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NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013


The stimulation of these points within the body
aids in the maximum potential of strength,
length, power, flexibility and endurance of the
Musculo-skeletal system.
By improving the neural pathways we can
conversely affect the hormones released by
the Pituitary and Hypothalamus which denotes
whether we are in Fright or Flight or Rest
and digest.
The initial course of action when focused on
the most efficient outcome-based treatment
should be to start at the very beginning and
this will give you the tools to do just that!

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

Neuro-lymphatic reflexes, or neurolymphatics as referred to in Applied Kinesiology, are
locations on the body that are believed to affect a specific muscle and organ. As mentioned
above, it is used in Applied Kinesiology for diagnosing the relationship between weak muscles
and dysfunction with that muscle or its corresponding organ or gland/tissue.
Neuro-lymphatic reflexes were discovered by Dr. Frank Chapman, an osteopath in the
1930s. Through palpation, Chapman found tender areas in the body, which he believed to be
the result of an increase and even congestion in lymph. Subsequent massage to that area
would increase lymphatic drainage and lead to positive effects of the individuals health,
especially to corresponding bodily organs, areas, and glands.
Dr. George Goodheart, the founder of AK, liked Chapmans work and through
experimentation discovered that he could turn previously weak muscles on by touching and
massaging these points. Chapmans work neuro-lymphatic points were all associated with
specific organs and glands as Goodhearts muscle testings were. The first correlation that
Goodheart found was that Chapmans neuro-lymphatic point linked with the stomach was
helped to turn on the Pectoralis clavicular muscle, also linked to the stomach. From there,
Goodheart was able to correlate all of the other muscles he discovered and now every muscle
has its own neuro-lymphatic point.

Stress is a term in psychology and biology, borrowed from physics and engineering and first
used in the biological context in the 1930s, which has in more recent decades become
commonly used in popular parlance. It refers to the consequence of the failure to respond
adequately to mental, emotional, or physical demands, whether actual or imagined on the
body. When someone perceives a threat, their nervous system responds by releasing a flood

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

of stress hormones, including adrenaline and cortisol and also neuropeptides into the
bloodstream. These hormones rouse the body for emergency action. The stress response is
the bodys way of protecting the person. When working properly, it helps in staying focused,
energetic, and alert.
Physiologists define stress as how the body reacts to a stressor, real or imagined, that causes
stress. Acute stressors affect you in the short term; chronic stressors over the longer term and
is achieved by the Autonomic nervous system.

General adaptation syndrome

A diagram of the General Adaptation Syndrome model as designed by Selye. Courtesy of Wikipedia

Stages of Stress
Alarm is the first stage. When the threat or stressor is identified or realized, the body's stress
response is a state of alarm. During this stage, adrenaline will be produced in order to bring
about the fight-or-flight response. There is also some activation of the HPA axis,
producing cortisol.
Resistance is the second stage. If the stressor persists, it becomes necessary to attempt
some means of coping with the stress. Although the body begins to try to adapt to the strains
or demands of the environment, the body cannot keep this up indefinitely, so its resources are
gradually depleted.
Exhaustion is the third and final stage in the GAS model. At this point, all of the body's
resources are eventually depleted and the body is unable to maintain normal function. The
initial autonomic nervous system symptoms may reappear (sweating, raised heart rate, etc.).
If stage three is extended, long-term damage may result, as the body's immune system
becomes exhausted, and bodily functions become impaired, resulting in symptoms and
conditions including ulcers, depression, anxiety, diabetes, digestion disorders,
even cardiovascular problems.
When the body is in this stress state it will commonly present in defensive positions, which
are the return to the foetal position. This shortens muscles of the hip and knee, shoulder
girdle and forearm, cervical region (poke chin) and Tx/diaphragm and Lx/Sx regions.

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

CNS response to Defensive posture

Poor muscle proprioception

Inaccurate information to the CNS therefore poor response

Imbalance of alignment and movement of muscle contractions

Poor breathing with reduced ability of the diaphragm to contract and thereby using
the accessory respiratory muscles including Scalenes and Pec minor.

Ceases the parasympathetic nervous system via the control of the Hypothalamus.

Alters the endocrine system , limbic system and musculoskeletal system

Alters the emotional state which can be embedded into the fascia.

Cost of stress long term

Rapid aging

Weight gain

High blood pressure

Heart disease


Digestive problems

Nervous breakdown, burnout

Cost of stress long term emotionally

Anxiety, fear, restlessness

Irritability, anger



Loss of libido

Impaired memory and concentration

Excessive smoking or drinking

Is there a way out?

Can we learn to start responding instead of reacting to our stress

Shift balance from sympathetic to parasympathetic

Can we interrupt these patterns quickly and effectively

What ever is in the mind is in the body

Stand and twist then visualise full rotation; think about that juicy lemon then bite it.


Relaxation response in the 1970s Dr Herbert Benson at Harvard Medical School
discovered what he called the Relaxation Response. Benson observed that trained yoga
specialists could control functions that had previously been believed to be autonomic. During

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

meditation, these yogis could reduce their heart rates, blood pressure, metabolism, body
temperature, and other physiological processes to surprising levels


The only way to activate the parasympathetic response is through

diaphragmatic breathing

Most of us dont know how to use it

We will learn how to get the diaphragm firing and instantly interrupt the stress

This relieves physical, mental and emotional stress in the body

Correct deep breathing means efficient gas exchange of O2, CO2 and haemoglobin.

Spontaneous respiration produces rhythmic discharge of motor neurons, and these

nerve impulses depend on the brain. The rate and depth of respiration in regulated by
chemoreceptors measuring PO2, PCO2 and H+.

75% of quiet inspiration is done by the diaphragm

Before we activate the diaphragm we need to become aware of the position of the
spine. The more upright you get your thoracic spine the more you open up your ability
to breath.

By correcting your position alone you can increase your oxygen intake by up to 1
litres per minute


Position is along the centre of the sternum; rub for up to 2 minutes taking more time on areas
of more pain.
This area is our primary defence position and when we are under threat, stress or pain the
Neurolymphatic points become dampened and very tender to palpate.
Easiest to stimulate in supine with knees bent so that the diaphragm can be activated in this
position directly afterward.
1. Breath in through the nose out through the mouth
2. Nothing in the chest and all in the stomach
3. Place one hand on the chest and the other between the navel and the xyphoid
4. 10 deep rhythmic breaths and we are looking for gut sounds [parasympathetic
response] and potential light headedness [ greater oxygenation to the blood stream]
5. Inhale should see the belly rise and very little movement of the chest and the exhale
should see the stomach contract back inwards.
6. If this is difficult to do slow down or apply more rubbing to the tender points. When
you can achieve this effectively you most commonly are aware of how quiet your
mind becomes, and noise and chaos settles.

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

Breathing is easy when doing
most things but when you get
into challenging situations or
exercises, you tend to either
hold your breath or shallow
or accessory breath. This is
the most important area to get
right and will improve
performance levels


Release the defence

position on the
Get your client
Deep relaxed breaths
2 minutes with you in
the treatment room
10 minutes per day


Ensure the CORE is fully activated by assessing and treating the Psoas-Glut-Hamstring
The CORE also includes the Transverse Abdominus, Rectus Abdominus and Obliques which
will be looked at in the next section.
Actions include hip flexion, hip extension and hip extension/knee flexion.
If the hip flexor shuts down then the Glut on the same side will shut down too due to
agonist/antagonist relationship and its reciprocal inhibition.



Psoas Major

ACTION - Flexes the hip joint, flexes the trunk if legs are fixed
Influences the biomechanics and balance of the pelvis and lumbar spine
When tight pulls the Lx spine into lordosis
When doesnt fire reduces the Lx lordosis
Its role in defensive positions is pulling the legs up into a ball

Testing the Psoas

Flex the hip with leg externally rotated and abducted to match the line of the Psoas
Stabilise the opposite Ilium with one hand

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

Press down on the elevated straight leg at the ankle whilst the client resists your
Look for strength and/or cramping in the Quadriceps (sign of overuse of this group)
Check the ability of the client to hold the leg up.


ACTION extends the hip and flexes the knee, short head flexes the knee only
Adductor Magnus (hamstring portion) extends the hip joint
Exercises for Hamstrings include leg curls, squats and Leg press with Quads

Testing the Hamstrings

We are looking for length and not strength in this instance

Take the relaxed leg into hip flexion till the client feels the stretch record length

Reflexes for Activation

Test the psoas and hamstring and allow the client to register their length/strength
Explain how they work together and why we test together
Work the Reflex points for 30 seconds each side
Now re-test the Psoas and Hamstring and expect dramatic shifts

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

Gluteus Maximus

Major muscle responsible for keeping us upright, stabilising the pelvis during
movement and power and control in sitting to standing/walking/stair climbing
ACTIONS extends the hip joint, braces the knee in extension, lateral rotation of the

Testing the Gluts

Client lies prone and flexes the knee 900 and then lifts the knee off the floor
You apply a downward force to the leg just near the knee and the client resists

Alternate test with dynamic stability

Client gets into the bridge position with one leg then raised vertically into the air
You then push the leg in multiple directions and see if they can resist those forces

Reflexes for activation


Along the occipital

Ridge from Mastoid
Process to the other

ACTION controls knee flexion but also flexes the hip

(Rectus femoris)
If the Psoas shuts down the Quads take over the role
due to this secondary action
They become tight to maintain hip stability
ACTION all heads extend the knee, and the VMO
provides correct patella tracking by pulling the patella
Exercises include leg extensions, squats, and leg press

Testing the Quads

Client lies supine with hip and knee bent to 90

Ask them to maintain this position whilst you push the
femur (just above the knee) and pull the ankle
simultaneously to try to straighten the leg.

Reflexes for activation

Multiple points to assist in maximal

Along the curve at the bottom of
the rib cage
On the back between ribs 8 12
and a general rub with the palm of
the hand is usually sufficient

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

Calves (indicate chronic stress)

Consist of 2 distinct muscles and actions, Gastrocnemius being the most significant.
As it crosses 2 joints and flexes both the knee and plantar-flexes the ankle if it is not
firing correctly and/or shortened it will impact overall biomechanics.
A tight Calf will unlock the knee in the stance phase of Gait and load the Quads
instead of the natural transfer up the lateral component of the leg, up and across the
sacrum and up the contralateral side of the trunk. The spine should be the engine of
all our movements and if this is not the case the body will lock up quickly
ACTION flex the ankle (aiding in pushing off in running or walking) and flexion of
the knee (not Soleus)
Exercises include standing or seated calve raises

Testing the Gastrocnemius

This test is a flexibility test and with the leg extended fully you are looking at the
dorsiflexion of the ankle
Push the knee into full extension and the angle of dorsiflexion should be a minimum
of 15 past 90 and good flexibility 30 40 past 90

Reflexes for activation

Gastrocnemius and Soleus have the same reflex points

Best points are in the front of the of the torso and located 5cm across and 5cm up
from the umbilicus
Note this can be very painful on highly sensitive people
Also points between the 10 and 12 ribs 3cm laterally within the Erector Spinae

Tibialis Anterior

Opposes the action of the Calf, when the calf is

tight it can create symptoms of shin splints
Reduced shock absorption of Gait
ACTION dorsiflexion and inversion of the foot,
assists in maintaining medial longitudinal arch of
the foot

Testing the Tibialis Anterior

Ask the client to dorsiflex the foot and toes

Place your hand over foot and include toes
Apply strong opposing pressure
Any give is a sign of poor activation

Activation for Tibialis Anterior

Neuro-lymphatic points

These points are found just above the inguinal

line on the edge of the Rectus Abdominus
Look at your client for defensive position to
suggest poor activation i.e. stress at a chronic

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

Lets go back to the CORE and the need for the entire unit to function as a whole, no matter
how strong, fit, big, athletic people appear it is surprising how pathetic their abdominal
activation is. This then means that the body needs to elicit other muscles to do the job of trunk
stability and this tends to be the neck and jaw.

Rectus Abdominus, Obliques internal and external and Transverse Abdominus all
have similar actions but can become very dysfunctional in their alignment similar to
setting up a tent with all the tent wires strung in different tensions.
ACTION flexion of the trunk, lateral flexion, rotation and tertiary stability, raises the
intra-abdominal pressure to provide stability (TA)
Exercises include crunches, sit-ups, leg raises, planks

Testing the Abdominals

Instruct your client to cross arms and perform a sit up and assist them if required
Ensure you have one arm locking their legs down by applying weight onto the knees
with your arm
Once in this position put your other forearm onto their crossed arms and push them
back to the table/floor whilst they resist
Make sure that the client is not cheating by using the neck; get them to slightly extend
the neck back to neutral and open the jaw
Variations include obliques where they twist their trunks and resist your pressure.

Reflexes for activation

Main reflex is inside the thighs just posterior to the Adductor Longus
The Rectus Abdominus is more distal and the Obliques and TA are superior and up
to the attachment area of the Adductors
Activation of the total region by slapping, finger kneading ensure that all muscles are
fully neurally stimulated and can assist in correct core function and less focus on the
Jaw and neck
The secondary region is on the back running in the mid-thoracic area, rubbing with
the flat of your hand is sufficient to stimulate it but in conjunction with the front region

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

This muscle group is closely linked to the shutting down of the TMJ and tight jaw muscles in
general. It is also affected with whiplash trauma as well as Post Traumatic Stress Syndrome
therefore it is wise to expect some emotional release when re-activating this muscle group.

When the SCM complex is in imbalance symptoms such as vertigo, dizziness,

nausea, vomiting, tinnitus, visual disturbances and headaches (with a possible link to
migraines) are common. This is due to the mechano-receptors receiving poor
ACTIONS include extension of the upper Cx spine, flexion of the head if it is already
flexed and contralateral flexion; and are involved with accessory breathing.

Testing for SCM

Ask your client to lift their head off the table

Give the forehead a firm push
If it is weak we need to activate

Reflexes for activation

There are 2 main areas for this to be most effective

First activation is on the sterno-clavicular joints
Second is at the Cervico-thoracic junction



When we lock or tense up the jaw, which is a common activity when stressed, it affects the 1
and 2 Vertebrae which dampens the neural activity throughout the body. It can also be felt
at the Gluts and will affect stride length.
Once we jaw bite the body becomes weak and will stay that way till we do something
about it.
Lock the jaw and walk
o Feel the tension throughout the body
o Decreased stride length
o Test the diaphragm reflex
o Touch toes and feel where you are tight, then open your mouth wide and
redo the move

Testing for the jaw

Open your jaw as wide as you can and see how many fingers you can get into it

Activating the jaw

Massage the masseter and pterygoids and work softly into any areas of increased
Then move up and massage the temporalis muscle looking for superficial fascial skin
Instruct your client to move the jaw from side to side for 30 seconds
Retest the jaw width with the fingers

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

Also re-check the hamstring and calf length to see if there is greater ROM (what
affects the top will affect the bottom)

Pelvic floor
Not to forget the necessity of the pelvic floor to assist in the
stability of the lower core and the correlation to lower back
pain; a group of tissues that include the long and broad

Testing for the pelvic floor

Instruct your client to do 5 pelvic floor contractions

Repeat on completion of activation for change

Activation for pelvic floor

Points found between S2 S4 on both sides of the

sacrum along the sacral/ilium ridge


The muscles involved within this system or sling include the Adductors, Gluteus Medius and
Minimus and the Quadratus Lumborum. Used for asymmetric weight bearing such as climbing
stairs and in the stance phase of gait this is 85% of the cycle.

Abductors and Adductors work together to

stabilize the hip.

The QL maintains pelvic height

SIJ joint instability can cause reflex shutting

down of the lateral system

Testing the lateral system

Client supine, abduct legs and ask

them to resist pushing them together
Client then adducts legs and you
attempt to pull them apart under resistance
Client holds the table and you
take both legs to the side and instruct
the client to resist you returning them
to the table
Repeat other side
If any test is weak then activate points

Activating the lateral sling

Points for activation lie over the iliac crest

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013


The transverse/rotation plan is responsible for backward rotational movements and stabilizes
the SIJ during gait.
Consists of the Glut max (and Piriformis) on one side and the Latissimus Dorsi on the
contralateral side, these are interconnected via the thoraco-lumbar fascia and act like a coiled
spring to conserve energy.

Piriformis and contralateral Lat stabilize the pelvic by co-contraction

If one isnt working efficiently then the other will under perform reciprocally
More dominant is the lat but symptoms appear most often in the Piriformis
Test the piriformis 1 then the lats strength/length
Treatment of the Lats tends to improve the piriformis length and abate the symptoms
ACTIONS of lats extends the flexed arm, adduction and medial rotation of the arm
ACTIONS of piriformis laterally rotates the hip joint

Testing the Piriformis-Lat looking for flexibility

Client bends their knee to 90 then pulls their ankle to the chin
Should be able to reach the chin on both sides
Assess length, pain, bilateral evenness
Test the lats by asking the client to internally rotate the straight arm and hold to the
side of the body
Ask them to hold it there and you pull outwards
If the piriformis on the left is the problem it is usually the lat on the right too

Activation of the posterior system


Front reflex is the most efficient and found between 7 & 8 ribs directly under the
Palpate the lower ribs and work up for this landmark (ie move 2 up)
Usually quite tender so go gently
Also points located between the 7 & 8 ribs approx 3cm lateral to the spine but less
Once activated re-check the Piriformis and Lat to test improvement

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013


Functional mobility of the shoulder and arm requires a stable and dynamic base from
the Tx spine.
When Tx tight especially into extension then the shoulder ROM is impaired and will
compensate for its ADL needs
Impacts T1 T4/5 therefore instigate neck and shoulder pain
First 165 is done from the shoulder joint and scapula
Last 15 from thoracic rotation (one arm) or thoracic extension (both arms)
Activating the anterior Tx area will allow for increased length, flexibility and function

Testing the Shoulder/Thoracic region

2 tests pending on shoulder ROM

Lack of full ROM is a + sign for treatment
Full extension requires muscle function testing
Keep the arms in full extension and ask the client
to resist you pulling up towards the ceiling
Do one arm at a time
Do the same test for the reduced ROM starting
at their end point

Activation of the Shoulder/Thoracic region

These points are located on the ribs below the Pectorals

Doing a general full rub of the entire area is the most effective way to stimulate these
Rub strongly with a flat hand or get the client to do it if its more appropriate
You can also use finger tips to dig in between ribs but do this with care as the area is
both ticklish and painful
Retest the range and function
This allows for any overhead activities to be easier to do, check also for spine alignment and
any head forward placement for improvement.

Lingering shoulder pain

Most often the pain is gone post the MAT

If its still there release the Levator Scapular
and Upper Trapezius via way of the
Infraspinatus Trigger Point

Testing the Trapezius/Levator Scapular

Supine the client flexes the arm to 90 and

adducts to point of stretch
Full range should be tissue approximation on
the chest without discomfort

Activation of the region

Neuro-lymphatic points

Side lying knead the Infraspinatus TrPoint

This is painful so do this sparingly
Retest the range and pain for change

Paula Nutting BHScMST

Copyright 2013

NHPC - Spring Conference Connect, Collaborate, Create Calgary May 2013

Tests for Supraspinatus and is heavily involved with the central meridian line in acupuncture.
When we are stressed we commonly roll the shoulder towards the midline which mimics the
defensive patterns.

Testing the Supraspinatus

Client lying supine with arm raised to 45 and held

You place your hand on the dorsum of the hand and ask them to resist you pushing
back towards the contralateral iliac crest
If the reflex points are inactive then strength will be limited

Activation of the Central line

There are 3 points for the activation of the Central Line

2 are massaged and 1 is a holding position
The first region is along the line of the armpit, if you start under the axilla and work up
to the AC joint then you should take on the Supraspinatus and the neck flexors and
The second region is between C2 and the occipital ridge encompassing both sides of
the spineous process
The last region is above the eyebrows in line with the frontal sinuses and even the
pressure can be quite tender.

After completing this sequencing for strength and function you should be able to effectively
assess, treat and give home programming for your clients. This treatment is very applicable to
the more stressed clients but you must show them the how and why this works so that they
can take ownership of their defensive sympathetic responses and manage the stress when
they acknowledge it.

Neuro-lymphatic points

Paula Nutting BHScMST

Copyright 2013