The Neuromuscular Connection
In the previous blog posts exploring Julie Wiebe’s online course, I have written about the diaphragm as being the driver of the core system, the importance of postural positioning to optimize the potential for core recruitment, and the relevance of the postural synergists to support postural changes and enhance strength and function.
Thus far, we have very specifically looked at the overall orthoapedic contribution to pelvic floor dysfunction, with some immensely important information in Wiebe’s course providing a framework for how we can address these mechanical challenges. However, within the heart of Wiebe’s work is the message of the importance of creating longstanding neuromuscular changes.
Neuromuscular control can be defined as the unconscious trained response of a muscle to a signal regarding dynamic joint stability.
Therefore, attaining changes in neuromuscular control requires initial persistence and attention; however, ultimately the aim is to develop a new norm, an unconscious understanding of what the body should do.
Wiebe supports that by changing the brain’s motor patterns we can have a long standing effect on our responses during functional demands, in whatever capacity that may be.
If we look at the chronic pain side of pelvic health dysfunctions, many practitioners (both physiotherapists and other) stick to the framework of rehabilitation that weak muscles are strengthened and tight muscles are lengthened. However, I so often see that tension can manifest in the pelvic floor for a multitude of reasons- from reactive tension based on trauma, poor load transfer (ie. Repetitive bearing down), stress/anxiety, fear, etc. The body has adapted, in some way, an inefficient neuromuscular strategy. When the tissues present this way, it is simply not enough to just stretch them.
By beginning to re-map the brain’s strategy for core coordination utilizing the entire container, we can begin re-balancing the system; ultimately re-educating the brain what safe and healthy movement feels like. By integrating these practices, we can create a neuromuscular effect- a motor programming change- and the brain begins to accept the healthy movement strategy as the new unconscious norm.
When I began Wiebe’s course I was in a unique position as I had taken one month off of work to rehabilitate from an ACL reconstruction. It is important to note that my surgeon and physiotherapist were amazing, and I was adherent to my rehab protocol, but I shifted my approach. I made a conscious decision to implement these strategies right from the beginning of rehab. I utilized breathing and core strategies everywhere from passive knee mobility to progressive single legs squats in an effort to better utilize the whole-body system. As I was struggling with atrophy and postural adaptations early on it was quite eye-opening to see how quickly my body changed; however, through dedication to postural correction and these progressive techniques, I was quickly and effectively able to change how the core system functioned. Interestingly, I also had a history of pelvic tension (I would call it reactive tension), which I worried would become exacerbated with decreased core control as I was trying to push myself through the next stages of rehab. I was pleased to realize that by utilizing this strategy that was not the case. I had re-educated my brain with what the strategy for core control was, creating a neuromuscular adaptation.
Having had a previous ACL reconstruction ten years previous I can tell you first hand that my recovery was immensely better this time around, and I do attribute that, in large part to the neuromuscular piece of the puzzle. Though the injury was a traumatic collision, I really wondered how a lack of a connection to a well-functioning neuromuscular system contributed to peripheral weakness down the chain, which had predisposed me to injury this time, and the times prior to that. Even though I had strengthened my lower extremities well the first time, I had missed an important piece relating to core control. I had fallen back into the same old patterns of movement during sport.
When I made the transition from patient to practitioner again it was really exciting for me to immediately integrate these strategies into my pelvic caseload, but also to continue to use my pelvic health ‘glasses’ in treating my ortho caseload and vice versa, and I feel the course beautifully blended these two usually divided systems.
If I was to conclude my thoughts on the Weibe’s course in one small paragraph, it would be this:
Julie Wiebe has, without a doubt, created an important course that is valuable to both pelvic health and orthoapedic practitioners alike, whereby she captures the underlying principles of form and function in treating pelvic health and beyond. Her systematic approach to concepts of postural modification, integration of core principles, use of synergists as a support system, and the aim of creating longstanding neuromuscular adaptations is a game changer, and not to be missed. These strategies challenge our pre-conceived notions of the importance of the core and how to connect to it, and reminds us of what the brain can do when provided with a nurturing environment.
Julie Wiebe and Pelvic Health Solutions have joined together to offer 20% off Piston Science Bundles A and B, Sports Medicine Bundles A and B, and Piston Science Module One. Click here to receive a 20% discount on any of these courses and use code NewYear20. Offer is valid until 02/28/2018.
Written by Michelle Vanderpol