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During the last sixty years, Neuromuscular Therapy (NMT)
has emerged as a significant methodology for assessing,
treating and preventing soft tissue injuries and chronic
pain. NMT, a series of 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 therapy,
physical therapy, nursing, dentistry, chiropractic, osteopathic
and physical medicine clinics worldwide. With a foothold
planted in both holistic and traditional medicine, its future
is solidly founded and holds much promise.
NMT is a thorough
program of recovery from acute and chronic pain syndromes,
which utilizes specific massage therapy, flexibility stretching,
and home care to eliminate the causes of most neuromuscular
pain patterns. This specific and scientific approach to
muscular pain relief will help to bring about balance between
the musculoskeletal system and the nervous system.
NMT enhances
the function of joints, muscles and biomechanics (movement)
and it releases endorphins, the body's own natural painkillers.
It can be part of a comprehensive program, complementing
all other health care modalities. The basis of modern
NMT rests within the following 6 principals:
- Ischemia is a lack of blood supply to the soft tissues
that causes them to become very sensitive to the touch.
- Trigger Points occur when nerves fire impulses at a
rapid speed into an area of the body other than that which
has been traumatized. This phenomenon produces an effect
where the real cause of pain is far removed from the actual
site of pain. Trigger points will inhibit proper blood
flow, which initiates a vicious cycle of pain and discomfort.
- Nerve compression or entrapment is pressure on a nerve
by bone, cartilage or soft tissue. As the tightness of
the soft tissues that surround nerve fibers increase,
more and more pressure is brought to bear on the nerve,
resulting in strangulation or entrapment of the nerve
against a bone or cartilaginous structure such as a disc.
- Postural distortion is an imbalance of the muscular
system resulting from movement of the body off the coronal,
mid-sagittal and horizontal plane. Trauma, gravitational
pressure or psychological patterning causes the soft tissues
to assume a weight-bearing function and thus become thicker,
denser and harder resulting in muscle contraction, body
distortion and pain.
- Biomechanical dysfunction is an imbalance of the musculoskeletal
system resulting in faulty movement patterns. Repetitive
strain of certain soft tissues results in adapted movement
patterns that become muscular "habits" and must
be re-educated to function properly.
- Nutritional, spiritual & mental wellbeing are essential
factors in overall health. Unless your NMT treatment plan
encompasses these elements of wellbeing, the healing process
may be slowed. My approach to NMT focuses attention to
anatomy, physiology, functions and dysfunctions of muscles
and joints through the above defined protocols. Protocols
for treatment of common pain syndromes combined with thorough
anatomy knowledge are the basis for success with NMT.
The central methodology I utilize with my clients focuses
on the St. John's approach to NMT. The St. John Method
of NMT is based on research that identifies the fundamental
causes of pain. The techniques are supported by scientific
neurological laws that explain how the central nervous
system initiates pain responses in the body. By understanding
how pain originates and by being able to locate the source
of pain in the body, St. John Neuromuscular Therapists
treat the CAUSE of pain (primarily musculoskeletal dysfunction)
not just the effects.
Is St. John NMT painful?
In a treatment,
the St. John Therapist will palpate the soft tissues to
determine if there are ischemic, trigger point, nerve compression
and/or entrapment possibilities. The appropriate pressure
to be used during a treatment varies depending upon age,
fitness, nutritional health, postural pattern, and the extent
of trauma and toxicity level in the tissues.
In the St. John
Method, the therapist applies pressure for 8-12 seconds
to each area being treated, prompting a therapeutic response
in the tissues. Since NMT is a highly effective method of
therapeutic massage, as opposed to relaxation massage, using
the proper level of pressure will elicit a mild state of
discomfort. If pressure is too light, it does not produce
the necessary stimulation of nerve receptors to produce
the desired therapeutic response.
However, pressing too hard can cause the body to treat the
pressure as an intrusion, particularly if there is inflammation
in the tissues. Optimal success is achieved by applying
pressure to trigger points or ischemic areas 3-4 times for
8-12 seconds rather than a longer duration. This is because
the therapist's goal is to interrupt the physiopathological
reflex circuits.
How was St. John Therapy Developed?
Paul St. John
had a vested interest in studying and researching soft tissue
pain and musculoskeletal dysfunction. He was seriously injured
three times in his life: he broke his back in three places
in a high school football game, was shot out of a helicopter
as a Green Beret medic in Vietnam, and was later involved
in a head-on automobile collision. For four years after
his last injury, he woke every day to headaches and unceasing
pain. Thousands of dollars in medical expenses left him
with no relief.
Frustration and fear led him to medical libraries where
he began his research on pain. He studied pain mechanisms,
spending many hours in medical libraries learning about
the functioning of the nervous system and the neurological
laws that govern the workings of the body. Through this
research he found that most pain conditions stem from problems
in the muscular system. In fact, Paul discovered a great
deal of literature on the interrelationship between muscles,
tendons, ligaments and fasciae, and the role they play in
causing pain. With this information he began to study his
own body and the pain patterns developing from his injuries.
He became familiar
with "receptor tonus technique," which prompted
him to attend a course with Dr. Nimmo, DC. He found
that by pressing on the tissues of his neck, back and shoulders,
he was able to get temporary relief from his pain. Encouraged
by this, Paul began perfecting the receptor tonus technique
and incorporating his knowledge of the body into his work.
He started teaching others how to treat his tissues, and
for the first time in four years, he was pain free. Out
of this, he began to integrate the teachings of such notables
as Marianno Racabado, PT, Janet Travell, MD, John Barnes,
PT, Raymond Nimmo, DC, Dr. John Christopher, Dr. Bernard
Jensen, and other orthodox and non-conventional teachers
into the development of the St. John Method of Neuromuscular
Therapy. Over the next 25 years, Paul and the therapists
who worked under him would treat thousands of people in
pain, changing their lives and the lives of their families
forever.
Benefits/Contraindications
The St. John
Method of Neuromuscular Therapy can help individuals who
are experiencing structural distortion, biomechanical dysfunction
and the accompanying pain that is often a symptom of the
underlying problem. It is a whole-body approach to treatment,
so most people find that when they are treated for their
back pain, their knee pain, headaches, bladder dysfunction,
and other problems they thought couldn't be helped or "weren't
a big deal" are also addressed.
Some of the conditions
NMT is successful with are: Headaches, Migraines, Scoliosis,
TMJ, Whiplash, Herniated Disc Syndrome, Back Pain, Neck
Pain, Shoulder Pain, Hip Pain, Knee Pain, Foot Pain, Osteoarthritis,
Plantar Faciitis, Torticollis, Carpal Tunnel Syndrome, Sciatica,
Thoracic Outlet Syndrome, Shin Splints, Tendonitis, Spasms,
Cramps, Strains, Postural Distortions, Fibromyalgia, Post
Polio Syndrome, and the list goes on and on...
How is
St. John Neuromuscular Therapy performed?
A St. John Therapist's
first goal in relieving pain is to achieve structural balance
in the body. They do this by looking at the body as a four-dimensional
object, and using the techniques of the St. John Method
to correct distortions in the horizontal, coronal and/or
mid-sagittal planes of the body. Their second goal is to
develop a precise treatment protocol for rehabilitating
the affected soft tissues. St. John Therapists believe that
the healing process should also be an educational process,
so they teach the patient about their health, structure,
biomechanics, and anything else that may be influencing
their pain condition.
In addition,
they will work with other healthcare practitioners such
as neuromuscular dentists, orthopedic shoe technicians,
nutritional counselors, and various other supportive professionals.
The client is actively involved in the process of healing
by helping the St. John Therapist understand his or her
particular condition. During the initial visit, which is
generally 90 minutes, the therapist measures various structures
of the body to evaluate for postural distortions and biomechanical
dysfunction. This analysis will point to the cause and effect
of pain.
The St. John
Therapist then palpates the soft tissues to determine if
there are problems with ischemia, trigger points, and nerve
compression/entrapment. Once the evaluation is complete,
the therapist will follow a specific protocol of rehabilitation,
designed to produce the most efficient and long-lasting
results. The steps in this protocol are as follows: Locate
and eliminate spasms, hyper-contraction and trigger points
from the soft tissues; restore postural alignment, proper
biomechanics or movement patterns; restore flexibility and
increase blood flow to the tissues; Rebuild strength of
the injured, weak, and/or atrophied tissues; build endurance
of the tissues for permanent results; and a comprehensive
nutritional and mental assessment is performed and incorporated
into the clients overall treatment plan.
How many
treatments?
This question
varies with each individual, depending upon the severity
of their condition, nutritional and emotional health, age,
fitness, and the skill of the therapist. Generally after
about 10 sessions the patient feels a great improvement
in their health. Once the problem is eliminated, the patient
should have a treatment every few months to maintain their
health and help prevent future imbalances from occurring.
St. John Therapists
believe the healing process should also be an educational
process, and they educate the patient about their health
and how to improve and maintain it on their own. A good
St. John Therapist is not after "lifetime memberships"
or client "annuities," their goal is to relieve
their client's pain as efficiently and permanently as possible.
Training/Licensing
See NMT
website.
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