It is not a question of if you will get injured as a serious athlete,
but when. Fortunately, there are some amazing techniques out there
such as active release technique and and trigger point therpy.
However, there is another technique that it is taking the athletic
community by storm called Pain Reflex Release Technique, PRRT.
This revolutionary technique of pain relief, developed by John
Iams, is providing injured athletes with a quicker return to the
playing field, and improved performance in their game. In this
interview with Steve Cotter, John Iams, PT, explains the science
behind his system of treatment, and introduces the method that
is changing the way athletes are rehabilitating injuries.
John, you have developed a system of pain
relief that has been very successful in treating all type of injuries.
Do you have a particular name for your system?
Steve, we call it the Pain Reflex Release Technique, PRRT.
Could you tell us a little about what this
system of medicine entails?
This has evolved over almost 40 years of practice. It consists
of looking for Primal Protective Reflexes that influence muscle
function and in this case, the 2 major reflexes I'm looking for
when I'm examining the body are the withdrawal reflex and the
startle reflex.
How has your practice brought you to working
with athletes and athletic performance?
Well, as you know, in the realm of athletics the return to competition
is everything and consequently the search continues to look for
the most effective and fastest method of treatment for athletic
injuries so that athletes can be back to full level competition
as soon as possible.
I think that's what's driven many athletes to my clinic for the
physical therapy that we provide with the Pain Reflex Release
Technique, because we're able to resolve most problems within
just 1, 2, or 3 sessions. Seldom does it require more than that
unless someone's had surgery. So that's probably what's driven
this the most, is the speed with which the change occurs, even
if other methods of treatment haven't been working.
Have you had any mentors in the field of
athletics that have influenced you to focus your work toward treating
athletes?
You know I think my influence in this probably has come more
from my interest in athletics, rather than from any specific mentors.
I played sports in high school and had injuries of my own, and
was frustrated in not being able to continue to play, particularly
football. I wanted to play college football, and was unable to
even play high school football, because of knee injuries. That's
what led me into the field of physical therapy and I continue
today to love sports. So, rather than have a particular individual
or individuals who've influenced this process, it's really more
my passion for sports and enjoying seeing individuals perform
at an optimum function where they're pain-free and able to apply
the gifts that they've either genetically received or the skills
they've developed through coaching.
Can you give an example in sport where
an athlete can utilize your Pain Reflex Release Technique
to immediately benefit his or her performance?
Yes, probably one of the easiest things that an athlete can do
that would give them a sample of what this work is all about would
be for them to be able to relax their hamstrings. This is particularly
important for athletes who are involved in sports that involve
running and jumping.
If the athlete were to sit in a chair and have their knees flexed
at a right angle and they were to karate chop themselves over
the patellar tendon, which is the tendon just below the kneecap,
they would be able to elicit a reflex in the quadriceps muscle,
not unlike when they go to see a doctor and he uses a little rubber
hammer to test the reflexes. In this case the athlete would be
eliciting their own reflexes, and they can initiate this just
by karate chopping that tendon. That would then have a reciprocal
inhibiting effect on the hamstring muscles, which of course are
important because most sports performances are enhanced by some
pre-stretching of the hamstring muscles, as well as other muscle
groups, but the hamstrings seem to be one of the most important.
So this done before the stretching allows an individual to have
even more range to be able to stretch through than they would
if they weren't performing that maneuver.
So, there is a clear physiological benefit.
There is a term in sports psychology "peak performance state"
that is utilized quite often to describe the ideal mindset for
successful performance in any sport. Is there any application
for eliciting a peak performance state or the "zone"
state that an athlete can enter into utilizing some of the techniques
that you've developed?
Well, if we're talking about peak performance, then we've shifted
in my mind a little bit, from the physical realm to the emotional,
psychological, if you will spiritual side of sports. For that
I typically incorporate the use of some of the techniques I've
evolved which are under the realm of what I call "sports
stress". One of the maneuvers I teach there is to teach an
athlete how to position their head in such a way to minimize the
effect that stress has on muscles in the neck, particularly the
upper trapezius and the sternocliedalmastoid. The way they do
this is by simply turning their head a small amount, usually it's
about 15 to 20 degrees, usually to the right, but they could turn
it to the left if they felt more comfortable.
So again, if they turn their heads slightly to the right and
hold it there for a matter of 30 seconds to a minute, usually
this will decrease the anxiety and the stress associated with
the moment in which they're experiencing that. Often times that's
just before a game is to start or if they have made a mistake.
They've had a situation occur where they clearly did something
they shouldn't have done-this is very hard for the athlete to
recover and get back into the peak performance state. Often times
they're going to be down on themselves and other people are down
on them at that point and they can tell that they're in a kind
of a funk. So this sometimes will let them ease back into that
faster than they would if they had just tried to recover on their
own.
Wow, that offers exciting possibilities!
I know if I mention the name of the physiologist Vladimir Janda
that you are very familiar with whom that is and the work he contributed
to the study of muscle physiology.
Yes!
In fact, many of our readers are aware
of Janda's research as it applies to exercise. In particular,
many readers practice the highly effective sit-up that is known
as the Janda sit-up. What aspect of Janda's findings most interested
you as a physical therapist?
I think the most impressive part of Janda's work is the science
behind what he's evolved. Many people in the field of sports rehab
evolve methods basically just from their experience and not with
a scientific model backing it. I think what makes Janda unique
in many of the approaches that he's taken, is the fact that he
has attempted to combine both experience and science. He's coupled
with that the passion that he had from his own physical disability
and from the sense of attempting to try to have other people benefit
from what he was challenged with. You put those things together
and that's pretty unique because this is a man who had dedicated
his life, and of course, he just passed away about maybe 4 or
5 months ago, which is a real loss. But his work will survive
because anyone who has made as much of an impact in the field
of rehabilitation and sports enhancement and sports performance,
I think that work is destined to be timeless.
How would you compare your Pain Release
Reflex Technique with something like chiropractic or massage?
Well, many people ask me that and it's always a challenging question
because when I talk about my work it sounds a little bit like
it might be similar to those two, but really it's quite different
than either of those. I guess to start with, chiropractic has
a basic tenet or model that generally says that there's a theory
that there is a vertebrae that is subluxed somewhere in the spine.
The goal of the chiropractor is to identify at what level, or
multiple levels, that vertebrae is out of alignment, and to in
some way, shape, or form place that vertebrae back in its ideal
position. So, right away, I do not agree with that, I do not believe
in that, and I don't seek out that as a solution for the patient
when I'm treating him. Right away we have a divergence of approach,
that many chiropractic approaches use some form of force. Some
are low force, some are high force, high velocity, manipulative
techniques.
My work does not incorporate any of that, mine is either very
gentle exercise movements or sometimes just isometric holding
of a muscle, or it will be a tapping over a certain tendon, to
elicit a certain reflex. So mine is very gentle, non-force, and
it really is designed to influence learning in the nervous system.
My goal is to try to encourage the nervous system to become engaged
in the process of participating in the correction, whereas I would
see chiropractic being something that is basically done to the
body, and the hope is that the adjustment will hold. Some adjustments
do and many don't. This is why many people go back to chiropractors
many times, over and over again, because often times they get
temporary, initial relief, but then they're back in again because
the adjustment doesn't hold and they have to be readjusted again.
The difference between my work is usually, if I can find the pattern
that is involved and correct that, usually within 2 to 3 sessions,
that pattern is no longer there and is holding, and the patient
doesn't need to continue to come for more treatment.
Now, in the case of massage, there are many, many types of massage,
much like there are many types of chiropractic treatments. The
difference there usually is, the massage is generally geared to
being able to influence and attempt to relax muscles that are
tight, to work knots out of muscles that are present, which are
often times called trigger points, or to release fascia, which
are the envelopes that surround muscles. My goal is not that.
Again I'm back to looking at how reflexes influence the nervous
system and then ultimately how reflexes up-regulate, or arouse,
or make muscles hyper-vigilant, when in fact muscles, when they're
not supposed to be working, should be at rest, should not be tender
and should be relaxed so that if they were palpated that wouldn't
cause that person to jump and have a reaction to that digital
palpation. So, I'm not attempting to work out anything that is
at the muscle-fascia level. Mine is a neural influence, and that
again is a divergence from where most massage and soft tissue
mobilization philosophies are going.
That makes it very, very unique it seems.
Well, I think so in that I've yet to find anyone that I think
is even close to what I am doing. I mean people attempt to compare
and contrast the Pain Reflex Release Technique with other
methods that are out there. I've studied everything that I can
find in all the different fields and I can't find anything thus
far that I've been able to identify, that is a similar form of
work that is attempting to address the body at this same level,
either by exam or by treatment. I have developed an exam called
the 1 minute nocioceptive exam. Nocioception means pain, that's
the term that is used in the pain literature; nocioceptors are
the pain receptors in the body.
I have a way in 1 minute of going through and screening the entire
body for the areas that I typically find are involved, and there
are certain patterns that we find these in. So as I go through
it takes me about a minute to find what's there, and then usually
within another 5 to 10 minutes I've gone through and made the
corrections and then go back and reexamine, reassess, and most
of those, if not all of those, have been resolved and they are
no longer tender. So, that system of both exam and treatment I
have not found anyone even close to replicating that. In that
sense I think at this point, until I find someone who is doing
something similar, I'd say it's unique.
John, I know that you regularly lecture
to medical doctors. Tell us about that.
Well, I lecture throughout the country to people of various disciplines,
not just to medical doctors. I have medical doctors who have attended
my seminars, I have chiropractors, I have physical therapists,
athletic trainers, massage therapists, personal trainers, osteopaths,
acupuncturists, naturopaths, so it runs the gamut of people who
are interested in and treat musculoskeletal pain. This seminar
I have coming up in another 2 weeks, I have two MDs who will be
attending, and my goal is to eventually be able to have a forum
of practitioners in all of these related fields, who would be
interested in finding out a faster way to resolve the musculoskeletal
pain challenges that they face.
Do you find that doctors are generally
receptive to your findings, and what type of questions do they
generally ask about PRRT?
I don't know that they're receptive any more than anyone else
is receptive when they first hear about what I'm doing. Because
as with anything new, and I do believe this is truly a new, revolutionary
approach to assessment and treatment, there is always skepticism.
I mean, I remember when Janda was first starting his work. He
ran into tremendous skepticism, I mean he had the language barrier
to deal with obviously, which made it even more difficult, but
you know, he was trying to make claims about tonic and phasic
muscle activity at a time when those concepts were really being
applied primarily, in the United States, to conditions that involved
problems like cerebral palsy, where there was a neurological pathology
underlying the nervous system. Those terms were not typically
being used; those concepts were not being bantered about in terms
of either sports or orthopedic kinds of influences. So, I mean
he's a good example of somebody who was a pioneer in, you know
the definition of a pioneer is somebody that has arrows sticking
in him. You know because that's what happens when you're out there
where other people haven't been. You tend to get shot at a lot.
So that's typically a tough thing to sell when I'm talking to
people about my work, because reflexes are not something people
understand well, be they at the spinal cord level or visceral
reflexes. In other words, whatever the level we're talking about,
of reflexes in the body, they're not really well understood. There's
not a lot written about them. There's not a lot of time and energy
in research being spent to analyze how these might influence pain.
Consequently, when I'm demonstrating this on physicians, as I
did the other day when I had lunch with a physician, an internist;
she was absolutely amazed at what I found on her because she thought
she was in pretty good shape. Then she was even more amazed when
she felt the changes, within 5 minutes time of going through and
making some corrections.
So, if they have a personal experience with the work, either
they or a family member, and I have many of them who have their
family treated by me, those individuals are very receptive to
this because they've seen it or they've experienced it personally.
But other members of other professions, as well as physicians,
sometimes have trouble getting the concept of how these primal
protective reflexes, like the startle reflex and the withdrawal
reflex, might truly be influencing motor behavior. So their questions
typically are, you know, "what's the basis to this"
or "what's this like?" "This looks a little bit
like this or that". So they're trying to compare it to something
else, and that's the basis of their questions, and then of course
they want to know what physiologically is happening. And that's
easily explained by just referring to the fact that the startle
and the withdrawal reflex are 2 reflexes that are hard wired into
our nervous system and present at birth, and both are tested early
in life.
Within a matter of days they make sure that the infant is neurologically
intact. So they're that critical to determining that the nervous
system is normal. Those reflexes continue to be there in the background,
much like how an operating system on a computer runs in the background.
You really don't see it on a day-to-day basis when you're operating
your computer, but it better be working, because otherwise your
computer won't work right. So you have to count on an operating
system to be functioning as it's supposed to, so that whatever
platform of software you're running will be appropriate in allowing
you to perform the tasks you want. Much the same way these reflexes
that are there to help us. They are literally life-saving at times,
if we reach out and touch something hot or sharp or electrical,
thank goodness we pull back from it as quickly as we do, otherwise
we might have more damage than we otherwise do. So that's the
withdrawal reflex. And the startle reflex is the difference between
life and death at times, if something happens and you don't react
quickly enough when you're startled, you can be dead!
So, those are 2 very primal reflexes that are very protective
in nature, but they should not be influencing motor behavior on
a routine basis. Yet they are, and that has not been identified
and that's what I've identified. Once the medical profession understands
this and other professionals who treat musculoskeletal pain, are
going to understand why we've been so slow in getting results
with many people who have this pattern. Not all, but many, and
once we establish that they have this pattern and we correct it
then within a couple of sessions we'll see the changes occurring.
Wow, you're taking something complex and
really simplifying it! Talking again about treating athletes,
is there a particular injury that is most common among the athletes
that you see?
It depends on the sport, because in say throwing sports, I see
a lot of professional baseball players, and of course the most
common injury with them is their shoulder, and secondly, their
elbow. If it's football it's the knee and the ankle, so it's kind
of sports-dependent. But in terms of the patterns that I see,
more commonly than not, in most athletes, there is an awful lot
of problems in their pelvis, particularly their sacroiliac joint,
because many of these athletes are jarred, many times by falling.
Many sports of course involve the athlete being off their feet,
coming down, and landing on their pelvis. So, many of them have
restricted motion in their SI joint. Many of them have injuries
to their diaphragm, literally where their breath gets knocked
out of them, they're sometimes unconscious for a matter of a few
seconds, and there is a diaphragm injury associated with that.
So many times we're treating the diaphragm.
Often times we find that they have a great deal of tension in
the rotator cuff muscles, particularly on the right side, that's
a common pattern we see. Even if they're not involved in a throwing
sport, but for sure if they are involved in a throwing sport on
the side of their dominant arm, we're going to see some up-regulated
muscle activity in the rotator cuff muscles, at rest. Then up
into the cervical spine, particularly at the base of the skull,
into the muscles at the base of the skull, the sub-occipital muscles.
And the last thing we see commonly, because of the stress involved
in sports, is muscles of the jaw, TM joint muscles, are often
times very tense. These athletes are sometimes clenching their
teeth at night, if not during the day; many of them chew gum for
hours at a time. So they're constantly stressing these muscles.
There is a big difference in using those muscles with chewing
food, versus using them when you are stressed, chewing sunflower
seeds, chewing tobacco, chewing gum when you're in a high anxiety,
high stressed mode. So those are probably the most common patterns
John, you truly are a pioneer in the human
potential movement and in physical therapy. From personal experience,
I know absolutely that your system of healing is incredibly effective
and I am grateful for the value that your work has added to my
general health and well-being and also to my athletic performance.
I know that this work is going to have a huge impact in the field
of athletics, and I really appreciate your sharing with us.
Thank you for your comments and I'm glad I had an opportunity
to present the work to your readers.
For information about the Pain Release Reflex Technique
and John Iams, PT:
Email: reflexrelease@cox.net
Toll Free: (800) 945-5865
Steve Cotter is a San Diego based strength coach
and fitness consultant. A champion martial artist and Senior RKC
instructor known for his unusual combination of strength and flexibility,
he is the creator of the Full Contact Kettlebell Training system.
You may contact Steve
Cotter for more information on Full Contact Kettlebell Training.
