“My dear, it’s not your body that’s broken. It’s your brain.”
That’s just what I wanted to hear during the first consult with my new physical therapist. There’s nothing like hearing a medical professional tell you your brain isn’t working right, especially when you walked into the office thinking the pain was in your hip.
I didn’t want to believe him. But he told me to lay on my stomach and lift one leg using my glute muscles.
“Nope. Try it again,” he told me.
Whatever! I thought. I can do this, my stubborn mind said. So I tried again, and failed again. I failed all the tests he threw at me that day.
“How do you think you can run properly if you can’t do something as simple as lifting your leg?” The new PT said. It was a rhetorical question. So we started retraining my brain.
The therapist calls it “waking up” my muscles. My insurance stub calls it “neuromuscular re-education.” iHealthspot.com gives this easy definition:
Together, your nerves and muscles work to produce movements. Nerves send signals between your muscles and your brain about when, where, and how fast to move. It is a complex process. Theorists believe that over time, nerve tracts are reinforced and muscle movement (motor) patterns are learned and stored in your memory.
My PT’s theory is that years ago, after an SI injury, my brain reacted by cutting off connection with certain muscles. Even though I would eventually feel like the injury was healing and I could run again, my brain was working on a different level. As it shutdown connection with my glutes, it started sending signals to alternative muscles to pick up the slack.
But since running wasn’t the primary job for those alternative muscles, they couldn’t sustain the amount of miles I wanted from them. Those secondary muscles and tendons would get worn out and I’d get hurt again. It was a vicious cycle.
“My job is to wake up those muscles and get your brain to use them,” the new PT said.
I’ve been through physical therapy plenty of times, so I’m a pro at clams or exercises with balance boards and swiss balls. But retraining your brain is different.
“I don’t care how high you can get your leg during these exercises. I don’t care if you can do a bridge twenty times or five times,” my new PT said. “I just care that your brain is telling the right muscles to do it.”
The exercises he put me through at first barely seemed like exercise. Most of the moves required very little physical movement. But I’d get incredibly frustrated because, just as he suspected, I really couldn’t lift my leg relying on the right muscles. I had to think about it. A lot. When I started running again I started whispering the phrase “Fire. Fire. Fire,” to myself with every step, hoping I could force my brain to make the connection to get the right running muscles to fire.
Repetition, Repetition, Repetition
“How long is this going to take,” I asked the PT after that first consult. He told me sometimes patients get it in two weeks. Other times it takes months. They don’t call it retraining your brain for nothing. Approach it like you do a race. You don’t start training two weeks before your marathon, right? It’s going to take some time for your brain to break old habits and pick up new ones.
Once your brain can trigger the correct pathways, the process starts to mirror traditional physical therapy with strengthening and conditioning drills, but the emphasis remains on making sure each muscle is doing the job it was designed to do.