AN EXPLORATORY CASE SERIES ANALYSIS OF THE USE OF PRIMAL REFLEX RELEASE TECHNIQUE™ TO IMPROVE SIGNS AND SYMPTOMS OF HAMSTRING STRAIN

Abstract

Background/purpose: Hamstring strain (HS), a common condition found among the injured physically active population, is often treated with rest, stretching, and modalities. Primal Reflex Release Technique™ (PRRT™) is a manual therapy technique used to treat pain caused by over-stimulation of the body's primal reflexes. The purpose of this case series was to explore the immediate effects of PRRT™ for treating hamstring strains.

Description of cases: A multi-site case series approach was used to report on the treatment of six patients with HS using PRRT™. The Numeric Pain Rating Scale (NPRS), Patient Specific Functional Scale (PSFS) and range of motion (ROM) measurements were collected, as well as evaluation of symmetry of the sacroiliac joints, reported as sacroiliac dysfunction(SJD).

Outcomes: Primal Reflex Release Technique™ (PRRT™) was an effective treatment for subjects with HS. Subjects reported a significant decrease in pain on the NPRS, averaging five points over the course of the treatment (95% CI of 3.374, 6.626). Functional measures on the PSFS were significantly improved following treatment (post-treatment mean = 7.8 ± 1.84, pre-treatment mean = 4.8 ± .97, p < .001; CI: -2.1, -3.9). The mean change on the Passive Knee Extension Test (PKE) (mean = 8.20 ° ± 3.96 °) and ASLR (mean = 10.333 ° ± 8.98 °) indicated statistically significant improvements of post-treatment ROM (mean change = 8.20 ° ± 3.96 °, p = .01). The presence of SJD was observed in all subjects prior to treatment and resolved in all subjects when reassessed after treatment.

Discussion: In this case series, the use of PRRT™ resulted in decreased pain, increased function, and increased range of motion, as well as resolved SJD. The Primal Reflex Release Technique™ may be useful in decreasing symptoms of HS acutely, but long-term effects are unknown at this time. Clinicians should consider using a treatment which targets the autonomic nervous system when addressing pain associated with HS.

Level of evidence: Level 4 - case series.

Keywords: Autonomic nervous system; primal reflex; sacroiliac joint dysfunction; up-regulation.

© 2020 by the Sports Physical Therapy Section.

Figures

Figure 1.

Plantar Release PRRT™: Patient plantar-flexes ankle and holds pen with toes for 1 minute.

Figure 2.

S1/Lumbar Release PRRT™: Patient adducts leg with hip flexion. The clinician resists against abduction of the hip.

Figure 3.

Hamstring Release PRRT™: Patient hip flexes to 90 degrees, knee flexed Simultaps hamstring tendons and patellar tendon.

Figure 4.

Patient hip-flexes and knee-flexes; clinician to 90 degrees; clinician simultaps on patellar tendon and on dorsiflexors of ankle.

Figure 5.

Stretching Passive Hamstring Technique: Clinician moves leg to hip flexion and knee extension and holds at end; patient stretches for 30 seconds.