Hellerwork Structural
Integration and RSI


Reprinted from The RSI Network - Issue 35 - Feb'99

Merry Nell Colborn, Certified Hellerwork Practitioner
Thousand Oaks, Calif., (805) 379-4747

Hellerwork Structural Integration is a bodywork technique that combines several modalities to provide a complete integration of body, mind, and spirit. The training is extensive, requiring over 2,000 hours for certification. Hellerwork is about balance, fluidity, ease, and alignment, and involves not only changes in structure but also changes in attitudes: an exploration into ourselves and our relationship with our environment.

The three main components of Hellerwork are:

  • Deep tissue bodywork. The work is deep, yet gentle—a "good hurt." A certified Hellerwork practitioner is trained to spot structural imbalances in the body. A thorough understanding of myofascial (muscles and fascia) anatomy enables the practitioner to determine the origin of the imbalance and therefore where to focus the bodywork.
  • Movement reeducation. Hellerwork shows what alignment with gravity (good posture) feels like, and offers movement and postural awareness tools that can be used during daily activities. For instance, letting your arms hang like pendulums, so that your hands are heavy and the shoulders are free, allows your shoulders to relax.
  • Dialogue: Verbal discussion about attitudes and emotions goes on throughout a session, to bring up any emotional "holding." Postural or emotional holding patterns create shortness in the fascia. Once these patterns become conscious, the client can make a choice to let go, to be at ease and in balance.

Over time the client adopts a new, more fluid, way of being. Hellerwork Structural Integration is an active learning process that brings about lifelong change.

A Hellerwork Perspective on RSI

There are many types of repetitive strain injury (RSI), affecting different parts of the body. I once had a client who suffered from an RSI in his hip joint: he was a truck driver, and the strain was caused by repetitive use of the clutch pedal. Carpal tunnel syndrome and thoracic outlet syndrome are common types of RSI that can be caused by restrictions in the fascia of the upper body. CTS and TOS sufferers experience discomfort anywhere from the fingers to the shoulder and neck; symptoms include numbness, tingling, burning, aching, weakness, stiffness, and restricted range of motion.

I believe that the "breeding ground" for RSI lies waiting in many of us, in the form of restricted, non-fluid fascia caused by previous physical trauma, emotional holding, or postural patterns. We can seemingly function normally until we test our body’s fluidity and mechanical ease by performing repetitive tasks. Most often we’re not aware of our fascial restrictions or lack of fluidity until we experience strain. Hellerwork brings our bodies to a balance that’s beyond what we’ve become accustomed to as normal, to a place of natural alignment with gravity, and brings our awareness to a place where comfort, fluidity, and ease are the new norm.

I have great faith in the healing properties of the human body. How severe the RSI is and how long it has been present will largely determine the extent of time needed to heal. A person’s ability to make changes also plays a part. Practical aspects such as the need to make a living, and emotional aspects such as the fear of failure, all need to be considered.

Treatment of RSI with Hellerwork

Since restricted fascia is the breeding ground for RSI, when I treat someone I look for where the fascia is most restricted, immobile, or swollen. I want to find the origin of the problem, not a secondary place of compensation. Here I’ll use carpal tunnel syndrome (CTS) as an example, but please keep in mind that the principles are the same for treating any type of RSI.

With CTS, the place where the fascia is most restricted is probably in the carpal tunnel itself: the underside of the wrist between the two meaty areas of the palm. There are many opportunities for fascia to interfere with nerves there. The carpal tunnel is a small valley created by bones, several tendons, and the median nerve, all held together by a tough band of fascia called the flexor relinaculum.

Fascia can alter its consistency, from a fluid, gelatinous substance called myofascia to a dense, immobile scar tissue. When subjected to stress, fascia changes chemically to become thicker, denser, and more rigid. It is this property that makes fascia one of the body’s most amazing protection mechanisms, but it is also this property of fascia that makes RSI symptoms so common.

In the carpal tunnel, each tendon is basically an extension of the myofascia from the muscles of the forearm. Even the nerves are encased in fascia. Where the fascia is fluid, the tunnel stays lubricated and all components interact with ease; when there is any irritation or strain, tendons can swell, interfering with nerves or impeding range of motion.

Treatment for CTS usually begins with fascial release on and around the area of the forearm and wrist. Initial symptomatic relief may take one to three sessions. Significant relief is typically achieved in fewer than six treatments. The carpal tunnel area is very rarely the origin of the problem, so it’s necessary to look beyond the forearm to find the true cause. Sometimes rebalancing the whole body is the only way to thoroughly treat RSI and prevent recurrence; this treatment would require at least ten Hellerwork sessions.

Other Aspects of RSI Treatment

Treatment for any RSI must incorporate an ergonomic (posture reeducation) review. Often the body’s structural balance is compromised at the workstation: the chair is too low, the monitor too high, the keyboard or mouse out of comfortable reach. Basic ergonomic corrections should be made immediately to support the structural changes being made in the body.

Another useful means of treating and preventing RSI can be found in Sharon Butler’s book Conquering Carpal Tunnel Syndrome and other Repetitive Strain Injuries, A Self-Care Program, New Harbinger Publications (Oakland, Calif.), 1996. Sharon has designed some subtle stretches that gently stretch the stuck fascia. When done slowly and properly, these stretches can be very beneficial.

Be patient in your search for relief. I’ve seen many clients with RSI resume normal activities after years of suffering. Keep the faith!

About the Author
Merry Nell Colborn has been practicing Hellerwork since 1987 and has additional training in educational kinesiology, fascial anatomy, treatment of sports-related injuries, and treatment of RSI. She has worked with many professional athletes and has had great success helping people with RSI and related problems. For further information, feel free to contact Merry Nell by phone or e-mail 

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Last Updated: 11/03/00