Have you ever noticed one of these patterns? If so, you will love what TMR will do for your patient results. Continue to read down the page for What is TMR, a video about how it came about, some interesting patterns you'll discover when using TMR and some myths about things you have come to believe.
A Warning
Changing course when you find your answers less than optimal can be one of the hardest things to do. It takes courage and persistence to go against the grain. The reason why is, so many people you respect and admire will still be doing things the old way and will provide you enough resistance that it will feel easier to conform. If you continue to move forward and pursue what you see to be more true and a better way than you are currently doing, it can be one of the most rewarding experiences. I hope you stay the course - your improvements will be worth every bit of frustration.
With this said, lets move forward to some explanations that will help wrap your brain around how TMR works.
What is TMR?
Total Motion Release (TMR) is a simple & less painful approach to healing. It is all done by bringing the body back into balance in a slightly different way than what is traditionally seen in therapy, however is constantly seen in nature. We use the good areas to fix the bad or injured areas of the body. These good areas are typically found on The opposite side of the injury. Do not however think that the opposite side is always left versus right. The body is three dimensional and thus there are three opposite sides - Left versus Right, Top versus Bottom, Diagonal versus the other Diagonal.
Lets take an example (See video of lady on leg extension machine.) A person with right knee pain is first put through a series of motions to access the movement that cause his knee pain to worsen. This we call the issue. Then motion tests are performed in the five large joints of the body (shoulder, spine/rib cage, hips, knees, & ankles). This will allow us to determine what area of the body is the most restricted. You would think that the most restricted motion would come from the knees seeing that is where the pain is. That is not typically the case. Once the area of greatest restriction is found, for example, trunk rotation to the right is much more restricted than to the left, this area will then be exercised or treated.
The difference with TMR treatment is that to fix a right rotation restriction we will exercise or treat into left rotation. This will be performed for a series of reps or a specific period of time. The right rotation will then be re-tested for changes as will the knee pain. These results are recorded on a TMR form designed to allow the patient to determine if the exercise is working or not working, based on the data recorded. This cycle of treating to the good side, recording & immediately analyzing the data is continued until either the twisting to the right is balanced with the left, the knee pain resolves, or the results plateau.
Teach don't Treat is our Motto
Additionally, the TMR process is designed to allow the patient to discover the patterns that cause his/her pain. In the example above, the patient will learn to recognize when they have knee pain performing left rotation will resolve it. They now take control of their own pain and their own treatment. As a former teacher, I find this self-help process quite remarkable.
Total Motion Release compliments much of what you already do and it will help you speed up patient healing. I have found Total Motion Release provides long lasting results because patients are taught to become mini-therapists. They love it because as they are doing their home program they can determine for themselves what is working, when it is working, and what to do if it is not working. TMR self-empowers patients and gives them a process to help themselves.
As you can tell from reading above, the entire Total Motion Release Program is geared toward teaching this pioneering process to the patient. It is an easy to follow 5 step process. Those using TMR are very motivated by the immediate results and look forward to performing the home exercises. The Total Motion Release Program teaches the patient how to become their own therapist so that the hours spent away from the clinic are as productive as those spent in session.
How TMR Was Discovered?
Once I had the initial ah-ha moment(s) I began to look for ways to make the process quicker and easier to understand – I wanted to develop a better mouse trap. After about 2 ½ years refining the system The FAB 5 (the foundation exercises) were finalized. The FAB 5 are the basic exercises and the basic format that allow people to fix themselves.
How the FAB 5 Came Into Existence The first year of Total Motion Release was mainly done by finding the patients restricted motions. A picture was taken of what the patient was supposed to do at home and they were given instructions on how to do the exercises. Finally Tom figured there had to be a handful of exercises that worked better than all the others. He wanted to find these exercises and create a pain relief program that could be developed around them. He planned on using the exercises to develop a self help process for his patients.
Tom got together with two of his therapist and began a process of elimination which eventually turned out to be the Fabulous Five. Tom asked Chip Moseley, and another therapist, to write down their top twelve TMR exercises they most often used on their patients. The three of them had fifteen exercises in common. After a discussion they finally whittled the fifteen down to twelve. Tom challenged them all to use only these twelve exercises on their patients during the next month. At the end of the month they agreed to share there findings.
Tom’s original intention was to whittle the twelve down to four exercises. At the meeting he told the other therapist that he wanted the twelve whittled down to eight. After this was done Tom expressed his concern that this was too many for a patient to remember. Tom says that he remembered from psychology class that people best remember five items plus or minus one. Therefore, his target was four exercises.
After a lengthy discussion they all selected the following: Arm Raise, Trunk Twist, Leg Raise and Sit-to-Stand. These were the exercises the patients had the most success with. Chip Moseley strongly suggested that another exercise needed to be added to the four, the Bent Knee Toe Reach. After listening to his reasons, which would later prove to be accurate, the Bent Knee Toe Reach was added. The FAB 5 was created.
Not knowing it at the time, the three had selected exercises that addressed the largest joints in the body. The Arm Raise affects the shoulder joints and the spine (upper.) The Trunk Twist affects the rib cage and the whole spine. The Leg Raise affects the hip joint and the spine (lower.) The Sit-to-Stand affects the hip and knee joints.
Additionally, these five exercises are functional motions the body assumes though out the day and each of them occurs in one plane of motion. The single plane movements allow the Fabulous Five to be easily learned by the patients. Tom challenged each therapist, including himself, to use only the FAB 5, for the next month, on every patient no matter what their condition.
He held each accountable and attempted to reduce the amount of fiddling by having patients shared between therapist. This way each of them could supervise the other and, most importantly, they could hold Tom accountable because he was the person most likely to fiddle.
The results over the next month were pretty astounding. They used the FAB 5 with every patient and on any condition. Each time a therapist fiddled into other motions the results were less effective and took a longer period of time to get pain reduction. When the therapist stayed pure to the FAB 5 the results were quicker, longer lasting and more easily followed by the patient at home.
After the month it was decided that there was enough evidence to prove that using the FAB 5 (regardless of the condition) resulted in better and longer lasting results. Because of this the FAB 5 became the foundation for the Total Motion Release concept. Advanced pain relief processes, know as the WOW, Wind Up, Super Six, Combinations and Free Flow were developed. Within a year Total Motion Release became the only concept practiced at the clinic.
Interesting patterns . . . .
Migraine headache sufferers - the eye in which they experience the throbbing headache in is often times the side they have shoulder restriction.
People who grind their teeth at night and are unable to open their mouth very wide are relieved both in tightness and in their ability to open their mouth simply by them gently compressing their teeth for two minutes.
Plantar fasciitis may not resolve until the upper rib cage or upper thoracic is released.
A person who is "unable" to stand up straight or backward bend can usually extend on one side easier than they can on the other side. Same goes for bending forward. A person who cannot bend forward, can bend forward if the bending is more one-sided.
A person who is balanced in their tissues can spin around like a child and have very little, if any, dizziness. The more dizziness a person experiences with this activity the more restrictions that will be found throughout the body (if you are going to try this - do it on yourself and not your patients.)
Tail bone and pelvic pain is not completely eliminated (long term) if the thoracic area and rib cage is not made more flexible.
Testing an individual for which eye they can see better out of is also the side of the shoulder/arm that is more flexible.
An acute back pain sufferer never (except on a few occasions) comes in stuck in extension. They are always slouched forward or to the side, and almost always the traditional form of therapy will try to get them standing up straighter rather than slouching over further. Have you ever tried to exaggerate what the body is doing - it is wonderful to see what effect this has on a person's pain. Try it!
Tightness of lets say the hand also shows up in similar movements of the shoulder. For example, a restricted motion at the wrist - cocking the hand out to the side can present as a restriction at the shoulder of not being able to raise it up and back, as if being a driver and reaching behind the passenger side car seat.
If one finds rotation restrictions at the shoulders most likely the patient will also have rotation restrictions at the hips.
When a person goes to squat down to pick something up, they invariably weight bear and squat down more on one side than the other.
If a person is asked to move their jaw to side to side, the side they can move to further (8 times out of 10) has a tighter shoulder and arm of that side.
Foot pain or issues of numbness and tingling also correspond to hand numbness or tightness on some occasions. Many people with plantar fasciitis also sufferer from tennis elbow, carpal tunnel, etc in one or both of their upper extremities
Restriction of the trunk can show up as a variety of ailments from musculoskeletal to visceral. Free up trunk range of motion and patients will tell you that all sorts of things have changed for them.
Every person has a good side and a bad side for every movement. Next time you get out of a chair focus on which side you place more weight on. Chances are you do this every time you go to stand and sit down. I have found this asymmetry to be one of the root causes to many pain complaints.
A pelvic shift and tailbone rotation causes a three dimensional issue in the entire spine and the patient usually has a variety of complaints they are seeing you for.
People even have a good and bad side for which ear they can hear out of better and which eye they can see out of better.
Things Most of Us Have Come to Believe Myth #1: You should strengthen a weak extremity This can be proven with an example. Go to a leg extension machine (or any fitness piece of equipment) and test your sides. Continue increasing the weight until you can tell a 50% or more difference between the sides. Now - the traditional thinking process is that in order to strengthen the weak side you must exercise the weak side. Lets see if that is true or false. Go ahead and perform 2 sets of exercises on the good side. Do as many reps as possible aiming for 12. Once you have completed the 2 sets, go back and re-test the weaker leg and see if it has changed. Make sure you re-test with the same weight that you had when you tested originally.
Do you still think weakness comes from a strength deficit? Absolutely not, it comes from a balance discrepency. If you realign the balance of the body weakness instantly fixes.
Myth #2: Treat the area of pain
The area of pain does not need to be treated or exercised, it needs to stop moving and other areas that are not working need to be made to get back to work.
This can be shown with a physics equation P = F/A and a quick scenario.
Assume that 10 joints of the body are required to do the workload of moving a 100 box from point A to point B. If all the joints are working then each joint will assume 10 lbs of pressure. If however, 5 joints are not functioning properly because of misalignment then each working joint will now be required to assume 20 lbs of pressure. Now lets assume all joints except one are not functioning properly. 1 joint is left to do all the work and take on the entire 100 lbs of pressure.
Who in this scenario is going to be screaming in pain? The joint who is doing all the work or the other 9 who are not doing anything? Is it more important to treat the area that is overworked or the areas that are not working? With Total Motion Release we find that getting the non-working joints back in action causes the entire body to realign and this re-balancing stops the pain felt in the injured area.
Myth #3: Perfect Body Mechanics is needed for lifting heavy objects.
After treatment of thousands of patients the reverse is what we find to be true. Any person who is made to hold or perform an activity with "perfect form" is more likely to cause an injury. I know this flies in the face of so much what you have learned, and even some research. Never take our word for it, until you experience this phenomenon for yourself.
The rationale for why this is a myth can be seen by the following example. A person lifting a heavy box off the ground has been taught to place the box squarely between their legs and lift with both legs placing equal amounts on each. Additionally, they are told to bend at the knees not at the hips. All of this would be fine - for the person who is anatomically in balance. If however, my left leg is weaker than my right leg and I place equal weight on both legs then as I lift my weak left leg will be burdened with this additional weight. This will cause the entire kinematic chain to have to compensate for this and will further throw the body out of alignment - setting the person up for injury.
If you repeatedly place an object on the ground and ask a person to just pick it up (without any instructions), you will begin to see their natural pattern of weight shifting to pick up an object. If you make them aware of this pattern and allow them to use it (which they will do anyways if they are not being "told" what to do) you will see they can in fact lift more than if they had been using "perfect lifting form."
I demonstrate this on people at the seminars. I will video tape and put it on the website. It is pretty cool to see.
