Order by Phone (USA) 1 800 741 5716

Order by Phone (Int) +44 161 802 0161




What do the therapists have to say about NAT?


Learn More About NAT


The reason the rotator cuff muscles are so key to our shoulder function is that our ball and socket joint is inherently unstable

The body is a marvellous, complex and self-healing machine. Proper shoulder alignment and function allows us to interact and manipulate our environment in an efficient way that requires minimal effort.

The problem is that when one of our muscles or tendons ‘goes wrong’, the body is forced to compensate and adapt.

The reason the rotator cuff muscles are so key to our shoulder function is that our ball and socket joint is inherently unstable. Our shoulder affords us a lot of movement but to achieve this there is instability built into the mechanics.


Rotator Cuff Trigger Points

The main damaged muscle for rotator cuff issues is the Supraspinatus

The rotator cuff muscles work together to pull the ball joint, downwards and backwards into the socket.

The cuff muscles interact to help maintain shoulder stability as well as initiate and help with movement.

Because of this dual function any problems with one of the cuff muscles will often become amplified.

The rotator cuff muscles blend together to share a common thick flat tendon. This tendon is vulnerable to overhead activities, sports occupation, overuse, underuse and aging.

Trigger Points

This complex situation means that when one of the rotator cuff muscles goes wrong not only do the other muscles have to compensate but also over time, they can become problematic themselves.

The muscles respond by getting tight and forming knots or ‘trigger points’ that often perpetuate pain and reduce shoulder function.

The brain sets-up a protective ‘holding pattern’. The damaged muscles become weak and, over time are prone to waste leaving a dent under the skin.

Some years ago, we began to recognize that all shoulder problems follow a similar ‘holding pattern’. In the case of the rotator cuff, the holding pattern is similar to that of a frozen shoulder.

NAT practitioners not only understand these concepts, but they have also learnt how to apply efficient, simple hands-on techniques to reduce pain and improve cuff function.

For the rotator cuff NAT practitioners add an evidence-based shoulder rehabilitation and exercise program to help clients return to full function. It's worth noting that manipulative manual medicine is suitable for the vast majority (90% - 95%) of all rotator cuff problems.

NAT uses the body’s own wisdom

By far the main damaged muscle for rotator cuff issues is the supraspinatus. This sits horizontally in a groove at the top of the shoulder blade.

During the day the weight of the arm hanging down shuts off the blood supply to this muscle, at night when there is no weight, the muscle attempts to repair itself causing horrible, classic night pain.

Supraspinatus is the most mechanically vulnerable shoulder muscle to injury; it is also vulnerable to wear and tear especially in overhead activities.


NAT and Rotator Cuff Specifics

NAT is an advanced trigger point technique; it was originally developed in 1999 by Osteopath Simeon Niel-Asher to treat frozen shoulder syndrome.

The same concepts have since been similarly applied for the treatment of a wide range of musculoskeletal disorders.

NAT involves specific repeatable and deliberate neuromuscular and trigger point (massage and compression algorithm).

In NAT the idea is that stimulating trigger points can equally be viewed as neural inputs; promoting changes in feedback to and from the brain.

With NAT these inputs are made in a deliberate and repeatable sequence to trigger points within agonists, antagonists and super trigger points (STP’s) around the joints.

The idea is to reduce the number of these neural inputs to a structured minimum. NAT deliberately utilizes automatic reflexes including:

- reciprocal inhibition;

- post isometric relaxation;

- post-activation depression;

NAT is fast, effective and evidence based; having successfully undergone randomized placebo controlled trials at Addenbrookes hospital, Cambridge UK (Weis et al 2003), and is now regularly used by thousands of therapist worldwide to treat a wide range of common musculoskeletal conditions.



Find a Trigger Point Professional in your area

More Articles About Frozen Shoulder

More Articles About the Rotator Cuff

Dry Needling for Trigger Points

NAT Professional Courses

Certify as a Trigger Point Therapist

Trigger Point Workbooks 


About NAT Courses

As a manual therapist or exercise professional, there is only one way to expand your business - education!

Learning more skills increases the services that you offer and provides more opportunity for specialization.

Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.

Help Desk


About Niel Asher Education

Niel Asher Education is a leading provider of distance learning and continued education courses.

Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.

Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.  

Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).

More About Us



We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.

Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.

Read Full Article 


Award Winning Instructors

Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT 2014.

Meet the Instructors


NAT Certification

If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.

In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.

There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.

About NAT Certification


Niel Asher Technique

Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.

The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.

Read More


Worldwide Free Shipping

Most of our courses are available as either "Printed" or 'Download" editions. When you purchase a download edition, you receive immediate lifetime access to all course material. Course texts can be downloaded and printed if required. 

When you purchase a "Printed" edition, you will also receive free access to the download edition.

We ship Worldwide from locations in the USA, UK, and Australia. Most items are despatched within 24 hours and shipping is FREE for all orders over US$50.
















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. 





feel good learning
NAT Global Campus Logo
NAT global campus

Learn More for Less

Unlimited access to all courses for just $19.95/mo