PRT (SCS) EXERCISE FOR CHEST

MUSCLES (see Fig. 8.1)

• Press just hard enough to hurt and grade this pain for yourself as a 10 (where 0 equals no pain at all).

• While still pressing the point, bend your neck and shoulders forward a little, very slowly, so that your chin moves towards your chest.

• As you move forward in this way keep deciding what the ‘score’ is in the painful point.

• As soon as you feel the pain ease a little, start to slowly turn your head and neck toward the side of the pain, until the pain drops some more.

• By ‘fine tuning’ your head/neck/shoulder position, with a little turning, side bending or increased bending forward, you should be able to get the score close to 0.

• When you find the most comfortable position (where the score is as low as you can achieve) you will have taken the pain point to its position of ease. If you stay in that position (you don’t have to keep pressing the point) for another minute or so, when you slowly return to sitting up straight, the painful area should be less sensitive to pressure, the area will have been flushed with fresh oxygenated blood and the muscles will have relaxed.

• If you self-treat the muscles between the ribs (as in this exercise) in order to ease feelings of tightness or discomfort in the chest, breathing should become easier and less constricted.

• The tender points that can help you to release tight muscles between the ribs are often found either very close to the sternum (breast bone) or between the ribs, either (for the upper ribs) in line with the nipple or (for ribs lower than the 4th) in line with the front of the axilla (armpit).

• If you follow these instructions carefully, creating no new pain when finding your positions of ease and not pressing too hard, you cannot harm yourself and might release tense, tight and painful muscles.

• If this were a really painful area – and not just an ‘experimental’ one – the pain would be expected to continue to ease over the next day or so, in response to this ‘treatment’, and the local tissues would stay relaxed (unless you did something to aggravate the area).

• You can self-treat any pain point in this way, anywhere on the body, including a trigger point (see Chapter 4).

• This method may not ‘cure’ the problem (sometimes it will, especially in recent strains) but it usually offers ease from pain, even chronic pain.

Figure 8.1 Self-treatment of upper chest pain using strain and counterstrain

Jones’ work

The osteopath who first discovered the principles of SCS was Lawrence Jones. His research showed that the position of ease, in which a tender point feels less sensi-tive, is usually identical to the position in which the original strain or injury occurred.

For example, if someone is standing on a ladder and painting a ceiling and she subsequently develops a pain in the low neck or shoulder, it is probable that some strain occurred whilst the arm was extended and the neck was tilted back.

It is in some variation of this position that either the pain itself would feel considerably reduced or the pain noted in a tender point being contacted by a probing finger would reduce (in such a strain the tender point would probably be located around the base of the neck).

Jones also found that the shortness of muscles that have been strained (chronically or acutely) gives a clear guide as to the ideal position of ease when using tender points as a guide toward comfort – and this is to make what is already short, shorter; to comfortably crowd and fold the already contracted muscles and other tissues. In other words, he showed that exaggeration of the already distorted position is what is comfortable for the tissues.

We are all familiar with the stooped position adopted by someone with

‘lumbago’. Try to force him to stand erect and the screams would soon stop the effort. Ask the stooped individual to bend further, however, and often this is easily and painlessly achieved if done slowly. Ask him if he recalls how it started and often you will be told that he was bending, lifting or carrying something awkward when a pain was felt and he was been stuck that way ever since.

The fascinating final piece of Jones’ jigsaw puzzle is that the tender point in a condition which resulted from bending forwards is not to be found in the region of the pain which the person feels in his back, but rather on the front of the body, in the abdominal muscles. The tender point for the injured low neck is found on the back of the body near the spine, when the injury occurred with the individual stretching up and bending backwards. In the same way the tender point for a forward-bending strain can be found on the front surface of the body.

If a strain occurs in a twisted or side-bent position then there would also be a more lateral location of the tender point than if the strain had occurred in simply bending forwards or backwards.

How can you use this knowledge in self-treatment? If you know how a strain took place, you can use that knowledge to locate the tender point, which can subsequently be used to help find the position of maximum ease, the position of release. If you do not know in what position the strain took place, you may have to experiment in order to find either a position of maximum ease in terms of an existing pain, or a tender point, found via palpation, which you can use as your guide to find a position of release.

Guidelines for self-application of PRT (SCS)

• You could be seated or lying down (which is sometimes the best position to avoid having to counteract the influence of gravity). Examples will be given later in this chapter of different positions for self-treatment using SCS.

• Locate any painful point, anywhere on the body, and press just hard enough to score 10.

• You should consider first searching for tender points in muscles that are shortened, as identified in Chapter 2.

• If the point is on the front of the body, bend forward to ease it.

• The further the tender point is from the midline of your body, the more you should ease yourself toward that side (except in the neck where movement may be toward or away from the tender point you are pressing, depending on which movement eases the pain most).

• If the point is on the back of your body, ease your trunk slightly backward until the pain ‘score’ drops a little and then turn away from the side of the pain and then ‘fine tune’ to achieve ease (a score of 3 or less).

• Make sure that no pain is being produced elsewhere when you are fine tuning to find the position of ease.

• If the tender point is on a limb, think of trying to ‘shorten’ the muscles which house the tender point (not stretching the muscle), by slowly moving the area into different positions and judging what each new position does to the pain ‘score’.

• When you are positioning an area, following the guidelines given above, if the score is not reducing, you should abandon the guidelines and try other directions of movement until you eventually identify a position of ease (this is why these suggestions are called ‘guidelines’ and not

‘rules’).

• Hold the final position of ease (where the pain score is 3 or less) for not less than 30 seconds (longer would be better, usually up to 90 seconds) and then very slowly return to the neutral starting position.

• It is advised that you do not treat more than five pain points on any one day as your body will need to adapt to these self-treatments and you might feel stiff and sore if you treat too many.

• Expect improvement in function fairly soon (immediately or within minutes) after such self-treatment, but reduction in pain may take a day or so and you may actually feel a little stiff or achy in the previously painful area the next day. This will soon pass.

Note: Those practitioners who use PRT as part of their treatment methodology are mainly osteopaths and physiotherapists, as well as some chiropractors and massage therapists.

A self-help formula

How can you know where to search for a suitable tender point to press on, while going through the positioning process described above? A simple formula exists to help you.

• Firstly you need to identify a movement that hurts or that is restricted.

• The formula states that the area of tenderness that you need to be monitoring (during the positioning process) will be located in muscles that would perform the opposite movement to the one that is painful or restricted.

REMINDER

It is important to emphasize that tender points to be used as ‘monitors’

during the positioning phase of this approach are not looked for in the muscles opposite those where pain is felt but in the muscles opposite those which are actively moving when pain or restriction is felt.

CAUTION

Because assistance is required for some of the positioning, as well as for the monitoring of tender points, when trying to ease the symptoms caused by backward bending of the spine, only a brief outline will be given of these strains.

It is not suggested that you offer treatment, or are treated, using these methods except as an emergency first aid approach while waiting for an appointment to see a qualified healthcare professional trained to deal with strains of the back.

PRT exercises

• If you feel pain (irrespective of where the pain is felt) when you turn your neck to the right, a tender (monitoring) point should be found in the muscles which turn the head to the left (and which are probably short and tight).

• The tender point (and the muscles in which it lies) will usually be ‘eased’ by carefully positioning the neck and head (using the guidelines outlined above) until the tenderness goes from the tender point.

• Hold this for 30–90 seconds. This could be done lying down or sitting (see Fig. 8.2).

PRT (SCS)