After the first five years of working as a Rolfer I sent out a questionnaire to all of my former clients. I asked them to rate their improvement of structure, symptoms, and psychological ailments on a scale of percentages starting from 100% and going down in steps of 20% to zero and then to “worse”. I also asked them to differentiate between the improvements as compared to the state before the treatment in the first year, the second year and until the date of filling out the questionnaire. This questionnaire was supposed to render results about the subjective self-assessment of the effects of Rolfing.
Parallel to this study of the subjective side, an evaluation of the objective structural development of the clients was attempted. The method chosen to attain this goal was the following: I presented the before-one and after- ten pictures of clients to Hans Flury and asked him to identify the structural type and to rate the structural improvement on the same scale as that which was filled out by the clients, that is in steps of 20%.
The results will be discussed in relation to the claims put forward about Rolfing during the training and in brochures of the Rolf Institute.
0.2. Methodological Considerations.
Selfevidently, an appraisal in percentages has no precision like a true measurement. Some exuberant persons will overstate everything. The sceptical may give a very low percentage. But with a large enough number above 30 persons matters start to approach statistical normal distribution and these differences cancel each other out.
As I had expected, some clients refused to mark a percentage and gave long verbal recounts instead. I did not count them in this report.
Others refused to answer even after three letters were sent to them. One can only speculate about their reasons.
It must also be considered that people tend to give favourable answers on questionnaires. This is even more so, if they know that the person who is most concerned will evaluate their answers.
Finally the consideration must be addressed that these results might only show that I am an incompetent Rolfer. It could be argued that most other Rolfers get much better results and that therefore my results are in no way representative of Rolfing in general. In a previous study done for the Notes on Structural Integration it was shown that pictures of persons who had been Rolfed by me were much more frequently recognized as having been Rolfed than those of the other two Rolfers who took part in the study. In a manner of speaking I produced the “best” results in that study. Therefore the results of this study probably are better than average. Still I suggest to assume that I am an average Rolfer. There is no way to prove this, but if we accept this assumption, the results of this study could be taken a representative and would show an average.
1. Results and their Discussion:
Of the 143 questionnaires sent out 81 (56,6%) were answered. This is a large enough number to approach statistical normal distribution. Most of the questionnaires that were not answered came back because the addresses had changed in the meantime. Therefore the selection of answered forms approaches a random selection which then allows the results to be treated as representative of the whole.
1.1. Subjective Assessments by the Clients.
1.1.1. Structure and Posture:
Of the 81 questionnaires sent back 69 (85%) gave an answer in percentages to the question: How many percentages did your body-structure or posture improve in comparison to the state before the treatment?
9 of these 69 reported zero percent improvement throughout the first, second and later years. This means that 13% had no feeling of structural or postural improvement. To me that is a rather shocking result and was a confirmation of my suspicions.
188.8.131.52. The first year.
During the first year 67 persons gave percentages of their improvement in structure and posture compared to the year before. Of these
13 (19,4%) marked 0% improvement for the first year,
1 (1,5%) marked 10% improvement for the first year,
11 (16,4%) marked 20% improvement for the first year,
11 (16,4%) marked 40% improvement for the first year,
1 (1,5%) marked 50% improvement for the first year,
20 (29,8%) marked 60% improvement for the first year,
8 (1,9%) marked 80% improvement for the first year,
2 (3,0% ) marked 100% improvement for the first year.
The average percentage of reported structural or postural improvement is 41,2% during the first year.
If one remembers that the self-presentation of Rolfing can easily create the impression that to have been Rolfed means a 100% improvement in structure because a Rolfed body is identical with an integrated body, then the 41,2% indicate that the claims should be formulated more modestly.
Fig.1 – Subjective ratings of structural or postural improvement during the first year (67 clients).
184.108.40.206. The second year.
According to the claims of Rolfing, the structural and postural improvements should increase in the following year up to a period of two years. In order to substantiate that claim I had asked my clients to mark their improvement compared to the state before the treatment two years after the treatment.
Of the 57 persons who answered that question,
7 (12,3%) had marked 0% percent improvement for the first year and gave an equal 0% for the second year,
13 (22,8%) marked a higher percentage for the second year than they had marked for the first year. The average improvement over the first year was 26,1%. One person went from 0% in the first year to 60% in the second; another from 0% to 40%. All the others reported 20% improvements: 6 went from 60% to 80%, 3 went from 20% to 40%, one person from 40% to 60%, and one from 0% to 20%.
17 (29,8%) marked the same improvement in the second year that they had marked in the first year. This can either mean that they felt no change in comparison to the first year or that they experienced a second improvement by the percentage marked. But since in 11 of the 17 cases the percentage of the two years would add up to more than 100%, this interpretation at least in these cases can not be applied. So these 29,8% can be taken as expressing “no further change” for the second year.
20 (35,1%) marked a lower percentage than they had marked for the first year. On the average they marked 30.5% lower in the second year. One person went from 60% to minus 30% in the second year, a 90% decrease. Another from 60% to minus 20%, an 80% jump. 2 persons went from 40% to 0% in the second year; 2 others from only 20% increase in the first year to 0% in the second. Three persons had a 40% decrease from 60% in the first year to 20% in the second. Ten persons had 20% decreases form 80% (5), 60% (4), 40% (1) respectively. One person reported a 10% decrease from 60%.
All in all it must be concluded that only 22,8% of my clients who answered the question reported the result that I had promised them, namely that their structural and postural improvement would continue into the second year. This promise of continuing improvement, generally made at the Institute, was easily believed by me as I had experienced it in my own body, so I readily passed it on to my clients.
Additionally the overall average improvement in the second year only is 36,8% compared to 41,2% in the first year. So also on the average the claim of continued improvement in the second year does not hold.
220.127.116.11. The years after.
Finally I asked the clients of my first five years to mark percentages to identify the improvement of their structure and posture at the time of filling out the questionnaire in comparison to the state before the treatment. So they marked the improvement that still remained with them after 3, 4, or 5 years had gone by.
This question was supposed to test the claim of Rolfing that the structural improvement given by Rolfing stays with the Rolfed person and that subsequent sessions are not necessary to keep up the improvement. Post-ten sessions and/or the advanced series, according to the claims of the Institute, build on the results reached by the basic ten and from there take the work deeper.
Of the 53 persons who answered the question
9 (17,0%) continued to report 0% improvement as in the years before – one of the most depressing results of the study.
14 (26,4%) marked a percentage that was lower than the one they had marked in the second year (one drop from 80% to 20% one from 100% to 60%, two from 80% to 40%, two from 20% to minus 20%, the rest were decreases of 20%). 18 (34%) marked in the last year a lower percentage than they had marked in the first year.
20 (37,7%) reported no change of their result after two years.
10 (18,9%) even improved in the time from two years after until the date when they filled out the questionnaire (one by 60% from minus 20% to plus 40%, another from minus 30% to plus 10%, two from 0% to 20%, two from 40% to 60%, one from 0% to 10%, one from 20% to 40%, and one from 60% to 80%, and finally one as expected and claimed from 80% to the full 100%).
So here more than half of the clients (56,6%) who answered the question were in accord with the claim: they held their change or even improved.
But if I compute the overall percentage, this optimistic result does not hold up to examination. The average percentage of improvement in structure and posture in comparison to the state before the treatment marked at the time of filling out the questionnaires is only 34,5% as compared to 36,8% after two years and 41,2% after the first year following the treatment.
So all in all none of the claims put up about the continued and lasting improvements by Rolfing hold true for the average of the clients Rolfed by me during my first five years of work.
One person reported 60% in the first year, 80% in the second and 100% until now; another40% in the first, 60% in the second year, and 80% until now. But these are the only two clients who had the same experience that I had had and that I continued to promise to my clients.
This goes to show – once more – the trivial and commonplace truth that it is no good to generalize one’s own experience.
1.1.2. The Symptoms.
18.104.22.168. The first year.
58 (63%) of the 81 questionnaires gave percentages of symptom relief for the first year.
Of these 58 answers
2 (3,4%) reported a worsening of their symptoms by 20%.
10 (17,2%) noticed no change in their symptoms during the first year.
1 (1,7%) reported an improvement by 5%.
1 (1,7%) reported an improvement by 10%.
9 (15,5%) reported an improvement by 20%.
8 (13,8%) reported an improvement by 40%.
14 (24,1%) reported an improvement by 60%.
9 (15,5%) reported an improvement by 80%.
4 (6,9%) reported an improvement by 100%.
The average overall improvement of symptoms during the first year was 38,4%.
Naturally, according to the claims of Rolfing, the 3,4% who had a worsening of their symptoms should never have happened. And the 17,2% who experienced no symptom relief at all also do not fit very well into the self-presentation of this work.
Fig.2 – Subjective ratings of improvement of symptoms during the first year (58 clients).
22.214.171.124. The second year.
For the second year only 50 clients gave percentages of the symptomatic relief compared to the state before the treatment.
25 (50%) reported no change. But of these 8 (16%)were at the level of zero in the first year as in the second. So actually only 17 (34%) had received symptom-relief in the first year and had kept that level in the second year.
16 (32%) reported that their improvement had gone down in comparison to the first year. Two persons felt worse in the second year than before the treatment (from plus 20% to minus 20%)! 5 persons felt that they had returned to the situation before the treatment (1 from 80% to 0%, 2 from 60% to 0%, 2 from 20% to 0%. The others experienced a 20% lessening of the symptom-relief they had gained in the first year (1 100% to 80%,180% to 70%,480% to 60%,160% to 40%, and 140% to 20%).
9 (18%) reported an improvement of their symptom relief in the second year over the first year, in one case dramatically from 0% in the first year to 40% in the second. In another case from 40% to 80%.3 reported an improvement from 20% to 40%. One from 40% to 60%? 2 from 60% to 80% and one – happily enough from 80% to 100%.
The overall average percentage of improvement in symptoms compared to the state before the treatment has risen to 39,7%. This slight increase in the second year is encouraging but contrasts with the dramatic reduction of well-being in two cases from plus 20% to minus 20% and the two cases of total disappearance of rather impressive improvements from 80% and 60% to 0%.
126.96.36.199. The years after.
47 clients marked percentages for the state of their symptoms at the time of filling out the questionnaire. For some of them it was in the third year after the treatment, for most several more years had passed.
Of these 47 clients
2 (4,2%) had marked a worsening of their situation by 20% for the second year and unfortunately stayed at a situation which was 20% worse than before the treatment even until the time of filling out the questionnaire!
11 (23,4%) marked zero improvement and had marked that already for the second year – seven of them had already marked zero improvement for the first year.
19 (40,4%) had marked some improvement in the second year and had kept that improvement until the time of filling out the questionnaire! (1 person 100%, 4 persons 80%,5 persons 60%,6 persons 40%,1 person 5%).
9 (19,1%) marked a worsening of their situation in comparison to the state after two years (1 from 100% to 40%,1 from 80% to 40%,1 from 70% to 50%,3 from 60% to 40%,1 from 60% to 20%,1 from 40% to 20%, and 1 from 40% to 0%).
6 (12,8%) marked an improvement of their symptoms compared to the state two years after the treatment. Two persons went from 805 to 100%!!, 3 persons from 60% to 80%!, and 1 person from 0% to 20%.
The overall average percentage is 37,3% at the time of filling out the questionnaire. In the first year it was 38,4%, then it rose to 39,7% and now has dropped by more than two percent. The continued improvement that the promises of Rolfing implicate are not what my average client experienced.
There are two clients who reported such an experience: they had 60% in the first year, 80% in the second and a 100% improvement at the time of filling out the questionnaire. But on the other hand there are also two clients who report the opposite: after a 20% improvement for the first year, they experienced a 20% worsening of their symptoms for the second year and they stayed with that 20% worsening until the time of filling out the questionnaire!
1.1.3. Psychological Improvements.
188.8.131.52. The first year.
Of the 81 questionnaires only 43 (53,1%) show percent ages for psychological effects of Rolfing.
Of these 43
3 (7,0%) reported a worsening of their symptoms by 20%.
9 (20,9%) noticed no psychological change during the first year.
10 (23,3%) reported an improvement by 20%.
8 (18,6%) reported an improvement by 40%.
7 (16,3%) reported an improvement by 60%.
2 ( 4,6%) reported an improvement by 80%.
4 ( 9,3%) reported an improvement by 100%.
The overall percentage for the first year was 34,4% psychological improvement. It is the lowest percentage for the first year.
Fig.3 – Subjective ratings of psychological improvement during the first year (43 clients).
184.108.40.206. The second year.
For the second year only 36 clients gave percentages for their psychological improvement compared to the state before the treatment.
23 (64% ) reported no change. But of these 6 (16,7% ) were at the level of 0% in the first year as in the second. So actually only 17 (44%) had received psychological relief in the first year and had kept that level in the second year.
8 (22%) reported an improvement of their psychological situation in the second year over the first year, in one case dramatically from minus 20% to plus 20% in the second year, in another case from 20% to 60%2 reported an improvement from 20% to 40%.2 from 40% to 60%,1 from 60% to 80% and one – happily enough – from 80% to a 100%.
5 (13,9%) reported that their improvement had gone down in comparison to the first year. One person had a really dramatic worsening of her psychological situation from plus 80% to minus 20% which amounts to a full 100% drop in well-being! 3 persons went from 40% to 20% and one person from 20% to 0%.
The overall average percentage of improvement in the psychological state compared to the state before the treatment has risen from 34,4% to 39,4%.
220.127.116.11. The years after.
33 clients marked percentages for their psychological state at the time of filling out the questionnaire.
1 (3%) had marked a worsening of his situation from 60% in the second year to an unspecified worse than 0%!
6 (18,2%) marked zero improvement and had marked that already for the second and first year.
16 (48,5%) had marked some improvement in the second year and had kept that improvement until the time of filling out the questionnaire! (5 persons 100% !!!, 5 persons 60%, 6 persons 20%). 4 (12,1%) had a 100% improvement from the first year until the time of filling out the questionnaire! That is the most remarkable improvement of the whole study.
9 (27,3%) marked an improvement in their psychological state compared to the state two years after the treatment. One person went from 60% to 100%!!! Another person from 80% to 100%!! 4 persons went from 40% to 60%! and the person who had dropped 100% from 80% to minus 20% now returned to plus 40%. Another person went from 60% to 80%, and 1 person from 0% to 20%.
Only 1 (3%) person marked a worsening of his psychological state at the date of filling out the questionnaire in comparison to the state after two years. He felt a reduction from 60% to something below zero.
The overall average percentage is 45,5% and has risen by more than 10% from the average of the first year at 34,4% and more than five percent from the average of the second year of 39,4%. So this is the only area in which the average client experienced something like the long lasting and continued improvement that is the general promise of Rolfing.
1.2. The Objective Structural and Postural Improvement.
Of 73 clients from the first five years the pictures taken before the first session and after the tenth session were evaluated. Hans Flury rated them for the improvement in structure and posture on the same scale of 20% steps that the clients were asked to mark their improvements on. 100% were given for the best possible result: meaning something very closely approaching structural integration. Additionally he identified each person as belonging to one of the four types described in the Notes on Structural Integration: regular internal, regular external, symmetrical external, and locked-knee internal.
The percentages on structural change given naturally have no objective quality. The judgment is just as arbitrary as that of the self-assessment of the clients. But it is the best that could be done. Since there exists no generally agreed typology in the Institute the alternative method of asking a larger group of Rolfers for their assessment and then calculating an average was not possible. They would all have started from different conceptions of what constitutes Integration. Asking Hans Flury to do the assessment made at least sure that a consistent criterion of structure and its integration was applied.
It is, however, questionable whether photographs represent structural changes since photographs can only show a mixture of both structure and posture. In reality tests would have to be used to grade the structural improvement. So these ratings of the structural improvement are only very rough approximations under the arbitrary assumption that the photographs show mainly structural changes.
The photographs themselves were taken under a rigorous regime: The client had his or right big toe always on the same spot with the same distance and relative position to the camera and with the same procedure and instruction on how to stand ( “Stand the way that you now feel straight without posing and without hanging”).
The pictures have, however, another much graver methodological flaw: while the “before” pictures have been taken before the session, the pictures of session ten have been taken right after the tenth session. Just having had a session produces unspecific and short-term effects like the lengthening of the body that always happens after one or more hours of lying on a horizontal surface. Therefore the pictures show a lot of disturbing postural elements. The assumption seems valid that the pictures that I presented to Hans Flury tended to show more change than pictures taken before the tenth or a week after would show. So the results of the picture assessment should even be tuned down a bit in order to arrive at a more realistic idea of the changes that really had taken place.
Naturally the ratings given by Hans Flury are a matter of his subjective evaluation and judgement. Yet since they are all done by the same person, some measure of consistency in the relations can be expected. And since they are done from the outside according to well defined, theoretically sound criteria, it seems justified to call them “objective ” in contrast to the subjective self-evaluation by the clients themselves.
1.2.1. Distribution of Structural Types and their Structural Improvement.
The pictures presented to Hans Flury were randomly selected. They should be representative of all my clients since 73 is a large enough number to approach statistical normal distribution. Contrary to the lore in the Institute that you attract clients of your own structure, symmetrical externals were the smallest group (16%) of my clientele. It seems more rational to assume that structurally there is a random distribution of clients. If that is correct, the following numbers are very interesting, because they can be taken as representing the distribution of structural types in central Europe.
18.104.22.168. Regular internals.
Of the 73 clients whose pictures were evaluated 31,5% (23) were regular internals.
Fig.4 – Objective rating of structural improvement in regular internals.
To remind you: Regular internals are structures with an anterior pelvic tilt and a posterior pelvic shift. The weight of the upper body comes down in front of the hip joint making the pubes go down in front and back, so that the gluteals have to hold against that thrust in secondary shortness. The knees are slightly bent and the whole system is in a holding pattern of muscles and connective tissue against gravity. The thorax is bent and tilted backwards. The ribs are pulled down and the thorax therefore tends to be flat in front with a strong kyphosis in the upper back.
In the Rolfing “recipe” which I was taught and which was represented to me as being “classical”, the goals were all cut out for the regular internal: “waist-line back”, “bring the pubes up” and “bring the cervicals back”. During the five years in question I faithfully worked according to this “recipe” (the same or very similar “strokes” were applied, a ritualistic order of goals and procedures was followed). It can therefore be no surprise that regular internals with 42,5% show the best structural improvement in my clientele.
However, if you look at the distribution of improvements, there is a sad note even in that optimistic result: there is one single 100% improvement. Therefore the assumption that a Rolfed person has an integrated structure seems to be the very exception and very much contrary to fact. And even applying a “recipe” designed for that kind of structure in one case lead to a disintegration of 20%. Two regular internals showed no structural or postural change at all, although I gave the very same “strokes” to them that I had given the person with a 100% structural improvement. This diversity of results even in the same structural type is remarkable and needs an explanation, which I do not have.
But still with regular internals the distribution of improvements is rather encouraging: 73,9% of the cases show an improvement of40% or more and only 13% show no change or disintegration!
22.214.171.124. Regular externals.
Of the 73 clients whose pictures were evaluated 20,5% (15) were regular externals.
Fig.5 – Objective rating of structural improvement in regular externals.
To remind you: Regular externals are structures with a slight posterior tilt and an anterior shift of the pelvis. The weight of the upper body comes down sightly in back of the hip joint. The way the system holds itself up against the pull of gravity is not so much by tissue tension and muscular holding like the regular internal, but by a compressional system of the bones of the leg. Therefore the legs are straight like broom-sticks stuck under the anteriorly shifted pelvis. The pelvis then functions for the trunk like a bowl on which the contents of the trunk rest as a hydrostatic system of bags inside bags inside bags. Therefore the shape of the upper body is much more open to habitual patterns than that of the other types. Since the pelvis forms a firm base for the upper body, there is no need for consistent antigravitational holding patterns. Seen from the side the regular external shows the characteristic banana-profile.
Since what I was taught as the “recipe” was not designed for regular externals it cannot come as a surprise to see that regular externals with 37,3% show a lower rate of improvement than regular internals (42,6%).
On the other hand: Among the regular externals of my clients the distribution surprisingly is more favourable than with regular internals: there are no 0% changes and no disintegration cases. But then there is no 100% change either and there are very few really good changes. The distribution shows only 46,7% of the cases with a 40% or better structural improvement (with regular internals it was 73,9% of the cases!).
126.96.36.199. Locked-knee internals.
Of the 73 clients whose pictures were evaluated 31,5% (23) were locked-knee internals.
Fig.6 – Objective rating of structural improvement in locked-knee internals.
To remind you: Locked-knee internals are structures with a slight anterior tilt and a pronounced anterior shift of their pelvic segment. They hold their body up against gravity not so much by muscular holding as by resting in the tensed tissue-slings which are in secondary shortness. The weight of the upper body pushes the pelvis forward into the tissue in front of the hip joint. Because of the anterior pelvic tilt, the center of gravity of the upper body is slightly in front of the hip joint, but still gives the pelvis a forward push and not a backward one as in the regular internal. The knees are pushed backwards by the overall weight coming down in front of them. They are more or less hyperextended (depending on the tissue quality) and rest in the tissue in back formed by the fasciae of the hamstrings and of the gastrocnemius, which therefore tend to go wide.
The trunk tends to collapse showing a more or less pronounced (again depending on the quality of the tissue) S- curve.
This type responds not very well to tissue manipulation. The knees can only come out of their hyperextended state when the pelvis comes back so that the weight no longer comes down in front of them. But for the clients their pelvis rests comfortably in the forward sling and it is very hard to bring the clients out of that position by manipulation alone.
The data for the locked-knee internal confirm this description: The average rate of improvement is only 26,1 %. This is much lower than with the regular internal (42,6%) and with the regular external (37,3%). But more important than the average percentage of improvement is the distribution of improvements. With 30,4% of the cases this type shows the highest percentage of disentegration and no-change of all types (25% for the symmetrical external, 13% for the regular internal, 0% for the regular external). And there are less people (13,4%) who show a 40% or better improvement than those who have no change or were disintegrated. Remember in contrast: with regular internals it was 73,9% of the cases who rated 40% and better, with regular externals it was still 46,7% of the cases.
188.8.131.52. Symmetrical externals.
Of the 73 clients whose pictures were evaluated 16,4% (12) were symmetrical externals.
Fig.7 – Objective rating of structural improvement in symmetrical externals.
To remind you: Symmetrical externals are structures which show a pronounced posterior tilt and posterior shift of the pelvis. The weight of the upper body comes down behind the hip joints. The persons have to hold themselves up against the pull of gravity by muscular strength enforced by rigidified tissue, without which the upper body would fall down in back of the legs. The legs are bent in the knees to bring the feet back below the center of gravity. The upper body is collapsed in front with a strong secondary shortness in the fasciae of the abductors (to counteract the pelvic tilt) and in the upper back.
Obviously this is the type for whom the “recipe” that I was taught is poison. The waist-line of this type is already too far back to begin with. It is only logical that the symmetrical externals among my clients suffered most under what I did to them. Their average percentage of improvement is only 20% (regular internal 42,6%, regular external 37,3%, locked-knee internal 26,1%).
Again the distribution shows the really bad message: There is no a single improvement above 40% and this types is the only one which exhibits a case of a 40% disintegration!
1.2.2. The Development in Time – or: did a learning process happens
If the most favourable type, the regular internals, for whom the “recipe” seems to have been designed, is taken as an example, the question can be looked into whether the “recipe” that I was taught in the basic training permits a learning process. If such a learning process did happen the results for that type should improve over time.
The following list shows the structural improvements by year of treatment.
Objective structural and postural improvements in regular internals by year of treatment:
1985: average 45% (4 clients) 0%(1) 40%(2) 100%(1)
1986: average 52,5% (8 clients) 20%(1) 40%(3) 60%(2) 80%(2)
1987: average 32% (5 clients) -20%(1) 20%(1) 40%(2) 80%(1)
1988: average 40% (3 clients) 0%(1) 40%(1) 80%(1)
1989: average 40% (2 clients) 40%(2).
The averages and the distribution show no improvement over time, no trend towards learning. The success or failure of a series seems more a random event than the result of a learning process. In my view that amounts to the harshest criticism that I could think of.
1.3. Relation of Objective and Subjective Appraisals of Improvements.
When comparing the structural changes with the self-appraisal of the clients no correlation could be detected. The only area where a very weak correlation can be detected is in the area of symptom relief.
The first consequence should be to stop making the open and implicit promises about lasting and continuing changes. Rolfing manipulation can probably work wonders in some few cases, but it does not produce reliable and good results on the average. Therefore Rolfing manipulation must be supplemented by a manner of educating the clients about the way they move with their bodies in gravity. They should be taught how a more economics way of moving would look and feel.
Hans Flury has developed the principles for this new and indispensable element of Structural Integration under the heading of “Normal Function”. It must become a central part of every session. Then the clients learn about their way of moving and – at least in principle – how they should change it. They then have a tool to work with by themselves.
The second consequence is to realize that Wolfing manipulation does not automatically create Structural Integration even and especially if the “recipe”, the traditional way of doing a session, is faithfully adhered to. Therefore such a “recipe” must be given up and replaced by a strategy that must be specially designed anew for each session and each individual client. That strategy must be solely determined by the individual structure of the client and not by the number of the session. His or he primary shortness has to be addressed before the secondary shortness is being lengthened.
The third consequence follows from the fact that some “miracles” do happen in traditional Rolfing manipulation based on the kind of “recipe” that I was taught. While it is obviously very necessary to raise the basic average result to a level that deserves the high pa we demand for our work, on the other hand we do not want those “miracles” to disappear. Therefore the strategy for a session should conserve as much of the of Rolfing manipulation as is possible without endangering Structural Integration.
With these considerations in mind the strategy for ten session series would have to look very different fro what it is now. Just in order to make that difference mo clear I shall give a short sketch of how such a differed “recipe” could look like. It is not intended as a re practical alternative but as an illustration for the direction which the results of my review of the first five years working as a Rolfer have taken me.
There would be ten sessions. Every session would consist of three parts: a lesson in normal function centered around one functional goal for each session; a manipulative part addressing the fascial impediments of that normal function so that the manipulative work has the goal to make that normal function possible; a manipulative structural part in which primary and secondary shortness of the structural type is addressed.
In the structural manipulative part primary shortness is lengthened until secondary shortness no longer has to compensate for the primary shortness. Then a general lengthening of the whole structure can be attempted.
Every session is focused on one normal movement. Its elements are taught to the client in the beginning of the session as far as this is possible. In that teaching process the impediments to that movement can be analyzed. In the following manipulative part of the session, these impediments to normal movement can be addressed on the table. After this the normal movement is taught again and further impediments are analyzed and addressed in further manipulative work. This goes back and forth until no further progress seems possible. In the last section of the session manipulative structural work takes place that is necessary for the structural type at hand.
The issues and the speed of learning vary from client to client, but there is a certain logic in what to teach first and what will then build upon this. Therefore I suggest the following order as a general guideline how to conduct the sessions. Like all guidelines one can always proceed differently – for a reason. The order was also selected because in the functional manipulative part of the sessions the anatomical structures that have to be given special attention to roughly correspond to those of the old “recipe”. Thus a new “recipe” could look like this:
In a presession or as part of the first session the problems of the client should be looked at under the perspective: is there a logical explanation for their misuse of the body in gravity? If such hypotheses can be developed they should be told to the client and they should be tried out right away by approaching normal movement for that situation, and by contrasting the experience of a movement that is more in accord with gravity with the habitual movement pattern.
First session: Sitting I.
Normal function: Rolling on the sitbones is an easy beginning and gives the insight, that the pelvic block is central to what happens below and above and that there is a basic difference between holding and letting go, between stretching elastic tissue as support and active muscle tension.
Manipulative work to make normal function possible would be needed on the fascial tissue of the hamstrings, in the groin and around the hip joint; additionally in most structures a lengthening of the front and back will be called for to allow an anterior convexity of the trunk.
Manipulative structural work would concentrate on the obvious primary shortness.
Second session: Normal standing and free movement of the pelvis in standing.
This is mainly a necessity for the structural analysis of the client: to be able to identify the structural type and the structural dynamics of the client as well as his or her side-to-side issues and rotations. But it also teaches the clients the importance of the support by the ground and that what they feel about being upright does not necessarily correspond to reality. Additionally, in understanding their structural type they also can understand their individual method of making themselves smaller and the way in which they can keep their length.
Manipulative work to make normal standing possible would be needed on the feet and legs, the structures that impede the mobility of the pelvis, and on primary shortness in the trunk. In this session the manipulative functional and structural work gets to be nearly identical.
Third session: Folding.
Folding is the basic movement for sitting down, lifting, sitting II, and walking. The major emphasis is on resting into the extensor slings around the folds to store elastic energy. For this the midline has to lengthen.
Manipulative work to make normal function in Folding possible would be needed especially on the folds and on keeping the midline long. So special attention should be given to the projection of the midline on the lateral aspect of the body.
Structural manipulative work would have to address primary shortness, keeping the secondary shortness long with the aim for equal length on both sides.
Fourth session: Sitting II.
Not rolling on the sitbones, but turning the pelvis around the pelvic center of gravity is the issue of this session, so that the hip joints and the sitbones are behind the pelvic center of gravity. For this, sitting down in Folding is necessary as well as increased pelvic mobility.
Manipulative work to make normal sitting possible would probably have to be on the fasciae of the hamstrings, rotators of the hip, abductors and the pelvic floor as well as those structures that impede anterior convexity of the trunk.
Structural manipulative work would continue on primary shortness to equalize length.
Fifth session: Walking I.
Walking in Folding with the weight of the trunk coming down in front of the hip-joint and with an anterior convexity of the trunk. Emphasis in this session is on keeping the center of gravity at the same level in walking. For this it is necessary to experience how the legs can swing forward like a pendulum in letting go from the hip. For this the weight of the trunk has to come down in front of the hip. When it comes down in back of the joint, the legs have to be lifted against gravity instead of being taken forward by gravity.
Manipulative work to improve the ability for normal walking would be called for on structures that impede the letting go of the legs from the hip and keep the legs from swinging along a straight course from the hip. Additional work may be necessary on structures that impede the anterior convexity of the trunk.
Manipulative structural work might begin on secondary shortness, if the places of primary shortness have gained enough length so that secondary shortness does not have to compensate any more.
Sixth session: Walking II.
Walking at different speeds in minimal Folding and with the trunk anterior convex. The legs should swing freely and in a straight course. The joint axes should be in a frontal plane.
Manipulative work to make normal walking possible probably calls for work on the legs and the back to allow the hip joints and pelvis to swing far enough back to allow for different speeds in walking and to ensure the straight course of the legs with the joints in a frontal plane.
Manipulative structural work would start on primary shortness when and where it is necessary, but the work on secondary shortness would have to come into the center of attention more and more.
Seventh session: Turning against the ground.
The turning of the head should be taught in this session as a rotation that is initiated by the letting go against the ground in the leg from which the head turns away. This should be taken through the whole body but should be exercised especially for head movements around the three axes through the center of gravity of the head. The experience of extension should be contrasted with the compression of the habitual way of moving.
Manipulative work to improve normal function is called for throughout the spirals and especially in the shoulder-girldle, neck and head.
Structural work looks more and more at the secondary shortness and how to gain overall length.
Eighth session: Lifting and bending and working in standing.
The emphasis is on bending from the hip and keeping the anterior convexity of the trunk.
Manipulative work to improve function is called for around the pelvis to enable the hip to function as the major joint assisted by the knees and ankles. Additional work must ensure that the anterior convexity of the trunk can be kept up throughout the movements.
Structural manipulative work must seek for gains in overall length.
Ninth session: Working in sitting, reaching.
Again the major joint should be the hip-joint with anterior convexity of the trunk so the shoulder girdle is brought close to the area of work in order to reduce the length of the lever. Initiation of all arm movements by relaxing the shoulder girdle and letting the shoulder come down.
Manipulative work to improve function might be called for on hands, arms, shoulder girdle and back and groin to ensure movement from the pelvis instead of from the back.
Structural manipulative work should test the danger of taking the structural type over to the other side of the opposite type. The structural point should be found and further work should attempt to take it closer to “normal”.
Tenth session: Walking stairs and inclines.
Emphasis must be on moving the center of gravity in a straight line with the weight coming down in front of the hip joints. Folding on one leg to lower the center of gravity and the unfolding on one leg to raise the center of gravity must be taught.
Manipulative work to improve function would have to concentrate on the folds and ensure the horizontality of the axes and their position in a frontal plane.
Structural manipulative work would have to look for overall length and stability.
“old recipe” / “alternative recipe”
– Goal: Change the pattern of breath, free the pelvis from the thorax, free the pelvis from the legs
– Function: Sitting 1 rolling on sitbones
– Area: Pelvis, hamstrings, trunk to enable acmott
– Structure: Primary shortness
– Goal: Relate the whole body to the earth through the feet, ankles, knees and spine, establish hinges.
– Function: Standing
– Area: Legs, feet back and front
– Structure: Primary shortness determine type
– Goal: Lengthen sides of body, front to back depth, separate girdles.
– Function: Folding
– Area: Midline in side view
– Structure: Primary shortness
– Goal: Lengthen the midline and awaken the core into the pelvis.
– Function: Sitting 2, turn around pelvic CG
– Area: Pelvic structures inner legs
– Structure: Primary shortness
– Goal: Continue length in midline through pelvis. 4.has awakend the inner line. 5th builds the pelvis around it, establish relationship of legs to LDH.
– Function: Walking 1, getting the weight to come down in front of hip
– Area: Belly, pelvic mobility, trunk
– Structure: Primary shortness
-Goal: Lengthening and organizing the back from heels to dorsal hinge, emphasizing the relationship of walking from the LDH.
– Function: Walking 2 minimal, folding and acmott
– Area: Back and front, hinges, trunk
– Structure: Primary and secondary shortness
– Goal: Relate head, neck to shoulder girdle, cervical and upper dorsal spine, establish the line upward.
– Function: Turning the head from the ground
– Area: Spirals around the body
– Structure: Primary and secondary shortness
– Goal: Harmonize and relate the upper and lower girdles, remedy interference between the two. Start on the one that would support the other.
– Function: Reaching from the hip
– Area: Shoulder girdle and arms from pelvis
– Structure: Primary and secondary shortness
– Goal: Relate the girdles to the center line, achieve flow from centerpoint through pelvis, shoulder, neck, lifting from LDH.
– Function: Lifting and bending from pelvis
– Area: Pelvic hinging function acmott
– Structure: Lenght through midline
– Goal: energy from center line in all directions, back to front, side to side balance, horizontality of joints, silkiness of tissue, ability to extend spine from the top and to let pelvis drop.
– Function: Walking stairs and inclines
– Area: Hinges, acmott, and trunk
– Structure: Lenght through midline