Neuromuscular re-education plays a major role to getting out of pain and improving function. Our body is very intelligent; the nervous system is prepped and primed for movements, actions and behaviors that are similar to what has happened in the past. This is useful because it frees up our system's energy for more important metabolic tasks. Unfortunately over time, the way we have done something in the past is not always helpful for the longevity of the tissues involved in the present movement.
Neuromuscular re-education drills help to create new neural circuitry to enhance proprioception, balance, motor control and coordination, which will have carry over to lasting healthy loads to the muscle and skeletal system.
Our Pelvis, Spine And Head Are Mobile... or I should say, We Want Them To Be Mobile
- Inability to isolate pelvic motion and/or rigid spinal motion
- Limited hip mobility in all ranges, especially hip flexion, adduction (moving toward midline) and internal rotation
- Hypertonic spinal muscles (increased mass and tone in the lower thoracic or lumbar area).
Movement drills to bring in neuromuscular re-education to these areas:
1. Get the spine moving; Get the pelvis moving. A great drill for this is pelvic tilts (click on link for a video of pelvic tilts on the floor). The video here demonstrates the pelvic tilts in sitting.
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3. Teach the erector spinae muscles that they don't have to 'HOLD TIGHT' all the time. This requires patience and lots of neuromuscular re-education time (maybe I can do some videos for the next blog). I like the client to connect to this in quadruped and then bring to standing with hip hinge and bending/ lifting drills. A good test to reveal the state of the muscles is to get into quadruped and see how the muscles respond (in this position they should soften and drop into extension). For many people who overuse their back muscles, the erectors will be hard and pronounced like a steel rod. The goal of rehab is to teach the muscle to let go and move into shortening (extending) and lengthening (flexing), which when held, doesn't perform either action very well.