There is an element of functional anatomy that I feel often goes over looked in NKT practice simply because with everything else that is or can be going on, it is easy to miss. Being aware of it, however, really helps decrease the chances you will miss something. This is the eccentric activation of musculature that is seemingly unrelated to the movement portion of various actions. A month or two back I wrote an article about why soft tissue becomes inhibited, detailing several reasons and mechanisms by which inhibitions happen or are maintained. I certainly go over the topic in that article but I wanted to shortly highlight the role of eccentric loading in compensations and NKT testing.

One of the primary and unsurprising methods the MCC uses to inhibit muscles is to keep an antagonist eccentrically loaded so that via reciprocal inhibition the target muscle is quite thoroughly inhibited. But what about when a muscle that isn’t an antagonist or synergist? One of my current favorite reads is ‘Stability, Sport and Performance Movement’ by Joanne Elphinston and in this text she excellently describes the role of local and global stabilizing muscles which during a movement will help keep the body stably moving through and appropriate vector for the desired action (and at the same time helping appropriate transfers of force). This means traditional ‘core’ muscles may be activating while you are asking the body to complete a seemingly unrelated pattern with an NKT test, though ideally in a fairly minimal way because of how we test.

Where the problem comes in is in two ways. One, as Joanne details, is that stabilizer muscles can become movers instead, which in the end can impede optimal and even adequate stabilization, range of motion, and technique for a given task and then in normal daily demands. This obviously causes lots of problems, and it’s no real surprise to most of us I imagine. The second issue here is the reason for this piece today. Your MCC is nearly as concerned with stability as it is with mobility in as far as we need to move to survive but your MCC is happy cutting down a lot of ROM and inhibiting a hell of a lot of tissues for the sake of minimizing injury or risk while we get that life sustaining movement done, to the point where we may not actually be able to move at all.

Through a wide range of proprioceptive mechanisms the MCC has a pretty damn good idea of how stable it is on a global and local level around any particular joint, not that the way it reacts to what it finds is the way we’d like. The typical response is a series of compression strategies and over-facilitations to limit range of motion and keep certain parts of the body on lock down. Part of feeling stable is holding enough tension through the Deep Front Line and similar foundational soft tissue lines to support the axial skeleton and overall make up our central line. If there isn’t enough tension on this line, the axial skeleton has to compress beyond feasible levels for non-degenerative action (think tensegrity units).

So if one element of the deep front line is not working in as such as it can create tension when and in the amounts needed, another part of the line tightens. This is where we find (in my experience) most TMJ cases, many pelvic floor dysfunctions, and other issues along the DFL. Normalize the function and tension in the DFL and many of these go away (for example get the TVA working and much of the time TMJ goes away, assuming it’s not via a scar or neck dysfunction).

While the increased tension on this fascial line can cause symptomatic issues like TMJ, or pelvic floor issues (constipation or leakage with jolts like sneezing or jumping), it can also be asymptomatic, but regardless of how noticeable the tightening is, it gives the MCC a sense of security because there appears to be global stability, even though this may be from bilateral knee valgus, and eccentrically loaded TM muscles, the diaphragm, and the pelvic floor. While these are eccentrically loaded, your tests may appear to be locks, though usually the patient will feel that despite being able to hold the test, it was one hell of a battle, and likely was confusing (aka not well organized). Especially if you suspect a muscle isn’t working, don’t just accept a functional success result from a test, also ask the patient how easy and confident it did or didn’t feel.

So what do we do about these misleading positive results? How do we confirm what the issue is? A muscle is likely eccentrically loaded to give the DFL and the MCC enough sense of tensile stability that it allows other muscles to function, but come into the dynamic world where the patient is participating in sports, outdoor activities, or just a small slip on a wet day and there is a high probability they won’t have the real stability to prevent an acute injury.

So to deal with the issue you will have to figure out the direct causes for the inhibitions of the muscles in question, be it the psoas, TVA, or an opponens digiti minimi. Sometimes it’s the eccentric loader, but I find that almost always these muscles are giving the tension to make the MCC feel stable, but isn’t the original cause nor the direct cause of inhibition, they merely muck up your testing if you’re not aware of their role. However, you can do a light release to see the effect it was having. Really challenge the diaphragm and see the effect on the TVA test, and then do a light release or appropriate breathing exercise, then challenge and retest. It will let you know what kind of effect it may be having on the TVA or other target muscle and give you a better idea as to whether the TVA is actually functional, though it may not be the diaphragm that is eccentrically loading (but commonly is).

The Bottom Line:
• A test may be a functional success, but is not a lock because a stabilizer (usually global, and usually in the deep front line) is eccentrically loaded, giving the MCC a sense of stability it doesn’t really have. Compression works in the same way; remove the compression and suddenly it doesn’t actually work.
• While the eccentric facilitator may need to be released, it often (note, I’m not saying never!) doesn’t in the case of the TM musculature, diaphragm or pelvic floor, though compression should be released barring ligament damage or acute injuries.
• Along the same line, while it shows a functional success, the eccentric loader is very rarely the direct facilitator, let alone the top of the faciliatory hierarchy.
• Simply be aware that this may be giving false-positives to tests, though if desired you can sometimes clear the false-positive effects of the eccentric loader, at least temporarily (My diaphragm needed to be limbically released before it stopped showing false positives for my abdominals) which can help you move on and find the real problem(s) both direct and hierarchical.

Filed under: The Practitioners Corner

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