Sure, it’s a pain, but does Structural Integration really work?

It wasn’t until I was standing virtually naked in a sky-blue room, with a skinny tattooed man staring at my figure, that I finally realized what I’d gotten myself into. Before this, the only thing I had heard about Rolf Structural Integration, or Rolfing, was that it’s an incredibly uncomfortable last resort for people suffering from muscle pain. As the owner of a chronically aching lower back, I’d decided to take my chances and give it a try.

“You seem to favour that leg,” Bradley Cornwell, a practitioner at the Rolf Bodywork Studio in North Vancouver, said as he pointed to my left one. “It’s also a little bowed. I can work on that.”

Cornwell began to look over my body, assessing the flaws in my natural stance. After this, I lay down on a motorized massage table, wondering what to expect. “If it gets too intense, just tell me to stop,” Cornwell reassured me. “On a scale from 1 to 10, I don’t want your pain to go above a 6 or a 7. If it does, I wouldn’t be doing my job right.”

Even with a Rolfer pressing my flesh, I still didn’t fully understand what Rolfing was. According to Cornwell and Jessica Silver—two of a handful of local practitioners—it’s the manipulation of the body’s soft tissues into the most efficient orientation. Rolfers believe injuries, stress, and movement habits can shorten and tighten the fascia, a layer of connective tissue that envelops our muscles and internal organs.

“We also kind of reeducate the body to move in a new way,” Silver explained in a phone interview. “For example, a lot of people are sitting when they’re on the computer. You need to sit on your ‘sit bones’, your sacrum. It’s like your feet when you’re sitting down. Usually people aren’t, and that makes them roll forward, which can cause a lot of strain. This reeducation is important because it allows people to live in their bodies more efficiently.”

However, pain relief isn’t the purpose of Rolfing, though Rolfers claim it can be a side effect. When aligning the body’s structure, practitioners try to alleviate unnecessary tension on certain muscles. In my case, Cornwell told me my pelvic area was angled downward, which was pulling on my lower back. By correcting this, he said, he could fix my problem. The work on my pelvis was the most agonizing part of the 10-session procedure: when focusing on the sacrum, the Rolfer applies considerable force to a tender area. Pain aside, this part of the treatment had the most noticeable effect. Just as Cornwell promised, my back pain is now nearly nonexistent.

Still, the medical community does not widely accept Rolfing. SFU psychology professor and well-known skeptic Barry Beyerstein has written a plethora of papers and articles about alternative and complementary medicine. In his opinion, the results of Rolfing have far less to do with the technique itself than with the client’s psychology. Beyerstein recently chaired a committee that advised ICBC on alternative treatments that injured policyholders wished to claim on their insurance. One of these was Rolfing.

“The idea that you develop characteristic plaques and adhesions that need to be torn apart by these deep, deep tearing movements of the therapist just struck the orthopedists on the committee as complete foolishness. As I recall, we recommended to ICBC that they not spend money on a pseudoscience like that,” Beyerstein said by phone.

“Like all placebo effects, if you put out money and you put your trust in somebody and you go through a certain amount of trouble to go through whatever they tell you to do—in this case you go through a certain amount of pain, as the people I’ve interviewed tell me—there’s a certain cognitive dissonance there,” Beyerstein continued. “In the end, if you put a certain amount of faith…and there is no effect, it can be psychologically devastating—so, of course, the placebo effect is very strong.”

As I neared the end of my 10 sessions, I couldn’t help but remember Beyerstein’s words. Rolfing was such a visceral experience that it’s hard for me to believe the work didn’t actually have a physical effect. Still, I can’t tell whether my reaction was completely psychological, as Beyerstein charged. Now that the sessions are over, though, my back pain is gone, and the reason why really doesn’t matter to me.