 Neutral Spine has Spinal Curves | 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
Many of the clients who walk into my office with hip, back or pelvic pain share some common features:
- 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. | |
2. Get the hips moving. Explore hip flexion and extension in quadruped (hands and knees or forearms and knees). Make sure that the spine is neutral (refer to the spine pic above for a visual of our spinal curves) so you can make sure to get into the hips. If the lumbar spine moves into flexion as you rock back, this means that you are not accessing the tissues of the hip joint.
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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. |  Notice the two mounds on each side of the spine just below the shoulder blades. You can see that the left side is just a bit more pronounced than the right. |
Susan McLaughlin is a physical therapist who specializes in the management of pelvic floor and orthopedic dysfunctions. She is the owner of ALIGN integration|movement in Salt Lake City, UT. Helpful tips and other self care strategies can be found at www.alignforhealth.com.
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