We had a client come in for the first time yesterday and her symptoms were all very much nerve related. Aching, burning, and numbness starting from the gluteal crest where the long head of the biceps femoris muscle originates at the ischial tuberosity through the posterior aspect of the knee, working laterally to the fibular head, wrapping around to the medial tibia, and eventually working its way down to the dorsal aspect of the foot (see Figure 1).
After physically running through this pathway with her hand to show me where these symptoms are being presented, I asked her if she was familiar with the pathways of the nerves in the lower body (see Figure 2).
I was pretty surprised by her answer, which was a simple, "no". Normally I would not be expecting a "yes", as I know its rare to be familiar with this side of health and wellness. It's not exactly the most exciting thing to Google in your spare time.
But, after hearing how long the symptoms have been around and the amount of time spent trying to find a solution, surely someone in the medical field had shared this information with her. My expectation was that at some point there had to be a specialist or doctor who ran through this information, especially being that there was a trip to Johns Hopkins Medical Center at one point for an injection.
So I went on to explain to her the comparisons between where she touched on her right leg to some of the nerves in the lower body.
Why am I sharing this with you? Well it could help you, a friend, or family member that has not yet found an answer to similar symptoms or given up hope. This client has had the issue for over 5+ years and has been through the wringer and back with "specialists", physicians, MRI's, and different methods of therapy, only to find out that no one knows what's happening or how to solve it.
Sleeping is terrible, sitting at work is beyond frustrating, and driving, well that sometimes requires the use of the left leg because of discomfort in the right. How frustrating!
After a few minutes of administering the Neuro Therapy search process, we were able to locate the exact areas in the body that were over-sensitized, which were directly correlated to the most distal portions of those nerve endings she discussed (see figure 3). These areas we found were actually about the farthest thing away from the most painful spot on her body, near the gluteal crest. We then went to work on correcting the issue at hand.
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The week of the World Cup finals seems like a good a time to bring back an ongoing debate – why does the US struggle at soccer?
One of the reasons behind their struggles carries over to many other areas of sports performance and training.
For those of you that don’t know, team USA failed to even qualify for the World Cup this year, despite the fact that four million American kids play soccer, more than any other country in the world.
There are a multitude of reasons for US Soccer’s recent failings including coaching/leadership, economic access to the sport, and competition with other sports for the country’s best athletes.
However, today’s article will focus on the differences in training in the US versus many other countries that excel at soccer. The difference comes down to the concept of internal cues versus external cues.
A cue is something that we as coaches, trainers, and therapists use to give direction to a client on how to move. When we give that direction, we can either place the focus on the internal or external.
If the focus is on the internal, we are encouraging the athlete to focus on his body parts as he moves. In soccer, an internal cue might sound something like this:
“Place your right foot next to the soccer ball and point it at the target. As you plant your right foot, drive your left foot through the ball.”
(Disclaimer: This is probably a terrible cue and shows how little an expert I am on soccer.)
An external cue focuses the athlete’s attention on something in his or her environment and the outcome of his/her movement.
An external cue may sound like this:
“Kick the ball as hard as you can into the top right corner of the net.”
There’s a developing body of research that indicates external cues may help an athlete improve more efficiently than internal cues.
The theory is that by using internal cues, we are introducing a level of consciousness that limits the nervous system’s ability to perform the task. In other words, we have to think about it so much that we can’t perform it as well.
By placing the focus on the external, the nervous system can self-organize without the constraints of being controlled by conscious thought. The body is able to figure out on its own the most efficient way to do the movement.
So how does this apply to US soccer? In the US, parents with dreams of their kids achieving the highest levels of soccer place them immediately into technical training programs. In many instances, the focus is to train the fundamentals, i.e. give youth soccer players lots of internal cues on how to correctly pass, kick, and dribble.
We make our kids think a lot to learn the sport.
In other successful soccer countries like Brazil, kids are learning to play soccer with hours of endless unstructured practice with other kids. Their bodies are able to develop necessary skills without over thinking it.
The result? More fluid, creative, athletes who consistently dominate the US on the soccer pitch.
So how does all of this apply to your training?
Place more focus on what exactly you’re trying to accomplish, rather than how you’re going to do it.
For example, if you’re back squatting, think more about driving the ground away, rather than squeezing the hamstrings and glutes.
If you’re pitching, think more about how you’re going to throw the baseball through the catcher’s glove, rather than rotating your hips.
By placing the focus on the external, rather than the internal, you’ll create an environment where the full potential of your nervous system can evolve and take your performance to another level.
In this article, we'll review a quick & easy self-check to help relieve pain, and all it requires is your phone and a friend.
Ready for it? Simply record yourself doing the movements that cause you the most discomfort. From there, playback the video to yourself and look for any movement patterns that look abnormal or imbalanced.
If you're comfortable using your phone camera, you can even record the video in slow motion or slow down the playback to help breakdown the film.
If you are in pain, have limited mobility, or decreased performance, I bet something will jump right off the screen. It's not rocket science and it doesn't have to be difficult. It's quick, easy, and can save a lot of time and money on the back end.
Let's look at a few examples of how we utilize this tool at Premier:
Figure 1 below shows a Premier family member walking. You can see the location of her pain is located on the posterior hip, near her glute medius.
When she walks, she presents significant knee valgus (knee collapses toward the midline due to hip adduction and hip internal rotation. Having this issue for many years, all of her muscles on the lateral side (or outside) of that right leg have been chronically lengthened.
You could infer that the pain is a result of these improper walking mechanics. Walking and sitting is when this client is in an elevated pain state. Ironically, she also sits with her right leg in this position (knee valgus). Coincidence? I think not.
Example #2 is a little more complex. This time, the Premier family member suffered from right shoulder pain.
The first step was to discuss what movements present the most discomfort. In this case, it was the "muscle-up" exercise. The next step was to have her perform that exercise and record it. The last step was to break down the video (in slow motion) and review for any compensations we did not catch in live action.
Upon first glance, the thing that jumps out the most is the difference in shoulder angle in Figure 4.
It's easy to focus on this part of the exercise because that's where the shoulder is doing the most work, and there is clearly an imbalance or compensation occurring. But, not so fast....
Let's rewind the footage a little bit and determine if there's another reason that shoulder imbalance is occurring.
Figure 3 shows the left leg swinging through faster while the right leg lags behind. Figure 2 shows that imbalance coming out even sooner in the exercise.
Is it possible that the end result of the exercise (pain occurring in the right shoulder) is actually a result of the initial muscle-up movement that involves a faster left leg swing?
Yes, that was precisely the outcome.
Now, let's take another look at Figure 4. The left biceps is clearly shortened - which is an issue. How do we know this? Well, if it were in more of a lengthened position, the left arm would look like the right.
When the left biceps stays in a shortened state during the muscle-up, the right arm is forced to do more work, putting it at high risk for shoulder pain.
This same biceps/triceps compensation presented itself during a straight-arm front delt raise in our Neuro Therapy sessions. As we climbed to higher output powers on the device, she was not able to keep her left arm straight.
(Remember back to why we look for straight lines and right angles? See blog here:
After a few weeks of re-educating the left arm muscles (biceps and triceps) to work properly together in the front delt raise, we were able to transfer the same mind-muscle connection to the muscle-up exercise, while focusing on an even leg swing. The pain in the right shoulder substantially decreased until finally subsiding for good.
Pretty awesome tool we all have in our phones, but I might be biased ;)
In 1954, Roger Bannister became the first person to do what was considered by many to be impossible. He ran 1 mile in less than 4 minutes. For 70 years, runners had chased the goal, but none had been able to break through the barrier. In most of the world's mind, it was just not possible.
Within just over a year after Bannister's feat, 4 more runners accomplished the achievement, and thousands of runners since have done the same.
A mindset shift.
Seeing Bannister accomplish the goal allowed them to believe the feat was achievable.
At Premier, we talk a lot about protective mechanisms that exist within the body. These mechanisms limit our ability to move freely and perform at our best. In many cases, these physically induced limitations can develop due to previous injuries or improper movement patterns.
However, the race to the 4 minute mile demonstrated that the most significant limitations can often occur in our minds..
Psychologically induced limitations are created when we have negative beliefs, thoughts, and emotions about the goals we set out to achieve. Negative thoughts serve to protect us from the psychological damage of failing (which in 99% of cases really is never as bad as it seems, right?).
In doing so, they drastically reduce our ability to set meaningful performance goals and strive for improvement.
Instead, negative thoughts allow us to quickly say "no" to new ideas and move on.
Just think about it for a second... when's the last time you had a great idea or ambitious goal?
Maybe it was to decrease your 40 time, throw more weight around in the gym, or start a new project for your business.
It's possible the idea ignited a fire of enthusiasm, but was quickly doused with a negative thought like "I could never do that."
Within seconds, negative thoughts limited your ability to improve and do something great.
On the flip side, having a positive thought in that moment would have expanded your vision, making you more receptive, creative, and likely to achieve your goal.
If negative beliefs are the walls that we build around ourselves, positive thoughts are the ladders that allow us to peak over that wall to see if it's a barrier worth overcoming.
Therefore, in order to perform at your best, we must work at replacing negativity with positive belief.
Because negativity is a much easier thought process, it can easily become our default operating mode if we don't work at it.
How to start shifting your mindset:
One way that's proven to be effective is tallying the number of times you feel positive and negative emotions throughout the day. You can do this on a piece of paper, a word document on your computer, or the notes app on your phone.
Positive emotions to key in on include:
Negative emotions include.:
By doing so, you'll place a focus on the positive, and quickly start to shift your mindset. Goals that previously seemed impossible will seem reachable, allowing you to constantly strive for better performance.
About the Author
Evan Lewis is a nationwide leader in Neuro Therapy and founded the Baltimore area's only specialist Neuro Therapy facility.
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