Neuromuscular Therapy

The textbook definition of neuromuscular therapy is the assessment and treatment of myofascial pain syndrome. While short and sweet, this definition is dense with meaning. To fully understand what it means, we need a brief list of words and definitions.

Definitions

  • myofascial pain syndrom - the presence of trigger points and associated dysfunction

  • trigger point - a hyperirritable spot in a muscle which gives rise to referred pain

  • referred pain - pain that is felt somewhere remote to the source of pain, such as a trigger point in your neck that refers pain into your head, creating a headache

  • associated dysfunction - dysfunction that occurs in response to trigger points and referred pain, such as favoring a leg that has pain, resulting in overuse of, and dysfunction in, the opposite leg

  • ischemia - a lack of blood flow resulting in impaired delivery of oxygen and nutrients

Theory

There are a couple of different theories within neuromuscular therapy that attempt to explain what trigger points are on a physiological level, but the fact remains that we don't have a proper understanding of them.

The working theory that I currently subscribe to is called the contracted sarcomere theory. It suggests that the location where the neuron that innervates a muscle fiber, called the motor end plate, is ischemic, or lacking blood flow.

This lack of blood flow reduces the supply of nutrients to the muscle fiber, which ultimately inhibits the fiber's ability to relax. This results in a trigger point. How the trigger point creates referred pain is still unknown.

Treatment

One way to treat a trigger point is to press on it. There are two theories that attempt to explain why this works. The first is a phenomenon called hyperstimulation analgesia. Basically, pressing on the trigger point creates a neurological feedback loop which causes the nervous system to release endorphins which block the pain signal and release the trigger point. 

The other theory is that the pressure is able to restore proper circulation to the area, helping to release the chemically perpetuated spasm.

A more advanced way to practice neuromuscular therapy is to assess the region for mechanical imbalances and address them. Addressing the imbalances removes the trigger point's reason for existing, and the trigger point evaporates without having to work directly on it.

Following release of the trigger point, stretching the affected muscle will help the muscle fiber to maintain its normal resting length, inhibiting the recurrance of the trigger point.

About the Author

My name is Lovelace Linares. I have been practicing massage in Atlanta since 2001. I taught all aspects of massage for nine years, five of which I directed the massage program at the Atlanta School of Massage.

I'm a bit unconventional in my thinking. I believe that self discovery is the purpose of life. Through it, we can all achieve our greatest potentiontial, both individually and as a society.

To that end, i believe that true relaxation comes from two things: (1) Alleviating pain that you are aware of and (2) addressing tension you are not aware of. Self-awareness is the key.

My practice is located inside Urban Body Studios on the scenic Atlanta Beltline. Orthopedics, Deep tissue, Swedish massage, neuromuscular therapy, Thai massage, and stretching are some of the techniques that I use in my practice.