was a deeper mind-body issue involved. This shows how much habit affects function, whether it is back pain from a habit of poor sitting posture or other body issues from the habitual way a musician holds and plays his instrument. And it is not surprising that there can be mind-body issues involved, particularly with professional musicians who are under tremendous pressure from an early age to develop and master their craft.

Besides Rolf Movement Integration, I would highly recommend Alexander Technique, the Feldenkrais Method® of Somatic Education, and Aston® Kinetics, three other sophisticated movement modalities that have helped many musicians and other performers. 

 

 

Rolfing® Sessions Help Renowned Pianist Leon Fleisher Cope with Focal Dystonia

Today I listened to an interview with pianist Leon Fleisher where he discusses his memoir My Nine Lives: A Memoir of Many Careers in Music and discusses how Rolfing® Structural Integration is one of the two primary therapies he uses to keep his right hand functional, despite suffering from focal dystonia.

In 1963, Fleisher was a renowned pianist scheduled to tour Russia as soloist with a leading U.S. symphony. He had to cancel the tour because he lost the use of the fourth and fith fingers of his right hand, obviously devastating for a musician. The problem was focal dystonia, a neurological movement disorder, although it wasn't diagnosed for years. As he could no longer perform, he had to switch his career to teaching music, conducting, and learning to perform the one-handed repertoire for piano. To try to regain use of his right hand, he tried many therapies over thirty years. Although there is no cure for focal dystonia, Fleisher has found a combination of therapies that allowed him to once again play and perform with two hands: he gets Rolfing work the day before performing, and botox injections to the contracted muscles every four months (this paralyzes the contracted muscle, which allows the opposing muscle to function). Fleisher reports that "Rolfing is a very healthy modality of physical therapy, thanks to both of them i'm a functioning two-handed pianist."

The Wikipedia entry for Leon Fleisher notes that when he received the 2007 Kennedy center honors he was described as "a consummate musician whose career is a moving testament to the life-affirming power of art." Although a devastating injury or ailment may change one's external reality, Fleisher shows us what can be accomplished with passion, adaptability, and the curiosity to explore alternatives. 

Another longer audio interview by Diane Rehm is here, where Fleisher and his co-author share much more about his background as a musician, and how he tried "everything from aromatherapy to Zen Buddhism" to heal his focal dystonia. You can read an earlier interview here, from Structural Integration: The Journal of the Rolf Institute. 

The Goals of Rolfing® SI: Grace, Pleasure, Aliveness

I love this quote from Rolf Movement ® Instructor Monica Caspari):  "As Rolfers™, we are after grace, pleasure, aliveness, and coherence of the body in motion. Joy and happiness are more important than perfection."   

While Ida Rolf stated the goal of Rolfing® Structural Integration as aligning the body in gravity, that alignment is not a rigid goal but rather a responsive and alive dynamism that the body expresses when it is open and balanced. It is said that Dr. Rolf hated the word "posture," because to her that suggested trying to stand up straight. Her goal in working the fascial system through a Rolfing® Structural Integration series was to restore proper relationships of body segments, which frees the movement of energy so that you feel the force of gravity as something that lifts you into alignment rather than drags you down. It sounds somewhat metaphysical, yet Rolfing clients report this again and again in words like "my body wants to stand up straight" and "I feel lighter."

 

 

Therapies to Improve Neck Range of Motion

I very often see clients who complain of reduced range of motion (ROM) in the neck (cervical spine). Oftentimes, reduced neck ROM means neck pain as well, or headaches. I find that I can generally bring back good ROM using a combination of Rolfing® Structural Integration and craniosacral work. Sometimes visceral work is needed, or manual therapy for the nerves. Finding a body therapist trained in all of these modalities is your best bet, as they can address the problem whatever its source is.

What Causes Neck ROM Problems?

There are three key motions for the spine: forward- and backward-bending, side-bending, and rotation. Any of these can be reduced by

• an auto accident (especially whiplash), 
• sleeping in an uncomfortable position, 
• a bad fall, 
• habitually having your head turned one way (eg., your computer monitor is to your right), 
• holding the phone to your ear with a shoulder, 
• a forward-head posture, or 
• tight muscles. 

 

Think for a moment about a whiplash. Say you are rear-ended while stopped at a traffic signal and your head is turned right because you are saying something to your friend in the passenger seat. Not only are the muscles at the front and back of the neck stressed, because your head is turned, a side-to-side imbalance can also set in, making it more difficult to turn your head one way. 

What Kind of Treatment Helps?

Chiropractic work is excellent in these cases, as there is sometimes a vertebrae "out," but the issue may not fully resolve without soft-tissue work like Rolfing sessions, as it's an imbalance in the muscle/fascial tension on the vertebrae that holds them out of place. (This is why people often need less chiropractic care after they do Rolfing sessions: the newly balanced soft tissue allows the vertebrae to hold adjustments better.) 

More severe restrictions can involve the dural tube (the "stocking" of fascia that surrounds the spinal cord), which responds to craniosacral work. Sometimes the ligaments that suspend the pleura of the lungs are also involved, as they attach directly to the 7th cervical vertebra; in this case, I do visceral work as well.

I also encourage clients to consider acupuncture as it can be of great assistance. For ongoing maintenance, a yoga practice is excellent.

How Many Sessions Are Needed?

In minor cases, one session will usually fix a "kinked" neck. With a major injury, repeated sessions are often needed, but you should get some immediate relief from the first session and see incremental progress with each session. In Washington and many other states, auto insurance policies will pay for your care after an auto accident, as will worker's compensation in work injuries. I will bill these insurances directly, and so will many other Rolfers™.

With good treatment, you can recover neck ROM in most cases where the problem is musculoskeletal. Your neck will not be a flexible as the chicken in this video below (there's something unique to chicken anatomy), but it might feel this loose!