Principles of PAS
Principles of PAS®-treatment (Proprioceptive Activation System) at the training center PAS®/ Active Form.
The Proprioceptive Activation System (PAS®) is developed by the owner and leader of the PAS®-center Per Gjeding, on the basis of his expertise and knowledge of the connection between the muscle function and nervous impulses to the muscle spindles, the Golgi tendon organs and motoric endplates, combined with an understanding of the energy metabolism of the muscles. For a period of ten years Per Gjeding received private tutoring and teaching by a chief physician of The University Hospital in Odense, Denmark.
The treatment/teaching program is thus based on known anatomic, biochemical, pathophysiologic and neurologic knowledge
Briefly described, proprioception is the awareness of our body’s position. When the proprioceptive sense is well functioning, we continuously adjust our body position. The sense helps us to take up the optimal position in a chair, to hold on to tools like a fork or a pencil in the right way; to estimate how to move through a room without bumping into things. If the system doesn’t function properly, one has to keep focus on things which should work automatically. For instance one may have to use sight to adjust one’s position.
Described in more details, proprioception is the process which enables the body to vary muscle contractions, as immediate response to incoming information about affect from outside, through stretch receptors in the muscles which supply information on the joint positions of the body.
Proprioception and kinesthetic, the sensing of joint movement and acceleration, are the sensory feedback mechanisms for movement control and posture. These mechanisms are – together with the vestibular system, the liquid filled network in the inner ear, registering the effect of gravity and keeping the body informed and in balance – unconsciously used by the brain to secure constant flow of sensory information. In this way the brain is - immediately and unconsciously - able to send out message of adjustment of joints and muscles to achieve movement and balance.
Example: Whip lash lesion
A whip lash lesion can be conceived as a straining of the brain stem which is responsible for all control in the body. Per Gjeding’s experience over the years show that a whip lash lesion causes so severe disturbances of the brain stem that a movement can no longer be carried out purposely which result in a degree of disablement. The movements which are nevertheless carried out are reflex movements, activated through the cerebellum. With a whip lash lesion there are dramatic communication disturbances between the brain stem, the encephalon, the cerebellum and the sensory cell ganglias and the periphery nerve’s contact with the gray matter of the spinal cord. Therefore the system doesn’t function optimally, and the muscles can’t maintain equilibrium and balance in the body. Hence the muscles cannot carry out a movement without locking the joints in the back. This causes reduced efficiency because the speed of impulse in the nervous system is reduced in both arms and legs. Reaction speed is significantly decreased which causes many complications in everyday life, just as one becomes more prone to industrial injury.
With any kind of pain in the body, the sympathetic nerves and the encephalon are shut off (by thalamus) which disables the motoric center in the cortex to be activated. The back muscles are after whip lash damage in tonic tension, and the big trapezius in particular, which is involved in holding the head, is very tense. Therefore the back muscles of patients with whip lash damage don’t function the way they should: carrying, protecting, moving and energizing. Instead they become straining to the joints and they dislocate the backbone, causing disturbing impulses to the cerebellum which constantly monitor the equilibrium and balance of the body. The imbalance is communicated to the encephalon which re directs the sensory messages to the cortex and prevents the motoric movements to be carried out properly. This is felt by the patient as muscle fatigue and reduced muscle function.
The unbalance of the back bone also affects the nervous system radiating from the spinal cord itself. The nerve roots, radiating from the back and taking care of the body’s functions, will be in a state of compression. Depending on the nerves that are affected, a dysfunction of the respecting areas of the body will occur.
Ideally, the normal curves of the backbone are preserved by an elastic and flexible equilibrium and balance between the long back stretching muscles and the abdominal muscles. The disturbance of this equilibrium with constant increased tonus in the back muscles - and a weakening of the abdominal muscles - has a significant impact in the development and upholding of pain.
A tonic tense muscle can’t sustain a normal blood flow, and this hampers the supply of oxygen and nutrients to the muscle, just as the drainage of vaste is hampered by the compression of the vessels. Conditions, all involved in the possibilities of developing strong pain.
The treatment begins with listening to the patient’s experience of his problem, followed by zone diagnostics. Per Geding has over the years developed a refined zone diagnostics, where he – through inspection of appearance and soreness on various parts of the feet – is able to localize where there is chronic tension in muscle groups around the neck and the back bone. Of the zone diagnostics, physicians who worked with Gjeding in a project on fibromyalgia, say:
These phenomena [the connection between tense muscle groups and the state of the feet] are as far as we know not mentioned in standard medical literature. We find them reproducible and of significant practical importance in the examination of patients with sufferings in the skeletomuscular apparatus. Apparently, there is a communication of impulses via crossed paths, and hence an involvement of the higher centers in the nervous system. As an example, a “frozen” right shoulder causes a sore infiltration around the left little toe. The method of examination also seems to be able to inform of dysfunction of organs and endocrine glands. The development of the diagnostics is a work in progress.
(The rapport on fibromyalgia, p. 8, my translation)
The PAS®-treatment mainly consists in the relaxation and stimulation of relevant muscle groups through witch a Golgi tendon activation of the encephalon – thalamus and hypothalamus – is carried out. This reestablishes the communication between the cerebellum and the cortex.
As a result, the muscles return to normal consistency which is felt by both patient and the PAS® specialist. When muscles and muscle groups are in tonic contraction exceeding 50 % of normal condition of tension, the blood supply to the muscles will suffer, resulting in insufficient supply of energy from the mitochrondria, causing insufficient drainage of waste products. This causes bad metabolism and bad function of the muscles with pain as a result.
It is an important part of the treatment that the patients are taught to use the body in the right way, and the patients must calculate with relapse in connection with the muscle groups around the column bringing this back to its original S-shape. These “growth pains” requires successive treatment.
On the basis of examining results, an individual program of exercises is made, which the patient must perform on his own daily, and this is followed up by repeated PAS® treatments. The exercises are controlled and followed up by further treatment and instruction.
The precondition for a lasting effect is that the patient understands and learns how to use PAS® as a key to the optimal function and well-being of the body. Hence, the patient must cooperate in establishing a natural balance in the muscle groups around the vertebral column in order to obtain natural movement and communication.
What can be treated with PAS®?
Many of the diseases, treated in the PAS®-center, share the common feature that they are disorders where we directly can establish that a wrong position and compression of the column is involved in diverse symptoms. These diseases and symptoms we can treat with good results.
Below is mentioned a few examples of chronic conditions:
- We have good experiences with the treatment of localized muscle pain syndromes, including pain localized to neck, loin and back; such as lumbago, schiatica, frozen shoulder, tennis elbow and tenosynovitis; and with pelvic joint pain (symphysis pubis dysfunction).
- Within the past years, we have had good results with treatment of generalized muscle pain syndromes with accompanying general symptoms/ symptoms of back compression, where the medical diagnoses have been fibromyalgia or chronic fatigue syndrome. Our experience this far is that increased tension in the large back stretchers causing wrong positions in the column has a great significance for these diseases’ symptomatology. The treatment relaxes the long back stretchers and at the same time the anterior muscles groups are strengthened. Hereby the vertebral column’s normal curvature around the plumb line is reestablished. During treatment, we have in several incidents observed the total ceasing or a significant decrease of not only the muscle pain but also the accompanying disabling fatigue. This is confirmed by the research, where 15 patients with the above mentioned symptoms were treated according to the above mentioned principals. The result is obtained after two years follow up.
- Good effects of treatment of secondary muscle changes by chronic inflammatory connective tissue diseases.
- Furthermore, it is our experience that the treatment has a prophylactic effect to particularly exposed groups in the development of degenerative arthritis. Especially in the case of children around puberty with rapid growth, developing kyphosis or kyphoscoliosis (mb. Scheuermann); farmers with hard physical labor, who have malalignments in the hip joint, and athletes with strong muscle groups, causing joint loading. By unloading the increased cartilage pressure, normal nutrition is reestablished and degenerative changes reduced or avoided.
- Patients with chronic headache (migraine) and patients with tinnitus (ringing of the ears) have clearly had relieving effect of massage treatment with subsequent decrease or stop in use of medicine.