The Power of Understanding versus the Force of Manual Therapy
New Soft Tissue Release Training
In 1990 I introduced Soft Tissue Release Training into the US and at that time in Europe it was described in running magazines as "unique and revolutionary." Here in the US there was no training like it available to chiropractors, physical therapists, athletic trainers or massage therapists. Initially it was used on World Class athletes, mainly sprinters, and was a very aggressive but highly effective injury treatment regimen based on the 'no pain – no gain' concept. The speed of results were outstanding, and because of the well known athletes receiving this therapy a lot of sports therapists and athletic trainers were attracted to the workshops. These sports injury based workshops continued until I stopped working on athletes around the time of the '96 Olympics
During that whole time I was working in a Rehab Clinic where most of the patients were in chronic pain due to failed low back surgeries and other non-responsive pain conditions. In private practice I worked far differently with chronic pain and fibromyalgia patients than I would with young injured athletes.
Although I tried to make this point very clear in the workshops I'm afraid it was not made clear enough or I needed to dedicate more time teaching how to deal with chronic pain syndromes.
Many of the new spin-off 'Release' techniques that emerged through the middle and late nineties by therapists that took a Soft Tissue Release workshop or two, still have this aggressive British Sports Therapy approach to chronic pain. One female therapist in chronic low back pain recently related to me that she felt physically brutalized during one of these workshops. Many therapists take pride in their 'deep tissue'work.
Pain is the greatest influence on the Central Nervous System (CNS). You cannot relieve pain by inflicting pain.
Some do respond to this, mainly because they feel that they must endure the pain to get well. These are the testimonials we see in the advertising for all sorts of therapies, however they account for a small fraction of those taught or treated. What about the silent majority, how are they doing? That has bothered me for some time and my goal is that everyone that is taught will do as well or preferably better than I do. Just as Soft Tissue Release is only for motivated clients this training is for motivated therapists, you really have to want to be able to take people out of chronic pain
Is your therapy for low back pain better than your client simply doing nothing?
Over the last 10 to 20 years there have been remarkable technological advances that now we take for granted, from e-mail to E-Bay, camera phones and palm pilots, even cars having global satellite positioning. In medicine there are new surgical procedures and exciting research on serious diseases. One area where there has been little advancement over the last twenty years is how we deal with chronic pain.
How effective are you in dealing with chronic pain conditions?
Earlier this year I read two clinical trials for low back pain. One study compared two groups with similar low back pain. One group was treated by "enthusiastic" chiropractors and the other group received no treatment at all. The conclusion of the study was that those who received chiropractic care felt they were getting good treatment but after the prescribed period of the trial, the outcomes of both groups were the same. Those who received no treatment had the same reduction in pain as those who had chiropractic care.
The other clinical trial was carried out in England comparing those in low back pain receiving traditional PT therapy and the second group that received no treatment at all.
The conclusion of the study was that there was no difference in outcomes for the two groups. Those who received treatment felt they were getting good care, but pain reduction in the group that received no treatment at all was the same.
Most studies on low back pain note that you are naturally free of pain in six to eight weeks. Most chiropractors would like to see you three times a week for six weeks. In the clinic I worked in, the average prescription for Physical Therapy was three times a week for six weeks.
If you are free of low back pain in six weeks anyway you must ask the question: Is my therapy better than my client simply doing nothing? Most of the time the answer is no, and that is really sad. After teaching massage therapists for the last fifteen years, the success record dealing with pain conditions quickly and painlessly is not good.
Imagine that, after all that schooling and training, some of your clients in low back pain may do just as well not receiving treatment.
The only way you could change that would be if on a regular basis you were reducing pain by over 50% in one or two treatments and these changes were permanent. That is the goal now of this training
In the early 90's I was able to carry out my own personal study over two years modifying an aggressive sports injury technique to a consistent answer to low back pain and other pain conditions. The success achieved was attributed to perfecting a technique. In my arrogance I thought STR was the best thing since sliced bread.
A Change of Opinion
Today, after two years of research and clinical trial I have arrived at a different opinion.
The quest has always been, how can you relieve pain quickly and painlessly and also make it permanent?
I had the privilege of working with some full time volunteer doctors and nurses in an Infirmary in New York. As they were dependent on voluntary donations there was the desire to save money and stop the "revolving door" in treatment. For six months, the triage nurses evaluated all those who came to the morning and afternoon clinic with low back, neck and shoulder, arm or hand pain ect. Normally they would be referred to the doctors who would prescribe ibuprofen, weeks of physical therapy and chiropractic care. However, if the triage nurse determined that it was a soft tissue problem they were referred immediately to the massage therapists trained in the new Soft Tissue Release Training. Unknown to the patients they were only going to receive two treatments and if the pain was dramatically reduced (by at least 50%) after the first or second treatment then they would continue with their specific home exercises. They would not get a third treatment. These therapists had been using Soft Tissue Release for some years, the additional training and the model of the study:
a. Changed the intention of the therapists.
b. Improved their motivational skills
c. Promoted patient responsibility through education and specific home exercises
Very specific and positive language was used at the beginning, during and specifically at the end of each treatment. This was to reduce the fear of pain and the fear of movement,
to reduce anxiety and to give the 'brain' and nervous systems positive data to process.
The result: Over six months less than 5% returned for a third treatment.
What was responsible for this amazing change in treatment outcomes?
First mentioned was change of intent of the therapists. This is not referring to the overworked new age spiritual vagueness about the word intention. Rather it is based on the application of principles in Quantum Physics as they apply to wellness. We borrow from the basis of Super Particle Position and the role of the Conscious Observer. At the risk of oversimplifying this: If you observe something as different, it can become different.
For instance, if you come to me having been told that your chronic back pain is due to a herniated disc between L4/L5, medically I know the probability of this being true is very rare. I know your intense pain is in itself harmless and the pain from the original site of injury has now transferred to the deeper centers of the brain and nervous systems
The continued inflammation process has irritated the damaged free nerve endings, nerve pain fibers now have a lowered threshold so fire sooner and faster. Normal movements and pressure become extremely painful and the whole system has become sensitized. That is why any deep pressure work that creates pain is counterproductive.
Pain is now a matter of Centralized Processing and Centralized Sensitization.
It has shifted to the cerebral cortex, the Limbic System and the Central Nervous System.
This happens after as little as three weeks. The pain experienced or perceived by the patient now has little or nothing to do with the original site of injury or where they tell you they are 'feeling the pain'. To keep looking deeper and deeper at segments or joints or muscles and fascia is missing the point. Skills that pace the nervous system are now more important.
A New Way of Thinking
Powerful language and understanding are needed to quickly diminish anxiety and fear of pain itself and fear of movement. The old way of thinking is that techniques are 'tools' of the muscle mechanic and that we are going to effect a healing by working on the periphery, on the 'outside'. The new way of thinking is that we are going to work from the inside out, by pacing the nervous system, powerful self-healing is initiated and that is why the results are permanent. My understanding of this changes my intention. Yes, I'm going to work on you physically, but through simple explanation and information, my goal now is to quietly reduce your anxiety, stress and fear and through positive suggestions change the nature of your pain by the next day. According to the proven principles of Quantum Physics, this powerful intention in itself makes a physical difference.
The brain, spine and CNS are powerful in carrying out data or input received. Sometimes that data is faulty, resulting in pain when the injury has healed or when there is no injury at all (fibromyalgia) Neuro-plasticity is a term now used to describe the willingness for the brain and nervous systems to quickly change how they process pain, if the input data is changed. Because they work so quickly, when you effect a change in Central Processing the perception of and sensitivity to pain immediately decreases and this becomes the new pain free program.
Long-term pain conditions change people physiologically and chemically so there are now factors, substance P for example, a neurotransmitter that makes you sensitive to pain. Deep depression and sleep deprivation can turn a lively fun person into a sad patient. These are not one or two treatment patients, they require non-judgmental patience and a very specific treatment protocol. Spontaneous nerve firing conditions can also require more time.
The Power of Information
The second principle we borrow from is Bells Theorem about information that passes between electrons. Again without trying to over simplify this: Information transcends space and time, as we know them. The information we can impart to our clients transcends the time we could spend working on them with any manual therapy and the space we share with them. Information and education if conveyed quickly and succinctly are more important in pain relief than any therapy you may use. This is called "the Two Minute Information Loop". In just a couple of minutes you simply explain what has happened, which muscles are involved, what you are quickly and gently going to do and that they are going to feel much better in no time at all. If correct information and education are given before, during and after treatments, then any modality you use will be more effective.
These easy to grasp principles are explained fully in the STR training.
Time for a Change
Over the last few years there has been a profound change in the research literature on pain and pain management. The soft tissue injury role in pain is mentioned almost in passing. Now the subject is nociceptive pain, pain from injured nerve endings and how that is processed centrally in the brain and nervous systems. Pain syndromes are experienced now without any injury (fibromyalgia) because the chemical changes have sensitized the system to it's own pain mechanism. Stress, anxiety and fear increase the excitement of the system, and pain is felt more. By reducing these, the sensation of pain is immediately reduced. What is the point of only dealing with an original site of injury at the periphery, injury that has healed a long time ago, when the pain is being processed in the brain and CNS? Simply continuing to work as a musculoskeletal mechanic is missing the whole point of the latest research. These findings have changed it seems almost overnight. Are you willing to change? My wife bought me an electric typewriter as an anniversary gift 20 years ago. It was great, I was so proud of the letters I sent out.
Do I use it now? No. Does it still work? Yes, but if I want to get information to family in England, do I use it? Technology has changed and so has the whole information industry. I'm suggesting that many of the things we were taught at school about chronic pain has changed too. Consider the person who taught you, when were they taught? The curriculum at schools today, when was that written down? If any instructor or workshop presenter makes the claim that a specific manual therapy alone is the answer to chronic pain, then I have a nice electric typewriter I'd like you to buy. If you are using any manual therapy in the same way that you were taught ten years ago, then it's time to make that therapy more effective, to make it easier, with faster results that are permanent. There are skills that you are using now but are unaware of their power if they were honed and perfected.
The Clinical Contribution of Desire and Expectation
The placebo effect. A large part of today's medical approach to chronic pain is through prescription dugs, anti-inflammatory drugs that can be deadly, opiates, anti-depressants, muscle relaxants and sleeping pills. At the same time your client may be taking drugs for hypertension, diuretics, acid reflux and so on. All of these drugs, before they get on the market, have to be tested in random clinical double blind cross over trials. Every drug for every ailment is treated this way. To prove their efficacy they are tested against a placebo, so the placebo is the most tested drug in the world. Across the board the placebo has a 50% success rate for all known conditions and up to 80% for some drugs. 50% of all anti-depressant drug trials are abandoned because the placebo does so well. What is the placebo? Conviction and belief that you are going to get well, and guess what, you get well from life threatening conditions. If conviction and belief can help you with your hypertension, your stomach or blood disorder and a myriad of other serious problems, imagine what it can do to the harmless perception of pain. The placebo is an inert substance, but you are the powerful Conscious Observer that can change the very nature of what is before you.
This training is to make your role as the therapist more than the placebo.
At the heart of the STR technique is an interesting rhythmic pressure and stretch routine.
By itself it works very well on athletic injuries and repetitive strain injuries. I can teach anyone how to take care of his or her own carpal tunnel pain in 10 minutes. However, if a woman has been in unrelenting pain for many years and I think that simply pinning down her muscles and putting her through a painful stretch is the answer, I am so mistaken.
Never confuse a stretch with a "release". The "release" takes place in the soft tissue between the ears, not at the periphery.
Do we need manual therapy then? Absolutely. We need it in acute injuries to stop the Centralization of Pain and in chronic conditions, because of fear of movement the muscles are de-conditioned. The shortened muscle length has been programmed into central programming, as we pace the nervous system we can also change the nature of the micro scarring in the muscles and fascia and gently regain the original resting length. That combination seems to effect an extraordinary change Any therapy has to be fast acting not slow, painless and easy on you. I look for changes in pain levels in 15 and 30-minute increments. It has to have consistent success because this confidence of 'knowing' gives you a quiet unspoken power that is tangible, almost palpable.
Not one single technique or one single therapist has the answer. If Soft Tissue Release was the answer, then what about acupuncture, what about the care of a knowledgeable and caring chiropractor and some of the amazing energy work that is out there. I'm a great advocate of acupuncture, good chiropractic care, homeopathy and herbal remedies. Just because something is 'old', or in the case of acupuncture ancient, does not make it invalid, in fact they are more needed today than ever. Of all the wonderful therapeutic care my wife and family have received over the years, it has always been associated with kind, loving and caring doctors who are deeply concerned and interested in your welfare, not in just making money or bolstering their inflated ego. Many clinics and practices today seem to be nothing more than insurance billing machines where the' bedside manor' is lost in the need for more and more patients to 'build the practice'.
Doctors today in the average HMO are more concerned about the condition that the patient has rather than the patient who has the condition. Today I am more concerned with the personal skills and intention of the therapist, rather that any technique that the therapist uses.
Soft Tissue Release Training is non-technical, and although the DVD's do not have the lighthearted humor of the Workshops (we all take ourselves way too seriously), the concepts are easy to grasp. You are invited to be playful and inventive, there is not a right or wrong way to do this. You are given a simple formula so that you can work out any problem in the future your self.
You are then equipped to go out and commit random acts of kindness.
Soft Tissue Release DVD Training
The purpose of this training is to enhance the effectiveness of any therapy you are currently using.
The technique demonstrated is based on a little used principle of Swedish Osteopathy, modified and added to, making it an elegant, fast acting and dynamic approach to healing. If you include STR with any therapy you love and use often, then that combination will work excellently
The Power of Understanding versus the Force of Manual Therapy
This discssion gives the background to the changes needed to make your therapy more effective. You will learn
1: How it is possible to make changes in your client at a cellular, molecular and even at the sub-atomic levels.
2. The power of words and phrases that create a positive effect in reducing fear, anxiety and hopelessness.
3. The latest research on nociceptive pain, now the focus of pain management.
4. How to pace the nervous systems and reduce the perception of pain.
5. How you can become more than the placebo effect.
6. How the technique works for soft tissue injury.
7. A protocol and discussion of Fibromyalgia and other related pain syndromes.
This understanding is more important than the techniques shown in the other three dvd's.
DVD # 2
How to be Balanced and React Fast in an Unsteady World
This used to be a 'runners injury' presentation but now it is more to do with regaining proprioception. Due to training, culmitive or severe injuries create imbalances in muscle groups and motor firing units. These then manifest themselves as inflammation at the attachments or fascia and are misnamed as bursitis, arthritis or condemned to cortisone injections or surgical intervention – all of which are avoidable. The goal is to regain the ability to react fast and avoid injury. There is a co-relation between old unattended ankle injuries and hip, shoulder and neck pain. I never address low back pain without doing the lower leg protocol. Because the extremities are more mechanical this is where the technique works really well.
DVD # 3
Chronic Low Back Pain and the Role of The Therapist.
In the last 10 years there has been an explosion of clinical studies proving exactly what is responsible for low back pain. It is not what your doctor or even you may believe. There are five questions to ask and depending on the answers there are five muscle groups to release. You will learn the "Two Minute Information Loop" and how to Pace the Nervous System. The use of powerful and positive suggestions are employed creating a change the very next day. Specific home exercises are given to retain the progress obtained in the first session. Although not always attainable, the goal is to reduce pain by 50% in two treatments. This is often accomplished after just one treatment if the client is really motivated and follows advice.
DVD # 4
The Repetitive Stresses of Everyday Life.
Carpal Tunnel Syndrome can be a single treatment if you have a motivated client. Most 'Carpal Tunnel' problems are not in the tunnel, hence the surgical failure rate. You need to know how to quickly release the Pecs and Scalenes. Tennis and Golfers' elbow are considered along with all shoulder problems. Frozen shoulder can sometimes be resolved in one session. Thoracic Outlet Syndrome is discussed along with a Rhomboids release. Whiplash Injuries are discussed and all the stretch releases are demonstrated including Levator Scapulae and the SCM's. Self help exercises are demonstrated. If the client is motivated to do their 'homework' then all of these conditions may only need one or two sessions.
This training has all the information of the four day workshop. All that is missing is your practice time. Unlike the workshop you can see the technique being demonstrated over and over again so you can perfect it. A recent study showed that remote or on line learning was more effective in the long run than on-site (workshop) learning.
To purchase - Four DVD's and Workbook for $249.00 + shipping. - Click here to contact us