“Don’t force things. If you’ve done your preparation right you don’t have to force things. There’s a steadiness, a gradual straightening that organises the body.” — Ida Rolf
Lower back pain is the most common condition that clients complain about when they start the Rolfing Series. It is often accompanied by its close contender for the crown, neck pain, both testament to many hours sitting in front of a computer. When a client starts Rolfing I clarify that it is not a quick fix, there is often no ‘magic button’ that will take away your pain. Clients sometimes have the impression that a quick crack will release all the tension and pain that they are feeling. This might be true in certain cases but a quick crack is not going to address the accumulated dynamic tensions and imbalances within the myofascial system which are influencing and compounding the painful condition. What is needed is a methodical approach of addressing each of the key contributory factors involved in lower back pain.
Back pain usually results from a mixture of bony and myofascial elements: sidebends and rotations in the lumbar vertebrae (typically the lowest vertebrae, L4 and L5) and asymmetrical strains in the muscles and fascia. These local rotations and strains are symptomatic of wider imbalances in the body which the Rolfing method addresses.
In Rolfing we consider the whole body, how imbalances, strains and myofascial asymmetries are distributed throughout your structure and come to bare on specific areas. The woeful pain sufferer is sharply aware of the pain in his back but naturally rarely considers the influence various far-flung areas of the body have on this one sore local spot. Clients are sometimes surprised to feel new connections in the body as they progress through the Rolfing Series (“When you touched my foot I felt something release in my neck”), but eventually most come to appreciate the importance of organising the whole of the body in order to improve any particular part such as the lower back.
There are certain key areas that must be dealt with in order to maximise the chance of resolving lower back pain:
- Lateral Line
- Glutes and Hamstrings
Let’s take a look at each area in a bit more detail. The relevant Sessions are explained in more detail here.
1 . Feet
How your feet are contacting the ground is crucial to the balance of the rest of your body. Key muscle trains start in the feet and go up through your legs and into the pelvis and hips. Therefore organising the bones and myofascia of your feet is integral to organising your legs and pelvis, which in turn affects the balance and comfort of your lower back.
An important ‘control point’ in the feet is the inside of the inner arch, specifically at the junction of the 1st metatarsal and cuneiform bones. This is where the Peroneus Longus muscle and Tibialis Anterior muscle meet. These muscles act as a kind of ‘stirrup’ or sling which supports the arches of the feet. It is important that the muscles which make up this sling, Peroneus Longus on one side and Tibilalis Anterior on the other, are in relatively good dynamic balance with each other. Any imbalances here, starting at the inner arch of the foot, will transmit disorganisation further up the body along their respective chains. We can understand this better by considering the pathway of each muscle.
The Peroneus Longus goes up the side of the leg, continues as the lateral hamstring and goes via the Sacrotuberous ligament into the myofascia of the lower back. The Tibialis Anterior goes up to connect to the Iliotibial Band (that often tight long ligament on the side of your upper leg) and connects to the Iliac Crest in the front of the hips.
If the foot is collapsed inwards (pronated) the Peroneus Longus will be tight and short, which may transmit tension all the way up to the lower back. If the inner arch of the foot is held away from the ground (supination) the Tibilalis Anterior is usually tight and short which may then continue into undue tightness in the Iliotibial Band, which in turn affects the pelvic tilt and potentially is another contributor to lumbar pain.
Session 2 in the Rolfing Series is dedicated to organising the feet and lower legs and thereby setting up the foot arches and stirrup muscles to be better supportive of a healthy lower back. The feet are further worked as a small part of various later sessions, specifically Sessions 3, 4, 5, 6 and 8.
2. Lateral Line
Session 3 in the Series deals with the lateral line, i.e. both sides of your body from the sides of the feet up through the sides of your legs and hips, then through your ribs and neck. The whole lateral line needs to be worked in order to help lower back pain but one section of this line is especially pertinent to lumbar pain. This is the Quadratus Lumborum (QL) muscle which connects your last (floating) rib to your hip.
Bilateral balance here is crucial because if both QLs are tight this will have the effect of compressing your ribcage towards your hips, thereby increasing pressure on your lower back and possibly causing pain. If one QL is tighter than the other it means that one side will be more compressed, which in turn causes sidebend and rotation in your lumbar spine: perhaps the most common cause of lumbar pain.
3. Inside Leg (Adductors)
The Adductors on the inside of your thighs can be especially important in relation to back pain. There is a myofascial chain from the inside thigh of each leg, through the pelvic bowl via the Psoas muscle to the lumbar spine on both sides. If the Adductors are tight and inflexible they can cause this myofascial train to pull on the spine and produce tension, often asymmetrically, which can lead to lower back pain. Session 4 in the Series can be a very important session as it addresses excessive tension in the inside leg and can have the effect of taking pressure off the lower back and continuing the process started in Session 3 of reducing lumbar compression.
4. Front of Thigh (Quadriceps)
The Quadriceps are very powerful muscles people commonly over recruit, i.e they will unconsciously make a big effort with these muscles for a relatively small action. You can check this yourself by lying on your back with your legs flat, then letting your knee float towards the ceiling while your foot drags along the floor. If you rest your hand on top of your thigh you will feel the muscle activate as your knee floats up — if it really kicks in then you know you are over recruiting the Quadriceps.
The relevance to back pain is that if this muscle group is chronically over working it will pull on your pelvis and tilt it forward and thereby increasing your lumbar curve and the likelihood of you getting back pain. Balancing the Quadriceps is important as it is common that one leg is dominant and tighter than the other, which will cause a twist in the pelvis and cause or aggravate lower back pain.
Session 5 in the Rolfing Series deals with muscular tension in the front of your body. Paradoxically releasing tension in the front can help with pain in your back.
5. Gluteals and Hamstrings
Tension in the back of your legs, from the Achilles tendons, up through the calves and Hamstrings and into the buttocks can be major contributor to lower back pain. It is vitally important to release excess tension in this section of your body in order to ease pressure in your lower back. Also tension further up the back needs to be released in order to allow space for any excessively tight myofascia of the back to relax. The work in Session 6 in the Series addresses strain and tension throughout your whole back line.
The remaining sessions after Session 6 continue to build balance and integration in your body’s myofascial net and structure. Each session has its role in organising your body. Usually by the later sessions there is a kind of tipping point where the accumulated effect of the sessions leads to a higher degree of order in your body. It is a process of continuing organisation, and the better organised your body becomes, the more chance that your back will be a balanced, healthy functioning and, hopefully, pain-free part of your body:
“In Rolfing, you start with disorganization … As you work, organization accumulates and disorganization decreases in the same percentage. By the time you get to the sixth and seventh hours, you have relatively little disorganization, and relatively a lot of organization. The critical mass has moved from disorganization to organization in that body.” — Ida Rolf