Rolfing is a therapy system created by The Rolf Institute of Structural Integration (also referred to as "RISI")[1], founded by Ida Pauline Rolf in 1971.[2] The Institute states that Rolfing is a "holistic system of soft tissue manipulation and movement education that organize(s) the whole body in gravity".[3] Manipulation of the muscle fasciae is believed to yield therapeutic benefits, including that clients stand straighter, gain height and move better, through the correction of soft tissue fixations or dystonia. Rolfing lacks a scientific evidence base.[4] Only practitioners certified by RISI can use the title "Rolfer," or practice "Rolfing," due to service mark ownership. The Guild for Structural Integration is the other certifying body, whose graduates use the title "Practitioners of the Rolf Method of Structural Integration." Skeletal muscles often work in opposing pairs called the "agonist" and the "antagonist", the one contracting while the other relaxes. Rolf theorized that "bound up" fasciae (connective tissues) often restrict opposing muscles from functioning in concert. She aimed to separate the fibers of bound up fasciae manually to loosen them and allow effective movement. Rolfers often prescribe a sequence of ten sessions to "balance and optimize both the structure (shape) and function (movement) of the entire body."[8][9] The theory is that "only by bringing peace 'from the ground up' can problems higher in the body be 'understood'".[10] A client generally lies down and is guided through specific movements during a Rolfing Structural Integration session. The Rolfer manipulates the fascia until it can operate in conjunction with the muscles in a "normal" fashion.[9] This takes place over a course of ten 60- to 90-minute sessions, with a specific goal for each session and an overall goal of cumulative results.[8] Some clients find Rolfing painful but it has evolved over the decades into a far more gentle practice than it was in its early days.[11] On The Oprah Winfrey Show in 2007 Mehmet Oz likened Rolfing to having someone do yoga for you.[12] [edit]Evidence base Rolfing Structural Integration is generally regarded as safe[13]. However, because it involves deep tissue manipulation, pregnant women and people with skeletal, vascular, or clot disorders should consult a health care provider before undertaking Rolfing sessions.[13] Rolfing practitioners have suggested its use for a wide variety of medical conditions.[13] According to a 2004 scientific review, peer reviewed research on Rolfing is limited, lacking controlled clinical trials: "there is no evidence-based literature to support Rolfing in any specific disease group."[14] Rolfing and other alternative therapies are described by skeptics such as Michael Shermer, founder of The Skeptics Society, as belonging to the category of pseudoscientific claims.[15] The overall concept of fascia limiting and permitting functionality is receiving more investigation. In late 2007 the first "Fascia Research Congress" was held and attracted attention from researchers and clinicians.[16][17] Within the Structural Integration community, Robert Schleip questions Rolf's emphasis on the plasticity of fasciae, and suggests that successes may have more to do with the reduction of high muscle tonus and other physiological effects that may as easily be elicited by the stimulation of mechano-sensory receptors in the fascial tissues.