How TMR Was Discovered?
Around 2002, Tom Dalonzo-Baker, MPT - had the initial ah-ha moment(s) about TMR. Gradually he began to look for ways to make the process quicker and easier to understand both for therapists and patients. After about 2 ½ years refining the system The FAB 5 (the foundation exercises) were finalized. The FAB 5 are the basic exercises and the basic format that allow people to fix themselves.
How the FAB 5 Came Into Existence
The first year of Total Motion Release was mainly done by finding the patients restricted motions. A picture was taken of what the patient was supposed to do at home and they were given instructions on how to do the exercises. Finally Tom figured there had to be a handful of exercises that worked better than all the others. He wanted to find these exercises and create a pain relief program that could be developed around them. He planned on using the exercises to develop a self help process for his patients.
Tom got together with two of his therapist and began a process of elimination which eventually turned out to be the Fabulous Five. Tom asked Chip Moseley, and another therapist, to write down their top twelve TMR exercises they most often used on their patients. The three of them had fifteen exercises in common. After a discussion they finally whittled the fifteen down to twelve. Tom challenged them all to use only these twelve exercises on their patients during the next month. At the end of the month they agreed to share their findings.
Tom’s original intention was to whittle the twelve down to four exercises. At the meeting he told the other therapist that he wanted the twelve whittled down to eight. After this was done Tom expressed his concern that this was too many for a patient to remember. Tom says that he remembered from psychology class that people best remember five items plus or minus one. Therefore, his target was four exercises.
After a lengthy discussion they all selected the following: Arm Raise, Trunk Twist, Leg Raise and Sit-to-Stand. These were the exercises the patients had the most success with. Chip Moseley strongly suggested that another exercise needed to be added to the four, the Bent Knee Toe Reach. After listening to his reasons, which would later prove to be accurate, the Bent Knee Toe Reach was added. The FAB 5 was created.
Not knowing it at the time, the three had selected exercises that addressed the largest joints in the body. The Arm Raise affects the shoulder joints and the spine (upper.) The Trunk Twist affects the rib cage and the whole spine. The Leg Raise affects the hip joint and the spine (lower.) The Sit-to-Stand affects the hip and knee joints.
Additionally, these five exercises are functional motions the body assumes throughout the day and each of them occurs in one plane of motion. The single plane movements allow the Fabulous Five to be easily learned by the patients. Tom challenged each therapist, including himself, to use only the FAB 5, for the next month, on every patient no matter what their condition.
He held each accountable and attempted to reduce the amount of fiddling by having patients shared between therapist. This way each of them could supervise the other and, most importantly, they could hold Tom accountable because he was the person most likely to fiddle.
The results over the next month were pretty astounding. They used the FAB 5 with every patient and on any condition. Each time a therapist fiddled into other motions the results were less effective and took a longer period of time to get pain reduction. When the therapist stayed pure to the FAB 5 the results were quicker, longer lasting and more easily followed by the patient at home.
After the month it was decided that there was enough evidence to prove that using the FAB 5 (regardless of the condition) resulted in better and longer lasting results. Because of this the FAB 5 became the foundation for the Total Motion Release concept. Advanced pain relief processes, know as the WOW, Wind Up, Super Six, Combinations and Free Flow were developed. Within a year Total Motion Release became the only concept practiced at the clinic.
Interesting patterns . . . .
- Migraine headache sufferers - the eye in which they experience the throbbing headache in is often times the side they have shoulder restriction.
- People who grind their teeth at night and are unable to open their mouth very wide are relieved both in tightness and in their ability to open their mouth simply by them gently compressing their teeth for two minutes.
- Plantar fasciitis may not resolve until the upper rib cage or upper thoracic is released.
- A person who is "unable" to stand up straight or backward bend can usually extend on one side easier than they can on the other side. Same goes for bending forward. A person who cannot bend forward, can bend forward if the bending is more one-sided.
- A person who is balanced in their tissues can spin around like a child and have very little, if any, dizziness. The more dizziness a person experiences with this activity the more restrictions that will be found throughout the body (if you are going to try this - do it on yourself and not your patients.)
- Tailbone and pelvic pain is not completely eliminated (long term) if the thoracic area and rib cage is not made more flexible.
- Testing an individual for which eye they can see better out of is also the side of the shoulder/arm that is more flexible.
- An acute back pain sufferer never (except on a few occasions) comes in stuck in extension. They are always slouched forward or to the side, and almost always the traditional form of therapy will try to get them standing up straighter rather than slouching over further. Have you ever tried to exaggerate what the body is doing - it is wonderful to see what effect this has on a person's pain. Try it!
- Tightness of let's say the hand also shows up in similar movements of the shoulder. For example, a restricted motion at the wrist - cocking the hand out to the side can present as a restriction at the shoulder of not being able to raise it up and back, as if being a driver and reaching behind the passenger side car seat.
- If one finds rotation restrictions at the shoulders most likely the patient will also have rotation restrictions at the hips.
- When a person goes to squat down to pick something up, they invariably weight bear and squat down more on one side than the other.
- If a person is asked to move their jaw to side to side, the side they can move to further (8 times out of 10) has a tighter shoulder and arm of that side.
- Foot pain or issues of numbness and tingling also correspond to hand numbness or tightness on some occasions. Many people with plantar fasciitis also sufferer from tennis elbow, carpal tunnel, etc in one or both of their upper extremities
- Restriction of the trunk can show up as a variety of ailments from musculoskeletal to visceral. Free up trunk range of motion and patients will tell you that all sorts of things have changed for them.
- Every person has a good side and a bad side for every movement. Next time you get out of a chair focus on which side you place more weight on. Chances are you do this every time you go to stand and sit down. I have found this asymmetry to be one of the root causes to many pain complaints.
- A pelvic shift and tailbone rotation causes a three dimensional issue in the entire spine and the patient usually has a variety of complaints they are seeing you for.
- People even have a good and bad side for which ear they can hear out of better and which eye they can see out of better.