As a Rolfer™, I do not practice medicine. I am not qualified to diagnose, and I do not treat any particular condition. This is not an oblique statement designed to avoid liability; this is an attempt to guide you toward a different view of the human body. Rolfers encourage health rather than treating disease. We help bodies move more efficiently and find easier ways of staying upright in gravity. I don't fix pain, I help bodies find alternatives to the coping mechanisms that have been causing pain and tension. Questions such as "Is it a muscle spasm or a problem with the facet or a nerve thing or a fascial restriction or inflammation?" make sense to ask. It's also reasonable to be concerned that if these questions aren't correctly answered that manual intervention could make the pain worse rather than better. I avoid answering questions along these lines for a number of reasons:
- Most likely, your pain is not caused by one of these things, but may involve all of these dynamics and more.
- For me to stay open to perceiving all sorts of information about how your body is working and struggling, it's important that I don't convince myself that I've got the situation all figured out.
- Thinking of one "cause" of a problem can get in the way of understanding how even the "broken" thing or "problematic symptom" can be serving a useful purpose. Without understanding the purpose of what your body is doing, it's hard to help it find alternatives to meeting those needs.
- Focusing on a diagnosis can reinforce the nocebo effect, making it harder to get well. (Please note that the placebo and nocebo effects are ALWAYS in play, regardless of the objectively verifiable effects of a given treatment.)
what is pain?
The most basic, automatic, fastest response to pain is to freeze the area that hurts. This involves muscle tension and sometimes even neurological inhibition of the associated muscles. Next comes inflammation, aiding in the immobilization effect as well as sending in the biological resources to repair damaged tissue. This can help prevent further injury by stopping someone from running on a sprained ankle, for example, but it can also create other problems.
When we hold one part of our body still, other parts of our body pick up the slack, sometimes getting damaged in the process. The lack of movement can inhibit circulation, making the swelling last and limiting the ability for that part of the body to get rid of cellular waste products and receive further nutrients. This condition itself is not conducive to long-term health, and so can be interpreted as dangerous by the brain, and so can produce more pain.
When pain lasts for a long time, the nervous system responds as if to say "you're not hearing my alarm response, so I'll get louder" and builds more receptors to respond to the "dangerous" situation quicker and more intensely. So the pain gets worse, so the immobilization intensifies, so the pain gets worse, so the immobilization intensifies, and so on.
When we hold a muscle short and still for a long time, the body responds by producing more fibrous tissues in the fascia, similar to scar tissue. This helps the body hold that position with less muscle effort. The down side is that it makes it harder to lengthen that muscle. Eventually the dense fibrous fascial adhesions immobilize the area, making pain and tissue damage more likely. This process gets faster with inflammation.
Every nerve is surrounded by a fascial sheathe, designed to allow muscles to slide over the nerve without compressing or stretching the nerve. When the nerve sheathe gets stuck to the surrounding muscle fascia, movement irritates the nerve. The body prioritizes nerve health over movement, so it tells the muscle to tense up and hold still. Sometimes this tension is enough to put more pressure on the nerve, causing pain and further immobility. As discussed above, if the pain lasts long enough the entrapped nerve will arborize, growing new receptors to speed and intensify the reaction to the seemingly dangerous situation.
When a nerve is entrapped, pressing hard on the surrounding muscle tension can sometimes cause the nerve to be stretched or compressed, irritating it further. Sometimes this can happen even when the pressure feels good at the moment (please ask me about foam rolling). So it's quite reasonable to be worried that deep tissue bodywork could exacerbate pain.
So, what do we do?
As a Rolfer, I track what's changing in many systems and tissue types in the body (skin, fascia, muscle, tendon, ligament, joints, bones, nervous system, viscera, breathing and blood flow), listening to and respecting the body's protective responses while inviting the body to move in healthy ways. By working with the whole body as a system, it's possible to restore comfort and mobility without causing the damage that the pain was warning about. Establishing balanced movement and relaxed upright posture can create a healthy momentum where precise localized movement improves tissue health, which allows for more freedom of movement in the whole body. So rather than fixing the dis-ease, Rolfers help people out of the cycle of pain by developing healthy, relaxed, balanced movement habits.