Muscular pain is one of the most treated issues globally and there are hundreds of modalities for treating musculo-skeletal issues. In my practice I often see many injuries that have often been dealt with in such a passive manner that there is never real hope of treating the issue. Identification of structural issues is key to changing the pattern of facilitation and inhibition that often occurs with many so called pain syndromes. An example of this pattern would be the Pec Minor’s inhibitory effect on the opposite hip flexor when facilitated. Why is it that so many people often fail to have successful responses to treatment? Here are just a few reasons.
- Incorrect biomechanical evaluation
- Poor treatment modality
- Patient compliance
- Imposed working postures, seated position.
- Over exercise and pattern overload
Much postural analysis fails to observe dynamic actions and test specific local to global muscle actions that could be responsible for the facilitation/inhibition cycle that is present when dysfunction and injury is present. Much soft tissue work that is used is often only used to treat facilitated tissue. For a treatment to be effective inhibited muscle tissue is required to be taken from an inhibited pathway to an activated functional muscle that executes the desired motor program and helps to reduce inhibition of facilitated muscle tissue.
Neuro Kinetic Therapy (NKT) is an effective form of analysis and treatment that allows a joint by joint and functional approach to assessing muscular dysfunction and addressing both facilitation and inhibition in an effective and efficient manner. Once dysfunctional tissue that is either inhibited or facilitated, has been located, a strategy to restore function can be achieved by observing functional links between muscles either synergistic or antagonistic. NKT is a favourable approach as it compliments many other rehabilitation, corrective exercise and performance exercise modalities.
If you take a look at the adaptation of Schmidt and Wrisburgs conceptual model of performance which is below. You’ll note that the stimulus and response stays the same to the activity undertaken, on a continuum of walking to complex sporting actions. However due to Sherrington’s law of reciprocal innervation the motor program can ultimately be changed to reflect the same outcome and other muscles can be recruited in compensatory mechanisms. This can occur during motor program execution and following muscular recruitment, can be impeded by either over training or poor motor recruitment.
There can many reasons why injuries occur which can include a simply repetitive over/underworked relationship between two muscles or through an entire muscular sling or line. Analysis of these relationships using NKT can reduce the amount of guesswork and increase the quality of both treatment and pain eradication. The days of laying on a physiotherapy or massage couches being treated by interferential machines and inappropriate cookie cutter exercises are numbered.