BRRM

4 days certification course by the Swiss Association IATF

Johan Lambeck

Bad Ragaz Ring Method (BRRM)
Around 1955, physiotherapists in the German city Wildbad started resistance exercise in the pool with patients in a supine position. Supported by a neck collar and car tubes around the pelvis and the ankles (when necessary). This method was quickly used in Bad Ragaz, where three-dimensional patterns of proprioceptive neuromuscular facilitation (PNF) were included in the early sixties. This was the start of a long history of adaptations to the state of art in aquatic PNF. The key element is the activation of muscles in (myofascial) chains as a preparation for functional activities in water and on land. Recently, principles of muscular fine tuning, PNF techniques (like combination of isotonics) and training physiology have been included. Also concepts like functional kinetics and core stabilization are a part of contemporary BRRM, and applied to working with neurologic, orthopedic and rheumatic populations. See www.badragazringmethod.org
Examples of contemporary topics that are included in the course are:
– Reversals of antagonists: Reversals increase strength much more than contractions in one direction
– Combination of isotonics: the eccentric component is very important to balance inflammation reactions in e.g. the muscle envelope
– proprioceptive discrimination training in an environment in which pain is “under the radar”, in order to influence neuro-inflammation; e.g. in low back pain
– three-dimensional movements are essential to a proper mechanotransduction, using fascia properties
– tensegrity of intramuscular fascia can be trained by smooth variable contractions and add to fascia resilience
– clinical reasoning with case related scripts

A clinical question in BRRM could be: “which bilateral reciprocal leg pattern and technique could be used for a patient who had a surgery for a herniated disc L4/L5 about 3 months ago and still experiences motor weakness at L5. How does the technique look like in order to specifically strengthen the segment-indicating muscle in the foot?”