What in the world is a neuromuscular massage and why should you have faith in it? How does it differ from the traditional Swedish or deep tissue massages we more often hear about? Is it painful, who can it benefit from it, and what should first-timers expect?
As an office focused on postural neurology and functional movement, we find that neuromuscular therapy helps the brain reconcile the nerves (neuro-) and the muscles (-muscular) as you undergo treatment. By providing your muscle fibers with directional assistance through smoothing them out and bringing conscious awareness to what you’re unconsciously experiencing through your daily life, we can bring total cognizance and spatial awareness into your everyday living.
What is Neuromuscular Manual Therapy (NMT)?
It is a short-term, site-specific and extremely focused treatment for dysfunctions or conditions that are nerve- or muscle-based. As a form of medical massage, the objective for neuromuscular therapy is to balance the central nervous system with the musculoskeletal system.
This style of manual therapy is more of an approach to therapy rather than any specific technique. It involves a verbal and visual assessment with precise use of multiple manual techniques, and considers the influences of biochemical, biomechanical, and psychosocial factors. A combination of these factors can lead to pain and dysfunction due to specific trauma, postural holding patterns, and repetitive movements (overuse).
In order to manage pain, rehabilitate muscle groups, and promote injury prevention we must bring attention to —and increase— your body awareness. This neuromuscular re-education approach revolves around the concept of specificity in touch; we aren’t rubbing everywhere in hopes that perhaps we’ll hit all the right points along the way — we’re intentional about where we begin and where we end.
How is it Different From a “Regular” Massage?
Swedish massage aims to relax and touch the entire body through long strokes, and deep tissue means to treat the body layer by layer with increasing pressure. Neuromuscular massage utilizes these techniques along with others in various interspersions for a desired result in one or two specific areas of the body.
Make sure you stay tuned for my next blog where I will go into further detail on these differing types of massages so I can rant about how misconstrued deep tissue is in pop culture! Deep tissue does not equate to deep pressure which can cause unnecessary tissue damage – we are looking to avoid prolonging our dysfunctions right?
Because this massage approach is goal-oriented, we start off palpating (examining through touch and pressure) before diving into the real work. This intentional touch provides the therapist with a “road map” of sorts to get a better idea of what is pulling where and which structures or muscles groups are being influenced by those snags.
While specific protocols may be used to first assess the areas of complaint in order to rule out differential diagnoses, there is no doubt that working with different amalgams of “tools” or techniques will aid in achieving the desired results: decreasing your pain, increasing your range of motion, and facilitating a better quality of life.
What’s Involved in This Therapy?
NMT uses everything but the kitchen sink! Fingers, thumbs, knuckles, palms, fists, forearms, elbows. The aim is to identify areas of discomfort and dysfunction, not to induce intense pain.
Techniques used include:
- Cross friction / deep transverse friction, or pressure applied against the muscle fiber direction
- Myofascial release (MFR), or gentle and sustained pressure in opposite directions meant to stretch the underlying fascia
- Lymphatic drainage
- Shiatsu / acupressure / reflexology, or static pressure holds
- Effleurage, or long stroking movements for tissue warm-up
- Deep tissue
- Kneading, or lifting the muscle in upward circular motions
- Wringing, or lifting and squeezing the muscle forwards and back
- Skin rolling and stretching
- Corrective action suggestions
- Proprioceptive neuromuscular facilitation (PNF) stretching, or a stretching technique meant to increase flexibility and range of motion
Who Can Benefit from NMT?
While this form of treatment may help to resolve most muscular based dysfunction, neurological conditions are better managed through this approach.
NMT is used to treat patients with:
- Trigger points; or, areas of hypersensitivity usually found at the neuromuscular junction of a muscle
- Nerve compression and/or entrapment; or, excess pressure on the nerve from the surrounding structures (be they cartilage, soft tissue, or bones) with entrapment occurring in narrow tunnel-like areas of the body by the same agents above.
- Neurological disorders
- Repetitive movement injuries
- Postural deviations
- Acute and chronic pain
- Tension and circulation concerns
Now, because every person and body is unique, no session is ever truly duplicated. People may have similar diagnoses or complaints, but our history isn’t the same, our genes vary greatly, and the way we perceive our reality differs from person to person.
Additionally, whatever physical or emotional trauma is stored in our tissues can compromise our postures or reactions to stimuli, and thus impact our pathway to healing. So, although a CNMT (certified neuromuscular massage therapist) may approach similar problems comparably to begin with, perpetuating factors and daily living activities will influence the way that treatment continues as the full body is studied and “mapped” out.
What to Expect
Your therapist will ask questions and watch your movements and posture before, during, and after the session.
Your first few sessions will be more “delicate”; we’re getting to know how your muscles and nerves respond to touch, which areas are prone to sensitivity, and which muscle groups are on guard.
Your 3rd/4th session will focus on more definitive work and progress — once your body and mind no longer feel threatened by an unfamiliar touch they are more likely to allow the “problem” areas to become apparent.
During a session, expect to experience unusual sensations that aren’t necessarily comfortable or seriously painful but that can also be slightly intense.
After a session you may feel confused. These oddball sensations can leave you radically relaxed and experiencing a bevy of emotions (we’ll tap into emotional release in yet another blog post).
Expect some potential DOMS (delayed onset muscle soreness) if the pressure turns out to have been slightly too much. Increase your hydration for a few days unless you’d like your muscles to regress or experience soreness and possible nausea.
Expect it to take several sessions to properly care for your condition; this isn’t a one-and-done, fix-all treatment — there is a method to the madness!
All in all, neuromuscular manual therapy is a way to explore and treat the dynamic relationships between the nerves and muscles. Check out this quick video above about the “brain map” that dictates our movement and how it influences our postural neurology, which is our offices speciality. Thanks for reading!