Will Rolfing Structural Integration help with knee pain?

Runner's kneePeople seek out Rolfing® Structural Integration for all kinds of painful conditions, not least of which is pain in or around the knee. I’ve seen a lot of people recently with knee issues that haven’t responded to chiropractic, physical therapy, and the rest of the standard melange of other treatments people often try (orthotics, knee braces, not running anymore, etc.).

I’d like to say that by doing a few sessions of Rolfing, you can expect all your knee pain to go away.  Sometimes it’s true. Sometimes all you need to settle down some knee pain is to look at what’s tugging and yanking your hips, knees, ankles, or even upper body out of line (thus stressing out the knee joint).  Unfortunately, sometimes even Rolfing doesn’t help.


Let’s say the excess tension that’s distorting proper movement and/or shock absorption of your knee exists only because one muscle or an area of fascia is just locally wound up and bound up. Getting in to release that area can be quite helpful. Many times I’ve seen, for example, trigger points in the lateral and posterior hips really irritate people’s knees. This is the best of options, because the positive change is fairly immediate and can last quite a while barring reaggravation.

But there’s the rub! For many people, the gooey bound up areas of tension do not exist in isolation. There are entire movement patterns built around the tight areas that make it very likely you’ll reaggravate. Without proper retraining of those movement patterns, the results of a few sessions of Rolfing are going to be rather short lived (unfortunately).

And that’s where proper exercise comes in.

One of the first places I look when a client tells me about knee pain is the hip joint. More specifically, I’ll put my hands over both greater trochanters to see how well the muscles are developed around each side.

Greater Trochanter from Gray's Anatomy

A lot of muscles attach to the greater trochanter. When well-developed, the mass of these muscles can be felt with your hands.

For folks with knee pain, I’ll usually find that the musculature around the greater trochanter is ridiculously underdeveloped at least on the side where the knee hurts, if not on both sides. Ideally, if you try to cup the back side of the greater trochanter with your fingers, the gluteal muscles will block you. With a lot of desk workers/weekend warriors, you can basically feel nothing but bone all around the greater trochanter. This is from squashing the butt all day long.

One exercise that helps reactivate the muscles around the hip is the ubiquitous clam.

Another exercise for the truly underdeveloped hips are hooklying abductor presses.

Hooklying Abductor Presses for your hip muscles

Lie on your back with your knees bent and feet flat on the floor. Tie a belt or strap around your thighs so they are parallel to one another. Pull your thighs away from each other (against the strap) and then relax. Do it for 2-3 sets of 20 reps.

Neither of these exercises should be particularly difficult, but if your hips are pretty weak, they will likely cause some intense muscle burn. You may even feel some burn of embarrassment when you realize how weak your hips are. It’s okay. This is just the first stage. Right now, the goal is simply to get the brain and butt/hip muscles talking again so that you can gradually increase the activation of those muscles.

As your ability to recruit those muscles improves, you’ll be doing much more “cool” looking hip exercises, and that extra help from your hip muscles will help your knee recover from all the overtime you’re making it work.

So back to our original question: will Rolfing help with knee pain? Maybe! If something is too tight, Rolfing will probably help. If something is too loose/weak, then it probably won’t (or at least not entirely).


About the Author

Matt Hsu is a trainer and orthopedic massage therapist. He fought a long battle with chronic pain all over his body and won. He blends the principles he learned in his journey, empirical observations with clients, and relevant research to help others get their lives back.