Scoliosis is characterized by asymmetrical tensions in the muscle and fascia system of the entire body. These cause the body to slowly twist and contract over the course of months and years. This is how the well-known S-shape of the spine develops. This twisting causes further symptoms such as pelvic obliquity, unevenly high shoulders, tension and headaches up to a reduced lung capacity. Scoliotic adolescents usually have no back pain.

Scoliosisis defined as a lateral curvature of the spine with simultaneous rotation of the vertebrae. The spinal column forms arches in the generally known S-shape or C-shape which compensate each other in order to maintain body weight.

Idiopathic scolioses usually develop from the age of 3 and worsen during periods of increased growth, especially between the ages of 10 and 16. The cause of idiopathic scoliosis (90%) is unknown. Functional scolioses (10 %) never reach the high degree of curvature of ideopathic scolioses. They occur, for example, as a result of vertebral fractures, operations, accidents, differences in leg length and nerve diseases.

You have probably already studied the orthodox medical findings and treatment methods for scoliosis extensively on some websites. If not, you will find a good summary of these facts in Wikipedias article about scoliosis.

How do I recognize a scoliosis?

You can recognize a scoliosis by different characteristics.

• The head does not sit in the middle over the pelvis.
• The shoulders do not have the same height.
• The tips of the shoulder blades are not at same height.
• The torso deviates from the midline. (Plumbline deviation)
• The „waist triangles“ (air space between arm and pelvis, siehe picture) have different shape and height.
• One hip is higher and more antrior and sometimes there is a leg length discrepancy.

Foto: www.kid-check.de

In the Adams-Test, the patient tilts forward and lets his arms hang loosely. If you stand behind the patient and look at the bent back, you will notice a scoliosis if …

• one shoulder hangs further down, the other shoulder stands further up (incipient rib hump)
• one-sided, more pronounced lumbar muscles (the so-called lumbar bulge)
• spinal collumn has a curve

Only when you take a closer look can you see that the spinal column is often twisted by 20° to the Cobb Angle. The specialist uses an X-ray to determine the Cobb angle of the individual curvatures of the spine and the rotation of the vertebrae in the vertical plane. Important data for the prognostic course are age and in girls the first menstrual period. – As the majority of untreated scolioses worsen, early detection is of outstanding importance.

Follow-up

Only 5% of juvenile scolioses are not progressive. The remaining 95 % increase by about 1 to 5° annually until reaching the age of 10. In adolescence, i.e. after the age of 10, they increase by 5 to 10° per year during the pubertal growth spurt. Within one year the angle can shift by up to 40°. Therefore, a 3 to 6-month follow-up by a specialist is indispensable.

Radiography X-rays are necessary for the diagnosis, but they mean radiation exposure. For this reason, they should not be taken more frequently than every 6 months for children, every 12-18 months for adolescents and every 24 months for adults (2) .

Rasterstereografie = 3D spine measurement
Rasterstereografie  is a light-optical measurement of the back surface. Although it is not suitable for diagnosis, it provides sufficient results for follow-up. It is state-of-the-art and is used in combination with X-rays.

Medimouse / Spinalmouse
Medimouse is a device similar to a computer mouse that is used by doctors to move along the spine. A three-dimensional image of the back line is displayed on the PC screen. The system is suitable for monitoring the progress of the therapy and its progress.

EOS 3D low-dose X-ray (Promotion Video)
The EOS x-ray generator is an alternative to classical x-rays and provides 3D x-rays with up to 80% less radiation exposure. In German-speaking countries, however, it is only used in a few clinics: at the University Hospital of Heidelberg, the Dortmund Clinic, the Friedrichsheim University Hospital, the Bad Sobernheim Clinic and the Balgrist Clinic in Zurich. You have to reckon with 250 Euro per x-ray.

Research into the cause

Progression of scoliosis
Various factors contribute to the progression of scoliosis, such as gravity itself, muscle actions, human gait, growth-induced torsion(3), and Davis’s Law(4), which states that tendons and ligaments shorten when they are not used or are too loose.

Cause of ideopathic scoliosis
As far as the state of research is concerned, slight disturbances of the sense of balance (vestibular dysfunction and nystagmus) have been frequently found in patients with scoliosis. Studies from recent years are increasingly dealing with this topic(5),(6). It is also being considered whether vestibular asymmetries could be the cause of ideopathic scoliosi (7),(8). In a metastudy the hypothesis is formulated that the origin of scoliosis lies in a slight asymmetry of the neuromuscular system(9).

I would like to ask you to consider this information when considering the following therapy options.

What are the options?

Orthodontic examination
An orthodontic examination certainly makes sense because there is a connection between scoliosis, weakness of the arch of the foot, pelvic obliquity, functional difference in leg length, asymmetries of the cervical spine and jaw asymmetries(10). Ideally, the bite plane height is tested using Professional Applied Kinesiology (PAH) techniques. The correction is then carried out by a dentist experienced in craniomandibular dysfunction (CMD).

Sensorimotor Insoles
The efficacy of sensorimotor insoles is often the subject of discussion(11),  because there are large differences in craftsmanship(12) and frequent mistakes are made in advice, product selection and application. The use of sensorimotor insoles is recommended for complaints emanating from the feet. However, insoles have the disadvantage that the feet quickly get used to the stimulus and then no longer react to it. It should therefore be clear that insoles cannot be permanent for many months or even years(13). Foot strength exercises, balance exercises and manual therapy are additionally necessary so that the feet soon no longer need the insoles.

Schroth method
The Schroth method has been used successfully for many years. Severe scolioses can be treated in rehabilitation clinics such as Bad Sobernheim or Bad Salzungen. Lighter scolioses can be treated by physiotherapists with Schroth training. The method is based on a combination of physical exercises and intensive breathing. With the help of so-called rotation-angle breathing and physical stretching, the spine is untwisted or unwound. With this method considerable progress could be obtained with even the heaviest scolioses, as is proven by many studies. Christa Lehnert-Schroth’s book “Three-dimensional scoliosis treatment” provides information about this.

Voita-Methode
The Voita-Medthode is based on the activation of reflex crawling, reflex turning and reflex locomotion (reflex crawling). Prof. Václav Voita has developed the method in newborns and it is now also used in adults. Repeated triggering of the reflex-like movement leads to release and re-insertion within the blocked nervous networks between brain and spinal cord. The method has a broad spectrum of effects, for example in cerebral paresis, scoliosis or hip dysplasia. It is offered by physiotherapists with Voita training. The method should be used three to four times a day for 20 minutes by the mother on her child or partner. With babies this can be easily done, with adolescents and adults with scoliosis it seems rather difficult to integrate the method into everyday life.

Spiral Dynamics
Spiral Dynamics is a three-dimensional movement concept that is occasionally offered by physiotherapists. The principle and the exercises from spiral dynamics are used in scoliosis treatment. One tries here to dissolve the scoliotic twisting of the body with a natural counter spiral. With the movement concept you have a nice introduction to understand the functioning of your body in movement. There are no studies on the effectiveness. Spiraldynamik AG offers 3-day seminars in Zurich for scoliosis patients. With the book “Skoliose Aufrecht durch Bewegung: Die besten Übungen aus der Spiraldynamik” by Christian Larsen will get you a good introduction and at the same time you can recognize the limits of the method.

Yoga, Pilates und Gyrotonic
You can use Yoga, Pilates or Gyrotonic to accompany scoliosis therapy. However, it should be remembered that with global stretching you help the body to become more elastic, but with stretching you usually do not reach the “hot spots”, i.e. the locally highly tense parts of the body, and run the risk that the spinal column therefore evades into the scoliotic pattern, and the scoliosis thus intensifies and progresses faster (14). The methods are therefore only suitable under expert guidance as an accompaniment to manual scoliosis therapy.

Sport
Dancers, swimmers and gymnasts have a lower risk of scoliosis(15), and sport does not harm scoliosis in general(16). Rather, sport, dance and physical games promote dexterity, the ability to balance and general body awareness. They help therapies such as the Schroth Method or manual therapies such as osteopathy or Rolfing to work better. Climbing, bouldering, slacklining (balancing), swimming, horse riding, dancing, ballet, athletics, floor gymnastics and Pilates are beneficial sports. Avoid weightlifting, high diving, golf, tennis, gymnastics or bodybuilding. Strength training is also the wrong approach because you cannot train scoliosis away by building up individual muscles. Rather, it is a matter of learning a new movement pattern by activating muscle chains – which preferably extend from head to toe – and integrating them into your everyday life and into your sport so that this movement becomes a second nature.

Balance exercises
Propriozeption is the sense for the position of your body in space and, together with the sensitivity to depth and the sense of balance, helps people to straighten up, to move, to walk and also to balance. Scoliosis patients have deficits here because the internal map of their body, represented in the brain, is partially distorted or not sufficiently pronounced(17). This causes scoliosis patients to move crookedly, but believe that they are straight. Here, balance exercises, preferably performed in front of the mirror, can help to align this internal proprioceptive map with reality. Therefore, balance exercises should be used with every scoliosis therapy. Frequent balancing strengthens the new pathways in the brain. In this way, movement patterns can change, the body learns to behave stably and at the same time elastically in an unsafe situation, and posture is improved. In the past, this was done by putting a book on the head of a young girl or by letting her walk on a rope. In my practice I like to use the Tuning Board by Darrell Sanchez.

Somatic Experiencing SE
The Somatic Experiencing^® method deals among other things with disturbances in the nervous system, which can also affect the sense of balance. These disorders may have arisen in early childhood or may be caused by traumatic events. In SE therapy, the autonomous nervous system is induced to reorient itself, which can also resolve balance disorders. These are closely linked to the orientation reaction, the basis from which the brain projects a movement and then executes it. The SE method will not eliminate scoliosis, but it can help you find a safe base.

Chiropractic
The American Chiropractic is an independent profession in the USA, which may even do surgery in some states. For the treatment of scoliosis, local chiropractors like to market a combination of chiropractic, Schroth method and SpineCore corset. Marketing strategies and the ethics of the profession are under discussion in the USA(18). American Chiropractic is rarely found in Germany. Here in Germany, chiropractic may be practiced by a doctor or alternative practitioner with appropriate additional training. From my point of view it can be used for very severe scolioses in addition to manual therapy such as Rolfing or osteopathy.

Osteopathy
In the Anglo-American countries and in Europe, osteopathy is a recognized profession with extensive training. Recently there has been an increasing effort to prove the effectiveness of the method through studies, which has been partially successful. Osteopathy is certainly a good choice for the treatment of scoliosis in children in their early stages. It is also suitable for the treatment of functional disorders caused by scoliosis in the organs and fine membranes of the brain. Osteopathy is a self-contained medical system that follows the principles of applied anatomy, physiology and pathology. It is based on the assumption that the body is a unit which always participates as a whole in health and illness.

Rolfing
Rolfing^® – Structural Integration has recently been associated more frequently with findings from fascia research by Robert Schleip(19) (20)..The properties of fascia are redefined by this research; these findings are noticed in the fitness and sports community and are discussed at congresses(21). In Rolfing one works with the fascial structures in the body in order to release chronic tensions and thus enable the body to stand up and move freely. Rolfing is therefore ideal for the treatment of scoliosis. Each scoliosis is a slow movement, in which the body twists and contracts at the same time, so that the spine moves sideways. The entire fascial system from the head to the spine to the feet is affected by this scoliotic twisting. In Rolfing, we work to unwind this scoliotic torsion, i.e. to achieve de-rotation and de-compression of the spine. – There are impressive case studies of what the Rolfing method can achieve.

Erik Dalton describes in “Scoliosis: A Case Study” how he treated the pictured girl with the Rolfing method in 1993. The two photos are 3 years apart(22).

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Dynamic corsets
An alternative to the hard shell corset is the dynamically correcting corset from SpineCore. It allows the body the necessary freedom of movement, can be worn under clothing and is used for children and adults up to an angle of approx. 30° on the Cobb scale/angle. Actually, it is not a corset, but rather a kind of bandage that gently pushes the body into the new movement pattern. However, the SpineCore corsets are not suitable for every scoliosis, they demand skill and expertise from the orthopaedic technician and committed behaviour from the patient. Currently, SpineCore corsets are only available in Freiburg, Germany.

Hard shell corsets
I do not share the view that one waits and does nothing until the scoliosis has reached 20° and then prescribes a corset. Rather, even low-grade scolioses should be treated as early as possible. Hard shell corsets are always controversially discussed. They reduce the quality of life(23),  and reduce the vital capacity of the lungs because they compress the ribs(24). The reduced lung function is comparable to that of a smoker. Corsets restrict movement, which is why the back and abdominal muscles atrophy (shrink); in the long term, joint problems can arise due to the lack of movement. The corset impedes mobility at a time when young people should try out their bodies intensively and move around a lot. If the corset is taken off, the body tends back to the scoliotic pattern because it could not create a new movement pattern. Therefore, it must be “trained out”, i.e. slowly discarded. Behind the corset is the idea that scoliosis can be pushed out of the spine laterally. This is a mechanical rather than a neurological view. If the back is slightly crooked and the brain thinks it is straight, movement therapy makes more sense than immobilization through a corset. Nevertheless, corsets continue to be prescribed because they have proven their worth to a certain extent. The corset technique has been refined in recent decades, but the success rate between corset types is very different(25). Unfortunately, it is impossible to predict whether and to what extent scoliosis will worsen. According to a study, 72 % of corsets are therefore successful depending on how long they are worn, compared to 48 % in the control group, which did not experience any deterioration without the corset. In other words, corsets are largely unnecessary, but one does not know when(26),(27).  In summary, if scoliosis becomes increasingly severe despite the use of alternative therapies and all your efforts, the corset may become necessary.

Operation
Orthodox medicine recommends surgery from a 40° Cobb angle. During the operation, metal rods are inserted and spinal sections are stiffened. The rate of complications caused by the operation is considered high(28). 19 % of those who have undergone surgery must be post-operated(28). 10 % have postoperative pain for more than one year(29).  25 % of those who have undergone surgery have chronic pain and therefore visit a pain clinic after years(29). 15 % of children report moderate to severe pain five years after surgery(30). Adolescents say they have more pain five years after surgery compared to two years after surgery(31). The failure rate of spinal surgery is assessed very differently and it seems difficult to predict failure based on factors such as tobacco use, obesity, depression, social factors or stress(32). The decision for or against surgery is also discussed among experts and examined in metastudies(25),(33) worth reading. The list of pros & contras from kidhealth.com(34) is clear and understandable for the average person. – The decision is certainly not easy and always depends on the individual case. If you have decided to have an operation, you need a surgical team that will advise you well and also look after you after the operation.

Graphic: Scoliosis Syndrome By Karena Thek

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My recommendation

You will not need or be able to take advantage of all the above therapy options. Therefore here now my recommendation.

• Medical specialist:
  Please visit follow-up checks regularly please clarify sensorimotor insoles Bite correction by the orthodontist
• Physiotherapy:
  Spiraldynamik, Schroth-Method, preferably from one source with the physiotherapist – so that you can get into motion and get to know your movement patterns.
• Sports
  At least 3 times per week e.g. climbing, jogging, swimming, water aerobics, etc.
• Manual therapy:
  Rolfing or osteopathy or both – so that the chronic tensions in the muscles and fasciae are gradually released.
• Movement training:
  You need a coach for movement, posture and for your self-perception of standing upright. This can be a Feldenkreis teacher, dance teacher or Pilates trainer.
• Balance exercises
  You should balance daily for a few minutes. It helps you build stability and trains the nervous system. I have listed it as an extra point because this exercise is so essential.

My way of working

In my practice we will find exercises specially tailored to your needs that you can integrate into your everyday life. We will work on your posture, your gait and the way you sit on chairs. We look at those movements your body lacks, has forgotten or doesn’t know, and then explore new movement possibilities. We explore how you can create stability and length in your body. It is not about control that you force on your body, but rather about playful searching, trying out and exploring new territory.

I will pave the way to this new, stable and yet flexible posture by releasing hindering tensions in your body with the Rolfing method. For this purpose you will spend more than half of the time on the massage bench in each session.

But much more important is that you become active in your everyday life, that you try again and again to deal consciously with your body and that you find joy in creative play with movement, that you are active in sports or dance and develop a feeling for balance.

This is the way I can accompany you or your child.

Journal Rückenzeit

In the journal „Rückenzeit“ you will find an interview with Stephan Lautz about scoliosis. Just click on the picture or  here.

References:

1  Quelle Foto: www.kid-check.de Die Aktion gegen Haltungsschwäche!
2  “SOSORT 2012 consensus paper: reducing x-ray exposure in pediatric patients with scoliosis” Patrick Knott, Eden Pappo, published 2012
3  “2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth” Stefano Negrini, published 2011
4  Davissches Gesetz Wikipedia
5  “Development of Auditory and Vestibular Systems” Book by  R. Roman Seite 501
6  “Horizontal postrotatory nystagmus response in female subjects with adolescent idiopathic scoliosis” Jensen GM, published 1979
7  “Vestibular Asymmetry as the Cause of Idiopathic Scoliosis: A Possible Answer from Xenopus” François M. Lambert, published 2009
8  “Does adolescent idiopathic scoliosis relate to vestibular disorders? A systematic review.” Catanzariti JF published 2014
9  “Hypothesis on the Pathogenesis of Idiopathic Scoliosis” F.H: Wapstra , published 2012
10  “Wechselwirkungen zwischen Körper- und Kieferasymmetrie? Untertitel: Bedeutung der pädiatrischen Vorsorgeuntersuchung mit kieferorthopädisch-orthopädischem Screening” Heike Korbmacher, Dr. med dent, Gerald Eggers-Stroeder
11  “Sensomotorische Einlagen: Bei Beschwerden können sie helfen?” BR Fernsehen
12  www.fussgesundheit.info
13  “Effektivität und Wirksamkeit einer funktionell-dynamischen Schuheinlagenversorgung im Sport” Heiner Baur, Dissertation 2004,  S. 119 ff
14  “Probleme mit Hatha-Yoga-Übungen bei Skoliose”von Christa Lehnert-Schroth, ca 2014
15  “Physical activities of Patients with adolescent idiopathic scoliosis (AIS): preliminary longitudinal case–control study historical evaluation of possible risk factors” Marianne E McMaster, published 2015
16  “Is physical activity contraindicated for individuals with scoliosis? A sytematic literature review” Bart N. Green, published 2008
17  “Scoliosis and Proprioception” by Robert Schleip published 2000
18  “Chiropractic controversy and criticism” Wikipedia
19  www.somatics.de Webseite von Dr. Robert Schleip
20  Deutsche Gesellschaft für Myofascial Release e.V.
21  Fascia Research Congress
22  “Scoliosis: A Case Study” Eric Dalton, ca 1993
23  “Outcome assessment of bracing in adolescent idiopathic scoliosis by the use of the SRS-22 questionnaire” Kenneth M.C. Cheung, 2006
24  “Pulmonary restrictive effect of bracing in mild idiopathic scoliosis” J D Kennedy, published 1987
25  “2011 SOSORT guidelines: Orthopaedic and Rehabilitation treatment of idiopathic scoliosis during growth” Stefano Negrini, published 2011
26  “Auswirkungen einer Korsettversorgung bei Jugendlichen mit einer idiopathischen Skoliose: die BRAIST – Studie” Carolin Reuschel
27  “Effects of Bracing in Adolescents with Idiopathic Scoliosis” Stuart L. Weinstein, published 2013
28  “Rate of complications in scoliosis surgery – a systematic review of the Pub Med literature” Hans-Rudolf Weiss, published 2008
29  “Persistent pain in patients following scoliosis surgery” G. T. C. Wong, V. M. Y. Yuen, published 2007
30  “Pain prevalence and trajectories following pediatric spinal fusion surgery.” Sieberg CB, published 2013
31  “Adolescent idiopathic scoliosis patients report increased pain at five years compared with two years after surgical treatment.” Upasani VV, published 2008
32  “Predictors of surgical outcome and their assessment” Anne F. Mannion, published 2006
33  “Adolescent idiopathic scoliosis – to operate or not? A debate article” Hans-Rudolf Weiss, published 2008
34  “Cons of Having or Not Having Surgery” and “Pros of Having or Not Having Surgery” by www.aboutkidshealth.ca
35  Quelle Foto: Muscle Imbalances and Scoliosis

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If you have any questions, please feel free to contact me in my practice in Berlin or Munich. Here you will find the contact page.

Running and triathlon are among the sports that place the greatest strain on the body. Runners are particularly prone to injury from overuse due to repetitive movements. Nothing is more feared than a break from training in the middle of the season due to injury.

But what can you do to reduce the risk of injury? The answer is very simple.

Listen to your body, get to know it well, pay attention to its signals – and train correctly and intelligently. Pay attention to the “Five S” that have to be observed for correct training:

–

Speed Strength Stamina Suppleness Skill

–

Drill  Sergant – Building a Better Runner

Endurance and strength are certainly the two most important aspects of running. In order for these two elements to have a solid physical basis and for endurance training to be efficient, it makes sense to improve balance, freedom of movement, posture, muscular endurance and resilience. If you work on your “running economy” this way, your performance will improve and the risk of injury will decrease.

Whether it’s a torn muscle fiber or a joint injury, most endurance sports injuries are injuries to the connective tissue and fascia system. They usually occur when the tissue lacks elasticity and resilience, or when it is weak and structurally poorly organized and cannot cope with continuous stress.

Rolfing works with the fascial system with which you train.

• Rolfing^® dissolves matting in the tissues caused by strength training and injuries.
• Rolfing isolates individual muscles so that they can glide more easily and quickly. It supports your plyometric training for explosive movements.
• Rolfing releases deep-seated tensions. It frees your body from postures that consume unnecessary energy, strain your joints and lead to premature wear and tear.
• Rolfing supports your body in the rehabilitation period or at the start of the season by providing a balanced level of tension in the entire fascial system.
• Rolfing enables the fascia tissue to reorganize and regenerate faster during the recovery phase.
• Rolfing releases tension at strategic points that impair movement. Your body can then move more freely, more fluidly, effortlessly, resiliently and with less strain on the joints, and the risk of overuse is reduced.

Photo by James Chou on Unsplash

Only for Runners, Triathletes, Crossrunners and Marathon Runners:

• The history of injuries that your body brings with it and your training goals are in the foreground.
• The overriding goal is to strengthen your resilience throughout the system. Without the ability of the fascia to spring and store energy temporarily, you will not get far in endurance sports.
• Rolfing attaches great importance to soft, flowing, efficient movements. Therefore we will go through and analyze your movement sequences again and again.
• We work mostly on the massage bench, but also sitting and on the mat. Rolfing addresses the most important muscle chains for endurance sports as well as breathing and pelvic dynamics. Rolfing can be quite intense and your comfort limit is occasionally exceeded when we use stretch and deep tissue techniques.

Video on the subject:

Coach Brian Clymer shows how essential the role of posture is in sports. The video begins with the sentence: “Posture is the bedrock of any athletic movement. Posture is the most important ‘infrastructure’ that any technical model for running, sprinting, jumping or throwing is built upon.”

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If you have any questions, please feel free to contact me in my practice in Berlin or Munich. Here you will find the contact page.

I often receive clients with severe complaints. Here the respective topic is so much in the foreground that I do not work after the 10 series.  In such cases it is important to help the body to quickly reduce the pain symptoms to a tolerable level.

Some clients come to me to get the Rolfing® 10 series. They know that this is a process in which they are entering. They usually have rather minor physical complaints which we can integrate into the process of the 10 series.

„You’ll hear a lot of the word ,Recipe‘ flung around here, meaning that there is a route, there is a map by which you approach this, but I will not be happy if that’s all you know about what you’re doing!“
Dr. Ida P. Rolf (1)

The Rolfing 10 series was conceived by Dr. Ida Rolf when, after 30 years of practical experience, she began to pass on her method to students. Each treatment has a special focus and the whole series follows an inner logic. In the course of the ten sessions, the shortenings in the fascial system are worked on step by step and you learn to deal with the newly gained inner and outer freedom of movement.

Dr. Ida Rolf taught the concept of the 10-series to her students, but when she gave a session herself, she rarely stuck to it. The concept is therefore not worthless, but shows that it is more important to recognize what a body needs than to encounter it with a ready-made concept. The concept also shows that it takes at least ten sessions to bring about a change in posture. It also shows that working on the human body is a process in many steps. It is no wonder that these steps follow a certain inner logic that the body demands of us.

Session 1 – Breathing and chest

Light, free breathing is the basis for you to relax, and relaxed breathing is the basis for a balanced body structure. To make the chest move and the lungs breathe freely, adjacent structures such as the neck, shoulder girdle, lumbar spine and even the thighs are worked on.

Session 2 – Stabilize feet, relax neck

The feet are the base that supports the body in its flexibility and stability. If the body lacks this base, it must provide stability further up. This often leads to tense shoulders and a tense neck. If the feet and lower legs stand well under the pelvis, the person can relax further up. Neck, shoulders and arms can then let go and become loose.

Session 3 – Align body sidelines

The lateral line begins at the outer ankle and ends at the ear. The most important area is the lateral space between the thorax and the pelvis. Giving the lumbar spine mobility and connecting it to the shoulder girdle and pelvic girdle from the lumbar spine helps the body to become mobile again and to turn freely.

Session 4 – Opening the core from the floor

The core of the body begins at the arch of the foot and goes on the inside of the leg over the pelvic floor along the inner spine through the neck into the head. The Session 4 works with the lower core area, from the arch of the foot to the pelvic floor, to create a base for the areas above. This base is created by contact with the floor and the permeability of the core from the inner foot to the pelvic floor.

Session 5 – Connecting the pelvis to the abdomen and legs

Session 5 is a continuation of the 4th session. Now it’s about turning the contact to the floor into movement. Consider movement as an impulse that comes from the floor and spreads from the legs over the pelvis into the body. The position of the pelvis, its mobility and the way it transmits movement from the legs to the trunk, how it supports the organs and connects to the chest are a big issue.

Session 6 – sacrum and spine get space

The sacrum needs space and mobility to transmit the impulses coming from the ground to the back. From the sacrum to the arms, the back should become permeable for the flow of movement. It should transmit impulses in a game of tension and relaxation. Each step you take sends kinetic energy into your back and prepares the next step. The more permeable the back becomes for the movement, the more effectively you move.

Session 7 – Connecting the head and neck to the sacrum

The head weighs a lot and wants to be balanced every second. If it is not in its place, it must be supported from below and hampers the mobility of the torso. Relieving the head and neck of tension simply does you good. But it is essential that the head and neck are connected to the shoulder girdle and the back in a balanced way and that a connection to the saurum is established. Only then can the head pick up the movement impulse from the legs, balance it and send it back to the feet.

Session 8 – Integration: static balance

The body is upright. The head rests over the feet. In the course of the 7th session many topics in the body were addressed. Some parts need additional attention to make the balance more stable. To integrate them means to relate them within the body to the environment and to gravity.

Session 9 – Integration: dynamic balance

With each step the body screws itself together a little, stores this kinetic energy in the fascia tissue like in a rubber band and releases it again with the next step. The more permeable the individual areas of the rubber band are, the easier the movement flows with each step, the more effective and pleasant the movement is felt.

Session 10 – Integration: inner and outer balance

The body is under the constant influence of gravity. The erection in the vertical is the first movement and already a balancing act. The second movement is the dynamic balance, the movement of the body through the surrounding space. The perception of how the inside of the body relates to the outside space is the third movement. In the 10th session, the body is captured in its three-dimensionality and viewed as a whole. It should form a unit in which each part is connected to the whole.

„We are not truly upright, we are only on our way to being upright. This is a metaphysical consideration. One of the jobs of a Rolfer is to speed that process along. We want to get a man out of the place where gravity is his enemy. We want to get him into the place where gravity reinforces him and is his friend, a nourishing force.“
Dr. Ida P. Rolf Rolfing and Physical Reality, page 88

I have sketched the Rolfing 10 series here with simple words. However, the anatomical and theoretical background is much more complex and requires extensive training from every Rolfing practitioner. You can consider the 10-series a recipe, a helpful guide, but ultimately it is the client’s body that determines the direction and course of each session. Therefore, there is no guarantee that each session will be exactly as described here. Also, after the 10-series you are not a finished, perfect human being, but your body is just a few steps further – and that can already mean a lot.

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(1) Quelle: “The Science of Structural Integration: A Rationale for Research” by Ben Hanawalt
Rolf, I. P. (Speaker). (1976c). Audio Tape A3, Side 1. Retrieved from http://www.rolfguild.org/member/ tape-a3-side-1

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If you have any questions, please feel free to contact me in my practice in Berlin or Munich. Here you will find the contact page.

With gravity it is like with fish in water. We humans are so used to this field of gravity that we pay no attention to it.

The unique thing about Rolfing is that Ida Rolf brought gravity into play. This visionary insight was a new element in the field of body therapy and is still the cornerstone of Rolfing today.

The three basic principles

Rolfing® is based on three basic principles that influence the human body.

• The body is a unit. If one part changes, this affects the entire system.
• The fasciae are plastic. The fascia system gives the body its shape.
• Gravity influences our body in every second. We always move in the field of this force.

Body as a unit

If you look at the structures of the body, you will see that it is composed of many elements – head, chest, pelvic area, legs, etc. These individual structures, which are in spatial relationships to each other, must be understood as a unity. If an element changes, this has an effect on the body as a whole, on the overall structure. For example, if you have a kinked foot and therefore limp a little, it affects the pelvis, the spine, and the neck that carries the head. Rolfing takes advantage of this correlation and changes the relationship of the units to each other. In this way the shape of the body is changed, which in turn leads to an improved function.

Fascia system

The muscles are covered by fine, white, more or less thin skins, the fasciae that run through the entire body. Fascia covers not only the muscles, but also the blood vessels, nerves, organs, brain and bones. Fascia is the packaging material that gives the body its shape. Fasciae hold joints together, form tendons and ligaments and thus transmit the forces that make the body stand upright. Fasciae are plastic. When an athlete exercises intensely, the body strengthens the fascia of the heavily stressed joints. If muscles are used less, the fascia’s properties change: they stick together and no longer glide so well, resulting in a restriction of movement. In yoga the fasciae are therefore stretched. In Rolfing we make use of this plastic property of the fasciae. With the slowly melting pressure of our hands and elbows,the Rolfer stretches exactly those fasciae that prevent the body from straightening out completely.

Fascia and Tensegrity

Fascia and ligaments connect bones and joints with each other. The way they do this is called Tensegrity. The special thing about Tensegrity is:

• If the tension is changed somewhere in the system, this has an effect on the entire system.
• The system only works as a whole. If an element is damaged, the entire system is damaged.
• The body’s ability to spring, absorb and release forces while remaining dimensionally stable is enormous.

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In this video you can see Tensegrity structures: Tensegrity Demonstration

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In Rolfing we work with this tensegrity property of the body. We don’t just loosen everything, we just change the fascia structures that hinder the body’s ability to be up right. Based on the model shown in the video, you can now understand why a change in your feet can have an effect up to the throat.

Gravity as a structuring force

In humans, the foot, the legs, the spine and simply all statically supporting structures are constructed according to the Tensegrity principle. This entire construction has only one purpose: The human should be able to move with flexibility and resilience in the gravitational field of the earth. The entire human tensegrity construction has adapted to the conditions of gravity on Earth. In this respect, gravity is the shaping and structuring force. The more optimal the adaptation of each individual human being to it is, the more effectively he can move. This is exactly what athletes can sing a song about, as well as the Neanderthal when he hunted his mammoth, in that Neanderthals and sportsmen try to reach their goal as effectively and quickly as possible. If, as described above, we intervene in Rolfing by arranging the relationship patterns of the body elements, then we do so with the aim of adapting the sum of all these structures as optimally as possible to gravity. If there are no more blockages in the body, the force of gravity can flow unhindered through it. The client then has the impression that he can suddenly move easily, elegantly and effortlessly.

Gravity and wear

However, if there are blockages in the body, these lead to movement restrictions. The body can no longer move effectively. Gravity intensifies the process, wear occurs. In the end, the joint is replaced during an operation. If the body is dysfunctionally organized, for example if the head slips forward between the shoulders, the body must use muscles that are not intended for this purpose. This leads to tension and pain. Now the body is fighting a hopeless battle against gravity, because gravity will always win. As a result, the head will slide deeper and deeper, the neck will shorten and the upper back will become rounder. Therefore Rolfer do not work on superficial symptoms. Rather, they improve the functionality of the body. Clients use their Rolfers to find ways to move more effectively. These are learning processes. In order to simplify these learning processes, the 10 series was created. The Rolfer has less the role of a therapist than that of a coach.

Gravity and aging

Aging processes are increasing rapidly, with astronauts in weightlessness, as NASA research has shown, with “couch potatoes” and with people in retirement homes. Why? Well, gravity is not the force that causes you to age prematurely, but it is the force that your body consumes to function correctly. Gravity is your friend. The more often you deal with gravity, e.g. when you jump on a trampoline, climb stairs or just get up from a chair, the better. If you learn in Rolfing to handle your body more effectively in order to move upright in gravity, you will also learn to understand its signals and needs better. This form of mindfulness has anti-aging character.

Photo by Brandon Morgan on Unsplash

Gravity, Balance and Coordination

If you can stand still, you will feel your body constantly “preventing” you from falling over. What you observe there are many small reflexes that allow you to stand upright effortlessly. The body does that for you. If you now have a blockage in one part of your body, this stiffening has to compensate for another part of your body with more mobility. If this increases, you will have problems with your balance. Elderly people have more problems with balance and coordination. Astronauts have the same problem when they return to Earth. Their bodies have forgotten how to play with gravity. Gravity challenges him to constantly deal with it, to constantly adapt to it, so that he does not fall, fall over, stumble, wobble, become insecure and lose balance, but remains in balance. In a body without blockages, the many small reflexes that keep it in balance cause it to remain in constant motion – each element remains a little bit in motion. Through these many micro movements, the body remains healthy, it can maintain itself, it can repair itself, it can heal itself. As Rolfers, we want this process to get going again. That is why we help the body and the client to stand up in gravity.

Photo by Marion Michele on Unsplash

Gravity and relaxation

Relaxation is only possible in the plumb line or vertically.

• In the first step you completely straighten up in gravity. You now stand upright.
• In the second step you allow your body to automatically keep itself in balance through the many small reflexes. Ideally, your head will balance on the first cervical vertebra. It wobbles slightly back and forth like a ball.
• In the third step you can now observe how your body relaxes.

You stand and relax at the same time. Upright and relaxed, that is the goal of Rolfing.

Gravity as an evolutionary force

In the development from ape to man, evolution has erected man. Dr. Ida Rolf now says that this evolutionary step of erection has not yet been completed. The Rolfers task is to accelerate this process.

Gravity and spirituality

Form and function: Once the body has assumed its upright form, it can fulfil its function. Then gravity can flow unhindered through it. Then the energy that connects heaven and earth can flow through him. Then he is the connecting element between heaven and earth – between the divine and the material. Dr. Ida Rolf was well aware of these considerations. However, she emphasizes that in Rolfing the body is only seen from a physical point of view.

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Book recommendations:

Dr. Ida Rolf,  Rolfing and Physical Reality 224 page, $14.73, Healing Arts Press November. 1990,  ISBN-13: 978-0892813803
A warm and wise self-portrait. Ida Rolf writes about her life, about the miracle of the human body, about life in general and explains her technique how muscles and connective tissue are manipulated and aligned. She does not present her thinking as a closed system, but raises questions that she does not answer directly.

Dr. Joan Vernikos,  The G-Connection: Harness Gravity and Reverse Aging,  294 page, $14.80, iUniverse, Inc. November 2004 ISBN-13: 978-0595329311
The book presents the results of 30 years of NASA research. When there is a lack of exercise or bed-resting in a nursing home and weightlessness in the space station, physiological aging processes are accelerated. Joan Vernikos comes to the conclusion that humans have to deal with gravity as often as possible in order to counteract ageing processes. The book recommends to office people that they get up briefly from their office chair every 20 minutes and sit down immediately. This is better than going to the gym 20 minutes a day.

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If you have any questions, please feel free to contact me in my practice in Berlin or Munich. Here you will find the contact page.