Neuromuscular Technique Chapter01

8/3/2019 Neuromuscular Technique Chapter01

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Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 1

Introduction to NeuromuscularTherapy




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




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)




Contraindications

• Large bruises

• Phlebitis

• Varicose veins

• Open wounds

• Skin infections




How NMT works

1. Assess soft tissue

• Use effleurage, petrissage and friction

• Locate chronically shortened muscles

• Deactivate trigger points




How NMT works cont’d

2. Use lengthening techniques

• Myofascial release

• Deep effleurage

• Muscle stripping

• Passive stretching


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How it works cont’d

Even horses have trigger points

Horse receiving NMT



Components of NMT

• History taking and evaluation

• Soft tissue assessment and treatment

• Lengthening techniques

• Trigger point therapy



Pressure to a Trigger Point



Components of NMT cont’d

• Stretches (passive, active and MET)

• Postural stress analysis

• Reducing perpetuating factors

• Client management and follow up



History

Europe (1930s-1940s)

• Stanley Lief

• Boris Chaitow

• Brian Youngs

• Leon Chaitow

All were trained in osteopathy and naturopathy



History cont’d

America

• Raymond Nimmo

• Janet Travell

• Paul St. John

• Judith Walker Delany



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



Goals and Therapeutic Intent

• Identify and isolate tissue irregularities

• Reduce ischemia

• Reduce hypertonicity

• Reduce soft tissue pain



Goals and Therapeutic Intent cont’d

• Normalize reflex activity

• Eliminate trigger points

• Restore normal ROM

• Release adhesions and fascial binding

• Eliminate perpetuating factors



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



Tools required

• Effective amount of lubricant

• “Thummby” for deep effleurage/possibly for triggerpoints

• Pressure bars (T-Bar)



Tools required cont’d

T-Bar Pressure Bar



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




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 onthis area?




Precautions

Do not treat clients with the following:

• Unstable heart condition

• Untreated high blood pressure

• Diabetes

• Inflammation

• Sunburn




Precautions cont’d

The therapist should also consider:

• Client’s fear of being injured

• Restricted ROM

• Very recent surgery

• Upcoming sporting event

• Pregnancy




Precautions cont’d

The following requires the therapist to refer client to amedical professional:

• Inflammation

• Discoloration

• Neurological symptoms




Review

What is necessary to apply neuromuscular therapyeffectively and with confidence?

• A. Palpatory artistry and good luck

• B. Precise and thorough knowledge of anatomy

• C. A medical degree

• D. Really strong hands



Answer

• B. Precise and thorough knowledge of anatomy

Documents

Neuromuscular Technique Chapter01