Time for Corey’s long post of the week (it’s a full typed page today). Seeing enough people have problems grappling with the concept of relational inhibition/compensation in general and that the way I explain it seems to help people come to terms with it, I wanted to share my line of thought and get some feedback on whether I am horribly off the mark or if this sounds about right. I also have a piece on some of the various specific causes for inhibition but I try to space out my walls of text!

One of the more difficult concepts for a lot of those new to NKT and the paradigm it works off of is relational inhibition and compensation and why they happen. Nearly all of us were trained based on a foundation of Gray’s Anatomy with a narrow view of anatomy; a carved in stone focus on their use in a few specific isolated actions and their simple origin and insertion nature. Many of us are lucky enough to have a good grounding in functional and integrated anatomy which has a much more holistic look at how these parts of the body actually work and organize together to create actual movement and stability. One of the central ideas that explains compensation patterns to me is that your body does not care about individual parts. Yes it wants to keep the lats functioning, doesn’t want ligaments torn and it’d rather not over-supinate but at the end of the day its function that matters, not parts.

The explanation I start with my patients or those I’m explaining NKT to is basically this: say 10,000 years ago you come across a bear in the woods with her cubs. You start running like hell and sprain your ankle; your body doesn’t even let you know let alone care, it just wants you to get away and survive. That is all that matters. You get away, but have an injured post tib. Its role in plantar flexon, supination and lateral stability etc. now get shunted onto other muscles and tissue as the matter is…there is no medicine and no rest time, the next day you need to hunt, forage, and run from danger so the body must find a way to continue. This is also part of the reason why compensations also commonly do not simply go away when injuries are healed; the brain expects you to have to keep moving and functioning in the real world, and not get it healed up nicely in a timely manner. The worse the injury (and the more unstable the body is since the injury) the more likely the compensation(s) remain after healing.

When it comes to compensations it’s the same thing (as the not caring about individual parts), which means that we need to really embrace a focus on holistic functions instead of individual anatomy pieces in explaining how and why movement and compensation happens, and by extension how we approach dysfunction. A great example at this last weekend’s seminar was one new NKTer who had distal adductors which were inhibited in an adduction pattern but were facilitated in an extension pattern. In one pattern they were the victim, in another the perpetrator. Your body doesn’t just simply choose one tool for each job, it chooses the best tool for the job given the situation of what it’s trying to accomplish. If it feels globally unstable it will compress the body and focus on using ‘tools’ that will get the function done but not compromise the compensation strategy it is using to feel stable enough to move.

Not only are functions dynamic, our compensations are too (though the general schema of compensation is generally to create stability however possible, which is typically compression and limiting range of motion, inhibiting anything that will stop that in the process) Look to muscles and tissues in functional patterns and relational inhibition/compensation will make a lot more sense. Muscles and tissues may get damaged and we fix parts in our work but compensations and compensation strategies are in patterns not pieces. The muscle is not the problem, the problem is in the unstable context your body sees and is trying to fix. Our movements are dynamic, so is the instability and the compensation approach that must be taken by the MCC and thereby the way we treat and integrate must be fit to this dynamic nature.

Filed under: The Practitioners Corner

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