STRUCTURAL NEUROREHABILITATION

Yes. Our programs are very safe and are designed to challenge your systems without bringing on pain or significant fatigue. Some people may notice mild, short-lived muscle soreness or tiredness, especially early on, much like after any new exercise. Please tell us if anything feels painful or uncomfortable, and we will adjust your program.

Much of what your muscles do is automatically steadying your body. When you reach out to pick up a pencil, for example, the pencil weighs almost nothing. Your arm is much heavier, and reaching out shifts your body’s center of mass. Without automatic adjustments, that shift would throw you off balance and put strain on your shoulder and spine.

That doesn’t happen because your brain has an automatic sense of where your body is in space, built from visual, vestibular and proprioceptive input. Your brain figures out where you are and predicts how your center of mass will shift. It uses this to activate stabilizing reflexes a fraction of a second before you move, so the movement goes smoothly and efficiently.

If your brain receives inaccurate input from your eyes, your inner ear or your muscles and joints, or has trouble combining that input, your automatic sense of where you are in space may be off. Your brain may then activate the wrong stabilizing reflexes, your muscles and joints may not work together as they should, and you may be more likely to reinjure yourself when you move.

This doesn’t have to be about muscle strength or tone. It is about how well the nervous system controls the muscles. We see athletes, including some who are very strong and highly trained, who keep getting reinjured because of problems with neuromuscular control.

Once we identify problems with your neuromuscular control, we start by working directly on how those control systems function and work together. This often involves some form of visual or vestibular rehabilitation, and may include light therapy or electrical stimulation as well.

As your control and coordination improve, we combine similar types of stimulation with specific therapeutic exercises and, when appropriate and safe for you, joint manipulation, with the goal of rebuilding your structural foundation from the inside out. As you improve, we make the exercises more dynamic, more challenging and usually more fun.

No. Our therapies are designed to be painless and to avoid significant fatigue. In some types of strength training, the goal is to work muscles until they are very tired, which creates tiny amounts of tissue stress that signal the muscle to build more protein and get stronger. Neurological rehabilitation works differently. Pushing a struggling nervous system pathway well past the point of fatigue can make symptoms flare and may set back progress. That’s why we work carefully to keep your nervous system challenged without pushing it past its limit. Some people may notice mild, short-lived muscle soreness after new exercises, and if anything feels uncomfortable, tell us right away so we can adjust your program.

Physical therapy is commonly used to address the physical injuries that can come with a concussion or traumatic brain injury. It can be very helpful for reducing pain, headaches and muscle spasms and for helping injured tissues heal. When someone injures a joint or muscle without any neurological injury, this kind of care is exactly what’s needed. After a brain injury, though, some of the physical problems found on exam may be partly a result of the brain injury itself. When that’s the case, care that addresses both the physical and the neurological sides of the problem can be helpful.

Here’s an example. If the brain pathways that move the eyes to the left aren’t working well, the eyes may tend to drift to the right. These pathways involve the frontal lobe, the cerebellum, the brainstem, the inner ear and other areas, alone or in combination. To keep you looking straight ahead, the brain may use a reflex that turns your head slightly to the left by tightening the muscles at the base of your skull. Over time, those muscles can become tight and painful and may contribute to headaches.

The brain isn’t trying to cause headaches. It’s trying to make sure you can see where the world is so you can interact with it. In a case like this, treating the tight muscles can ease the neck pain and headaches, but the tension may return if the eye movement reflex driving it isn’t addressed too.

Our approach is to look for the brain pathways that may be behind these patterns and include targeted rehabilitation for them, along with hands-on and structural care when appropriate. Our goal is to address the neurological and physical sides of the problem together. Our care can work alongside your physical therapist and other providers, and results vary from person to person.