THE TWO ARE NOT UN-CONNECTED. . . .

Ask any Chiropractor, Physical Therapist, Structural Integration Practitioner, and even most General Practitioners, and they will tell you that poor posture and low energy have a chicken and egg relationship. Did your posture deteriorate because you sat, immobile in front of the computer until you were exhausted? Then your tired body just slowly, little by little slumped deeper into your chair? Or did years of bad posture wear you out so much that slumping into a chair became your favorite past time?

Who knows.

But the fact is that poor posture isn’t just cosmetic. It has real, physical side effects that can lower your energy, limit your mobility and cause agonizing pain.

When you were 20, you were so young and strong and resilient that the exaggerated curve to your shoulders and jutting jaw actually looked rather good. But now, in your 30s or 40s and beyond, that “curve” is a slouch and your jaw reminds you a bit of a bird of prey. Worse, both are causing severe neck pain. And sometimes, you can’t manage a deep breath at all.

How will you ever breath deeply again?

Ida Rolf, who earned a Ph. D. in biochemistry, studied Organic Chemistry and Atomic Physics, understood that the human body was really one, completely connected entity. And like a long line of  swerving, curving overlapping dominos, when one piece gets tipped out of place it careens into another, and that into another and another, and so on. So whether you slouch in front of a computer or just slouch in general, muscles shorten, others stretch and lose elasticity, and discs in your back get pushed awry. Until at some point, you feel severe pain and/or you slouch so far forward that your lungs barely have room to take in energy-supplying oxygen.

Fortunately for us all, Dr. Rolf did something fruitful with her medical background and keen understanding of the human body. She developed the Structural Integration Rolf Method–a step-by-step process, grounded in chemistry and biology, and designed to systematically relieve pain and realign the human body to its optimum form.

The Treatment

Focusing on something called the “myofascial system” (or the network of soft tissue that connects AND protects muscles, tendons and ligaments and gives them shape), I will use pressure and friction created with my hands to warm and soften the “fascia.” Just as clay softens when it is warmed by hands, I will manipulate the fascia and associated muscles in order to re-orient neck muscles, stretch and realign back muscles and relieve pressure on vertebrae. The immediate result will be a looseness you haven’t felt for months or even years, and a release of stress and pain from your neck and back. Ultimately, though, after some or all of the recommended 10 Structural Integration sessions, your body will realign itself to its natural, state. You will stand more erect, your chest will lift upward and your movements will become more fluid. You will breathe easily and deeply, filling your lungs with oxygen and kicking your energy level up.

The Role of Structural Bodywork in Treating TMJ

Temporomandibular Joint Disorder (or TMJ) is no laughing matter. It certainly wasn’t for one teenager, who came to see me this year suffering from headaches and chronic pain in her jaw.

By the time she came to my office, Sally was 15 years old. She had been suffering from TMJ for three years. Her jaws popped and made harsh grinding sounds when she chewed. She felt a terrible searing ache from her chin to her cheek and sometimes experienced blinding headaches.

Three years earlier, in response to the pain (and on the advice of her dentist and orthodontist), she stopped chewing gum and started wearing a guard at night to minimize tooth grinding.

The pain subsided after making those adjustments, but then inexplicably returned – this time with a vengeance. The pain was so intense Sally’s father reported, “She had problems concentrating, would cry herself to sleep, and stopped eating.”

Sally’s parents took her to see an oral surgeon, who specialized in TMJ and was put on anti-inflammatory meds and muscle relaxers. She was put on a diet that consisted of soft foods only. She was even given Botox shots to reduce the pain.

In each case, after an initial honeymoon-phase in which the throbbing would become bearable, the pain would return often with multiplied intensity.

The Incredible Moving Pain of TMJ: Now You Feel It. Now You Don’t.

Why did the pain in Sally’s head, neck, mouth and jaw subside with each of those traditional medical and dental treatments — only to return with greater force later?

The answer lies in the nature of TMJ itself.

Like many causes of chronic pain, TMJ is not a single disorder. It is a series of dysfunctions in the body, that can be triggered by still more events.

In other words, TMJ is like one of those complex, interrelated works of “Domino Art”. The trigger can come from the left or right, top or bottom, inside or outside. And each string has

the potential to touch several other strings – triggering a cascade of tipping, falling, painful dominos.

In the case of TMJ, the muscle spasms cause tension, torsion and imbalances that affect the way the sufferer holds her mouth, chews her food and even talks. One side of the mouth may become tonic (or tense) and over-muscled as the patient chews her food on the same side of her mouth day after day, meal after meal.

The other side becomes weak and atrophied.

Eventually, the lopsided musculature pushes the angle of chewing further and further into unnatural angles. . .

* Pinching nerves
* Triggering more tension
* Creating overcompensation in related muscles and in tendons of the neck and cranium.

Over time, the imbalances spread and pain grows in intensity and regularity.

TMJ can be triggered by. . . .

* Acute Trauma – Falling or being hit in the mouth can impact proper alignment, and if not treated can alter overall tracking of the mouth
* Oral Health Disorders – cavities, advanced periodontal disease, loose teeth and mouth ulcers are just some of the oral health disorders that can cause a patient to begin chewing, talking and holding their mouth in unnatural positions
* Stress – many people grind and chew their teeth while sleeping in response to stress that has built up during the day
* Genetics – often people who are strongly left handed or right handed are also left-side or right-side chewers.

Treating Pain Points

In many cases, dentists, oral surgeons and general practitioners are able to treat TMJ. However, when the pain becomes chronic and returns again and again, it is highly likely there is soft tissue injury (muscle, tendon, and fascia) to the chest, neck, head and face. For that, the patient requires supplemental treatment designed to address imbalances, torsion points, and irregular tracking of the jaw and chronic pain.

The Goal of Structural Bodywork

The goal of Structural Bodywork is to get to the root of the patient’s pain and suffering. My goal in treating patients with TMJ is to look beyond the immediate pain and contracted muscles, and to consider the entire, connected, interrelated structure, so I can create a better-functioning structure, overall. So before I begin treatment, I spend time up front interviewing my client to understand what events led up to their very individual case of TMJ. Once I understand the source of the disorder, I can begin unwrapping the layers of imbalance, pain and adhesion that have built one upon the other.

How Sally’s TMJ was Treated with Structural Bodywork

For Sally, treatment began on the face and cranium with the goal of releasing the external patterns of tension that are often so unconscious among TMJ sufferers. After a noticeable release of tensions was achieved with the ‘outer’ layers, I then moved inside the jaw to work on the critical that impact the mechanics of the jaw and mouth. I released spasming in her masseter (chewing muscles). Then I turned my attention to her pterygoids (the muscles above her molars) that had become tense and tight causing her jaw to track unevenly and making it difficult for her to open her mouth. I went on to stretch and reposition strained, weakened and over-developed muscles on one side of her face and along her cranium (temporalis).

In addition, to address secondary and contributing factors to strain patterns in the face and cranium, I worked to release tensioned muscles at the base of her cranium (sub-occipitals), which often contribute to headache patterns.

Following that initial treatment, Sally is now fully-functioning, pain free. . .
These are the results of Sally’s treatment, in her father’s words:

“During that first session, Joe was able to have her open her jaw fully without discomfort.The pain literally went away overnight. After two months of treatment, we discontinued use of anti-inflammatories and muscle relaxants and eased her back into a normal diet (still minus the gum and other similarly chewy foods).

Now, five months later, our daughter’s severe jaw pain is a distant memory. She does daily stretching exercises and sees Joe every six weeks. There are occasional episodes of jaw pain, which can be associated with some stressful event; however, the pain is quickly relieved using the exercises that Joe provided.”

*The patient’s name has been changed to protect her privacy.

To take control of your TMJ and schedule your appointment today!

For those unfamiliar with Structural Integration, Structural Integration is a 10 session systematic process of deep bodywork designed by Dr. Ida P. Rolf that improves the Structural and Functional abilities of the human body in its relationship to the gravitational field. Through the systematic approach of reorganizing major joints, and body segments, while releasing the chronically held tension and torsion patterns we are able to achieve a rapid change in structural mechanics and correction of chronic musculoskeletal pain or dysfunction. Athletes perform better while stress is significantly reduced. Postural balance and flexibility are improved with each session. Professional athletes, dancers, and performance artists throughout the world have successfully utilized CORE Structural Integration. Business and professional leaders have found that the beneficial results have improved their focus and attention, their vitality, and their creative abilities. CORE Structural Bodywork can significantly balance the emotional and cognitive abilities of anyone who completes the 10-session series. In preceding articles that explain the ten-session series, you have seen how Structural Integration can benefit the general population by empowering the body to work in the way it was intended through aligning each body part to its correct place and function.  Now it is time to take a look at how these benefits can apply to the growing statistic of 1 in 5 people who live with chronic pain.

“When a body is in pain or discomfort, whether physical or emotional, the unconscious response is to tighten and shorten in an effort to “get away” from the pain. Our work focuses on lengthening and balancing the body in order for the tightened tissue to have some place to go upon release.”

— Ida Rolf

We all experience physical pain.  In its normal state, pain is a healthy message that something is wrong with our body.  Pain is typically a short-lived response to some stimulus.  These stimuli may include an injury (such as a sprained wrist), a disease or infection (such as arthritis or an ingrown toenail), a traumatic intrusion (ranging from the major, such as surgery, to the minor, such as cutting your finger while chopping tomatoes in the kitchen), or even the most natural of body functions (such as giving birth to a baby)

“As a doctor I find myself standing during procedures for 4 to 6 hours daily. At the end of the day, I am often exhausted, sore, and sometimes unable to sleep comfortably. Joe’s therapy allows me to recover faster and sleep better so I can continue to endure my long days at work.”  Sassan Pazirandeh, MD

As a cautionary physical response, pain is a good thing.  But when pain continues for an extended period of time to the point that it interferes with your regular activities and comfort, it becomes chronic pain.

“The gospel according to osteopaths is to try to go to the center to get to the cause and change it. The gospel according to Rolf is that you can’t get to the center to change it until you work with the outside. The body is like an onion. To get to the center without injury you must peel it layer by layer” Ida P. Rolf

Defined as pain that lasts beyond what would normally be expected for a given injury or disease, or for more than six months, chronic pain comes in varying degrees and, whether sporadic or ongoing, can be debilitating.  Its negative impacts are widespread:

• It can affect sleep patterns, resulting in a vicious cycle of insomnia and fatigue.
• It can decrease appetite in response to physical discomfort, or increase appetite in response to the resultant stress.
• It can interfere with the brain’s chemistry and natural analgesics, sometimes resulting in dependence on prescription pain medications.
• It can wreak havoc on one’s emotions, resulting in anger, sadness, anxiety, and stress.  Depression is a common result of chronic pain.
• It can impact your finances, due to absenteeism, distraction on the job, or decreased productivity.
• It can impact life’s pleasures by curtailing social activities and taking the passion out of hobbies and favorite pastimes
• It can impact one’s entire family as they try to cope with the many ways that chronic pain affects the sufferer

“The Journal of Orthopedic and Sports Physical Therapy recently cited that patients with chronic low back pain may respond better and sustain longer improvements when treated with alternative treatment protocols like Structural Integration.”

Common sites of chronic pain include the back, neck, shoulder, and head.  Whatever the source of the chronic pain, its impact on the rest of the body is tremendous as other body parts try to compensate for the pain-site’s inability to function correctly.  Image When an injury of some sort has taken place in the body, the vibration of this injury is taken up by the whole structure in a series of compensations and adaptations to limit the site of pain. These stressors that are arriving at any bony junction are manifestations of distal soft tissue and visceral strains. Typically, what I often see in my practice is what I term the ‘end point’ or ‘end chain’ of pain, this is where the structure cannot adapt to the strain or torsion pattern.  An example is a client will present with a chronic shoulder injury, however as we progress through the 10 session series and begin releasing and unwinding tension and torsion patterns in places far away from the shoulder such as the base of the feet, relief begins to arrive. Restoration of the normal mobility ultimately rests on the establishment of system wide support and adaptability. This means that healing is a system wide event and local problems are not local. This is the missing link in many of the myriad of healing approaches out there available to the public, which many people endlessly try without success and frustration, offering temporary relief at best with little or no success.  The lack of success in these modalities lies in the fact that once again they are chasing the ‘symptom’ instead of addressing the origin of the problem causing the chronic pain.  Many have relied on prescription drugs, over-the-counter remedies, surgeries, and procedures.  They’ve tried relaxation, counseling, and biofeedback.  They’ve tried massage, acupuncture, and chiropractic approaches.  In desperation, many have even tried remedies that may seem less than sensible, sound, or wise – all in an effort to relieve themselves of chronic pain and its negative effects. The real skill as a Structural Integration practitioner I’ve found is keeping the big view while attending to local events.  Stated quite simply understanding that the presenting “symptom” has a context. It is the whole human being. Just a quick summary Structural Integration addresses chronic pain at its origin, providing a corrective remedy rather than a temporary ‘band-aid’ approach to treatment.

“I am dealing with problems in the body where there is never just one cause. I’d like you to have more reality on the circular processes that do not act in the body, but that are the body. The body process is not linear, it is circular; always, it is circular. One thing goes awry, and its effects go on and on and on and on. A body is a web, connecting everything with everything else.”

Ida P. Rolf, Ph.D.

“The 10 sessions of Structural Integration has helped me tremendously after I injured my back. I feel better than I did before my motorcycle accident. Thank you so much for showing me a new way to use my body. I learned so much in our time together. Your encouragement and knowledge are very motivating. Thank you! “

Suzanne Chartier

Many treatments work well in conjunction with SI, so you can feel free to continue with them while receiving SI therapy.  For instance, massage can be a wonderful way to relax your body and increase your sense of well-being.  A conventional doctor can address specific medical concerns and prescribe medication or suggest procedures that may indeed be advisable.  A chiropractor can enhance the manner in which your joints function by moving bones into their appropriate places.  A counselor can help you deal with the emotional barrage surrounding chronic pain.  All of these approaches can be valuable components of your ongoing health maintenance program, and their efficacy will only be enhanced and supported by the work that I do.

If you or someone you know has been suffering from chronic pain, now is the time to take your health back. Enjoy the benefits of the most advanced form of Structural Integration offered at this time.

“Joe, I am a firm believer in Structural Integration and the work you do. The ten sessions straightened and aligned my body resulting in less aches and pains due to years of nagging injuries and bad posture. After only a few visits you relieved the nagging ache in my lower back and hip that I lived with for years. I thought aches and pains were part of getting older but you explained what the problem was and how to correct it I have and do highly recommend the 10 sessions and your services to anyone.” Thank you,

Peter Maher

So is the answer to stretch the hamstrings as often as possible to get greater length and pliability?

Perhaps not.

I recently read an abstract of a research study conducted by Henry Pollard and Graham Ward titled ” A study of two stretching techniques for improving hip flexion range of motion”.

What these researchers found out was that when they used PNF type stretching for the hamstrings they were able to get a 9% increase in muscle length. However, when they stretched the small sub-occipital muscles (muscles which attach from c1, c2 to the base of the cranium) they were able to get an increase of 13% in muscle length!!

How is this possible?

They propose that this has to do with the neuorological importance of the sub-occipital muscles. This area of the body holds the highest amount of muscle spindles, which play an important role in our sensory function, and that the researchers propose that through the ‘Tonic Neck Reflex’ that extension in these muscles will result in a decrease in tone to the hip joint extensors (ie. Hamstrings).

So as a take home, if you are one of those individuals that often finds his or her hamstrings to always be tight, realize that if you are also shortening the upper neck, you are fighting an uphill battle. However, if you release the base of the neck whether through structural bodywork,  myofascial release or alternative stretching then lengthening the hamstrings will be a much easier and lasting process….

10 sessions of structural integration overview

Visual Overview of the 10 sessions series of Structural Integration. This poster shows the structural and functional goals of each session along with the region of the body that is treated within that session. Poster can be purchased for your own practice for $29.95 + tax and shipping at https://www.corestructuraltherapy.com/products

It is also helpful to understand that ‘symptoms’ are the last item in a chain of events. By the time things begin to be symptoms whatever has been going on in the body in terms of disorder has been there for a long time, and where one is registering the ‘symptom’ whether this be a pain, ache, irritable bowel, lack of energy, feeling ‘stuck’ or unable to move forward in life, where ever this may be this is really the weakest link in a complex web of imbalances, it is the place that has become overworked because other parts are not participating enough in sharing the functional burden.  Structural Integration is about getting to the cause or chronologically a much earlier state of disorganization than any symptom would give us to understand.

A brief example of this would be someone that presents to me with a chronic neck complaint. Most therapists will apply moist heat to the neck, perhaps some ultrasound or light stretching, followed by massage or manipulation of the cervical spine. However, as a Structural Integration practitioner I want to look at the whole structure, the whole person and look for the strain patterns that are transmitting up to the neck. Often you will see someone in this pattern w/locked knees, a tipped anterior pelvis, a lordotic curvature in the spine, followed by a kyphosis or pushing backwards of the spine in the posterior thoracic (the bodies attempt to maintain balance), the next sequence is that head migrates forward in an attempt to balance the thoracic region, but after this compensation there is no further place for the body to try and adapt,  and as strain continues to be pushed into this region, by nature of the persons current structural alignment and balance, the body will finally find a boiling point and begin to register this to the person with ‘symptoms’. So using this analogy and the earlier typical treatment protocols if I only ease the cervical area, then yes I may calm the ‘symptom’ of neck pain, or speed the healing of tissues locally, but in doing so, I’ve also moved this strain to another part of the body where it will likely show up and register as a ‘symptom’ and have not attempted to remove the strain by balancing and organizing the whole structure in gravity.  

Whether treating a specific local area or orthopedic condition of the body, or someone looking to balance and realign their body, the fact remains while you can mobilize or reduce a complaint or injury in a short time the clients structure isn’t open enough to support the longevity. There is a series of 10 sessions that enable the body layer by layer to not only achieve more maximum structural alignment but to maintain it. These progressive sessions also allow the client to practice either self help or movement re-education and awareness exercises to embody the session work.

The goal of Structural Integration as Dr. Ida Rolf originally set out was to increase the human potential of each person from the structural to the cellular level.  She was not so concerned with ‘fixing’ ailments, but changing the person.  She frequently said if you change the structure of the individual you will no doubt increase the ‘function and vitality’ of that person, whether the function is a stay at home mother, factory worker, athlete, yogi, etc…  However, with that said we know that people feel common strains and pains and that these symptoms (i.e. low back pain) are the end point of structural imbalances. A common and easy to follow example that Dr. Rolf once gave was the child who falls off his bicycle and badly hurts his thigh, and so for the next several days when he walks his leg hurts him, and it also hurts if he carries his body in a certain pattern. The problem here is that the pattern of movement that hurts is typically the ‘normal’ pattern. So this boy will shift from that ‘normal pattern’ to a pattern that will remove the pain or discomfort [a random pattern].

Once the body has assumed this ‘non – normal or random’ position the affect of this on his balance is that there will be less motility in the region of the unbalance, there is less movement, muscles then begin to shorten and harden. And as that happens there is a progression, this vicious cycle is started, this progression toward hardening, towards less movement, less flow of vital fluids, less pumping of nourishment in and out of  that area, muscle continue to harden and gristle, fascial envelopes around individual muscles begin to adhere together with their neighbors. The overall area begins to turn towards fibrous material. And historically this process repeats itself over and over with further trauma’s overuse conditions adding disorganization and randomness to the structure. Structural Integration seeks to reverse this process by introducing ‘patterned’ energy into the system, as disorder increases in any system the only way it can change is with the introduction of energy directed in a particular thrust. In SI we utilize a goal oriented systematic approach  of reorganizing major joints, and body segments, while releasing the chronically held tension and torsion patterns. It is through this approach that we are able to make dramatic changes in both structure and function in a very rapid period of time.

The Importance of SI
One important principle of Structural Integration is that the body is significantly affected by the powerful force of gravity. In a misaligned state, the body’s valuable resources are used inefficiently, laboring to keep a person upright in the field of gravity. In addition, the stresses of daily life, physical injuries, unhealthy movement patterns and attitudes are things that can take a toll on one’s physical structure. Over time, the body will shorten and tighten to accommodate stresses, creating stiffness, pain, fatigue and lack of well being. Like any structure, the human body is vulnerable to the effects of the world around it.  Gravity, repetitive motion, injury, and any number of other factors can take their toll.  By the time you experience an interruption in the way you interact with the world – perhaps in the form of pain, fatigue, or some other clue that all is not right – it is likely that structural imbalance has occurred in your body.

One metaphor that is often used to illustrate this point is that of a house built on a sinking foundation.  The homeowner, clueless to the potentially catastrophic hazard developing underfoot, probably thinks he is doing everything he needs to do to keep his house operating smoothly.  He might even invest in home improvement projects to enhance visual aesthetics and property value.   But then he begins to notice symptoms of something being wrong in his house.  Perhaps he sees that doors are no longer functioning as they were made to.  He could address the problem with temporary means – like shimming the door – or he can go to the problem’s origin and repair it there.
Structural Integration (SI) is about addressing problems at their origin.  Through a systematic series of sessions, I work with my clients to restore balance to the body (front to back; side to side; top to bottom, inside to outside).  As each part of the body is realigned to its original place and function, things begin to work the way they were intended.

The benefits of SI are many, and they all relate back to the essential truth that a body in proper alignment will function optimally.

Some benefits, like enhanced flexibility, apply to everyone.  But when that flexibility is restored to a yoga practitioner, it takes on additional significance when it allows her to hold poses that she couldn’t attain prior to SI therapy. Additional benefits of Structural Integration are:

• IMPROVED POSTURE AND ALIGNMENT
• DECREASED ACHES AND PAINS
• INCREASED FLEXIBILITY
• IMPROVED FLUIDITY OF MOVEMENT
• INCREASED OXYGENATION
• IMPROVE ATHLETIC PERFORMANCE
• IMPROVED EVERYDAY PERFORMANCE