Tag Archives: pain management


a turning pointe gravity


When it comes to structural integration, gravity is our best friend. When properly aligned, our bodies hold our strength and form better, injuries are prevented and our circulatory, nervous and lymphatic systems are allowed to run their course properly.

Imagine a 2 pound cantaloupe on the end of a 2 foot stick. If we were to grab the base of the stick and hold the melon straight up, most of us would have little problem doing so. The direct downward pressure would be manageable enough for our hands, forearms and back to accommodate. Now, slowly lean the stick and melon away from you. Doing this changes the muscles that are being used to support it. Tension is removed from the back and biceps and placed squarely on the forearms and front body wall. The further the stick leans, the greater the pressure and eventually, even the strongest among us would be unable to keep the stick aloft.

Or, imagine a carefully stacked pile of rocks, where each stone is resting on its neighbor in the perfect manner in order to keep the pile upright. Could any of the stones be replaced with a different one and still keep its position? Would the removal of part of one stone, an injury perhaps, keep the stone strong enough to do its function? Sure, if one of the middle stones is injured we could create a patch (surgery) to repair the damage or shore up the weakness …… but the damage would still remain. The tower would still be weakened.

Some individuals may perceive their losing fight with gravity as a sharp pain in their back, others as the unflattering contour of their body, others as constant fatigue, yet others as an unrelentingly threatening environment.  Those over forty may call it old age.  And yet all these signals may be pointing to a single problem so prominent in their own structure, as well as others, that it has been ignored: they are off balance, they are at war with gravity.

Ida P. Rolf, Ph.D.

Thankfully, we aren’t sticks and stones. Though we’re subject to the same laws of gravity, our bodies are blessed with the ability to heal and strengthen. Evolution has blessed us with the ability to retrain our soft tissue so that we may remedy the damage done by most injuries. Additionally, even after years of overcompensation, we can retrain our tissues to relieve us of the maladies we’ve inflicted on ourselves.

Remember that car accident 20 years ago? Your left knee was injured and you’ve been listing to the right since then and now your lower back pain is too much to tolerate. Those headaches? Are they caused by the vertebra that was tweaked and had been altering  nerve impulses to and from the brain? Is proper organ function being interfered with because of your worsening scoliosis?

Structural integration and our related practices are not miracle cures. What they do is attempt to place your body back into a position where your native systems can work to their maximum effectiveness. We don’t heal you. You heal yourself.

At A Turning Pointe Physical Therapy, we know that your body can be your best friend and most effective hearing resource. We want you to “Feel Better!”

This is the gospel of Rolfing: When the body gets working appropriately, the force of gravity can flow through.  Then, spontaneously, the body heals itself.

Ida P. Rolf, Ph.D.


Understanding Pain

The human body and brain are marvelous devices with interacting complexities that science and medicine are barely beginning to unravel.  Despite the vast amounts of what we don’t know, we DO know quite a lot about pain and pain management.  In just the past five years, we have found that it’s quite often personal and lifestyle choices we make that affect our chronic and persistent pain level more than anything else.  There is a time for pharmaceuticals and there is a time for surgery but those times are not nearly as often as conventional medicine normally dictates.

More often than not, with a stronger knowledge of pain types and how our bodies send and receive pain, we can be empowered to manage or mitigate our pain more effectively.  The end goal is to live a rich and full life, no?  Imagine how much improvement there could be in your life with your persistent pain reduced by 50%.  How about 25%?  While the goal is a 100% reduction in pain, any lessening is an improvement.

The amusing video below explains, in clear and simple terms, how pain works and affects us.  Simply by understanding pain better, we can make positive choices in our own care.

Watch, learn and, go ahead, “Feel Better!”

Visceral Manipulation for Low Back Pain

Though written by therapists for therapists, this article gives patients a wonderful and informative view of this innovative healing practice. On our staff we have two highly experienced therapists that are more than proficient with Visceral Manipulation; Laurie and Linda.

Give us a call and “Feel Better!”




Visceral Manipulation for Low Back Pain

Published in Massage Message Journal, January/February 2009

By Dee Ahern, P.T. and Judy Russell, B.A., B.SC,


As we watch a graceful ballerina or enthusiastically cheer on our favorite tennis or football players, is it only the agility and ease of movement of the musculoskeletal system that we observe?

Or is it that which lies within the cylinder that forms the torso that often is responsible for creating the flow of movement patterns visible to the naked eye?

Have you worked with clients precisely applying manual therapy techniques that relate to the fascial system, the neuromuscular system, or the craniosacral system, yet your clients are not experiencing long lasting relief from low back pain and dysfunctional movement patterns?

A primary focus of orthopaedic and musculoskeletal education for massage therapists when addressing low back pain has been the study of how the structures that lie behind the spine influence the spine’s mobility and function. The curriculum presented in the Visceral Manipulation Program offers a method for assessing and treating the influence of those structures that lie in front of the spine. Those influential structures can include organs and their fascial attachments, peritoneum, the greater omentum or blood vessels. Visceral Manipulation is commonly called “organ specific fascial mobilization”. It addresses dysfunction within the contents of the cylindrical torso.

Visceral Manipulation was developed by Jean-Pierre Barral, a Registered Physical Therapist and Osteopath. He holds many positions including Director (and Faculty) of the Department of Osteopathic Manipulation at the University of Paris, School of Medicine, in Paris, France and Chairman of Department of Visceral Manipulation on the Faculty of Medicine Paris du Nord. He developed this form of manual therapy based on his theory that each internal organ rotates on a physiological axis. Each internal organ also has a relationship through fascial attachments to the spine. Today, his Visceral Manipulation courses are taught around the world by certified teachers who successfully complete a rigorous training program with the Barral Institute.

Consider the following orthopaedic dictum: any structure that crosses a joint has the ability to restrict that joint. It is certainly true for muscles. This also holds true for organs. Barral’s in-depth study of patterns of stress in tissues of cadavers at the Lung Disease Hospital in Grenoble, France complemented his interest in biomechanics in living subjects. He recognized the potential for the organ system to create lines of tension within the body. This observation was fundamental to his development of Visceral Manipulation. His interest was also piqued when a client confirmed he felt relief from back pain after going to an “old man who pushed something in his abdomen.” Since that time he has worked with researchers in France and North America to create evidence-based data, documenting changes in the viscera with the use of x-ray fluoroscopy, endoscopy, Doppler and ultrasound before and after manipulation of the organ.

How do organs become restricted? They can become restricted by a direct trauma (fall on a soccer ball), acute/chronic illness (pneumonia), absorbing the force of a motor vehicle accident (seat belt trauma), or scar tissue formed after surgery. We take approximately 24,000 breaths a day. Our heart beats 120,000 times per day. Any lack of mobility in these structures could promote chronic spinal restrictions – e.g. the attachment of the pericardium to the lower cervical and upper thoracic spine via the thoraco-pericardic ligament.

The mesenteric root of the small intestine can limit the mobility of the spine as it crosses the third and fourth lumbar vertebra. A mechanical restriction at the first lumbar vertebra may be influenced through constant irritation of an old appendectomy scar stimulating the autonomic nervous system. The cecum/appendix and L1 share this viscero-somatic interchange. Decreased flexibility of the fascial connection between the bladder and the head of the femur can limit the mobility of both structures. Chronic dysfunction of the right and left sacro-iliac joint can result from decreased mobility of the cecum and sigmoid respectively. A ptosed kidney on the anterior surface of the psoas muscle can compress one of five nerves (e.g. ilio-inguinal) in the vicinity. In fact, Jean-Pierre Barral has found through his clinical treatments and research that up to 90% of musculoskeletal problems have a visceral component.

The key in Visceral Manipulation is to find the most significant area of reduced mobility. A restriction will pull the surrounding tissue towards it. Another Orthopaedic dictum is that „the body hugs the lesion (restriction).? With training, your hands will feel the pull of tissue to the area that is causing the greatest mechanical tension in the body – this is an evaluation technique known as „Listening?. You will also learn to evaluate visceral mobility – the ability of an organ to move freely in three dimensions in its anatomical environment. In addition, you will be able to feel visceral motility – the organ’s inherent tissue motion. Like joints, organs must move to stay healthy. They have sliding surfaces that articulate with each other, with muscles, with ribs and with the spine. You will be able to ascertain what is normal or abnormal. This is not unlike what we learn about joints. The efficacy of treatment depends on the accuracy of your assessment and the specificity of the application of gentle manual forces in three dimensions to promote the health of the organ and relief of restriction in the body. There can be an immediate response to treatment or a response that becomes apparent over several weeks time as the body unravels a long standing restriction.

Gail Wetzler, P.T. of Orange County, California performed a clinical study that examined the neuroreflexive and structural relationship between the internal organs, their attachments and the musculoskeletal low back when in a state of dysfunction. The conclusion of the study showed that low back spinal dysfunction may be more effectively and efficiently resolved with the addition of Visceral Manipulation into the treatment program.

We cannot imagine our practices without these tools. It is exciting, rewarding and challenging. Visceral Manipulation tests your knowledge of anatomy and inspires you to learn more. We invite you to be curious and learn to look inside the body for possible organ specific fascial restrictions that may be causing low back pain, as well as other dysfunctions in the body. For more information about the Visceral Manipulation, the Barral Institute and the availability of courses in your area, we encourage you to visit www.barralinstitute.com.


Barefoot Running

Often times as therapists, we become the go-to person for our patients when there is a new or returning exercise trend.  The barefoot running phenomenon has created a lot of buzz lately, and several of my Rolfing clients are curious if they should give it a go.

I, myself, have tried barefoot running several times over the past two years. From my years of ballet, I have very tight feet and legs and barefoot running proved to enlighten me on this fact. Each time I that I have run barefoot, I’m sore for usually 3 days. This brings up a few questions. Is the abnormal soreness a good thing or a bad thing?  Should I even be barefoot running if I’m experiencing extended soreness? What does the soreness indicate?

I stumbled on the article below a few days ago.  Maybe this will help you in your decision whether to give this new fad a try……or not.


Are We Built to Run Barefoot?


At a recent symposium of the American College of Sports Medicine’s annual meeting in Denver, cutely titled “Barefoot Running: So Easy, a Caveman Did It!,” a standing-room-only crowd waited expectantly as a slide flashed up posing this question: Does barefoot running increase or decrease skeletal injury risk?

“The answer,” said Dr. Stuart J. Warden, an associate professor of physical therapy at Indiana University, “is that it probably does both.”  But in the past year, anecdotal evidence has mounted that some runners, after kicking off their shoes, have wound up hobbled by newly acquired injuries. These maladies, instead of being prevented by barefoot running, seem to have been induced by it.  Barefoot running remains as popular and contentious a topic among exercise scientists as it is among athletes, even though it is practiced by only a tiny subset of American runners. These early-adopter runners, however, tend to be disproportionately enthusiastic and evangelical. Many cite the best seller “Born to Run,” by Christopher McDougall, which touts barefoot running, and claim that barefoot running cured them of various running-related injuries and will do so for their fellow athletes. “There are people who are convinced that barefoot runners never get injured,” said Daniel E. Lieberman, a professor of human evolutionary biology at Harvard who runs barefoot himself and spoke on the topic during last week’s symposium.

So what really happens to a modern runner when he or she trains without shoes or in the lightweight, amusingly named “barefoot running shoes” that are designed to mimic the experience of running with naked feet? That question, although pressing, cannot, as the newest science makes clear, easily be answered.

Most of us, after all, grew up wearing shoes. Shoes alter how we move. An interesting review article published this year in The Journal of Foot and Ankle Research found that if you put young children in shoes, their steps become longer than when they are barefoot, and they land with more force on their heels.

Similarly, when Dr. Lieberman traveled recently to Kenya for a study published last year in Nature, he found that Kenyan schoolchildren who lived in the city and habitually wore shoes ran differently from those who lived in the country and were almost always barefoot. Asked to run over a force platform that measured how their feet struck the ground, a majority of the urban youngsters landed on their heels and generated significant ground reaction forces or, in layman’s terms, pounding. The barefoot runners typically landed closer to the front of their feet and lightly, without generating as much apparent force.

Based on such findings, it would seem as if running barefoot should certainly be better for the body, because less pounding should mean less wear and tear. But there are problems with that theory. The first is that the body stubbornly clings to what it knows. Just taking off your shoes does not mean you’ll immediately attain proper barefoot running form, Dr. Lieberman told me. Many newbie barefoot runners continue to stride as if they were in shoes, landing heavily on their heels.

The result can be an uptick in the forces moving through the leg, Dr. Warren pointed out, since you’re creating as much force with each stride as before, but no longer have the cushioning of the shoe to help dissipate it. Most barefoot runners eventually adjust their stride, he and the other presenters agreed, landing closer to the front of their feet — since landing hard on a bare heel hurts — but in the interim, he said, “barefoot running might increase injury risk.”

Even when a barefoot runner has developed what would seem to be ideal form, the force generated may be unfamiliar to the body and potentially injurious, as another study presented at last week’s conference suggests. For the study, conducted at the Biomechanics Laboratory at the University of Massachusetts, runners strode across a force plate, deliberately landing either on the forefoot or on the heel. When heel striking, the volunteers generated the expected thudding ground reaction forces; when they landed near the front of the foot, the force was still there, though it generally had a lower frequency, or hertz.

Earlier research has shown that high-frequency forces tend to move up the body through a person’s bones. Lower-frequency forces typically move through muscles and soft tissue. So shifting to a forefoot running style, as people do when running barefoot, may lessen your risk for a stress fracture, and up your chances of developing a muscle strain or tendinitis.

So where does all of this new science leave the runner who’s been considering whether to ditch the shoes? The “evidence is not concrete for or against barefoot or shod running,” said Allison H. Gruber, a doctoral candidate at the University of Massachusetts and lead author of the hertz study. “If one is not experiencing any injuries, it is probably best to not change what you’re doing.”

On the other hand, if you do have a history of running-related injuries or simply want to see what it feels like to run as most humans have over the millenniums, then “start slowly,” said Dr. Lieberman. Remove your shoes for the last mile of your usual run and ease into barefoot running over a period of weeks, he suggests, and take care to scan the pavement or wear barefoot running shoes or inexpensive moccasins to prevent lacerations.

And pay attention to form. “Don’t overstride,” he said. Your stride should be shorter when you are running barefoot than when you are in shoes. “Don’t lean forward. Land lightly.”

On this point, he and all of the scientists agree. Humans may have been built to run barefoot, “but we did not evolve to run barefoot with bad form.”

Of Grace and Gravity

Sometimes, it’s so very difficult to explain what Rolfing or Structural Integration is.

We can say that it is the lengthening and strengthening of the soft tissues.  We explain that everyone’s body has an ideal place or placement for their muscles; that your tendons have a place to live in your body that will provide you maximum flexibility.  We can tell you that, given room to flex and “breathe”, your muscles will strengthen and grow and bring you to a point where you can be taller, stronger, faster, leaner or simply live without the pain that has been haunting you for years.

Sometimes we at A Turning Pointe are able to properly explain our thoughts and sometimes we cannot.  In order to help share with our friends (you) more about the benefits of Rolfing, we’d like you to watch this short film.  In it you’ll see and hear some of the most senior practitioners of the Structural Integration (SI), and in their own voices you may be able to hear how it can be as much of an art as it is a therapy.  These folks have studied with Dr Rolf in the early days of SI and have done a magnificent job at teaching not just the science of her work, but the beauty of it as well.  The title, Of Grace and Gravity, is quite apt.


Courtesy of BKube Productions

Dr Ida Rolf was undoubtedly one of the most significant women of the twentieth century. A great mind and pioneering thinker, a creative scientist years ahead of her time, she spent much of her life exploring the human capacity for healing. Her education, professional career and life circumstances led her to explore various modalities that gradually evolved into what become known as “Structural Integration” and then took on the name “Rolfing.” Essentially, Rolfing seeks to address the development and liberation of an individual’s innate human potential, with the palliation of symptoms an ancillary benefit. Dr Rolf was initially educated and trained within the empiricism of scientific academia and remained firmly rooted in those traditions. Her work was founded upon the physics of aligning the human body within the field of gravity. She integrated her scientific perspective with mind-body awareness without relying on an eastern mystical philosophy to justify her conclusions. It is clear from her writings and teachings that her studies of biological chemistry and physics provided critical insight, inspiring such statements as, “You cannot change the energy field, but you can change the man–the body will go as far as it will physically go, within the laws of physics.” and “What would happen to behavior if you changed chemistry? The first way to change chemistry is to change physics.” Dr Rolf conceived of “Rolfing” as a gateway into making progressive changes within the human organism, encompassing the physical, intellectual and emotional aspects.

Ida Rolf: Of Grace and Gravity, will explore Dr Rolf’s life, work and legacy.



Dynamic Manual Therapy / Lowen System

Hello, Friends

I’ve received a few e-mails and phone calls this week asking questions about DMI, including how to find practitioners outside of the Spokane Area.  While we’re always happy to answer any questions that folks may have, you may find answers to most of your DMI related questions at their site.


Certified practitioners may be found at :

Certified Practitioners and Teachers

Don’t hesitate to call or write with any questions that you may have.  We’ll do whatever we can to make you “Feel Better!”