In 1983 I was auditing Rolfing class. Van Dam, our assistant teacher, told us during his demonstration of the seventh session that he often did a lot of work on the scalp. I must admit that for many years I never paid much attention to his advice.

About 15 years ago, I started to work extensively with cranio-sacral therapy. I started with Upledger and did the first two courses. Then, over the last eight years, I have been continuing my studies with the French osteopath, Alain Gehin, author of The Atlas of Manipulation of the Bones of the Cranium and Face.

At a point, looking at a chart showing the acupuncture meridians and points, I noticed that the meridians and points related directly to the sutures of the skull.

I sometimes think that the skin, including the related connective tissue, is a bag. Everything is inside the bag. Robert Schleip gave us a picture of our structure as bags within bags. Groups of muscles are in a bag. The individual muscles are within another bag, the epimysium. Within the epimysium are groups of muscle fibers in their own bags. Even a single muscle fiber is within a connective tissue bag.

All of our organs are within a bag. The peritoneum holds most of the organs in our abdomen. Within the peritoneum is a bag for both the stomach and the liver. The stomach is itself a bag. There is another bag, the omentum, for the small intestine.

The dural membrane is a bag. Within that, the brain itself is within another bag, the pia mater. The nerves are within a bag of perineural connective tissue. Etc.

One of my Rolfing teachers told us that Ida said that one muscle should slide over another like one silk bag over another. And so it should be – not only with muscles, but also with all of the bags of the body.

From trauma, repetitive movement or just plain aging, we get an adherence, gluing or gunk that restricts one bag from sliding in relationship to its neighbor. This gives a fixed point within the bags within bags. All of the movement of all of the bags is now more or less in orbit around this fixed point. With lots of fixed points, we get further restrictions in the movements. We get further and further away from an integrated structure. This distorts our movement and interferes with optimal function.

When I first started as a Rolfer, I was very much interested in releasing the myofascia – tension levels in muscle itself. I used the usual assortment of elbows, knuckles and finger tips to press into the body. At times, I gave way to the temptation and ploughed through what I had gotten into.

But when I looked at the acupuncture charts together with the Western anatomical muscle charts, I saw that acupuncture points were often located where two muscles overlapped each other. When I explored with my fingers, I found that I could easily dive through a tunnel. The margin of one muscle was on one side of my finger and the margin of the other muscle was on the other side of my finger.

I found that working the margins of the muscles was often faster, easier and more effective than working on the external surface of the muscle facing the underside of the skin. What was more fascinating was that I could hook my finger under the muscle into the loose connective tissue between two muscles. That gave a bonus. I can highly recommend it to others working with structural integration.

Let us direct our attention back to the head. The bag that we call the skin hangs from the top of the head. If there are areas of tension in the skin further down on the body, they will cause a shortening of the entire fascial plane. That tightening will pull the crown of the head down in the direction of shortness.

Take a hypothetical example. If the bag of skin is tight on the right side of the neck and shoulders, it will tip the head slightly to the right. Of course in reality, the skin is not tight in one area – it is tight in patches, spirals and stripes at different locations in the body.

Working against the downward pull of the skin, we have the tensegrity of the bones and ligaments of spine and the rest of the skeleton creating lift in a well-organized body.

The connective tissue bags themselves can also help to give us upward lift. The bags can hold us up by connective tissue belts, just as a balloon can be firmed up and lengthened. If you tie elastic rubber bands around a balloon, you can make it more firm and at the same time change its shape. Louis Schultz and Rosemary Feitis gave us a wonderful description of these connective tissue bands in their book, The Endless Web.

Tension in the skin anywhere in the body will create a constriction of the skin over the cranium. This results in a lessening of the amplitude of the cranio-sacral rhythm. And this in turn results in a diminished circulation of the cerebro-spinal fluid. This carries glucose and essential ions that are necessary for the metabolism of all of the cells of the brain and spinal cord.

In cranio-sacral therapy, we work to increase the amplitude of movement of the bones of the cranium by releasing tensions in the system of internal membranes (falx, tentorium and dural tube). Alain Gehin and some traditional American cranio-sacral therapists work to mobilize the sutures of the cranium. There is yet another approach to releasing cranial tensions by directing the fluid movements within the skull. This derives from the late work of W. G. Sutherland and has been explored by Jim Jealous, Roland Becker and Franklyn Sills.

With our background as Rolfers, it appears obvious that we could increase cranial movement by releasing tension in the skin anywhere in the body. We could also increase the effect on the cranium by working on the connective tissue structures and muscles of the cranium itself as well as the face.

The acupuncture points offer an interesting approach to releasing the skin itself. Make the bag bigger and the movement of the cranium increases. Then there are the dozens of muscles in the face, scalp, throat and neck. Many of them can be easily accessed through acupuncture points. Release of myofascial tensions gives a similar effect, lessening pulls and distortions affecting the bones of the head.

There are other connective tissue structures in the head and face. For example, the aponeurosis is often glued to the bones below, or affected by chronic tension in either m. frontalis, m. occipitalis or both.

Looking at the acupuncture meridians, we see that the medial margin of the aponeurosis lies just under the bladder meridian. The lateral margin of the aponeurosis lies just under the gall bladder meridian. Both meridians have end points in both the face and the feet.

Combining the direct work on the connective tissue structure of the aponeurosis with stimulating acupuncture points and meridians opens up an interesting possibility. We can release tension in the aponeurosis by “holding the tissue and calling for movement ” – a phrase which comes down to us from Ida. For example, if the medial edge of the aponeurosis.is glued to the cranium, you can grab hold of it with your finger tips and have your client rotate their foot. When their foot moves to a position where there is maximum stretch of the bladder meridian, you will feel the tissue tighten under your fingers on the medial edge of the aponeurosis.

I find that rotating the foot and stretching the bladder meridian quickens and improves the quality of the release of the aponeurosis beyond what I usually experience with just working on the head alone.

There are many other interesting connections between structural integration and acupuncture. Upledger referred to a British medical doctor named Moss who had practice on Harley Street in London. Moss used S6 (Stomach 6) to rebalance the sacro iliac joint. S6 is a point on the face, just over the distal medial edge of the masseter muscle. I have used S6 many times to re align the sacrum and the ilia. To my amazement, the technique works.

For people working with osteopathic techniques, it is useful to explore the relationship between the acupuncture meridians and the organs themselves. For example, if you hold a point on the stomach meridian with a finger tip of one hand and pull the stomach down with the other hand (as if you were releasing a hiatal hernia with a stretch of the esophagus), you will feel the tissue tug under your finger on the stomach meridian. You can use the acupuncture point to help release the tension in an organ, or moving an organ to help release a tension in the acupuncture point or meridian.

Or, when clearing the restrictions at the costal arch, if you find a restriction at the point where the kidney meridian crosses the cartilage, it might indicate a ptosis of the kidney on that side. A kidney ptosis is when a kidney “wanders” or falls downwards in the space behind the posterior peritoneum.

There are many acupuncture points at sutures of the face and cranium. For example, the points S1 and S2 (stomach 1 and stomach 2) are at the joint between the maxillaand the zygoma.

These are some of the relationships between structural integration, with its focus on connective tissue, and Chinese classical acupuncture and the osteopathic disciplines of cranio-sacral therapy and visceral massage.