The PRRT concept was developed by John Iams, PT from San Diego CA. The theory of PRRT is based on the idea that   reflexes can become dysfunctional and create a persistent state of pain. Iams describes two reflexes, the Startle and the Withdrawal. The Startle Reflex is seen in situations when you are trying to prevent a fall after you trip. The Withdrawal Reflex is seen when you touch something painful and the body forcefully contracts to remove itself from the painful stimulus. In both of these situations the body undergoes a “tensing” in an attempt to avoid injury. In most cases, after an episode like this the body “relaxes” and returns to normal. However, in a dysfunctional state the muscles stay taut and they restrict motion that leads to neurologically sustained pain.

PRRT uses a palpation examination to identify areas that are being “held” in this tense state. Once identified, the therapist will use a number of painless techniques to release these areas. The therapist can use rapid muscle contractions, quick tapping and sustained positioning. Once the tension is released in one area it allows other areas to release as described in the paper Breaking the Reflex Pain Cycle . Once the neuromuscular system is able to function without restrictions the results obtained will last.

The appropriate patient for PRRT is anyone with pain that has not responded to other treatment approaches. The key is when PRRT is indicated, it will have its effect within 2-4 visits. Many times PRRT is the only treatment needed but it also can be integrated with other treatment techniques to obtain the maximal benefit.

Frank Gargano PT, DPT, OCS, MCTA has been personally trained by John Iams, PT at the advanced level programming.

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