Tarheel Footprints

I attended a fabulous course in November of last year, Total Motion Release: TMR Tots. This course is an adaption of the the Total Motion Release therapy that is being successfully implemented with a wide array of patient populations. During the course I got to interact with pediatric physical therapists from various settings and home locations. A few of the therapists attending the course were there for the second time and had been finding frequent success using this innovative manual technique.

Total Motion Release therapy was originally begun with Tom Dalonzo-Baker, MPT. He was about to leave his PT office one afternoon and a lady came in asking for him to help her in any way he could. She had just left the orthopedist and was scheduled to have back surgery, but was currently in severe pain. The only position that brought her comfort was the position that unconventional. Any other movements or manual techniques were bringing her to tears, so he said, "Let's just go where your body wants to go". Tom took the patient into her comfort position and then even farther. After working in that position for awhile her pain was almost alleviated. She ended up not needing back surgery! 

So what does that mean for the pediatric population? Well, what research and patient experiences have indicated about TMR is that frequently a limiting factor of mobility is fascia - not just the muscle and/or bone.  ascia is like Saran Wrap that covers the tissues of our bodies and allows them to move easily against one another. Oftentimes the fascia restrictions are very impactful on our movement. For example when working with a child with an upper trunk rotational restriction, one side of the trunk is restricted, in this case we'll say it's the right side. So the child can turn far to the right, but is unable to turn his upper body to the left, indicating a discrepancy.  Instead of the more conventional idea of stretching the child and turning them far to the left (which they hate) we take them to the position of ease - in this case the right and hold them there. Guess what happens? We gain movement in the opposite direction! Counterintuitive? Maybe at first. But think about the fascia like a piece of yarn with a knot in it, the knot being the restriction... the more you pull on the yarn in each direction, the tighter the knot gets. If instead you relax the yarn, you can remove the knot. Our fascia is very similar to that yarn. 

Interested? Check out www.totalmotionrelease.com/pediatricblog.html. Also, continue to check back here and I will update with successful patient cases!