When we think of the effective movement of the body, we typically think of strong muscles and joints that move well without pain. But if you have good strength and mobility, yet your muscles are not firing at the right time or are not coordinated with other body parts, that strength and mobility are not doing much for you...
What is Neuromuscular control?
A key component of moving well is what we call neuromuscular control. Neuromuscular control is the ability for the body to utilize sensory information to detect, perceive and apply that information to perform a specific activity or task. To be able to successfully perform a task or activity it requires multiple body parts working together in coordination. The achievement of this coordination is made possible by gaining information from receptors in your body that provide feedback regarding your body’s awareness of where it is in space (termed “proprioception”), balance and neuromuscular control. (Dutton, 2012)
What are some examples of poor neuromuscular control?
One common example of impaired neuromuscular control is poor knee stability during jumping, landing and cutting movements. This decreased control is often due to a lack of coordination of trunk muscles and impaired lower extremity movement patterns lending to an increased risk for ACL tear. (Dargo, et al, 2017) Another example of impaired neuromuscular control is diminished coordination and decreased stability in low back musculature in individuals that experience low back pain. (Pourahmadi, 2020) In both examples the body is not working together efficiently and the end result is pain or increased risk for injury. By training neuromuscular control, we can improve functional movement and decrease risk for injury as well as pain.
How to train neuromuscular control
Having good muscular strength and focusing on performing tasks with good form and proper technique, thus improving neuromuscular control, are the initial goals of training and rehabilitation. The good news is that neuromuscular control can improve through specific training, just like strength training can improve general strength. The way we improve neuromuscular control is through neuromuscular education. The focus of neuromuscular education is to strengthen the ability of the central nervous system to generate efficient muscle firing patterns, increase overall joint stability and decrease joint forces. (Dutton, 2012) Ensuring that movement patterns are performed correctly, by emphasizing proper form, is also integral to neuromuscular education. It allows us to move as intended without relying on compensatory patterns which can place our body at an increased risk of injury.
So what do we do about this?
For an effective training or rehabilitation program, the focus should first be on utilization of a proper movement pattern. This requires identifying and correcting any faulty movements or deficient motor skills and is assessed by a trained professional. Strength training is another key focus as weakness will limit the ability for the body to move effectively and coordinate various movements. Finally, incorporating components of neuromuscular education with focus on proprioceptive training, balance and stabilization is important to ensure the body can perform specific tasks and activities at optimal levels.
How can PT help?
Your Physical Therapist can first and foremost help to identify problem areas. By correctly identifying specific issues, your Physical Therapist will provide you with an individualized plan to ensure, through neuromuscular education, that your muscles are firing properly, your joint awareness is providing efficient feedback and coordinating the appropriate body movements to most effectively perform a specific activity or task at hand. In turn, this will also ensure that your strength is up to par and will help you move efficiently without increasing your risk of injury.
Contact Dynamic Physical Therapy and Wellness TODAY for your assessment and individualized training program to ensure you Perform Better, Live Better, and Get Better.
References:
Dutton M. Orthopaedic Examination, Evaluation, and Intervention. Third ed. New York: McGraw Hill Medical; 2012; chapter 14.
Dargo L, Robinson KJ, Games KE. Prevention of Knee and Anterior Cruciate Ligament Injuries Through the Use of Neuromuscular and Proprioceptive Training: An Evidence-Based Review. J Athl Train. 2017;52(12):1171-1172. doi:10.4085/1062-6050-52.12.21
Pourahmadi M, Sahebalam M, Bagheri R. Effectiveness of Proprioceptive Neuromuscular Facilitation on Pain Intensity and Functional Disability in Patients with Low Back Pain: A Systematic Review and Meta-Analysis. Arch Bone Jt Surg. 2020;8(4):479-501. doi:10.22038/abjs.2020.45455.2245
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