The science of touch.
Over several years, from high school through college, I experienced manipulation, adjustments, auriculotherapy and trigger point therapy to correct severe low-back pain with sciatica and thigh atrophy, severe breathing issues, and severe foot and shoulder damage.
Injured from time to time, I was in the habit of going to MDs first [never helped], osteopaths second [helped once], chiropractors third [nearly always helped]. That’s why I decided to become a chiropractor instead of an abstract mathematician.
Later, directional non-force technique (DNFT), a low-force adjusting method, corrected a posterior knee injury and my firstborn son’s pointed and lopsided skull causing repeated atlas subluxations and continual crying.
I attended technique seminars every two weekends while in chiropractic college, absorbing whatever possible and helping family and other students who needed care.
Noting deficiencies in each technique, I read continually, spending heavily on scientific textbooks for several years, and attending technique seminars (totaling about $1.5 million on seminars to date), trying to learn to solve more conditions.
When everything changed
In my mid-50s, one of my knees was so bad that it shifted when I stood up, feeling like a red-hot dagger was stabbing and twisting in it. I had to go up steps one at a time, dragging the bad leg for four long years; I saw several doctors and tried acupuncture and many other techniques, but got no improvement.
One day, I noticed a small patch of non-painful skin below the knee that didn’t move (acupuncture point ST-36) and after freeing it up for a few seconds, I stood and sat several times, walked up and down a winding staircase, then taking the steps two at a time, and finally running with no shifting or pain.
Recalling barely touching hundreds of previous patients in severe pain who were suddenly pain-free, the common feature was lightly touching the skin.
This led to my development of the TTAPS approach, which stands for:
- Tapotement (a tapping manipulation) of
- Tangoreceptors (nerve receptors responding only to touch) to induce
- Anodynia (freedom from pain) by correcting
- Proprioceptive information (sensory nerves concerning body movements and position) for a
- Sanative (healing) effect.
Supporting research and science
Guyton’s Textbook of Medical Physiology, Chusid’s Correlative Neuroanatomy and Functional Neurology, Robbins Basic Pathology, Dorland’s Illustrated Medical Dictionary, and others note a few similar effects, but not systematized for the whole body.
Hilton and Davis’ laws; tactile mechanoreceptors including Merkel’s disks, Meissner’s corpuscles, Ruffini endings, and Pacinian corpuscles; myotatic withdrawal and gait reflexes; tangoreceptors; and reciprocal innervation and inhibition beneficially affect proprioception and central and peripheral nervous system activity. Nerves in the skin control underlying joint structures, and body parts neurologically interact with other local and distant parts.
TTAPS techniques are evidence-based medicine and best practices as described by ACA guidelines, which require “utilization of research with clinical experience.”
To prove effectiveness
The clinician should perform standard orthopedic and neurologic tests just prior to treatment and then retest immediately after treatment so patients can realize the care they just received was what caused the immediate improvement.
But pain can have lasting effects. According to Arthur C. Guyton, MD, facilitation “gives the person a perception of experiencing the original sensation, although, in effect, they are only memories of the sensations.” Furthermore, as memory is sustained with primary and then secondary neurotransmitters, these secondary messengers can cause the sustained or prolonged memory of trauma.
The neurology of correction
Despite the fact that insults and traumas heal over time, the brain and body can act as though the injuries are still there. The use of TTAPS can easily correct this condition using myotatic and other reflexes through various withdrawal and locomotion-gait reflexes, literally erasing the memory of the event from the brain.
Central nervous system (CNS) facilitation can produce perpetual simultaneous-withdrawal patterns, entailing muscle tone imbalances on joints, thereby leading to subluxations and meningeal compression on CNS structures resulting in:
- Trigger points
- Circulatory disorders
- Lymphatic drainage disorders
- Sympathetic and parasympathetic nerve dysfunction (affecting visceral function)
- Scar tissue formation
Degree of force
Every adverse event sufficient to cause withdrawal reactions and getting facilitated or “stuck” can be undone with a counteraction, but you don’t need to use the same intensity to undo it as the trauma that initiated the long-term reaction.
According to Guyton, pain receptors in the body can be “stimulated by usual touch or pressure stimuli” making use of the large AB sensory fibers “from the peripheral tactile receptors” to reduce the perception of pain signals. This is part of the underlying basis of the gate theory of pain management.
Isaac Newton first presented his three laws of motion in the Philosophiæ Naturalis Principia Mathematica in 1687. His third law states that for every action producing force between two objects, there is an equal and opposite reaction.
This principle can be applied to the nervous system, but with a much lesser force applied to well-recognized neurological pathways to correct CNS facilitation that perpetuates a variety of symptoms long after an injured area has healed.
Again, per Guyton, the “opening of sodium channels allows large numbers of positive electrical charges to flow to the interior of the post-synaptic cell.” As the cellular membrane potential increases in turn, it approaches the threshold of excitation.
This mechanism is common to all sensory receptors. Regardless of stimulus, the effect on the receptor is a change in its potential through the opening of ion channels.
TTAPS in action
When doctors attend a TTAPS seminar, one of the first activities that demonstrates the technique is to lightly tap the bottom of the foot slightly deeper than skin resistance with an instrument with a tiny blunt tip. This would be appropriate to treat a patient with difficulty going down on one knee and pushing back up. The brain still perceives the healed injury to be damaged and wants to withdraw instead of push.
After TTAPS, recheck in a few seconds and the patient should get up easily (unless extreme atrophy exists, in which case resolution may take longer).
As another example, students observe how someone walks, stands or adopts incorrect posture, exhibiting a state of imbalance. The patient is then repeatedly lightly jarred enough to throw them slightly more off balance. The brain reacts by immediately and automatically correcting muscle imbalances and quickly strengthening the body.
Adverse events of sufficient magnitude can cause central and peripheral nervous system facilitation, e.g., biceps flex and triceps relax in the flexion “hot plate” reflex, but don’t release totally because the brain is still registering the insult and commanding the body to stay in a constant state of withdrawal (pain avoidance). Perceived patterns of pain are similar.
With patients in this condition, you would palpate the whole body, note the spots painful to pressure, lightly tap a certain non-painful spot several times just a little deeper than skin resistance and in a few minutes re-palpate and you will find little or no residual pain.
To correct subluxations, have someone stand and palpate their paraspinal musculature to demonstrate pain and rigidity due to compensatory subluxations. Then, by lightly tapping a certain vertebra germane to that individual just a little bit deeper than skin resistancTTAPSe, you can immediately relax the rigidity and get rid of the pain.
This technique can also be applied to paresthesias and neuropathies with similar positive outcomes.
The nervous system processes information and instructs the body to adopt the appropriate responses. When the nervous system of certain patients is normalized, somatovisceral normalization occurs in turn and results in a successful intervention.
Alan Bonebrake, DC, has treated over 20,000 patients, including over 800 professional athletes and over 3,000 prep and collegiate athletes. Hosting a radio show for 15 years, he has been the subject of numerous newspaper and magazine articles, and radio and TV news programs. He has also co-authored research studies and journal articles. He can be contacted at firstname.lastname@example.org, and to learn more about TTAPS, visit ttapscenter.com.