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Principles of Neuromuscular Therapy

By Laurence Layne, LMT, CNM

Neuromuscular Therapy (NMT) is considered part of massage therapy, and the greatest number of NMT practitioners are massage therapists. This article will serve to help health professionals, therapists, doctors, students, and others to understand the level of study and proficiency needed to perform Neuromuscular Therapy. 

The primary goals of Neuromuscular Therapy are:

  • Pain Relief

  • Restoration of Proper Biomechanics

  • Improved Whole Body Function

Neuromuscular Therapy evaluation consists of:

  • Postural Analysis: sitting, standing, prone, and supine

  • Analysis of Cranial and Pelvic anatomical structures

  • Gait Analysis

  • Analysis of Flexibility and Biomechanics

  • Palpation of 'Soft Tissues

Soft Tissues of the Body:

  • Muscles

  • Tendons

  • Ligaments

  • Fascia

Neuromuscular Therapy treatment consists of:

  • Soft Tissue Manipulation

  • Stabilization & Mobilization of Joints (Soft Tissues)

  • Massage

  • Myofascial Stretching

  • Muscle Energy Technique

  • Hydrotherapy Nutritional Supplementation

  • Health Education

Types of massage used in Neuromuscular Therapy include:

  • Deep Tissue Massage

  • Cross Fiber Friction

  • Pincer Massage

  • Ischemic Compression

  • Traction &l Stretching

  • Range of Motion

  • Skin Rolling

  • Tapotement

  • Visceral Massage

Unique Components of Neuromuscular Therapy:

  • Treats origin, insertion, and belly of muscles

  • Uses pressure bars, known as "T" bars for instrument assisted massage

  • Uses bones as handles to release tight, constricted muscles

  • Utilizes principle of "structural homeostasis" for pain relief

  • Uses neurological laws as principles of treatment

  • Integrates wholistic thinking as means to problem solving

  • Integrates somatic movement therapy into treatment regimen

  • Philosophy similar to Chiropractic but adapted to soft tissues

Neurological Laws used in Neuromuscular Therapy:

  • Law of Facilitation

  • Davis' Law

  • Hilton's Law

  • Head's Law

  • Hooke's Law

  • Sherrington's Law

  • Wolff's Law

  • Arndt-Schultz Law

  • Pfluger's Laws

Neurological Concepts:

  • Pathological Reflex Arc

  • Spasm

  • Dermatomes

  • Autonomic Nervous System

  • GAS and LAS

Muscle Energy Principles in Neuromuscular Therapy

  • Post Isometric Relaxation

  • Reciprocal Inhibition

  • Eccentric Contractions

  • Concentric Contractions

Biomechanical Principles in Neuromuscular Therapy

  • Structural Homeostasis

  • Righting Reflexes

  • Fryette's Laws

  • Law of Motion

  • Proprioception

Seven Factors or Principles of Chronic Pain in Neuromuscular Therapy:

  • Ischemia

  • Postural Distortion

  • Trigger Points

  • Nerve Entrapment/INerve Compression

  • Biomechanical Dysfunction

  • Nutritional Deficiencies

  • Emotional Wellbeing

Five Stages of Rehabilitation in Neuromuscular Therapy:

  • Pain Relief

  • Restore Biomechanics

  • Restore Flexibility

  • Rebuild Strength

  • Build Endurance

References:

St. John Neuromuscular Therapy Seminar Manuals 1–5, by Paul St. John, LMT, Largo, Florida, 1990–1994.

St. John Neuromuscular Therapy Seminar Manual 8 A/B, by Paul St. John, LMT, Pinellas Park, Florida, 2004.

Neuromuscular Therapy, American Version, Certification Manual, Vol. 1–5, Judith (Walker) DeLany, LMT, St. Petersburg, Florida, 2001, 2002.

Modern Neuromuscular Techniques, Leon Chaitow, DO, Judith (Walker) DeLany, LMT, Churchill Livingstone, 1996.

Clinical Application of Neuromuscular Techniques, Vol. 1–The Upper Body, Leon Chaitow, DO & Judith Walker DeLany, Churchill Livingstone, 2001.

Myofascial Pain and Dysfunction, Vol. 1. Upper Half of Body, David G. Simons, MD, Janet G. Travell, MD, and Lois S. Simons, PT, Williams & Wilkins, 1999

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