"Rolfers work
deeper than cranial osteopaths,
but they prepare
the body for the changes."
Ian
Marsh (Director, Board of Cranial Institute,
An Osteopath Looks
At The Rolf Method
Jocelyn
Proby D.O.
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I
have been asked to write an article with some such title as ,,an Osteopath
looks at the Rolf Method." I am willing to make the attempt, and it is
possible that I am better qualified to do so than some others because I have now
been an osteopath for some forty years and I have been a Rolf fan ever since I
met Dr. Rolf and began to learn something of her ideas and methods some eight
or nine years ago. To me osteopathy is not a technique or a rigid system but a
principle, and the means which are used to apply that principle must, and
indeed should, change from time to time as the result of experience and in
accordance with the widening of our knowledge and changes in social habits and
organization.
Ever
since I began to think about the matter I have been convinced that the science
of medicine can only be established and progress by discovering basic and
universal principles by which health and disease are governed or conditioned
and then working out techniques by which these principles can be applied to
prevent and cure disease. The trouble with orthodox medicine seems to be not
that it is based on wrong principles but principles at all. There are, it is
dear, quite a number of great principles or natural laws on which health depends;
some of these may be said to have discovered, others to be more or less clearly
discernable, and others have, perhaps, only begun to be thought about.
Osteopathy, whatever its deficiencies may be, is based on a fundamental law
which may be expressed in various different ways hut which amounts to the fact
that the functioning of the living body is conditioned by its structural,
postural and mechanical state.
The
first thing which it is important to note about the Rolf method is that Dr.
Rolf has restated in a very original and powerful manner the basic principle
and has, I believe, given us a dearer and more complete picture of the
machinery which the health and functioning of the body is influenced by its
posture and by its structural and mechanical state. Good posture is a thing
about which there has been and is a lot of talk, but it is rare to find anyone
who understands what it is or is able to show any effective way to create it
when it does not exist. Most osteopaths are obsessed with the individual spinal
lesion and seem to believe that posture will look after itself if the spinal
joints are worked on and put right. It is therefore refreshing to have it
pointed out that most spinal lesions are secondary to a bad postural state and
that such a state which is due to a breakdown of the proper relationship of the
body to the ground and of the gross structural parts (such as head, thorax,
pelvis, and limbs) to one another, is the beginning of the trouble. This is the
thing which begins to cause a departure from health by a continual drain on the
energy of the person who, instead of working with gravity, is fighting against
it in all his movements and activities even when, as he believes, he is sitting
or standing and doing nothing. The more specific effects on particular joints,
muscles, nerves and parts of the body, important though they are, will tend to
disappear if the posture and mechanics are restored to what they should be.
When
we come to consider Dr Rolf's technical approach to the task of creating, as
far as possible, a perfect postural and mechanical pattern, there are two
somewhat separate points to he discussed. First there is her particular way of
working on the tissues with her hands (and elbows) and secondly there is the
particular sequence of ten treatments or ,,processings" which, if
successfully carried out, can get rid of the distortions exhibited by the
patient and restore him to a good state of posture and body mechanics.
The
work which Dr Rolf does on the tissues of the body is, so far as I know, of an
unique character, being different both from the usual type of osteopathic
manipulation and from massage or physiotherapy as generally used and
understood. The objective is first to organize the fasciae which cover more or
less the whole body and surround muscle structures and, second, to organize
muscles and tendons especially at their origins and insertions. The secret of
the maintenance or restoration of good posture and mechanics is that these
structures should be free, elastic and balanced as between the two sides of the
body and as between flexors and extensors and that where there are areas of
fibrosis, bunching together and degeneration, hypertonicity and hypotonicity
these should be eliminated or corrected as far as possible. No one who has seen
Dr. Rolf at work can doubt that her technique is highly effective for bringing
about these results and that she can bring them about in an astonishingly short
time in a way that is both immediately spectacular and essentially permanent.
For myself I would say that I have now come to use this type of technique far
more than any other and I obtain results which are far quicker, better and more
stable and permanent than any I was able to obtain before or could have hoped
to obtain.
I
do not pretend, however, that l use this type of technique exclusively for I
cannot feel that any technique, however good, is an end in itself or that it is
in all circumstances the best or the only way of obtaining the result which one
wishes to obtain. In particular I believe that there are cases in which it is
clearly indicated that one should do a thing which Dr. Rolf seldom or never
does which is to put leverage on a particular joint and move it or adjust it
with the use of a certain amount of thrust or force. In a general way there is
only one joint in the body, the sacroiliac, which is on of a rather unique
character, which in all circumstances required to be dealt with in this way
whatever steps one may subsequently take to balance and stabilize it. Not to
adjust this joint and to keep it adjusted is court trouble and difficulty,
waste time and reduce the effectiveness of all other treatment as well as to
lessen one`s ability to give quick relief and improvement in acute and subacute
conditions in which the pelvis and low back are involved, as indeed they nearly
always are.
In
the case of other joints I would agree that in the vast majority of cases it is
better not to manipulate by the use of leverages because if the structures
which determine the positioning and movement of a joint are balanced and in
good order, there is nothing to prevent that joint moving as freely as it
should and coming to rest in its proper position. To manipulate it before it is
free is useless or even harmful and to manipulate it after is unnecessary.
Nevertheless experience seems to show that there are cases in which it is
important or essential at some stage to move a particular joint in a particular
pain or symptom produced by an irritation on nerves or to overcome a locking of
the joint in an abnormal or semi-dislocated position. Most, though not all, of
these cases have a history of a recent and fairly severe strain or trauma and
they may be described as bonesetting cases and are, in fact, the legitimate and
happy hunting ground of bonesetters, some of whom are very skillful and do very
good work though they may sometimes dash in where angels fear to tread. There
is, I am convinced, a place in a complete system of structural therapy for
bonesetting or joint moving techniques and if such are never used at the least
much time can be lost and, in some cases, the best possible result will not be
obtained. I believe that the explanation of this is that though it is right in
most cases to regard bony malpositions and joint fixations as secondary to
trouble in the tissues by which the bones and joints are supported, moved or
acted upon, there are cases in which, for practical purposes, the reverse is
true, the abnormal positioning and locking of the joint setting upon spasm in
muscles and irritation of nerves which are best relieved by adjusting or
gapping the joint surfaces.
In
the case especially of spinal joints, to work directly upon the deepest
muscles, many of which are very small, is no easy matter, and to move the
joints in the right way at the right time may be the most effective method of
freeing and normalizing the muscle structures. Some such explanations as these
would seem necessary to account for the undoubted fact that the most
spectacular changes in the whole picture exhibited by a patient, including
changes in the posture and mechanics of his whole body can sometimes be brought
about by nothing more than the movement or correction of one or two joints. I
would also add that there are quite a number of techniques and procedures in the
armentarium of conventional osteopathy which can be extremely useful in acute
conditions of various kinds, not so much for bringing about great changes in
posture or mechanics as for their short term effects in aiding body functions
such as respiration, circulation, temperature regulation, elimination, heart
action etc.
I
would now like to pass to a consideration of the form and sequence of the ten
separate hours of work which together constitute the Rolf method or course of
treatment as generally applied. The more I consider this, watch it in operation
and try myself to carry it out the more I am struck by its comprehensiveness,
Ingenuity and effectiveness. By us comprehensiveness I mean that it seems to
contain within it so many useful ideas and procedures which link it with other
traditional and contemporary methods of treatment. For instance the work which
is done over the whole surface of the body not only enhances the whole
appearance, feel and functional efficiency of the skin and superficial tissues,
but also has remote effects of a reflex character on other parts and organs of
the body. This connects it with methods of therapy based on reflexes, such as
acupuncture. The "awareness" which Dr. Rolf seeks to bring about and
the instruction which she gives in the use of the body and in movement have
affinities with such things as Eeman's "myognosis" and with other
psychosomatic ideas and methods such as those of Matthias Alexander. Much of
what is useful in osteopathic cranial technique is contained in the seventh
hour of the Rolf method.
What
the relationship is or should be between the Rolf method and various other
forms of treatment of physical culture which aim at achieving and do, in fact,
achieve the same or similar results with more or less success, is a matter
which is worthy of thought and investigation. That such methods have existed in
the past and do still exist in various parts of the world can hardly be denied
and most of them would appear to spring directly or indirectly from the ancient
civilizations of the east. Yoga is probably the most important of these. lt is
interesting to note that yoga aims at producing and maintaining flexibility and
that it does so, not so much by exercises as by postures which have the effect
of stretching muscular and other tissues. More than this I will not say except
that I know from personal experience and from experience with patients that
yoga postures can be used very effectively to assist, maintain and enhance the
changes brought about or initiated by the Rolf techniques.
The
ingenuity of the arrangement of the ten hours of work has, perhaps, to be seen
and experienced to be fully appreciated, but certain features may be especially
noted. First there is no doubt that Dr Rolf is right in maintaining that work
of this kind on the body should begin on the superficial tissues and work down
gradually to deeper levels. As the course of treatment advances this in fact is
what happens until the central ,,core" of die body from the occiput,
through to the lower extremities by way of the mediastinum, diaphragm and psoas
muscles is reached and, as it were, cleared or liberated so that it is not
interfered with by movement of the limbs, torso and head. Again while the first
seven hours are concerned largely with pulling down or taking apart distortions
and barriers which exist at die start, in the last hours the aim is to pull
everything together and to build it into an integrated and co-ordinated whole.
It is extraordinary how each of the hours seems to lead into the next, so that
the body seems to be asking for the next hour's work both by its appearance and
by the feelings and sensations of the patient as it seeks to adjust to the work
already done. If the work of all the hours is well and successfully done the
final result is the establishment of a straight line of gravity from the ear
through the shoulder, hip and knee to the ankle and a qualitative change in the
tissues leading to a balanced, co-ordinated and flexible movement of all parts
of the body around this line.
I
may perhaps be forgiven if I conclude what I have to say on a personal note.
Feeling as I do about the Rolf method, I am naturally anxious to embrace all
reasonable opportunities of putting people who come my way through the ten
hours of work to the best of my ability. Yet it would be quite impossible in
any ordinary kind of osteopathic practice to subject everyone to a course of
treatment of this kind. The majority of patients come to an osteopath with some
very definite pain, disability, or presenting symptom for which they seek as
quick relief as possible. To give such relief must inevitably be the first
consideration and this can frequently be done, at least for the time being, by
something far short of a long course of treatment, though I believe that all
such work well done should make a beginning in bringing about a general
improvement in the posture and body mechanics of the patient. I do in fact see
many patients whom I should not wish to put through the whole course even if I
could, at least initially. I have come to the conclusion that it may often be
better first to get rid of the most glaring symptoms and postural distortions
before embarking on a complete reconstruction and that to do so can be a very
good preparation of the patient both psychologically and physically for taking
the full course of treatment and obtaining from it the maximum benefit.
Such
experience as I have does, in fact, incline me to make a plea that more
consideration should be given in a number of the more difficult and complicated
cases to preparing the patient for the course and also, in some cases, to
tailoring or modifying the procedure to meet the particular needs or
difficulties of the case. My chief reason for saying this is that I have
noticed very great differences between patients both as to their tolerance to
treatment and their response to it. It is inevitable and, I believe, to some
extent necessary that the treatment should be accompanied with a certain amount
of pain, for it seems that pain is, as it were, stored up in tense and
degenerated tissues, especially when the physical tension is bound up with
emotional or psychological tension. Nevertheless, there are cases in which I
feel that the pain occasioned by doing the work in the time and in the way
prescribed is more than it is reasonable to expect the patient to tolerate.
When this is so I believe that the operator is bound to defeat his own ends,
because if the patient, with the best will in the world, cannot accept the
treatment both with his mind and with his tissues, it is not going to achieve
the best results. In such cases it would seem to me that there are two possible
ways of coping with the situation. One is to do something to re duce the
sensitivity of the tissues and the other is to do the work to be done more
gradually and gently with an interval between. I believe that I can claim to
have had a certain success through both these methods of approach. I believe it
is possible to reduce the sensitivity of the tissues in a number of different
ways, by manual treatment, by water treatment and by homeopathic and dietary
measures aimed a improving the body chemistry. The improvement of body.
chemistry can be all the more important because in many cases in which the
tissues at very sensitive they also show poor response to treatment an tend to
revert to their bad state to a greater or less degree. This is perhaps
particularly so with people with rheumatic or arthritic trouble. At this point
I feel bound to confess that sometimes when I have found myself in difficulty
with tissues which are extremely painful to work on and which have a kind of
rubbery consistency on which it is very difficult to make any great or
permanent impression, I have put the patient onto the daily dosage cider
vinegar and honey which is recommended by Dr. Jar of Vermont in his book
"Arthritis and Folk Medicine." The results of doing this seem always
to be good and sometimes to be quite astonishing, making it possible in a very
short time to work really hard on the tissues and to produce a permanent
improvement in them and in the whole condition of the patient.
Another
conclusion which I have reached is that, if in many cases it is advisable to
prepare the patient for the treatment, it is always desirable to keep him under
observation for a certain time after the completion of the course. For a period
of some months many patients seem to be prone to have crises and reactions
during which they require a certain amount of readjustment and care and there
are very few who have had a long-standing condition of bad posture and
mechanics who do not have some tendency to fall back into the old pattern if
they are not watched and given some attention. Again I would make a very strong
plea for not attempting to shorten too much the time taken for carrying through
the ten hours of work, although it is clearly advisable to keep moving steadily
when a start has been made. I personally would feet that, as a general rule,
one treatment a week is quite enough, especially in the case of elderly and
difficult patients. I do not believe that the body can or should be called upon
to make such radical readjustments too quickly and the individual tissues which
are worked on should be given time to settle down before new ground is broken.
In some cases it may be difficult to avoid haste and this is perhaps less
undesirable if the patient is on holiday at the time and able to devote himself
entirely to receiving the treatments, adjusting to them and having plenty of
rest. Even so, I would doubt very much the wisdom of taking less than six weeks
for the completion of the ten hours work.
Finally,
I would like, with some hesitation, to make one more point. I think all would
agree that nearly all patients who appear and who require this kind of
treatment, fall into two main groups. There are those in whom the normal or
physiological curves of the spine are exaggerated and there are those in whom
they are reduced or almost non-existent so that the spine is practically
straight. As a general rule I find that the former group are the more easy to
deal with and I seem to be happy and successful applying the normal sequence
and routine of the ten hours to them. The cases in the second group I do not
generally find so easy and I sometimes wonder whether the routine as laid down
is quite so appropriate to them and in particular whether the emphasis laid on
the "pelvic lift" procedure at the beginning of and throughout the
course is entirely for the best. I make this point less in any spirit of
criticism than in a search for enlightenment and confirmation of faith.
First published
in the Bulletin of Structural Integration, Vol. III,
No. I, pp. 25 - 32.
Reprinted in ROLF
LINES® Vol. XXIII No. 3, November 1995.