Currently, rehabilitation of back pain focused is on a mechanical model. Sensory information from your eyes, balance, and body builds your posture and determines how you move. Like a recipe, if they combine poorly they will create compensations to your posture and spinal alignment. Imbalances to the muscles of your back will increase the on load on discs, and joints and the result –
Rehabilitation needs to change to match the research.
1* Posture; provides structure to stand up
2* Mobility; Your spine allows you to move
3* House and protect the spinal cord within a bony canal
To maintain good posture you must integrate sensory information from:
Vision; you see where you are in your surroundings and when your surroundings change, i.e sunlight to dark, dry to slippery surfaces, even to uneven, more obstacles.
Balance(Vestibular); are you standing up, lying down, bending over, walking, running, up hill, downhill, etc.
Body position sense(proprioception); where your arms and legs, hands, and feet are.
Poor movement control of the spine can result in back pain.
Head tilt, head rotations, shoulder drop, pelvic drop, functional short leg are all postural changes that are observed.
Cortical smudging changes how the brain processes sensorimotor(input = sensory, output = motor) information. It’s like a digital photo, high resolution = optimal function whereas low resolution = poor movement control, injury risk, muscle imbalances, muscle spasms, tight/restricted movement.
Because Sensory input comes before motor/movement
With Neuroplasticity the brain is able to restructure itself and the changes that result from training are known as upregulation. Your brain forms new connections, builds networks, with activity and repetition neurons that “fire together wire together” create change. Neuroplasticity is also brain resiliency. It learns but it also adapts to injury and trauma.
Postural alignment and stability are results of how your brain integrates and combines sensory information. Postural muscles hold you upright and these muscles create postural distortions when misfiring. But these same muscles are involved with each movement you make. Then the outcome of poor posture control is poor movement control and probably back pain.
Changes how the brain interprets this sensory information, Pain inhibits neuroplasticity, Pain changes your posture, it changes your brain.
I am sure that you can appreciate that if your posture is not optimal then neither will movements of your spine, shoulders, and hips and extremities.
Neuroplasticity that gets downregulated from injury or pain can also be retrained, rebuilt, and upregulated with specific exercise, this is the beauty of sensory-based rehabilitation versus mechanistic models. It is where you start from that matters.
You stimulate neuroplasticity.
1/ The Brain craves Complexity: You will perform complex movements over multiple planes of motion. Feedback from the exercises helps make correction errors in poor movement control.
2/ Focus on motor skill acquisition: Novel motor-skill training is more efficient and effective for improvements, with the intention of creating more impression on the cortical map for those muscles and joints.
3/ Stairstep progression: The equipment you will use changes as you improve your skill acquisition to reach the next level. This is to avoid plateaus.
4/ Keep it interesting: There are multiple games, all are different they are specifically designed to improve motor skills across multiple levels.
To achieve the 3 goals;
Look Better, Move Better,
and Feel Better