*This article is a translation of one I wrote while I was practicing in Japan.

I would like to report on the progress of Ms. N’s 10th session. Six months had passed since her last visit. Her physical condition was very good, and she reported that when walking while being conscious of the sensation in her toes, as we worked on last time, she could naturally feel an openness in her chest and maintain a brighter mood. She was keenly aware of the connection between mind and body, and mentioned that she now understood why there are so many body-related idioms in the Japanese language. However, she also shared that it’s true that old habits haven’t completely disappeared, and she sometimes finds herself moving in her previous patterns without realizing it.

Upon examining Ms. N’s body, I could objectively observe the connection between the functionality of her toes and the suppleness of her upper body, as she had reported in her feedback. From a structural perspective, the knock knees were still present, and I was looking forward to seeing how much further change could be achieved in this final 10th session.

Abdomen and Neck: Psoas Major and Longus Colli/Capitis Muscles

In Rolfing sessions, we particularly emphasize the standing posture, focusing on the balance between posture and gravity. When viewing the human body line from the side, it can be broadly divided into lordotic and kyphotic groups. The curled-up, kyphotic posture of an infant, which is their natural state at birth, is said to be a safe and secure posture for humans. In contrast, the knees, lower back, and neck form a group characterized by lordosis.

During the growth process in early childhood, lordosis develops in each of these areas to acquire social abilities such as “holding up the head,” “crawling,” and “walking upright.” Because lordosis is formed for the acquisition of social skills, it is said that the knees, lower back, and neck are particularly prone to reflecting a person’s personality, qualities, communication tendencies, and interpersonal relationships as postural patterns.

At the beginning of Session 10, I checked Ms. N’s standing posture. The areas I wanted to approach were consolidated into three parts. These corresponded to the knees, lower back, and neck of the lordotic group, and among these three structurally and functionally closely connected areas, I first focused on the lumbar spine, which showed a slightly stronger curvature. The relationship between the lower back and neck is particularly important when considering posture and movement.

The psoas major muscle in the lower back and the longus colli and capitis muscles in the neck are key points for further application of the inner form we introduced earlier. So, I had Ms. N lie on her back with her knees bent and performed work to enhance the coordination between her abdominal area and neck. However, in Ms. N’s case, this didn’t quite fit. In such situations, it’s often more successful to change the focus point rather than persisting with the same area.

Is Your Arch Collapsed? Lifting the Second Cuneiform Bone

Although the goal remained the same, I decided to try a different approach by shifting the perspective to “the chain from lower limbs to upper limbs.” Continuing from Session 9, we deepened the approach to the toes and soles of the feet, connecting this to the knock knees and hyperextended knees. Last time, we focused on activating the flexor hallucis brevis and adductor hallucis muscles to enhance the functionality of the big toe. As a development of this, this time I had her experience lifting the second cuneiform bone of the foot.

The method involves maintaining a high position of the second cuneiform bone to preserve the arch of the foot while flexing and extending the knee and ankle. When done correctly, one can feel appropriate tension in the muscles of the toes, soles, and around the tibia and fibula. Activating the second cuneiform bone creates appropriate tension in the lower limbs, which serves as one of the switches to enhance the fascial chain from the lower to upper limbs.

While this can be a difficult point to sense for those unfamiliar with it, Ms. N, who had already grasped the sensation of activating her toes in the previous session, was able to make the feeling of lifting the second cuneiform bone her own without difficulty. From her feedback that she felt it was easier to engage her abdominal muscles when conscious of the second cuneiform bone, I could tell that she was effectively using the core unit of the lower limbs and abdomen.

Characteristics of People with Hyperextended Knees

After working on lifting the second cuneiform bone, we approached the knock knees and hyperextended knees. People with hyperextended knees tend to unconsciously maintain excessive tension in their quadriceps femoris muscles. One approach to address this excessive tension in the quadriceps is to work on the kneecap – the patella.

First, in a seated position, I had Ms. N herself feel the space that should exist between the patella and femur, allowing her to experience the muscle’s overtension and mobility when relaxed. Next, I had her maintain awareness of the space between the patella and femur while standing. When performing this patellar work in a standing position for people with hyperextended knees, almost everyone gives feedback that “it feels like my knees are bent.”

This is due to a temporary sense of discomfort arising from capturing one’s center of gravity in a position where knee tension is released, differing from the familiar way of using the knees. At first, Ms. N also felt like her knees were bent, but as she became able to simultaneously be aware of lifting the second cuneiform bone, she seemed to experience a remarkably stable connection in the line from her lower to upper limbs. As she savored this sensation, the balance between her lower back and neck, which we attempted to address at the beginning of the session, also shifted into a beautifully harmonized position.

In Ms. N’s 10th session, we focused on the relationship between the knees, lower back, and neck from a macro perspective, while from a micro perspective, we concentrated on improving her knock knees and hyperextension. The truly refreshed standing posture at the end of the session was particularly impressive.

Conclusion

The chain of the body is truly mysterious, and the reactivity of the fascia varies completely depending on the angle of approach. The fact that desired results can be achieved through approaches from different areas is a testament to regained flexibility. In Ms. N’s case, I condensed the approaches we’ve taken over the 10 sessions into a few simple works as the essence of “sensory knacks” that can be practiced in daily life.

I believe I was able to provide her with cues that will allow her body to return to a comfortable center of gravity position when she remembers to practice them. Correcting issues like knock knees only on the treatment table is just one method. Rolfing views “functional aspects such as movement and sensation, and structural aspects such as posture and form as one and the same.” We progress through sessions with the aim of having clients relearn comfortable ways of using their bodies that allow them to feel better in their daily movements and have a brighter mood. One of the essences of Rolfing is the belief that by continuing to use the body comfortably, one naturally returns to a natural line through the effects of gravity.

At the End of the Session: The Relationship Between Cough and Structure

During the six months between Session 9 and this session, Ms. N had fallen ill and was troubled by throat discomfort and chronic cough. This chronic cough was apparently always the main symptom whenever she fell ill. At the beginning of Session 10, when I attempted to approach her neck, she mentioned that there was a point around the mastoid process and sternocleidomastoid muscle that seemed to trigger the cough she had been struggling with.

Considering this from a structural perspective, it appeared that the neck was solely bearing the burden of dysfunction in the lower limbs such as feet and knees, and poor movement in the lower back. This also ties back to the relationship between the three areas: knees, lower back, and neck. The chronic accumulation of stress on the neck area causes circulatory issues in the sternocleidomastoid region, which in turn negatively affects the stellate ganglion and thoracic sympathetic trunk through the microcirculatory system of the neck, ultimately manifesting as chronic cough symptoms.

In acupuncture terms, this corresponds to the Fuukei point. In some schools, this point is heavily relied upon as an essential point for improving the immune system and associated chronic inflammation. It was an intriguing state where the comparison between acupuncture points and symptoms as seen from Rolfing’s structural perspective was clearly evident. I informed her that by improving her habitual patterns and ways of moving, there was a possibility of alleviating her chronic symptoms as well.

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