Is Rolfing Structural Integration the Same as Deep Tissue Massage and Myofascial Release?

Rolfing® SI sitting back workThere seems to be a lot of confusion in the public’s awareness of the difference between Rolfing Structural Integration and deep tissue massage therapy. Instead of writing one more article explaining Rolfing SI and how it can benefit you, I have decided to take a different approach. I recently had a new client come into my practice who is the perfect example of why Rolfing SI can be so powerful a method for resolving postural/structural issues and musculoskeletal pain patterns. I have John’s permission to share his story with you.

John is a healthy, active male in his late 40s. He came to see me with the stated goal of alleviating structural imbalances in his right hip and thereby hopefully avoid hip replacement surgery in the future. (One doctor had suggested to him it might be necessary at some point.) He had also been experiencing a significant amount of pain and stiffness on the right side of his pelvis and low back and was hoping I could give him relief from it.

John had originally sought medical attention because he had been experiencing right knee pain. An x-ray of his knee could find no source for the cause of his pain so the orthopedist suggested exploratory surgery to see if anything could be found. John chose to opt out of that offer. He continued to pursue a probable cause for his knee pain and another doctor suggested a leg length difference might be the culprit. An x-ray was eventually performed in a supine (lying down) position at the local medical facility and it was determined John’s right leg was shorter than his left. That information was passed on to John’s podiatrist who made orthotics with the appropriate amount of lift for the right leg based on the x-ray results.

In my office I examined John standing in his shoes and orthotics. I found his right iliac crest and greater trochanter to be higher than his left. That would be an initial indication his left leg was short, not his right. I had him take his shoes and orthotics off and looked at him again. I found his iliac crests now even as well as the greater trochanters.

Next I had John lay down on my table so I could check his supine legPelvic Torsion length. Indeed, his right leg was now shorter than his left. That meant something was going on in his back and pelvis that was causing his leg length to go off when non-weightbearing. I had him stand again and checked his pelvis and found a pelvic torsion. His right innominate was anteriorly rotated and his left posterior in relation to the coronal plane. I also examined his spine and noticed he has a mild curvature causing a right side bend and left rotation in his lumbar area. I inquired of John if anyone else in his family had a scoliosis and he affirmed that was indeed the case.

I set to work manipulating the soft tissues around John’s pelvis and back in a way that would resolve the structural imbalance in his pelvis, and hopefully ease off some of the curvature in his spine. The details of how I accomplished that are beyond the scope of this article. After completing the soft tissue manipulation I checked John’s leg length again with him lying supine. His legs were now the same length and the pelvic torsion was resolved. I had him stand barefoot and the iliac crests of his pelvis were still even.

I asked John to spend a little time walking barefoot to feel this new change for himself, and then suggested he put his shoes and orthotics back on. His response upon first standing in the shoes and orthotics was telling. It appeared to me like he had just stepped in something disgusting with his right foot, and the look on his face told the story that the lift felt wrong. I checked his iliac crest and greater trochanter height again and now the right side was higher than the left. I suggested to him to stop wearing the orthotics; they were throwing his structure off. He would need to get them altered.

I have completed three sessions with John and he is amazed at how much more balanced his pelvis feels and indeed his whole body. He reports much more mobility in his pelvis and back and significantly reduced hip pain. In John’s own words:

There is no question that the high level of comfort that I feel today is directly attributable to the three sessions of work you’ve done with me. I feel a freedom of motion in my hips that I have not felt in at least ten years.

My theory on what happened with John is that no one practitioner was looking at his entire body. One doctor was only looking at John’s knee. The knee hurt so the problem must be in the knee. Considering that the knee pain could be coming from a leg length discrepancy was a good idea. However, measuring leg length with the client supine is not considered a very accurate method, precisely for the reason I found with John. He had a pelvic torsion which created a functional leg length difference when lying supine, not a true bony leg length difference when standing.

Best way to x-ray leg length differences

Radiographic evidence that measures the actual height of the femoral heads when standing is considered the best way to measure true bony leg length differences. And finally, because the measurement of John’s leg length difference was not accurate he was fitted for an orthotic lift that he didn’t actually need. It precipitated and aggravated his right hip problem. I was the first practitioner John saw who actually looked at his entire body to see how he was structurally organized in gravity. I was the first practitioner to notice what was happening in his lumbar spine that could be throwing his pelvis off.

Certified Rolfers™ are the structural experts on the human body. For John, deep tissue massage therapy around his right hip would not have been enough to give him the relief he was seeking. He needed someone with a structural evaluation skill set as well as soft tissue manipulation skills to figure out the cause of his problem and implement the appropriate treatment.

© Carole LaRochelle, 2009.


  1. kathy la duca says

    Hi Carol
    Where are you located? I am in santa Rosa and am looking for someone close to me.

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