PT/OT Today
Vol. 5, No. 40
Mind & Body

Therapeutic Pain

by John F. Barnes, PT


Traditional therapy has viewed pain from two different perspectives. One school of thought was to avoid pain, "mask" the symptoms and teach the patient to cope with his or her problem. This approach did not cause direct trauma, but forced people to be satisfied with limited results. There was the possibility of cumulative trauma since untreated restrictions caused micro trauma to the patient's system over time. This micro trauma was like a ticking time bomb left in the system, forcing a return of symptoms or a shift to another area. This is rarely a satisfactory solution.

The other school of thought was "no pain, no gain." Too many times patients were instructed to exercise and force their way through the pain. The result: a lot of strong patients in agony. Or manipulation and other aggressive manual techniques produced force into osseous structures while paying no attention to the tight surrounding myofascial environment. The aggressive force used created the possibility of increased pain, injury or a return of symptoms because the environment of every osseous structure, the myofascial system, had not been released first.

Myofascial Release can safely and effectively free the osseous structures and/or create a more open environment to enhance the effectiveness of manipulation, mobilization procedures, muscle energy techniques and exercise and flexibility programs.

Is there a possibility of another option for the relief of pain and the restoration of motion? I strongly believe the possibility exists, based on my years of experience and the experience of over 20,000 physical therapists (one-third of the profession) that I have had the opportunity to train in this approach.

I would like you to consider the possibility of a third treatment option of relieving pain and restoring motion: therapeutic pain.

One aspect of the Myofascial Release Approach is where the therapist applies gentle, sustained pressure into the fascial system, creating what the patient reports as a feeling of good pain or a good stretch. Release of the pressure of the fascial system around the muscles, nerves, blood vessels and the osseous structures creates a free mobile environment of these pain-sensitive structures, producing consistent results in relieving pain and restoring functional mobility.

Another aspect of myofascial release is the sophisticated facilitation techniques called Myofascial Unwinding. The fascial system is a piezoelectric tissue, so when the therapist applies gentle sustained pressure into the fascial system through compression, traction or twisting the fascial system or moving a particular body part (taking gravity out of the system), it creates a flow of the body's bioenergy. This flow triggers the mind/body complex into spontaneous motion. This spontaneous therapeutic motion allows the body to assume positions in space that represent positions of past traumas. These positions of trauma represent one's subconscious fear, negative memories and/or pain that have created holding or bracing patterns which have impeded progress of the traditional therapeutic approach. It is these positions in space and the re-experiencing of this pain memory which is never injurious, that takes the threat out of the system and allows the mind/body complex to let go of these holding or bracing patterns so that healing can commence.

Working in reverse, Myofascial Release, and Myofascial Unwinding, release the fascial tissue restrictions, thereby altering the habitual muscular response and allowing the positional, reversible amnesia to surface, producing emotions and belief systems that are the cause of holding patterns and ultimately symptoms. Thus it is important for the therapist to quiet his or her mind and feel the inherent motions. Quietly following the tissue or body part three-dimensionally along the direction of ease takes the patient into the significant restrictions or positions. With Myofascial Unwinding, the therapist eliminates gravity from the system. This unloading of the structure allows the body's righting reflexes and protective responses to temporarily suspend their influence. The body can then move into positions that allow these state or position dependent physiologic or flashback phenomena to reoccur. As this happens within the safe environment of a treatment session, the patient can facilitate the body's inherent self-correcting mechanism to obtain improvement.

The Myofascial Release Approach is more than just an assemblage of techniques.

Instead, it creates a whole-body awareness allowing the health professional to facilitate change, growth and the possibility for total resolution of restrictions, emotions and belief systems that impede patient progress.