I am one of those who went through the whole P-DTR (proprioceptive-deep tendon reflex) education, without ever using it in practice after. If I were to tell it to any of my colleagues from the course, who are using it daily, the comment might be: “You wasted your time!” (and big money), or something in that line.
I tend not to be disturbed by those facts – “wasting” time and “wasting” money; it’s up to you to let the stuff make you richer in experience, whatever time and money you used for it. Also from the outside, a muggle might say – there’s no point in paying for it if you will not be using it; or there’s no point in going to doctoral studies if you will not be pursuing a scientific career; respectfully, I disagree. Somewhere deep inside, I viscerally know I needed the P-DTR (and doctoral studies too).
I am not using it in practice, for a simple reason I’ll explain below, but I am well aware of what P-DTR can do for you, and more importantly I am more and more aware of what I can still do with all the skills that I have (including the knowledge that P-DTR gave me) despite not using P-DTR per se. That’s an interesting concept that stirs my mind a lot, and the body of evidence working in my favor is just growing in return.
What’s P-DTR?
P-DTR gives you a very vivid perspective of the body being an electrical signalling system, all happening by the means of our nervous system. In this therapy, it is with specific tests done via receptors of our body (15+ different kinds of them) that we can easily see how some input from our external or internal environment is affecting output that our system will give.
To illuminate it a bit more – your body has two main categories of output (could discuss if there is more) – your muscle tone and your hormone production. The state your muscles are in is the end product of the commands that your controlling centre, the motherboard, sends to it. After all the computing based on stimulus from all the receptors is done, then your brain decides if a certain muscle region should change its tone – should it be more protective, should it be underactive, or should it be normal. If for some area your brain computes that it needs more protection, it might increase the tone in the muscles around it, so it can feel less stimulus, because it didn’t like the rate and sensitivity of input from that area (injury, overstimulation, overuse, stress, emotional impact). In turn, because our brain is very smart, it will probably make some nearby or far away area also change its tone, to match and compensate for the “problem” it had in the first place.
That is, in essence, why not dealing with stuff in your body for prolonged periods of time, creates a mess. It ends up so that while you are untangling one problem, something else soon comes up at some other place, and then again and then again. P-DTR has a majestic way of finding where the dysfunction started and clearing it up in your informational system immediately (it deserves its own discussion, whether or not that is always the case and how exactly it works). The other way your body controls what it needs to control, is your hormone production. It works as a negative-positive-feedback loop, where certain stimuli or levels of hormones in the body direct the hormone production axes to do their job. It is not something P-DTR deals with, because there is no easy way to test your hormones on the spot.
But, for the muscles – we can do the notorious muscle testing. In P-DTR it does not mean testing the strength of one’s muscle, but testing its stretch reflex activity. Stretch reflex should have its normal way of operating, and any dysfunction in it can tell us if there is a computing problem at that spot.
I say notorious because muscle testing is exactly the reason I am not using P-DTR – I am not good at it. I tried for 2 years, it was usually me trying to give therapy to my family. I tried for 20-30-40 minutes, trusted myself less and less with each test, got terribly irritated and quit. I know that there might be a way out there for me to find the strength to learn it well enough so I can use it, but for now I decided that I will not put more time and effort into it. I use my eyes for diagnostics every day, and that is a tool I enjoy sharpening; it does not give me irritations.
Broader perspective and why this knowledge is important
The point is – knowing what P-DTR proposes, that the brain has the final word on the state of your muscles, it might seem that there is no overriding of the reflex muscle response to the stimuli you receive without clearing up the dysfunction at the source. Or is there? It means that if one muscle shows as being hypoactive reflexively, you can do all the contractions in the world but it will not change its reflex activity. Or will it?
It will definitely not (in the short term) – BUT that does not mean that P-DTR is the only way to change the reflex activity of your muscles. Yes, it can alter the reflex activity at the source, as no other method I’m aware of can, but turning the switch on/ off is not the only way your brain learns. Your brain is, at the same time, just a computer and not just a computer.
It learns by gathering all the information all the time, by measuring the changes in physiology around the issue, by being in a certain autonomic state (para/sympa), by your fears/ motivations /beliefs, by feeling safe or unsafe. Every cell of your body is constantly in an aquarium of all of that, and I believe that it is safe to say that by changing the aquarium, you can also change the motherboard.
What I got from P-DTR is knowledge that this exists and knowledge that it needs to be taken into account for any kind of rehab. And muscles, and pain, and movements are all still a great way to diagnose it even without using exact muscle testing.
Main principle of balancing the reflex activity
The premise is simple: the brain needs safety. When you put your brain (body) in a position which was previously regarded as dangerous/ too sensitive, but you now cover it with a safe environment, everything can change. Constantly being in a safe environment is no way to live, but it might be (it definitely is) the way to start rehabilitating your nervous system.
In practice it happens all the time – people recover from all kinds of stuff without using P-DTR. I recover from all kinds of stuff without it. There are things in which the P-DTR can be a great, potent facilitator for things to move from the dead point. But even after you have got that initial push, the person must continue working on its aquarium, otherwise sooner or later a new/old problem will arise.
More so, I believe that it is more comprehensive of a recovery if you truly manage to do the recovery with full engagement of the person, rather than giving them a blank switch on/off treatment. As always, the sooner you take the wheels in your hands, the sooner you will know how to deal with any issue you have.
How to do that
You get a blanket, print SAFE on it, and cover people with it when they come to you. You can tell them that it’s like the invisibility cloak (second HP reference in this text), which makes it impossible for pain to find them. Then you have them do all the stuff which usually hurts. That way the brain actually thinks that it’s safe doing those.
If you do not have a safe blanket, then there are some other ways too:
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- Calm their nervous system down by having them observe their breathing, then engage in simple movements which do not have anything to do with what usually hurts
- Teach them how to engage in (opposing) muscle activity which doesn’t produce pain and them get a small window of doing the activity which usually hurts without pain too
- Make their circulation better in place where the issue persist and everywhere else, especially at midline structures
- Make their lymph flow better
- Work on the strength and stability of their midline structures, so they are anchored the whole time, and the periphery can “relax” out of grasping for stability
The premise is simple: to thrive, the brain needs safety first. Choose whatever method you have at hand to get there.
Feature Photo by Anna Mitchell on Unsplash.