8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 1/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Chapter 1
Introduction to NeuromuscularTherapy
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 2/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 3/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
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)
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 4/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Contraindications
• Large bruises
• Phlebitis
• Varicose veins
• Open wounds
• Skin infections
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 5/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
How NMT works
1. Assess soft tissue
• Use effleurage, petrissage and friction
• Locate chronically shortened muscles
• Deactivate trigger points
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 6/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
How NMT works cont’d
2. Use lengthening techniques
• Myofascial release
• Deep effleurage
• Muscle stripping
• Passive stretching
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 7/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
How it works cont’d
Even horses have trigger points
Horse receiving NMT
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 8/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Components of NMT
• History taking and evaluation
• Soft tissue assessment and treatment
• Lengthening techniques
• Trigger point therapy
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 9/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Pressure to a Trigger Point
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 10/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Components of NMT cont’d
• Stretches (passive, active and MET)
• Postural stress analysis
• Reducing perpetuating factors
• Client management and follow up
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 11/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
History
Europe (1930s-1940s)
• Stanley Lief
• Boris Chaitow
• Brian Youngs
• Leon Chaitow
All were trained in osteopathy and naturopathy
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 12/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
History cont’d
America
• Raymond Nimmo
• Janet Travell
• Paul St. John
• Judith Walker Delany
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 13/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 14/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Goals and Therapeutic Intent
• Identify and isolate tissue irregularities
• Reduce ischemia
• Reduce hypertonicity
• Reduce soft tissue pain
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 15/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Goals and Therapeutic Intent cont’d
• Normalize reflex activity
• Eliminate trigger points
• Restore normal ROM
• Release adhesions and fascial binding
• Eliminate perpetuating factors
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 16/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 17/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Tools required
• Effective amount of lubricant
• “Thummby” for deep effleurage/possibly for triggerpoints
• Pressure bars (T-Bar)
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 18/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Tools required cont’d
T-Bar Pressure Bar
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 19/25Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 20/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
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?
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 21/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Precautions
Do not treat clients with the following:
• Unstable heart condition
• Untreated high blood pressure
• Diabetes
• Inflammation
• Sunburn
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 22/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Precautions cont’d
The therapist should also consider:
• Client’s fear of being injured
• Restricted ROM
• Very recent surgery
• Upcoming sporting event
• Pregnancy
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 23/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
Precautions cont’d
The following requires the therapist to refer client to amedical professional:
• Inflammation
• Discoloration
• Neurological symptoms
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 24/25
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins
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
8/3/2019 Neuromuscular Technique Chapter01
http://slidepdf.com/reader/full/neuromuscular-technique-chapter01 25/25
Answer
• B. Precise and thorough knowledge of anatomy
Recommended