How PRRT Works

By Patricia Anttila, PT, PRRT Instructor

Humans are gifted at birth with many primal reflexes that help us to survive. Most of these reflexes disappear after a few months. The startle and withdrawal reflex are a couple of the reflexes that remain. The startle reflex is very common in patients who have experienced some form of trauma, like a car accident. We all know someone who startles easily. The withdrawal reflex occurs when you accidentally step on something sharp. Without thinking about it, you will "reflexively" pick up that foot and transfer your weight to the other side. This is a "normal" protective reflex!

These two reflexes work in concert with the autonomic nervous system (ANS). The ANS automatically controls certain bodily functions, like breathing, blinking, salivation, digestion etc.

Immediately after an injury, there is a withdrawal that occurs, possibly with a facial grimace and a groan, as we reflexively grab and/or rub the painful area. In many people who are injured, muscles stay in a state of reflex muscle spasm, possibly for years. So now the startle and/or withdrawal reflex become abnormal. When these abnormal reflex muscle spasms are examined by the physical therapist, patients may withdraw away from the pressure, grimace, groan or grab, just like they did when they were injured. When this happens, we say that the patient is an "upregulated" state.

When a patient comes to our office in pain, we examine him or her from head to toe in an attempt to find areas that are upregulated. The examination only takes a couple of minutes, but it is extremely revealing and may be the most thorough physical therapy examination you have ever experienced. These upregulated areas are obvious, because the patient will withdraw away from the therapist's palpation (touch). It is important to know that an upregulated area has the potential to cause pain in multiple locations throughout the body.

The physical therapist will then treat the painful area in a way that is similar to a doctor testing your knee jerk with a reflex hammer. This type of treatment can be done anywhere on the body and significant pain relief can be experienced in a few treatments as opposed to weeks and months. In more sensitive areas of the body, light tapping is used instead of the reflex hammer. Overall, the PRRT™ evaluation and treatment is gentle, non-invasive and it can be extremely effective.

Another wonderful feature of PRRT™ is that when It fails, it falls fast. This means we will know within the first couple of visits whether or not PRRT™ will work for you. Then you are not wasting a lot of time, energy and money over weeks and months waiting to see if you will get pain relief. If PRRT™ does not work for you, we then proceed with conventional physical therapy treatments.