An interesting explanation of how dysfunction in one part of the body can affect other parts of the body (also dysfunctional) is offered by the model of tensegratic structure, applied to “living” tissue = the so-called biotensegrity. The term “biotensegrity” was introduced by Levin, who hypothesized that stress integrity is the mechanism by which the body is able to maintain the stability of various organs and systems, particularly the spine. Levin proposed that muscle tension throughout the musculoskeletal system puts pressure on the rigid components, the bones, and allows you to function and move upright. When a person’s biotensive chain is stressed, such as when getting up from a chair, the musculoskeletal system becomes stiffer, and the tone of the tissue increases. Connected myofascial chains shorten or lengthen in response to changes in the body’s position in space, adapting to work under different conditions and loads. The concept of an integrated kinetic chain assumes that muscles and fascia are interconnected and form an extensive, interwoven network of myofascial chains with multiple joints capable of transmitting force between them (1). The Structural Integration method refers to the concept of “biotensegrating structure”, whose geometry and shape are determined by the equilibrium of rigid and tensed elements held in certain spatial relationships. In such structures, locally induced perturbations / dysfunctions change the shape and geometry of the whole structure (2). According to Ida Rolf’s assumptions, tension equilibrium or its absence in fascial structures (tension elements) is a strong determinant of bone alignment and joint function (rigid elements), which means that the human body functions according to the principle of a tensegratic structure. The “alignment” of fascial tension through specific mobilization/manipulation of soft tissues is thought to facilitate the interaction of the body’s central axis in the field of gravity, producing what is known as the functional anti-gravity reflex. Other biomechanical features of tissues and the human body that guided Ida Rolf include a kind of restoration of body symmetry, horizontal alignment of the main body segments in relation to each other, and restoration of “grace” during movement (e.g., walking) (3).

Is there anything more that can be done in the area of conservative treatment besides the recommended pelvic floor exercises? The neuromuscular, holistic concept of working with the body, Structural Integration, seems to be an interesting concept to use when working with women of all ages and with various pelvic floor disorders. In a study of the effects of 10 sessions of Structural Integration on the bioelectrical activity of the pelvic floor muscles in healthy girls, it was found that the bioelectrical activity of the pelvic floor muscles was reduced while the muscles were supposed to “relax”. .” The increase in activity occurred during the so-called contractions of the pelvic floor, which can be interpreted to mean that fast twitch fibers were recruited and it was possible to produce “more force”. The interpretation of these results in relation to the publications of other authors gives another direction of research focused on the application of the concept of Structural Integration in different types of pelvic floor dysfunction (mainly urinary incontinence and chronic perineal pain – in different situations) (4).

Grzegorz Jędrzejewski

References:

1. Masi AT, Hannon JC. Human resting muscle tone (HRMT): Narrative introduction and modern concepts. J Bodyw Mov Ther. 2008;12(4):320–32
2. Dischiavi SL, Wright AA, Hegedus EJ, Bleakley CM. Biotensegrity and myofascial chains: A global approach to an integrated kinetic chain. Med Hypotheses. 2018;110:90–6.
3. Jacobson E. Structural Integration, an Alternative Method of Manual Therapy and Sensorimotor Education. J Altern Complement Med. 2011;17(10):891–9.
4. Kasper-Jędrzejewska M, Jędrzejewski G, Ptaszkowska L, Ptaszkowski K, Schleip R, Halski T. The Rolf Method of Structural Integration and Pelvic Floor Muscle Facilitation: Preliminary Results of a Randomized, Interventional Study. J Clin Med. 9 grudzień 2020;9(12):E3981.