Lodaer Img

Knee Valgus

A technique that has served me well is the application of a concept known as reactive neuromuscular training (RNT). Essentially, it is defined as the integration and processing of peripheral sensory information in the central nervous system (CNS) to elicit the most efficient motor response (Harrison & Hart, 2010). RNT can be further defined as a means to stimulate muscle co-activation prior to a perturbation (i.e., preparatory) to help mitigate joint and tissue loading. Utilizing closed kinetic chain (CKC) exercises to stimulate joint mechanoreceptors generally leads to co-activation of muscles surrounding target joints (Harrison & Hart, 2010).

I use RNT to help the client become consciously aware of the movement dysfunction I wish to eradicate. A simpler, more colloquial, definition is that RNT amplifies the degree of the dysfunction. For example, if a client slips into some valgus motion during a split squat, I implement RNT by pulling the already valgus knee into a deeper form of valgus. This causes the client to become hyper aware of the dysfunction I am trying to change. They reactively pull the knee back into midline. It is not absolutely perfect the first few times. It could be argued as normal if we consider the dynamic systems theory (DST) postulates new movement patterns move through a phase of variability and instability before the new pattern emerges as a permanent, predictable, and consistent pattern (Magill, 2011). Please see the below link for a video on an RNT split squat.

RNT Split Squat YouTube Link: https://www.youtube.com/watch?v=oS24i1TexuE

References

Harrison, B. C., & Hart, J. M. (2010). Reactiveneuromusculartrainingin low-back pain rehabilitation: Part one. Athletic Training & Sports Health Care, 2(6), 253-254.

Magill, R. A. (2011). Motor learning and control: Concepts and applications (9th ed.). New York McGraw-Hill.

Page, P., Lardner, R., & Frank, C. (2010). Assessment and treatment of muscle imbalances: The Janda approach.Champaign, IL: Human Kinetics.

 

-Michael McIsaac