Exploring safer return to sport screening

What is Neuromuscular control

To perform activities that require running and jumping (dynamic activity) it is advantageous to possess adequate dynamic stability to allow controlled landing and it has been postulated that deficiencies in dynamic stability can lead to increased risk of injury as you can see from Kurt Zouma's video above.

On a microscopic level dynamic stability is maintained via feedback from receptors contained in joints, muscle, ligaments and other soft tissues allowing accurate prediction of what might happen next, and hence performance of activities with correct joint alignment (Riemann and Lephart., 2002).

This feedback system is known as neuromuscular control (NMC), it is defined as “the unconscious activation of dynamic restraints occurring in preparation for and in response to joint motion and loading for the purpose of maintaining and restoring functional joint stability” (Riemann and Lephart., 2002 page 73).

There is therefore, great utility in developing ways to analyse and measure neuromuscular control with specific reference to the following two groups:

1. Healthy individuals looking to avoid injury or embark on exercise that requires a higher level of neuromuscular control than there body is accustomed (Hewett et al., 2005; Cook et al., 2006; Chorba et al., 2010)

2. Individuals following lower limb injury to establish when it is safe to return to running, jumping activities and ultimately sport (Wilk et al., 1994; Petschnig et al., 1998; Reid et al., 2007; Paterno, 2010; Logerstedt et al., 2012). This is particularly important following surgical repair of ligaments and soft tissues when poor dynamic control during running and landing could lead to failure the repaired structures causing further damage.

Common dilemma

A common dilemma in clinical practice is predicting when an injured individual has adequate Neuromuscular Control to move from a low level dynamic task, such as squatting and lunging, to a high level dynamic activity such as running, hopping and ultimately returning to sport.

Here at the Performance lab we have proven ways to measure this and ensure a safe return to sport.

Over the next few weeks we will go through some of the ways we analyse this and also look at some of the research we have performed around this subject.

thanks for listening

see you next time

Matt