Integrated Neuromuscular Inhibition Technique
Integrated Neuromuscular Inhibition Technique (INIT) is the creation of celebrated author, teacher and Osteopath Leon Chaitow DO. INIT links three separate treatment modalities into one, efficient, treatment series. The three treatment modalities are: Neuromuscular Technique (NMT), Postural Release Technique (PRT), and Muscle Energy Technique (MET).
First, in NMT, a trigger point is located by palpation, most usually with the fingers. A trigger point is a localised area of deep tenderness. The experienced practitioner will often notice a palpable change as a finger passes over the trigger point. Pressure on a trigger point will often cause twitching (called fasiculation) in the muscle that houses the trigger point. If digital pressure is maintained on the trigger point, the trigger point will produce a pain which refers to an area outside the muscle which houses it. This area does not have to be contiguous with the muscle containing the trigger point. There may well be a number of different trigger points and their reference areas may well overlap.
The next step in the procedure is that digital (i.e. finger or thumb pressure) is applied by the Chiropractor (or other health care provider) to the trigger point. Typically this extra pressure may be applied for five seconds and this can be repeated a number of times until it feels to either the Chiropractor or the patient that the trigger point is starting to change. This concludes the Neuromuscular Technique part of the INIT protocol and the next stage of the procedure involves the application of Positional Release Technique.
In PRT, the objective is to put the muscle housing the trigger point into a “position of ease”. This position is the reverse of a stretched position. So, rather than being lengthened, the muscle is ideally shortened in all three dimensions. That is to say, “slack” is put into the muscle. Additionally, the Chiropractor may even compress the muscle shorter still. This should feel very easy and relaxed and non-stressful for the patient. If the patient is in an acute phase and full of pain, ideally the position of ease would reduce substantially that pain. The objective of the position of ease is that the patient’s nervous system will relax and calm down. Hopefully, any hyertonicity or spasm in the muscles will be reduced. The patient will be held or kept in the position of ease for, say, ninety seconds. After this position of ease, the next stage is for the Chiropractor or other health care provider to move on to using a Muscle Energy Technique.
In MET it is recognised that a muscle is at its most relaxed just after it has been contracted. So the Chiropractor will invite the patient to push against him for a few seconds using relatively little force, say less than 20% of the patient’s available strength. If the patient is at the acute stage or is still otherwise full of pain, then the patient may be invited to push much more gently. In certain cases, even eye movements will produce enough muscular contraction.
After the contraction has occurred the Chiropractor will then attempt, gently, to lengthen the muscle housing the (former!) trigger point. This procedure can be repeated a number of times, if patient tolerance permits. In conclusion, it can be said that INIT is a very safe way to treat trigger points and other soft-tissue dysfunction. It can be safely applied to the acute patient who is in considerable pain, if necessary omitting the MET stage.
In 2000 and 2002, Chiropractor Andrew Hunter DC was able to study with Leon Chaitow DO at both at undergraduate and post-graduate level: Neuromuscular Techniques (NMT), Positional Release Technques (PRT), Muscle Energy Techniques and Integrated Neuromuscular Inhibition Technique as an external student at Westminster University. If you would like to experience INIT at one of Andrew Hunter’s three London clinics (Canary Wharf, Moorgate in The City, or Blackheath), please call him on 07855 916 602.