A Practitioner’s Experiences with Proprioceptive Deep Tendon Reflex (P-DTR)

P-DTR® recognizes that proprioception (sensation of touch, pressure, hot, cold, pain, etc.), and the way the body processes the information from these receptors, is paramount in determining neuromuscular responses throughout the entire body. Motor function is not just determined by the motor system, but rather is modified by the inputs of these receptors.

Using a comprehensive system of muscle testing and neural challenges, involved receptors can be located and normal function can be quickly restored. Most physical therapy and other therapeutic modalities deal with the “hardware” of the body, neglecting the fact that much of the pain and dysfunction we experience is often actually a problem with our “software”.

P-DTR® deals with the various sensory receptors (proprioceptors) of the body and the way they affect and modify our movement patterns. These receptors (those for pain, stretch, pressure, hot, cold, vibration, etc.) all send information to the brain for processing and the brain takes this feedback into account when making decisions regarding our movement.

If this information is incorrect, as is often the case, the brain is making its decisions based on bad information. Pain and dysfunction frequently result. P-DTR® uses neural challenges specific to the involved receptors and muscle tests combined with proper stimulation of the deep tendon reflex to make immediate and lasting advances toward restored function.

P-DTR is the most comprehensive and effective technique I’ve come across in my career for dealing with these “software” issues. The work is rapid, tremendously effective and unlike anything you’ve ever experienced.

Some of the benefits of P-DTR include:

  • Treats the problem, not the symptoms
  • Accelerates recovery from acute injuries
  • Eliminates lingering dysfunction and pain from chronic injuries
  • Eliminates the debilitating effects of repetitive stress
  • Optimizes athletic performance
  • Restores muscle function and coordination quickly
  • Increases range of motion, strength and stamina
  • Achieves quick, long-lasting results
  • Maximizes stability and balance throughout the entire body
  • Resolves problems you thought you’d “just have to live with”

Thomas Wells, CMT.

Santa Rosa, California.

Thomas has over 12 years of experience eliminating pain and improving function both in the clinic and in the gym. He holds credentials from numerous institutions including the National Academy of Sports Medicine and the Prague School of Rehabilitation.

He is a nationally licensed and California certified massage therapist as well as a nationally and internationally certified personal trainer. Thomas has also served as an adjunct instructor of Advanced Functional Anatomy at the Alive and Well Institute of Conscious Bodywork.

Past Injuries Causing Present Health Problems

Injury Recall Technique (IRT) is a treatment technique that is unique to those who use Applied Kinesiology. It was brought to Applied Kinesiology by Dr. Schmitt who had learned it from podiatrists.

What these podiatrists had found was that trauma on the body would change the structure of our feet which would often lead to other problems later in life. Dr. Schmitt expanded on this and found that through Applied Kinesiology techniques we are able to identify previous traumas or injuries that are affecting the current health of our patients. While the previous injuries had healed, the compensations that the body made during the injury had remained. These compensations were causing pain or health problems, sometimes in the same area of the body, but often times in seemingly unrelated areas. When treated with IRT, the compensations are eliminated and subsequent treatments produce results much quicker.

To the patient, the treatment for injury recall seems too simple to actually do anything. The patient will touch or rub the area of injury while the doctor adjusts the heel or heels that are affected. There is also a low force adjustment to the head and neck area where the doctor lightly tucks the patient's chin to their chest. That is it. This resets the body's compensations toward that injury and we move on to the next injury.

Dr. Jose Palomar presented a paper in Los Angeles a few years ago on proprioceptor recalibration using deep tendon reflexes. This seems to be an Injury Recall Technique that gets deeper than the IRT that Dr. Schmitt has presented. By deeper, I mean that treatment with Dr. Palomar's recalibration will sometimes erase the need for Dr. Schmitt's IRT.

Proprioception is the body's way of knowing where we are in space. The muscles and tendons send messages to the brain so we know where our body parts are and we don't run into walls or stub our toes. If there is a problem with proprioception, it can affect our balance, how we walk, our endurance, and cause pain in our joints and confusion in our head.

Similar to Dr. Schmitt's IRT, Dr. Palomar's recalibration has the patient touch the area of injury, but this time the doctor has to find the anatomy train that has become affected because of the injury. If you remember the old song about "the head bone is connected to the neck bone", that is the easiest way to understand anatomy trains. The head and the foot are connected, indirectly, by all the muscles, ligaments and tendons that are in between. There are many anatomy trains within the body. The doctor's job is to find which one(s) were affected and treat them accordingly.

To the patient, treatment for Dr. Palomar's recalibration will seem as simple as treatment for Dr. Schmitt's IRT. After the patient touches or rubs the area of injury and the doctor finds the affected anatomy train, the doctor then taps a deep tendon reflex while both ends of the train and the injury are touched or rubbed. A common deep tendon reflex is when the doctor taps the knee and the foot kicks out uncontrollably.

These two simple techniques allow me to reduce the number of times I see my patients, and the number of times I adjust the same areas. I have found that treating the previous injuries helps patients hold adjustments much longer than if these injuries were not addressed. These techniques have helped with ongoing joint pain, balance problems, poor posture, and improving athletic performance.

As simple as these treatments may seem, they have deep impacts on the body and the health of the patient.


Jonathan Herbert D.C.

Northland Applied Kinesiology
Hermantown, Minnesota.

History and Overview of P-DTR

Overview

Proprioceptive - Deep Tendon Reflex (P-DTR®) is a product of the original thought and investigations of orthopedic surgeon Dr. José Palomar.

This work recognizes that proprioception (sensation of touch, pressure, hot, cold, pain, etc.), and the way the body processes the information from these receptors, is paramount in determining neuromuscular responses throughout the entire body. Motor function is not just determined by the motor system, but rather is modified by the inputs of these receptors.

Using a comprehensive system of muscle testing and neural challenges, involved receptors can be located and normal function can be quickly restored. Most physical therapy and other therapeutic modalities deal with the “hardware” of the body, neglecting the fact that much of the pain and dysfunction we experience is often actually a problem with our “software”.

P-DTR® deals with the various sensory receptors (proprioceptors) of the body and the way they affect and modify our movement patterns. These receptors (those for pain, stretch, pressure, hot, cold, vibration, etc.) all send information to the brain for processing and the brain takes this feedback into account when making decisions regarding our movement.

If this information is incorrect, as is often the case, the brain is making its decisions based on bad information. Pain and dysfunction frequently result.

P-DTR® uses neural challenges specific to the involved receptors and muscle tests combined with proper stimulation of the deep tendon reflex to make immediate and lasting advances toward restored function.

History and Information for Practitioners

Muscles, Testing and Function by Kendall, Kendall and Wadsworth is considered a classic text describing muscle testing technique and parameters. The authors declare in the 1971 edition that muscle testing is an integral part of the physical examination. It provides information, not obtained by other procedures, that is useful in differential diagnosis, prognosis, and treatment of neuromuscular and musculoskeletal disorders. Accurate muscle testing, as described in the book, was focused on determining the site and extent of nerve lesions. The concept of muscular strain and stretch lesions is also included.

Even though the previously mentioned book is an excellent resource, we found ourselves obliged to develop novel muscle testing procedures at the time many of us are clamoring for more standardized classical testing methods. While standardized or classical testing are essential, they are also limiting and should truly only be used as a starting point in our quest to become congruent with the unique needs of the case we are treating at that moment.

The need for novel testing procedures was a result of an increase in understanding acquired as we investigated the particularities of neuromuscular dysfunction. Initially, we continued to test muscles in the classical fashion until we began to understand its inherent limitations.

The new understanding that we have come to, during the several years necessary to develop this work, has shown to us that proprioception, in all its forms, and also the way the central nervous system processes that proprioceptive information, is paramount in determining neuromuscular responses throughout the body. Motor function is not determined just by the motor system. Any form of proprioception can be the decisive modifier of motor function. Undoubtedly this reflects the complex interactions of the spinal interneuron pools and more central interactions.

Once we understood that we were only using a small part of the proprioceptive receptor fields available to us to determine our interventions we broadened our investigations to include other proprioceptive fields. Heat, cold, pressure, light touch, joint position sense, vibration, pain, and others all have their place and any one of these may be decisive in the outcome of a therapeutic intervention. We now have greatly expanded therapeutic options.

Most of the neuromuscular dysfunction we are trying to correct in consultation is not the result of some lesion or aberrant function inherent to the muscle under consideration. The real problem is that the central nervous system has come to a bad solution based on the proprioceptive information it has received. If we can find a way to demonstrate to the central nervous system the nature of its error, the central nervous system will instantly modify the neuromuscular responses. This is the beauty of P-DTR.

- Dr. Jose Palomar MD