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Chapter 1
Introduction to NeuromuscularTherapy
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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
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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)
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Contraindications
• Large bruises
• Phlebitis
• Varicose veins
• Open wounds
• Skin infections
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How NMT works
1. Assess soft tissue
• Use effleurage, petrissage and friction
• Locate chronically shortened muscles
• Deactivate trigger points
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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
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Components of NMT
• History taking and evaluation
• Soft tissue assessment and treatment
• Lengthening techniques
• Trigger point therapy
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Pressure to a Trigger Point
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Components of NMT cont’d
• Stretches (passive, active and MET)
• Postural stress analysis
• Reducing perpetuating factors
• Client management and follow up
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History
Europe (1930s-1940s)
• Stanley Lief
• Boris Chaitow
• Brian Youngs
• Leon Chaitow
All were trained in osteopathy and naturopathy
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History cont’d
America
• Raymond Nimmo
• Janet Travell
• Paul St. John
• Judith Walker Delany
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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
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Goals and Therapeutic Intent
• Identify and isolate tissue irregularities
• Reduce ischemia
• Reduce hypertonicity
• Reduce soft tissue pain
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Goals and Therapeutic Intent cont’d
• Normalize reflex activity
• Eliminate trigger points
• Restore normal ROM
• Release adhesions and fascial binding
• Eliminate perpetuating factors
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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
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Tools required
• Effective amount of lubricant
• “Thummby” for deep effleurage/possibly for triggerpoints
• Pressure bars (T-Bar)
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Tools required cont’d
T-Bar Pressure Bar
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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
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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?
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Precautions
Do not treat clients with the following:
• Unstable heart condition
• Untreated high blood pressure
• Diabetes
• Inflammation
• Sunburn
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Precautions cont’d
The therapist should also consider:
• Client’s fear of being injured
• Restricted ROM
• Very recent surgery
• Upcoming sporting event
• Pregnancy
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Precautions cont’d
The following requires the therapist to refer client to amedical professional:
• Inflammation
• Discoloration
• Neurological symptoms
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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
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Answer
• B. Precise and thorough knowledge of anatomy