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P&M Myofascial Release, Physical Therapy, Chiropractic, A.R.T...What's the difference?

Back, Neck and Shoulder pain and how other treatments DID NOT WORK....and then what did.

It's been almost a year now since my one and only appointment with you. It is hard to remember the chronic back, neck and shoulder pain that motivated me to spend – let's see – 18 visits times 1.75 hours equals 31.5 hours (not including driving) seeking relief at a specialized clinic that combined physical therapy, massage therapy, and chiropractic care all in one place, all in one appointment. They were all knowledgeable, deeply caring, extremely competent people. But they worked under the restrictions of an insurance-based system. When I came in with back pain, they all worked to treat that specific back pain. When the pain would move to a different location in my back or neck, their treatment would move there also. I would often feel much better for a couple of days, but I would soon be desperate for my sometimes weekly, sometimes twice weekly appointment, depending upon my progress. Once or twice I even went in to an appointment with pain in my SI area and of course they worked on that and showed me how to do core strengthening to remedy that over time.

            I finally went to see you at the insistence of a friend who couldn't bear to see me with my neck locked – I had to turn my whole body to shoulder check when I drove. I wondered what was wrong with me that none of the take-home exercises worked, that after all this time and effort I was simply having pain in different areas than when I started. I blamed myself for not doing something right, or for aggravating their treatment somehow.

            When I got to Therapy Central, you looked me over - me and my tight back and neck muscles – and promptly announced you had to start with my SI in order to resolve anything. My SI wasn't even actively bothering me! Your explanation that what was misaligned below caused problems above made complete sense. I put my body in your hands, and one appointment was all it took to remove all that pain.

            Since then, I have a great appreciation for all my precious connected parts and I practice light yoga mindfully. I drink lots of water and try and sleep in a position that agrees with my body. Thank you! Donna Barton

What's the difference between P&M Myofascial Release, (what we do) & Active Release Therapy?

This is a question asked by those that have done a lot of research and noticed there are some similarities between the two.

From what I remember, AR was patented by a couple of Chiropractors in Colorado a few years ago. Their focus is on attachments/ tendons, etc.  where pain is most prominent. If you attend workshops they will train you to become certified in AR.

A couple of things. Insurance generally only pays for "active" modalities and doesn't like to pay for "passive" modalities. I'm guessing that was the primary thinking for the name.

Further, being chiropractors, they couldn't start working the "belly" of the muscle that attaches to the tendons/bones. That would have been very close to an admission that the MUSCLE, not the BONE was actually the cause of the client's pain...not something any chiropractor is likely to do any time soon.

I will give those guys credit though. They have recognized that chiropractic alone was not getting the job done and instead of sticking their heads in the sand they went to work and developed a pretty effective treatment that has helped many people with their pain. If they would get off the attachments and into the muscle belly  AR would start to treat the problem, (tight, contracted muscle and fascia),and not the symptom of the problem, (pain at the attachments of the tight, contracted muscle). 

If you are a practitioner of AR and have any input on this please Contact Us with your thoughts.

How does this differ from Physical Therapy, Chiropractic or Swedish Massage?

This is a question we are asked often. Let's start with Physical Therapy and how it got started as a modality in the treatment of pain and dysfunction. It used to be the case that during and after wars our injured veterans were sent to hospitals to heal from the wounds suffered in combat. Many of them spent months, even years in those hospitals getting weaker by the day as they lay virtually motionless in bed. Physical Therapy was born out of the need to rehabilitate these veterans and get them back on their feet and productive again.

They needed to get stronger from the injuries suffered but also from the weakness caused by being so inactive for so long. Therapists did gate training and exercises designed primarily to get these guys walking again...and it worked! Even though many still had a limp or some other dysfunction and may have still had some pain they lived with, they were able to walk and function in society.

The problem is that the paradigm Physical Therapists were operating under then is the same one they are still using and applying to athletes with pain, active adult workers with pain, kids with pain and recently hospitalized patients with post surgical pain. They are still attempting to STRENGTHEN contracted, tight muscle tissue. IT CAN'T BE DONE.  You cannot strengthen a contracted muscle! When you attempt to do this you will strengthen the area around the injury so the symptoms in that area may subside...but will not be completely resolved.

For those of you who have had physical therapy your experience went something like this. The therapist did a muscle strength test assessment which checked the injured area against the same muscles groups on the opposite side. You were then given a set of exercises to strengthen the 'weaker' side or area. Along with the exercises you may have received ultra sound, e-stim, heat and a few moments of light massage. You started gaining strength for a time and then plateued. The original pain still lingered. You were then probably discharged because the therapist could not justify further treatment because of lack of progress. This process took a matter of weeks or months. You may then have been referred to a pain management clinic which attempted to teach you how to live with the pain you would never be rid of.

This process is as frustrating for the patient as it is for the physical therapist. Physical Therapists have done everything they've been taught in the best schools in the country. It is ridiculously difficult to get into PT school and almost as tough to stay in and graduate. These, in most cases ARE the best and the brightest. Why doesn't what they do to eliminate pain work? They are working from a basic flaw in theory. They need to substitute the word "weak" with the word "tight" to get on the right track. The patient isn't in pain and "weak" because some area(s) need to be strengthened. The patient is in pain and weak because some area(s) are too "tight" and need to be lengthened to correct soft tissue imbalances. When you do this, pain is eliminated.

Chiropractic

This is a little easier to describe. Generally speaking, Chiropractors, (many of whom are friends of mine), are taught that the skeletal system is the horse and the muscular system is the cart...that the bones affect the nerves and muscles, not visa-versa.

Again, generally speaking, we believe that the skeletal system is the CART and the muscular system is the HORSE. The skeleton cannot move unless muscles pull it. If the spine is out of place some muscle(s) or muscle group(s) have pulled it out of place. If you lengthen the muscle(s) or muscle group(s), relieving pressure on the nerves, the spine will go back into place, eliminating the pain and dysfunction the patient is feeling.

Is Chiropractic useful? Sure it is, in some cases. Is Physical Therapy useful? Sure it is, in some cases. Are both of these over utilized as a means to reduce physical pain and dysfunction? I don't think there is any question but that they are. When nearly 60% of the adult population in this country is in chronic pain AND EXPECT THAT THEY WILL ALWAYS BE, according to a recent study, it is clear that these two modalities alone have not been getting the job done. We can, and must do better.

Swedish Massage

Okay, to be fair I'll hit massage here as well. Nearly every massage school in the country teaches it's student that "you should NEVER hurt your client! If you are hurting them you are going too deep!" It is no wonder then that traditional Swedish Massage is not getting the job done either.

I'll really catch some grief over this one but, oh well. The truth is that if you don't get into the tissue that is injured, shortened, tight and constricted you'll never get the problem resolved. I believe the reason for the stance of the schools is fear of law suits and liability. To be fair, for the most part they are teaching light touch massage but even in advanced training workshops dealing with injury rehab most of what I've heard is the same warnings about not hurting people during their treatment sessions.

There, now I think I've offended everyone!

What We Do, (P & M Myofascial Release)

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