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Neuromuscular Massage

Advanced body mechanics

Neuromuscular means nerve-muscle. This is a type of massage which has been developed by Western osteopaths and masseurs, mostly in the USA. Basically it is a form of deep massage which is intended to reach nerves, ligaments, tendons, and other connective tissue not normally reached by soft-tissue massage and its practice is not widely known.

Like most methods of deep massage, neuromuscular massage is performed with the pads of the thumbs and/or fingers. A certain amount of pressure is required - as a general rule not more than 10 lb, although 30 lb or more may occasionally be used by experienced masseurs. (The pressure exerted may be tested out by pressing with thumb or finger on your bathroom scales.) Several movements are used, the most usual being a circular movement. The thumb or finger is placed on the skin, and then performs small circles, moving over the underlying tissues but keeping contact with the same area of skin. This is very good for medium-depth massage, and useful when giving a general massage or when very deep massage is not desirable. For deeper penetration a sawing type of movement is used. While pressure is maintained, move the thumb or finger backwards and forwards along the same line, again keeping contact with the same area of skin.'Sawing' is a very deep movement, and is often painful, although this also depends on the amount of pressure exerted. Do not use it for more than twenty seconds on the same area, or for more than a total of ten minutes in one massage session. It can also cause slight bruising. This is sometimes inevitable, and some people bruise very easily, but it should be avoided where possible.

The third movement is not really a movement, merely a downward pressure. It is almost as deep as sawing, but not so painful, and can be used more freely. As in the other movements the amount of pressure should be geared to -the pain response: a certain amount of discomfort is expected, but never intense pain.When doing any form of massage which requires pressure it is usually easier to use the thumbs, since they are stronger than the fingers, and can withstand more pressure for a longer time. On the other hand you may find it less of a strain to alternate between thumbs and fingers. It is also much easier to use your body-weight - by keeping your arm straight, and leaning over the patient than it is to apply pressure using your hand and arm muscles alone. This may feel strange at first, but in the end is much less tiring.

By massaging the area immediately to either side of the spine one can give a massage which is stimulating and relaxing at the same time. The result is that the patient feels much more relaxed, while at the same time his whole body, including the internal organs, has been toned up. This happens because the nerves which are massaged constitute the nerve supply to the whole body (except for the head which is supplied by the cranial nerves). This does not mean that spinal massage makes further massage unnecessary, but it does make the spine the most important area in the body for deep massage.

There are two ways in which you can use the diagram of spinal nerve roots.Firstly, if you know that a certain area or organ needs treating, you should devote more time to massaging the corresponding spinal nerves. By doing this you stimulate the nerve supply to that area, which then receives more energy, thus stimulating cell renewal, relieving congestion, and so on. If you find the spinal area painful you can be sure it needs massage. Secondly, by massaging the whole spinal area, you will find certain spots which are particularly painful.These areas need special attention, and care for deep massage: they may also - though not necessarily indicate trouble in the organs supplied by those nerves. The area we are concerned with lies between the spine, and the ridge of muscle lying an inch or so to the side of it. This 'gutter' is, very conveniently, just wide enough for the thumb. You can use any of the three movements described above - circling, sawing, or pressing - and work on both sides of the spine at once, or do them one at a time, working upwards or downwards as you prefer.

Neuromuscular massage is very useful for sprained joints, strained muscles, muscular tension, or spasm, and sundry related problems. It can also be used to stimulate nerves as described above, and so may lend itself to a wide variety of complaints as an 'auxiliary therapy. Much of this type of massage is done on the origins and insertions of muscles. It is interesting to note that these points sometimes correspond exactly with acupuncture points. All muscles, except for a few on the face, are attached to bone at either end. The attachment takes the form of a bundle of white tissue which we call a tendon. Some tendons are extremely short, while some are several inches long. The points of attachment are called the origins and insertions. The origin is the more fixed point, and the insertion is on the bone which the muscle moves. The origin of the calf muscle, for example, is at the knee, while the insertion is at the heel; the origin of the biceps is at the shoulder, and the insertion is at the elbow.

Massage on the origins and insertions (0. and I. massage) has a stimulating (yang) effect. If a muscle is a tonic (too relaxed, too yin) 0. and 1. massage will have a tonic effect, and so help to restore normality. This type of massage also helps to prevent the wasting of muscles; it stimulates cell regeneration, and helps to keep the blood and nerve supplies to the muscle healthy. If you want to know what neuromuscular massage feels like try massaging the area where the back of the neck meets the skull, getting your thumbs under the ridge of bone you will feel there. This area is painful in most people, especially towards the outside. Use enough pressure to make it hurt, though not unbearably. As well as massaging the insertions of twelve muscles you are massaging seven acupuncture points. Massage of this area helps to relax the head and neck, and is very good for headaches, which are often related to congestion and tension at the back of the neck.

If a muscle is too tense (too yang) and massage does not increase the muscle tension, it may even help to normalise the condition. There is also a method for treating muscle spasm, which is to press on the centre or belly of the muscle.  The result is an expansive, relaxing, yin effect. Pressure should be exerted for about one minute, without any movement. Make sure you are on the centre of the muscle. Most people's spines need neuromuscular massage. Because we wear shoes, walk on concrete, sit badly, and so on, our backs usually suffer in time. Bone manipulation may be necessary, but in the majority of cases several treatments of neuromuscular massage are sufficient to correct any problem which is not serious. On the other hand manipulation which is performed without also giving deep massage often fails to correct the problem, which involves ligaments and muscles as much as bones. The result is that an endless series of manipulations are given, with only a slight improvement to show for it. On most backs you will find small knots of tension muscle spasm - next to the spine. Sometimes they are so obvious you can see them quite clearly. These are the spots that need pressure, and they are always painful. Quite often you will hear a small click as the bone readjusts itself without any forceful manipulation being used.

Neuromuscular massage is not something you should attempt without some form of training in massage. It requires the exertion of quiet heavy pressure and you might hurt someone through lack of practical knowledge.

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