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The theory of how neuromuscular techniques (NMT) have their effect

Neuromuscular techniques (NMT) relax and normalise tense fibrotic muscle tissue, improve lymphatic drainage and circulation as well as reducing reflex and trigger point activity. The aim of treatment is to reduce pain and restore normal function to the affected tissues.

Before explaining the theory, it's worth explaining trigger points and reflex points. When palpating the body, specific points can be found that cause pain. Points that cause referred pain (i.e. when palpated, cause pain in different areas of the body) are considered to be true trigger points. Points that cause pain that is only felt locally to the palpated area are usually called reflex points. Charts that map these common trigger and reflex points on a large number of people closely follow traditional Chinese acupuncture charts. In healthy people these all remain calm but if someone has health problems, suffers injury or is under stress, these points will become active and extra points will develop. People often only become consciously aware of the soreness when deep pressure is applied to them.

NMT applies very deep specific pressure into these points for approximately 90 seconds. This is quite painful at first but the pain eventually subsides and the tissues can spontaneously relax. A theory for how pain subsides is that the body releases endorphins that interact with the receptors in your brain to reduce your "perception" of pain and hence relax the tissue. The strong focused pressure also forces the blood away from the area causing a local ischemic reaction. To try keep the suppressed tissue supplied with blood, the body pumps more into the area and then when the pressure is removed, there is a far greater inflow. This sudden engorgement of blood aids healing and relaxes the tissues.

When a muscle is injured or stressed, it will cause pain if stretched or lengthened. This pain sensation is transmitted along sensory nerves to the central nervous system which, through a reflex pathway, sends messages back via motor nerves to increase contraction and shorten the muscle which takes the discomfort away. Because this new hypertonic state is now the new position of comfort it becomes set by the neuromuscular system and becomes the new normal. NMT uses the pain points as a gateway into the neuromuscular reflex system to effect a change to this state.

A person's normal reaction to feeling pain would be to stop it happening or move away but instead is encouraged to not do this, to accept it and to relax into it and accept it. Instead of the natural reaction to contract the muscle to stop the pain, the patient is encouraged to not do that. By overcoming their natural neuromuscular reaction they are able to reset the reflex pathway back to a normal level. Encouraging patients to breathe deeply rather than holding their breath can also help them focus their attention on the trigger point.

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