Frequently asked questions

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Can BMT cure everything ?

Of course not. Its indications are limited to diseases due to lasting muscle spasms, also called contractures.

However these are very numerous, since skeletal muscles represents about half the mass of the body, and are often very disabling ; BMT can treat most joint diseases, and more : several vascular, visceral or neurological diseases can be due to contractures.

As we have showed, all joint and myofascial pains and restrictions of joint movements (except in the case of tumor) are a reliable indication of BMT, but we must not forget that muscle contraction can compress nerves, blood vessels and viscera, and disrupt their functioning.

Do physical therapy and other manual therapies not also treat the muscles ?

Since the cause of joint pains can only be muscular, physical therapy and manual therapies, whatever they are, all treat the muscles, but often without knowing it ! Therefore they do not do it in the same way as BMT and, for this reason, not at all with the same results. And it is always better to know what you treat, and not to think that you treat displaced bones without knowing that muscles are in fact the primary cause of troubles.

Besides this, results of the different kinds of manual therapy (chiropractic, osteopathy - and it should be reminded that there are many quite different forms of osteopathy -, etc.) are rarely published, to our knowledge. On the opposite, quantitative studies on the effectiveness in many diseases treated by BMT have been made and published. It seems to us important not just to say that a manual therapy is effective, but to prove it.

Is the technique of BMT also used under another name ?

No, as far as we know. BMT is an entirely original technique, quite different from any other manual therapy. (And we should know, since we found most of the characteristics of BMT by ourselves.)

The only other technique we know about that uses muscle shortening as a treatment method is the 'counterstrain' method developed in the 1960s by late Lawrence Jones. But his shortening protocol and his diagnosis method are not the same as in BMT, and his approach ignores other fundamental concepts we use, such as the fact that the primary cause is always located at the neck or the ankles, and that is the most important place where they have to be treated, or the important distinction between dynamic and tonic muscles. What makes this technique rather complex to implement, as compared with BMT. There is no known assessment of its efficiency.

All other methods of manual therapy use other therapeutic principles than passive muscle shortening – in fact they all stretch the muscles, and often abruptly, with the consequences we have described before. There is no known assessment either of the efficiency of these different techniques.

What is the difference between 'Myotherapy' and 'Brachy-Myotherapy' (BMT) ?

These two method aim at treating the muscles as cause of pains and movement restrictions, however the approach is completely different.

Diagnosis is different : myotherapy is based on the idea that all myofascial pain is caused by 'stress on trigger points', whereas BMT observes that joint or myofascial pain is caused by muscle spasms, easy to ascertain by observation and palpation.

Myotherapy, developed in the 1970s by Bonnie Prudden, based on the work of Dr. Janet Travell , also ignores fundamental aspects of BMT like the observation that the primary cause is always situated at the neck or the ankles, where it has to be treated, or the distinction between dynamic and tonic muscles.

Treatment is also different : Myotherapy uses a range of techniques including massage, sports and remedial techniques, exercises, passive stretching, hot or cold therapy, transcutaneous electrical nerve stimulation, pressure on trigger points, acupressure or acupuncture. BMT uses only one technique : passive muscle shortening, for this is enough.

There is no known assessment of efficiency of Myotherapy. On the contrary statistical proofs of efficiency of BMT exist for over 50 diseases.

How come you treat all joint pains, osteoarthritis or not, the same way ?
   Is this reasoning not a bit too simple ?

Why should the response to a single disease, muscle contracture, even if it is the cause of so many apparently different health problems, not be unique ? It would seem rather illogical to do otherwise, to treat differently one single muscle dysfunction, under the pretext that its manifestations are diverse in locations or in symptoms.

We have seen that osteoarthritis itself is caused by contractures, and that the symptoms attributed to it are clearly due solely to these contractures.

Studies show that the approach used in BMT seems to be very effective (and any BMT-therapist knows this from its own practice), so why use other methods that are less so ?

Furthermore BMT is self-sufficient, so it does not need the help of other techniques.

Should muscles not be strengthened in some patients rather than relaxed ?

For patients with joint pain, contractures (i.e. spasmed hypertonic muscles, involuntarily and uninterruptedly contracted by a self sustained reflex loop) are involved in almost all cases. In other words the dysfunctional muscle is already too 'strong', too tense. By relaxing them, which means reducing their abnormally high tone, the symptoms disappear, because their cause is treated.

To strengthen them by exercise or whatever can only worsen the problem.

Even in the cases of weakness and/or melting of dynamic muscles, we have seen that it is always due to a contracture of tonic muscle which limits the movement of the joint commanded by the weakened muscle - which is weakened because its use is disrupted.

It should be kept in mind that contractures are very simple to diagnose at the patient's examination. A good therapist knows thus without any risk of mistake whether muscle spasms are present or not, and if so of which muscles, and can see that these spasms have disappeared after BMT treatment has been effective.

Can certain conditions such as sprains not be due to joint hypermobility ? 
   And what is due to ligaments in joint pain ?

A joint hypermobility is of little practical importance, since it is not the ligaments that hold a joint, but the muscles - except in a direction where there is not supposed to be any mobility, because there would be no muscles, which is rare : this mainly concerns lateral non-movements of the ankle.

A hypermobility paradoxically rather protects the ligaments in ankle sprains, leaving time for nearby muscles to absorb the shock.

However, it is true that there often is a hypersensitivity of a ligament (alone or associated with muscle contractures) in the case of a sprained ankle, but this is apparently another reflex loop than a histological or anatomical injury ( unless proven rupture or avulsion), since 20% of acute sprains are cured in one session of BMT (because this therapy can also treat post-traumatic ligament hyperalgesia), although as we said, these disorders are otherwise very rare and limited to a few joints).

Would joint diseases not be due to too long muscles, or to muscle weakness,
   rather than to contracture ?

The strange concept of too long muscles is mechanically illogical, knowing the fact that when contracting a muscle shortens only by a third of its length, this would imply that the joint movements should be limited according to the length excess : this simply does not exist. For it is scientifically proven and well known that any muscle adapts its length to the distance between its insertions, even if it is surgically transplanted.

As for muscle weakness, since in practice neurological disorders are rarely the cause of it, it exists usually as a secondary symptom of movement restriction of the joint, more or less blocked by spasms of tonic muscles, as we have seen. Function maintains organs, i.e. muscles fit in strength and volume to what is usually asked of them. To try to strengthen weak muscles is totally illusory, because this would deal with a consequence and not with the cause.

By strengthening the muscles one might exacerbate the symptoms or trigger them, because this would inevitably also concern the contractured muscles increasing their tone, thus the latent or manifest pain and the movement restrictions.

On the opposite treating the contractures solves the problem, as can logically be expected.

Why are there no double-blind studies on BMT ?

The double-blind experiments are for testing the effectiveness of ... drugs, by comparing a new one to an already known one. This cannot be used to assess the effectiveness of manual therapy, nor by the way a surgical technique, which is fortunate, because in both cases this would imply not only that the patient does not realize how he is treated (which seems unlikely), but also that the therapist does not know what it does, which might turn out be dangerous ...

Feasible and valid comparative studies (see our study on elbow pain), or 'crossover' studies where the patient is his own control during two successive therapeutic methods (see the study on Cervicobrachial Neuralgia), or studies with x-ray measurements before and after treatment (our study on scoliosis correction), or studies where the difference between the number of expected and actual attacks is the reference (the study on migraines), or even simple studies on a large number of cases with many therapists (the effects of BMT on about 60 diseases have been studied 150 doctors on more than 2000 patients ; for objectivity's sake the therapeutic results of the author have never been included).

All these studies can be referred to on www.myotherapie.org (mind, not 'myotherapy.org'...).

© Dr. Jan Polak, MD

President of the International Myotherapy Society

- 2010 -