Koda Integrative Therapy Group

Therapeutic Massage and Health Partners for Recovery and Performance

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Physiotherapy vs. Neuromuscular Massage

Physiotherapy is a health profession concerned with helping to restore physical well-being to people who are suffering from an injury, pain or disability. Using knowledge from our extensive scientific and clinical background (Masters or Doctorate of Physical Therapy), and they are Chartered Physiotherapists or managed by a professional association. They can assess, diagnose and treat conditions and illnesses that affect people of all ages and social groups.

Chartered Physiotherapists, or Physical Therapists, use manual therapy including manipulation, mobilization and myofascial release as well as complementary modalities including electrotherapy and Medical Acupuncture & Dry Needling. In recent years pain management education and counselling techniques have also become integral in most treatment programs. The Chartered Physiotherapist also utilizes prescriptive exercise as a rehabilitative tool to help patients achieve their full potential. While traditionally, Physiotherapy and/or Physical Therapy was regarded as rehabilitative and mainly hospital-based, the profession has expanded greatly into other health care areas. 

Neuromuscular therapy (NMT) is a specialized form of manual therapy that integrates specific massage techniques, flexibility stretching and home care practices to eliminate the causes of neuromuscular pain. NMT theory explains how injury, trauma and other factors can destabilize nerve transmission, making the body vulnerable to pain and dysfunction.

Through neuromuscular therapy training, students learn to manipulate muscles, tendons and connective tissue to restore balance to the central nervous system.

Neuromuscular therapy examines five elements that cause pain: ischemia (lack of blood flow), trigger points (more about trigger point therapy), nerve compression, postural distortion and biomechanical (movement) dysfunction. During an initial session, neuromuscular therapists interview patients about their health history, current physical condition, lifestyle, and stress levels and devise a treatment plan that addresses their pain syndromes.

Using fingers, knuckles or elbows, neuromuscular therapists apply concentrated pressure on areas of pain until they reach a trigger point, usually a spot that’s extra tender or numb. At this point, they’ll begin a stronger, more localized massage to relax the muscle. Relaxing muscles in this way releases lactic acid, increasing blood and oxygen flow, which, in turn, enhances the function of joints, muscles and movement.

Although both are forms of manual therapy, and they deal with the soft tissue of the body - Neuromuscular therapists can be more preventative - since they may see clients with varying degrees of discomfort. The appointments can also be used in conjunction with many other types of treatment including chiropractic visits, acupuncture, physical therapy and orthopedic rehabilitation (post surgery).

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What is Neuromuscular Therapy or NMT

When people ask my ‘what type’ of modalities I specialize in – I usually say I’m a neuromuscular therapist. I prefer to use that title rather than massage therapist, because most people will respond with, ‘Oh, you’re a masseuse.’ Um, no! Because I do a lot more than relaxation massage and helping people de-stress (although I do that too). I am more of a pain management specialist.


What is neuromuscular therapy – it is the most effective type of massage therapy for muscle pain, and it is also called trigger point or myotherapy. The American Academy of Pain Management recognizes this form of massage therapy as an effective treatment for pain caused by soft tissue injury (such as a muscle strain), joint pain throughout the body, muscle tension, spasms and injury and/or surgical recovery or addressing trigger points.

Neuromuscular therapy consists of alternating levels of concentrated pressure on the areas of pain, tightness or muscle spasms. The massage therapy pressure is usually applied with the fingers, knuckles, or elbow at a consistent rate (ischemic pressure) on the spots chosen – until the muscle releases. The pressure may continue from 30 secs to several minutes.

Because Neuromuscular therapy is a specialized form of deep tissue massage digital pressure and friction are used to release areas of strain in the muscle for superficially and deep (think joint pain you can’t get rid of), and these areas of strain are called tender or trigger points and are the cause of muscular pain symptoms.

Trigger points are areas of hypersensitivity in a muscle caused by a continual firing of the signals to the muscle that do not allow it to relax between movement (either contraction or stretch).  These are small areas with the muscle in which there is a contracture of muscular tissue (think of a tiny grain of rice under a sheet).  Blood circulation and nutrients are lacking in that part of the muscle and therefore the muscle spindle is unable to relax.  Trigger points cause pain, fatigue and weakness in the muscle.  Trigger points also create a phenomenon called referral pain.

Referral pain caused by trigger points can exist in areas far from the trigger point – the best example of this Carpal Tunnel – because the source of the issue is generally in the neck, yet clients come in with pain in their wrist. Additional people suffer from sensations of pain, tingling, or numbness.  Examples of referral pain include: sciatica like symptoms (lower leg), lower back pain (from hips and thighs) and headaches (neck).

Neuromuscular therapy is used to treat many different soft tissue problems.  The following list is a small example of issues that may be helped by neuromuscular therapy:
Lower back pain, upper back pain, carpal tunnel like symptoms, sciatica like symptoms, hip pain, headaches, plantar fasciitis, calf cramps, tendonitis, knee pain, iliotibial band friction syndrome, jaw pain, tempomandibular joint pain (TMJ disorders).