What’s the difference between Swedish massage and Structural Integration?

People seek bodywork for two reasons: they want to feel good, or they want to stop feeling bad.

For someone who’s feeling stressed, who just wants to chill and be soothed, a good relaxation-style massage is wonderful. Relaxation-style treats the body by kneading tight muscles and gentle-touch techniques on the skin. This lowers the resting tone of the sore muscles. It includes sensory experiences with long flowing strokes, slow deep breathing, pleasurable rocking of the limbs to allow release of tension, and music designed to lower stress.

But if someone hurts, like from an old injury or a demanding job, they want the pain to go away. They get the best relief from therapeutic massage. I practice two forms: (1) deep-tissue myofascial, which is done through gentle-but-deep pressure combined with moving the muscle, aka “Soft Tissue Release,” and (2) a modified style of structural integration, a contemporary form of Rolfing called “Myofascial Integration — Posture Alignment.”

Myofascial therapy can different from Swedish in that it doesn’t necessarily follow a choreographed flow for the sake of bringing pleasure, but rather just fixes things. It focuses on imbalances of posture, shortened muscles, and restricted fascia like adhesions or scars. It addresses not just the muscles or the skin, but on the bigger-picture, the multi-joint structures. This can lengthen, separate, or reposition them relative to other structures. It uses no lotion, to get a better grip on the tissues and transmit lengthening forces through the skin.

This kind of therapeutic massage feels different from a relaxation one in a few ways. It has a goal, or focus: fixing whatever injury or pain you’re having, or addressing the balance of the entire body and the relationships between its structural and functional systems. It also involves more participation from the receiver (like my asking “stretch this way and inhale”), and doesn’t have as much sense of soothing flow. Because it’s more like physical-therapy than a spa experience, it is usually done with clothing, like a swimsuit or underwear/bra, and draping is only used for warmth and comfort. Many practitioners prefer not to even call it massage (see Rolfing is not massage).

Rolfing-style work is also done very slow and requires focussed concentration. Its very nature lends itself to a state of meditation, both in the giver and the receiver, and so it is often done in silence.

What is fascia?

Fascia is a network of collagen fibers that covers and connects every structure in our body, from the largest muscles and organs to the smallest arteries, and even the membranes of each cell. It is like a high-tensile plastic wrap that both separates everything in our body, and then holds in it place. Like fascia, tendons and ligaments are also made from collagen; all three are “connective tissue.” Ligaments join one bone to another, tendons join muscle to bone, and fascia connects muscles to other muscles and to the skin.

From the Greek for glue, collagen means “glue producer” and refers to the early process of making glue from animal products. The seamless, continuous web of collagen glues the body together and integrates all its structures. Collagen is also the main component of gelatin.

The Fascial Research Congress offers a more complete definition: “Fascia is the soft tissue component of the connective tissue system that permeates the human body. It forms a whole-body continuous three-dimensional matrix of structural support. Fascia interpenetrates and surrounds all organs, muscles, bones and nerve fibers, creating a unique environment for body systems functioning. The scope of our definition of and interest in fascia extends to all fibrous connective tissues, including aponeuroses, ligaments, tendons, retinaculae, joint capsules, organ and vessel tunics, the epineurium, the meninges, the periostea, and all the endomysial and intermuscular fibers of the myofasciae” (fasciacongress.org).

What is Myofascial release?

Myo- is Greek for muscle. Myofascial release therapy manipulates both muscles and their connective structures to “release” restrictions and achieve long-term improvement to a body’s functioning. Unlike many forms of “complementary alternative medicine,” this type of bodywork has been shown by objective scientific studies to be effective; see about evidence-based medicine.

Interestingly, lengthening the fascia by external touch has many of the same effects as doing yoga. In yoga you stretch entire groups of muscles at a time, like when you lean forward to touch your toes. As you hold that pose for 30 seconds or longer, you gradually lean farther forward as the tissues elongate. Therapists “do yoga” on just one muscle at a time, using their own hands to slowly apply the stretching force. This lengthens your muscles and tendons and you feel looser, lighter, longer.

Rolf herself was a dedicated member of one of the first hatha yoga groups in New York city in the 1920s, and believed yoga to be one of the most effective forms of self-healing. When she began to learn manual therapy and osteopathy to heal others, her first intent was to help them get into yoga poses, using her hands to gently (and not-so-gently!) guide their bodies into positions of free movement. To the receiver’s nerve receptors, there’s not much difference between putting her/his own body into a position of stretch, vs a therapist using their hands to stretch the tissues. Because both can have the same effect, I think of Rolfing as applied yoga.

How does it work?

Structural Integration can improve posture, correct inefficient movement patterns, and ease chronic pain. For some people, it can be more effective than relaxation massage. Techniques can include manually stretching tendons and entire muscles; contracting and relaxing muscles during stretches; pinning or moving muscles during lengthening; and sliding the superficial fascia between the muscles and the skin.

Movements are slow and deliberate. There is no pain — at least, not the way I do it! The key is taking it slow, warming everything up first. My sessions are “about” 90 minutes because my hands follow the needs of the body, not the dictates of the clock. As Rolf would say, “it’s not how deep you go; it’s how you go deep.”

Some practitioners believe that manual therapy can significantly lengthen and repattern fascia. But collagen is extremely resilient material — it has to be, given the huge stresses of pressure and tension placed on tendons. It is unlikely that any real change could be effected in the fascial structure of the body without aggressive work, like for example the stretching routines of a gymnast or the focused techniques of cross-fiber friction.

Rather, the benefits of myofascial are from neuro-muscular proprioception, which just means our body’s sense of itself. Pain and tension sometimes has a physical cause in the muscle, e.g. a trigger point, but most tension has a different cause. It is set by the nervous system. The brain itself decides how short and tight, or how long and loose, each muscle is. When we do a daily stretching routine we might be lengthening the collagen network a tiny amount, but mostly we’re retraining our brain to accept a longer length for that structure. Tiny sensors in our muscle called Golgi Tendon Organs will gradually allow us to stretch more without triggering pain and the sense of “that’s as far as it’ll go!” Once the muscles are in their new position or the fascia has “repatterned,” the brain will remember this new length and sense of ease. It is a neuro + muscular change.

A Rolfer would say: the therapist isn’t imposing a change upon a client’s body, but rather helping the body remember its original childhood state of being light in gravity, unhindered by injury and use. It’s a form of bodywork that sticks with you, that stays: because your body likes the feeling of the new freedom, the new patterns will imprint.

Another factor is warming up the tissue. Collagen has a property called thixotropy, which means that it resists fast movement or changes while it’s cold, but gets pliable when it’s warm or moved slowly. It’s like Jello, which is also made from collagen. Warming up the soft tissues (superficial fascia and skin, muscle, fascia around muscle, and tendon) through Swedish massage, hot packs, or slow lengthening allows the collagen to release. One of the best ways to warm up the fascia to painlessly stretch it is hot stone massage. The heat and density of the stones swiftly softens muscles and other tissue. While the thixotropic effect goes away as soon as the heat/pressure are released, the sense of looseness remains.

The exact mechanisms by which fascial therapy works are not yet known, but that it does work is evident to most who’ve tried it. It could be merely a matter of sensory/nerve input, as hypothesized by Diane Jacobs’ Dermo-Neuro Modulating (DNM). Some other examples of what might be happening are given in these articles, If We Cannot Stretch Fascia, What Are We Doing? and We Have Much to Learn from Fascia Research.

Further reading

Download brochure: About Myofascial Massage [PDF]