Structural Medicine is a school of Structural Integration. There are 17 schools of Structural Integration, all based on the teachings of Ida Rolf.

Structural Medicine’s aim is to free up the body’s fascia (connective tissues) in order to relieve pain, balance posture, and create greater ease of daily movement. Structural Medicine is comprised of myofascial length testing, hands-on bodywork, and personalized movement education. The myofascial length testing helps me pinpoint where to work, the bodywork portion enables the client to improve their natural movement patterns, and the education piece helps the client to cultivate greater awareness in their own body.

The Institute of Structural Medicine, founded by Donna Bajelis, PT, CHP, SMS explains it as this: “Structural Medicine involves extensive evaluation of postural alignment and movement, in order to balance the myofascial tone, length, and strength across all the major joints of the body. Through myofascial reorganization, the Structural Medicine process moves the body closer to a more efficient organization and function in gravity.” The contribution of Structural Medicine to Structural Integration is the rigorous myofascial length testing which helps the practitioner zero in on where the client needs attention most.

The Structural Medicine process is a series of sessions that build upon each other. Each session focuses on a particular body part and intention. Although the series follows a framework, each individual is unique, so each person’s sessions and results in the series will be unique to them.

Structural Medicine is based on the work of Ida Rolf, who called her work Structural Integration. Somewhere along the line, her last name was turned into a verb and noun. Hence, Rolfing ™ and Rolfer ™ were trademarked. There are now 17 schools of Structural Integration, all based on the teachings of Ida Rolf.

As a graduate of the Institute of Structural Medicine (ISM), I am a Structural Integrator designated a Structural Medicine Specialist. I use these terms interchangeably to describe myself.

Merriam-Webster defines massage as “manipulation of tissues (as by rubbing, kneading, or tapping) with the hand or an instrument for relaxation, or therapeutic purposes (i.e. pain relief—ed).”

Structural Integration is a process, not a technique. The objective of Structural Integration work is to free up the fascia (the connective tissues of the body) to relieve pain, balance posture, and create greater ease of movement.

There is a great deal of overlap between Structural Integration (SI) and massage and there are also differences. In the State of Washington, massage therapists (LMT) must graduate from a State recognized massage school and pass a licensing exam in order to practice. To be qualified as a Structural Integration (SI) practitioner, they must pursue and complete additional training.

For a person to call themself a Board Certified Structural Integrator, as I am, they must graduate from an IASI certified school and pass a certification exam. SI practitioners often include massage therapists, chiropractors, physical therapists, occupational therapists, and physicians.

Each Structural Medicine session includes postural analysis, hands-on manual therapy, and movement education.

Postural analysis tells us where support and work is needed in the body. Manual therapy helps release connective tissues and muscles for improved alignment. Movement education offers the client greater awareness of their body and their movement patterns.

“No pain, no gain” is not part of my practice. During a session, there may be some discomfort during manual therapy, but it is not excessive. This is where open communication is very important.

If there is too much intensity with a particular technique, please kindly speak up. Part of my responsibility as a practitioner is to pay attention to how a client is responding to our work together. I will verbally check in with you during the session, but if you have any needs, questions or concerns, please don’t hesitate to ask.


Your initial session will last 80 minutes. We’ll review your health and medical history, establish your expectations and goals of our work together, and answer your questions. The rest of the session may include:

  • An explanation of my approach
  • A physical therapy scan, where needed, to rule out any red flags
  • A visual assessment of your structure
  • Myofascial length testing
  • Hands on bodywork
  • Movement education

During a session, clients are typically in their undergarments: men in their underwear (please no boxer shorts) and women in their underwear and a bra (opening in the back please). For both men and women, no thongs please. If shorts are preferred, wear loose (not tight-fitting) shorts. This is to support the visual assessment, movement education, and bodywork parts of each session.

Clients report many positive results from receiving the SI series. They include:

  • Decreased pain from long-standing issues
  • More ease and comfort in one’s body as one moves through the world
  • Improved response and resilience to life’s challenges

People who have benefited from Structural Integration include:

  • Long-distance athletes
  • Weekend athletes
  • Martial artists
  • Rock climbers
  • Pilots
  • Barre students and teachers
  • Yoga practitioners
  • Police and firefighters
  • Office workers
  • Healthcare professionals

Learn more about the series »