Joel Rolefson, PT, TMRc
My interest in Physical Therapy developed from my own personal experience. I injured my lower back at the age of 18 while doing a squat lift during college track and field practice. After 2 years of misdiagnosis followed by traditional physical therapy that made no change, an MRI showed that I had a ruptured L5-S1 disc with a loose disc fragment. I was informed that only surgery would correct this problem. I went ahead with the surgery but after it I continued to have the same severe back and left leg pain that prevented me sitting more than hour, standing more than 30 minutes or doing anything physically demanding. Injections, chiropractic treatment, and further traditional physical therapy all made no change. I was unsure of what to pursue as a career due to these issues, so I graduated with a degree in history and political science and found work doing loan servicing at a bank where I could alternate between sitting and standing to manage my pain.'
During this time, since I could no longer compete as an athlete, I coached track & field for three years at Shorewood High School and then for one year at UW-Milwaukee. My love for working with athletes and my frustration with my continued problems led me to go back to school to become a physical therapist to learn how to help myself and others. I also became a personal trainer to help pay for my college expenses. Approximately a year after graduation I attended a Strain and Counterstrain course and was the beneficiary of treatment by the instructor as a demonstration (approximately TEN YEARS after the initial injury). After 15 minutes of treatment my pain and mobility improved by 60% IMMEDIATELY and the benefit lasted. I was amazed by the improvement. I sought further treatment after that which resolved my leg pain and reduced my back pain by 95%.
This led me to pursue continuing training in Strain and Counterstrain which I have utilized for over 17 years. The treatment effect was discovered by accident in 1955 by Doctor Lawrence Jones, DO, FAAO, who devoted the rest of his career developing an understanding of how to help more patients with Counterstrain treatment. He eventually identified over 100 dysfunctions and treatments. He named the treatment process on the concept that the body suffered a strain causing the condition, and he applied a tissue positioning of “Countertstrain” to correct the condition. The initial theories of why it worked were based on muscles and the stretch reflex system, but there were inconsistencies with this model and the neurologic rationale to fully the explain the effects remained elusive.
The current understanding is that Counterstrain treats specific chronic dysfunction(s) in the body’s protective web of connective tissue called “fascia.” Previously fascia was thought to be completely passive. In 2007 it was discovered that the fascia in the body, which surrounds the body's inner tissues including nerves, blood vessels, lymphatic vessels and organs, has contractile cells (akin to the “smooth muscle” in the intestines) imbedded throughout it. These cells will contract in a protective response causing the fascia to tighten around these internal structures when they are strained in some way. Unfortunately, the protective response can become dysfunctional and not release to normal when the strain is gone. Since the problem is a dysfunction in the nervous system and not a true tissue injury, this problem does not heal over time. The body can only compensate for the dysfunction(s) by increasing tension in other tissues.
Untreated, these dysfunctions prevent normal movement of a section of the body’s internal tissues. This abnormal restriction then continually causes excessive stress somewhere in the body due to the abnormal motion. That “somewhere” is where things begin to “wear out” (become arthritic, unstable, painful). In other words, Counterstrain often provides the answer to WHY that side of the lower back is painful, WHY that knee is painful and not the other knee, etc. The dysfunctions are relatively easy to identify since patients will have a palpable “tender point” in a specific area that will resolve when the internal dysfunction has released. The effect is immediate and lasting. Once the dysfunction(s) are corrected the body’s normal motion is restored, and stress decreases on the painful tissue so it can finally begin to recover.
This finding has led a continued expansion of research to identify all of the potential dysfunctions that can occur. Brian Tuckey, PT, OCS, JSCCI, a protégé of Dr. Jones, is the originator of the fascial dysfunction treatments and is currently doing research to identify the remaining dysfunctions. I am up to date with all of the current training and attend courses on new information as they become available. Currently I am one of only 3 therapists in the Greater Milwaukee Area to have this level of training.
In addition, over the past 14 years I have utilized an innovative exercise concept known as “Total Motion Release.” This treatment effect was also discovered by accident by Tom Delanzo-Baker, PT. This has been a tremendous addition to our treatment approach since I find it consistently correlates with what I find with the Counterstrain assessment. It is therefore the previously "missing" home exercise program for this problem. I am currently only one of three therapists in the Greater Milwaukee Area to be certified in the Total Motion Release exercise concept. I am the only one to have the combination of experience and training with both Counterstrain and Total Motion Release in the Greater Milwaukee Area.
In addition to this and other various traditional exercise concepts, I have training and many years of experience using other manual therapies such as Mobilizations with Movement, Mechanical Link, and Muscle Energy Technique for joint restrictions. I also have training in Myofascial Release and Craniosacral Therapy which are also forms of fascial treatment, although they rely on the “feel” of the practitioner versus the confirmation of successful treatment through the change in the palpable tenderpoint. Overall I have attended nearly 40 continuing education courses related to these conditions.
My philosophy of treatment is to correct as much dysfunction as possible, provide exercise training to enable you to self-treat any future dysfunction, and provide education in posture and strengthening to help prevent a future strain. I primarily use exercises involving body weight or exercise bands that patients can do at home without needing specialized equipment so that they can continue that program independently.
I look forward to working with you!