“IF YOU LISTEN TO THE BODY IT WILL TELL YOU EVERYTHING YOU NEED TO KNOW!” ” L. H. JONES D.O.

  • Positional Release Therapy (TRP), also known as Strain-Counterstrain (tension, counter-tension), is a therapeutic technique that uses a comfortable position of the body, its appendages and tissues to resolve dysfunction somatic.
  • Somatic dysfunction is defined as a disturbance of the sensory or proprioceptive system that results in facilitation and inhibition of vertebral segmental tissue (Korr 1975).
  • .Jones (1973) proposed that due to somatic dysfunction, tissue often twists or knots, causing pain, spasms, and loss of range of motion.
  • Simply, the TRP loosens the tissue as one would with a knotted collar, gently twisting and pushing the tissue to release tension from the knot.
  • When one link in the chain is not twisted, others unravel nearby, providing profound pain relief (Speicher and Draper 2006a).
  • In essence, TRP is the opposite of stretching.
  • For example, if a patient has a tense area in the calf, the clinician traditionally dorsiflexes the foot to stretch the calf to reduce tension and pain.
  • Unfortunately, this could lead to muscle protection and increased pain.
  • Using the same example, a clinician using TRP would place the foot in the most comfortable position (plantar flexion), shortening the muscle or tissue in order to relax them.
  • In the early 1950s, Dr. Lawrence Jones, an osteopathic physician, founded this approach; he first called it the positional release technique and then coined the term Strain-Counterstrain (Jones 1964).

A discovery by accident

  • Jones described his clinical discovery as “a lucky accident and nothing more” (Jones, Kusunose and Goering 1995, 2).
  • Jones had difficulty helping patient with severe back pain
  • His biggest challenge was to sleep at night and if he could find a comfortable position he could gain relief.
  • Jones recalled that he had helped a patient who was also having difficulty sleeping, and that the fetal position offered him great comfort.
  • He left it there while he examined another patient.
  • Upon return, the patient presented painlessly for the first time in four months.

Jones did not understand how placing a patient in a comfortable position for a short period of time could bring a complete stop to the relentless pain after the failure of so many traditional therapies.

  • Three years later, he accidentally discovered that treating anterior pelvic points often relieved posterior pelvic pain.
  • Based on this observation, Jones believed that the trigger points were the result of a counter-tension mechanism: if one tissue is sharply stretched, the opposing (antagonistic) tissue is counter-strained in its attempt to stabilize itself against the tensile force, resulting in the production of antagonistic trigger points that prevent the tissue strained by the agonist from fully healing (Jones 1995).
  • Trigger points, unlike myofascial trigger points, are not associated with hyperirritable bands of tissue, but are discrete areas of tissue tenderness that can occur anywhere in the body (Speicher and Draper 2006a).
  • Myofascial trigger points are hyperirritable nodules of knotted muscle tissue that often trap local nerves and vessels and cause pain, inflammation and loss of function (Simons and Travell 1981).
  • Myofascial trigger points, whether active or latent, are found in tight bands of muscle tissue.
  • An active myofascial trigger point produces local or referred pain or other alterations in sensory perception with or without manual stimulation, whereas a latent trigger point requires manual stimulation to activate potential pain or a sensory response (Dommerholt , Bron and Franssen 2006).
  • Trigger points can also be active or latent, but they are usually not present in knotted muscles. Jones mapped the locations of TPs based on segmental levels of the spine, but the locations of the TPs have also been closely associated with the locations of myofascial trigger points first described by Travell in 1949.
  • Myofascial trigger points and possibly trigger points may also be associated with ahi shi acupuncture points used for the treatment of pain (Hong 2000) as well as lymphatic reflex points (D’Ambrogio and Roth 1997).
  • Melzack, Stillwell, and Fox (1977) asserted that there was not much difference between the locations of myofascial trigger points and acupuncture points based on their finding of a 71% correlation.

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