A neuromuscular massage is a form of soft tissue manual therapy. It is distinguished from other types of massage in that a quasi-static pressure is applied to the skin with the aim of stimulating specific areas of skeletal muscle. Often these areas of muscle are myofascial trigger points. NMT is a comprehensive program of soft tissue manipulation techniques that balance the central nervous system (brain, spinal column, and nerves) with the structure and form of the musculoskeletal system. NMT is based on neurological laws that explain how the central nervous system maintains homeostatic balance. The American Academy of Pain Management recognizes this form of massage therapy as an effective treatment for back pain caused by soft tissue injury (such as a muscle strain). Neuromuscular massage therapy is a specialized form of manual massage in which digital pressure and friction are used to release areas of strain in a muscle. Strain areas are called tender or trigger points, and they tend to be the cause of ongoing muscular pain symptoms.
The application of NMT is dependent on several key factors:
- The location of myofascial trigger points
- Force has to be applied perpendicular to the skin surface if the muscle is to be stimulated.[1] From Wikipedia, the free encyclopedia
This kind of bodywork gets the job done but can be very uncomfortable!
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 ensure 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, neuro excitants, 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 require a multidisciplinary approach.
NMT assessments and examinations primarily address
- ischemia (tight tissue with reduced blood flow)
benefits of massage for ischemia
- Increases blood flow/circulation.
- Increases pulmonary function; promotes deep breathing.
- Reduces heart rate.
- Improves soreness/fatigue.
- Lowers blood pressure.
- Regulates mood.
- Controls stress.
- Assists in relaxation.
- 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), and 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)
- and dysfunctional gait patterns (manner of movement when walking)
- with constant consideration for many other 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.
Neuromuscular Re-education Massage
The American Medical Association defines neuromuscular reeducation as the use of therapeutic techniques for the purpose of improving impaired movement, balance, coordination, decreased kinesthetic sense, and impaired proprioception. Although neuromuscular reeducation therapy includes several modalities, the procedures used at Strictly Therapeutic involve proprioceptive neuromuscular facilitation (PNF) and muscle energy techniques (MET).
PNF reprograms the nervous system by 1) stimulating proprioceptors, which are the receptors in the joint that communicate information about body position to the brain by way of the motor nervous system via sensory nerves, and 2) employing a series of diagonal contract-relax stretching patterns to assist the increase of movement. Often clients with pain can be unaware of the postural adaptation their body makes to enable them to continue with their activities. For example, unconsciously holding one shoulder higher than the other over time can introduce neck pain. By stretching groups of muscles in a variety of diagonal movement patterns and by making use of light resistance at various points in the range of motion, PNF can help promote a new awareness of unconscious holding patterns and weaknesses, as well as assisting the client toward improving their strength and flexibility.
MET is a method of active resistance performed by the client against a gentle force applied by the therapist. The theory behind this treatment is that the voluntary action by the client to contract muscles against resistance requires higher brain function. Restoring normal muscle function by way of higher brain function empowers the client and can dramatically change chronic pain patterns. In addition, the client is a participating member in the process and therefore is no longer a passive recipient of therapy. MET has been known to stimulate the synthesis of new cells to repair injured tissue, help realign and strengthen connective tissue fibers, lengthen shortened tissue, increase the range of motion of the joints, and balance the strength of muscles crossing the joints to help evenly distribute the pressures moving through the joints.
How Does Neuromuscular Reeducation (NMR) Work?
Any part of the body can get injured such as muscle, fascia, connective tissue, tendon, etc. When there is any injury to the tissues, the body deals with it by swelling in that particular tissue. After this, fibrous healing occurs where the scar tissue builds up rapidly in order to protect the injured regions. These adhesions of the scar tissue may persist or remain in the tissues for many years after the actual injury and this hinders the muscle strength as well as its range of motion resulting in impaired movements and pain. Here is where NMR comes in by benefiting in various aches and pains including back, neck, and joint pain, stiff joints, and any regions which have a limited motion like old injuries and sports injuries that have not completely recovered. NMR does not comprise a pain-free or relaxing massage. Very firm pressure is used in this deep manual therapy or massage in order to reach the adhesions and scar tissue in the muscle fibers and break them down. Slow and controlled strokes are used. Patients may feel tenderness and pain after this treatment, but it should be tolerable and not to the extent that it becomes very painful or unbearable. If it does become very painful, then the patient should tell the therapist to use less pressure during the treatment. The Neuromuscular re-education technique concentrates on detecting and breaking up the cross-fiber adhesions in the injured soft tissues. A skilled chiropractor feels for the location and direction of the adhesions and starts to manipulate and massage the soft tissues so that they are restored to their normal tension, texture, and length.
Benefits of Neuromuscular Reeducation (NMR)?
The Aim Of Neuromuscular Reeducation Technique Is:
- Breaking down the soft tissue adhesions, restrictions.
- Releasing the entrapped nerves.
- Restoring the flexibility, strength, and function of the muscles and tendons.
- Restoring normal texture, tension, and movement of the tissue.
Post Treatment Care for Neuromuscular Reeducation (NMR)
Many patients have a remarkable improvement in their degree of pain and range of motion immediately post-treatment. The regions where treatment was done will feel tender for a day or two and then the tenderness subsides along with an increase in mobility and strength. The patient should take care to maintain a balance of activity and rest. After the treatment, the patient should make the best of his enhanced strength, reduced pain and improved range of motion in order to get the brain and body used to the enhanced function, as getting rid of adhesions is only a part of the treatment, but with pain and limited range of motion, a patient gets used to the limited mobility and continues to move in a limited fashion even after the injury has resolved. So, in order to completely heal an injured area, the patient has to re-train himself/herself to actively and consciously (or unconsciously) move the injured region through its full range of motion, otherwise, the limited and inappropriate movements will cause re-injury to the tissues.
*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
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