What is Neurokinetic Therapy (NKT)?
“NKT is not about strengthening muscles. It is about activating neural pathways that have been made unavailable due to accidents, posture, poor movement,etc.... Apparent strength comes from a compensation pattern, which eventually will lead to dysfunction." [David Weinstock, creator of NKT]
What is neurokinetictherapy (NKT) and how does it fit into the delivery of care here at NCRC?
As other posts on this website have discussed, when treating the body, we must be principle driven as opposed to methods driven. By this I mean, give the body what it wants and needs rather than layering on your favorite method of care such as manipulation, physical therapy exercises, traction, acupuncture, massage, etc. Just because I, as a provider, really like a particular method of treatment doesn’t mean it is what you, the patient, needs. You may need it my favorite treatment, but we first have to do our detective work from a functional standpoint to see where your deficits are.
Back pain or shoulder pain are just that, but WHY? What has caused the painful area to become overworked, sore and dysfunctional?
NKT is a perfect addition to our other training in functional movement such as the Functional Movement Screen (FMS), the Selective Functional Movement Assessment (SFMA) and other functional tests used from Stuart McGill PHD, (www.backfitpro.com.) With NKT we stress the body to challenge it to see what is working too hard, what is working when it shouldn’t and what isn’t working hard enough. In other words, what is working overtime and what is on permanent vacation.These imbalances in muscle and fascia result from previous injury, repetitive motions such as running and chronic postures such as sitting.
Once we have taken a history and done an orthopedic and neurological exam and followed up with FMS, SFMA and other functional tests, we look for inhibited muscles (those on vacation) and facilitated muscles and their fascia (those working overtime) using NKT.
NKT allows us to look for what we call, a neurolock. We tests muscle for the neurolock. We are not initially looking to see how strong or powerful the muscle is. A neurolock is challenging a muscle with light pressure to see if on demand it activates and does its job in the sequencing of muscles during a movement pattern.
All movement patterns have built into them an ideal sequence of which muscles fire and when. If the muscle doesn’t fire on demand, the motor control center (MCC) of the brain which stores all movement patterns substitutes another muscle which can do the job in milliseconds but would prefer to only help and not do the job on a continual basis.
When I talk movement patterns, I am looking at walking, running, using your arm overhead to reach for something etc. All of these thousands of patterns are stored so you don’t have to relearn them each time. A baby learns to walk through repetition and failure (such as falling) mixed with ever increasing success until they walk effortlessly.
Sometimes our MCC of the brain gets a virus from injury (think ankle sprain and limping) and rewrites your new movement pattern to avoid pain and still allow you to walk. This new pattern is dysfunctional and causes pain and inefficiency in our movement patterns leading to an ever increasing compensation and injury. The body will always do three things: avoid pain, finish the task at hand and be as energy efficient as possible. It will, under duress, substitute quality for quantity so you can do your job and other activities.
NKT allows us to enter into your MCC and see which muscles and their fascia are not working properly and become either inhibited or facilitated. The MCC will not recognize a muscle that has become inhibited and will simply in milliseconds substitute the next best muscle and its fascia and this will become your new movement pattern unless identified and corrected with manual therapies (ART) etc. and proper exercises based on the findings of NKT, FMS and SFMA. Giving the patient a sheet with generic shoulder (back, hamstring, etc) exercises is guess work at best. Your exercise program will be different then someone else's.
So here at NCRC your home program is kept at typically three exercises and they are based on YOUR needs. We retest each visit with NKT to see what the exercises have done for you. This drives your homework.
The brain is excellent at compensation and adapting to current needs. Your MCC needs hundreds of repetitions to write the new movement pattern software in the brain. After hundreds of repetitions it moves into your long term memory. Remember, you very possibly will be going back to the same chronic postures and repetitive motions. Thus, you must work on these exercises which will take less than five minutes each time.
NKT (www.neurokinetictherapy.com) has been an excellent addition to our bag of detective work assessment tools. The best method of care in the wrong place, wrong time or just not needed is a prescription for failure.
ALWAYS, ALWAYS, ALWAYS check functional movement first through FMS, SFMA and NKT before doing any strengthening exercises for strength, endurance and power. If your movement is bad or dysfunctional with inhibited or facilitated muscles, strength training will only reinforce a dysfunctional movement pattern leading to more compensation and injury. So, treating a patient for a back problem may at it’s root have a past ankle sprain as its core cause.
You must assess through FMS, SFMA and NKT along with other tools to give any “method” a chance to make meaningful changes.
A chronic muscle spasm on the shoulder blade is often treated multiple times and keeps recurring. WHY? It is working too hard (facilitated) and something else is on vacation (inhibited) as far as the MCC is concerned.
We must release the facilitated muscle and give proper activating corrective exercises for the inhibited tissues to share the workload during a movement pattern. This method of detective work and the subsequent care has become the gold standard at all levels of sports, work place and life.
Remember: Thinks aren’t always as they appear. Test. Don’t Guess!