Updated: Jan 30
So here goes, this is why we look at neurology! And why it plays a huge part when you come in for help with your riding and want to move pain-free, move better, stronger or faster.
When you decide you want to move your knee you have to take in information from your knee like its position, the pressure, the direction you want it to go ( and loads more). This information is sent back to the brain which then interprets that information to decide how "threatening' that knee movement is. This includes any previous experience, how well it knows how to control all elements of the knee (including muscles, ligaments, tendons, bones, blood supply, etc) as well as the information that is coming in from the knee. Once the brain has all this information it then can decide how to move the knee and send a signal to the muscles and structures of the knee. If any of these areas are performing poorly it will lessen the movement at the knee as the brain feels there is a threat to the body. This will reduce the range of motion, increase pain, and limit power just to name a few. When we ask you about your injury and goals, yes we are looking at where your injury is and what you want to achieve but we also need to consider the way the body is talking to itself to produce those movements. If there is an issue anywhere along the line of communication then that will reduce your performance and this is where we can help fix those. Ever had those niggly injuries that never seem to go away regardless of the rehab and strength you have been doing. It is likely to be an issue in the inputs or interpretation of information by the brain (more about this shortly). This is happening for every body part, every movement, every second of the day! If your system isn't working no wonder your struggling with the movements you desire. Let's break it down and look at it in parts, starting with inputs and what they are. Brain Inputs What are they? How do we get information into the brain? We have 3 types, Exteroceptive(outside the body), Interoceptive (inside the body), and Proprioceptive(body awareness of itself). Exteroceptive are inputs you will be already aware of, they are our senses and these are used to tell you what is going on around you outside of your body. They allow you to take information in about your surroundings and for your brain to decide how safe your surroundings are. For example, you can see a step in front of you on the floor, you can hear cars, you can feel sharp objects, you can smell fire, and you can taste food that is off. Interoceptive are input from within the body and are reported back via internal receptors. We have receptors for everything from chemical status which help you know if your carbon dioxide is too high in the bloodstream, you have receptors for pressure, hunger, thirst, and heart rate, this list is huge as there is a receptor for everything that is inside you that has a job to do to keep you alive. Proprioceptive input is about the receptors for joint angles to muscles position to where each body part is. This can be from the joint position to knowing where your hand is with is without looking. having proprioceptive awareness allows us to move subconsciously. All of these need to work well for your brain to receive clear information about how safe it is. Now imagine if you had a scar from surgery on your knee (or a tattoo) and poor vision, high blood pressure due to stress and you are a little clumsy walking into things. Your brain will be getting poorer information from the skin as it cannot tell what it can feel (scar). It will have poor information about your surroundings (eyes). It will internally all the systems will be working harder or trying to slow you down to reduce your blood pressure but only if the stress is reduced. It will reduce your range of motion and limit your balance if you are unaware of where your ankle, knee, and hip are in space. ...... and now you go for a walk or run?!? Your body was already in a place it was not getting enough information in for it to know it is safe so now asking it to move more it wants to slow you down to keep you safe, as it is still getting poor input from those areas listed above. As you move, the blood pressure increases to help the oxygen demand, but the pressure was high already, so it has to get even higher to deal with the increased demand. The skin of the knee is still not giving clear information due to the scar, and the vision is less clear because you are moving faster. Your ankle, knee, and hip want to move under control but you are still unaware of them proprioceptively. The brain says it is all too scary and there is too much threat (or too little clear information), so it tightens muscles to support you, to keep you safer. It reduces power so it can cause less harm to itself, and when you overload it acts as if there is too much threat, then *PAIN* kicks in. You ignore it (obviously, it is just a little niggle) and then you compensate to remove that pain. But that then is stressing other areas of the body on top of the poor inputs and irritation caused by loading initially which in turn creates more threat which leads to more pain, tightness, and fatigue.
But guess what, when you stop, the pain stops until the next time. But this only happens for so long before you irritate it that much that the body has too much inflammation causing a structural issue... if you ignore the warning, you are hurting yourself. So when we ask about sleep, stress, nutrition, tongue position, and gut health, and all you want us to know is about your knee... it is because we are looking at the WHOLE picture. As this is movement neurology and input matter if you want to move and ride well. If you feel you have an issue with your input get in touch there are lots of things we can do to help improve and work on these, this includes stress, poor gut health, and poor vision. As you can see we are more than NORMAL therapists. Brain interpretation Once your brain has received information about its environment the has to sort that information out and it needs to do it well. We look at how well your brain is functioning and talking within itself. So are all the part doing their jobs, the right and left talking and reacting as they should, we look at the order that information comes in and can it process it and correct it when there has been an error. Because if your brain isn't working well, you won't move well. It is like trying to use a broken computer. In a movement, we start with 4 key areas of the brain, the Cerebellum, the Brainstem, the Partial lobe, and the Frontal lobe. There are many more than this but these are the vital areas when it comes to rehab and movement. Why? Well, the cerebellum is responsible for accuracy, balance, and coordination... all key areas to movement. If this area isn't working well we see clumsiness, poor balance, and coordination. This can be one side or both sides of the body. This is also your error detection area. The brainstem is the gatekeeper in and out of the brain but it also plays a huge role in the regulation of the body from breathing and balance, to heart rate and sleep ....and so much more. These are key to insuring that the body is reacting to the stimuli as it should. for example, you have to run to cross the road. The brain has to signal to increase heart rate to allow this to happen.
The Parietal lobe processes your senses in the somatosensory cortex and plays a key role in spatial awareness, navigation, and language. When you are moving you need to be able to be aware of and control the direction your body is going in. The Frontal lobe houses lots of significant things, but the key one for today is the motor cortex. ... where all your movement maps are stored. This is the area needed to be able to do and move and repeat the movement over and over again. When we do an assessment, there are movement tests we do that start to show us how your brain is interpreting the information it is receiving. We do not scan your brain, we scan your movement to see where there are potential deficits and relay it back to where in the brain is controlling that movement. Next, let's look at outputs. Brain outputs Brain outputs are the things you look for in movement. If you have good inputs, and good interpretations then you will get the performance things happening when you move. If you have poor input or interpretation then your body will guard and end up within the survival list of outputs, these are all things that don't help us move and feel well.
As Sports Therapists, our job is to ensure you are working towards being on the performance end of the scale. This is why we ask lots of questions when you have your initial assessment. In our assessments we look at you as an individual with a unique brain that tells you what to do, these things are all learned from your own previous experiences which are all unique. If you have Achilles tendonitis, yours will be there for a reason but possibly not the same reason as every other person. Yours may be due to poor visual input, or poor knee control. Other people may struggle due to poor ankle proprioception and balance. As you can see, this means the reason it is there is different so it may need to be treated differently- fixing the actual cause is the only way to stop it. This is the very reason this is why blanket rehab exercises don't work. The Sports Therapists use this to assess you using this science and knowledge whether it is for our injury assessments. Looking at the Neurocentric approach allows us to see where issues are actually coming from and where gaps in performance are. this enables us to help reduce your pain and hugely improve your performance.