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The strong hands of Thomas Stout, a certified Structural Integration practitioner, bore down on my lower right leg and began pressing in, at an angle, around my ankle. The pain was almost unbearable. Involuntarily, I yelled out. Stout eased up slightly. “Meet me on the edge of pain,” he instructed gently. I took a deep breath and willed myself to relax. When I was ready, he started in again.

Welcome to the world of Structural Integration. You might not think you’d want to go there, but there’s an incentive. Done properly, by trained hands, such pressure does far more than produce pain. It also loosens and releases the connective tissue that surrounds muscle and binds it to bone.

Yes, it will probably hurt. But afterward, with muscles released and re-situated, you’ll feel better, run better, stand with better balance and perhaps even become taller. Which was why I was willing to meet Stout at that edge, willing to let him push, pull, press – and then mercifully release – the connective tissues throughout my entire body. Like many who have undergone Structural Integration work (or its sister method, Rolfing), I am now measurably taller, sit more comfortably and sashay down the sidewalk with a longer, looser stride. I feel aligned, “untwisted” and at ease in my body.

Intensive Therapy

Structural Integration (SI) has long been the secret of professional and Olympic athletes, dancers, musicians and many others determined to find relief from injuries and pain that interfere with their chosen vocation (see a list of famous folks who’ve been Rolfed at With 30 years of results to reference, some medical doctors are now directing patients with chronic aches toward this intense body therapy as a way of easing pain, increasing flexibility and improving alignment.

But you don’t have to be injured, a pro athlete or dependent on Advil to be a candidate for SI; anyone can benefit from a single spot session or, better yet, a formally designed series of 10. And it doesn’t necessarily have to hurt like heck, either. While SI has gotten a reputation for being excruciating in some circumstances, the level of discomfort you are willing to endure is really up to you.

According to Briah Anson, author of Rolfing: Stories of Personal Empowerment and a master certified Rolfer in St. Paul, Minn., this type of work should never be agonizing. “It’s really not necessary to cause a lot of pain in order to get good results,” asserts Anson. “We can work on places that are excruciating, certainly, but the patient has a role in communicating with their practitioner about the intensity and pace of change they can tolerate.

“I think SI’s reputation for being painful originates with people who unnecessarily bite the bullet while they are being worked on,” she continues. They wind up feeling a lot better as a result of the treatment, but then all they talk about is how much it hurt, not realizing that intense pain isn’t an essential part of the exchange.”

Anson also notes that the pain factor associated with Rolfing and other SI techniques is often encountered with the surface areas of the body. “In many cases, once those areas are worked with and melted,” she explains, “the body opens and allows the practitioner to work quite deeply without a lot of discomfort.”

Rolfing is not just about deep-tissue work, however, but rather about the balance of the layers of tissue in the body. “What distinguishes Rolfing from other forms of deep-tissue work,” notes Anson, “is that Rolfing focuses on establishing an appropriate relationship between the superficial, middle and deep layers. By aligning these segments, working methodically to establish order throughout all the major portions of the body, Rolfing gives people’s bodies more space and length. It also gives them lightness, lift, energy, more dynamic movement in the body.”

Finding Release

To understand how SI and Rolfing work, you have to understand fascia – the tissue that connects your bones to your muscles and your muscles to each other. It’s a fine sheath that surrounds every nerve, muscle, tendon and ligament in your body, interconnecting them and supporting their shape. This sheer and almost lace-like web looks something like pantyhose material, but it’s incredibly strong (as it must be to keep your body’s various parts in place). Injury can cause the fascia and other connective tissues to stiffen and constrict movement. So can hours of computer work, repetitive exercise, driving a car, slouching and other habitual postures.

In fact, just about any restricted or excessive range of movement can become deeply ingrained in your body’s fascia – and thus its structure. Over time, your connective tissue shortens and tightens, literally holding on to its most favored postures. The constant pull of gravity also takes its toll, and as a result, most bodies gradually shrink or shift themselves out of alignment.

“The body ends up being a suitcase of all the things you experience,” explains Sam Johnson, a certified advanced Rolfer in Dallas. “Maybe you’ve had a sports injury or a car accident. Or perhaps you pulled a muscle and had to carry more weight on the other leg for a while. Over time, your body’s connective tissue adapts and your posture gets stuck in place.”

Stiffness, pain and fatigue set in as a result of the structural imbalances, and you can lose movement potential as a result, Johnson explains. Structural Integration techniques like Rolfing work directly with the fascia to release those habits, and those limitations. “We try to unwind all the ways your posture has gotten stuck in that Jell-O mold so that you get your body back,” says Johnson.

Robin Cashion of Dallas found out how her connective tissue was holding her out of alignment when she suffered a low-back injury in a triathlon. Ten sessions of Rolfing, which covered the entire territory from her head to her toes, restructured her body and effectively resolved the injury.

“It’s like peeling away the layers of an onion,” says Cashion, age 30. “After years of use and abuse, our bodies build up their experiences, almost like calluses. Rolfing got to the root of that for me and also helped me create better balance in my life. I feel like everything’s connected now.”

During SI and Rolfing therapy, trained practitioners apply pressure to stretch and release and rebalance the body’s vast and intricate web of fascia. Those trained therapists apply pressure and strokes to the fascia, bearing down with their hands and forearms, even elbows, in order to get the tissue to stretch, shift and reorient itself in healthier ways.

Fascia is particularly conducive to manipulation and stretching because it has more elasticity than other tissues, such as tendons. Once the fascia is released, the muscle is able to realign itself in a more efficient manner and rediscover its structurally optimal position. “A muscle might tighten up over a period of years, but once it opens up through Rolfing and SI, that layer of fascia, or even many layers of fascia, will stay open,” Johnson says.

Making Connections

You might feel pain in your hip and tell your doctor you have a hip problem. But doctors, physical therapists and SI practitioners know that in the body, structures are linked, and the real cause of an injury or pain can be far from the pain.

“People say, ‘I have shoulder pain,’ but in many cases, to get a lasting result that resolves that pain, you must address the whole fascial web that holds the body together,” says Karlis Ullis, MD, medical director of the Sports Medicine and Anti-Aging Medical Group in Santa Monica, Calif. “Maybe a pelvis out of alignment is the reason for the shoulder pain. Rolfing and SI realign the web of fascia to treat the body as a whole unit.”

Most athletes, regardless of whether they’ve been injured, stand to benefit from SI and Rolfing, according to Ullis. This may be particularly true for athletes like tennis players and figure skaters, whose sport requires finesse. But it’s also true for any athlete whose sport subjects one or more areas of the body to extreme stress. “Swimmers almost always have shoulder problems,” Ullis explains, “and the structural area around the shoulder blade is even affected as far down as the hamstrings.” Ullis says he sometimes refers patients to Rolfing and SI as a means of avoiding orthopedic surgery.

Turning Back Time

“I’ve always had trouble with my knees, especially running during dryland training in summer,” says Wendy Wagner, 31, a cross-country skier from Utah who competed in the 2002 Olympics. Wagner started with spot Rolfing sessions several years ago for her knee problems (subluxing patellas) and then underwent 10 sessions in 2002.

Wagner noticed more than pain-free knees. “I’ve had quicker muscle activation and more natural, effortless body movements,” she says. “The greatest benefit for me is an increased body awareness and better access to my athletic potential, more time training and less time dealing with injury.” Rolfing also added an inch to Wagner’s height, a gain that’s lasted more than two years.

Because SI allows the body to regain it’s natural flexibility and alignment, Ullis recommends Rolfing and SI for anyone who wants to slow the impact of the aging process. “The first thing that often goes bad as people age is their biomechanical efficiency,” he notes. “It’s important to restore any losses as early as possible so people can maintain a lifetime of physical activity.”

A decade ago, Lynn Collins, 57, of Albuquerque, N.M., sought out a Rolfer to help with the pain from neck injuries suffered in a car accident 30 years before. “After the third session, the neck pain went away,” she says. She kept going because she liked how her body felt and functioned after the therapy.

“I feel like there’s more space between my bones and muscles now. It’s an expansive feeling,” she observes. It also sharpened her body awareness. “Rolfing acts as a sort of muscle-memory coach. So I now notice and naturally correct certain habitual things, like how I sit in a chair,” Collins says. Rolfers and SI practitioners coach their clients on how to alter their movement patterns and habits so they’re using their bodies more efficiently.

Deeper Awareness

There’s also a spiritual aspect to the experience, at least for some. Many experts attribute it to heightened body awareness, others to the release of repressed emotions from the body at the cellular level, still others to the improved connection people feel to the earth beneath their feet.

John Latz, a practitioner and instructor of SI at the Institute for Structural Integration in Miami, Fla., asserts that some of SI’s most profound benefits emerge as the result of self-exploration. “The deeper you are willing to go inside yourself with your awareness, the more you discover,” he notes.

I count myself lucky to have profited from both SI’s spiritual and physical payback. My before-and-after photos show a person standing taller by just over a quarter inch, with a longer neck. And the results are lasting: I continue to enjoy greater body awareness and increased flexibility. So was it worth the transformation pain? Yep, every last twinge.

Making Sense of Structural Integration

Trying to sort out the difference between Rolfing and Structural Integration?

The late Dr. Ida Rolf, a biochemist and Rockefeller University fellow, pioneered the process of both techniques. “Dr. Rolf originated this unique process and drew some of her ideas from the principles of yoga and homeopathy,” says Sue Seecof, spokesperson for the Rolf Institute in Boulder, Colo., a global organization founded by Dr. Rolf in 1971.

Today, the terms Rolfing and Structural Integration (or SI) are often used interchangeably. While they share similar techniques, though, each is considered a separate discipline.

Practitioners are certified in one or the other and follow the training of their respective schools.

Rolfing is a brand of SI bodywork, Seecof explains, and is only performed by those certified by the Rolf Institute. On the other hand, a host of teaching organizations certify bodyworkers in SI, including the Guild for Structural Integration, another Boulder, Colo.–based group that Dr. Rolf also helped form.

Both therapies are a considerable investment. Expect to pay from $120 to $200 per session; a 10-session series can range from $1,000 to $1,800. Sessions are typically scheduled weekly or biweekly and will cover you from head to toe.

This article originally appeared as “Your Structure, Yourself” in the January/February 2005 issue of Experience Life.

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