2

Introduction to NMT
CHAPTER CONTENTS
NMT: A brief historical overview
Imagine a palpation technique that becomes a
NMT: A brief historical overview 35
means of therapeutic intervention by virtue of
Stanley Lief 35
the addition of increased pressure.
Associated approaches 36
Imagine also a palpation technique that, in a
Assessment is key 36
non-invasive manner, meets and matches the tone
A brief history of NMT 37
of the tissues it is addressing and sequentially
Peter Lief 38
seeks out changes from the norm in almost all
Tissues involved in NMT 38
accessible (to finger or thumb) areas of the soft
Site of application 38
tissues.
Chemical structure 39 Imagine this approach as systematically
A function of circulation 39
providing information regarding tissue tone,
Stressor stimulus 40
induration, fibrosity, oedema, discrete localized
Judith DeLany’s overview of NMT in the USA 40
soft tissue changes, areas of altered structure,
Various chiropractic perspectives on Nimmo’s work 41
adhesions or pain – and being able to switch from
a painless and pleasant assessment mode to a
treatment focus that starts the process of normal-
izing the changes it uncovers.
This is neuromuscular technique (NMT).

Stanley Lief
The developer of European NMT was Stanley Lief,
who was born in Lutzen in the Baltic state of
Latvia in the early 1890s. He was one of the five
children of Isaac and Riva Lief (Riva was the
author’s grandfather’s eldest sister, i.e. her maiden
surname was Chaitow). The family emigrated to
South Africa in the 1890s where Stanley was given
a basic primary school education before starting
work in his father’s trading store in Roodeport,
Transvaal.
Lief’s poor health led to an interest in physical
culture, one source of which was found in popu-
lar health magazines published in the USA.
 CHAPTER TWO
36 Introduction to NMT

Eventually Lief worked his passage to the USA in particular focus, the use of NMT in treatment of
order to train under the legendary ‘physical sports injuries, is briefly outlined. Another evolution
culturist’ Bernard Macfadden. He qualified in chi- of an NMT-like approach, known as Progressive
ropractic and naturopathy before World War I, Inhibition of Neuromuscular Structures (PINS),
and was in Britain at its outbreak. After serving is described by its developer, Denis Dowling, in
in the army he returned to England and worked Chapter 11.
in institutional ‘Nature Cure’ (naturopathic) In Chapter 12 a description is given of Thai
resorts until 1925, when he established his own yoga massage – or rather a Western modification,
clinic, Champneys, at Tring in Hertfordshire. which explains some of the overlaps between this
At this world-famous healing resort he estab- ancient system, and NMT. That there is a similar-
lished his reputation as a daring and pioneering ity should not be surprising, since aspects of
healer. By using the dietetic, fasting, hydrothera- modern NMT derive from Ayurvedic techniques,
peutic and physical education and manual meth- as will become clear later in this chapter.
ods by which naturopathy aims to restore In the appendix the work and influence of Ray-
normality to the sick body, he developed a huge mond Nimmo are evaluated. The lead author of
following. It was during his most successful this book had the opportunity to attend a course
years, before World War II, that he evolved the conducted by Nimmo in the 1960s in London,
technique that this book attempts to describe. and was struck then by the similarity his concepts
Stanley Lief, together with his cousin Boris and methods had, as compared with those of
Chaitow, who worked as his assistant at Champ- Stanley Lief, the primary developer of NMT in
neys before and during World War II, developed Europe. Brief evaluations of Nimmo’s work are
and refined the uses of NMT. Boris Chaitow was given later in this chapter.
also born in Latvia and grew up in South Africa As a modality, NMT complements and may be
in the small mining town of Pilgrim’s Rest, now incorporated into any system of physical medi-
a ‘museum town’, where the Chaitow trading cine. It may – and indeed often should – be used
store-cum-home still stands. He later qualified as as a means of treatment on its own, or it may
an attorney, and was in practice with my father accompany (preceding for preference) manipula-
when he became inspired by Stanley Lief’s exam- tive and other physical modalities. Its main use
ple and, with Lief’s help, trained as a chiropractor up to the present has been in the hands (literally)
at National College, Chicago, before joining the of the osteopathic profession; however, many
staff at Champneys in 1937. physiotherapists, chiropractors, massage thera-
pists and doctors of physical medicine who have
studied and used NMT have found it comple-
Associated approaches
mentary to their own methods of practice.
In this book, Lief’s basic NMT applications, As it offers a simultaneous diagnostic and ther-
together with a variety of specialized associated apeutic capability, NMT is time-saving, energy-
soft tissue manipulation techniques, will be pre- saving and, above all, efficient.
sented. There will also be discussion of various Other soft tissue manipulative methods such as
reflex systems that fall within the scope of soft tis- muscle energy technique (MET) and functional
sue treatment in general, and NMT in particular. positional release approaches (strain/counter-
For example, detailed reference to, and illustra- strain, for example) are commonly used as part
tions of, the neurolymphatic reflexes of Chapman, of NMT treatment. These are briefly explained
together with illustrations of other reflex patterns in Chapter 8: Associated Techniques.
such as myofascial trigger points, have been
included.
Assessment is key
Another of Lief’s assistants at Champneys,
Tom Moule, continued the development of NMT The key to the successful use of NMT is an ability
in health care, and his son, Terry Moule, has con- to sense accurately what it is that the hands are
tributed his thoughts in Chapter 9, in which his feeling while at the same time having a clear
 NMT: A brief historical overview 37

picture of what the particular movement or tech- new tissues begin to be built up again.
nique being employed is aimed at achieving. If Our method of treatment, by the removal of all
the practitioner can learn to ‘see’, with the hands, obstacles to the flow of nervous current, allows
and by using them let the patient’s body ‘tell its energy to proceed unimpeded.
own tale’, then the intelligent application of the
Lief found various of Varma’s techniques clini-
methods described has much to offer towards
cally useful, and from these ideas and methods
the recovery of normal function.
developed his own soft tissue approach – NMT. Lief’s
Holistic methods of healing demand that, in
cousin, Boris Chaitow, describes this early devel-
order to create the situation for the maintenance
opment of NMT as follows (B. Chaitow, personal
or the restoration of health, the individual must
communication, 1983):
be seen as a totality.
It is necessary, therefore, to attempt to recog- In the middle of the 1930s Stanley Lief realised
nize the various factors affecting both the internal that the integrity of a joint was to a great extent
and external environment of the individual, related to the character of the tissues surround-
because these are part of the complex interacting ing the joint, related to muscle, tendons, liga-
totality that can influence the individual for good ments, blood and nerve supply etc. He felt that
or ill. In the end, the body is self-healing, self- in order the better to achieve effective mobility
repairing and self-maintaining, if the prerequi- and integrity of function of joints – particularly
sites for health are present. Emotional stability, in the spine but also in all bony articular rela-
nutritional balance and hygienic considerations tionships – it was advisable to normalise, as best
all play their part, as do structural and mechani- one could, the adjacent soft tissues by removing
cal integrity. any function-interfering factors, such as ten-
sions, contractions, adhesions, spasms, fibrositic
A brief history of NMT contractures etc., with appropriate application
of fingers and hands to those tissues. To this
In Europe neuromuscular technique has evolved
end the neuromuscular technique was evolved
over the past 60 years from the original work of
to cover every possible type of lesion in whatever
Stanley Lief. In the mid-1930s he was seeking
part of the body (articular, soft tissue, abdominal,
improved means for preparing soft tissue struc-
glandular, nervous, vascular etc).
tures for subsequent manipulation. The develop-
It so happened that at that particular time
ment of NMT (neuromuscular therapy) in the
Stanley Lief had heard of a well-known Indian
USA is described at the end of this chapter.
practitioner named Varma operating in Paris,
Lief had studied the work of Rabagliatti, whose
who was applying an unusual but very effective
book Initis influenced his interest in connective
soft-tissue technique on patients with remarkable
tissue problems.
benefits. Lief decided to arrange to have a series
Lief also became aware of (and studied) the
of treatments on himself from Varma, and finally
work of Dr Dewanchand Varma, a practitioner
persuaded the latter to teach him this specialised
of Ayurvedic manipulation (Varma called his
technique. Much as he appreciated the method
method ‘pranotherapy’) who was practising in
used by Varma, he felt it could be improved,
Paris. In Varma’s book The Human Machine
and began to develop and subsequently practised
and Its Forces (Varma 1935), he states:
the method for which he devised the name of
We have discovered that the circulation of the ‘Neuromuscular Technique’. This name was an
nervous currents, slows down occasionally accurate definition of the purpose of the method
because of the obstruction caused by adhesions; he evolved from the cruder technique used by
the muscular fibres harden and the nervous cur- Varma. NMT involved an application of hands
rents can no longer pass through them. We have and fingers to the appropriate areas of soft tissue
demonstrated effective and positive methods related to the affected bony articulations, as well
designed to restore nervous equilibrium which as all other areas of soft tissue which his sensi-
promotes the healthy circulation of blood, so that tive fingers found to be abnormal in texture.
 CHAPTER TWO
38 Introduction to NMT

This enables adverse factors in such tissue to be number of causative factors, giving rise to neuro-
corrected to allow the full function of muscles muscular lesions, which may include:
and nerves to be re-established. In doing so the
• fatigue, exhaustion, bad posture
double benefits are achieved in improving nerve
• local trauma
and blood circulation, improving texture of mus-
• systemic toxaemia
cle tissue and in being better able to get effective
• lack of exercise and oxygen (ischaemia)
results in manipulating the bony articulations
• dietetic deficiencies
involved, and assuring lasting integrity of their
• psychosomatic causes bringing about muscular
normal function.
tensions.
Stanley Lief also maintained that joint lesions
were not the only factors in the interference in The presence of a ‘lesion’ (current terminology
nerve force integrity, but that tensions, contrac- would define this as an area of somatic dys-
tions, adhesions, muscle spasms and fibrositic function) is always revealed by an area of hyper-
contractures in soft tissues could in themselves sensitivity to pressure. It is remarkable to note
constitute primary factors in disease (symptom) just how close Lief came to defining the causes
causation by reducing effective nerve and blood and characteristics of myofascial trigger points,
circulation. To this end he developed his diagnos- although working many years before the trigger
tic sensitivity with his fingers so that in a few point research of Travell and Simons (Simons
seconds of palpation over any area of the body, et al 1999, Travell, Simons & Travell 1999)
he was able to assess abnormalities present in (see Ch. 3).
relation to tensions, adhesions and spasms.
The body’s integrity, and its functional effi-
ciency, depends not only on its chemistry influ-
enced by the nature of the food and drink we Tissues involved in NMT
consume, but also on the effective nerve and
blood circulation free of mechanical and func- Boris Chaitow and Peter Lief have both taken part
tional obstructions. To this second vital purpose in the development and evolution of the theory
there is no formula devised by the osteopathic and application of NMT as first described by
or chiropractic professions that will more effec- Stanley Lief, as has Brian Youngs.
tively achieve the optimum result than the At the time of writing (2009) Youngs remains
philosophy and technique devised by Stanley (in his ninth decade) a leading naturopathic/osteo-
Lief. There is no single part of the body that he pathic practitioner in the UK. He was a colleague
was not able to apply his method to to achieve of both Stanley and Peter Lief, and was for many
remarkable physiological responses. years, from the 1950s, a leading tutor at the British
College of Naturopathy and Osteopathy – now the
British College of Osteopathic Medicine, founded
Peter Lief by Lief.
Stanley Lief’s son, Peter (also a naturopath, chiro- Youngs (1962) has given the following descrip-
practor and osteopath), has described (Lief 1963) tive overview of the tissues involved in NMT.
the ‘neuromuscular’ lesion as being associated
with:
Site of application
1. Congestion of the local connective tissues
2. Disturbance of the acid–base balance of the As the technique (NMT) operates primarily on
connective tissues connective tissue it will usually be concentrated
3. Fibrous infiltration (adhesions) at those areas where such tissue is most dense,
4. Chronic muscular contractions, or e.g. muscular origins and insertions, especially
hypertrophic or hypotrophic (tone) changes. the broad aponeurotic insertions. The most fre-
The aetiology of the neuromuscular lesion, quent sites are the superior curved line of the
according to Stanley and Peter Lief, includes a occiput, the numerous insertions and origins of
 Tissues involved in NMT 39

the large, medium and small muscles which attach The fibres are white fibrous (collagen), yellow
to the vertebral column; the iliac-crest insertions; (elastin), and reticulin. The collagen fibres are
the intercostal insertions and abdominal-muscle also protein and polysaccharide in composition
insertions. Nevertheless, the technique can of and are stabilized chemically by the presence of
course be applied to any area which requires it – the ground substance constituents. The presence
head, face, wrists, etc. Connective tissue is, after of chondroitin sulphate, for example, renders
all, ubiquitous. the enzymatic breakdown of collagen much more
To understand the therapeutic effect of the difficult. The importance of this point will
technique one must have some knowledge of the become clearer later. The formation of fibres
pathophysiology of the tissue upon which it oper- appears to be due to a precipitation of fibre con-
ates. Connective tissue consists of a matrix con- stituents by serum glycoproteins under the influ-
taining cells and fibres. It was largely ignored ence of adrenocorticotrophic hormone.
until recently, but has now been made the subject Reticulin contains more polysaccharide than
of close study – and even international confer- collagen, and some lipid also. Elastin is also
ences – in regard to its structure and functions. protein and polysaccharide in composition.
Dr Rabagliatti, 45 years ago (note: Youngs Sulphur is a constituent of all three. Cells
was writing in the mid-1960s) was so inter- include fibroblasts, mast cells, macrophages
ested and far-seeing that his book, Initis, and others.
contained concepts the general truth of which is
being proved today. He was, however, a lone
A function of circulation
voice and because he held unorthodox ideas he
was, typically, ignored. The nature and composition of connective tissue
The ubiquity of connective tissue caused is a function of circulation. Circulatory efficiency
Dr Rabagliatti to analogize it to the ether – as in any area will determine (1) the influx of ma-
the medium for, as he termed it, ‘the zoodynamic terials to the area, and (2) the drainage of the
life force’. (See Box 1.7 for current thinking area.
along these lines.) Incoming blood leads to the production of
Through the connective tissues’ planes run lymph and this fluid permeates the ground sub-
the trunks and plexuses of veins, arteries, nerves, stance, bringing all the constituents of the blood
and lymphatics. Connective tissue is the support except the proteins to the connective tissue. Some
for the structural and, therefore, functional rela- of these constituents are hormones. Thyroxine,
tionships of these systems. adrenoglucocorticoids and adrenomineralocorti-
coids are only three of these. Oestrogen and
androgens are two more. All these have known
Chemical structure
effects upon the structure of connective tissue.
Briefly, the matrix consists of a jelly-like ground Thus, a diminution of thyroxine leads to an
substance in which the fibres, cells, vessels, etc., increase of water retention in most cells and an
lie. This ground substance is the ‘physical increase in the quantity of ground substance.
expression of the milieu interieure’ intervening The sex hormones also do this, but of most inter-
everywhere between the blood and lymph vessels est to us here are the opposing groups of the adre-
and the metabolizing cells; it plays a major role nocortical hormones. Selye divides these into
in the transport, storage and exchange of water anti- and pro-inflammatory hormones (A-Cs
and electrolytes. The chemical structure is essen- and P-Cs). These are produced in response to
tially polysaccharide, hyaluronic acid, chondroi- stress situations and they exert both a general
tin sulphuric acid, chondroitin sulphate and and a local effect. By regulating the balance
chondroitin itself, together with proteins which between these two the body can control the abil-
contain a considerable amount of the amino acid ity of the tissues to produce an inflammatory
tyrosine, which forms the majority of the thyrox- response. But when the A-Cs and the P-Cs are
ine molecule. both present in the blood the A-Cs always win
 CHAPTER TWO
40 Introduction to NMT

the contest, i.e., there is an anti-inflammatory The principal author has, over the past 40
response. years, since working as assistant to Boris Chaitow
in the early 1960s, helped to promote knowledge
Stressor stimulus of NMT – particularly in its diagnostic mode –
so that it stands today as a major therapeutic
The A-Cs are produced in response to a stimulus
instrument for use by manipulative and massage
– the stressor. The stressor in neuromuscular
therapists worldwide. The use of NMT as a
technique is pain. Effective technique appears to
broadly applicable sequential assessment and
be accompanied by pain in all such conditions
treatment tool was enhanced by exposure to the
(and also in the condition without treatment).
work of Raymond Nimmo in the late 1960s.
Pain is probably due to two factors. A much
Nimmo and his ‘receptor-tonus’ work seems to
reduced threshold in the area due to circulatory
be a common link between ‘European’ NMT and
inhibition enabling a build up to just below the
American NMT. Descriptions of Nimmo’s work
threshold level of Lewis pain substance or, alter-
will be found in the Appendix, however a brief
natively, a disturbance of electrolyte level (e.g.,
perspective on his influence, from one of the
increase of hydrogen ions or disturbance in the
USA’s leading NMT teachers, Judith DeLany, is
calcium/sodium/potassium balance due to the
given below.
same circumstances). Consequently pain will be
produced by even slight stimulus, let alone the
heavier movements of neuromuscular technique. Judith DeLany’s overview of NMT
Also, pressure and tension proprioceptors may in the USA
be overstimulated and pain can result from an
What has today become neuromuscular therapy
over application of any ordinary stimulus.
in the USA, was spawned in the late 1970s from
The A-Cs liberated will produce both general
receptor-tonus method (the work of the late
effects (general adaptation syndrome) and local
Dr Raymond Nimmo). Nimmo, a 1926 graduate
effects (local adaptation syndrome) and their
of Palmer College of Chiropractic, states in his
effect is anti-inflammatory, both generally and
writings that he questioned many of the philo-
locally, at the area of application of the stressor,
sophical and theoretical teachings of his profes-
i.e., at the areas of technique application. Conse-
sion (Nimmo 1959). He studied many aspects
quently, there is a breakdown of collagen fibres
of classical chiropractic even though he was con-
and a general decrease in water retention in
vinced that adjustment of the spine was not
the ground substance; the congested area is
enough to ensure the health of the individual.
decongested.
He also sought out information as to the role that
What Youngs has described tallies closely with soft tissues play in pain and dysfunction in an
what is now known about the biochemical status attempt to explain the syndromes he was con-
of tissues under stress, and particularly of the fronted with in his work.
trigger point entity, which will be evaluated in As Nimmo developed his skill in palpating
following chapters. muscles, he noted particular points within the
Stanley Lief, albeit inadvertently, provided for muscles which, when pressed, referred pain to
the generation of practitioners who were to follow various distant areas. He called these ‘noxious
him a tool with which to deal with this pain- generative points’ (NGPs). In 1952 Nimmo pur-
producing adaptive end-result of the multiple chased Connective Tissue: Transactions of
stresses faced by the modern musculoskeletal the Second Conference (Travell 1952), in
system. which Janet Travell discussed her theories of trig-
In the latter part of the lives of Stanley Lief ger points. Nimmo found illustrations of referred
(d. 1963) and Boris Chaitow (d. 1996), awareness pain patterns in Travell’s work that coincided
grew as to other applications of use for NMT, most precisely with his own discoveries. He began
notably its potential to identify and commence working obsessively to develop a sensible treat-
elimination of myofascial trigger points. ment plan and states that, as time went by, he
 Tissues involved in NMT 41

learned from others, but it is estimated that 80– law of cause and effect, and Delany’s NMT
90% of the techniques he taught were his own American Version incorporating a systematic
work. approach towards pain relief which addresses six
Nimmo’s constant striving to prove the phys- physiological factors: ischaemia, trigger points,
iological basis of his work, complete with integra- nerve compression/entrapment, postural distor-
tion of neurological laws that gave validity and tion (biomechanics), nutritional components and
substance to his principles of practice, derived emotional well-being (stress reduction).
not only from being in the forefront of a newly
Judith Delany provides a detailed overview of
emerging profession, but also from the fact that
NMT American Version in its current stage of evo-
his interest in the soft tissue component of the
lution in Chapter 10.
body placed him at the fringes of the teachings
of that profession.
Various chiropractic perspectives on
He faced peers at a time when they were
Nimmo’s work
attempting to validate the principles of chiro-
practic and asked them to question the very basis Cohen & Gibbons (1998) have detailed the chiro-
of their beliefs. His work endured and many practic perspective on the work of Nimmo. They
healthcare practitioners who studied with him point out that, in a survey carried out in 1993 of
carried the work forward, under a variety of procedures currently employed by chiropractors
names (see below). in the USA, fully 40% were using Nimmo’s recep-
In 1979, Paul St John, who had studied receptor- tor tonus methodology, which closely approxi-
tonus methodology with Nimmo, published course mates NMT (National Board of Chiropractic
manuals relating to similar techniques, which Examiners 1993).
he called neuromuscular therapy (NMT). His Gatterman & Lee (1995) summarize Nimmo’s
concepts were influenced by not only Nimmo approach:
(Vannerson & Nimmo 1971), but also Travell
Nimmo found noxious generative points [trigger
& Simons (1983), Mariano Racabado, Leon
points] in muscles that referred pain in charac-
Chaitow, Rene Cailliet (1977), Aaron Mattes,
teristic patterns. Viewing these hypersensitive
John Barnes, John Upledger and others, through
areas, the trigger points of Travell, as abnormal
their writings and seminars.
reflex arcs he developed a manual technique
Judith (Walker) Delany’s professional associa-
designed to reduce the irritable loci. He referred
tion with St John in 1984–1989 led to revisions
to the inter-relationship of muscle tonus and
of previous concepts, with significant changes
the central nervous system as ‘reverberating cir-
in treatment techniques and teaching materials,
cuits’, whereby stimulus was self-perpetuating
which came to include the influence of posture
until the cycle was broken . . . This procedure
and craniosacral methods.
referred to by Travell as ischemic compression
During this phase, the work of Janet Travell
offers a noninvasive chiropractic technique
and David Simons had enormous influence.
instead of the common medical practice of injec-
Their book Myofascial Pain and Dysfunction:
tion of the painful trigger points.
The Trigger Point Manual, Volume 1: The
Upper Body (Travell & Simons 1983), and To reach a point where his belief in soft tissue
numerous articles by them, began to explain in origin of much musculoskeletal pain was widely
greater detail the background to what Nimmo accepted by his own profession, Nimmo had to
had taught. In 1989, St John and Delany sepa- contend with, and overcome, the prevailing chi-
rated their work and both continue to teach neu- ropractic model of ‘bone on nerve’ concepts.
romuscular therapy. The approaches they have He was certainly an original thinker and his trig-
taken, although still containing elements of Nim- ger point research was contemporary with, and in
mo’s original work, have now diverged, with the some ways ahead of, that of Janet Travell, the
St John Method focusing on structural homeo- major medical researcher into this field. At the
stasis of the body and cranium by applying the very least, Cohen & Gibbons (1998) suggest:
 CHAPTER TWO
42 Introduction to NMT

‘The similarities are striking and suggest one con- We should recall that Nimmo’s concepts were
cept developed concurrently by two outstanding evolving in the 1950s and that, at that stage of
independent researchers.’ her work, Travell was advocating injection as
There were, nevertheless, distinct differences the primary tool for trigger point deactivation.
between the early treatment approaches advo- Over the years, direct compression (‘ischaemic’)
cated by Travell, compared with those suggested – now called ‘trigger point release’ – has become
by Nimmo, in the developmental years of their the preferred method of trigger point treatment,
research into the pain generated by trigger points. along with stretching (restoring the muscle hous-
Cohen & Gibbons (1998) explain: ing the trigger point to its normal resting length;
see Ch. 3).
Travell advocated injections to the trigger points
Nimmo’s insistence that trigger points had a
and later spray and stretch and ‘ischemic com-
neurological origin has not been validated, how-
pression’ to relax the involved muscle. On the
ever, as evaluation of the latest findings of Simons
other hand Nimmo stated, ‘I have found that a
et al (1999) will show (see Ch. 3). This in no way
proper degree of pressure, sequentially applied,
detracts from the enormous contribution made
causes the nervous system to release a hypertonic
by Nimmo to this area of study. See the Appendix
muscle’. Nimmo did not see the trigger points as
for more information on Nimmo’s work.
an object to be injected, stretched, massaged or
dissolved by ultrasound.

References
Cailliet R: Soft tissue pain and disability, Philadelphia, 1977, Travell J: Connective tissue: transactions of the second conference,
FA Davis. New York, 1952, The Josiah Macy Jr Foundation.
Cohen J, Gibbons R: Raymond L Nimmo and the evolution of Travell J, Simons D: Myofascial pain and dysfunction: the trigger
trigger point therapy 1929–1986, J Manipulative Physiol Ther point manual, vol. 1, The upper body. Baltimore, 1983,
21(3):167–172, 1998. Williams & Wilkins.
Gatterman M, Lee H: Chiropractic adjusting techniques. Vannerson J, Nimmo R: Specificity and the law of
In Peterson D, Weise G, editors: Chiropractic: facilitation in the nervous system, The Receptor 2(1).
an illustrated history, Chicago, 1995, Mosby, pp 240–261. Reprinted in Schneider M, Cohen J, Laws S, editors: 2001,
Lief P: British Naturopathic, British Naturopathic Journal The collected writings of Nimmo and Vannerson, pioneers of
5(10):304–324, 1963. chiropractic trigger point therapy, Pittsburgh, 1971,
National Board of Chiropractic Examiners: Job analysis of Self-published.
chiropractic, Colorado, 1993, Greely. Varma D: The human machine and its forces, London, 1935,
Nimmo R: Factor X. The Receptor (1) 4. Reprinted Health for All.
in Schneider M, Cohen J, Laws S, editors: 2001 The collected Youngs B: Physiological background of neuro-muscular
writings of Nimmo and Vannerson, pioneers of chiropractic trigger technique, British Naturopathic Journal 5(6):176–190,
point therapy, Pittsburgh, 1959, Self-published. 1962.
Simons D, Travell J, Simons L: Myofascial pain and
dysfunction: the trigger point manual, vol. 1, Upper half of
body, ed 2, Baltimore, 1999, Williams & Wilkins.