I arrived at Dr. Eric Nelson’s office for my usual appointment. Even though my leg has not shown signs of ITBS for several months, I still go for maintenance every two weeks in order to STAY healthy.
When I showed up, Eric was excited. I was too because just a few days prior, I had completed a 75-minute run with mile splits that were as fast as I used to be before ITBS decided to overstay her welcome.
I was better–or so I thought.
I walked into the examination room, and he said, “Okay, we’re going to do something a little different today. It’s going to blow your mind.”
I paused. “Uh…huh?”
“It’s all good. I’ve got a few tests to check out a few things.”
With that, I laid down, face up on the examination bench, with my legs extended straight out for the first test.
“Raise your right leg.” I did so, and Eric placed his hand on top of my lower leg, and began to apply resistance, trying to push my leg down.
“Don’t let me push your leg down,” He instructed. I flexed my leg, and easily countered the resistance he applied.
“Okay, that’s good.” He said. “Now bend your right leg.” Still lying on my back, I bent just my right leg for the second test.
He put his hand underneath my foot and said, “Don’t let me raise your leg.”
Again, I countered the resistance.
“Okay, good.” He said again.
Next, he took my bent right leg out to the side of the bench, so it dropped toward the floor. Again, he grabbed the bottom of my foot. “Don’t let me raise your leg.”
This time, I couldn’t push against the resistance. He easily overpowered me. I failed the third test.
“Okay. That glute still isn’t firing properly. It’s still inhibited.”
My heart sank. I’ve been doing exercises to strengthen my glutes and hips for eight months. I’ve been running pain free. And, yet, here was evidence that my butt is still lazy.
Eric began some ART (active release technique) manipulations on my iliacus muscle. The iliacus muscle is next to the Psoas, as you can see from the diagram at the right. This muscle is a hip flexor that helps lift and flex the leg forward.
It hurt. Bad.
“Just breathe,” he instructed.
After an agonizing 30 seconds or so, we returned to the third test.
“Don’t let me raise your leg.”
Like magic, this time I was able to counter the resistance. My glute was firing! He repeated the ART manipulation and test two more times. Each time, the iliacus muscle became a little less painful, a little looser, and my glute became a little bit stronger, more able to counter Eric’s resistance.
“Holy crap!” I exclaimed. “That’s like some voodoo magic!”
Eric laughed, “It’s neurokinetic therapy.”
This therapy is used to identify and correct the root cause of dysfunctional motor patterns. In my case, the dysfunction is inhibited glute muscles. While I have been working on strengthening my glute muscles, apparently an overactive iliacus muscle was continuing to inhibit my glute muscles’ ability to fire as they should.
Release the iliacus, engage the glute. That’s what Eric did. But, why does it work?
The Motor Cortex
Neurokinetic Therapy begins with the recognition that our motion patterns are dictated by the motor cortex, or what is sometimes referred to as the brain’s command center. Each time we move, our brain stores information about these movement patterns. Over time, some muscles become strong and facilitated, while others become weak and inhibited.
In my case, the iliacus became overstimulated, thus inhibiting my glute. Eric explained this issue with my iliacus can be common among triathletes, given the use of the muscle for cycling. This makes sense in my case. I’ve been running since I was 13 years old, but I never had an issue with ITBS until I started heavy cycling volume.
Yup, story checks out.
So, what to do about it?
I have to reprogram my motor cortex by releasing the iliacus through massage for about 20-30 seconds, and then engaging immediately in 20 single-leg bridges to stimulate the right glute. 3 sets, twice a day. I return to Eric next week to see if I reset my brain.
In using this therapy, it was as if Eric flicked a switch, and my butt went from lazy to lively. Like most magic tricks, this one had a logical explanation of how it was performed. Even so, the many intricate connections within our bodies are magical. From our brains to our bones, our bodies are interdependent systems that permit the magic of motion.