TMR

What is Total Motion Release?

Abilibee Therapy utilizes a foundation for treatment known as Total Motion Release (TMR).  TMR is a non-traditional approach to the care of your child upon which more traditional approaches are built.  TMR will set your child up for far greater success in his/her movement and function in life.  It is a highly effective technique placing the power of healing and care in the hands of the individual and caregiver.

TMR was discovered and developed by Tom Dalonzo-Baker, MPT.  Tom’s pain-relief program has proven successful with nearly 100% of the clients who try it.  His concept is easy, comfortable and highly effective.  Susan Blum, PT, cTMR is the developer and instructor of TMR for children.  She was a former patient of Tom’s and adapted his TMR concepts for use with the pediatric population.  Over time, it became clear that Susan’s adaptations brought TMR to children of any age, particularly those requiring the assistance of a caregiver to complete the tasks.

According to Susan, TMR is “a modified positional release and feedback system to assess and treat postural asymmetry in order to achieve objective improvements in functional outcomes, i.e., issues with alignment limit access to a full palette of muscle function.”  TMR looks at the entire body and how it interacts, understanding that the human body is amazingly interconnected.  Of chief concern is asymmetry in the body caused by areas of limitation and restriction, leading to structural imbalances.  TMR focuses on the release of these restrictions, freeing the body to achieve symmetry, thus improving the success of other more traditional treatment approaches.

You may ask why these asymmetries and restrictions are bad and where did they come from. Restrictions may come from intra-uterine positioning, prolonged hospital stays or immobility, or from asymmetrical body usage due to a challenging diagnosis or underlying condition. The limitation of movement in one or more areas of the body creates a ripple effect throughout that wonderfully interconnected body, impairing access to movement, motor control, and development of typical skills. An asymmetrical body may struggle with pain, impaired gastro-intestinal function (trouble with bowels and/or digestion), challenges to breathing and eating, difficulties with speech and an overall increased use of energy to achieve simple daily living functions.  When a child is expending excessive energy on basic living, they have a loss of energy available for higher cognitive/thought processes.  As a result, brain development can be restricted and impaired – with a basis in the physical limitation present in the body.  TMR can help free a child’s body so that it will move more symmetrically, diminishing the negative impact previously encountered by the restricted body.  The sky is the limit for a child’s potential once freed from their own body’s restrictions.

So, how does TMR work?  At Total Motion Kids, we assess your child’s body looking for many things including restrictions and asymmetries unique to your child or you.  We teach you how to release these restrictions – freeing the body.  You will learn to follow your child’s lead helping him/her work in his/her most comfortable and preferred positions.  We will help you determine your child’s “easy” movement patterns and preferences and work with these to achieve unlatching of restrictions.  We then incorporate traditional therapeutic approaches to help you and your child progress as far as possible toward reducing your challenges.  The techniques are tear-free and fun with NO painful stretching and no difficult positions.  They are very easy to use and we help you incorporate them into your daily routine so you can achieve success.  The results will be improvement of function faster than with traditional treatment approaches alone.  Incorporation of traditional therapy techniques on a more balanced and symmetrical body facilitates greater success.  The mobility and function of your child can easily surpass the expectations of both the parent and therapist!

 

 

Heather Denman, MPT, cTMR offers personal testimonials of the power of  TMR?

“Sally”

I had been working with an 8-year-old young lady (we will call her Sally) in the recovery stages from leukemia and the impact of chemotherapy treatments.  She was a toe walker, resulting from chemo meds.  I was already many years experienced (about 18 years in pediatrics) and had many successful strategies to help this young lady.  However, despite months of effort, we were not making the progress I’d like to have seen with her toe walking.  We were discussing use of orthotics to help “break the habit” of toe walking, but both Sally’s mom and I were concerned that it’d be tough to get consistency from the family to make this approach successful.  Sally also had incredible pain at her medication port location at her left upper chest.  She would sleep curled in a fetal position to “protect” the port and experienced intense pain each and every time she received injections at the port.  I began implementing my new knowledge in Total Motion Release (TMR) strategies immediately following my first TMR training.  Instead of forcing the family to stretch the backs of her ankles to stretch her toes progressively upward, we went in the direction of ease for her body and pointed the toes down (relaxing the muscles and tissues at the back of her ankle).  I must admit, this made me a bit nervous.  This approach and strategy was 180° opposite to what I’d been doing and I was a bit afraid we’d set Sally back.  But, I knew the TMR concepts were strong and we had little to lose.  So…I instructed Sally and her mom in pointing Sally’s toes downward several times a day.  We also added an upper twist and arm raises.  We completed the arm raises with her right arm since her medication port was on the left side and it hurt to move the left arm.  Well…we were all amazed at thrilled at the results.  We saw improvement in Sally’s ankle range of motion immediately.  Within 3 weeks, she was no longer toe walking at all!  But, we witnessed an added bonus because ALL of her medication port pain disappeared.  She no longer slept curled to protect it and experienced no pain during injections.  This is a story I share often as the change in Sally was so dramatic AND I was able to compare traditional treatment strategies vs. TMR.  We do continue to complete periodic adjustments with Sally’s TMR to address various issues.  But, she has never resumed toe walking and has never had recurrent issues with her port.  

 

“Sam”

Sam has Prader Willi Syndrome, Ehrler’s Danlos Syndrome, scoliosis and has a host of other diagnoses mixed in.  He also happens to be sensitive to dairy.  I have provided treatment for Sam for over 14 years.  He and his mother have always been great sports about trying out new techniques as I progress and learn in my career as a physical therapist.  I began implementing TMR with Sam several years ago.  Since that time, we have addressed a variety of weekly issues that arise.  But, we primarily focus on prevention of progression of his scoliosis.  I also always address his abdominal area looking for tightness.  TMR has enabled me to relieve periodic abdominal pressure caused by constipation, exposure to dairy or a variety of other triggers.  Sam’s mother never tells me that he is struggling with his Gastro-intestinal tract, but I can always tell by feel.  And, his mother reports that Sam experiences relief and release from his GI concerns several hours after TMR interventions, every single time.  I’m thrilled to report that Sam has been able to avoid spinal surgery as we’ve prevented progression of his scoliosis despite all expectations that it would progress.

 

“Jordan”

Jordan’s mom consulted with me for assessment due to her own gut instincts that something was wrong.  According to mom, Jordan’s pediatrician kept assuring mom that all was fine, he was just a bit slower to progress than some.  Jordan was an 8-month old baby who could not yet roll in any direction, hated time on his belly and propped on his hands to maintain sitting.  I was immediately concerned as a baby of that age should be rolling all over the place, sitting solidly, playing with toys in sitting and working his way toward crawling.  Jordan was also very very fussy and had stopped vocalizing about one month previous to our assessment.  I completed a TMR assessment as well as a general pediatric evaluation.  I issued mom a home program of 2 TMR motions to complete.  Fast forward one week and Jordan had made dramatic changes.  He was now sitting upright with a solid and straight spine and no more need to prop on his hands.  (Mom’s before and after photos were impressive).  He was rolling in all directions.  He had restarted babbling.  And, his tongue was now centered in his mouth…mom had not mentioned to me that she and her husband had been concerned about Jordan’s tongue hanging to the side.  But, it had been corrected along with many other issues.  Jordan still has quite a bit of catching up to do.  But, we will continue with TMR to help him attain optimal symmetry of his body.  We can then teach him strength, balance and movement coordination skills to bring him up to age appropriate skill levels.  (Jordan’s amazingly fast progress is not necessarily typical, but it’s notable since it was directly related to the TMR interventions).

 

“Lilly”

I received a call from Lilly’s mom to set up an appointment due to concerns about torticollis (head is tilted to one side and sort of stuck there) and plageocephaly (misshapen head).  Unfortunately, I was headed out of town for nearly 2 ½ weeks and wouldn’t be able to evaluate Lilly for over 3 weeks due to scheduling limitations.  Mom was pretty desperate and asked if there was anything she could do until I was available.  I told her about my TMR approach and how powerful it had been for me with kiddos with torticollis.  I described many basics of TMR to mom including ONLY moving Lilly toward her easy side.  I talked mom through ways to assess her child’s asymmetries and ways to start to work with her.  Mom was very receptive and picked up on the concepts quickly.  Fast forward 3 weeks to our evaluation.  Mom was over the moon…Lilly no longer had any issues, in her opinion.  After assessing Lilly, I had to agree.  Her torticollis was resolved and her head shape was perfect.  Lilly’s mom reported that Lilly’s head shape had changed in the few weeks since we’d spoken.  We were both thrilled and I did not recommend any continuation of treatment.