There is a semi-permeable membrane (in a metaphorical/functional fashion) between the conscious brain and the limbic/motor control center. When we learn a new skill we must pay more conscious attention to help our ‘employees’ that are the limbic/motor centers execute techniques properly and then memorize/pattern the movement. This is one example of conscious data going to more subconscious layers, but it flows both ways. When on the table a patient may feel certain angles or tests, or releases/directions of release are actually threatening and uncomfortable, while others (even just a minor change in direction) may be perceived as relaxing and therapeutic.

Similarly, when a patient is trying to organize the movement strategy on the table they may come up with rolling eyes and conscious confusion where they have no idea how the hell to complete the task at hand. We give their brain a task, the MCC interprets it and comes back to the conscious brain like employees asking the manager for help…but the manager doesn’t know either. This shows that in the context of functioning tools, the MCC has no idea how to complete the task it has interpreted (I use this wording because what you’re asking their body to do may be interpreted as a different action by the MCC that may appear similar but is quite different, one they may be able to do, the other they can’t. One may be a compensation to achieve similar ends, or just a neurological misunderstanding of sorts).

Similar still is when you go to complete an action, which could be squatting down to pick something up, to walking on ice, to a complex gymnastics or martial arts technique and your limbic/motor control center sends you a conscious sense of danger. You actually don’t feel safe, like if you try to do whatever it is you were going to, you may be seriously injured. It may be because of perceived joint/global instability via the MCC or a memory of a past injury/trauma (emotional or physical) in a certain posture/motor pattern. Any of which, and all of the above examples, are ways the brain attempts to avoid potential threats. By learning effective and efficient motor skills, avoiding actions that your brain perceives as being clearly threatening or outside of your MCC’s repertoire of motor control, and making sure you pay attention when you are at the edge of these areas.

The clinical repercussions of this barrier should be in part pretty obvious. If a patient on the table is feeling threatened by a test you know that there is probably some pretty considerable instability there, which may even be caused by a limbic issue more than a direct physical instability (not to say that there isn’t an instability, but it may also be put in place by inhibitions caused by limbic trauma/perceived threat). Confusion is another obvious sign of significant inhibition, while you have to watch a little bit more closely to see the MCC select a different action than you asked for because it knows it can’t do what you’re asking but it is finding another way to ‘get the job done’ which may be an entirely different movement pattern.

A good history and honest discussion before/during this point can help you figure out if it’s instability from neuromuscular causes or if it may require the work of a specialist that can help with limbic issues, especially those which are directly connected with the physical body or specific motor patterns/body positions (I have another article written on this which I haven’t managed to post yet as of this writing).

The two aspects that I really wanted to briefly chat on in this article however looks more to a movement therapy perspective/practice. We all recognize that part of the cause or contributing factors to injuries, instability, and movement incompetence is due to the drastically limited nature of the majority of modern human movement. What little movement that does happen is repetitive and very limited in range of motion, so it surprises none of us that when our bodies are in essentially isolated incidents taken out of this normal range, both in actual range of motion as well as in more dynamic/unstable contexts, often result in injuries.

Even those who exercise, while in a better state in this capacity than those who do not, often execute their techniques in a very specific form, aka ‘ideal technique.’ I want my clients to know and execute their deadlift with proper technique, of course, but part of where the disconnect between ‘exercise’ and real life movement takes place is that the demands of natural movement do not always allow for that platonic ideal form. I want my clients to execute that normal form when they can, but when they are confronted with having to lift an awkward size/shape/weighted load (like their injured child which is no longer just a toddler) and find themselves having to go over/under something, their MCC better have the ability to take that deadlifting/carry/squat/step over skill and use it dynamically outside of normal form. If the MCC does not feel generally comfortable with the ranges of movement they are going through, it may inhibit and lock things down, shunting tension and forces through less supported routes (like an unstable knee which gets an ACL tear in a very minor movement deviation that likely would not have happened, had the knee stabilizers been working).

What I’m getting at is that all of the above calls for two specific types of intervention, which can be implemented as the same thing. Perceived threat is what runs our body, with the drive of movement/survival and reproduction behind it. That feeling uncomfortable on a sheet of ice, or not being able to do a lunge because you very powerfully feel like you WILL be injured is not nameless fear, but stimulus from the limbic and/or MCC telling your conscious brain to be very careful and be sure it really wants to do what it’s about to do. It’s trying to protect you, so don’t ignore it! We wouldn’t want to simply shut off our conscious/unconscious connection when it comes to warning us of perceived threat. While some people ignore it and end up doing some pretty stupid stuff, or their trainer makes them ignore it and do something that is sue-worthy, or at least cringe-worthy, it’s a valuable tool to help show us and let us work with our limits.

Just as using NKT we show the body that perceived instabilities and past injuries are no longer a threat to it, we can show it that it doesn’t have to keep acting like the damage is still there and be freer with its movements once more. Proper movement therapy/training can do very similar with movement based perceived-threat. By working in what the brain considers a safe range of motion and slowly expanding it (note…I really don’t mean stretching) we can simultaneously show it that there is no threat in this motion, which will grant us the semi-conscious confidence to actually do it, and expand the motor pattern of let’s say squatting, to let us go deeper while having just as high quality motor control as half the depth would.

So by slowly progressing in range (not just actual direct ROM like the depth of a squat but the more multi-planar dynamic range, which may include the coordination of multiple not fully related simultaneous actions) we remove perceived threat, we lay down permanent movement patterns that let us operate with higher degrees of motor control at these various ranges, And we improve the actual musculature that supports these ranges, especially the stabilizers, in the actual stability roles they have instead of just focusing on prime-movers shifting heavy weights.

So how would this look? Paul Mcllory, a renowned strength trainer and guest on Perry Nicklestons Stop Chasing Pain podcast series has a superb technique whereby if he has two identical athletes (let’s say clones/twins for the example) and one of them has been having repeated injuries, or pain from a long healed shoulder injury and they want to gain strength on bench he will start them both at 150 pounds, progressing to 300 pounds over 12 weeks. Obviously for the injured client we would have a lot we could do as various forms of NKTer’s but I still find a lot of value in his technique for removing the connected perceived threat/vulnerability from the injury, and better integrating our work anyway. For the injured client he puts six ½” boards on his chest, thereby limiting the end range of motion where most injuries of this nature occur in bench. Each week a board is removed, slowly increasing the range of motion and with this repetition in the ‘comfort zone’ of motor control, we expand the comfort zone and raise the perceived threat threshold of the movement and motor pattern. Halfway through the boards go back to 6 as the weight scales to the upper half and the athletes’ strength potential is increased. Starting from even an unloaded movement is a great way to help your patients begin this process as a way to take their homework and movement integration to the next step.

A fellow trainer in my facility shared with me another technique, which I have used sense to good success and have detailed in my limbic/MCC article (again, haven’t posted this as yet at the time of this writing). He had a client that had been thrown from a car at a younger age (I can’t recall if he was an adult at the time or not) and hit the back of his head in the process. Since then he has been unable to back squat without his head trying to throw itself forward away from a potential impact. Front squatting is just fine, but anything that suggests to his brain a risk to his head has a very low (aka trigger-able) perceived threat threshold and his body acts accordingly. The moment a sense of stability is given he is able to squat neutrally instead of leaning forwards. By using a band to the squat wrack above/in front of him, or holding it in a chest loaded (front squat) position, or even with very light pressure from behind via his trainer or other implement, neutral form is created and maintained.

I have used similar on another car accident victim where stepping up onto a tire was well within her strength capability (despite known neuromuscular dysfunctions) but she couldn’t manage. With this technique we showed her a sense of safety and stability in this pattern and she accomplished it like it was nothing with full conscious comfort, instead of the sense of vulnerability and threat moments before. By training this and slowly removing layers of external stability, the comfort zone is expanded and the perceived threat threshold is raised, giving more developed motor control and muscular stability in the process.

Outside of injury/incident victims I instill this in my general clientele by teaching proper form first, such as proper squatting or deadlifting technique, while working on neuromuscular/patterning dysfunctions. Once good competency is acquired, we start expanding this ‘motor skill/pattern’ to a wider range/more dynamic nature, helping the body learn not only a different circumstance/environment where it might use that skill, but improve its running ability to adapt its current motor pattern skill set to novel demands. How this looks isn’t too surprising. With squatting as an example I will start with bodyweight box squats for form and move adding some weight in goblet form, then back squat, and move to bodyweight full squats (no box), then adding weight. Then we may do it on a plush 6” gym mat, eventually on a balance board, and progress in this kind of fashion until they can squat in non-standard form while under an abnormal load on an abnormal surface, possible while carrying out other simultaneous but disparate tasks.

Exercise systems which are based on ‘functional movements’ or ‘natural/primal movements’ have a lot of obvious crossover here. If you place the body in a biomechanically advantageous and natural (often both being the same thing for all intents and purposes) state then using/learning proper efficient and safe patterning while avoiding over use and injuries in general is a hell of a lot easier. They also drastically improve dynamic stability and the ability to adapt to novel situations given that we work on skills and movements in all manner of fashions that typical gym work simply does not offer. By supplementing with corrective work there is pretty much everything you could ask for, and working in long distance endurance training for runners, or heavy squats for strength based athletes no longer ends up being more of a risk than productive work.

This whole process not only gives the average client the strength, weight loss, general fitness and flexibility they likely came to me for, but also increases their movement confidence, and seriously decrease injury risk by improving their fine motor skills in a more dynamic nature, including their brains ability to adapt movement patterns to novel situations and demands outside of the normal range. This also obviously is a fantastic way to integrate corrective work (NKT homework) into re-patterning poor movement strategies for more profound and permanent results.

Filed under: The Practitioners Corner

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