Massage Therapy Journal Winter 2025

70 • Massage Therapy Journal

“We teach therapists

As Sarah Lashley, owner and director of Somavida Pain Relief Center and PNMT Clinic puts it: “PNMT is defined by creative problem-solving skills, not by adherence to a singular approach.” How Does PNMT Differ from Other Modalities? PNMT is different from neuromuscular therapy because neuromuscular therapy is often viewed as primarily trigger-point focused with an emphasis on structural symmetry. Nelson notes that while both of these are components of PNMT, PNMT also looks at other possible causes of dysfunction. “PNMT differs from traditional neuromuscular therapy and deep tissue massage in that when we see a postural asymmetry, first we ask is this a defense or a defect? We don’t just assume everything is a defect that needs to be fixed,” says Lashley. “We have assessments to help us investigate if this is a nerve issue, muscle issue, fascial issue or a combination of these. Then we approach the issue with our wide range of tools.” Nelson also points out that PNMT is much less physically demanding than much of deep tissue work. Because PNMT by its nature is hyper precise, the amount of force needed to engage the area being worked is much less than is required in deep tissue or other massage therapy approaches. The amount of pressure used in PNMT is not a one-size-fits-all approach. Instead, Nelson likens it to volume in music. “There is a time for intensity and a time for softness,” he says. The time for intensity or the time for softness is determined by asking the client direct questions during the session, including: • Am I in exactly the right place? • Am I doing it in a way that feels productive? • Does it feel more productive if I hold still or induce movement with pressure? These questions allow the client to choose the approach and dictate the amount of pressure being used. Nelson finds it important to note, however, that when a therapist finds themselves in exactly the right spot, no one ever asks for more pressure. “I tell my students that when a client states, ‘Well, maybe if you pressed harder,’ that is code for ‘you are in the wrong place.’”

how to review a multitude of possible neuromuscular reasons for any clinical complaint presented by the client, then how to

reason through the possible suspects without necessarily treating each one, which would be very inefficient,” says Douglas Nelson, founder of Precision Neuromuscular Therapy. “Each possible explanation might require a very different treatment approach, and the wisdom is in the choosing of which one and, most importantly, why. When plan A fails, and more often than not it does, therapists need multiple possible strategies.” This homing in on the neuromuscular reasons for a complaint is what gives PNMT its precision and provides therapists the ability to narrow down any possible sources of pain or discomfort. They can target those areas to achieve the best results using the best-suited techniques for a client.

Examining the position and movement of the scapula to discover its possible role in shoulder function.

Photos provided by Douglas Nelson

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