Advanced Neuromuscular therapy
Neuromuscular therapy (NMT) accelerates the body’s overall healing process by re-educating the link between the muscles and the central nervous system. Through a series of soft tissue manipulation protocols, the function of joints and muscles is enhanced, and the release of endorphins is facilitated.
This modality is based on neurological laws that explain how the nervous system initiates and maintains pain, while emphasizing and stimulating the body’s natural ability to heal itself. Developed in the 1930’s, NMT uses a holistic approach towards healing based on the practitioner’s skill, anatomy knowledge, and precise palpatory application. The outcome of this therapy is to help relieve pain and dysfunction by alleviating the underlying cause.
“Neuromuscular therapy (NMT) is a precise, thorough examination and treatment of the body’s soft tissues using regionally oriented protocols that are taught in a step-by-step process. These time-tested, hands-on techniques are built upon a science-based foundation and guided by clinical evidence. NMT can integrate well into any practice setting and is frequently included in mainstream medicine, integrative medicine, chiropractic care, and multidisciplinary clinics worldwide.
In addition, NMT considers perpetuating factors that may be associated with the client’s complaints. For example, when a client presents with shoulder pain, the upper extremity protocol will be used as the primary examination. In addition to the muscles directly crossing the shoulder joint, muscles that attach the shoulder girdle to the torso would be included along with steps to help insure mobility of the scapula. Dysfunctions within the arm, forearm and hand often produce compensation patterns in shoulder movement, so examination of those regions should be included. Since innervation to the shoulder exits the spine at the cervical region, mobility and muscles of the neck will be considered; compression or entrapment of the nerves serving the shoulder should be ruled out.
Perpetuating factors can also include shoulder joint pathologies, postural positioning, habits of use, nutritional components, emotional wellbeing, allergies, neuroexcitants, neurotoxins, and other core elements that can masquerade as myofascial pain and dysfunction. Due to the diverse nature of perpetuating factors, astute NMT practitioners build a broad network of healthcare providers for referral of those clients whose symptoms suggest “red flag” warnings or underlying pathologies.
Most factors that cause pain and dysfunction can be easily grouped under three general headings of biomechanical, biochemical, and psychosocial factors, with the interface between these being profoundly related. Most practitioners apply strategies from only one of these categories, often resulting in improvement that plateaus before full recovery. However, a synergistic effect – often with significant relief – is obtained when all three categories are addressed. This may required a multidisciplinary approach.
Neuromuscular therapy assessments and examinations primarily address:
- Ischemia (tight tissue with reduced blood flow)
- Myofascial trigger points (hypersensitive points within muscles that give rise to referred phenomena, including pain)
- Neural entrapment (pressure on nerves by muscles and other soft tissues)
- Nerve compression (pressure on nerves by osseous and other bonelike tissues, such as cartilage or discs).
- Postural assessment (assessment of the position of the body as a whole)
- Dysfunctional gait patterns (manner of movement when walking)
- Perpetuating factors, such as hydration, nutrition, breathing patterns, and psychological stress.
NMT is highly effective for clients who present with chronic pain and is often successful in reducing or eliminating even longstanding painful conditions. Some of the techniques can also be applied to acute injuries and for post-surgical care; many help to improve performance in sport or dance and to prevent injuries due to these activities.”
–NMT Center
Many clients struggling with acute or chronic pain request deep tissue massage, with the belief that their ailment is something they need to “fight through” with a “no pain, no gain” attitude. For this reason, it’s important to distinguish between neuromuscular therapy and deep tissue massage. Deep tissue massage releases chronic patterns of tension in the body through slow strokes and deep pressure on the contracted areas, typically in a cross-fiber technique going across the grain of muscles, tendons and fascia.
While deep tissue massage can be extremely effective for structural integration and alleviating long-standing restriction patterns, it’s not particularly useful when working with a client experiencing an overly sensitized nervous system. For example, if someone’s arm is tender to the touch, going in with a deep pressure will most likely have an adverse effect, causing more pain and guarding. Conversely, addressing this same issue with a lighter tough can be highly beneficial. According to Hilton’s Law, “The nerve supplying a joint also supplies both the muscles that move the joint and the skin covering the articular insertion of those muscles.” – The American Heritage® Stedman’s Medical Dictionary. This means that a therapist may initiate significant change to sensitive areas while applying very little pressure, if they know exactly where and how to apply it. This is a main principle of neuromuscular therapy; creating lasting change in the body by stimulating the nervous system rather than attempting to directly force or manipulate the muscles.
“In the last 60 years, neuromuscular therapy (NMT) has emerged as a significant way to assess, treat and prevent soft-tissue injuries and chronic pain. Today, NMT is widely used not only in the treatment rooms of massage therapy, but also in occupational therapy, physical therapy, nursing, dentistry, chiropractic, osteopathic and physical medicine clinics worldwide.” Heather L. Fenity
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