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Coordination and sensation in rehab

Having just listened to John Kiely’s Pacey Performance Podcast, I felt compelled to get some ideas down. John, as ever, discussed some thought provoking points (thanks John) some of which came up in conversation of the last week, particularly around coordination in injury. John talked about alterationsĀ in coordination and reduction feedback of sensation in injured athletes. This, I think, rings true for traumatic injury with ACL reconstruction especially coming to mind where the majority of training is focused on restoring, and hopefully surpassing, prior strength and movement qualities. My conversationĀ around changes in more chronic conditions such as low back pain, athletic groin pain and maybe repetitive hamstring injuries was subtly different.

Instead of reduced sensation, it seems possible that these conditions present with the opposite. This left me with some questions that may be worthy of conversation:

  • What if every movement, common in chronic conditions, begins and ends with the thought ‘how does my back/hamstring/achilles etc feel’? Does that increase neural drive to that set of tissues?
  • Does that thought process, and potential alteration in recruitment, result in alterations in coordination that continue to drive these chronic conditions? For example bracing patterns in low back pain or hamstring driven hip extension
  • Could it be argued that the main effect of our addressing psychosocial aspects relating to these conditions is altered coordination and therefore altered loading on certain structures?
  • Do we slow down recovery in these conditions through continued drawing of attention to the painful structure? e.g. ‘how does movement that effect your back?
  • Can we speed up recovery by drawing attention to a different set of sensations?

Neil Welch

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