The physical work of massage involves muscles, joints and fascia. Most massage therapists (myself included) use compression, stretching, mobilization or some combination of modalities in order to relieve pain and tension. However, in order to get the relief to last, we need to go further and address the neurological framework of the body. My approach to massage work is to calm the nervous system so the body can access its own self-healing. Systemic relaxation can allow the body to turn off its protective pain patterns and feedback loops, effectively re-educating the body on a neuromuscular level. There are multiple ways to go about this. One way is through a profound treatment modality called PRT, or positional release technique. This technique is extremely gentle and easy for the body to integrate, and you can learn how to do it on yourself at home.
PRT is an indirect and passive form of therapy that seeks to restore homeostasis through gentle specific positioning. In other words, the body is placed in a maximally comfortable position, in which the target muscle has no tension on it. The body is folded around a tender point in such a way that the muscle is completely slack, so it doesn’t have to do any work and the tissues can completely relax. PRT is essentially the opposite of stretching, because it shortens rather than lengthens the muscle.* This is thought to reset the resting length of the muscle and turn off proprioceptive feedback loops which keep the muscle in a pain-spasm-pain cycle. (At the moment of injury muscles tighten in order to protect the body, but the protective tension patterns can persist long after they are needed. The muscle goes into spasm, causes pain, which leads to spasm – it’s a self-perpetuating cycle). “Simply put, PRT works to “unkink” muscle and fascia much like one would a knotted necklace, by gently twisting and pushing the tissues together to take tension off the knot. When one link in the chain is unkinked, others nearby untangle.”**
People are often surprised at how effective it can be, because PRT is so gentle. Many people believe they need an aggressive treatment in order to force the body to change. However, as I have mentioned, while this type of therapy produces results, it does not always produce long-term healing. Genuine healing comes from within, and the process to get the body to release and HOLD that release for an extended period of time involves respecting the body’s own pace of healing. British osteopath Arthur Pauls says “an organism can only accept so much change at a time.” He is referring to the continued release that happens for days after a healing session, but the opposite can also occur. Overly aggressive treatments can put the body in a state of armoring. The body will not always be able to hold the position if the change is too drastic – the muscles sometimes need a slower process to adapt to the release and to learn how to hold the release patterns on their own.** (Exercises to develop the strength to support the new positions are also imperative to maintaining the healing effects.) Pauls developed his own modality based on PRT called Ortho-Bionomy. Luann Overmyer wrote a fantastic book, “Ortho-Bionomy: A Path to Self Care”, which illustrates techniques to be used on every part of the body that can be done by yourself at home without the use of any equipment. This is the book I use to show my clients what they can do at home in between massages.
An easy example of PRT to do at home is the iliopsoas release. This muscle is the body’s strongest hip flexor and when it is too tight it can pull the pelvis into anterior rotation and compress the spine. In order to relax it, lie on your back on the floor, bend your knees and rest your lower legs on a chair or couch. Your heels and lower legs will be resting at knee level or just above, so your legs will be in a ninety degree angle. The area just below your hip bones where your legs meet your torso is the area we are targeting. The muscle should be completely relaxed; you should feel no tension there. Hold this position for at least 90 seconds, but preferably longer. When you get up, slide yourself back and use your arms to put your legs on the ground to avoid re-engaging the muscle immediately.
PRT is by no means the only modality that works to interrupt the pain cycle. However, it is a very effective tool that can gently encourage the body to heal at a deeper level. By learning the concepts and applying them at home, you can empower yourself to continue your own healing.
*“Introduction to Positional Release Techniques for the Neck and Upper Shoulders”, Ed Buresh, LMT, MTI
**”Top 10 Positional Release Therapy Techniques to Break the Chain of Pain, Part 1”, Tim Speicher, MS, ATC, CSCS and David O. Draper, EdD, ATC. PTHMS Faculty Publications, Sacred Heart University, 2006
***“Ortho-Bionomy: A Path to Self Care”, Luann Overmyer