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Back Fix Bodywork
Understanding the cause of back pain
and how to get it

Fixing back problems with Structural Integration Bodywork



Includes more about back problem causes and gives body therapist "tips"


by Lou Gross, School Certified Master Postural Integrator
27 years successful track record
For more information & free consultations, call 321-726-9083


This book consists of an introductory overview and a series of seven sections, plus a group of appendices. The sections explain:

1. The causes of back pain,
2. How those causes create the problems we actually feel,
3. A sure-fire method to correct those causes.

     Each of the seven sections is organized as a series of short chapters, with each chapter explaining a particular part of the section’s topic. The appendices explain, one after another, how Structural Integration is different from, yet compatible with other commonly used treatments for back pain...and how this unique treatment actually helps each of them increase their benefits. The last two appendices explain how to find a practitioner for yourself and how to contact me for consultation.

     The chapter, section and appendix titles are very descriptive, so by reviewing the table of contents, a person can see what each chapter or appendix is about and how I discuss each topic. And you can also get an idea of the whole book.

     I've chosen this short chapter and descriptive format because I want to get across a lot of different information and not overwhelm the average person with long technical chapters. Nor do I want it to seem to the busy therapist or doctor that he or she needs to set aside a lot of time to get into the book. Each Section, and each short chapter within it, "spoon feeds" a digestible amount of information. Each builds on what the person's read before and provides understanding for what he or she will read next. The most significant cause of back pain, and the least understood, is described first. So if a busy person gets just that far into the book, he (or she) may still have gotten what he needs.

      Structural Integrators will find it interesting to see that this book on fixing back problems is also an explanation of the Structural Integration Bodywork treatment itself. But it presents this explanation in the context of fixing back pains. Here is how it covers the subject. These are the things Structural Integrators talk about.

SECTIONS I & II:      Overall body misalignments & the
                                       psoas muscles
SECTION IV:              The accumulation of everyday tightness,
                                       & movement education
SECTION V:                Mental & emotional tension,
                                       & energy imbalances
SECTION III:             The parallel of our psychological attitude
                                       with our physical form
SECTIONS VI & VII: The treatment process
THE APPENDICES:    How it compares with other body therapies


This Section I describes the two basic elements that Structural Integration deals with, the soft connective tissue called fascia and the shortness it accumulates. This is the foundation for understanding all the treatment can do. Then we discuss one of the major causes of most people's back pain: pelvic tilts and shortness in the large internal muscles of the lower torso, called the psoas (so-as).

If you look at your pelvis sideways in a mirror, and at other people's, you'll notice that many tilt down to the front and some tilt down to the back. Some also tilt to the side. You'll also notice that when there's a tilt, there's also an arch in the lower back. These are related by cause and effect. If one part of you leans one way, another part will have to lean the other way, or you'll fall over. These zigzagging leans get solidified in the body as the shape of the fascia and the positions of the muscles and bones. And when something's too short, there's pain.

In this Section, I also explain the difference between what we think of as "muscle" shortness and what is really causing chronic problems: the shortness of the fascia. You'll be hard pressed to find another book, outside of those on Structural Integration Bodywork that explains this very important point. And you probably won't find any other book that focuses on fixing back pain that even mentions it.

This Section I explains why we slouch and how the usual admonitions to "Sit up straight!" just add more shortness and tightness. They are compensations, on top of existing shortness and tightness, and they're a strain. They make backs hurt. The premise of this book is that it's much better to lengthen the existing shortness rather than adding more.

This Section I also discusses back problems from a human development point of view. It explains that some of the shortnesses underlying back pain are actually parts of us that didn't grow up; and others are the strains we've made to compensate for them. This is quite literal with regard to childhood traumas that created psychological blocks; those energies are still part of the physical shortness. And it's also quite literal with regard to being able to stand vertically upright; shortness keeps us from doing it.

A fully erect structure can stand upright, all by itself, and the person doesn't have to strain and tighten against these restrictions. People who can stand this easier way also exhibit fewer psychological restrictions. And they don't have to make excessive attempts to compensate for those shortcomings that aren’t there anymore. Both physically and psychologically, easy up tightness is a more balanced condition. All of us can become that way if we're more fully lengthened.

Even when the shortnesses have developed simply from adult activities, they keep us from being fully erect. That, too, restricts us both physically and expressively, even if it's just temporary until we get more Bodywork. In the meantime, it forces us to strain and compensate.


In the last section you learned how shortness in the fascia solidifies pelvic tilts, and how those tilts are related to short psoas muscles. This Section will explain how this condition causes back problems.

Tilts create whole body misalignments, from head to toe, and these mis-alignments also include chronic tightness in the leg muscles, pelvic muscles and abdominal muscles, as well as in the psoas.

There is a basic, perhaps universal misalignment that I call the Basic Imbalance. And there are a few variations of additional tightness that get added on top of it. These are very obvious conditions once they're pointed out and anyone who looks for the zigzags can see them.

These misalignments are the most common reason for back tightness and its muscle pain, and for disk and pinched nerve problems as well. It is also physically impossible to correct these misalignments, and therefore the back problems they cause, without lengthening the chronically short fascia of the abdomen, pelvis and legs. And often times, the removal of this shortness corrects the back pain immediately.

Bulging abdomens are both a cause and a result of these misalignments. Sit-ups and back flattening can help them, but they can also cause the back to hurt more. And holding in emotions can create back tensions, too.

This Section II explains all of this in a logical and graphic manner, in quite some detail. And it also explains how upper back, shoulder and neck pains come about because of the whole body misalignments as well.

Most professionals familiar with massaging or stretching bodies can use the information in Sections I & II to help their clients, and do better than if they tried to treat only the part that hurts.


There are psychological components related to these physical misalignments. The way the body is positioned correlates to the mental and emotional attitudes of the person. This Section III discusses the two most common conditions: never letting down and already giving up.

In one case, the pelvis is tilted way down in front and there is a big arch in the lower back. Here, the person is fixed into a position of straining up against the forces pulling him down. This "posture" refuses to give up and be defeated. In the other case, the buttocks are tilted down in back, and the chest collapses down into the abdomen. This person is fixed into a position of collapsing down, into the forces that go against him (or her), and he strains up against that collapse. This "posture" has already given up, and then tries to go ahead "on top of" that. If acted out in an extreme, the problems inherent in both attitudes cause problems in a person’s life and can sabotage the ability to get the back problems fixed. One person may think he can't let down to get the treatment. The other may think it's hopeless to try.

In this Section III, I discuss the physical patterns, the psychological patterns and the pitfalls to be aware of. In general, we're looking at two kinds of compensation. They're two very common ways that people get locked into strain and pain because they make adjustments on top of shortness instead of eliminating that shortness.

This Section III also points out that stretching and many physical therapies are limited when they try to fix many people's back problems, the ones that are caused by whole body misalignments and hard, short fascia. It explains that the difficulties to fixing the problems are usually with the particular therapy, and are not the fault of the back pain sufferer, no matter what they're told. The methods are inadequate, and it's not in the person's head.

There are also inadequacies in verbal psychotherapy. Because the psychological attitude is formed in the physical fascia, verbal work can only go so far in helping a person identify and correct his or her problem. We cannot emotionally relax out fascia nor mentally affirm away its shortness. The change requires a physical manipulation. And once that manipulation is done, the verbal therapy can do much more good.

This Section III can help people with back problems understand what's involved in getting successfully treated. It may interest those in psychotherapy, or personal growth practices, to get the Structural Integration treatment.  And it may aid psychotherapists to help their clients better.

It will definitely add to the training of Structural Integration practitioners because, in all my experience, I've never heard this kind of analysis from someone else.


Besides whole-body misalignments, back tightness also comes from just bunching up the fascia with everyday and athletic activities. In the legs this happens from running, hiking and jumping, and from sitting cross-legged while meditating for long periods of time. When the muscles get bunched up in the fascia, certain injuries can occur, like pulled hamstrings, groin muscles and Achilles tendons, and damage to the knee.

A lot of upper back pain occurs from bunched-up arms. This Section IV explains how arms tighten and what activities seem to tighten them the most. Then it explains how the arms are interconnected with the back, so that arm tightness ripples through to cause back, neck and shoulder tightness, and pain, and other torso tightness that even restricts breathing.

This Section IV describes how the arms are an extension of the torso. The arms connect to the shoulder girdle and it connects with a set of muscles that make up a big "vest" covering our chest, sides and back. This vest, with arms, fits right on top of the ribcage and spine.

With this understanding of our physical structure, we can get an idea of the psycho-somatic function of the arms and torso. They're anatomically designed to carry out our intentions and express our feelings. And in a reverse direction, they're designed to bring in feelings and other energies from the outside world. When we have tightness bunched-up in the arms and torso, both the expression and receptiveness are restricted. Some of that restriction appears as back pains.

One chapter in this Section IV gives examples of a few different conditions I have helped, and describes the not so obvious structural interconnections that need to be improved in order to fix the problems. These include carpal tunnel syndrome, pain between the shoulder blades and the very common tight shoulder and neck condition that doesn't relax with direct massage.

Besides mentioning how Structural Integration Bodywork corrects the shortness that's already developed, a final chapter describes Movement education techniques that show us how to use our arms and other parts of our bodies without tensing them up so much.

These methods are based on how our arms developed in our physiology and how they work best when integrated with the rest of our structure. The arms and legs developed from the fins of fishes through the four legs of other land animals and through the uses of arms and legs in other primates. Some of these folks swing in trees as their principle means of locomotion, versus ours of walking and running on the ground. When we find out how we're designed, we can better understand how each part contributes a different aspect to our whole body movement. Then we can do physical practices that make use of these not so well known understandings. This will enable us to make more powerful movements and express ourselves with greater presence, more relaxation and less strain. These methods work most effectively, and are easier to do, after the body has been empowered to do them with this Bodywork treatment.

The "how-to-fix-it" examples should give massage therapists and other Structural Integrators some tips on how to do their work better.

And the emotional expression and Integrated movement chapters can help athletes, dancers and other performing artists find out how to increase their level of performance


This Section V explains how heads and necks are structurally interconnected to the back and then goes on to describe how we accumulate head tension from stress, from structural misalignment, and from the usually overlooked but very important aspect of digestive disturbance.

The head is not one solid piece; it's a "Chinese puzzle" of many interlocking bones, muscles and ligaments. And it's supposed to have its pieces move around, as the rest of the body likes to move around. But on most people it's tight. And that tightness makes the neck, shoulders, back and even the chest tight. It puts tension on the spine, and blocks the energy flows in the entire body which creates tension in all the internal organs and in many of the structural muscles through which these energy flows run. It also puts stress on the body's vertical balancing system that keeps us standing up.

All of this creates back tension, which adds to the tightness caused by misalignments and tight arms. In addition, back tension for any reason creates head tightness. And besides the above list of displeasures, head tightness weakens the parasympathetic nervous system's ability to relax and rejuvenate the body. Generally speaking, a tight head undermines all the relaxation that a nice massage does for the rest of the structure. And it significantly prevents body therapies from relaxing the torso and legs, including releasing tight back muscles.

One chapter of this Section V goes into detail about the behavioral causes of stress, the energy blockages they create, and the negative psychological patterns these blockages perpetuate in our daily behaviors. Another chapter describes the structural nature of headaches, the things that cause them to occur and how repeated headaches bunch up tissue so that it's easier to have more headaches. A third chapter describes how holding in emotions with the mouth, that is, not expressing them, causes back tightness. A final chapter even explains how many pillows it's healthy to sleep on.

This Section sheds light on the need to treat an often neglected part of the body. And the various kinds of information it provides can be of assistance to sufferers and physicians alike. I even point out how eating different kinds of foods makes a person more uptight or less uptight.

Understanding the need for deep bodywork on the head can help massage therapists create better relaxation, improved neuro-muscular function and even better muscle lengthening.


Now that you know the underlying causes of back problems, this section explains the approach we can use to correct them. It summarizes the principles of Structural Integration Bodywork. In discussing these principles, we'll review, and organize, many of the comments I've already made throughout the book.

First I introduce the origins and some history of the process. Then I talk about how the body is actually a group of segments, all connected together at major joints, and how aligning the centers of gravity of all these segments allows the body to stand upright without strains and compensations. I discuss how the many muscles and bones are all part of an interconnected system, and that tension in one part of the body affects many other parts. Then, of course, I discuss how the tensions and shortnesses get fixated in the shape of the fascia, and how manipulating the fascia releases and lengthens them. In the process, we resolve all the interconnected stresses and align the segments one on top of another.

I also introduce the "recipe" of 10-steps that unravels and reorganizes the body with the manipulations. I point out that this recipe defines the whole treatment. Each step works a particular muscle group in one area of the body and at a specific level, or depth, in the structure. But each step does a different area. Ten steps means 10 different things. So when we say it takes a certain number of hours or sessions to align a whole body, we are describing the length of ONE treatment, a treatment that is spread out over a number of weeks instead of being applied in 10-20 hours straight.

This is very different from many applications with other kinds of therapy, in which each short treatment does a little more of the same thing.

This point is especially important for chronic pain sufferers. During some of the earlier sessions, long-term pain often goes away but comes back a few hours to a few days later. This is confusing for many people. And it can even cause them to stop in the middle of the process. They think this series of treatments is like those other series' of treatments. But it's not. Only when we do enough hours will we have lengthened all the muscles that are making the person have that pain for such a long time. And in each hour we'll be doing more muscles. In this discussion I explain the psychological as well as the physical problems of chronic pain conditions and give tips on how to judge if progress is being made even before the chronic pain is gone.


The first chapter in this Section VII describes the areas worked and the benefits that accrue as we do each of the 10 steps of the recipe. Quite a few details are provided. As you read it, you'll see how the system is put together and why we do one part of the body before or after another part.

The second chapter describes seven common ways we can tailor the system to improve its efficiency for different conditions. For example, one of the ways is to treat the tightest and most heavily used area first. If we do some of the head first, we can help mental stress right away. If we also do some shoulders, neck and back, the immediate stress release will be even greater. For running athletes, we can start with the legs and pelvis, since that's the area they tighten most, and often. And for massage practitioners, some musicians and tennis players, doing the arms first brings a lot of immediate relief and improved performance.

These chapters give good guidelines. They'll help body therapists, including new Structural Integrators, do their work better.

The third chapter concludes the main part of the book and gives guidance on what to expect with the treatments. It emphasizes that we are NOT treating pain in the way doctors treat pain. We are correcting the cause of many pains, which are

1. Shortness in the fascia all over the body and
2. The misalignments that show up in these shortened whole body forms.

By doing these two things, the nerve sensors that give pain signals usually become inactivated. i.e. They get turned off. These are the signals that were saying, "such and such part is too short." So what we're doing is improving the structural health of the body by re-educating it; it becomes more appropriately longer and better organized.

With this in mind, I answer the question that so many people ask, "How long will it take?" I explain that practitioners can estimate how many treatments or hours it will take to do the 10-step basic process and some advanced sessions in order to align a particular body. And while many people get significant results sooner, this estimation is to at least do the 10-step process. During that process, the practitioner will be able to see and feel how quickly any one person's tissue is lengthening and how much their daily activities between sessions are recreating tensions, if any.

Practitioners can combine what they feel happening with what they see in "body reading" Polaroid photos. The practitioner's explanation can then help the client correlate the improvements he sees in the photographs with what he feels happening in his body. Generally speaking, when the body looks longer, straighter and more relaxed, people are feeling better.


This section of the book is meant to help a person find a practitioner and enable him (or her) to combine this treatment with others if he or she chooses. The appendices provide some basic information about what these treatments do and how well they work to fix back pain. These are the kind of inquires I often get. I've pointed out how each of these therapies, in its own way, is effective for doing certain things. But none of them move fascia and align structure the way Structural Integration does.

Appendix 1 explains massage and trigger point therapy and points out how they are both helpful to a person receiving the Bodywork. It also points out how the Bodywork improves things they do not, and that enables them to do more.

Appendix 2 explains how the Bodywork helps chiropractic in many ways. And it points out how the combination of both treatments helps people correct serious conditions more than if they were doing only one of them. The combination also helps people as a routine maintenance, for continued well being and in athletics.

Appendix 3 discusses acupuncture and acupressure, and explains how they are parts of the much larger system of Traditional Chinese Medicine. Here, too, I point out how these treatments loosen tension, but that it is muscular tension and not much fascial reorganization.

Appendix 4 explains how the Bodywork can preclude the need for back and other kinds of orthopedic surgery. And if structural surgery is required, it explains how the Bodywork can help remove the stresses that caused the injury to occur in the first place, so a repair may heal better, and sooner. This appendix also describes how the Bodywork improves areas of old scar tissue and how it improves overall coordination even when there's nerve or tissue damage.

Appendix 5 tells you good ways to find a practitioner and gives you a checklist of what to ask when you contact one. It includes the names, addresses and phone numbers of some major schools that can provide you with the names of Bodyworkers in your area. This appendix also offers a brief review of some of the other books that describe the Structural Integration treatment. And it gives you the name, address and mail order phone number of a large bookstore that carries them.

Appendix 6 explains my own professional background and gives my phone number and address so people can contact me. I offer brief consultations and appreciate comments and suggestions on the book.

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