What is Neuromuscular Therapy?

This past week was an exciting week for me, as I officially became certified in neuromuscular therapy. All massage therapists have some knowledge of neuromuscular therapy and how to perform this modality, but certified neuromuscular therapists have specific knowledge of muscle tissues and what causes different restrictions in those tissues.

Because this type of therapy is new to me and many of my clients, I wanted to write a blog post this week explaining what it is, when it’s needed, and how it differs from other modalities.




Neuromuscular therapy addresses a type of muscle restriction known as a trigger point. According to Sean Riehl in the Neuromuscular Therapy & Advanced Deep Tissue manual, “Trigger points (TPs) are areas of hyper-irritable tissues that send so many signals to the spinal cord that it becomes overwhelmed. These irritated tissues (TPs) cause the person to feel that their pain is coming from somewhere else.” In other words trigger point is a kind of muscle knot that transfers pain to a different area of the body. For example, trigger points in the bicep muscle of the arms send pain into the anterior shoulder and elbow joint. TPs can feel like pain, stinging, burning, cold or grabbing.

A trigger point is formed when a muscle becomes chronically tense. The muscle becomes inflamed because the tension has restricted blood flow for too long, meaning that the muscle is not getting the proper supply of oxygen and nutrients, and bodily acids are not moving along from the tissue. The resulting inflammation causes over irritation to the nerve cells, causing them to become hyper-irritable.

Neuromuscular therapists know where TPs in most muscles refer pain, and where to work to diminish this pain. The format of a neuromuscular massage session consists of range of motion or resistance testing, working over the believed area of concern (multiple areas can refer pain to the same point), and retesting. If applied correctly, neuromuscular therapy can diminish this pain in as little as 30 seconds.



Image by Salus Massage showing referral patterns in the back.

Of course, if the root of the problem is not also taken care of, the pain will come back. It will take multiple sessions to completely rid the client of pain. I could write an entire blog on why this is, but for now I will just say that it takes years for pain to accumulate, so it’s unreasonable to expect it to completely disappear after one massage.

Besides diminishing pain, neuromuscular therapy can increase range of motion, muscular strength and definition, and limberness. This type of therapy, contrary to popular belief, does not need to be painful. In fact, a painful massage is counterproductive to the goal of the session.

Neuromuscular therapy differs from other modalities in that it is a different, more effective way to address pain. The therapist has a more advanced understanding of the tissues, and the work is more specific. It is not for everyone, though, as different pathologies make the pressure applied too painful or dangerous for the client. If you’re not sure if this modality is right for you, just ask!



Riehl, Sean. Neuromuscular Therapy & Advanced Deep Tissue. Real Bodywork, 2002. Print.


About Tonya Sapiel, LMT

My goal with The Wellness Seeker blog is to educate the general public on the benefits of massage therapy, why it is an important addition to their health care routine, and what they can do to help themselves in between their massage therapy sessions. I welcome feedback and questions. I also accept requests for post topics. For more information about me or my practice, please visit www.tonyasapiel.massagetherapy.com

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