Releasing Joint Restriction (RJR) Technique

What is Releasing Joint Restriction technique?

The title “Releasing Joint Restrictions” (RJR) is one that I made up.  It is based on the technique of Strain and Counter Strain (SCS) developed by Dr. Lawrence Jones, D.O.  This is the clinical way to perform this highly specialized stretching protocol.  

 

RESTRICTION INDICATOR

Using a specific tender point or Restriction Indicator, (RI) helps you to find the precise position your body needs to resolve that particular restriction.  As noted below, if you do not want to check for the restriction indicators, simply do the stretches and see if it makes a difference for you.  If, however, you are able to use the Restriction Indicator, it makes your treatment much more precise.  It will also make the RJR treatment protocol much faster.  This RI or tender point helps you find out if you even need to do the stretch or if you can move onto the next restriction.

 

If you do not check for the RIs it is best if you do the stretches anyway.  This is much slower and sloppier because you have to do the stretches and there is no way to determine if you are in the best position for that joint.   Once you have turned off the RI you can be confident that the position you are in is perfect for the joint that is restricted.

 

THE GIFT OF PAIN.  THE GIFT OF A LIFETIME

I finished my Master's degree in Physical Therapy and one month later I was in a motor vehicle accident (MVA).  I was able to walk after the accident but I felt pretty banged up.  Over the next few days, I became sorer and found that my back was stuck in flexion which means I was bent forward and could not stand up straight.  Not only could I not stand up straight I could not bend backward at all.  I lived about an hour from the clinic I worked in so I was forced to find a physical therapist closer to home.  My husband drove me to my first appointment with this new therapist. 

 

As a new graduate in physical therapy, I was expecting Bob to put me in a gown so he could see my back.  I also anticipated him to use all of the specific tools such as a reflex hammer and a two-point tester but he did not.  Instead, Bob asked me to bend forward and bend backward, or at least try to straighten up.  He measured my spine's ability to move into these positions and asked what my pain level was during these movements.

 

After he finished asking me questions and observing my range of motion, I was ready to lie down on my stomach so he could work on my back.  However, I was in for a shock.  Bob asked me to lie down on my back which really confused me.  How could he work on my back if I was lying on it?  Next, Bob started pushing on the front of my stomach and pelvic bones.  I was not shocked that this was horribly painful because as I showed Bob, I had horrible black and purple bruises across my breasts and stomach from the seat belt.  Of course it would hurt when you pushed on a bruise. 

 

The next shock came when Bob lifted my legs and put me in a very awkward position and when he poked again on the sore spot, it was no longer painful.  I was very confused by this.  Since the skin was bruised, it should have hurt to poke on that area.  It did not hurt at all, however.  Bob continued to locate the most tender points and used specific positions of my spine and legs to make the tender points go away.  After about 20 minutes of this work, he had me stand up.  I could not have been more surprised to find myself to be standing up straight and able to bend forward and backward without pain.  My pain level coming into the clinic was probably 9/10 and leaving after only 20 minutes, the pain was down to 0/10.

This experience was an amazing experience to have the pain resolve so quickly.  It was especially amazing for me as a therapist to experience this transformation for myself.  Over the years, I have continued to wonder what the tender point comes from since the bruises were not tender once he got me into the treatment position and even coming out of the treatment position it still did not hurt.  I still question why this tender point goes away immediately but am now suspicious that it is a bubble of lymphatic fluid that is trapped by the joint that is held in a restricted pattern.  As soon as the joint is put into a free position, this allows the fluid to move out.  There is no proof of this, it is just my theory.

Overall, I have learned that pain is a true gift.  It tells your brain that something is wrong and requires assistance to resolve the pain and improve function.  My experience with Bob truly changed my life.  I have spent my professional life since 1993 studying this technique and experimenting on all of my patients to find the best way to help people.  I have especially worked to teach people how to use this tool on their own and that is the purpose of writing this website.

 

How to perform Releasing Joint Restriction technique:

  • FIND PRE-TEST OR MOVEMENT OR POSITION THAT CAUSES THE MOST DISCOMFORT OR PAIN.

  • CHECK ALL OF THE RESTRICTION INDICATORS (RIS)-EXQUISITE TENDER SPOTS INDICATING THE SPECIFIC SITE OF JOINT RESTRICTION.

  • USE POINTY TIP OF YOUR FINGER (NOT THE FAT PAD).

  • USE THE SCALE OF 0/10 WITH 0/10=PRESSURE AND NO PAIN; 10/10=WORST PAIN IMAGINABLE AND FIND THE WORST RI.

  • ONCE YOU HAVE FOUND THE WORST RI, KEEP IT MARKED ON THE SPECIFIC SPOT BUT STOP PUSHING.

  • TO RELEASE THE RESTRICTION-FIND THE BEST MOVEMENT COMBINATION OF THE BODY THAT REDUCES THE RI (SEE SPECIFIC HANDOUT).

  • RECHECK THE RI USING THE SAME AMOUNT OF FORCE AND IN THE SAME DIRECTION WITH EACH POKE.

  • CONTINUE CHANGING POSITIONS AND CHECKING THE RI AFTER EACH CHANGE UNTIL YOU FIND THE POSITION THAT MAKES THE RI TURN OFF OR REDUCE AS CLOSELY TO 0/10 AS POSSIBLE.

  • ONCE YOU HAVE THE RI TURNED DOWN, STAY IN THIS POSITION FOR 90 SECONDS.

  • RETURN BODY BACK TO A NEUTRAL (STRAIGHT) POSITION VERY SLOWLY.

  • RECHECK RI WITH THE BODY PART STRAIGHT.

  • REPEAT PRE-TEST AS A POST-TEST AND DETERMINE IF ANYTHING CHANGED.  CONTINUE TO CHECK AND TREAT ANY RIS YOU FIND UNTIL THEY ARE ALL RESOLVED.

  • CHECK FOR RIS AT LEAST 2 TIMES A DAY.

  • IF YOU HAVE PAIN, THERE ARE LIKELY JOINT RESTRICTIONS OF THE SKELETON AND RIS SOMEWHERE.

  • IF YOU ARE UNABLE OR DO NOT WANT TO LOOK FOR RIS BUT STILL HAVE PAIN TRY THE POSITION LISTED IN THE MOVEMENT COMBINATION FOR 90 SECONDS TO EACH SIDE (RIGHT AND LEFT) AND SEE IF THIS CHANGES ANY SYMPTOMS.

  • CHECK FOR TENDER RIS AT LEAST ONCE A DAY THE REST OF YOUR LIFE. IF YOU FIND AN RI AND TREAT IT YOU WILL IDEALLY BE ABLE TO PREVENT ANY PAIN FROM RETURNING AND YOU WILL PREVENT BREAKING DOWN OF THE BONES AND MUSCLES.

Handout:  

 

Contact:  Loraine@doctorlovejoyevans.com

 

© Dr. Loraine Lovejoy-Evans, DPT