Home The Book Dr Articles Products Message Boards Journal Articles Search Our Surveys Surgery ESWT Dr Messages Find Good Drs video

Has anyone heard or tried neuromuscular therapy (and an overview)

Posted by lauriel on 3/11/03 at 19:01 (112591)

This might help with TTS and PF pain

I posted that last week that my good foot went caput after wearing bad shoes, well I went to see a Chriproactor for my back and had him adjust foot. I now have tingling numbing sensation and severe pain in my arch and ankle Feels like nerve, after what I just went through with my surgery on my left I am panicking, I thought I better do something fast. So I went for a treatment of this today to help this and to help with the stiffness I am having from surgery on the other foot. I thought It cant hurt.

If you read this, they say can help with PF, carpal tunnel, foot pain.

What is Neuromuscular Therapy
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.
What conditions can St. John Neuromuscular Therapy help?

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, Trigeminal Neuralgia, 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
How many treatments does a patient need?

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. One person may need only one session, while another may need 25 sessions. 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.

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, D.C. 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, P.T., Janet Travell, M.D., John Barnes, P.T., Raymond Nimmo, D.C., 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.

Re: Has anyone heard or tried neuromuscular therapy (and an overview)

Sharon W on 3/11/03 at 19:39 (112595)


Please do a search of messages on 'Carmen' -- she was very interested in this technique and has made a number of posts on this subject.


Re: Has anyone heard or tried neuromuscular therapy (and an overview)

lauriel on 3/12/03 at 10:03 (112641)

Sharon, thanks - I did a search keyword neuromuscular therapy and came up with only one post from 1999, I will try this. My foot alredy feels better than yesterday!

Re: Has anyone heard or tried neuromuscular therapy (and an overview)

lauriel on 3/12/03 at 10:29 (112644)

Sharon, I did a search for Carmen and nothing came up.

Re: Has anyone heard or tried neuromuscular therapy (and an overview)

Sharon W on 3/12/03 at 11:56 (112652)


That's strange -- I had no problem searching for Carmen, but she is so prolific the posts didn't go back to the one I remembered! So, I searched for 'trigger points' instead -- and found this repost (by Suzanne) which copies Carmen's previous post. (It is a subject that has been discussed at considerable length in the past...)

I do keep in contact with Carmen, and if you give me your e-address (being careful to leave an extra space, of course, to discourage spammers) I will try to put you in contact with her so you can learn more about this from someone who's done it.

Anyway, here's a copy of Carmen's post last summer:



Message Number 87261

Re: trigger points View Thread
Posted by Carmen on 6/12/02 at 08:42

You can start with the book I posted....Claire Davies is a massage therapist.
Sharon is correct Claire Davies wrote the book. Also the book by Travell & Simons Myofascial Pain and Dysfunction: The Trigger Point Manual' is worth checking out. It's VERY in depth on trigger points. Janet Travell developed the concept of myofascial pain syndrome in the 1950's. She was Kennedy's white house physician. He too suffered from trigger points. The syndrome most often occurs between the ages of 30 and 60 years...but has ben found to happen in all ages.
MPS has many complex factors to condsider so it's not an easy diagnosis. Now for the sources you need to be more versed on trigger points.
Keep in mind that not EVERY article will pertain to feet. So they must be read thoroughly and with concentration. But since you're a relatively bright person Scott when it comes to matters of the body you should find this easy reading. I use book tabs and a highlighter....it keeps my own condition in check.

First here are a few names of supporters of Trigger point therapy and it's concepts.

Bernie S. Sieglel M.D.-Former student of Travell & Simons
Joseph F. Audette, M.D.-Instructor of Harvard Medical School Director of Outpatient Services Spaulding Rehab.
Scott M. Fishman M.D. Chief of the Division of Pain Medicine Dept of Anesthesiology nad Pain Univ. of Calif.
Robert Gerwin(who actually wrote to me last week)-M.D. Neurologist in Mass.
Robert K. King-founder and president of Chicago School of Massage Therapy
Michael D. Reynolds-M.D. Rheumotologist
Devin Starlanyl-M.D.-GREAT source online
Now some online sources to read up on:

http://www.sover.net/~devstar/ (this site is very informative)
http://www.olc.ort.cuhk.edu.hk/news/ETOIMS_20020314.htm (on this site if you scroll down you'll see they just did a seminar n March of 2002 on the muscles of the foot)
http://www.physsportsmed.com/issues/1997/02feb/fomby2.htm (this site will tell you in the article that trigger points in the gastroc. can lead to instep foot pain...which is where I have it)

Here's on specifically for feet ( I need to read further on this one..it's extensive)

She does seminars on spray and stretch technique and other release therapies for trigger points. She's a physical Therapist.
Mary Maloney PT
Naugatuck Physical Therapy
175 Church Street
Naugatuck, CT 203-723-0533

An excerpt from an article on MPS:

'Myofascial TrPs can entrap the nerves, blood, and lymph vessels, causing a variety of symptoms that confuse doctors and patients alike. Often nerve damage is erroneously suspected, and many expensive, unnecessary (and often painful) tests are ordered.

TrPs are formed of multiple microscopic areas called active loci (pronounced low-sigh). These loci cause the segments of the muscle fibers, called sarcomeres, to become distorted. Eventually, a contraction knot forms, as well as a taut band. When you have TrPs, your muscle strength becomes unreliable. You may also notice that when one part of your body is supported by another part while you are sleeping, the part being compressed goes numb.'

More from Devin's site Some symptoms of trigger point pain:

'shin splint-type pain [peroneus, tibialis], FMS&MPS Complex foot* (wide in front, narrow in back, high arch), Morton's foot*, heel pain [soleus, quadratus plantae, abductor hallucis, tibialis posterior]'

This was a bit more than a journal or two but it should get you started. If you need any more I have a SLEW of references. I am a plethora of information on this. I have much more to read myself so I am still learning.

Re: Has anyone heard or tried neuromuscular therapy (and an overview)

lauriel on 3/12/03 at 12:56 (112664)

Sharon, thanks, t Qwas it, there is a lot of good info on it.