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Similarly, the 2025 literature advances the conceptual precision of the neurovascularmuscle axis by clarifying that mechanistic overlap does not uniformly translate into additive clinical magnitude

Clinical Principle Appropriate manual physical therapy techniques (e.g., maneuvers that resolve pelvic, abdominal and/or hip muscular trigger points, lengthen muscle contractures, and release painful scars and other connective tissue restrictions), if appropriately trained clinicians are available, should be offered to patients who present with pelvic floor tenderness

doi: 10.1016/j.smim.2023.101781 74 HustonHCAndersonMJFinkSL

Important roles of tyrosine 9 and aspartic acid 101 in catalysis