Change the Way You Move

08/26/2022

A Superhero Saved by NKT

Not long ago the stunt man for a major motion picture superhero film came to see me for intense pain in his left rhomboid/trapezius region that was most aggravated in the mornings while drinking his coffee. The pain persisted all day but those early mornings were debilitating - which is saying something for a stuntman whose job is to basically get hurt. After 3 months of this discomfort he was limited in the stunts that he was able to perform but was able to modify his duties and coordinate stunts, however filming for a new movie was starting soon and he was the the stunt double for the lead superhero. This needed to be addressed ASAP.

He had seen multiple practitioners and had acupuncture, soft tissue release and chiropractic adjustments to the surrounding area. MRI results showed nothing of significance. He had heard about NKT and decided to give it a try since he was receiving some temporary relief with soft tissue release to the rhomboids. Maybe there was a compensation pattern in the area?

Anytime I hear that soft tissue work yielded temporary relief, I think that muscle was likely overworking and causing discomfort, but the muscles that are underworking were not being addressed. The human body can be pretty creative when it comes to compensating so I find a diligent history is foundational to understanding how the body has adapted to injury over time.

Since the injury history for this stuntman resembled an encyclopedia, I decided to focus on the 6 months prior to when the pain started. There was a left AC joint separation after a fall from an 8 foot platform that needed to be rehabbed ASAP for a role. The rehab process involved a lot of “scap setting” which essentially means he used his rhomboid/mid traps to stabilize for every exercise. Under normal circumstances this is generally an OK strategy as the glenohumeral (GH) joint appreciates a stable scapula, however in this circumstance the muscles around the AC joint needed more attention after an AC separation injury. Using the scapula to stabilize for weakness in the GH joint was not working to his advantage in this scenario.

The first NKT pattern we focused on was rhomboid facilitated for posterior deltoid. When we took away his scap setting, his posterior deltoid was very weak. If he set his scapula, it was very strong. His body relied on his rhomboid/mid trap to stabilize the GH joint. After this yielded significant improvement, we worked on the pecs facilitated for serratus anterior and after a couple sessions of this focus his pain was gone. Cautious optimism was in the air as he prepared for the film by getting thrown into walls, flung around with bungie cords, etc. Once filming started symptoms came back about 10% but continuation of his NKT exercises shortly led to the pain being completely resolved and he was able to film successfully.

As a Chiropractor who started his practice releasing all the tight muscles and tight joints he could find, I will forever be grateful for finding NKT 10 years ago. The ability to understand and unravel compensation patterns has not only made my practice much more successful, but much more enjoyable. Please join me as I share this wonderful technique October 1st-2nd, 2022 in Calgary, Alberta. Early bird registration ends in 6 days! Visit https://neurokinetictherapy.com/upcoming-seminars/ to register.

01/23/2020

Clinical thought process is everything. Guess, then test. Must have a hypothesis and a way to test that hypothesis. Tis the NKT way.

Patient came in with anterior shoulder pain of 40 years that started after a car accident where she broke right clavicle. Unfortunately at the time it was not properly diagnosed and she was not casted.
She recalls carrying her new born on that side and it being quite difficult, but considering her child was also injured in the accident, she was not very focused on her own injuries at the time.

When bones fracture all muscles attached to them undergo neurogenic inhibition so to encourage healing and reduce stress on traumatized area. Consider the pecs, traps, deltoid, and SCM all have clavicular attachments, these structures were unavailable to support her child. Time to compensate.

The coracobrachilias is often overlooked and in this case was a major contributor to pain as it was called on to compensate many years ago and never learned how to relax. The tension reduced her ability to dissociate the humerus from scapula which turned a neurological compensation pattern into a structural one. This pattern was initially suspected as patient would always flex elbow and internally rotate shoulder while lying on the table, even after I would repeatedly straighten the arm. This led me to believe elbow flexors and/or shoulder internal rotators may be neurologically over active. I confirmed this hypothesis with NKT testing.

After releasing the coracobrachilias and activating muscles attaching to the clavicle, there was immense relief of tension and an overwhelming sense of relaxation she was unable recall ever experiencing in the arm. If tight enough, the coracobrachilias can entrap the musculacutaneus nerve, which supplies the bicep, potentially leading to further shoulder inefficiencies.

Lesson of the day? How people hold their body in space can be valuable hints when understanding how their body has compensated around trauma and pain.

01/22/2020

01/14/2020

Love this relationship! Scalenes and Levator both attach to transverse processes and are always working to balance each other out like good TVP friends should!

A young Mom came to see me today experiencing pain and weakness in her left shoulder that was believed to be the result of carrying her kids too much.

NKT testing revealed tight and under active anterior and middle scalenes along with an over active levator scapulae on the same side. Because the brachial plexus travels between the anterior and middle scalenes, shoulder weakness and pain can often result when these muscles come under excessive stress. If the scalenes are unable to adequately support the neck it is common for levator scapulae to step in at the expense of the shoulder. Due to this complex relationship symptoms in the neck or arm can vary greatly when this compensation pattern exists.

After releasing the levator scapulae and activating the anterior and middle scalenes, symptoms abated significantly. It is now important for the patient to comply with her home exercise program so this compensation pattern doesn't return the next time she carries her kids.