Neuromuscular therapy (NMT) is form of manual treatment for painful muscles or myofascial pain. Myofascial pain syndrome (MPS) treatment dates back to 70ies with original research of Janet Travel M.D. Recently myofascial therapy has been updated and integrated with fascial treatment due to variety new good quality research regarding the role of fascia in producing muscle and joint pain. The success of NMT is largely connected to the fact the biggest factor producing muscular pain is hypo perfusion of the muscle tissue (under saturation of muscle tissue with blood). Muscle pain syndromes occur because the muscle is forced to work under condition of ischemia (decreased blood supply). The vicious circle established by decreased blood supply (ischemia) leads to energy crisis which further leads to compression of small blood vessels and release of Ach (acetylcholine) which leads to development of trigger points (taut bands) in the muscle tissue.
Neuromuscular therapy works by application of varying degrees of pressure to palpable taut bands in the muscles. By quasistatic pressure to different parts of muscle pain recepxors can be inhibited by normalizing metabolism in the muscle with activation or facilitation of the muscle recepxors (muscle sensory organs). The hands of the neuromuscular therapist are trained to feel different terrain of muscle tissue and slowly eliminate muscular imbalances by precise manual pressure stretch like movements.
At NYDNRehab we have been providing different forms of neuromuscular therapy for fifteen years. Our approach is a combination of different neuromuscular and fascial techniques. We also enhanced our NMT by application of EPAT (Extracorporeal Pulse Activation Treatment) technology.
Neuromuscular therapy most effective for:
and a faulty diagnosis can make treatment a total waste of time.
Failure to accurately diagnose a condition in its early stages can lead
to chronic problems and sometimes devastating results.
Diagnostic musculoskeletal sonography (MSUS) provides the perfect tool for the rehab practitioner. Yet many doctors and physical therapists have no experience with MSUS, are unaware of its advantages, and have no idea how to use it as a diagnostic tool.
Below is a prime example of how ultrasound can take the guesswork out of diagnosis.Successful Treatment
A bad physical therapy experience is one of the primary causes of unnecessary surgery.
We have equipped our clinic with the latest research-grade technology to arrive at objective and accurate diagnoses, and to objectively measure our patients’ progress.
Most importantly, we are the only facility in the US where structural medical diagnosis is reflected in functional treatment, and vice versa.
In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.
Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.
The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.
Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup
Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)
Complete tear of rectus femoris
with large hematoma (blood)
Separation of muscle ends due to tear elicited
on dynamic sonography examination
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