Neuromuscular Therapy

Neuromuscular Therapy (NMT)

Overview: Neuromuscular Therapy includes a variety of techniques (several described below) aimed at releasing dysfunctional patterns in the body including pain and restricted movement from injuries, surgeries, and compromising positions.

Going Deeper: The muscles and nerves, when communicating optimally, create your desired movement pain-free allowing you to do what you want to do. Patterns develop with how the muscles and nerves communicate (a facilitated pathway), commonly referred to as “muscle memory”, that can be desired or undesired. Desired patterns can include remembering how to ride a bike or typing on a keyboard, while undesired patterns can include poor posture or a protective muscle spasm following an injury.

Neuromuscular reeducation seeks to release restrictive patterns and adhered tissues to facilitate healthy pain-free movement.

Myofascial Trigger Point Therapy

Overview: Trigger Points are an undesired, yet common, phenomenon, that can cause local pain and referred pain. Local pain is felt at the site of the trigger point while referred pain is felt further away from the trigger point. Manual Therapy Techniques release trigger points restoring healthy movement and function.

Going Deeper: A trigger point is an involuntary sustained muscle contraction. Muscles that contain trigger points can entrapment (pinch) nerves, be ischemic (lack of blood flow), and restrict movement. When left unacknowledged, trigger points can exist in the muscles over an extended period of time and lead to secondary pain patterns and dysfunction.

Trigger points occur from overuse of muscles (repetitive use, long-held postures), underuse of muscles, injuries (tears or direct trauma).

Trigger points can be released through manual therapy techniques, restoring healthy movement and function.

Fascial Release

Overview: Fascial Release is a technique that brings space and mobility to the fascia (connective tissue) throughout the body.

Going Deeper: Fascia is the wrapper around, and through, the structures in the body. It is what holds everything in place. Every muscle, tendon, ligament, organ, and vessel has fascia. Without the fascia, the body would be a big puddle of fluids on the floor.

Fascia contains a matrix of strong fibers, made from collagen, providing strength. There is also a unique fluid substance, ground substance, that provides mobility and glide. Fascia is adaptable meeting the required function and demand on the body. There is the phrase, “form follows function”, that aptly applies here.

Dysfunction (limited movement and pain) can happen when imbalances occur.

When muscles are short and tight for prolonged periods of time, such as those containing trigger-points, the fascial wrapper also shrinks (like shrink wrap) encapsulating the muscle. When the collagen fibers in the fascial matrix are too close together for extended periods of time, adhesions form. An example is a hairstylist holding their arms up hour after hour, day after day, year after year, resulting in “Frozen Shoulder”- a condition that limits mobility in the shoulder and can be painful making it difficult, or impossible, to lift the arm.

Adhesions (fibers sticking together) create restrictions and can limit a full range of movement.

Reinforcement and fibrosis are responses to a prolonged high demand, or stress, placed on the tissues in the body. While the reinforcement serves a purpose (strength) and is efficient (requires less maintenance than muscle fibers), it comes with limitations. An example of reinforcement can be seen with a cyclist’s IT bands becoming thicker and stronger as they ride longer miles and push harder to go faster.

Challenges experienced by adhesions and reinforced fascia (think scar tissue) include reduced mobility (feeling stiff and tight), entrapped nerves (pain, tingling, numbness, loss of function), and entrapped blood vessels (loss of circulation- experienced as a body part “falling asleep”, pain, and tingling).

The good news is, this fascial wrapper can be released through manual therapy techniques to restore healthy pain-free movement.

Myofascial Release

Overview: Techniques specific to releasing the fascia in and through the muscles (myo).

Going Deeper: Muscles are made up of many little fibers that are designed to contract and release. The fascial wrapper around each unique muscle fiber is called the endomysium. The muscle fibers are grouped together in bundles held by fascia called perimysium. The bundles are held together by the epimysium creating an entirely unique muscle.

Different activities require place a unique load on the body. A soccer player uses their legs differently than a cyclist, or someone downhill skiing, or someone climbing a 14er, or someone rockclimbing. All of those activities require muscles engaging in the legs, however, unique demands required and placed on the body for each activity, vary greatly. The muscle will develop differently in size and shape relative to the activity. In addition, the unique individual anatomy, conditioning, experience, training, previous injuries, genetics, and mental engagement, can all influence how the muscles and fascia respond to the demand of the activity.

A healthy balance through the muscles and fascia can be maintained and supported with myofascial techniques.

Active Release

Overview: Active Release is a technique that actively engages a muscle to release tension, facilitating longer muscles and a full range of movement.

Going Deeper: The body contains proprioceptors which are sensors for receiving sensory information. A Golgi Tendon Organ (GTO), is a proprioceptor that reports tension in a muscle. A muscle spindle reports the length of a muscle. Muscles contract getting shorter and release getting longer and have a neutral resting length. The muscle has protective mechanisms in place to keep it safe and intact. Sometimes these mechanisms can perceive incorrectly, perceiving a shortened muscle as in its neutral position or a fully lengthen position when it is not there yet. This misperception will inhibit a full range of movement.

Actively engaging (contracting) a muscle then letting it release (in a very specific and intentional way) will help to reset a shortened tightened muscle to its neutral resting length and optimal functional length. Commonly compression is included with the active movement to achieve a very specific release.

These techniques facilitate a full range of movement, quickly.

Passive Release

Overview: Passive Release is a technique restoring muscle length to increase the range of movement with someone else moving your body.

Going Deeper: Passive Release is a gentle passive movement, often combined with compression, with the therapist moving the client to keep the client’s muscles relaxed. This is an effective technique to by-pass sensitive or reactive muscles restoring a full range of movement.

Reciprocal Inhibition

Overview: Reciprocal Inhibition release a muscle but engaging the muscle on the opposite side of the joint.

Going Deeper: For movement to happen, muscles on one side of the joint need to be strong enough to move the body part, and on the other side of the joint, long enough and relaxed enough, to allow the movement to happen. If a muscle is challenged to release and let go, engaging the muscle on the opposite side of the joint, might aid and facilitate the letting go.

This is a gentle technique often applied with a sensitive muscle or one recovering from an injury, where the range of movement is limited.

Positional Release

Overview: Positional Release is a passive placement of a body part in a position of muscular ease and neutrality to facilitate a letting go of a muscle contraction or activated trigger point.

Going Deeper: The protective response in the body can create and maintain a muscle contraction when an injury is present, a perceived threat is at hand, or trigger points are activated. This facilitated pathway of response can linger far beyond the threat creating and sustaining pain from