Lower Back Pain

A Three-Paradigm Treatment Model Using Soft Tissue Mobilization and Guided Movement-Awareness Techniques for a Patient with Chronic Low Back Pain:

John T. Cottingham, MS, PT Jeffrey Maitland, Ph.D., Journal of Sports Physical Therapy, Volume 26, III, September 1997

Reprinted with permission by senior author.


  • The use of non-conventional holistic techniques of soft tissue manipulation (Rolfing) and movement awareness methods for the treatment of chronic low back dysfunction were successful in this case study.
  • The client received previous back treatments from a chiropractor, massage therapist and exercise therapist. These therapies provided her with only temporary relief from her back symptoms (1–5) days.
  • During the 4th session, the treatment focused on improving overall postural alignment and movement patterns.
  • In sessions 4–5, the clients faulty motion patterns were optimized through a series of soft tissue manipulations and guided movement techniques based on the work of Dr, Ida P Rolf.


  • After the 5th session the client’s low back pain disappeared and did not return during the 6th and final session.
  • The client remained symptom free after a 1-month follow up.
  • After 6 months, the client was still symptom free.


  • The patient exhibited a sustained improvement in her low back symptoms and a reduction in the forward tipped pelvis, only after she showed a dramatic enhancement in the pattern of her basic movements.

“When movement patterns and the body as a whole are reorganized, chronic low back pain is more likely to also disappear.”

John T Cottingham, Physical Therapist, Certified Advanced Rolfer, and research associate at the Illinois, Christie Clinic Association. Author of Healing through Touch: a History and a Review of the Physiological Evidence (Rolf Institute, Boulder, Colorado)

The authors also maintain that integrative approaches may be successful in treating musculoskeletal dysfunctions other than low back pain- especially disorders involving autonomic nervous system imbalance. They cite fibromyalgia and chronic myofascial pain syndromes as examples.

Jeffrey Maitland. Ph.D. is Faculty Chairman and Director of Academic Affairs for the Rolf Institute. A Certified Advanced Rolfer, Maitland is one four Advanced Rolfing Instructors in the world, author of Spacious Body: Explorations in Somatic Ontology (North Atlantic Books, Berkeley, CA, 1995).