What is NOMPT?

Neuro-Orthopedic Manual Physical Therapy (NOMPT)

What happens when you give a Physical Therapy license to a medically-trained PhD Neuroscientist?

You get a revolutionary blend of cutting-edge neuroscience with the best hands-on physical therapy imaginable.

You get the most effective non-invasive treatment for pain, injuries, and movement problems.

You get NOMPT.

NOMPT is pure science at work on the human body. It is a holistic, no-nonsense, research-based approach to physical therapy. Through tried and true manual therapy techniques, NOMPT restores the neuromuscular reflexes that control our movement. With NMT treatment, body alignment is corrected, joints move freely, muscle balance is restored, and pain is eliminated.

Treating symptoms is just a band-aid. But with NMT, the real problem is addressed, so true healing can take place.

Neuromuscular reflexes

When was the last time you consciously told your hip muscles to tighten when you take a step?  Or the muscles along your spine to contract when you stand up straight?  Or the muscles in your calf and thigh to tighten so your knee doesn’t buckle?

Probably never.  We have the amazing ability to walk, talk, and chew gum at the same time.  Why?  Because most of our movements are reflexive.  You don’t think about all the motions of your arms, legs, and trunk when you walk.  Your brain just gives the command “WALK.” And you walk!

Well, sometimes the commands from the brain become confused.  The neural signals that control complex movements depend on feedback from muscles (and other systems too).  The muscular feedback comes from muscle stretch, which is monitored by “stretch receptors” (AKA “muscle spindle fibers”).

The brain “reads” information from muscle stretch receptors and uses that information to activate other muscles.  But, if the muscle being monitored becomes tight or injured, the information to the brain becomes scrambled, and the other muscles do not get activated normally.

For example, a tight soleus muscle in the calf results in “weak” (inhibited) hip extensor muscles (watch a video here). The soleus/hip extensor relationship is so powerful that the hip can lose 80-90% of it’s extension strength when the calf is tight.  Research has shown that dozens of these patterns exist.  And many of them are so important clinically, that when stretch reflexes become inhibited, a variety of painful conditions result.

Dysfunction of the stretch reflexes is the root cause of most body pain, inflexibility, weakness, joint degeneration, and biomechanical stress. Many painful conditions like plantar fasciitis, achilles tendonitis, knee pain, shin splints, IT Band syndrome, hip pain, back pain, rotator cuff impingement, neck pain, on and on…. are all derived from inhibited stretch reflexes.

NOMPT is an approach that (1) identifies the root problem leading to the symptoms, (2) restores stretch reflexes and joint movement, and (3) teaches the patient how to prevent the problem from resurfacing in the future.

NOMPT was developed by Scott Hadley, PhD, DPT, who has a PhD in Anatomy & Neuroscience and a Clinical Doctorate in Physical Therapy. Dr. Hadley has published numerous scientific papers in the fields of neuroscience and rehabilitation, served on the faculties of Grand Valley State University, Hope College, and Calvin College, and is the owner of the Hadley Clinic in Grand Rapids Michigan. He has taught NMT to other physical therapists, who have been very successful with the approach.


Science of NMT

In the NMT treatment philosophy, most types of musculoskeletal pain are viewed as a dysfunction of the neuromuscular system. Neuromuscular impairment is often the root cause of biomechanical stress, inflexibility, weakness, and joint degeneration.

In 1898, Charles Sherrington published his initial findings on stretch reflexes. A muscle stretch reflex is triggered when a muscle’s spindle fibers are stretched, activating a sensory neuron. The sensory neuron activates spinal motoneurons which cause the muscle to reflexively contract.

In 1957, J.C. Eccles and colleagues reported that the stretch of one muscle not only causes reflex activation of that muscle, but other muscles are activated as well. Eccles thus defined two types of stretch reflexes. A homonymous stretch reflex occurs when the stretch of a muscle causes that muscle to contract. A heteronymous stretch reflex occurs when the stretch of a muscle causes a different muscle to contract.

During the past 60 years, heteronymous stretch reflexes have been investigated extensively by neurophysiologists. Through surface EMG recordings in human subjects, dozens of heteronymous reflex patterns have been identified. It is thought that the heteronymous stretch reflexes allow the central nervous system to monitor and reflexively control gait and other complex human movements.

Heteronymous reflexes depend on normal elasticity of muscle and fascia. When myofascial structures become tight and inelastic, the heteronymous reflexes become impaired, muscles that control movement and stability become inhibited, and biomechanics become dysfunctional. The result is usually a painful condition that has both a biomechanical cause and a neurological cause.

The NMT treatment approach takes into consideration the impact of heteronymous stretch reflex patterns on normal and abnormal movement. Using information from published patterns and patterns identified through clinical practice, we are able to restore strength to muscles by identifying other muscles that control them through heteronymous reflexes. By doing so, we can get to the source of the problem, without focusing only on the symptoms.

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