<span style="font-weight: 400;">Sounds fancy eh! </span>

<span style="font-weight: 400;">Sometimes when you look at the definitions of those fancy words you realise it is things you already do. However we can often be put off reading some articles because they sound complex and maybe beyond our remit of understanding. Yet when we dive deeper into the details we can also often find we do these types of exercises already and so this blog is about contextualising the intrinsic biomechanics of neuromuscular exercise. </span>

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<h1><span style="font-weight: 400;">What Is A Neuromuscular Exercise?</span></h1>
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<span style="font-weight: 400;">Neuromuscular means relating to both nerves (neuro) &amp; muscles (muscular)</span>

<span style="font-weight: 400;">Neuromuscular training focuses on performing exercises that train nerves &amp; muscles to react &amp; communicate. </span>

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<p style="text-align: left;"><span style="font-weight: 400;">Neuromuscular control is for the process of the brain controlling movement of the limbs. Optimal neuromuscular control is gained through training the brain with specific neuromuscular exercises.</span></p>
<p style="text-align: left;"><span style="font-weight: 400;">Neuromuscular ‘control’ is the muscles response to a signal regarding joint stability while moving. </span></p>
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<span style="font-weight: 400;">Neuromuscular ‘exercise’ affects your client’s biomechanics, activation of muscles &amp; the surrounding joint musculature.</span>

<span style="font-weight: 400;">Basically this method of considered programming can help us help clients with balance &amp; reaction control while reducing risk. Therefore perfect for pretty much everyone but also certain populations like those at risk of falls. </span>

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<h2 style="text-align: center;"><span style="font-weight: 400;">What DOES it look like?</span></h2>
<p style="text-align: center;"><span style="font-weight: 400;">Coordination training </span></p>
<p style="text-align: center;"><span style="font-weight: 400;">Balancing </span></p>
<p style="text-align: center;"><span style="font-weight: 400;">Trunk conditioning </span></p>
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<h2><span style="font-weight: 400;">What DOESN’T it look like? </span></h2>
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This consideration is likely to be one of the main reasons gym equipment/machines have been given a bad reputation for improving function.

<span style="font-weight: 400;">Gym machine training is far less likely to allow for neuromuscular training effects for a given sport due to the 'support' given by the seating, padding or stability from the machine.</span>

There is a time and a place for all modalities of training the body, including the use of gym equipment/machines but we should always consider specificity of the client's circumstances and goals.

The better we understand the different models of training and their pros and cons, the better placed we are to choose the most appropriate method of TIMING of introducing certain training modalities.

This is when being able to test benchmarkers of your clients intrinsic biomechanics and movement quality can be most helpful.

Most clients at some point or another are likely to require trunk conditioning. This can be measured using core assessment progressions, core isometric ratio testing and functional stability screens. The beauty of these tests is that each tests becomes the exercise when coached appropriately.

Trunk conditioning, also commonly described as core stability, is an important aspect of our clients programming but knowing when, what, why, how to choose the right neuromuscular exercise is often missed or can be lacking.

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<h3><span style="font-weight: 400;">Neuromuscular ‘progression’ is a great way to consider training your clients trunk to stabilise their bodies movement during ADL. This simply means progressively reducing the base of support to challenge the stabilisers more over time, thus developing the nerves and muscles tolerance to load.</span></h3>
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<h1>Consider....</h1>
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<ol>
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<h4>how many neuromuscular exercises can you list?</h4>
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<h4>what order would they be in to go from easiest to most challenging?</h4>
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<h4>which clients would start where in the progression and why?</h4>
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<h4>how would you know?</h4>
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If you do not have a testing / assessment system in place we can offer you this in both face to face or online training.

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If you have any questions please do not hesitate to contact us rachel@biomechanicseducation.com

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<h2><span style="font-weight: 400;">References</span></h2>
<span style="font-weight: 400;">Boyd, K., 2003. Low Back Disorders: Evidence-Based Prevention and Rehabilitation. </span><i><span style="font-weight: 400;">Physiotherapy Canada</span></i><span style="font-weight: 400;">, 55(02), p.124.</span>

<span style="font-weight: 400;">Clausen, B., Holsgaard-Larsen, A. and Roos, E., 2017. An 8-Week Neuromuscular Exercise Program for Patients With Mild to Moderate Knee Osteoarthritis: A Case Series Drawn From a Registered Clinical Trial. </span><i><span style="font-weight: 400;">Journal of Athletic Training</span></i><span style="font-weight: 400;">, 52(6), pp.592-605.</span>

<span style="font-weight: 400;">Faries, M. and Greenwood, M., 2007. Core Training: Stabilizing the Confusion. </span><i><span style="font-weight: 400;">Strength and Conditioning Journal</span></i><span style="font-weight: 400;">, 29(2), p.10.</span>

<span style="font-weight: 400;">Filipa, A., Byrnes, R., Paterno, M., Myer, G. and Hewett, T., 2010. Neuromuscular Training Improves Performance on the Star Excursion Balance Test in Young Female Athletes. </span><i><span style="font-weight: 400;">Journal of Orthopaedic &amp; Sports Physical Therapy</span></i><span style="font-weight: 400;">, 40(9), pp.551-558.</span>

<span style="font-weight: 400;">Gschwind, Y., Kressig, R., Lacroix, A., Muehlbauer, T., Pfenninger, B. and Granacher, U., 2013. A best practice fall prevention exercise program to improve balance, strength / power, and psychosocial health in older adults: study protocol for a randomized controlled trial. </span><i><span style="font-weight: 400;">BMC Geriatrics</span></i><span style="font-weight: 400;">, 13(1).</span>

<span style="font-weight: 400;">Hibbs, A., Thompson, K., French, D., Wrigley, A. and Spears, I., 2008. Optimizing Performance by Improving Core Stability and Core Strength. </span><i><span style="font-weight: 400;">Sports Medicine</span></i><span style="font-weight: 400;">, 38(12), pp.995-1008.</span>

<span style="font-weight: 400;">Huxel Bliven, K. and Anderson, B., 2013. Core Stability Training for Injury Prevention. </span><i><span style="font-weight: 400;">Sports Health: A Multidisciplinary Approach</span></i><span style="font-weight: 400;">, 5(6), pp.514-522.</span>

<span style="font-weight: 400;">Lee, B. and McGill, S., 2015. Effect of Long-term Isometric Training on Core/Torso Stiffness. </span><i><span style="font-weight: 400;">Journal of Strength and Conditioning Research</span></i><span style="font-weight: 400;">, 29(6), pp.1515-1526.</span>

<span style="font-weight: 400;">Lepley, L., Lepley, A., Onate, J. and Grooms, D., 2017. Eccentric Exercise to Enhance Neuromuscular Control. </span><i><span style="font-weight: 400;">Sports Health: A Multidisciplinary Approach</span></i><span style="font-weight: 400;">, 9(4), pp.333-340.</span>

<span style="font-weight: 400;">McGill, S., Childs, A. and Liebenson, C., 1999. Endurance times for low back stabilization exercises: Clinical targets for testing and training from a normal database. </span><i><span style="font-weight: 400;">Archives of Physical Medicine and Rehabilitation</span></i><span style="font-weight: 400;">, 80(8), pp.941-944.</span>

<span style="font-weight: 400;">McGill, S., n.d. </span><i><span style="font-weight: 400;">Ultimate back fitness and performance</span></i><span style="font-weight: 400;">.</span>

<span style="font-weight: 400;">Myer, G., Chu, D., Brent, J. and Hewett, T., 2008. Trunk and Hip Control Neuromuscular Training for the Prevention of Knee Joint Injury. </span><i><span style="font-weight: 400;">Clinics in Sports Medicine</span></i><span style="font-weight: 400;">, 27(3), pp.425-448.</span>

<span style="font-weight: 400;">Physiopedia. 2022. </span><i><span style="font-weight: 400;">Neuromuscular Exercise Program</span></i><span style="font-weight: 400;">. [online] Available at: &lt;https://www.physio-pedia.com/Neuromuscular_Exercise_Program&gt; [Accessed 14 February 2022].</span>

<span style="font-weight: 400;">Reiman, M., Krier, A., Nelson, J., Rogers, M., Stuke, Z. and Smith, B., 2010. Reliability of Alternative Trunk Endurance Testing Procedures Using Clinician Stabilization Vs. Traditional Methods. </span><i><span style="font-weight: 400;">Journal of Strength and Conditioning Research</span></i><span style="font-weight: 400;">, 24(3), pp.730-736.</span>

<span style="font-weight: 400;">Risberg, M., Mørk, M., Jenssen, H. and Holm, I., 2001. Design and Implementation of a Neuromuscular Training Program Following Anterior Cruciate Ligament Reconstruction. </span><i><span style="font-weight: 400;">Journal of Orthopaedic &amp; Sports Physical Therapy</span></i><span style="font-weight: 400;">, 31(11), pp.620-631.</span>

<span style="font-weight: 400;">Willson, J., Dougherty, C., Ireland, M. and Davis, I., 2005. Core Stability and Its Relationship to Lower Extremity Function and Injury. </span><i><span style="font-weight: 400;">Journal of the American Academy of Orthopaedic Surgeons</span></i><span style="font-weight: 400;">, 13(5), pp.316-325.</span>

<span style="font-weight: 400;">Willson, J., Dougherty, C., Ireland, M. and Davis, I., 2005. Core Stability and Its Relationship to Lower Extremity Function and Injury. </span><i><span style="font-weight: 400;">Journal of the American Academy of Orthopaedic Surgeons</span></i><span style="font-weight: 400;">, 13(5), pp.316-325.</span>