Bethany Ward, MBA, BCSICM, CARTM, is a Rolf Movement® practitioner and instructor at the Rolf Institute® of Structural Integration. Past-president and current board member of the Ida P. Rolf Research Foundation, she serves on the International Fascia Research Congress Steering Committee. A self-proclaimed fascia geek, Ward can’t stop talking about fascia and structural integration—whether in the classroom, workshops, or in her private practice in Durham, NC.
I’m always amazed how my decision to study structural integration (SI) has changed my life— and continues to instigate personal growth on all levels. This article is meant to give you a taste of what is going on in fascia research, with special attention to its relevance to SI. As I write this, I once again find myself a bit awe-struck by fascia. How it provides form, support, and the ability to interact with the world. How it creates needed separations and simultaneously unites structures to function in ways that would be impossible in isolation. And how, the more I learn about fascia, it seems more like a metaphor for living and relating to others, rather than a whitish soft tissue we rarely see.
A Brief History
In 2005, the Rolf Institute of Structural Integration (RISI) had a research committee (they still do), and I was asked to join. I got to work with the likes of Tom Findley, MD, PhD, and Robert Schleip, PhD, so I was glad to serve and learn from people I considered my mentors. Dr. Findley held the first fascia conference at the VA Medical Center where he worked. I remember he and Dr. Schleip talking about creating a fascia research congress. I didn’t think much of it because, in my experience, people often talk a lot more than they do and it seemed like an enormous project. But I didn’t know Findley and Schleip that well at the time.
By 2007, what started as RISI’s research committee became an independent non-profit called the Ida P. Rolf Research Foundation (IPRRF).
Here’s where I need to pause and thank the Rolf Institute for their commitment of initial funds and talent, as well as their support when we decided to morph the committee into an independent foundation that would serve the entire SI profession.
Fascia Research Congress
2007 was a big year for fascia research. We created the IPRRF as a non-profit with a mission to encourage and support evidence-based studies of structural integration’s effects and its implications for conventional and complementary health care. We introduced the foundation at the first International Fascia Research Congress (FRC). We didn’t know it was the “first” congress, because the meeting that Drs. Findley and Schleip (with the sweat of so many other individuals I can’t list here) created was meant to be a one-time event. But, by this time, I was learning to stop underestimating this duo.
Seven hundred people from 28 countries attended the first FRC held on the Harvard campus in Boston. To our amazement, the most influential fascia scientists were accepting speaking invitations in droves, and registrations sold out within weeks of posting the conference. Due to logistical constraints, we couldn’t add more days or space so we crammed all the learning and sharing we could into two days.
Before the congress was over, the planning of the next one began. Now that we knew the meeting would be an ongoing event, it needed a home. So the IPRRF, which was introduced at the first congress, now took the FRC under its umbrella of projects.
Congresses became three days, and the next FRC was hosted by Vrije University in Amsterdam— only two years later because there were still more important ideas we needed to cover. Five hundred and fifty people from 40 countries attended the 2009 congress. The Third International FRC, held in Vancouver, was again sold out with 820 registrations, with speakers and attendees from across the globe, and additional workshops held before and after the event.
. . . the Fascia Research Society (FRS) was created to give participants
a forum for maintaining and developing connections with
the fascia research community
Fascia Research: Bringing us together Bringing together scientific, medical, and manual therapy professionals, the FRC provides for an exchange of information about fascia that was never before possible. Since the very beginning, the goal for these meetings has been to bring scientists and clinicians together to inform each other’s work.
The first congress focused mainly on basic science with a smattering of clinical representation. This was appropriate, because most of the fascia researchers had been working pretty much in isolation— they may have read each other’s work, but most of them had never met each other, and few had ever considered that manual therapy had anything do to with what they were looking at under the microscope.
Five years later, at the 2012 congress, it was a very different matter. Although the focus for the FRCs will always be high-level science, the initial goal of creating meaningful relationships between scientists and clinicians is becoming a reality. This is where the FRC is really relevant for SI practitioners—now is the time to get involved with fascia research. Our practical experience adds dimension and direction to research projects, and scientific questioning and outcomes can inspire and recharge our methods. In the same way that you can’t separate the function of muscle and fascia, there is a symbiotic relationship between those who endeavor to understand how fascia works and those who attempt to work with fascia. We are intertwined.
The foundation was excited to see professionals from diverse backgrounds coming together to discuss their obsessions with fascia. But something else was needed. People were coming together and getting excited every three years, but the momentum died down during the interim. How could we support the dialogue and collaboration between clinicians, researchers, and academicians between the congresses? We developed the Fascia Research Society.
Fascia Research Society
Introduced at the 2012 congress, the Fascia Research Society (FRS) was created to give participants a forum for maintaining and developing connections with the fascia research community.
Still in its infancy, there is a lot more to come for society members. We say a special thank you to SI practitioners who believed in us enough to become members in 2012—even while we were asking questions like, “What would you like the FRS to offer?” For those of you who would like to join us, you can become a member at the Fascia Research Society website, FRS members receive:
? an online subscription to the Journal of Bodywork and Movement !erapies ( JBMT), which contains a section about fascia in every issue;
? discounts on Fascia Research Congress books and DVDs; and
? discounted admission to selected fascia conferences and events.
Many join just for the JBMT subscription. If you haven’t perused this journal you can learn more at their website, www.bodyworkmovementtherapies. com. Search for “Fascia Research” to read an excellent review of current fascia research (Findley, Chaudhry, Stecco, & Roman, 2012). Subscribers can download the entire article.
Membership also entitles you to discounted fees for many fascia conferences and events. For those of you who didn’t get a chance to attend the Vancouver FRC, you might consider attending the replay event with Dr. Findley and our host, orthopedic surgeon Dr. Thomas Hausner, held in Vienna on April 19, 2013.
Structural Integration Research Projects Very often, I have heard SI practitioners comment that current fascia research doesn’t speak to what they are doing in their daily lives. I have to take issue with this. First of all, fascia was hardly studied until about fifteen years ago. We have a lot of catching up to do and a lot of the questions that need answers are basic ones, such as: “What is fascia? What is it made of? What are its properties?” These are basic science questions and, for some, they may seem too indirectly related to manual therapy. I think this may be short-sighted. The more I understand the basics, the more it informs the way I work. Just learning that fascia has contractile properties or that nociceptive input (messages from pain receptors) from the thoracolumbar fascia may be a significant contributor to low back pain (it’s not all nerve impingements at the spinal discs!) changes what I do with clients.
Of course, we want evidence-based research that evaluates structural integration more directly, and a few of our colleagues are doing just that:
Structural Integration for Chronic Low Back Pain
Eric Jacobson, PhD, CARTM, is currently conducting a pilot clinical trial of structural integration for chronic low back pain that is funded by a training grant from the National Center for Complementary and Alternative Medicine, a division of the National Institutes for Health. Conducted at Spaulding Rehabilitation Hospital in Boston, this study is collecting preliminary data for designing a larger trial. In addition to assessing patient-rated pain and disability, the study is assessing psychological factors, standing balance, gait dynamics, and blood biomarkers to better understand the way SI may address back pain. This is the only clinical trial ever conducted of SI for low back pain, and the only one to investigate changes in gait dynamics and blood biomarkers that may contribute to the therapeutic impact of SI.
Structural Integration, an Alternative Method of Manual Therapy and Sensorimotor Education Published by the Journal of Alternative and Complementary Medicine, this article (Jacobson, 2011) reviews scientific research on the hypothesized mechanisms and clinical effects of SI. It finds preliminary evidence for improvements in neuromotor coordination, sensory processing, self- concept, vagal tone, and for reductions in state anxiety.
Structural Integration: Origins and Development
In this article, also published by the Journal of Alternative and Complementary Medicine, Dr. Jacobson (2011) reviews Dr. Rolf ’s background, major influences on her development of structural integration, her early teaching activities, and the development of SI training institutes.
For full text access to these articles, see References.
Myofascial Structural Integration: A Promising Complementary Therapy for Young Children With Spastic Cerebral Palsy Karen Price, CARTM, continues her Stanford University Medical School’s research study on the effectiveness of structural integration for children with spastic cerebral palsy (CP). Initially, Price and her research team created a randomized crossover design study to assess motor function using established measurement techniques, at baseline and after the treatment and control conditions, in eight children with spastic cerebral palsy, aged two to seven years. Results showed major improvements in six children after the therapy; three of the children also showed improvements after the control phase.
Since then, Price and her research team received a two-year grant from the Gerber Foundation to enroll 24 children with CP, aged two to three, for a follow-up study. The size of the research team has doubled and now includes a PhD/PT for assessments, an additional pediatrician who specializes in CP, PhD consultants, and an individual to assist with grant applications. Many children are currently enrolled and work will continue through 2013. The team has also applied for a second grant to fund children aged three to seven.
A paper on the findings from the pilot study was published in the Journal of Evidence-Based Complementary and Alternative Medicine (Hansen, Price, & Feldman 2012), and the team presented a poster at the Pediatric Academic Societies Annual
Meeting in Vancouver, BC, 2010. Links to the paper, the poster, and a 2012 San Francisco Chronicle article about the project are available under the research section at www.rolfingchildren.com.
Rolfing Structural Integration Treatment of Cervical Spine Dysfunction
Tom Findley, MD, PhD, CARTM, and fellow researchers completed a three-year retrospective study investigating the effect of structural integration on cervical spine dysfunction. Researchers looked at neck motion and pain levels of 31 subjects who received a Rolfing Structural Integration ten-session series. The investigation demonstrated that the basic Rolfing ten-series, when applied by a physical therapist who was also a Certified Advanced Rolfer, was capable of significantly decreasing pain and increasing active range of motion in male and female adults with complaints of cervical spine dysfunction, regardless of age. This work was published in the July 2009 Journal of Bodywork and Movement Therapies (James, Castaneda, Miller, & Findley).
Research Grants and Travel Awards
Of course, if you have your own structural integration research project in mind, don’t hesitate to contact the IPRRF ([email protected]). Although we currently do not have the financial resources to provide substantial grants (we’re working on it), we have a Science Advisory Board that can advise you on study design and potential collaborations. We do provide small research grants and you can apply for a grant via the foundation website.
In addition to grants for scientific research, the foundation generally provides three to five travel awards of up to $1000, annually. To qualify, your research must be published in a peer-reviewed journal and be presented at a medical or scientific conference.
There are great opportunities to get involved in fascia research. If you haven’t joined the Fascia Research Society yet, that’s a good start, as you’ll immediately get connected in with the community. You’ll hear about opportunities like attending Dr. Findley’s presentation, “Fascia research – 100 years since A.T. Still,” which he gave November 2012 at the Touro College of Osteopathic Medicine in New York City.
If you weren’t able to attend the most recent Fascia Research Congress, replay events are available. The next replay of the 2012 FRC will be held in Vienna on April 19, 2013. Or, if you have a lot of fascia enthusiasts in your circle and want to organize a replay event in your area, you can contact info@ rolfresearchfoundation.org to find out how. Or, if you’d prefer to work through the FRC presentations at your own pace, DVDs and proceedings books are available at www.fasciacongress.org.
We are still planning the dates and location for the Fourth International Fascia Research Congress. It will be in 2015, and organizers have their sights set on a US location on the east coast. We’ll have the details worked out soon—these things take quite a bit of planning.
But, in the meantime, keep your eye out for a one- day fascia symposium at Touro College, NYC. Join other fascia professionals in a day of didactic lectures combined with a cadaver workshop! Workshops are planned for 2013 and 2014. Touro plans to buy a special camera to make the cadaver lab experience especially instructive. For those of you who’ve attended fascia anatomy labs with Robert Schleip at Ulm University in Germany, you’ll know what I’m talking about. Touro is planning to purchase a camera, similar to the one used at Ulm that allows each participant to have the best seat in the house during the dissection. No longer will you have to crowd around a cadaver, elbowing for a good view.
Like the fascial matrix itself, my ongoing interest in fascia continues to provide support, connection, and resilience in my life.
Whether you take classes, join the FRS, start a research project of your own, or simply contact us and tell us you’d like to join a committee, there are a lot of ways to get involved. I found my way into fascia research, not because I was a researcher, but because I was willing to lend a hand. I’ve done a lot of work that I didn’t get paid for, but the benefits from being part of this community have repaid me many times over. I had a mentor once who told me to put myself among people who grew me, those that demanded a lot from themselves, and who enjoyed spending time with others of the same ilk. That is what I find when I hang out with SI practitioners, and it is especially so when I’m with those who attend fascia research events.
Like the fascial matrix itself, my ongoing interest in fascia continues to provide support, connection, and resilience in my life. There are times for separation and times for unity. And my relationship with this community makes it possible for me to accomplish goals that wouldn’t be realized on my own. If you haven’t already, I invite you to join us.
Findley, T. W. (2012, November). Fascia research – 100 years since AT Still. Lecture presented at Touro College of Osteopathic Medicine, New York, NY.
Findley, T., Chaudhry, H., Stecco, A., & Roman, M. (2012). Fascia research – A narrative review. Journal of Bodywork and Movement !erapies, 16(1), 67-75.
Hansen, A. B., Price, K. S., & Feldman, H. M. (2012). Myofascial structural integration: A promising complementary therapy for young children with spastic cerebral palsy. Journal of Evidence-Based Complementary & Alternative Medicine, 17(131).
Hansen, A. B., Price, K. S., & Feldman, H. M. (2010, May). Myofascial treatment for children with cerebral palsy: A pilot study of a novel therapy. Poster presented at the Pediatric Academic Societies Annual Meeting in Vancouver, British Columbia. Retrieved from http:// www.rolfingchildren.com/stanford.html
James, H., Castaneda, L., Miller, M. E., & Findley, T. (2009). Rolfing structural integration treatment of cervical spine dysfunction. Journal of Bodywork and Movement !erapies, 13(3), 229-238.
Jacobson, E. (2011). Structural integration, an alternative method of manual therapy and sensorimotor education. Journal of Alternative and Complementary Medicine, 17(10), 891-899. Retrieved from www.ncbi. nlm.nih.gov/pmc/articles/PMC3198617
Jacobson, E. (2011). Structural integration: origins and development. Journal of Alternative and Complementary Medicine, 17(9), 775-780. Retrieved from http://www. ncbi.nlm.nih.gov/pmc/articles/PMC3162380[:]Fascia Research Creates Opportunities for Community and Personal Growth