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What is Neuromuscular Therapy and How is it Accomplished?

  
Neuromuscular Therapy is a specific approach to the problem of pain based on sound physiological principles and neurological laws.  Neuromuscular Therapy allows a reversal of the stress-tension-pain cycle.  Pressure specifically interrupts afferent impulses to the spinal cord, reduces the intensity of nervous activity within the tissue and muscle then relaxes, circulation is increased and the body returns to normal neuromuscular integrity and balance.

Proper stages of rehabilitation

Based on the findings, the therapist will look for the cause of the client’s pain, rather than just treating the effects.  The therapist will develop a treatment plan based on the proper stage of rehabilitation.  The proper stages of rehabilitating an injury are as follows:

  1. Eliminate spasms and hyper contraction in the tissues (therapy.)
  2. Restore proper biomechanics (re-education.)
  3. Restore flexibility to the tissues (movement & stretching.)
  4. Rebuild the strength of the injured tissues (exercise.)
  5. Build endurance (conditioning exercises.)

Important:
If rehabilitation is attempted without following this order, re-injury and setbacks usually occur.  For example, if an injured person attempts weight training before the hyper contractions have been properly eliminated from the tissues, the usual result is that the tissues will re-spasm and the old pain patterns will recur.

What specific health problems have responded successfully to Neuromusclular Therapy?

  • Muscular Cramping
  • Muscular Tenderness
  • Muscular Weakness
  • Neck & Shoulder Pain
  • Sciatica
  • Postural Distortions
  • Shin Splints
  • Spinal Disorders
  • Sprains & Strains
  • Stiff Neck
  • Tendonitis
  • Tennis Elbow
  • Tinnitus
  
  •  Arm & Hand Pain
  • Athletic Injuries
  • Back Pain
  • Bursitis
  • Carpel Tunnel Syndrome
  • Equilibrium Disorders
  • Extremity Numbness
  • Headaches
  • Hip Pain
  • Jaw Pain
  • Joint Immobility
  • Knee Pain
  • Leg & Foot Pain
  • Whiplash
  

Principles of Neuromuscular Therapy

  
  1. Ischemia - Lack of blood.
  2. Trigger Points - Ischemic soft tissues that when stimulated, refer high neurological activity into other parts of the body thus creating secondary pain.
  3. Nerve Compression/Entrapment - Pressure on a nerve by an osseous or cartilaginous structure/pressure on a nerve by soft tissues.
  4. Postural Distortion - Imbalance in the muscular tonus system resulting in movement of the body off the coronal and mid-sagittal planes.
  5. Biomechanical Dysfunction - Imbalance in the musculoskeletal system resulting in faulty movement patterns.

Does Neuromuscular Therapy hurt?

There is a certain amount of occasional discomfort in any deep muscle therapy.  The greatest discomfort is usually experienced after the first treatment.  Mild pressure does not illicit pain in normal healthy tissue, therefore, the presence of pain during the physical manipulation of tissue is a valuable guideline to the therapist.  It indicates those areas where adhesions, muscular spasms and trigger points are located.  Continuous feedback from the client is encouraged to insure that the therapy is conducted with the minimum degree of pressure necessary to carry out the process successfully and achieve the maximum results.

Normal Tonus

Both the nervous system and the muscular system are involved in the stress-tension-pain syndrome.  Tonus is a neurological interchange between the muscle, the spinal cord and brain.  In the normal state the brain maintains a low level of tonus in all muscles.  Superimposed on this low level is a fluctuating level implemented by a reflex arc within the spinal cord and determined by the condition of each muscle, ligament and tendon, and by the conditions around their receptors.  Receptors are specialized nerve ending which adapt our body to its immediate environment by way of input into the nervous system.

Hypertonicity

 When there is a state of stress such as that which results from traumatic injury, lack of exercise, faulty diet or the daily stress of life, then increased sensory stimuli enter the spinal cord.  Such stimuli entering the cord will evoke a strong motor response, which is up to ten times greater that the sensory stimulus, and it may involve the action of whole groups of muscles.  This manipulated motor response is a natural physiological protection as exemplified by the reaction elicited when stepping on a thorn or touching a hot stove.  When muscle receptors are continuously stimulated due to injury or other forms of stress, then the muscle develops a focus of intense nervous activity and the amplified motor response results in a muscular state of “high tone” or hypertonicity.  Blood vessels in the area become constricted, circulation is slowed, and metabolic wastes accumulate around the receptors.  This waste will further intensify the receptor’s sensory input firing to the cord, causing yet stronger motor stimuli to be received by the affected muscle resulting in tension raising to still higher levels.

Stress Reaction

 Nearly every tender muscle is a candidate for acute pain when a little more stress is imposed upon the organism.  When a muscle is already close to the threshold of pain, then a minor stress to the body such as bending, reaching or sneezing may be all that is necessary to set off pain.  There are many forms of stress (physical, emotional, mental and nutritional) but there is only one stress reaction - namely increased muscle tension and vasoconstriction with liberal release of adrenaline to keep the process going.  Stress may stem from a variety of sources, but the nervous system’s reaction is always the same.  Stress conditions set the stage for pain and according to J.J. Bonica, M.D., the foremost authority on pain, “Skeletal muscle tension is the most common cause of pain.”

Recurring Pain

In severe cases, hypertonic muscles set off a pain cycle that is neurologically facilitated and thereby becomes chronic.  A law of neuro-physiology known as the Law of Facilitation states that once a nerve impulse or stimulus has traveled through a specific route, it is then easier to the next impulse to make the same passage and then for all succeeding impulses, the passage will even be easier.  The pain was transmitted through a specific neurological pathway, which then became “facile” or “of easy access”.  The pain then continues or refers this pathway or groove as a result of the slightest stress.

Trigger Points

The cyclic condition of stress and tension gives rise to pain and the formation of trigger points, which may persist long after the original causation, has ceased.  The trigger is the point’s strongest input to the cord and is the point of strongest motor return from the cord back to the muscle.  This focus of metabolic accumulation becomes a small mass of drawn-up muscle fiber, which is tender to pressure.  The trigger has command over the pain and the tension of the muscle.
 

Referred Pain

If the stressful condition and the resulting high intensity barrage of sensory stimulation to the cord persist, then there can be a spreading effect to to other tissues of the body remote from the trigger point site.  Strong stimuli may pass up or down the cord to another segment and out to another muscle, thereby causing referred pain and malfunction.  Also, hypertonic muscles can create additional complicating conditions.  There is a shortening effect throughout the length if the hypertonic muscle, which results in, an increased pull at its attachments.  When there is a constancy of hypertonicy in muscles on one side of the body and more nearly normal tonus on the opposite side, then the mechanically self-evident imbalance results in additional pain.