Neuro Therapy, Straight Lines, & Right Angles

Over the years we've had a number of different strength and conditioning coaches and personal trainers come into our clinic. One question that always comes up is, “Why are you looking for straight lines and 90° angles in your movements during therapy?"

More times than not, this question of “why?” comes up during our knee touch exercises (more widely known as a stiff-legged dead lift or SLDL) in which we coach clients to completely extend the knee, or perhaps more easily described as “no bend in the knees.” 

In the strength & conditioning world, a lot of coaches shy away from complete extension of the knee in a Romanian Dead Lift (RDL), because it is difficult to perform correctly with weight.  By extending the knees, you make it more difficult to activate the glutes, and place more of the load on the hamstrings and back.  If performed incorrectly, it can lead to damage to involved ligaments or the back. 

During a Neuro Therapy session, we remove this risk because there is no weighted load. 

The load is provided only by electrically induced muscular contraction.  Therefore, we can safely train the muscles at the end range of motion.

Cuing movements at straight lines and right angles enable us to accomplish two things:

1. Quickly identify compensation patterns and ranges of motion where our clients cannot demonstrate neuromuscular control.

Straight lines and right angles are easy to see with the naked eye, and if the client deviates from that pattern, it shows us there is a lack of control or compensation pattern in that range.

2.  Train muscles in their fully lengthened state. 

As I mentioned earlier, it's difficult to train with weights at the end ranges of motion.  Most of us simply don't have enough control there to train with the amount of weight we use to build strength.  Working in straight lines and right angles takes many muscles to a fully lengthened state, helping us to reset length-tension relationships.

A future blog will discuss what we call the hip hinge epidemic (there needs to be a book written about this topic because it is ridiculous how many people struggle with this movement, yet it should be so simple). Essentially, it’s the inability to isolate and rotate the hips anteriorly and/or posteriorly on command - see figure 1. We find that many of our clients cannot do this on day 1 of therapy. You could infer this issue is a contributing factor to many lower body/back issues - but once again, it's a topic for another time.

But how does the hip/hinge epidemic topic play a role in this discussion?

Let’s swing back to “no bend in the knees.” If I’m watching a client try to touch their knees and the only was he/she can accomplish that feat is by bending the knees, there are a number of issues that surface. In my mind, I know we are about to achieve great results from a minor adjustment.  Let’s take a look at a few of those problems:

1. The length/tension relationships between all opposing muscle groups we are targeting are off.
2. The hamstrings do not want to lengthen.  Instead they stay in a guarding/protective state, which limits range of motion
3. The glutes shorten (instead of opening up and lengthening), the back extends (rounds), and the hips posteriorly rotate (or tuck under the body) instead of anteriorly rotate (see figure 2).

In a matter of seconds, through one repetition, prompted by a simple instruction of “don’t bend the knees,” we can pin point a number of different compensations and we are well on our way to reaching two objectives - identifying  compensation patterns and reseting length/tension relationships

Now take this same thought process and apply it to our 90° methodology. Let’s put different body parts to make 90°. Same objectives, same thought processes, same outcomes.

All in all, we are not looking to change form, we are not saying there is one way to move that is better than the other, and we are definitely not saying your strength and conditioning coach is wrong when telling you to Romanian deadlift aka RDL (with a bend in the knees).

​We are simply looking to place the body in the most basic positions possible so we can easily identify compensation patterns and reset length/tension relationships.