Whole-Body Integration

In the News: Rolfing® SI Helps Hockey Player and Gymnasts

Here's a quite good news story from a couple of days ago that describes how former professional hockey player Mark Howe of the Philadelphia Flyers credits Rolfing® Structural Integration with improving his game and extending his career after an injury. The text can be read here. There's comments from a Rolfer and testimonial from Howe, his father Gordie Howe, and two young gymnasts who discuss how it helps them to stand up straight with better posture and to relieve pain.

 

A Rolfer's Thoughts on Barefoot Running

There's been alot of talk about barefoot running since Christopher McDougall published his book Born to Run a few years ago. The premise is that humans walked and ran barefoot for millenia, and that running injuries were not the plague they are now until the "sports shoe" industry developed all those high-fallutin' shoes with cushioned heels. McDougall himself had had to give up running due to injuries, but tossing his running shoes and learning to run barefoot allowed him to resume running without pain or injury. To help understand why, read this article about barefoot running, and watch the video with Harvard scientist Daniel Lieberman (chairman of the human evolutionary biology department) showing the impact of heel strike in a shod runner versus a barefoot runner. 

Not everyone wants to run completely barefoot, and in response to the barefoot running premise, new minimalist sports shoes have been developed, the most well known being Vibram FiveFingers®. Such shoes have a thin rubber sole that lets you feel the texture of the surfaces you move on, and also lets all the joints in the feet have mobilty and play.

I ran some in my 20s, but haven't run for years - especially since my surgeon for a lateral tibial plateau fracture in 2003 advised against it. I became curiuos when other Rolfers™ on our community email forum began talking about barefoot running after reading McDougall's books. They reported that barefoot walking and running were completely synergistic with the ideas of Rolfing® Structural Integration: in our form of bodywork we are concerned with the natural alignment of the body, and the mobility and integration of body segments. They reported that in barefoot walking and running, your toe hinge functions as it should for push-off, because the toes are not engaged in a wad of leather and rubber. And they reported that the increased mobility of the foot was working its way up through the chain of muscles, fascia, and joints and improving issues with knees, hips, and low backs. At that point I went out and bought a pair of Vibrams, to give barefoot walking a try.

I remember my first walk in them. It was late evening, a damp and cold autumn night in Seattle, and I was tired and reluctant to go out, but I hadn't walked my dog yet. So I put on my new Vibrams, put the furry girl on a leash, and headed out for our usual 20-min loop around the neighborhood. Astonishingly, within a couple of blocks, I felt pure unadulterated joy surging through my body and I was wide awake. It seemed like having my feet in such deeply felt contact with the ground was awakening dormant energy and enlivening me. I've always believed in the mind-body-spirit connection, - it's what drew me to Rolfing - but this still surprised me, the intensity and immediacy of the response. I spend the entire work day barefoot, yet something about being "barefoot" and actually striding and moving with a purposeful gait was waking up my feet and my energy in startling ways. I've been a convert to barefoot walking ever since, and I've also noticed improvement in my knees. I'm even starting to run tiny bits again.

Besides McDougall's book, there's alot to read on the web about barefoot running, including this article from today's New York Times, where McDougall updates the barefoot running world on the importance of form for good effects and also mentions Dr. Lieberman's research on unshod runners in Kenya. In other words, it's not just the shoes (or lack of shoes), you have to re-learn how to move so that you minimize heel strike and move more to the forefoot. I believe that Rolfing sessions can greatly assist in this process as part of what keeps us in habitual movement patterns is the familiar tension patterns in the body. So I would recommend that anyone transitioning to barefoot walking or running read up on the available literature, but also schedule a session with a local Rolfer to work on, especially, the sole of the foot, the calves, the knees, and hips. Getting more freedom through these areas will make for an easier transition and quicker benefits, and also help to attain proper running form.

I have recommended minimalist shoes to any number of my Seattle Rolfing clients, and many take me up on the idea. (I recommend REI locally, because they have a great selection of minimalist shoes (not everyone likes the toes on the Vibram FiveFingers, and a shoe that fits like a second skin is key to the benefits), and because you can return shoes if you don't like them, even if they have been worn. One friend who switched to Vibrams has also found that she no longer has flat feet. This makes total sense, as the arch of the foot is based on a balance of muscles and fascia through the legs. Rolfers have known this and worked to "create" arches through balancing fascia, but my friend's story shows it can also be done through proper foot mechanics from barefoot running.

 

 

 

Great Article on Fascia and Sports Injuries

What is behind sports injuries that won't quickly heal? Running Times Magazine published a great article on the rolf of fascia, and you can read it online here, including information on how Rolfing® Structural Integration can help with fascial injuries and problems.

The article starts with a great explanation of what fascia is, summed up in this quote from Rolfer™ Tom Myers: "While every anatomy [book] lists around 600 separate muscles, it is more accurate to say that there is one muscle poured into six hundred pockets of the fascial webbing." What this means is that any injury or stress to an individual muscle will affect the fascial webbing as a whole. Think of a snag in a knit fabric; it will be most gnarly in the area of the snag itself, but it will create a pull through the fabric that can distort the whole. Resolving the problem means fixing not only the area of the "snag" but also it's compensating patterns in other areas of the fascial net / body. 

The article goes on to explain that new research shows that fascia is not just wrapping, but tissue that can "contract, feel, and impact the way you move" - meaning that it can be negatively impacted by lack of activity, chronic stress, poor posture, injuries, and repetitive movements. While this is new news to mainstream healthcare and media, Rolfers have known this for years, and in my Seattle Rolfing® practice I see many athletes with fascial issues that can be helped, as well as many non-athletes whose fascia has become tight or imbalanced from other activities - like hunching over a computer for hours a day, carrying young children around, auto accidents, and the like.

The article mentions Rolfing in a section on fascial care. The things you can do on your own to maintain healthy, flexible, resilient fascia include staying hydrated, streching, and not pushing through injuries. Outside help includes movement education and seeing a "fascial specialist." I think it's fair to say that Rolfers were the first fascial specialists, as Ida Rolf was one of the first people to 1) credit fascia with its proper role in the body and to 2) develop work to lengthen, sculpt, and balance the fascia. Many other practitioners will be trained to work with a local injury, but not necessarily know how to work with the pattern as it extends through your whole body. (I wrote about that here in a blog post about how Rolfers work with fascia differently than massage therapists, but the same thinking applies also to Rolfing versus physical therapy.)

If you are interested to learn more about fascia and how Rolfing could help you, feel free to call me if you are in the Seattle area for a phone or office consult, or visit the Rolf Institute® website for a list of Certified Rolfers and Certified Advanced Rolfers in your area. Like some other Rolfers, I also practice visceral work, craniosacral work, and nerve work. While these use a lighter end of the touch spectrum, they are also fascial-based modalities as fascial strain patterns are behind visceral strain, cranial strain, and tethered nerves. 

All in all, Running Times Magazine has published a great article, well worth reading to understand more about your body and fascia in particular.

Viniyoga: This Rolfer's™ Favorite Form of Yoga

Rolfing® Structural Integration and yoga make a perfect pair. The Rolfing work gets your body aligned and open, freeing both surface and deep restrictions, and yoga is the perfect practice to keep you body supple, elastic, and toned. Yes I have clients who don't do yoga – or other stretching – and that's ok, they just need Rolfing tune-ups a bit more frequently. That's beneficial for my business bottom-line, but my real business is to help clients become more embodied, and a yoga practice increases body awareness and reduces your reliance on outside help from chiropractors, Rolfers, massage therapists, physical therapists, etc. 

There are many types of yoga, suited to different body types. If you are young and flexible and energetic, power yoga may be for you. Many of my clients, however, need to 

• recover from an injury or get help with chronic pain,
• reduce the impact of aging,
• regain lost mobility, or
• reduce stress

My favorite form of yoga to recommend to these folks is Viniyoga, and my favorite Viniyoga studio in Seattle is Whole Life Yoga in Greenwood. Whole Life Yoga has a new blog, and one of the early posts is "What Makes Viniyoga Different?" She outlines the 4 main factors, which I'll explain below from a Rolfer's perspective.

1. Adaptation – This means the yoga asanas (poses) are adapted to fit your body – you don't have to become a pretzel to fit a strict form. This is important for me in recommending Viniyoga to my Rolfing clients who have had injuries that limit flexibility, range of motion, and the like. It's a form of yoga that works for all bodies.
2. Use of Repetition and Stay – In a Viniyoga class you do sequences that move you in and out of a pose a number of times before holding it. I support this as a Rolfer because it prepares the body for change by gradually signaling stretch receptors in the muscles to give a little more, then a little more. You are also working your awareness of your body in motion, and noticing the changes with each repetition. If you can't notice something, you can't embody it – that's why at the end of every Rolfing session I ask my client to "stand up and see what you notice, what's different." Repetition helps to focus the mind and enhance awareness. 
3. Moving with the Breath – It sounds so simple – as you breathe in, move this way, as you breathe out, move that way – yet coordination of breath and movement is magic balm for the nervous system. I see hypertoned (too tight) bodies every day in my Rolfing practice, and a portion of that tightness comes from a wound-up nervous system. As you coordinate your breath and movement you automatically slow down, become more fluid in your movements, and bring your nervous system back into balance.
4. Sequencing – Viniyoga practice combines poses intelligently into a fluid moving practice based on class goals. For example, I often recommend that clients with back pain try out Tracy Weber's Yoga for Healthy Backs as I know that her Viniyoga training has taught her to string poses together in a way that will pose-by-pose prepare the body to gradually and sensitively open painful areas. (Tracy owns Whole Life Yoga; you can read here how yoga resolved her severe back pain.

If you see me for a session, be sure to ask me for a free class pass for Whole Life Yoga, to experience for yourself what Viniyoga is.

 

 

 

Seattle Has a Superhero

Check this out: Seattle has a posse of guys who dress as superheros to stop crime! From reading an article about Phoenix Jones, apparently he and his team all have either military or mixed martial arts backgrounds - that shows in his build, particularly those crazy quads. He seems to have fairly good mobility for being encased in rubber, although I'd say his body is somewhat on the tight side, probably particularly in the IT bands and quads, also through the quadratus lumborum as you see him sidebend quite a bit in his walk. I think his current uniform is a big improvement from the earlier one seen here.

I'd like to try a session on a superhero, so if anyone knows this guy, have him call me! I think Rolfing® Structural Integration could help him move a bit more smoothly, aiding his vigilante activities!

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. 

 

 

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. 

The Impact of Negative Attitudes and Language Towards Our Bodies in the Rolfing Process

As I'm a Rolfer™, most of the clients coming into my Seattle bodywork practice are addressing posture or pain in some fashion – even if their bodies function pretty well, they want them to function better. This is a great goal, and Rolfing® Structural Integration in particular works to optimize the body's structure in a way that serves this goal. As do craniosacral work (for headaches, TMJ, whiplash, auto injury) and visceral work (implicit in many postural issues and often a "missing piece" when someone has a stubborn pain issue).

In my practice one of my goals is "mind-body integration," and with yesterday being Thanksgiving I reflected on how our attitudes towards our bodies can affect how easily we can recover from injury and change old patterns. This is not to say that pain is "all in your head." After all, an auto accident or other injury, or pain from a postural complaint, can definitely turn aspects of your life downhill. Rather, it's to say that viewing your body in an appreciative way, for all that it does for you, gives holding and context for change and optimization to occur, and compassion for the ways we are suffering.

For example, I'll never forget a client of mine who was dealing with alot of physical pain – from fibromyalgia, and from an acute knee injury. She also had emotional pain from a recent ugly divorce. One day during a session she said with vehemence "I hate my body." I don't know how that felt to her or to her body, but to me it felt like a slap, and I wasn't even the object of her hatred.

In wondering how her body felt in response to the hatred and rejection she expressed toward it, I remember an episode in Unit II of my training at the Rolf Institute® of Structural Integration. In this phase of the training, students work on each other to learn the Rolfing "Ten Series" of work. The training is intense, requiring students to both give and receive work, as well as to absorb large amounts of information about anatomy and Rolfing theory in a period of about 10 weeks. It's not uncommon as a Unit II student to feel pressured and at your "edges" as a combination of the learning challenges and receiving at least two Rolfing sessions a week. One day the student working on me was doing her pre-session visual analysis, with an instructor observing. She was frustrated with her work and said something like "I fixed the arches in Anne's feet last session and now I don't see the change anymore, what happened?!!" While I intellectually understood her frustration with her learning curve and felt for her, my body had an entirely different reaction: It felt like it locked down and said "well then, screw you, I'm not going to change just to make you happy."

This is why one of the things we learn in Rolfing training is to language change in a way that is supportive. Here's an example: As a practitioner, I could say "Your shoulders are up in your ears, you've got to learn to let them go," which implies complaint, judgement, and an expectation that you change for me. Alternatively, I could say "How would it feel if your shoulders could relax back and settle here?" (using my hands on the mid-back to give a sensory cue). This is language that is meant to evoke, to help the body feel and consider an alternative that might be more comfortable. It's also language that invites the body to participate, rather than to put up resistance and deflector shields in the face of demands for it to change.

Whatever our pain or posture issues are, these bodies we move through life in are a miracle of interconnected functioning. They work so hard for us in the face of our criticisms and judgments ("sit up straight," "you're too fat," "you used to be in shape," "you're looking old"....) Any time you find yourself wishing something were different about your body, I encourage you to take steps toward that betterment, and at the same time to appreciate all that your body does for you despite whatever limitations it may have. That viewpoint makes it easier to enlist all of you in the change you seek.