Consists of training (or re-training) your muscles, your brain, and the nerves used for them to communicate with each other to improve movement, strength, balance and function.
In order to produce a movement, your brain sends messages through your nerves to your muscles, communicating how far, how fast and how powerfully to move. No matter how strong your muscles are, if they are not getting precise instructions, you will be unable to perform complex tasks successfully.
Physical therapists use specific exercises to challenge your muscles and your mind to practice and improve communication and coordination. There are many different techniques that therapists might use to achieve these goals, such as:
Standing Balance Exercises
One of the most common examples of neuromuscular re-education during physical therapy is balance training. Putting patients in challenging positions (such as standing on one leg, or with one foot in front of another as if tight-rope walking) or having them stand on unsteady surfaces (such as a trampoline or a BoSU ball) are ways to practice engaging the muscles that help us upright and aligned.
Seated Stability Exercises
Similarly, performing upper body or lower body movements while sitting on an exercise ball challenges the core muscles to keep the trunk upright as your center of gravity shifts and the balls starts to roll around.
Poor posture, especially poor sitting posture, is the cause of many of the injuries that end up requiring physical therapy. Our physical therapists will help you learn what proper posture feels like, what muscles should be engaged to create it, and how to maintain it even when performing challenging movements.
Isometric Muscle Contractions
Sometimes when we suffer an injury or undergo surgery and stop using the affected body part, the brain “forgets” how to tell those muscles to contract because of lack of practice. Nerve injuries also impact the messengers that convey those signals. Isometrics (contracting the muscle without shortening or lengthening it) can be a gentle and safe way to for muscles to re-learn how to receive and follow instructions from the brain.
Proprioceptive Neuromuscular Facilitation (PNF)
PNF is a broader category of physical therapy techniques that uses scientific principles of how the neuromuscular system works to stimulate the muscles we want to fire or inhibit the ones we don’t. For example, we know that muscles come in “antagonistic pairs,” meaning that when one muscle contracts, its antagonist automatically relaxes. So if we are having trouble getting a pesky tight muscle to stretch, we might have the patient engage the antagonist muscle to force it to relax. This is just one of many examples of PNF that physical therapists use to “trick” the muscles into getting the results we want.