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Total Motion Release (TMR) is an
approach to therapy using a series of exercises to balance strength and range of
motion. It was developed by Tom Delanzo-Baker, a physical therapist and former
high school math teacher who saw a need to incorporate data into a patient’s
home program so they and the therapist could see which exercises were most
beneficial and document the response to each. This
systematic approach starts by finding the “issue of the session”, i.e. a
movement or position that consistently reproduces pain or shows a decrease in
range of motion. We then test the FAB5 motions involving large joints of the
body and compare right to left, then rank them in order of significance.
Exercises are then performed to balance the right and left, using a series of
repetitions or sustained holds on the “good” side and rechecking the “bad” to
see how it responded. This is recorded on a form so it can be easily determined
whether an exercise is working or changes need to be made. The idea of using the
opposite side to affect the involved side may be a little difficult to believe
at first… here’s an example off the Total Motion Release website… (try this only
if you are pain free.)
Go to a leg extension machine (or any fitness piece of
equipment) and test your sides. Continue increasing the weight until you can
tell a 50% difference between the sides. Now, the traditional thinking process
is that in order to strengthen the weak side you must exercise the weak side.
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Let’s see if that is true or false. Go
ahead and perform 2 sets of exercises on the good side. Do as many reps as
possible, aim for 12. Once you have completed the 2 sets, go back and
retest the weaker leg and see if it has changed. Make sure you re-test
with the same weight that you had when you tested originally. Do you still
think weakness comes from a strength deficit? Absolutely not, it comes
from a balance discrepancy. If you realign the balance of the body,
weakness instantly fixes. |
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The results from Total Motion Release can be interesting and
surprising to you. A sit-to-stand exercise can help correct an elbow issue, a
trunk twist can increase shoulder range of motion. This is not surprising to a
therapist who looks at the body as a whole, we are an interrelated group of
muscles, joints and connective tissue that truly attach from our ear to our big
toe. Looking locally at the point of pain may help, but the best way to correct
a recent injury or a long time problem may be to eliminate the imbalances in the
entire system. Case Study:
49 y/o female with 2 weeks of right shoulder pain from yard
work and gardening. Issue of the session:
Reaching out and rotating back produces pain in the back of the shoulder,
40/100%. Testing the FAB 5 exercises shows the most significant difference in
order…Sitto- Stand, Arm Raise, Twist, Leg Raise, Bent Knee Toe Reach. We start
with the most significant, Sitto- Stand and perform 2 sets/12 reps on the Left,
the “Good” side.
Retesting shows 20/100%, a reduction from 80/100%, much easier now on the right.
Retesting the “issue”, reaching out and rotating the right shoulder improved
from 40/100% to 20/100%, a 50 % decrease by just performing a leg exercise! We
continued exercising the Sit-to-Stand until the left and right balanced out and
the shoulder issue was now at 15/100%. The next exercise in ranking was the arm
raise. This was also performed on the “Good” side until balanced. The “issue” of
rotation was now down to 6/100% and we moved to the third ranked, the twist
exercise. We performed this until the issue was 2/100. The total time was 20
minutes and the pain was completely gone with full range of motion the next day.
We here at Performance Physical Therapy have been using Total
Motion Release as an adjunct to all our other techniques or sometimes as a
stand-alone treatment. Visit the Total Motion Release website at
totalmotionrelease.com to view the demonstration videos. |
