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Home Trigger Point Blog Trigger Point Techniques - What is NAT?

Trigger Point Techniques - What is NAT?

Posted by Simeon Niel Asher on Dec 02, 2016

NAT, trigger points are regarded not as the familiar knotsof muscular dysfunction, but as inputs to the spinal cord and central nervous
system.

NAT utilizes the neurophysiology behind myofascial trigger points in a novel and deliberate way.

NATuses deep stroking massage and compression/ inhibition techniques blended together in a choreographed algorithm. In NAT, trigger
points are regarded not as the familiar knotsof muscular dysfunction, but as inputs to the spinal cord and central nervous system.

This is because trigger points are exquisitely painful - and stimulating the pain pathways has many profound eects on the nervous
system, including the attenuation of peripheral and central sensitization.

The Importance of Sequence

During most hands-on treatments, a haphazard stream of various mechanoreceptors are stimulated. In NAT, the number of inputs is
reduced to an absolute and purposeful minimum.

Inputs are madevia the trigger points in repeatable sequences, which always includethe manipulation of STPs as well as trigger points in
agonists and antagonists.

Part of the NAT input sequence is performed three times. Repeating something three times (either verbally or somatically) seems to help
the nervous system get the point.

Stroking massage is performed in one direction only, and compression techniques are performed to the point of pain (and are
sometimes held for up to 10 minutes).

NAT and Frozen Shoulder Syndrome

NAT was originally developed in 1999 to treat frozen shoulder syndrome (adhesive capsulitis). The shoulder is one of the most complex
regions in the body, involving four joints and eighteen muscles.

A frozen shoulder is considered by many to manifest the worst components of all other shoulder problems put together. It is in many
ways an enigma, and like other enigmas, solving the puzzle helps us gain many truths and insights of the inner workings of the nervous
system.

We observed that specic tender/trigger points seemed to be present in the same distributionin every single patient. To our surprise, by
manipulating these pointsin a sequence, we discovered that our patients long-standing frozen shoulders seemed to melt away in as few
as one or two treatments.

This rapid defrosting could only be explained by a neurological process which led to the current theoretical model.

 Chris Packard, Chiropractor, successfully integrates NAT techniques in his practice

NAT Theory

NAT is all about intentionally stimulating mechanoreceptors embedded within and around the trigger points (and joints) to generate a
novel neural signature. Thisaects the spinal cord and the somatic cortices.

NAT deliberately utilizes some of the automatic reexes associated with trigger points, including:

 Co-coordination
Reciprocal inhibition
Post-isometric relaxation
Post-activation depression
Pure facilitation
Co-facilitation
Autonomic (ANS) responses
Pain Gate
Spinal cord reex responses
Neuroplasticity

Trigger Points as Inputs to the Nervous System

The nervous system responds to these input sequences by releasing the holding pattern, normalizing motor unit output, and improving
co- coordination. Clinically, after each NAT session, patients describe a sense of joints being oiled inside or feeling that normal muscular
controlhas been regained.

With regard to somatic dysfunction, NAT is readily used to reinvigorate and release protective joint postures and/or treat protective spasm
around joint problems (such as an arthritic hip).

Performance Enhancement

Furthermore, NAT sequences seem to tone or re-activate the muscles around the joint. As an automatic response, there is also an
increase in strength and power. This is one of the reasons why NAT was successfully used by physical therapists for members of the
Canadian and Australian teams in the 2012 London Olympics.

Evidence for this phenomenon has been supported by research at Addenbrookes Hospital in Cambridge, UK (Weis et al. 2003). Patients
with long-standing shoulder pain and weakness treated with NAT demonstrated a signicant improvement in active range of motion
(P<0.002) and in strength and power (P<0.046) over and above standard physical therapy and a hands-on placebo, even though no
exercises were given to the NAT group.

NAT is now used to treat a wide range of musculoskeletal conditions by over 40,000 therapists worldwide.

My Journey with NAT - Stuart Hinds (Soft Tissue Therapist)

My Journey with NAT - Michael Coee (Licensed Massage Therapist)

My Journey with NAT - Suzanne Hibberd(Osteopath)

My Journey with NAT - Martin Bates(Chiropractor)

My Journey with NAT - Andy Eckley(Soft Tissue Therapist)

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This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis
or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare
professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any
particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.


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Really brilliant approach to trigger points. Has changed my practice and Im a big fan ever since I attended your workshop in Bedford last
year (which was brilliant)!

Jordan Brown on Dec 04, 2016

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Fantastic trigger point course, referred to me by a phenomenal Sport Chiropractor. Good stu!!

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