The Kinetic Chain and its Therapeutic Application

We know the hip bone is connected to the thigh bone. Kinetic chains both closed and open have been understood and utilized by physical therapists, personal trainers, and orthopedists for many years. We are now gaining a greater appreciation of the fascia and its role in kinetic chains thanks largely to Tom Myers in his book “Anatomy Trains”. Regardless of your orientation, understanding how kinetic chains function and how to apply that knowledge therapeutically is of paramount importance to the world of rehabilitation. We know that when we use muscles in coordination with others that they work in a defined fashion along patterns of kinetic chains. For example, when you brush your teeth, you must first pick up the toothbrush using muscles in the hand and forearm. Then you must bend your elbow and bring your hand up to your mouth. This action requires muscles that affect the elbow and shoulder. Bringing the toothbrush to the mouth engages muscles of the neck. All of this happens on a subconscious level. But how did this motor program originate?

Motor programs are created in the cerebellum in the motor control center. Many unsuccessful and successful attempts are made before the brain selects the most successful program and stores it as a routine in the motor control center. This works fine as long as this routine remains functional. However, if one or more of the muscles involved in the kinetic chain become injured, weakened, or dysfunctional then other muscles in the kinetic chain must pick up the slack and compensate. This kind of compensation when performed over time can lead to injury. How is this compensation pattern evaluated?

Manual muscle testing can be performed to evaluate the strength of a muscle. However, if another muscle is compensating for a weak muscle in its kinetic chain, that weak muscle may test strong. A very important piece of information would be missed if only testing in this fashion. In NeuroKinetic Therapy, testing is performed in a very specific protocol. First,the muscle suspected to be weak is tested  followed by the one suspected to be strong. Sometimes the “weak” muscle immediately fails the test. In this case look for another muscle in the kinetic chain that is tight or sore. Find a spot on that muscle that makes the “weak” muscle test strong. This process is called therapy localization. Then release the sore muscle using whatever technique you already know. Sometimes the “weak” muscle initially tests strong. Next test the “sore” muscle and it should test strong. Finally retest the “weak” muscle and it will test weak. This is an example of a reactive muscle pair. Muscles that work together in a kinetic chain can compensate for each other and create dysfunctional movement patterns. To resolve the reactive pair simply employ the NeuroKinetic Therapy protocol, by using therapy localization, releasing the tight muscle, and finally retesting the weak muscle to make sure it is strong. When the NeuroKinetic Therapy protocol is successful, you have reprogrammed the motor control center. This is how permanent rehabilitative change is made.

Let’s go back to the example of  brushing the teeth. If the grip muscles in the hand are weakened, another muscle in the chain will compensate. For example, if someone comes to you with neck pain and you only work on the neck, the weakness in the hand may be exacerbated because you are depriving the body of the mechanism by which it stabilized the grip. For a successful outcome, first test the grip muscles to see if they are weak. If so, therapy localize the neck muscles to see if they strengthen the grip. If this is successful, release the neck muscles and retest the grip muscles. If the grip muscles become strong, you have reprogrammed the motor control center. To challenge this new program, repeat the process by retesting the grip muscles, then retest the neck muscles, and finally retest the grip muscles. If there is any failure in the challenge, simply repeat the protocol until everything tests strong.

Knowing kinetic chains  is an important part of being a good body detective. But it is not enough to simply release muscles along a kinetic chain. You must change the way the brain has coordinated those muscles in the chain in order to affect a successful rehabilitation.