The
Roots and Branches of Neuromuscular Therapy
by Judith (Walker) DeLany, LMT
by Judith (Walker) DeLany, LMT
|
The
Roots and Branches of Neuromuscular Therapy
by Judith (Walker) DeLany, LMT |
(This article first appeared in AMTA Florida, Number 11, Autumn 1999. Reprinted by permission, and with minor revisions.)
During the last sixty years, neuromuscular therapy (NMT) has emerged as a significant methodology for assessing, treating and preventing soft tissue injuries and chronic pain. NMT, a series of treatment protocols based on the practitioner's skill, anatomy knowledge and precise palpatory application, has found its home, not only in the treatment rooms of massage therapy, but also in occupational therapy, physical therapy, nursing, dentistry, chiropractic, osteopathic and physical medicine clinics worldwide. With a foothold planted in both holistic and traditional medicine, its future is solidly founded and holds much promise. To understand more about where this magnificent methodology is headed, a look at its past (both in America and in Europe) is in order.
European and American NMT Cross Paths
The Roots of Modern NMT
Neuromuscular therapy techniques emerged in both Europe and North America, almost simultaneously over the last half-century. It is interesting to note that the early developers knew little, if anything, about each other, yet the theoretical basis of all the modern protocols are similar since they are each rooted soundly in physiological principles.
European Version
Between the mid-1930s and early 1940's, European-style neuromuscular techniques (as NMT is called in Europe) first emerged, developed by the skillful hands of Stanley Lief and Boris Chaitow. These cousins, trained in chiropractic and naturopathy, studied with teachers like Dewanchand Varma and Bernard Macfadden and integrated solid concepts of assessment and treatment steps for soft tissue dysfunction. Their practice of NMT was set in Lief's world-famous health resort, Champneys, at Tring in Hertfordshire, England where they were presented with a wide variety of conditions on which to test their theories and methods. Many osteopaths and naturopaths, including Peter Lief, Brian Youngs, Terry Moule, Leon Chaitow and others, have taken part in the evolution and development of European neuromuscular techniques. NMT, now taught widely in osteopathic and sports massage settings in Britain, forms an elective module on the Bachelor of Science (BSc(Hons)) degree courses in Complementary Health Sciences at the University of Westminster, London, a program developed (in part) by Leon Chaitow, DO.
American Version
A few years after neuromuscular techniques emerged in Europe, across the ocean in America, Raymond Nimmo and James Vannerson first published their newsletter, Receptor Tonus Techniques, where they wrote of their experiences with what they termed 'noxious nodules'. Over the next several decades, a step-by-step system began to emerge, supported by the writings of Janet Travell M.D. and David Simons M.D.. Travell and Simons' two volume set of textbooks, Myofascial Pain and Dysfunction: The Trigger Point Manual (upper body published in 1983, lower body in 1992) impacted the medical, dental, massage and other therapeutic communities with documentation, research and references for a whole new field of study - myofascial trigger points.
Eventually, several of Nimmo's students began teaching their own treatment protocols, based on Nimmo's work. Among Nimmo's students was Paul St. John, who began teaching his own system in the late 70's. In the mid-1980's, Judith (Walker) DeLany became St. John's first additional instructor of his method of neuromuscular therapy. DeLany (then Judith Walker) worked with St. John for five years (1984-89), where she assisted in the development of NMT techniques and protocols for massage therapy application. In 1989, the two separated the work into two styles - NMT St. John Method and NMT American Version. Both systems still retain a strong focus on Nimmo's original material, although both developers have significantly influenced their own particular methodology with unique insights and new techniques.
European and American NMT Cross Paths
European and American versions of NMT have a similar theoretical platform yet subtle differences developed in their hands-on applications. In the exploration to uncover contracted bands or muscular nodules, American-style neuromuscular therapy uses a medium-paced (thumb or finger) gliding strokes whereas European-style neuromuscular techniques use a slow-paced, thumb-drag method of discovery. They also have slightly different emphasis on the method of application of ischemic compression when treating trigger points. Both versions emphasize the need to develop a home-care program and encourage the patient's participation in the recovery process.
In 1996, a landmark event for American NMT occurred when the American version of NMT was overviewed in Leon Chaitow's Modern Neuromuscular Techniques, as contributed by Judith DeLany. This significant text was the first to offer both the European and American methods within the same volume. The following year the publishers of Chaitow's text, Churchill Livingstone Publishers (subsidiary of Harcourt Publishing), invited Chaitow and DeLany as well as athletic trainer Benny Vaughn and chiropractor/author Craig Liebenson to design the first peer reviewed journal in the field of bodywork, Journal of Bodywork and Movement Therapies. JBMT has proven to be a tremendously resourceful multidisciplinary publication with a strong interest in neuromuscular therapy. Its articles focus on the clinical application of all forms of soft tissue therapies and the integration of multiple disciplines of health care.
NMT- American Version Today
In late 1998, a new edition of Travell and Simon's classic text, Myofascial Pain and Dysfunction, The Trigger Point Manual, (Vol. 1 Upper Half of Body), presented substantial breakthroughs in theories and application, which altered neuromuscular therapy once again. On June 12, 1999, Judith (Walker) DeLany first presented the integration of the new trigger point theories as they apply to the practice of NMT and other manual modalities. This conference, Advances in NMT - New Theories and Methods, provides the practitioner an overview of the Travell/Simons volume as well as a new emphasis on lymphatic drainage (based on study with Bruno Chikly, MD) and on respiratory function (based on DeLany's current writings with Leon Chaitow, DO). In 2000, Chaitow and DeLany's integrated textbook, Clinical Application of Neuromuscular Techniques, Vol. 1- The Upper Body, was published by Harcourt International Publishing and has now substantially altered NMT's foundation and future. This text features NMT American versionTM and integrates it with the European version as well as positional release techniques, muscles energy techniques, regional anatomy, and substantial discussions of the physiology of the development of dysfunction in soft tissues. Its tremendous success reflects the value of combining the vast knowledge of these two authors as well as integrated protocols for application of their hands-on techniques. The second volume regarding the lower body is schedule to be released in early summer of 2002.
Says DeLany, "Teachers are students first and foremost. The ability to pass on what one has learned while retaining an enthusiasm for the subject is often based on the excitement of integrating new material. When a mass of new material emerges, particularly from several sources, the pure ecstasy of integrating and synthesizing its impact produces a joy exceeded by very few other experiences in the work.
The teacher should never lose sight of being a student herself and also a peer with the audience members. When these elements are lost, it is merely a lecture that transpires. When they are remembered, what presents itself is true sharing, contagious enthusiasm and a wonderful learning experience for all concerned, including the teacher."
©2008 NMT CENTER