Would you like to learn more about the practice of neuromuscular therapy? Have you ever heard of neuromuscular therapy? Neuromuscular therapy also known as NMT is hands-on soft tissue manipulation that helps properly align and improve function of the human body. While there are additional benefits, some NMT applications include client evaluations and much more. Here’s and example:
Kyphoscoliosis is a combination of two different medical conditions that create a three-dimensional deformity of the human vertebral spine:
- Kyphosis is an excessive forward or anterior curvature in the upper thoracic spine.
- Scoliosis is an excessive lateral or sideways curvature of the spine, which would always affects multiple areas of the spine.
In neuromuscular therapy appointments, clients should complete a written client intake form or health history prior to hands-on bodywork. The client’s goals for their treatment should also be included during this client intake period, with reasonable goals set and mutually agreed.
After a provider has the client’s medical diagnoses in writing, they should then evaluate a client’s posture amongst other evaluation techniques to provide proper hands-on neuromuscular therapy treatment. Hopefully, if you ever see an individual similar to the one pictured here, they would already have a kyphoscoliosis diagnosis so that a provider could easily communicate with the client about their medical condition.
When a practitioner is not qualified to create a diagnosis within their licensed scope of practice, then they would not be able to diagnose or tell this individual that they have kyphoscoliosis. Instead, someone such as a massage therapist (LMT), physical therapist assistant (PTA) and others who cannot legally diagnose medical conditions would need to make a medical referral to a doctor for a proper diagnosis, if or when the client is unaware of their medical condition.
Kyphoscoliosis (or any spinal deformity) becomes easier to treat once a medical diagnosis has been made. While working various spinal deformities are covered in our neuromuscular therapy courses, we are showing this example here for one obvious reason. Do you see the shoulder bag on this individual’s depressed shoulder? If you had a kyphoscoliosis client like this, which shoulder would you recommend they carry their shoulder bag?
The answer is this kyphoscoliosis client should be carrying their shoulder bag on their elevated left shoulder. Their left shoulder is elevated while their right shoulder is depressed. That creates a lateral curvature of spine which is known as scoliosis, and almost always results with uneven shoulders and/or pelvis. Your goal would be to try to even the two sides of the vertebral spine to bring them anatomically level to one another. So, while hands-on techniques such as myofascial release, trigger point therapy, deep tissue bodywork or massage therapy could help improve a client’s anatomical position, it would be difficult to maintain any improvements if a kyphoscoliosis individual spends their days walking around like this.
This is why it is critical in neuromuscular therapy appointments to review the client’s activities of daily living, workplace ergonomics, everyday lifestyle habits and more. This can help you determine if they are doing something that could be harmful to their progress after they leave your treatment room. Then practitioners can address harmful activities to help prevent a client’s continued digression. Otherwise, a client might not feel that your therapy is effective or helpful when they do not achieve desired results.
Attempting to correct long term spinal deformities is extremely difficult. It is practically impossible to achieve structural improvement in cases such as structural scoliosis. Functional scoliosis would prove easier to treat. Each individual and spinal deformity would have a different degree of difficulty or possibility. A client’s activity outside of your treatment is just as important as the therapy provided inside of it.
If a client with a vertebral spinal deformity is in pain, then pain relief would be an obvious treatment goal. However, treating the root cause of the pain would create longer lasting results which is why in this case here, we would want to try to even the shoulders into normal anatomical position, if or when possible. This could take years without 100% success. In this individual’s case, we would consider any postural improvement to be a success and continued digression a possible failure. Keep in mind that it is difficult in neuromuscular therapy treatments to determine when there is failure because the treatment could have slowed or minimized the client’s digression, and it would be hard to tell otherwise. One indicator of success versus failure would be if a client terminated their neuromuscular therapy and then rapidly digressed worse than what was happening during treatment, then you’d both know your past treatment(s) were quite successful.
When providing neuromuscular therapy, if we learned our client was walking around with a shoulder bag on their depressed shoulder, we would want to immediately suggest to swap the bag onto their elevated left shoulder, or to not carry anything on their uneven shoulders at all. We would educate the client that hanging weight on their depressed shoulder could create further depression and deformity, and work against shared treatment goals in neuromuscular therapy. Although we do need to be a bit careful when making these recommendations because of our licensed scope of practice. If the client wants greater lifestyle direction beyond a few tips, practitioners such as LMTs and non-autonomous nurses and the like should refer the client to the proper professional who can address any lifestyle improvements to be made as part of their licensed scope of practice. There are specialty practices that can provide this educated direction.
We hope this visual and written explanation helps define what neuromuscular therapy practice could be for you, beyond the hands-on work itself. To learn more as a licensed healthcare practitioner who is capable of performing evaluations and soft tissue manipulation, please visit and register for our neuromuscular therapy training at: https://ceinstitute.com/collections/neuromuscular
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