Neuromuscular therapy
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During the last several decades, neuromuscular therapy (NMT) has emerged as a significant methodology for assessing, treating and preventing soft tissue injuries and chronic pain. NMT, a series of manual treatment protocols based on the practitioner’s skill, anatomy knowledge and precise palpatory application, has found its home, not only in the treatment rooms of massage therapy, but also in occupational and physical therapy, nursing, chiropractic, osteopathic and physical medicine clinics worldwide.
With a foothold planted in both wholistic and traditional medicine, NMT emerged in both Europe and North America, almost simultaneously over the last half-century. It is interesting to note that the early developers knew little, if anything, about each other, yet the theoretical basis of all the modern protocols are similar since they are each rooted soundly in physiological principles.
Between the mid-1930s and early 1940’s, European-style neuromuscular techniques (as NMT is called in Europe) first emerged, developed by the skillful hands of Stanley Lief and Boris Chaitow. These cousins, trained in chiropractic and naturopathy, studied with teachers like Dewanchand Varma and Bernard Macfadden and integrated solid concepts of assessment and treatment steps for soft tissue dysfunction. Their practice of NMT was set in Lief’s world-famous health resort, Champneys, at Tring in Hertfordshire, England where they were presented with a wide variety of conditions on which to test their theories and methods. Many osteopaths and naturopaths, including Peter Lief, Brian Youngs, Terry Moule, Leon Chaitow and others, have taken part in the evolution and development of European neuromuscular techniques. NMT, now taught widely in osteopathic and sports massage settings in Britain, forms an elective module on the Bachelor of Science (BSc(Hons)) degree courses in Complementary Health Sciences at the University of Westminster, London, a program developed (in part) by Leon Chaitow, DO.
A few years after neuromuscular techniques emerged in Europe, across the ocean in America, Raymond Nimmo and James Vannerson first published their newsletter, Receptor Tonus Techniques, where they wrote of their experiences with what they termed ‘noxious nodules’. Over the next several decades, a step-by-step system began to emerge, supported by the writings of Janet Travell and David Simons. Travell and Simons’ two volume set of textbooks, Myofascial Pain and Dysfunction: The Trigger Point Manual (upper body published in 1983 and lower body in 1992) impacted the medical, dental, massage and other therapeutic communities with documentation, research and references for a whole new field of study - myofascial trigger points.
Eventually, several of Nimmo’s students began teaching their own treatment protocols, based on Nimmo’s work. Among Nimmo’s students was Paul St. John, who began teaching his own system in the late 70’s. In the mid-1980’s, Judith (Walker) DeLany became St. John’s first additional instructor of his method of neuromuscular therapy. DeLany (then Judith Walker) worked with St. John for five years (1984-89), where she assisted in the development of NMT techniques and protocols for massage therapy application. In 1989, the two separated their work into two styles. St. John's became NMT St. John Method, while DeLany's became NMT American Version™. Both systems still retain a strong focus on Nimmo's original material, although each developer has significantly influenced his or her own particular methodology with unique insights and new techniques.
European and American versions of NMT have a similar theoretical platform yet subtle differences developed in their hands-on applications. In the exploration to uncover contracted bands or muscular nodules, American-style neuromuscular therapy uses a medium-paced (thumb or finger) gliding stroke whereas European-style neuromuscular techniques use a slow-paced, thumb-drag method of discovery. They also have a slightly different emphasis on the method of application of ischemic compression when treating trigger points. Both versions emphasize the need to develop a home-care program and encourage the patient's participation in the recovery process.
In 1996, a landmark event for American NMT occurred when NMT American version™ was overviewed in Leon Chaitow's Modern Neuromuscular Techniques, as contributed by Judith DeLany. This significant text was the first to offer both the European and American methods within the same volume. Chaitow and DeLany have since published three definitive texts integrating the American and European versions of NMT. Clinical Application of Neuromuscular Techniques, Vols. 1 & 2, with accompanying Case Study Exercises, which aims to standardize the training of NMT techniques.
