Neurokinetic Therapy New Zealand

The other day a patient was looking to resolve headache symptoms. There are different types of headaches. Some of which are mechanical in nature. NKT works wonderfully for assessing and deciding which muscle groups are going to respond best to what mechanical intervention!

After assessing, this patient’s symptoms were cervicogenic in nature. This means that it is coming from the neck. Specifically, with this patient at the upper cervical region. There are many muscles that move this area, but we started with checking what range was restricted. Their C1/C2 was struggling to move to the right. Now while a joint range loss might indicate joint mobilisations or manipulations, we first checked with some the level 2 joint de/compression protocol. Turned out the joint was in fact decompressed and did not need joint mobs or manips. Instead, it would benefit from biasing an exercise to a muscle. Which muscle though?

NKT testing showed a facilitated right splenius capitis and an inhibited left sternocleidomastoid. While these muscles don’t directly attach to the upper cervical spine, they do move the head on the neck. This is the movement we were interested in improving.

After quietening down the right splenius capitis, we did some exercises for the left sternocleidomastoid. After a few sets at the correct dosage for that patient, their headache symptoms had reduced significantly, and their upper cervical flexibility had normalised.

NeuroKinetic Therapy

Come join us in June 2023 and learn how to use NKT to get to the root of motor control dysfunction! For more information follow the link on my profile.

Come join us in June 2023 and learn how to use NKT to get to the root of motor control dysfunction! For more information follow the link on my profile.

NeuroKinetic Therapy

Images from today's post.

A patient came in after hurting the outside of their knee while playing soccer. They reported feeling a crunching sensation and sharp pain on the outside of their right knee. After clearing the knee of any ligament or meniscal pathology we started looking at functional impairments. They were having outside knee pain with turning the leg in, jumping and single leg squats. It was clear they were missing tibial external rotation during these movements. Interestingly they had a lower leg fracture many years ago which they felt they never fully recovered from.

Tibial external rotation requires the outside hamstring and shin muscles to shorten and the inside hamstring and shin muscles to lengthen. Interestingly, Neurokinetic Therapy testing found the biceps femoris muscle facilitated and the tibialis posterior muscle inhibited. The issue was an inability for tibialis posterior to lengthen under the load.

They were given a seated self-ball massage of the hamstring and tibialis posterior calf raise for homework. After doing a couple sets they noted their pain was markedly reduced and were comfortable turning the leg in, jumping and doing single leg squats.

If you are looking to find the missing link between your client's symptoms, assessment and rehab then Neurokinetic Therapy is what you are looking for! With a Neurokinetic Therapy skillset you learn to breakdown complex motor patterns, enabling you to provide both effective and patient specific prescription.

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Motorcycle accident, midfoot eversion, gracilis and peroneal longus.

What did all of these things have in common? Knee and anterior hip discomfort! This patient had loss of midfoot flexibility, specifically into eversion.

Did you know you don’t feel pain? We feel nociception, or noxious stimuli. All of this can become pain. Pain is emergent. It is created from an ingredient pool of many, many variables. This can include structural issues, but not usually after regular tissue healing timeframes. When does tissue or structural issues become a nociceptor source past healing timeframes? Peipheral sensitisation and a phenomenon called wind-up is a potential source. When nociceptors are stimulated at, or over a specific rate of 0.3 hertz, wind-up can occur at the dorsal horn of the spinal cord. This can lead to mechanical information like stretch and compression, to be perceived as noxious. Mixed signals in essence that share the same fork in the road.

In theory, encouraging reduced sensory input at that segmental spinal level and increasing it at other levels can leverage pain gait theory. What does this mean in this patient case? This patient had sensitisation of their sciatic pathway from a tibial injury from a motorcycle accident. This led to bracing of the peroneals and tib posterior. They had lost midfoot flexibility secondary to this. Neurokinetic Therapy helped unravel the bracing pattern to find that the same side gracilis was facilitated and the peroneals were inhibited. What is the mechanical relationship here?

The peroneals externally rotate the tibia and directly evert the midfoot. The gracilis internally rotate the tibia and indirectly invert the midfoot. So they are antagonists, or opposites in movement.

Coming back to our pain conversation, the gracilis is innervated by the obturator nerve from L2-L4. The peroneals are innervated by the superficial peroneal nerve which joins with the sciatic nerve, ascending up to L5-S2 (L4 if you consider other pathways). Building into the theory, stimulating the obturator pathway, may distract from the sciatic.

In this case the patient was prescribed a Cossack squat to stretch the gracilis and peroneal raises to encourage mechanical input to the peroneal muscles. Afterwards their discomfort was greatly diminished and they had improved single leg jumping and squatting performance!

Neurokinetic Therapy opens your lens to filter and interpret complex movement patterns into simple digestible and practical chunks. This translates into straightforward homework for the client.

Always a win when it comes to adherence! NKT is logical, accessible and practical.

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Abdominal scars and back spasm.

A patient came in with back spasm after a fall. After discussing how the injury happened, their history and performing an assessment it was clear that the injury was not severe. In fact, it was the response to the fall that stood out. Filtering information through a biopsychosocial lens is important to pick up all potential contributing factors. While most back pain will resolve with time, in this case the reaction of the muscles, did not match the mechanism. From a psychosocial aspect they were fine! What other biological factors could be considered? They had reduced lumbar flexion. Was this secondary to the spasm or pre-existing?

NKT allows us to filter how and why someone moves the way they do. Our NKT assessment found the lumbar erectors were being inhibited by a scar on the abdomen! The scar was from many years ago. They second aspect to this was they were unable to breath into their abdomen comfortably. After working through the scar, we moved into some coordination work. They needed to use their lumbar erectors while also breathing into their abdomen. Dual tasking!

Going forward, we’ll have to progress this coordinated skill into upright and flexion based postures to restore their lumbar flexibility.

Afterwards, all the previously painful spinal movements were pain free. Their lumbar flexion had also improved.

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Welcome to the newest Level 1 grads from Auckland, New Zealand!

Fantastic weekend of learning and applying motor control theory. 🤗

This group of students can now assess and resolve motor control, and learning issues from head to toe!

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And that's a wrap for Day 2!

Students covered everything from the neck down to the finger tips 🤙. Big day of learning and reinforcing NKT theory and protocol.

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Day 1, Level 1 in Auckland, New Zealand complete!

Everyone did exceptionally well digesting scar and NKt protocols today. Bring on the neck and upper limb tomorrow!

Loss of spinal extension, abdominal scars and dissociation.

Spinal extension is an interesting beast. It requires coordination of controlled segmental extension, potential rib elevation and pelvic control. Control doesn’t mean stationery. Control through the range.

If standing with feet together, the pelvis must move forward to counteract the weight of the thorax and head as the spine maximally extends. Some key muscles that control this are the multifidi, transversus abdominis, and internal obliques. They connect the ribcage, pelvis and lumbar spine together. Their attachment points must be able to move apart from each other at the front and together at the back. While this is happening, the ribs must be able to dissociate from the spinal extension, expressed as breathing.

This can be a lot to coordinate when balancing on your feet. Abdominal surgeries can make this even harder. After any surgery it is reasonable to see if rehab is relevant for you. Anecdotally there will be reduced control, somatic awareness and flexibility around abdominal scars. Particularly with breathing flexibility.

This patient had an old abdominal scar on the front of their abdomen. They were able to flex forward from most places but had limited lumbar contribution. Extension however, was limited globally. The ribcage and pelvis were unable to demonstrate range of motion through lumbar flexion or extension.

Neurokinetic Therapy testing found the abdominal scar was inhibiting the lumbosacral and thoracolumbar multifidi. However, the crux was the loss off dissociation from front to back. With injuries we will co-contract around regions to protect. With chronic symptoms, this habit can persist. This patient had co-contracted their transverse abdominis with their multifidi. All or nothing at the expense of a relaxed breath.

Homework was to stretch the scar, followed by multifidi activation WHILE encouraging breathing into the front of their abdomen. Afterwards, global extension was much improved and walking felt much looser. Not to mention a more relaxed neck. Getting to the root of the pattern allowed the co-contracto to relax.

NeuroKinetic Therapy