Structural integration was Ida Rolf’s name for her pioneering work in fascial release.1 Her method became widely known as “rolfing” during the 70s. Later, Rolfing became a brand name, and structural integration has remained as the generic descriptor. The International Association of Structural Integrators (IASI) recognizes approximately 20 schools certified to train structural integration practitioners (including, in the interest of full disclosure, my Anatomy Trains SI program).
Many variants of deep-tissue work have their roots in Ida Rolf’s techniques, whether today’s practitioners know it or not. Here, let’s show what distinguishes structural integration from other forms of bodywork, including deep tissue, and introduce some of the new concepts that are fueling a renaissance in her work—what we call structural integration 2.0.
Education for the Body
Whatever the version number, structural integration is a system of soft-tissue manipulation and movement education designed to:
• Ease the standing body out of its accumulated, inefficient structural patterning, working toward a calm (unforced) alignment around the gravity line.
• Release fascial adhesions and restore normal glide and hydration between layers of connective tissue to promote responsive movement and strain-free tissue tone.
• Restore full kinesthesia—filling in the entire body image for accurate spatial perception and interoceptive awareness, which leads to robust autonomic self-regulation.
Structural integration techniques and strategies, like most manual therapy, are practiced one-to-one in a therapeutic setting. Structural integration is applicable for many situations: in rehab and pre-hab, for persistent musculoskeletal pain, to advance developmental issues, as injury prevention, to facilitate somato-emotional release and trauma resolution, to reduce stress and autonomically induced anxiety, as an antiaging tonic, or for performance enhancement—either athletic or artistic.
At heart, however, structural integration is an educational process—an intensive course in your body’s structure and your perception of it.2 Common responses to the work include smoother movement, better alignment, decreased pain, increased available energy, more expressive communication, and a feeling of being at home in your body.3
Structural integration, as developed by Ida Rolf and her early teachers,4 was a multisession protocol of direct, specific, and sometimes painful manipulations designed to release the literal “thorns in the flesh” (to use her phrase), meaning the areas in our myofascial system that were too short or too stuck to move easily according to the body’s design.5
Fascia’s Role
Ida Rolf’s initial experience was with yoga, though she was later influenced by osteopathy and the Alexander Technique. Rolf developed a 10-session recipe—a series of sessions that progressively cover the whole soft-tissue body.6
Central to her idea was that our bodies assume a pattern (due to accident, injury, imitation, or life circumstance) that is written into the brain’s habits, exported to the muscles, and finally rooted deeply into the body’s biological fabric—the fascia.
Fascial cells build many versatile materials. Connective tissue constructs your joints, your teeth, heart valves, the cornea of your eye, and glues and weaves all your 70 trillion cells together during your next loaded squat.7
Fascia is coming into its own both as tissue and as a system.8 Only a few of us took up Rolf’s “flag” of fascia during the 1970s. Since her passing in 1983, though, a flood of new research on the extracellular matrix, motor learning, and sensory systems has deepened our knowledge and expanded our technical library.
The properties of the nervous and cardiovascular systems have long been studied; now the overlooked fascial system is getting its due attention. The Fascia Research Congress,9 begun in 2007, has done much to spread the word on fascia and to cross-link efforts from disparate areas of research—athletic performance, rehabilitation, and the basic properties and responses of fascia in the lab.
The fascial system—the collagenous network, the extracellular matrix—is so pervasive that no intervention (therapeutic or coaching) can safely ignore its effects. Every intervention surely affects neurons, muscles, epithelia, and connective tissues with their extracellular matrix; many activities, from dressage to Olympic lifting, are finding that attention to fascia improves results.10
What Makes Structural Integration Unique?
Structural integration’s coupling to fascial tissues gives it some unique characteristics.
• The central methodology of the multisession protocol (or, as Rolf called it, the “recipe”) means that structural integration is a project, with a beginning, middle, and end. Initial sessions deal with the superficial myofascial layers, the middle sessions address core myofascial layers, and the final series integrates both superficial and deep layers in movement.
This differentiates structural integration from much of massage, psychotherapy, chiropractic, and many forms of physical therapies or rehab that can run for years with no end or resolution in sight. In these therapies, clients tend to keep rebooking until they run out of money or interest.
Structural integration is unique in that it offers a discrete program, which is an intensive educational project. Of course, clients can come back for more, after they have had six months or a year to let this deep work settle in, when they will likely have a more functional pattern than the posture they arrived with initially.
Long story short—postural change works better with short periods of intense fascial work interspersed with longer periods of absorption.
• Structural integration relies on visual assessment to individualize strategies. While taking a history and doing palpatory or movement assessments with clients is obviously valuable, structural integration uses visual assessment of the global body pattern of structure and habitual motion to determine strategies within the overall protocol of the recipe.
The client’s pain reports are of interest but unreliable to give the practitioner solid information. A shoulder pain may be anchored in what the client perceives as a “pain-free” rib cage, low back, or neck. We need to look to see what the individual pattern is, and work accordingly. Especially in chronic cases, where the dysfunction has been around for months or longer, a visual “bodyreading” is essential to determine where in the body the fascia is not functioning properly, regardless of where the pain is.
“Where you think it is, it ain’t,” Dr. Rolf would often say. Determining an assessment such as “glenohumeral impingement” is not difficult. What is more difficult, but also more important, is to see where that pattern is anchored in the body. What’s stopping it from functioning properly or healing up? Get some freedom there—in the neck, in the mid-back, where the ribs meet the spine, then your impingement treatment works and stays that way.
Chronic plantar fasciitis, for instance, is rarely relieved from working on the foot. It is far more often relieved by releasing densified layers in the lower leg between the soleus and the deep posterior compartment, or where the hamstrings attach to the pelvis, or even from the neck. Everything’s connected—only by looking can we determine the particular connections in any individual client.
• Structural integration reaches deeply into the body’s tissues to release held patterns. Although yoga can “hurt so good,” and other less-invasive techniques such as cranial osteopathy can reach deeply into the system, structural integration reaches profoundly into the body. Rolf’s work was the original “deep tissue,” and often deals with connective tissues in the more central muscles and tissues close to the bones and joints.
Unearthing these forgotten areas can be “sensationful,” as we call it (painful, let’s not be coy), for the client. The recognition of being deeply touched helps the pattern change and the pain “leave” the body. It is important not to add more pain. The sensation of being touched—deeply, slowly, and sensitively, but with a strong intent to truly open tissue and create interior space—is one that is welcomed by movers and body explorers everywhere.
The depth of the actual manipulations, the generalized recipe protocol that gives a definite arc of the structural integration process from start to finish, and the attention to inter-relationships within the myofascial body as a whole in gravity, all make structural integration 1.0 unique.
So, what additionally can be counted in structural integration 2.0?
Properties of Structural Integration 2.0
1. Structural Integration 2.0 is a Complete Healing System
The intervening years of research and practice between 1.0 and 2.0 have only expanded our respect for the multiple roles fascia plays. The connections among medicine, development, immunity, and fascia are continuing to reveal themselves.
“Fascia not only connects all parts of the body, it connects all the branches of medicine,” writes osteopath G. Snyder.11 Because the fascia is intimately connected to all the body systems, we routinely see changes in habit, neurology, or chemistry that we would not expect if the treatment is purely viewed from a musculoskeletal perspective. Who would have thought, for instance, that bodywork could help regulate a woman’s monthly cycle? Yet, it happens often.
Study of structural integration leads not only into anatomy and physiology, it also begs familiarity with embryology, anthropology, psychology, kinesics, and whatever dim inklings we currently have concerning the brain’s control of movement.
The original structural integration confined itself to the myofasciae—the biological sheets and strings of the musculoskeletal system, but structural integration 2.0 is concerned with the entire extracellular matrix. This collagenous network extends into the hard tissues of cartilage and bone, and into the tunics around the organs and vessels. Each of these specialized areas of fascia requires its own approach, as in the chart below. A comprehensive approach to the extracellular matrix/fascial system would include them all. Getting all those methods into one’s hands is aspirational for most structural integration practitioners (it takes years to assemble all these skills), but structural integration practitioners either have these skills, or they know when to refer to get the client the most efficient path to ease.
The fascial network is one of the three all-body communicating networks, and is thus a part of every human function. Understanding the health, patterning, and common dysfunctions of this system gives us a door into the whole body, the whole person, and the entire process of development, recovery, and kinesthetic learning.
The research is just beginning to look at how fascia responds to different stimuli, and fascia’s role in shaping us. What is the proper dosage of stimulus or work for this person at this time? Theories abound, but an evidence base is still being developed.12 At this early stage, we can admit our lack of knowledge and set about filling it in.
Until now, reports of the benefits of structural integration have been largely anecdotal. There is a pressing need for better documentation of case studies, as well as comparative studies to gauge the effectiveness and longevity of structural integration’s results. We see the improvements, but they must be properly cataloged to be recognized by others.
2. Structural Integration 2.0 Employs the Newly Elucidated Fascial Properties
Over the decades, structural integration has absorbed the research into how the neuromyofascial web so exquisitely manages global stability with local mobility.13 This has expanded the approach of structural integration and done much to put the traditional model of movement biomechanics into proper perspective.
Long regarded as passive packing material, the fascial net has proven to be remarkably responsive to our lives and activities. We are mostly water—and the fascia holds most of it in a slightly Jello-y mix that adapts to our movement habits. (As in: your Achilles tendon is approximately 63 percent water. Feel your Achilles tendon—that fact astounds me!) That water is bound up in a system of sponge-like mucopolysaccharides (mucousy gels) set in a body-wide network of collagen.14
Body processes can alter the amount of water, the nature of the gels, and the orientation and disposition of the sinewy fibers. Through modification of these three elements, we manufacture and sustain all types of connective tissue—from hard bone to viscous blood, including the cornea of the eye, the teeth, and heart valves, not to mention all the tissues in joints.
What properties do these biological building materials have?
Viscosity. Ida Rolf emphasized fascia’s plasticity—its ability to deform when subjected to certain types of stress, and its ability to reform when that stress is alleviated. We now know that the fascial system’s viscosity—its non-Newtonian gel-like property, like Slime, Silly Putty, or oobleck made from corn starch—plays a vital role in protecting body tissues and bones from the effect of daily impact. What forms of treatment, training, or diet might alter the viscosity in a positive direction? We don’t know yet.
What we do know is you can clap your hands together hard and your bones do not break. It is the viscosity, the gel-like nature of the extracellular matrix that dampens those forces like a shock absorber, and distributes them away from the bones. These shocks go through the fascial system at the speed of sound, some three times faster than neural impulses, and therefore cannot be seen except in slow-motion films.15
Elasticity. We now know that fascial tissues store and release elastic energy in quick cyclic movements that bounce in recoil.16 The implications for training, from explosive force to efficient long-distance running, are being busily explored. We already know that training can dramatically improve fascial energy storage and elastic recoil through cyclic loading of around one second or so. Thus, much of what constitutes sport involves training in increased fascial elasticity.
Elasticity is a property we typically associate with youth. If little Johnny falls down the stairs, there will likely be some tears but no broken bones. If grandma falls down the stairs, the result may be more serious. What if we can train grandma to retain her elasticity? (Now, don’t laugh, this writer is a grandpa who has done exactly that, and research confirms we can all train elasticity into our fascia. In a phrase, you are as young as you move.)
Structural integration 2.0 recognizes the value of bringing cyclic movement to the mix to train the fascia into increased elasticity.
Plasticity. Fascia is plastic (deformable)—this was Ida Rolf’s main contribution to our understanding. It appears that collagen fibers cannot actually elongate, but we may be able to melt the bonds cross-linking these fibers to allow them to slide along each other to reach a longer span.
Plasticity happens over minutes, so very little athletic activity induces fascial plasticity. Yin yoga, for instance, with its held poses, gives time for the “melting” required for tissue to deform in this plastic manner. Such melting is also a component in most myofascial release methods.
Remodeling. We are familiar with remodeling actions in re-knitting a broken bone, or the natural process of tissue restoration in wound healing, but now we have come to realize that the system is constantly remodeling at differing rates in different people. We also know that remodeling increases after “healthy loading,” including exercise, a strong stretch session, or a deep bodywork session.17
Fascial remodeling is an essential process to understand in strength conditioning, bodybuilding, and athletic skill-building. Differing genetic tendencies in the fascial system (stiff versus lax, for example) produce different responses and thus require different training to avoid injury and build new tissue.
Enhancing the remodeling process is a lot of what is being included today in the science of “recovery” after the stimulus of training and exercise.18
Building all four of these properties/processes into our 2.0 thinking will facilitate a stronger, more effective, and more efficient approach to relieving body pain and enhancing performance.
3. Structural Integration 2.0 Includes Myofascial Tone Balance
The muscles are embedded in the fascia to function as adjustable guy-wires within the fascial net. Therefore, structural integration 2.0 recognizes the value in balancing muscle tone—increasing or decreasing it locally to promote an even tonal balance across the myofascial tissues of the whole body.
We now understand that the body is a tension-dependent structure, where the bones rely on the balance of soft tissue—muscle and fascia—to stay articulated and upright. In this way, the bones can be seen to “float” within the surrounding sea of soft tissue. This tensegrity engineering has changed the way we see the body and how we assess proper movement.
An entirely new line of study, pioneered by Donald Ingber, MD, explores tensegrity at the cellular level, where it is absolutely clear that each cell is “Velcroed” into the fascial net as transmembranous proteins hook the cell to the extracellular matrix. Each cell responds to not only its chemical milieu, but also to its mechanical surroundings.19
Structural integration 2.0 posits that the general improvements in health we see from structural integration come from numerous body cells finding themselves in their happy mechanical place and starting to function without excess tensional stress, as originally designed. But passive manipulation on the table that characterized the original iteration of structural integration is not enough, if the client does not change their movement patterns when they get off the table.
The 21st century has plunged us into an inactivity crisis. Structural integration 2.0 values personal and athletic training, working hand in glove with whole-body inclusion methods like yoga and whole-body exercise methods such as martial arts and Pilates (among many tone-restoring trainings). A lot of us have trouble moving enough or moving correctly, just as many of us have trouble staying still, so let us include meditation among the somatic disciplines that regulate cellular health.
The vital role that nourishing movement plays in our health—from deep epigenetic changes right on out to better communication—is being shown in study after study.20 This line of inquiry links structural integration to fitness training and rehabilitation.
4. Fascia as a Sense Organ: Interoception
Another line of research that has proceeded apace since Ida Rolf formed her theories is interoception. We now know that fascia is the richest sensory organ we have, with 100,000,000 sensory endings distributed throughout the body.21 The brain is intensely interested in what is happening in the fascial system and gets regular (and mostly below-the-conscious-level) signals about the pressure and tension in the whole system.
These receptors inform the brain how all the sheets and strings of fascia are stretched, pressured, twisted, vibrated, and sheared relative to all nearby structures. Mixed in with these nerves that tell you where you are (proprioceptors—spindles and such) are nerves that tell you how you feel—interoceptors.
Interoceptive endings go to a very motivational part of the brain—the part that makes you wipe your brow, heave a sigh, open the fridge, or look for a bathroom. Messages from your guts are interoceptive, but so is the feeling that makes you shift your seat at work every once in a while. It is not pain, exactly, but it does motivate you. (And, of course, pain is also experienced through these sensory nerves. The source and progression of nociceptive signals is another area of intense study, with the biopsychosocial model and other studies indicating increased roles for the central nervous system in pain processing.)
Put it all together to see the cycle: the brain listens to the fascial proprio- and interoceptors, weighs that data against previous experience, blends it with the observed world, and produces its best shot at a motor response out to the muscles. The muscles are thus tensed or relaxed in either a temporary pattern (for a task), or in a more lasting set to the muscles—seen in the everyday world as posture. This postural set in the musculature then acts on the skeleton in gravity, and the passive fascial system does its best to manage (through remodeling) the forces created by our activity in gravity, working within the limits of the system’s raw materials.22
Structural integration interrupts this cycle by reawakening the body’s sense of itself, requiring “numb” places to sit up and take notice. These days, our customers often have less regulated autonomic systems, stuck in fight or flight in its various expressions. We help them toward becoming more centered and self-regulated, with resulting health in emotional expression and management. When it is more fully known, this line of inquiry, however, will link structural integration to psychology, psychophysiology, and psychoneuroimmunology.
5. Structural Integration 2.0 Seeks Integration of Extrinsic and Intrinsic Movement
We need to understand how our extrinsic movement (everyday or athletic contraction of the striated muscles) builds on intrinsic movement (the physiologic movement of the cells and smooth muscle fibers). In the embryo, the organism does only intrinsic movement—cell division and cell migration—as the organism multiplies and grows. The first twitching of the voluntary muscles happens later and is usually felt by the mother as the “quickening.”
The body, in its intrinsic wisdom, continues to adjust the bronchioles and blood vessels, digest your food, maintain the craniosacral pulse, the inspir and expir of the organs, heart rate variability, and a hundred other rhythms below our conscious level of awareness.23
Structural integration links our outer movement to these inner ones through the language of reflexes and developmental movement. Meditative explorations like Continuum are also useful in linking our inner animal movements (termed biomorphic by Continuum founder Emilie Conrad) into one seamless whole.
A New Understanding of Biomechanical Autoregulation
To summarize all these points, the structural integration practitioner of the 21st century is concerned with a new, wider understanding of biomechanics. We now understand that muscles have important attachments beyond their origin and insertion. We now understand that ligaments are in series with the muscles, not running parallel to them.24 Biomechanical autoregulation extends beyond visible anatomy into the very cells themselves.
Our autonomic nervous system is highly sensitive to changes in mechanics as well, such that basic psychophysiological foundations like security, safety, readiness for challenge, and ability to express are themselves dramatized in characteristic posture and movement.
It is a miracle of mechanics in general that a single wet and vulnerable cell can divide, grow, and succeed in the womb world during embryonic development, make the transition to the gravity world in the first year, and deal with the challenges to grow into sexual, emotional, and mental maturity.
All these systems—the fascia, the muscles, the nerves, and the epithelial linings, not to mention the vestibular system, right down to the mechanical connection to epigenetic expression within each cell—are part of how we self-regulate our biomechanics, mostly below but also above our threshold of consciousness.
From a small crack in the traditional model that structural integration 1.0 made, we are now seeing that structural integration 2.0 is at the center of a small revolution that applies holism to body movement in a practical way. We hope to report further progress in all these areas before another decade of the 21st century passes.
Notes
1. Ida Rolf, Rolfing (Rochester: Healing Arts Press, 1977); E. Maupin, A Dynamic Relation to Gravity, Vol. 1–2 (San Diego: Dawn Eve Press, 2005).
2. Ida Rolf, Rolfing & Physical Reality (Boulder: Rolf Institute, 1979).
3. Fascia Research Society, accessed March 2019, www.fasciaresearchsociety.org/papers.
4. Dr. Ida Rolf’s name for her work was structural integration, but it took the nickname Rolfing in the 1970s, and Rolfing is currently a branded name for one of the schools who follow her work.
5. Thomas Myers, Anatomy Trains 3rd ed. (Amsterdam: Elsevier, 2014), Appendix 2: 279–92.
6. International Association of Structural Integrators, “IASI Recognized SI Training Programs,” accessed March 2019, www.theiasi.net/iasi-recognized-si-training-programs.
7. Thomas Myers, Anatomy Trains.
8. Robert Schleip et al., Fascia: The Tensional Network of the Human Body (Edinburgh: Churchill Livingstone, 2012).
9. Fascia Research Society, accessed March 2019, www.fasciaresearchsociety.org.
10. M. Wanless, The New Anatomy of Rider Connection (North Pomfret, Vermont: Trafalgar Square, 2017).
11. G. Snyder, Fasciae: Applied Anatomy and Physiology (Kirksville, Missouri: Kirksville College of Osteopathy, 1975).
12. P. Friedl and E. B. Brocker, “Three-Dimensional Extracellular Matrix,” Cellular and Molecular Life Sciences, 57, no. 1 (2000), 41–64, accessed at https://link.springer.com/article/10.1007/s000180050498; S. Pivar, On the Origin of Form (Berkeley: North Atlantic Books).
13. J. Guimberteau, “Strolling Under the Skin,” accessed March 2019, www.youtube.com/watch?v=eW0lvOVKDxE.
14. G. Pollack, Cells, Gels & the Engines of Life (Seattle: Ebner & Sons, 2001).
15. “High Jump Hinge Demonstration,” www.youtube.com/w.atch?v=HspzxKXhpzk.
16. N. D. Reeves, “Myotendinous Plasticity to Ageing and Resistance Exercise in Humans,” Experimental Physiology 91, no. 3 (2006): 483–98.
17. S. P. Magnusson et al., “The Pathogenesis of Tendinopathy: Balancing the Response to Loading,” Nature Reviews Rheumatology 5, no. 6 (2010): 262–68.
18. For a review of recovery studies: www.ncbi.nlm.nih.gov/pmc/articles/PMC4720789.
19. D. Ingber, “Mechanical Control of Tissue Morphogenesis During Embryological Development,” International Journal of Developmental Biology 50 (2006): 255–66; D. Ingber, “Mechanobiology and the Diseases of Mechanotransduction,” Annals of Medicine 35 (2003): 564–77.
20. K. Bowman, Move Your DNA (Propriometrics Press, 2014); D. Ingber, “Cellular Tensegrity Revisited: J Cell Structure and Hierarchical Systems Biology,” Journal of Cell Science 116 (2003): 1,157–73.
21. K. Mahler, Interoception, The 8th Sense (AAPC Publishing, 2015).
22. Thomas Myers, Anatomy Trains.
23. H. Milne, The Heart of Listening (Berkeley: North Atlantic Books); J. P. Barrall, Visceral Manipulation (Seattle: Eastland Press, 1985).
24. J. Van der Wal, “The Architecture of Connective Tissue as Parameter for Proprioception,” Journal of Bodywork and Movement Therapies 2, no. 4 (2009): 9–23; P. A. Huijing, “Intra-, Extra-, and Intercellular Myofascial Force Transmission of Synergists and Antagonists: Effects of Muscle Length as Well as Relative Position,” Journal of Mechanics in Medicine and Biology 2 (2002): 1–15.