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TheRootsandBranchesofNeuromuscularTherapy

byJudith(Walker)DeLany,LMT

(ThisarticlefirstappearedinAMTAFlorida,Autumn1999.Reprintedbypermission,andwithminorrevisions.)

Duringthelastseveraldecades,neuromusculartherapy(NMT)hasemergedasasignificantmethodforassessing,treatingandpreventingsofttissueinjuriesandchronicpain.NMTis
composedofaseriesofmanualtreatmentprotocolsbasedonthepractitionersskill,anatomyknowledgeandprecisionduringpalpation.Ithasfounditshome,notonlyinthetreatment
roomsofmassagetherapy,butalsoinphysicalandoccupationaltherapy,nursing,chiropractic,osteopathicandphysicalmedicineclinicsworldwide.Withapositionfirmlyanchoredin
complementary,integrativeandtraditionalmedicine,itsfutureholdsmuchpromise.Alookatitspast,presentandfutureisworthwhile.

TheRootsofModernNMT

EuropeanVersion

AmericanVersion

EuropeanandAmericanNMTCrossPaths

NMTAmericanVersionToday

TheRootsofModernNMT
NeuromusculartherapytechniquesemergedinbothEuropeandNorthAmerica,almostsimultaneously,overthelasthalfcentury.Itisinterestingtonotethattheearliestdevelopersknew
little,ifanything,abouteachother,yetthetheoreticalbasisofallthemodernNMTprotocolsaresimilar.Thisismostlikelybecausetheyareeachrootedsoundlyinphysiological
principles.

Backtotop

EuropeanVersion

Betweenthemid1930sandearly1940s,Europeanstyleneuromusculartechniques(asNMTiscalledinEurope)firstemerged,developedbytheskillfulhandsofStanleyLiefandBoris
Chaitow.Thesecousins,trainedinchiropracticandnaturopathy,studiedwithteacherslikeDewanchandVarmaandBernardMacfaddenandintegratedsolidconceptsofassessmentand
treatmentstepsforsofttissuedysfunction.TheirpracticeofNMTwassetinLiefsworldfamoushealthresort,Champneys,atTringinHertfordshire,Englandwheretheywerepresented
withawidevarietyofconditionsonwhichtotesttheirtheoriesandmethods.

Manyosteopaths,naturopathsandpractitionersfromotherfields,includingPeterLief,BrianYoungs,TerryMoule,LeonChaitow(nephewofBoris),JohnSharkeyandothers,havetaken
partintheevolutionanddevelopmentofEuropeanneuromusculartechniques.Inthe1990saprogramdeveloped(inpart)byLeonChaitow,DOformedanelectivemoduleaspartofa
BachelorofScience(BSc(Hons))degreeattheComplementaryHealthSciencesattheUniversityofWestminster,London.Althoughthiswasthefirstundergraduatedegreesettingto
includeNMT,itisnowcommonlytaughtinosteopathicandsportsmassagesettingsinBritain.LeonChaitowhasalsomadesignificantcontributionsastheauthorofdozensofbooks
andtextbooksthatfeaturedetailedapplicationofNMT,particularlytheEuropeanversion.

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AmericanVersion

AfewyearsafterneuromusculartechniquesfirstemergedinEurope,acrosstheoceaninAmerica,RaymondNimmoandJamesVannersonpublishedtheirnewsletter,ReceptorTonus
Techniques,wheretheywroteoftheirexperienceswithwhattheytermednoxiousnodules.Overthenextseveraldecades,astepbystepsystembegantoemerge,supportedbythe
writingsofJanetTravellandDavidSimons.TravellandSimonstwovolumesetoftextbooks,MyofascialPainandDysfunction:TheTriggerPointManual(upperbodypublishedin1983
andlowerbodyin1992)impactedthemedical,dental,physicaltherapy,massageandothertherapeuticcommunitieswithdocumentation,researchandreferencesforawholenewfieldof
studymyofascialtriggerpoints.

Eventually,severalofNimmosstudentsbeganteachingtheirowntreatmentprotocols,basedonNimmoswork.AmongthemwasPaulSt.John,whobeganteachinghisownsystemin
thelate70s.Inthemid1980s,Judith(Walker)DeLanybecameSt.Johnsfirstadditionalinstructorofhismethodofneuromusculartherapy.DeLany(thenJudithWalker)workedwith
St.Johnforfiveyears(198489),wheresheassistedinthedevelopmentofNMTtechniquesandprotocolsformassagetherapyapplication.

In1989,St.JohnandDeLanyseparatedtheirworkintotwostyles,NMTSt.JohnMethodandNMTAmericanversion,respectively.BothsystemsretainedastrongfocusonNimmo's
originalprotocols,althougheachdevelopersignificantlyinfluencedhisorherownparticularfoundationsandteachingmethodologywithuniqueinsightsandnewtechniques.DeLany
continuestoteachtheNMTAmericanversion,whichhasevolvedsignificantly,asdiscussedbelow.St.JohneventuallysoldNMTSt.Johnmethodandseminarstoanewowner.
Althoughthenewownernolongerteachesthemethod,manySt.JohncertifiedNMTscontinuetouseitasthefoundationoftheirwork.

Inthemid1990s,NMTAmericanversionwaspilotedasaschoolprogram,taughtwithinthecurriculumofthreemassageschoolsanddeliveredbyschoolinstructors.Itwas
immediatelyrecognizedthattheschoolformatallowedforaslowerpacefortheprogram,morecontinualaccesstotheinstructorsandmorerepetitionoftheprotocolsthantheseminar
format,whichallowedstudentstograduatewithclinicalskillsforintegrationintoalmostanyhealthcaresetting.Withtwodecadesofsuccessinavarietyofschoolsacrossthecountry
aswellasincoasttocoastseminartrainings,NMTAmericanversiongrewtobeawellestablishedmethodforaddressingmyofascialpainanddysfunction.
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EuropeanandAmericanNMTCrossPaths

EuropeanandAmericanversionsofNMThavesimilartheoreticalplatforms,yetsubtledifferencesdevelopedwithintheirhandsonapplication.Intheexplorationtouncovercontracted
bandsormuscularnodules,Americanstyleneuromusculartherapyusesamediumpaced(thumborfinger)glidingstrokewhereasEuropeanstyleneuromusculartechniquesuseaslow
paced,thumbdragmethodofdiscovery.Theyalsohaveaslightlydifferentemphasisonthemethodofapplicationofischemiccompressionwhentreatingtriggerpoints.Bothversions
emphasizetheneedtodevelopahomecareprogramandencouragetheclient'sparticipationintherecoveryprocess.

In1996,alandmarkeventforAmericanNMToccurredwhenNMTAmericanversionwasoverviewedinLeonChaitow'sModernNeuromuscularTechniques,ascontributedbyJudith
DeLany.ThissignificanttextwasthefirsttoofferboththeEuropeanandAmericanmethodswithinthesamevolume.AlthoughthiswasonlyabriefchaptercontributionfortheAmerican
version,itdidofferinternationalexposureforDeLanysworkthatledtoabroadfuture.

ChaitowandDeLany,aswellasinternationallyknownathletictrainerBennyVaughnandchiropractor/authorCraigLiebenson,formedtheeditorialteamforthefirstpeerreviewedjournalin
thefieldofbodywork,JournalofBodyworkandMovementTherapies.ThefirstissueofJBMTwaspublishedinOctober1996and,withfourissueseachyearforalmosttwodecades,
hasproventobeatremendouslyresourcefulmultidisciplinarypublicationwithastrongpresenceofallmanualmodalities.Itsarticlesfocusstronglyontheclinicalapplicationofallforms
ofsofttissuetherapiesandtheintegrationofmultipledisciplinesofhealthcare.

ShortlyafterJBMTemerged,ChaitowandDelanypublishedthefirstdefinitiveacademictextbooksonNMT,integratingtheAmericanandEuropeanversions.ClinicalApplicationof
NeuromuscularTechniques,Vols.1&2(laterpublishedassecondeditions),withaccompanyingstudyguide,establishedahighstandardofacademicexcellenceforNMT.Amoderate
degreeofintegrationofthetwomethodswasachievedthroughtheauthors'discussions,debatesanddeterminationtoweavetogethermaterialfromosteopathyandmassagetherapy,
whilealsoretainingeachmethod'sindividualidentity.

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NMTAmericanVersionToday

In1999,asecondeditionofTravellandSimon'sclassic1983text,MyofascialPainandDysfunction,TheTriggerPointManual,(Vol.1UpperHalfofBody),waspublished.Itpresented
substantialnewideasinthetheoriesoftriggerpointformationaswellasinapplicationstotreatthem,alteringtheplatformofNMTonceagain.Ithadbeenfifteenyearssincethefirst
editionwaspublishedandvoluminousresearchhadbeenconductedworldwidetosubstantiateanddebatethetheoriesthatSimons,TravellandSimons(alongwithcontributorsandan
editorialteam)presentedintheirsecondedition.Evendecadeslater,TheTriggerPointManualsarestillconsideredbymanytobethegoldstandardintriggerpointtreatmentprotocols.It
includesasubstantialemphasisonmassagetherapyapplicationsandothermanualtechniques,andemphasizestheurgentneedforacademicresearchandcontinualrevisionof
foundationalbeliefsabouttriggerpointsandmyofascialpain.

TheadoptionofSimonsetal'sintegratedhypothesisbyChaitowandDeLanywasthefirstmajorchangeintriggerpointconceptsinbothEuropeanandAmericanNMTindecades.In
recentyears,newtheoriesaswellasresearchevidenceregardingtriggerpointsandfasciahasemerged,insuringthatthefoundationalplatformofNMTremaininaneverevolvingstate.

Shortlyaftertheturnofthe21stcentury,NMTreceivedasignificantspotlightwhenJohnSharkeyandstaffattheNationalTrainingCentreinDublin,IrelanddevelopedaNMTHigher
Diploma(NMTHDip)programdesignedforseriouspractitionerswhowantedtoacquireadvancedknowledgeandabroadcollectionofskills.Theprogramisopentomanualtherapists
alreadyinpractice,includesapproximately14weekendsoftrainingspreadover21/2years,andprovidesexpertinstructorsfromacrosstheglobetobuildacomprehensiveapproachto
clinicalpractice.TheHDipprogramteachesbothEuropeanandAmericanNMTphilosophiesandtechniques,muchofwhichisdeliveredbyLeonChaitow,JudithDeLany,andJohn
Sharkeyaswellastrustedmembersoftheirteachingstaff.
In2013,aMaster'sdegreeprograminNMT,associatedwiththeUniversityofChester,wasofferedforthefirsttime.SpearheadedbyJohnSharkey,thisprogramwasimplementedwith
thehigheststandardsofprofessionallyrecognizededucationwithanaimtograduateadiverserangeofskilledpractitionerswhocaneffectivelyandethicallytreatoffascia,myofascial
triggerpoints,acuteinjuriesandchronicpain.Theprogramaimstoenabletheparticipantstodevelopcompetenceandconfidenceinallaspectsofprofessionalpracticebyencouraging
autonomyandcriticalityinthinkingandaction.

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Regardingeducationandcontinuallearning,JudithDeLanynotes,

Teachersarestudentsfirstandforemost.Theabilitytopassonwhatonehaslearnedwhileretaininganenthusiasmforthesubjectisoftenbased
ontheexcitementofintegratingnewmaterial.Theteachershouldneverlosesightofbeingastudentherselfandalsoapeerwiththeaudience
members.Whentheseelementsarelost,itismerelyalecturethattranspires.Whentheyareremembered,whatpresentsitselfistruesharing,
contagiousenthusiasm,andawonderfullearningexperienceforallconcerned,includingtheteacher

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