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Using P-DTR to Create Stability with Hypermobility

I've had a massage client for a long time who has started to incorporate P-DTR into her session. She is hyper-mobile and is naturally very cautious of her body. This is because hyper-mobile people because have ligaments/tendons stretch further than is healthy for the average person, making them more prone to injuries. In her case she has the normal symptoms but has also dislocated her right knee numerous times. This means she has a hard time trusting her own body.

1st P-DTR Experience: The Right Shoulder

One day she came in for her normal massage but she said her shoulder felt really bad and loose. I did just a little muscle testing and found EVERY muscle that overhaps the shoulder girdle to the humerous to be extremely weak. I went on to explain how massage therapy would be great for making a tigher muscle relax, but if we already have muscles that are extremely weak it would only get worse if we applied a massage therapy technique to that region. I explained I'd really like to dedicate some of our massage therapy time to doing some functional neruology work. We spent the next 45mins of our 90 min session just working on rotator cuff and shoulder muscles with very light testing. We eventually managed to get a normotonic response (strong when the muscle needs to be strong, and able to properly go weak) on all the muscles. Since then for almost a year later her shoulder has felt great.

2nd P-DTR Experience: The Knee

After the shoulder injury we worked on other small things here and there over the next year but one day she finally trusted me to work on the knee that had been dislocated many times. It started off that I could literally not even touch the structure. We quickly realized we could not even do muscle testing because of just how unstable the joint was. So I had to have her put herself into positions and attempt microcontractions of the muscles I wanted to test. After some time we slowly created strength in the hamstrings and quads to a point I could even provide some gentle resistance and touch her leg. It was a great first step.

3rd P-DTR Experience: Single Leg Stance

Following appointment of the knee we decided to keep working on that joint. I provided some climbing assessments, worked on patella stabilizers, and then we decided to do a 1 legged stance.

Once we did a foot legged stance assessment which is basically just balancing on one foot, we instantly realized there were still some severe issues. When having to balance on the leg we were assessing she was extremely shakey and even avoiding the flat of the foot. While you may think "how often am I going to balance on one foot", and the answer is every single time you take a step. After some work on the bottom of the foot, deep ligaments, and the ankle stabilizers we retested near the end of our session and to our amazement she was perfectly stable and completely changed the way she balanced.

While we were both really happy with the results I look forward to continuing my work with this client to not only give her proper mechanics but prevent/reduce future injuries as well by creating balance and stability around the joints.


Massage Therapy is a fantastic way to reduce pain and muscle tension, however for some clients we really need to focus on activation of muscles and proper mechanics of the joint.

Using P-DTR we can help recover from chronic issues and prevent them as well.

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