Neuromuscular Therapy - Brisbane MSK Clinic

Neuromuscular Therapy is a form of myofascial release that uses ischemic compression to treat myofascial trigger points, pain and restrictions in mobility. The technique is a form manual therapy with origins in Osteopathic medicine. The terms Trigger Point Therapy (TPT) and Neuromuscular Technique - NMT are often used to describe similar techniques. These methods all have a lot in common with the ancient Chinese art of Acupressure. Techniques have evolved, leading to variations in name and how one performs them. Neuromuscular therapy techniques are just one of many treatment methods available at the Brisbane MSK Therapy Chronic Pain Clinic in (Morningside).

Trigger points within tissues often create pain and restrict mobility. The body tries to avoid pain by adapting how one moves, which is helpful in the short term (see the article on Soft Tissue Adaptation to activity and injury). Adaptations mean that we move differently to normal, which can lead to further changes. The human body is good at masking or hiding issues, and it may take months or years for some people to notice that there is a problem. There will likely be months or years of soft tissue adaptations and learned movement patterns in chronic pain cases (see the article on Chronic Pain Treatment for further details on aspects of such conditions and treatment). Chronic or persistent pain occurs due to issues impacting the normal tissue healing process, effectively unresolved trauma. Such a situation can arise for many reasons, such as a lack of treatment, ineffective treatment and recovery plan or further injury.

Effective treatment with NMT relies on the therapist's ability to palpate. Most forms of manual therapy require a refined sense of touch or palpation skills. Such skills take years to develop, and even though many massage therapy courses teach NMT, they do not teach palpation. Without such skills, one would be assessing by guesswork and then treating based on a guess at best. Finding Myofascial Trigger Points or Trigger Points (TrPs), for short, is not just about finding areas of pain. Equally, treating TrPs is not just about finding a painful point and pressing it until some form of relief occurs. Poor palpation and technique application skills result in an unpleasant patient experience. Furthermore, there can be a tendency to require additional treatment(s). Equally, applying any soft tissue therapy in the wrong situation can worsen symptoms. Terry at TotalMSK was fortunate enough to learn in-depth palpation skills during his six years of training at the McTimoney College of Chiropractic in the UK. Over the 16 years, he has been working in the soft tissue therapy field, these skills have evolved.

There may well be similarities in how NMT and Trigger Point Dry Needling (DN) work. Both methods work with MTrPs and involve finding these and then applying a form of pressure or ischemic compression. Dry Needling is more invasive, as the method uses a filament needle to pierce the skin (not that one always feels this). The actual tissue release for both methods feels similar, almost a melting sensation. Again, what one feels may vary between therapists and based on the factors covered earlier. Currently, there are good theories on how both methods work, but nothing concrete. One can use both techniques very precisely with the right level of anatomy knowledge and palpation skills. Besides the similarities between the methods in locating and treating myofascial trigger points and the releasing sensation, there is also evidence of the techniques producing similar effective results. Studies demonstrating the benefits of NMT methods include those for headaches _[1], Neck and shoulder pain _[2,3,4,5], upper arm pain _[6], carpal tunnel syndrome _[7], lower back pain _[8], knee pain _[9] and ankle pain _[10].

There are advantages and disadvantages for techniques, and NMT or other ischemic compression techniques are no different. Dry Needling (DN) has additional risks due to the invasive nature of the method, though these are easily manageable. Also, Dry Needling requires direct skin contact/access and various ancillaries. Few risks are associated with using Neuromuscular Therapy techniques, and there is no need for direct skin contact or access. It is sometimes unsafe or higher risk to access some of the deeper muscles within the body using a needle, yet it is possible with NMT methods. On other occasions, a needle may prove more effective in releasing a deep muscle over NMT.