A client came in with severe back pain on the right side, around the bottom of his ribs. He was a builder and as his day was progressing, he was finding it very difficult to breathe and he kept getting painful spasms on rotational movements.


Through our assessment we found the source of the problem to be in the costal facet joints, where the rib joins to the spine. Dysfunction in the Golgi Tendon Organs at the Costal Facet joints of the Ninth and Tenth ribs was creating Hypertonicity in the surrounding muscles. We find this by stimulating the GTOs and then measuring the response of the nervous system through Manual Muscle Testing.

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Golgi Tendon Organs measure stretch of a joint space and tell muscles when to fire and when to relax. If a GTO becomes dysfunctional then the muscle may become problematic, and lean towards staying engaged all the time (Hypertonicity) or failing to engage when required (Hypotonicity; or Inhibition).


What caused this to happen?


In this gentleman's past he had fallen on to the ribs on this side and fractured them. At the site of the fracture we found a Nociception Dysfunction, a message of pain from the injury site to the brain.


So as the client was working, doing his job; he was restimulating the old injury site and his nervous system was making the surrounding muscles Hypertonic to try and protect him.


Using PDTR we corrected the Nociception Dysfunction and the Golgi Tendon Organ Dysfunction, this allow the muscles to relax to normal tone and reduce the sensitivity of the area.


The client was able to move around much easier and his breathing was pain.


For homework he will have to practice his breathing and also some rotational patterns, to help keep the movement of the ribs safe and pain free.


By investigating the causes and not just calming symptoms, we can help reduce the likelihood of pain returning. And by setting home exercise strategies, the client takes ownership of the situation and builds self reliance, and confidence that they are fully recovered.


My goal as a therapist is not to fix people but to help them be capable and more resistant to injury & pain.