Introduction to Neuromuscular Therapy: Techniques, Applications, and History

1. Chapter 1 Introduction to Neuromuscular Therapy

2. Chapter Objectives • How Neuromuscular Therapy (NMT) works • Components of NMT techniques • History • Goals and therapeutic intent • Knowledge and tools required • Relating to a client • Precautions

3. NMT Applications Used to treat acute or chronic pain in: • Sport injuries (strains and sprains) • Automobile injuries (whiplash) • Repetitive strain injuries (carpal tunnel syndrome) • Accumulative trauma injuries (TMJD) • Skeletal disorders (herniated discs)

4. Contraindications • Large bruises • Phlebitis • Varicose veins • Open wounds • Skin infections

5. How NMT works 1. Assess soft tissue • Use effleurage, petrissage and friction • Locate chronically shortened muscles • Deactivate trigger points

6. How NMT works cont’d 2. Use lengthening techniques • Myofascial release • Deep effleurage • Muscle stripping • Passive stretching

7. How it works cont’d Even horses have trigger points Horse receiving NMT

8. Components of NMT • History taking and evaluation • Soft tissue assessment and treatment • Lengthening techniques • Trigger point therapy

9. Pressure to a Trigger Point

10. Components of NMT cont’d • Stretches (passive, active and MET) • Postural stress analysis • Reducing perpetuating factors • Client management and follow up

11. History Europe (1930s-1940s) • Stanley Lief • Boris Chaitow • Brian Youngs • Leon Chaitow All were trained in osteopathy and naturopathy

12. History cont’d America • Raymond Nimmo • Janet Travell • Paul St. John • Judith Walker Delany

13. History cont’d European and American similarities: • Importance of understanding etiology • Treatment of trigger points • Client home care program • European and American difference is hands-on approach

14. Goals and Therapeutic Intent • Identify and isolate tissue irregularities • Reduce ischemia • Reduce hypertonicity • Reduce soft tissue pain

15. Goals and Therapeutic Intent cont’d • Normalize reflex activity • Eliminate trigger points • Restore normal ROM • Release adhesions and fascial binding • Eliminate perpetuating factors

16. Knowledge Required • A precise grasp of musculoskeletal anatomy • An understanding structural kinesiology • Orientation of trigger points/referral patterns • Postural stress analysis • Assessment skills to examine client’s dysfunction

17. Tools required • Effective amount of lubricant • “Thummby” for deep effleurage/possibly for trigger points • Pressure bars (T-Bar)

18. Tools required cont’d T-Bar Pressure Bar

19. Relating to the Client Avoid fostering dependency • Dependent clients expect to be fixed • Do not feel responsible for their own health Promote client participation • Encourage client participation • Provide support

20. Relating to the Client cont’d Client-therapist communication is vital • Ask client the following three questions: • Where is it tender or sensitive to my touch? • Do you feel sensations in any other part of the body? • Do you feel a decrease in discomfort as I press on this area?

21. Precautions Do not treat clients with the following: • Unstable heart condition • Untreated high blood pressure • Diabetes • Inflammation • Sunburn

22. Precautions cont’d The therapist should also consider: • Client’s fear of being injured • Restricted ROM • Very recent surgery • Upcoming sporting event • Pregnancy

23. Precautions cont’d The following requires the therapist to refer client to a medical professional: • Inflammation • Discoloration • Neurological symptoms

24. Review What is necessary to apply neuromuscular therapy effectively and with confidence? • A. Palpatory artistry and good luck • B. Precise and thorough knowledge of anatomy • C. A medical degree • D. Really strong hands

25. Answer • B. Precise and thorough knowledge of anatomy