Kathleen M. Murphy, LMT CNMT CMTPT
Practicing in Annapolis, Maryland

Conditions Treated

Neuromuscular and Trigger Point Therapy directly address hypertonicity in skeletal muscle and adhesions in related soft tissue; the primary aim is to improve muscle function, restore range-of-motion, and reduce related pain. These techniques are frequently used to treat conditions such as:

Tension-Type Headache and Migraine, which can be provoked or exacerbated by tension, neural entrapments, and trigger points in the upper back, neck, and cranial-facial muscles

TMJ-Related and Orofacial Pain, which can originate from muscle tension in the regions of the temporomandibular joint, face, and jaw, and can be referred into those regions by trigger points in the neck, face, and head

Rotator Cuff and Shoulder Pain, which can involve hypertonicity and trigger points in the middle and upper back and shoulder girdle muscles

Golfer's Elbow and Tennis/Climber's Elbow (medial and lateral epicondylitis, both inflammatory conditions of elbow tendons), which can be exacerbated by hypertonicity of the forearm flexor and extensor muscles as well as the triceps, and can be mimicked by referred pain from trigger points in various shoulder, arm, and forearm muscles

Muscular Back and Hip Pain, which can be provoked or exacerbated by postural back muscles, as well as local and referred pain from trigger points in the gluteal muscles and the hip flexors and rotators 

IT Band Pain and Restriction, which can result from hypertonicity in the Tensor Fascia Lata muscles, and also trigger points in the gluteal muscles and vastus lateralis, the large lateral quadriceps muscle directly beneath the IT Band

Muscular Leg Pain, which can originate from hypertonicity and trigger points in any of the many leg muscles --- quadriceps, hamstrings, adductors, calves, shins, and ankle stabilizing muscles

Muscular Nerve Entrapments, which can include:

  • Carpal Tunnel Syndrome-like symptoms in the forearms and wrists (from pressure of forearm muscles such as pronator teres and flexor digitorum superficialis on the median nerve)
  • Cubital Tunnel Syndrome-like symptoms in the elbows and forearms (from pressure of the forearm muscles flexor carpi ulnaris, flexor digitorum superficialis, and flexor digitorum profundus on the ulnar nerve)
  • Radial Tunnel Syndrome-like symptoms in the elbows and forearms (from pressure of the forearm muscles supinator and extensor carpi radialis brevis on the radial and posterior interosseus nerve)
  • Sciatica-like symptoms in the hips and legs (often from pressure of the piriformis muscle on the sciatic nerve)
  • referred pain patterns from trigger points in the arms, forearms, gluteals, and legs can also mimic these respective nerve entrapment symptoms

Complex Postural Distortions such as Upper Crossed Syndrome and Lower Crossed Syndrome (see below), which may result from chronic shortening and lengthening of pairs of muscular agonists and antagonists through patterns of routine and long-term ergonomic stress (such as computer use, commuting, or playing a musical instrument)

Please note that while these applications are supported by clinical evidence and research, as with all healthcare disciplines, individual outcomes cannot be guaranteed.


Janda's Crossed Syndromes

Upper Crossed Syndrome and Lower Crossed Syndrome are patterns of postural imbalance first described by Czech neurologist and physiatrist Vladimir Janda in the 1980s. Janda observed that tonic muscles (typically involved in flexion and posture) tend toward tightness, while phasic muscles (typically involved in extension and dynamic movement) tend toward weakness. Specifically, when tonic muscles become chronically shortened, they neurologically inhibit their phasic antagonists. In the words of Anatomy Trains author Tom Myers, tonic muscles can become "locked short," while phasic muscles can become "locked long."

Janda proposed that these patterns of muscle imbalance are both functional and structural in nature --- they can originate from the nervous system in an effort to protect a compromised or malpositioned joint, and they can develop through a history of muscular injury, strain, or fatigue. When operating under chronic stress, both tonic and phasic muscles are prone to the development of myofascial trigger points.

Janda's imbalance patterns should not be interpreted as absolute blueprints for postural dysfunction (posture is reasonably fluid, and individual biomechanics can vary quite a bit). However, these patterns do present frequently in cases of chronic myofascial pain, and are often associated with forward head position and internally rotated shoulders ("computer hunch") or an anteriorally rotated pelvis ("sway back"). Most importantly, when considered within the context of a client's individual history and personal pain patterns and mobility issues, they can offer clues to relationships between functional and dysfunctional groups of muscles. It is rare for any one muscle to be painful, hypertonic, or weak in isolation.






For more information on Dr. Vladimir Janda and his work, see The Janda Approach website.


Associated Bodywork & Massage Professionals
© Copyright 2020 Kathleen M. Murphy, LMT CNMT CMTPT. All rights reserved.