Neuromuscular Massage

neuromuscular therapy, myoskeletal alignment, etc.

Many massage modalities (Trigger Point Therapy, Muscle Energy Techniques, Myofascial Techniques) fit under the general umbrella of Neuromuscular Massage, Neuromuscular Therapy, or just NMT. I am certified in Precision Neuromuscular Therapy, and lean very heavily on the training I received from teachers like Doug Nelson and Seth Will. I am also certified in Erik Dalton's Advanced Myoskeletal Alignment Therapy, and the differences between those two schools are noteworthy. I practice relatively few of the many tools used in Erik's seminars because I have largely moved away from that purely "mechanical model" of thinking about the human body. So, while I spent a lot of time and money learning his modality, I don't use it much anymore. I use PNMT daily.

It is important for me to acknowledge that no modality has ever demonstrated a reliably better result than any other, there is no one method that works for every one. Studying massage scientifically is very difficult, and results are often unreliable or misleading. If you want to know more about this problem, I highly recommend you check out this epic article on Painscience.com. Often we are driven by clever advertising to think about solutions to problems in terms of "what product should I buy?" Modalities are an answer by wrapping up a few approaches and techniques in a shiny new package with a sciencey name. After years of CEU classes which made big claims then taught the same techniques under a new name, I lost faith in the "sage on the stage" model of education and decided instead to pursue university classes in the fundamental sciences (biology, physiology, anatomy, chemistry, physics, etc.) as my continuing education credits. This led me to get my Bachelor in Exercise Science and my Doctorate in Physical Therapy. Among the many CEU classes and schools of thought I have studied, PNMT is always an outlier.

Precision Neuromuscular Therapy differs enough that I still make time to attend classes when possible. PNMT emphasizes a best-practices approach rather than a handful of techniques or a guru-led miracle cure for whatever-ails-you. This page cannot exhaustively cover PNMT, I will only offer a brief summary of what, within it, I find useful. The core of the approach is motivational interviewing (listening to your patient and aligning with their goals), science literacy (reading and interpreting what the research has to say), clinical competency (knowing what you are doing and how it might help), quantitative/qualitative outcome measurements (measure something to see if it gets better), regular follow-ups for a short time (3-or-more visits in a short time period), and client education (giving the client the knowledge to help themselves!) which aligns with how I deal with any patient with pain. As far as I can tell, these practices are universally accepted and often overlooked. They are certainly well within the scope of physical therapy

This approach works equally with any technique you choose to employ, and I've been able to take it with me through my personal evolution as a massage therapist and clinician. The general takeaway message is that it matters more what we do with our minds than what we do with our hands. Massage is an interaction between therapist and client, and what happens in a massage session should be focused on outcomes and goals rather than tradition. "Practice" is used in medicine or law to denote the need "to do" rather than to just learn from a book. One practices massage on living, complex organisms which requires humility, experience and flexibility, as well as patience, understanding, and kindness. No modality can teach those things, but PNMT comes closer than I have seen elsewhere.