As a chiropractor, I have been focusing on the human nervous system and correction of related neuromusculoskeletal dysfunction for over 20 years. Although chiropractic adjustments constantly produce tremendous results, the holding elements and soft tissue components of the subluxation complex and biomechanical dysfunctions have been largely undervalued. Trigenics® is a form of manual medicine that provides a solution to correcting soft tissue dysfunction and neuromuscular/neuro-energetic imbalance. A treatment such as this fits in perfectly with current chiropractic paradigms. The Trigenics® Institute of Myoneural Medicine has been teaching Trigenics® seminars in Canada and Australia now for a number of years. The response from many notable chiropractors that have undertaken its study, in these countries, has been that of high acclaim. The Registered Trigenics® Practitioner program and "R.T.P." designation was recently introduced to the United States. As such, this article will serve as a brief introduction to "The American Chiropractor."

Trigenics® is an interactive, neurologically based soft tissue assessment and manipulative treatment system that symbiotically combines aspects of both eastern and western manual medicines. It involves the simultaneous application of 3 components for a cumulative synergistic effect.

The 3 main components are: 1) Autogenics (cerebropulmonary biofeedback) 2) Myogenics (meridian muscle manipulation) 3) Neurogenics (reflex neurology)

Trigenics® main therapeutic applications revolve around neurologically modifying muscle tone and somatic function as well as restoring and balancing functional sensorimotor biomechanics. Although each of the three originating components in Trigenics® ("genics") could basically be used as a stand-alone therapy, the synergistic effect of combining three in a specific way provides results that are profound. This is further supported by a recent study done by Masakado Y (2001) who demonstrated that inhibition on a target muscle is significantly increased when the two stimuli (stimulation of the peripheral nervous system & central nervous system) were given together than separately. Ikai (1996) also suggested that inhibition of antagonist muscles may occur at the cortical and spinal cord levels. One of the key concepts of Trigenics® is to 'trick' the CNS into super-inhibiting the target muscle. Once the muscle is put into a temporary unloaded state, it can easily and rapidly be strengthened or lengthened using various manipulative procedures.

There are 3 main treatment procedures in this system:

1. Trigenics® Strengthening (TS) - Used to instantly increase strength in weak, injured, or normal muscles. Effects are cumulative.
2. Trigenics® Lengthening (TL) - Used to instantly increase length in shortened or normal muscles, and joint ROM.
3. Trigenics® Manipulation (TM) - Used as a non-force alternative to high velocity adjustments. Effective with acute injuries and chronic injuries (i.e. frozen shoulder, osteoarthritis).

Vladimir Janda has clearly delineated that many muscular and biomechanical problems develop as a result of muscle imbalance that is created by either shortened or weakened (inhibited) muscles. Imbalanced development, or more clinically, aberrant alignment and disruption of the kinetic chain integrity will inevitably lead to injuries. Traditionally, doctors and therapists have been prescribing stretching exercises for the shortened muscles and isotonic/isometric resistive exercises to strengthen weakened muscles. Although these exercises have been widely utilized, however, it will take a few months to achieve results. It will take at least the initial 4-6 weeks just to regain the proper neural recruitment (Moritani and Devaries 1979, Sale, 1992). In addition, these exercises do not necessarily correct muscle spindle dysfunction. These exercises can even be counterproductive if a greater state of imbalance is created due to aberrant neurological input to the heavily innervated sensorimotor system. Trigenics® assessment procedures provide delineated methods of locating and objectively mapping out patterns of weakness and shortening. A second key concept is the active-assisted-resisted training and interactive involvement from the patient. The patient is an active participant rather than a passive recipient as they actually exercise their muscles simultaneously during the treatment. This allows early training of neural recruitment to improve muscle strength and shortens the total time for rehabilitation training. This also serves as an early stimulation of the joint mechanoreceptors and proprioception training as well as stimulation of the muscles' strength building elements.

Following assessment, Trigenics® TS and TL treatment procedures enable the practitioner to alter the muscles neurological firing pattern for a cumulative tonal "resetting" effect. (With the advent of digital muscle testing devices, such as the MicroFET III, objective results are easily recorded and shown to the patient pre and post treatment.) Only after the muscles' aberrant firing patterns have been normalized will rehabilitative exercises work to enable the musculature to respond in such a way that the resetting will be held. Muscles will then respond to exercise in a way that creates balanced growth and development.

Trigenics® is generally not hard on the doctor or the patient. It is much easier for the doctor to apply and easier for the patient to receive than regular mechanically based soft tissue techniques. The patient usually does not experience appreciable pain during the treatment and rarely has any delayed onset of post-treatment soreness. In collectively facilitating the patient's nervous system to reduce pain signals and inhibit the target muscle, the protocol allows for much easier and even deeper access than would otherwise be achievable.

The Trigenics® Practitioner, or "Trigenist", may use manual or instrument contact in the application of the treatment. Contact is made with the tissue in such a way as to distort the fibres to stimulate local mechanoreceptor activity and to increase the mechanical load on the tissue in order to stimulate proliferation of fibroblasts at a cellular level (Eastwoord 1998 & Galen 1999). This form of manual contact is referred to as Proprioceptive Distortional Myomanipulation, or "PDM." (Direct ischemic compression pressure and longitudinal traction pressure are avoided and not used with Trigenics® as they are often painful to the patients causing reflexogenic contraction of the muscle.) The application of PDM often results in a Myoneural Reduction, or "MNR", wherein a muscular or articular cavitation is notably felt.

Many doctors who have studied Trigenics® have commented that Trigenics® "puts it all together." They see it as an effective treatment formulation, which includes key aspects of many singular treatment and exercise modalities already known to be effective. The Trigenics® treatment combination, with the incorporation of recently researched neurophysiological reflexes, provides results that are not linear but exponential.

Trigenics® treatment protocols can be used in close succession for optimal results with multiple treatment plans. Adjunctive laser applications and topical post-treatment homeoceuticals such as Trigel® are also used in certain cases. (Trigenics® treatments average 10-20 minutes with fees standardized at $75-$150/tx.) There are 4 application levels for the TS and TL procedures with 4 types of PDM techniques depending upon muscle size and design.

Examples of Conditions, Protocols, and Application levels

Ultra-light application (UA)

1. Acute inflammatory conditions (TS, TM)
2. Acute sprain/strain injuries (TS, TM)
3. Pediatrics (I.e. infantile torticollis, hip dysplasia) (TS)
4. Severe fibromyalgia, severe osteoporotic patients (TS, TM)

Light Application (LA)

1. Acute torticollis (TL), disc herniation and canal stenosis (TS), fibromyalgia (TS, TL), geriatrics patients (TS, TL, TM)
2. Major neurological impairment from conditions such as trigeminal neuralgia, cerebral palsy, multiple sclerosis, Bells Palsy (TS)
3. Patients with conditions in which integrity of the vasculature is in question such as chronic diabetic and rheumatoid arthritis patients (TS)

Moderate Application (MA) & 4. Heavy Application (HA)

1. Most musculoskeletal or musculotendinous conditions such as: tendinitis/tenosynovitis/tendonosis, frozen shoulder, sciatica, headaches, chondromalacia patella, plantar fasciitis, disc protrusion (TS, TL, TM)
2. Post-surgical / post joint replacement rehabilitation (TS, TL)
3. Athletic strength and power augmentation (TS, TL)
4. Neurological conditions such as Cerebral Palsy & Stroke (TS, TL).

BIOGRAPHY

 Canadian-Estonian Chiropractor, Dr. Allan Gary Oolo Austin is the originator of Trigenics. He is a Certified Chiropractic Sports Physician, Certified Chiropractic Rehabilitation Doctor, Doctor of Natural Medicine, Doctor of Acupuncture, Fellow of the International Academy of Medical Acupuncture, and Fellow of the Trigenics® Institute of Myoneural Medicine. Dr Austin began developing Trigenics® in the early 1980s.  In 1994, Dr. Austin began to write the current procedural and theory manuals and commenced upon forming The Trigenics® Institute. In 2004, Dr. Austin will be speaking about Trigenics® at the ABCSP Sports Symposium and the SWIS Symposium.

For more information, contact the Trigenics® Institute of Myoneural Medicine, toll free at 1-888-514-9355 or by email: institute@trigenics.com

or visit www.trigenicsinstitute.com

References:

1. Eastwood M, et al. Fibroblast responses to mechanical forces. Proc Instn Mech Engrs. 1998; 212 (H): 85-92.

2. Galan GM, rt al. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exer 1999; 31(4):531-535.

3. Ikai et al. Electromyographic Clinical Neurophysiology, 1996 vol 36

4. Masakado Y et al. The effect of transcranial magnetic stimulation on reciprocal inhibition in the human leg. Electromyogr Clin Neurophysiol. 2001 Oct-Nov;41(7):429-32

5. Janda, V, Muscle Function Testing. London, Butterworth, 1983

6. Liebenson, C. L.: Active  Muscle Relaxation Techniques. Clinical application. J. Manipulative Physiologic Therapeutics 13(1): 2-6, 1990

7. Moritani, T and Devries, HA (1979) Neural factors versus hypertrophy in the time course of muscle strength gain. American Journal of Physical Medicine. 58(3): 115-130

8. Sale, DG. (1992) Neural adaptations to strength training. In strength and power in sport, PV Komi, pp249-265. Blackwell Scientific Publications, London, England.

9. Chaitow, L.: Muscle Energy Techniques. New York, Churchill Livingstone, 1997

10. Clark, M. A: A scientific Approach to Understanding Kinetic Chain Dysfunction. National Academy of Sports Medicine (Publishers). Thousand Oaks, CA, 2000

11. McAllister, P.: Making Strides: The Trigenics® technique is applied to an 11-year old girl with cerebral palsy to improve strength and range of motion. Canadian Chiropractor, Vol 8 (3); pp18-23, 2003.