Sunday, May 9, 2010

Let's put the Neuro back into Neuromuscular

I just read an article on groin injury rehab in a popular journal. The protocol was divided up into warmup, strengthening, sports specific. The warm up got off to a pretty good start- a good combo of different kinds of squats of lunges. However, the remainder was very much muscle tissue focused on hip adduction. Exercises like a seated adduction machine; squats squeezing a ball between the legs.

Most of the exercises in the protocol all seemed to involve a good deal of stabilizing isometric contractions that I'm wondering if they possibly contribute to the neural confusion that causes these injuries in the first place.

Remember the adductors come off the pelvis; and forces coming bottom up from the same side foot, & top down from the opposite leg, torso, and arms also need to be taken into account. It sounds complicated, but it's really not. Trying to piecemeal individual muscles is what makes it seem complicated. Functional science requires the practitioner to think on their feet- the rehab is customized to the athlete and injury.


JH said...


When I suggested that we should consider the other links in the chain, I was told to be careful because I needed a script for those other links. This is one of the problems in the HC system. Let us do our job and address ALL the areas contributing to the injury/dysfucntion.

Great stuff joe!! Keep it going!!

Joe Przytula said...

-not the first time I've heard that complaint JH. Whatever happened to the good 'ole "evaluate & treat" script?!

Anonymous said...


Neural confusion is a great term. I have also heard, in talking about the glutes, gluteal amnesia. Similar principle.

Performing the seated adduction exercises does nothing at the foot, knee, etc. and so they get to the body gets to the real world and doesn't quite know how to respond.

Although you mentioned they did squats and lunges as part of the warm-up, I'm interested to see if single leg training was used in the strengthening phase. Single-leg and double-leg are totally different as well. Neglecting single length strength training in place of double leg is also a shortcoming of many programs.

As always, thanks for the thought provoking post.

KP said...

Joe - where was the article?