It is assumed that the reader is familiar with the theoretical premises and manual technology that combine to make up the method of Rolfing. If not, Dr. Rolf’s book ?Rolfing, the Integration of Human Structures? is recommended’. In addition, some of the ideas that will be presented here are rooted in the osteopathic concepts elaborated by Dr. John Upledger in his book ?Craniosacral Therapy?(2). A general working knowledge of musculoskeletal anatomy and basic functional kinesiology is assumed to be among the reader’s skills.
Dr. Rolf’s premises held that gravity bore on the body as a major ?environmental? factor in its well-being. She observed that to the extent the structure was organized around a ?central vertical line?, representing gravity’s influence, it would operate relatively free of compression, actually drawing support from the gravity dynamic. Conversely, because of the body’s segmental organization, gravity will act on individual segments when they are displaced away from that same central vertical axis. This adds compressional loading to the structure and sets up an adversary relationship with gravity
The synthesis in Dr. Rolf’s thinking lay in the observation that the connective tissue was the organ of adaption to the structural struggles in the gravity field. This tissue can change the direction and density of its fibers with changing demands on the body. She saw that this mechanism of adaption could be used to support a higher level of organization in the body if it were manually freed from its habitual ?set,, and the person educated to utilize that freedom; to repattern their structure toward alignment with that central vertical axis of gravity’s effect.
In following the direction indicated by Dr. Rolf’s inquiry, and in teaching the work for several years now, I have come to a set of diverse observations about the body that both validate and elaborate on her basic premises. As in Dr. Rolf’s inquiry, these findings have arisen from diverse roots, including studies in osteopathic theory, taoist martial arts, articular mechanics of the skeleton, and a liveley private practice over many years’ duration.
Central to these ideas are some catalytic observations about that aspect of functional anatomy known as the craniosacral system. This work focuses on the premise that the pressure of the cerebrospinal fluid rises and is release rhythmically in a semiclosed hydraulic system bound by the dura mater of the brain and spinal cord. This pressure gradient will, in some individuals, demonstrate a preference for the pressure rising (flexion) phase, and in others for the pressure release (extension) phase. Upledger observes that these individuals will also demonstrate a pronounced postural habitue as a reflection of that ?pressure preference?(3).
The flexion type shows a preference for external rotation, as referenced from our central vertical axis. The extension type prefers the posture of internal rotation.
Simple enough, but as a Rolfer, conceptually based on the premises of Dr. Rolf, I was immediately galvanized by the implications of a system that recognized a continuity between surface contours and the deepest biophysical rhythmic ?setup of the body. It occurred to me, on contemplation, that I rarely saw ?pure? types of the kind suggested. In fact, my clinical experience showed mixed types to be the norm in terms of internal or external rotation. In addition, the semantics of this description are an elaboration on the metaphor of segment displacement, expressing intrinsic mechanics of the segments more exactly.
Of note to me was the implication that the legs of each polar type respectively had external rotation produce the classic genu valgum, or ?knock knee?, and internal preference produce the genu varum, or ?bow legs?. Consider that you usually see bow legs on a thin person and knock knees on the more obese. With this observation, you have the two polar types in mind.
To clarify this, I began to make notes on the characteristics of the two types, holding the fully externally rotated as a ?pure? theoretical example at one end and the internally rotated type at the other. These I called the congruent structures. In the case where a segment is not congruent with the baseline set of the body, I call it conflicted. The full checklist is quite a bit more detailed. I have pulled out some evocative examples to illustrate the system (Chart l).
It is possible through averaging the congruent characteristics to come to the type of structure you are examining. My clinical experience shows that the long axis orientation of the femur is congruent, in about 90% of the cases, with the pressure preference perceived by direct palpation of the inherent motion in the craniosacral system. The 10% not described by the femur seem to be cases in which events like high-velocity trauma, severe emotional stress, advanced pathology, or birth injuries have cut across the integrity of the structure. Palpation may reveal conflict within the cerebrospinal system. Such individuals often demonstrate behavioral as well as structural dysfunction.
As you begin to evaluate these ideas and examine them in your practice, you will notice that the more ?purest types are easy to recognize. The externals’ character is often outgoing, and though not as agile as the internals, they may demonstrate great manual dexterity. The internals are more reserved in character and generally better on their feet than the externals. The more conflicted types are harder to read initially, but if you carry on the inquiry, you will soon get a feel for the baseline ?type? in just about anyone.
With the recognition of this grouping, we have the opportunity to expand on the language we use to conceptualize the scope of any intervention. If each person we see is to more or less a degree of either internal or external rotation, and if their posture demonstrates ?conflict? in the form of counterrotation of the various segments against one another, then it is apparent that there is a directionally correct way – call this a right or wrong way if you will – to approach the release of this preference. This direction will ultimately be determined by considering the question of whether the body’s baseline habitus is one of flexion or extension.
Figure 4 + 5: Transmission Lines in Internal Type.
The internal line focuses on the posterior cervical compartment, crosses from back to front across the sternum, traverses the abdominal obliques to the iliacus to blend with the lumbar fascia, continuing down the medial hamstrings. A secondary line from the tensor fasciae latae and vastus lateralis joins, and they traverse behind the fibula and reach the planta pedis by way of lateral arch.
When this view of structure is compared with the foundation premises elaborated by Dr. Rolf, a continuity emerges that supports both viewpoints. Stacking the segments around the central vertical line of gravity’s effect on the structure and unwinding the extremes of internal and external rotation and the compensatory counterrotations, both converge toward a norm in which structure and function improve. This is seen through better organization both of the body in space and more even patterning of the primary movement of the craniosacral system. Of note here is that with the recognition of overlapping values a polar approach has to be acknowledged in the method of intervention characteristic to each system. If Rolfing manipulation is vigorous to one extreme, then Craniosacral Therapy represents a light touch to the other. The technical approach in each case is determined by the body system targeted in theory. The unifying factor lies in the mode of delivery which is in both cases ?hands-on?. Longer term investigation may indicate that some blending of method is appropriate.
Once the recognition came that internal-external and congruence-conflict are other, more elaborate ways of describing the segmental displacements of Rolfing, then another level of insight into the nature of the patterning in the connective tissue would follow.
Dr. Rolf observed that the connective tissue was ?the organ of form? in the body and that it would adapt to posture-structure demands by changing the density and direction of its fibers. It follows that any postural habitus has a corresponding ?imprint> on the supporting connective tissue. With the advance of the theory of internal-external as a primary postural baseline point from which other adaptions reference, comes a recognition that a pure (theoretical) type will have a familiar postural surface contour and a recognizable pattern in the connective tissue.
Figure 6 + 7: Transmission Lines in External Type.
The external line involves an anterior cervical compartment, crosses anterior to posterior to focus on midthoracic hinge, then crosses internal at the dorsal hinge and follows the psoas major and minor into the femoral triangle, follows the rotators out from the pelvic basin down the lateral hamstrings, crosses behind the knee and traverses the deep posterior compartment to emerge on the medial tibia, and then goes through the medial arch to the plantar foot.
In each of the polar types then, there is a predictable imprint on the myofascial web that is demanded by the habitual use of the structure. I call these the lines of transmission of kinetic energy. It was necessary to reference these theoretically pure types in order to isolate the lines. In practice, the farther a body is toward the ?pole? of its type, the stronger these lines emerge. As conflicts are resolved and the segments begin to relate better, the lines become less defined.
Note the language that emerges here. The description of Int-Ext is referenced to the segments and the skeletal armature. The ?lines of transmission? are the soft tissue response to the pattern. In practice, the lines are worked manually to establish enough length and better tonus along the congruent lines of transmission. Segments in conflict to the type (internal in this example) are treated with the lines through that segment as predicted by the polar type of that segment.
There is a hierarchy predicted by this method. Internal-External is a description of front-to-back structural dynamics. As the bodies have their extreme preferences brought toward center and the conflicts between segments are lessened, the body will lengthen in space as a by-product. It is at this point that side-to-side balance issues may be more effectively addressed. Curvatures and scoliosis are results of the initial loss of length that occurs in concert with the compensations aforementionned.
As front-to-back order increases, there will be a spontaneous derotation of the segments on one another. Initially then, the unwinding of side-to-side balance issues is accomplished indirectly by attending to front-back issues as the foundational ones. In order to effectively recognize and resolve side-to-side displacements directly, a working knowledge of pelvic bony relationships, mechanics of spinal rotation and corresponding ribcage patterns, and the attendant predictable myofascial arrangements is needed.
At this point it is possible to be quite coherent in understanding the priorities of the body in front of you in terms of its direction of growth. All trauma is laid over and integrated into the existing milieu of internal-external preference and adaptations of developmental spinal mechanics.
If the injury is fresh and the treatment is immediate, then a more local approach is called for, as it would be inappropriate to undertake an evolutionary attempt in the face of a current acute situation. On the other hand, if the traumata are part of the longer physical history of the person, then the scars and adaptions are integrated into those. underlying physiopostural events and remain to be addressed as ?detours? from the lines of transmission. They are the marks of individuality and lend their own, less predictable element to the work.
From these lines of inquiry, a most important element is emerging. This is the creation of a language that more accurately describes structure and hence opens up the possibility of more coherent communication both among ourselves as practitioners and with those we would learn from… and teach. The language is quite free of charged psychological metaphors and so describes structure without offending. The ramifications of this line of inquiry may reach far beyond the parameters of the average Rolfing practice. When I presented these concepts to a friend who is a professional midwife, her comment was that the ?external moms? presented a higher risk on delivery due to thickened perineum and narrow tuberosities. Not that all external females would be at risk, but that the probability was predicted by the structural surface contour.
There is also some indication that these types present with different metabolic rates of ?burn?. Witness the externals’ tendency to gain weight easily, even when thin they often show very little definition of muscle contour. The internals, conversely, seem to be able to consume large quantities of food and drink without showing it as excess body fat.
In closing, it seems that this is a significant contribution to the understanding of structure. These ideas utterly validate the premises of Dr. Rolf while taking the inquiry of what constitutes normal for human structure a step further.
1. Rolf, Ida P.: ?Rolfing?, Harper & Row, NewYork etc., 1978
2. Upledger, John E., and Jon D. Vredevoogd: ?Craniosacral Therapy? Eastland Press, Chicago, 1983
3. op. cit.