Introduction

It has been over six years since Jeff Maitland first started using the Erchonia PL5000 low-level cold laser as an adjunct to his work. When Jeff first discovered the laser, he was amazed by the results and shared some of what this remarkable machine could do in “The Too Good to Be True Machine.”(1) What Jeff discovered then remains true today: appropriate use of the cold laser in the context of Rolfing Structural Integration (SI) not only makes the work more effective, but also makes possible results normally beyond the reach of traditional Rolfing SI methods.

This article is about the use of the low level cold laser as an adjunct to Rolfing structural integration. It incorporates and builds on new information, as well as ideas already set forth in several recent articles in Structural Integration: The Journal of the Rolf Institute, which articles suggest the primacy of the nervous system in Rolfing and suggest that perhaps we should be rethinking what it is we are actually doing in our SI sessions.

The authors are keenly aware that this new idea and technique is an uncomfortable fit for practitioners who believe and desire to define our work by only those goals and objectives that can be achieved by exclusively manual means. We respect those beliefs and both appreciate and welcome the rich diversity of tools, techniques, experiences, and opinions that make up the Rolfing community. However, the way to remove doubt and skepticism is through experience, and the vast majority of practitioners who are trained in this adjunct technology can’t imagine ever going back to a time when they did not use it.

 

Where Are We Now – And How Did We Get Here?

For several years now, the nature of nervous system tissue and its impact on our work has attracted the attention of prominent persons in the SI field. In Christoph Sommer’s particularly eloquent article, “A New Paradigm: On Nerve Tissue Treatment,”(2) he discusses neurogenic inflammation and fascial restrictions, and predicts, “These developments (i.e., nerve palpation and manipulation) represent the next paradigm shift for our work.” Don Hazen’s “Peripheral Nerve Work – Compare and Contrast,”(3) while mainly a commentary on Jean-Pierre Barral’s peripheral and cranial nerve work, is also a summary of his own survey of medical literature on neurogenic inflammation and pioneering neurology work by Australian physical therapists.  In Pathophysiological Model for Chronic Low Back Pain Integrating Connective Tissue and Nervous System Mechanisms, Helene M. Langevin, M.D. and Karen J. Sherman, Ph.D. describe the relationship between the nervous system’s afferentation and connective tissue remodeling as it relates to low back pain.(4)

Nearly ten years ago, in an interview published in Structural Integration, Erik Dalton discussed the omnipresence of the nervous system in all soft tissues, including ligaments, fasciae, joint capsules, intervertebral discs, and tendons/muscles, as well as the net impact when afferentation through proprioception is compromised to the extent efferent pathways are not activated.(5) In The Core as a Coordination, John Smith reviewed many of Godard’s observations on Australian research, which described the neuromuscular coordination required to achieve “core stabilization”; i.e., the optimal balance between tonic and phasic or intrinsic and extrinsic muscles.(6) In “The Confluence of Neuroscience and Structural Integration: A Discussion with Sandra Blakeslee,” Kevin Frank concludes, “In essence, our work may be more about the body’s motor control than we previously thought.”(7) Finally, Robert Schleip’s, “Fascial Plasticity – A New Neurobiological Explanation” (Parts 1 and 2, published in the Journal of Bodywork and Movement Therapies), identifies an explanation for neural control of fascia(8).

Building on the work of Jean-Pierre Barral and Don Hazen(9), Mark Hutton discovered how to use the laser in conjunction with visceral touch to effectively and efficiently address nerve inflammation.(10) Meanwhile, Jon Martine found a way to use the laser more quickly to stabilize and integrate tonic and phasic function as it relates to stabilizing the appendicular and axial components in movement. Mark and Jon were so impressed by the results they were getting that they began to hold workshops in which they donated their time to teach the use of the laser to other Rolfers. As a result of those workshops, many Rolfers are now using lasers in their practices. At this point, Mark has been using the laser for over three years (with over six thousand hours of laser use) and Jon for two years.

 

How Does the Laser Affect the Nervous System?

Perhaps the most important recent insight about the nervous system is that inflamed nerves can be found in myofascial restrictions and strains. The implications for our work are staggering: to the extent that Rolfing cannot address inflamed nerves, it cannot achieve full integration of the body in gravity. Because we know that mesodermal structures are governed by the ectoderm,(11) it is clear that to work only with the connective and muscle tissues and ignore the role of the nervous system profoundly and tragically limits the possibility for change. Our collective experiences are clear that when certain neurological conditions are not addressed, our ability to achieve structural integration in gravity is limited.

 

Afferentation

We are indebted to Hazen, Allen, and Barral for their groundbreaking work and writings about the role of neurophysiology in structural integration. Allen(12) says, “The entire experience of human existence is based upon joint mechanoreceptor stimulation as a result of joint movement, and joint movement is a result of muscle function. The ability to resist the Earth’s gravitational field is as a consequence of postural muscles, through cerebellar reflex pathways. No function of human existence is independent of joint mechanoreceptor potentiation.” Therefore, if afferent information is not available, then the innate wisdom of the body will not order “efferent” movement and joint stabilization energy. Without efferent movement energy, there is no joint stability. Neurogenic inflammations lead to decreased afferent nerve information as well as the fascial restrictions that create malalignment and efferent down regulation. Afferent loss can occur due to disease, injury, posture, surgery, and aging.

By aligning joints and segments, we remove the physical and physiological blockages to optimum afferent information to the brain. This usually results in increased efferent activity, leading to increased stability and strength in those joints.

 

Neurogenic Inflammation and Myofascial Restrictions

Our combined experience suggests that the myofascial restrictions and strains associated with misalignment in gravity can usually be traced to neurogenic inflammation or neurologic deficiencies. Even the existence of so-called trigger points and myofascial pain syndrome have been questioned, based on epistemological, clinical and pathophysiological evidence suggesting that these phenomena might be better understood and treated as secondary hyperalgesia of peripheral neuro-inflammation origin.(13) When nerves become inflamed, they create restrictions by adhering to muscles, tendons, and ligaments. Over time, more fascial restrictions occur, causing a down-regulation of afferent activity, which, in turn, interferes with the stabilizing function of the efferent system. Joint stability is compromised, resulting in a loss of continuity throughout the whole body, with the appearance of joint fixations and overall misalignment in gravity.

To the degree that myofascial restrictions are linked to neurogenic inflammation(14), the structural work of Rolfing will be compromised to the extent we cannot free our clients from neurogenic inflammation. Until the work of Barral, Hazen, and Martine(15), we had no way to mitigate neurogenic inflammation. Mark’s discovery was about how to address inflamed nerves using the laser in conjunction with Rolfing. In the authors’ experiences, this method is the quickest and most efficient way to address what traditional Rolfing techniques often miss. See Figures 1 and 2.

<img src=’https://novo.pedroprado.com.br/imgs/2010/1092-1.jpg’>

<img src=’https://novo.pedroprado.com.br/imgs/2010/1092-2.jpg’>

Figures 1 and 2: Jon Martine using the laser to reduce neurogenic inflammation and release fascial strain.

 

What the Laser Does

The low level cold laser is clinically proven to increase two things: (1) cellular energy production and regeneration (without the reciprocal release of free radicals or increase in inflammation), and (2) cellular communication. Cellular regeneration involves the physiology of cell metabolism, mitochondria and the synthesis of ATP.(16) Cellular communication involves the nervous system, phospholipid cell membrane and the integrin system.(17) The biochemistry is complicated and the physiology even more so; but generally the different frequencies programmed into the laser’s diodes stimulate integrins  –  the photoreceptor cells on the phospholipid cell membrane –  to produce a variety of different enzyme cascades.(18) The laser accomplishes these two broad tasks by varying the frequencies (Hz) to produce the desired results.

To increase energy and regeneration, we use various frequencies to elicit a wide range of changes, from reduced inflammation to increased stimulation of muscle spindle fibers.(19) To increase communication, we enhance transmission of information via the three-dimension collagen fiber living-matrix that Dr. Oschman writes about.(20) This communication has been measured at the speed of light and is believed to link changes in the mitochondria across all ten body systems – i.e., the muscular, skeletal, endocrine, respiratory, etc., systems.

 

Use of the Laser within the SI Paradigm

In our clinical practices, the results we achieve using the laser in support of the goals and objectives of SI are consistently greater than those we achieve without the laser. It is the extraordinary results the laser produces that compels us to teach, write about, and urge consideration of this new tool and the inclusion of the neural tissue in the conception of our work. The science of the low-level cold laser is well-established in peer-reviewed literature.(21) We hope that someday the science and basis of SI is equally well established. Meanwhile, what follows is an outline of why and how we use the low level cold laser in the context of structural integration.

 

Why We Use It: What We Have Learned

By trial and error, accident and experiment, our use of the cold laser brought us the following insights, which ground our use of the laser as an adjunct to SI:

1. That the physiological and mechanical aspects of neurogenic inflammation might be the single most neglected factor in the understanding fascial restrictions, joint malalignment, subluxations, and lesions.

 

2. That the inability of the efferent nerves to fully fire the muscles, which stabilize joints, might be the single most neglected reason why structural changes sometimes do not hold.

 

3. That the cooperative relationship between afferent and efferent nerve function might explain what actually happened under Dr. Rolf’s hands, and therefore might explain what she taught.

 

4. That the neurophysiology of afferent and efferent nerves, peripheral and cranial nerves, sympathetic and parasympathetic nerve balance, brain hemispheric balance, and various ailments and injuries actually influence, if not constrain, our ability to achieve the goals of structural integration.

In our view, these discoveries and insights are a logical extension, evolution, and advancement of Rolf’s observation that “the study of nerves per se are not the province of structural integration. Our work deals primarily with systems derived from the mesoderm.”(22) Our purpose here is not to diverge from the fundamental tenets of SI, but only to acknowledge new information supporting the critical role of the nervous system in respect to the behavior of mesodermal tissues and to show how easy it is to incorporate this understanding into our work using the laser.

We believe that it is a now possible to leverage the unique paradigm of our work into a somatic practice that can call forth the person’s innate blueprint of perfection at a life-transforming cellular level. This work requires the same discipline of a traditional Rolfing session or series  –  including that the work be an extension of our heart and soul.

On the one hand, with the laser it is not only possible but common to achieve in each session what Michael Salveson calls unique states of consciousness. One innovative aspect of Rolf’s work was the primacy of order and pattern. According to Salveson, explicit in Rolf’s work is the idea that “patterns of order in the body” might be “constitutive of states of consciousness”: “A Rolfing session that moves a person into alignment with gravity is often accompanied by heightened energetic, perceptual and intentional or volitional awareness and control.” (23) Salveson goes on to say that how the parts are related produces the desired results. The good news is that with the laser we can produce these results with more regularity than without the laser. The energy from the laser lets the practitioner make changes and communicate them to every cell in the body. As a result, patterns of order come directly from the mitochondrial energy and mitochondrial DNA processes, where many believe a blueprint of perfection originates and is instantaneously transformed across all body parts and systems.

On the other hand, we have the dramatic structural and functional changes that come from the laser’s nearly instantaneous effect on neurogenic inflammation (and resultant myofascial restrictions), cellular inflammation, nerve imbalance between and among body systems, hemispheric imbalance in the cortex/cerebellum control of posture and movement, sympathetic dominance and parasympathetic depression, and loss of afferent/efferent information and control. In our experience, these remarkable changes become routine when the laser is used as an adjunct to Rolfing.

 

How We Use It: Strategies in a structural integration session

We teach very specific ways to use the laser in a Rolfing session. Typically, we use it for three strategies: (1) balance and testing, (2) healing and repair, and (3) stabilization and integration. Each strategy respects the time-honored principles, goals and objectives governing each Rolfing session.

Our choice of lasers is based on both safety and the availability of substantial and reliable clinical data. We have chosen to use the lowest-power laser on the market: the Erchonia Low Level Cold Laser, which has a power output of 1/200th of a watt and a wavelength of 635 nanometers (a nanometer is a billionth of a meter). It is the safest, most-studied, and most-sophisticated laser on the market. The wavelength has been proven in many clinical trials to pass through cell membranes without a single recorded instance of damage of any kind.(24) It has also been cleared by the FDA for adjunctive use in various pain and rehabilitative therapy.

 

Balance and Testing

Most sessions begin with three to five testing protocols, the first of which is designed to establish that applied kinesiology (AK) can be used to make further determinations. In accordance with strict testing protocols(25), we use the laser to address issues in the brain, spine, organs, impingement sites, and tissue memory to find a strong muscle that is both testable and not switched. Next, we test hemispheric balance, looking for the cerebellum or cortex that displays weak. The laser is used to correct the weakness and hemispheric balance is restored. Third, we test the parasympathetic cranial nerves (III, VII, IX and X). Using AK and the laser, we work with weak-appearing parasympathetic cranial nerves until they exhibit strength.

The fourth and fifth protocols are optional depending on the practitioner’s skill and the client’s needs. We primarily use Liz Gaggini’s tilt and shift model, which gives us a starting place to understand malalignment, malfunction and course of action. We then use AK as yet another way to verify the most neutral and original pattern of the client.

Last, we will sometimes use an advanced technique called gait analysis to determine whether or not the muscle-firing pattern has been altered such that key muscles are firing when they should be inhibited. This is not a “walk while I watch you” assessment: it is a very sophisticated and accurate test. We believe that a failed gait test or incorrect muscle firing sequence reveals the most fundamental and deepest cause of almost everything that appears in our office that seems resistant to holding change. Performing all of these tests takes only five to seven minutes and they are taught in our basic training.

 

Healing and Repair

We believe that malalignment and myofascial distortions are a function of neurogenic inflammation. Therefore, after testing has identified the relevant issues with form and function, we address all of the restrictions that stand in the way of achieving the structural goals of the particular session. In general we will spend from half to three quarters of the session addressing these fascial restrictions.

 

Stabilization and Integration

Most sessions need an integrating piece at the end. With the laser, a common one is to address all the weak acting muscles crossing the joints of greatest interest (i.e., either the shoulder/neck complex or the pelvic girdle and all joints below). When we use the laser to up-regulate the energy of the efferent motor neurons, the effect is dramatic: the client usually feels the internal strength that comes from muscles fully firing to stabilize key joints. Later in the series, we often use Jon’s methods to integrate girdle movements with the spine, in which the laser is set in a stand and directed to the spine while a particular movement is practiced (see Figure 3). We can use this approach with clients on wobble boards or Bosu balls, or performing movements of particular interest. This work can take ten to twenty minutes.

<img src=’https://novo.pedroprado.com.br/imgs/2010/1092-3.jpg’>

Fig.3: Jon Martine using the laser to integrate girdle movements with the spine. (Note: the laser would normally be placed in a stand, but is held in this photo by a workshop participant)

 

Examples

We are confounded by how to express results, which as witnessed or felt, are so remarkable that they seem exaggerated – or even perhaps fabricated. Our clients have had their “never-quite-resolved” issues addressed and resolved – sometimes in a single session. Injuries that prevent normal session work can now be addressed, resolved, and eliminated as obstacles toward optimum form and function in a single session. When the laser is used at the outset for balance and structural testing, session benefits of healing and repair, and stabilization and integration, are much greater than would otherwise be expected.

For example, one problem traditional methods of Rolfing cannot easily address is hemispheric brain balance. To understand its importance for integration in gravity, try this exercise: Stand with your ankle bones and toes touching. Look straight ahead and then close your eyes. Notice what happens. Do you sway more to the left or more to the right? If you sway more to one side than another, the side of your cerebellum to which you sway is not summating properly, in which case you simply will not be able to maintain a clear midline. Of course, the midline is a major axis of orientation for the human body and the better established it is, the better organized the structure is. Continual listing to one side progressively imbalances the structure, and somatic dysfunctions get progressively worse. With the laser, hemispheric imbalance can be corrected early in the series – in a matter of seconds.

Another important function of the laser is its ability to reset neuro-muscular-skeletal conditions. Accompanying pain, injury or poor posture are often what appear to be weak muscles. However, the weakness is most often from nerves not conveying information to the muscles. When the problem is with the nerves, not the muscles, no amount of gym (or home) strengthening exercises will restore proper function. Whatever caused the physiological dysfunction, and whatever exercises the client does, the weak muscles will neither regain nor sustain their normal strength until the relevant nerve/muscle complex is turned back on. Unfortunately, because traditional Rolfing techniques do not address this kind of weakness in the information system, any attempt to integrate the person in gravity is compromised when it is present. Fortunately, the laser allows us to reset the conditions within thirty to sixty seconds.

 

Conclusion

While the cold laser most certainly cannot accomplish the work of SI unless it is used by a competent structural integrator, it does allow the SI practitioner to achieve results far greater than those achievable by traditional SI techniques. Conversely, the SI viewpoint and context seem to maximize the laser’s potential.

By our conservative estimate, Certified Rolfers and Advanced Rolfers have delivered between twenty and thirty thousand sessions of laser-assisted SI. Based on this collective experience, in addition to our extensive personal experience, we believe that SI, as measured against some ideal of neutral or optimal form and function and innate perfection, is enhanced by appropriate changes to the nervous system. These changes address the structural inefficiencies created by cellular and neurogenic inflammation; the down-regulation of efferent nerves that reduces muscle strength and destabilize joints; the brain hemispheric control of absolute balance and centeredness; the balance of sympathetic and parasympathetic function; and muscle-firing sequence malfunction. We believe the cold laser is the single-most-effective currently available means through which to evoke these changes in the context of structural integration.

 

Endnotes

 

1. Maitland, J., “The Too-Good to Be True Machine.” Structural Integration: The Journal of the Rolf Institute, June 2004.

 

2. Sommer, C., “A New Paradigm: On Nerve Tissue Treatment. Structural Integration: The Journal of the Rolf Institute, December 2006.

 

3.Hazen, D., DC, “Peripheral Nerve Work – Compare and Contrast.  Structural Integration: The Journal of the Rolf Institute. March 2008.

 

4.Frank, K., “The Confluence of Neuroscience and Structural Integration: A Discussion with Sandra Blakeslee,” Structural Integration: The Journal of the Rolf Institute, June 2009.

 

5. Dalton, E. An Interview. Structural Integration: The Journal of the Rolf Institute, Spring 2001, pp. 5-7.

 

6. Smith, J. The Core as a Coordination: Structural Integration: The Journal of the Rolf Institute. June 2008.

 

7. Frank, K. A., Discussion with Sandra Blakeslee. Structural Integration: The Journal of the Rolf Institute. June 2009.

 

8. Schleip, R., “Fascial Plasticity – A New Neurobiological Explanation,” Parts 1 and 2. Journal of Bodywork and Movement Therapies, March and April 2003.

 

9.See http://dhazen.com/neuropages/nerv_struct.html.

 

10. As an acupuncture patient of Dr. Peter Courtnage L.Ac. in Anchorage, Mark observed his combination of manual manipulation techniques with a low-level cold laser. In his own experiments, Mark discovered that nerve inflammation disappeared significantly faster under a combination of visceral palpation touch and the laser than with either of them used alone. This observation has been confirmed through over 6,000 hours of laser use to eliminate fascial restrictions caused by neurogenic inflammation.

 

11. See http: //dhazen.com/neuropages/nerv_struct.html, “Report Overview, The Embryonic Background,” where Hazen states, “What mesoderm structures exist at that time (third and fourth week) are primarily to support this neuron factory (a nervous system).”

 

12. Allen, Michael D., DC, NMD, DAAPM, DIBAK, DACAN, DABCN, Chiropractic Neurologist. “The neurology of spinal erection, research report from the Space Shuttle Columbia.”

 

13. Quintner, J.L. and M.L. Cohen, in Referred Pain of Peripheral Nerve Origin: An Alternative to the “Myofascial Pain” Construct, cite epistemological, clinical and pathophysiological grounds that myofascial pain syndrome (i.e., trigger points) is invalid and that the phenomena it purports to explain is better understood as secondary hyperalgesia of peripheral neural origin. 1994. Clinical Journal of Pain, 10, 243 – 251.

 

14. Hazen, D., “The Neurology of Posture,” and “The Peripheral and Cranial Work of Jean-Pierre Barral and its Relation to Pain, Neurogenic Inflammation and Structure” at http://dhazen.com/neuropages/nerv_struct.html.

 

15. Jon Martine has established beginning and advanced trainings devoted to the palpation and identification of inflamed nerves that cause myofascial restrictions. See http://www.integrativehealthinc.com.

 

16. Karu, T., Ten Lectures on Basic Science of Laser Phototherapy, Laboratory of Laser Biology and Medicine, Institute on Laser and Informatic Technologies. Troitsk: Russian Academy of Sciences, Moscow Region, 2007, p. 120: “Free energy from this redox chemistry is converted into an electrical potential across the inner mitochondrion, which ultimately drives the production of ATP. The laser stimulates cytochrome c-oxidase as the central role in this bioenergetics equation.”

 

17. Oschman, J.L., Energy Medicine in Therapeutics and Human Performance: Elsevier Limited, Cambridge 2003 (see Ch. 8, Introducing the Living Matrix).

 

18. These concepts are fully explained in Turner, J. and L. Hode, Laser Therapy: Clinical Practices and Scientific Background. Churchill Livingstone, Cambridge, Prima Books 2002.

 

19. Students in our laser trainings receive a manual with descriptions of possible changes and the specific frequencies and their protocol for each change. The laser has the potential for a million different frequencies. See also Manual for Physicians, Dentists, Physiotherapists and Veterinary Surgeons. The Low Level Laser Therapy as a Medical Treatment Modality by Professor Dr. Med. Pekka Pontinen Kuopio: Art Urpo Ltd.,2003, one of the original Scandinavian laser-therapy pioneers, who presents the applications of low-level laser therapy for medical biostimulation, pain relief and pre- and post-operative care. Pontinen provides comprehensive theoretical and practical information on how to apply low-level laser therapy in the treatment of chronic pain with focus on musckuloskeletal and myofascial pain and dysfunction, vascular disturbances, wound healing, and ulcer treatment. He gives a special attention to the role of soft lasers in acupuncture.

 

20. Oschman, J., Energy Medicine, The Scientific Basis. Edinburg: Churchill Livingstone, 2000. See Chapter 3 (The Circuitry of the Body) for research and citations supporting the living matrix whereby trans-membrane linking molecules, or integrins, link intra- and extra-cellular environments electrically and physically throughout the whole body.

 

21. Perform a Google search on “low-level cold laser” within PUBMED.COM for hundreds of articles on this subject.

 

22. Rolf, I., Rolfing: The Integration of Human Structures. Rochester, VT: Healing Arts Press, 1977.

 

23. Salveson, M., “The Evocation of Unique States of Consciousness as a Consequence of Somatic Practices.” Structural Integration: The Journal of the Rolf Institute, June 2008. In no way are we implying that Salveson endorses this article or the laser. We use this reference only out of a need to express a type of result found in our sessions, out of respect for his ideas, his stature as a student of Dr. Rolf’s, and his long and distinguished tenure on the Advanced Faculty of the Rolf Institute.

 

24. In the Preface to D.A. Chu’s Efficacy of the Low Level Laser (LLL) in Physical Therapy (Mckinney, Texas: Erchonia, 2010), Erchonia President Steven Shanks reports: “Although the technology has become more sophisticated over time, the benefits of low-level lasers or cold lasers has not changed much and has been well-documented for wound healing, physical therapy, nerve regeneration, and pain management. In fact, there are more than 2000 published articles worldwide and not one reports any negative side effects. This is one of the reasons why the Erchonia lasers fall into the laser classification of 3A, which is considered a non-significant risk factor by the FDA.”

 

25. Hawkins, D., Power versus Force. Carlsbad, CA: Hay House, Inc., 2007. See Chapters 2 and 3.

The Low-Level Cold Laser as an Adjunct to Rolfing Structural Integration[:]