Rolfing and Pilates: Dynamic duo for low back pain
by Mark Powell
Finally, about 20 years ago, a now-colleague of mine, Wayne Henningsgaard, did a series of Rolfing sessions that totally eliminated my back problems, an experience that eventually inspired me to become a Rolfer® myself.
I had occasional back problems after that, but usually I would have to do some fairly extreme athletic hijinx to re-injure my back (I also taught PE part-time for some years.)
In short, I received the lesson: Our healing will always require our own responsibility. For lower back pain, one of our responsibilities usually has to do with strengthening. A Rolfer’s hands can lengthen, soften, and differentiate a client’s tissues; they cannot strengthen muscles that are weak or flaccid. That requires exercise, but not just any exercise: Where lower back pain is concerned, strengthening must be especially smart, elegant, and highly specific.
I’ve always given my clients yoga postures to practice and sent them to yoga classes. I’ll continue to do this, because yoga is a powerful adjunct to the Rolfing work. But I’ve recently come across a unique exercise system which is based upon a deep, balanced strengthening of the core of the body, the trunk, and all of the muscles associated with the lower back. This system is called Pilates.
The Pilates Method
The Pilates Method is a comprehensive and systematic approach to changing and supporting body structure and function. It is located at the intersection of physical fitness and physical therapy, being both a diagnostic and a prescriptive system. The Method employs specialized equipment that uses springs as resistance. The springs expand and contract like your muscles. This creates a strong but long and lean muscle fiber, as opposed to the bulky muscle fibers which typically result from weights. The Pilates exercises emphasize awareness, sophisticated integration of movement and balance, and functional strength. Amazingly, the movements simultaneously strengthen and stretch the body, where more conventional strengthening methods shorten tissues. The exercises strengthen the core muscles that support movement as well as focusing on precise alignment and correct body mechanics. In the Pilates Method, the focus is on using the entire body in an integrated fashion through strengthening, stretching, and movement re-education.
The Rolfing Method of Structural Integration
In Rolfing, the goal is to create deep, comprehensive order, alignment, and integration of the body in gravity. Rolfing quite literally changes your shape, sometimes dramatically. Instead of exercises, Rolfers use their hands to carefully soften, stretch, and lengthen the soft tissues of the body (muscles tendons, ligaments, and fascia) in a highly specific and systematic way, restoring ease, alignment, and “order” to the body. People feel lighter, more balanced, energized, more grounded. They are longer and more upright. They experience greater range of motion, fuller breathing, and usually any pains they have are at least significantly reduced. Quite often they are eliminated.
Pilates and Rolfing together
Rolfing and Pilates achieve complementary goals by different means–one through exercise and one through bodywork. Both systems design your program based on a visual analysis of your structure. Both systems emphasize differentiation of body parts (i.e. raising your arms up over your head should not require bulging neck muscles, and so on) and learning to move from the core (our deep, intrinsic muscles). Both systems are re-educating movement patterns. Both are creating balance and stability while simultaneously increasing mobility–fluid, graceful, and continuous movement. Because of these and other points of overlap, a Pilates instructor named Dylan Skybrook and I are working together more and more frequently, referring people back and fourth. The results for these clients have been excellent.
For an example, let’s look at a staggeringly simplified snapshot of how Rolfing and Pilates might address low back pain, specifically low back pain which is caused by hyper lordosis, the exaggerated lumbar (low back) curve, a very common pattern.
Rolfing response
There are many elements involved in this pattern, and whatever I change in the pelvis will necessitate changes throughout the structure-above and below. Nevertheless, restricting my discussion to the “local” pelvic scene, some of the first muscles I would look at as “likely suspects” in the forward tilted pelvis (which usually, though not always, accompanies hyper-lordosis), would be the muscles involved in hip flexion and the layered webworks of connective tissue which enwrap them. I’ll also assess the activity of the hamstrings and the rotator muscles, which can restrict both the hip joints and the sacrum.
“Freeing the pelvis” also usually involves addressing the various lower back muscles and the strong ligaments which hold the sacrum in place (the sacrum is the triangular bone at the base of your spine; the point of the triangle being your tailbone).
Very slowly and mindfully, I will work with these tissues; sometimes softening and stretching, sometimes “ungluing” a structure which has become stuck and undifferentiated from its neighbor, sometimes just sinking in deeply, letting the hard, tough tissues “melt” and invite me in. It is all about pacing, rhythm, and sensitively listening to the tissues. (In other words, no, Rolfing does not hurt!) The result is that the pelvis can soften down and back, compression on the lumbar vertebrae is eased, and length spans through the lower back. The legs feel loose and free and spacious in the hip joints.
Pilates response
Maybe you can imagine how this pattern-anterior pelvis with an exaggerated lower back curve-also “spills” the stomach and viscera forward, creating the appearance of more “tummy” than you truly have. Then imagine how a new and potent sense of abdominal support would transform the whole situation.
This Pilates does like no other system I know of! The Pilates work strengthens the deepest layers of the abdominals, creating a dynamic sense of support for the whole torso. We’re not talking about crunches and sit-ups that merely shorten the front of the body, but rather a powerful strengthening of the entire “corset” of muscles around and throughout the torso. The result is an exceptional quality of pelvic stabilization.
In addition, due to the uniqueness of the Pilates Method, it is simultaneously re- educating movement, such that our movement begins to come from our core. Pilates work is ultimately about fluid and fluent, graceful movement.
Both Rolfing and the Pilates Method address low back pain (stemming from an exaggerated low back curve or a panoply of other causes) in many more ways than this article allows. I hope I’ve made it abundantly clear that addressing low back pain is just one very small aspect of both Rolfing and Pilates. Both are tremendously rich, elegant, and fully elaborated systems for creating dynamic change, grace, and freedom in the body. Often, either one by itself will clean up lower back problems. Together, they are uncommonly potent.
©2007