Primary Respiratory Mechanism

vs

Permanent Muscle Motility

We will deal here with the comparative study between PRM and PMM concerning the physiological mechanics that manage human activity and that we have been able to highlight through palpation.

The relevant physiological data are briefly described on this site.

For a good understanding, it is obviously preferable to have carried out, beforehand, the tests proposed in the file “Palpatory evidence of MMP”.

The forces involved

The Primary Respiratory Mechanism (PRM)

Although it has been anticipated before, it is to W.G. Sutherland that we owe the emergence of the PRM.

This mechanism is described as having a rhythmicity ranging from 6 to 12 beats per minute.

It is described as having two phases, an expansion phase (inhalation) and a contraction phase (exhalation).

During the inspiratory phases the upper and lower limbs describe external rotation and vice versa.

These inhalations and exhalations are described as independent of the costo-diaphragmatic respiration.

The rhythm of PMR is the same throughout the body, the source of PMR being unique.

Permanent Muscle Motility (PMM)

Described for a long time now, a thesis on muscular activity was defended by Frederick Becker of the University of Michigan.

He believed that the mobility of the cranio-sacral rhythm could result from the tonic response of the extra-hard muscles. This theory was challenged by J.E. Upledger on the grounds that the denervated muscles of paraplegics seemed to move at 20/30 rhythms per minute, which seemed incompatible with the functioning of the craniosacral system. (Cranio-sacral therapy – J.C. Herniou)

This thesis is again defended in 2004 within the association “Teutaros”, which was granted by the UN as an NGO in 2012 on the issue of PMM.

The PMM describes rhythms from 4 to 20 / 30 rhythms per minute. Muscle chains can have different rhythms.

The origin is the contraction and relaxation of skeletal muscles.

These contractions are characterized by their functioning as muscle chains that work alternately (while one muscle group contracts, the other relaxes and vice versa).

The purpose of these contractions is to assume the circulation of venous return, lymphatic circulation (no doubt), joint drainage and that of the tissues in general.

Comparative table of the forces involved

The engines:

For PMM, these are the permanent muscle contractions we may feel. The origins are multiple.
For PRM, the most widespread theory is still that of the production of cerebrospinal fluid in the choroid plexus. The origin is unique.

The power:

In PMM, each muscle in the body is involved in the mobilization of joints and tissues.
For PRM, it is difficult to imagine that a force that is necessarily weak so as not to interfere with intra-meningeal processes can exert actions at a distance, mobilizations as intense as those we can feel.

The mechanical characteristics:

For PMM the alternating muscle contractions will lead to axial rotational movements of the joints. These articular movements work in a “gearwheel” mode. On inspiration the femur makes an external rotation but the tibia under the femur makes an internal rotation (outside the lesional frame).
For PRM, the production and resorption of CSF would cause expansion/concentration phenomena. On inspiration, all limbs are externally rotated.

Rhythms:

Concerning the PMM, we find rhythms ranging from 4 to 30 cycles per minute and depending on the muscular lesions. These rhythms are also found biologically with SPOC waves which could be the translation of PMM in vitro. Within the same subject, or even within a limb, we will find several muscles with different rhythmicity.
For PRM, there is only one rhythm linked to CSF production. But the secretion of the CSF is done over the cardiac systolic time, so 72 times per minute…

Relationship to diaphragmatic chest breathing:

For PMM, the thoraco-diaphragmatic inspirations and expirations will manage the internal or external running of the muscles. All the muscle chains have a relationship, and only one, with the dorsal, costal, omovertebral or xiphoid joints.
For MPRM, there is no established relationship

Concerning the asynchronisms:

PMM can treat temporal torsion, we can even produce it.
PRM does not offer any tangible theory to explain them. Classical osteopathic treatments improve the loss of temporal amplitude but do not eliminate the original lesion.

Concerning sweeping and high tides:

PMM through the notion of sweeping explains the rhythms of the high tides.
PRM does not deal with the notions of sweeping, which we have not discussed here.

Venous return:

The muscle is a venous pump that stops during the ultimate stiffness.

Correspondence between the vertebrae and the skull bones:

Skull bones are an integral part of the myo-articular chains of PMM. We have been able to determine them by means of lesions caused by loss of rhythm or desynchronization. For example, the 5th cervical corresponds to the ethmoid, by freeing the joint between the 5th and 6th cervical you can, most often, remove a symptom of homolateral nasal obstruction. The patient must feel the nostril open within 30 seconds and then wait 5 to 10 minutes for a complete opening.

In conclusion

PRM now finds many detractors among Osteopaths themselves. The characteristics describing it are not found in the clinic as soon as the therapist’s hand apprehends the muscular rhythmicity. This learning requires more time and work and is never taught in Osteopathic schools. PMM has the advantage for her of being consistent with what lives under our hands. It answers many questions about physiology, injury mechanisms and symptomatology.

It takes an average of 30 years for a paradigm to be understood and accepted.

It’s easier to disintegrate an atom than a prejudice…
Albert Einstein