Jaw Problems Turn Into Hip Problems

A young swimmer came into the clinic complaining about their stroke being erratic and their turns being off balanced. During our screening I noticed that thee was an obvious lateral rib shift and global imbalance. Generally when I see and postural shifts I always like to see what the muscles around the hips and thorax are doing. We continued with our NKT assessment.

I had found the left QL inhibited and neurologically underachieve and right QL very tight and overactive. I also checked is TFL’s, the left was also inhibited. Its apparent that we have a lateral sub-system relationship here, but my question was, why?

After further investigation I found a nasty L medial Pterygoid tender to touch. Using my NKT protocols I tested the QLs in relation with the left Pterygoid, there was an obvious relationship here. 

I released the left Pterygoid, R QL and activated the L QL. This reset made a big improvement within the QLs and TMJ but I still had a weak TFL. There was something else contributing to the TFL’s inhibition. 

When testing the TFL I noticed the same side foot would turn in as we did the test. Using palpation I found a nasty Tibialis Posterior. Again using NKT protocols I checked to see if there was a dysfunctional relationship at play, and surprise surprise there was. We released the tib post and activated the TFL. This brought function back to the TFL and to the hips. 

We rechecked posture. We made a solid improvement in just 60mins. With some corrective exercise this young swimmer will be back to their best once again. 

Heavy Aching Arms After Running

A client came in with mentioning that there hands and forearms felt tight and heavy about a day after they went for a run. This was an interesting symptom to have post run so I decided to investigate further. I tested grip to see if there was any dysfunction within the hand itself, both sides were fine. From here I decided to test both lats as they are apart of a powerful group of muscles called the 'Posterior Oblique Sling'. They were both weak. I now had to find a dysfunctional relationship in the both that included both lats and a central point. Understanding that this run was done at a higher intensity I decided to see what the respiratory muscles were doing. I tested the lats against the diaphragm and sure enough, there was a relationship present. Using NKT protocols I released the over-active diaphragm and activated the lats. This process brought back full function to the lats. I then did some soft tissue massage on the forearms and hands to relieve the compensatory relationship that had development post run.

The client has some simple homework to do and we discussed periodising their running sessions to development more aerobic capacity. With these improvements, their symptoms should no longer bother them.

Left Achillies Pain

A client came in presenting with sporadic L Achilles type of pain. This pain would only be evident mainly in the mornings and would get better during the day. This client did mention that they would feel a little achy or restricted in the ankle as well. Using palpation I found that the Fibularis Longus and Tibialis Posterior where very high tone and tender to touch. 

During my NKT assessment, we found that the Tibialis Posterior was weak and neurologically under-active. I tried to see if there was a relationship between Tibialis Posterior and Fibularis Longus but it just wasn’t convincing enough. We continued our assessment and found a super nasty Popliteus. 

Using NKT protocols I tested the Tibialis Posterior against the Popliteus, there was most definitely a relationship here. I continued to released the Popliteus, use Dry Needling on the Fibularis Longus to reduce the compensation and activation of the Tibialis Posterior. 

We then retested the the dysfunction. The restricted feeling had gone and all muscles weren’t sore to touch anymore, and to top it off they had full function of the Tibialis Posterior again. 

The client has some simple homework to do but they should make a full return to function. 

Hip Pain

A client came in with left hip pain. This pain usually came on when they started to ride their bike. When describing the discomfort they would be pointing around the hip pocket area. I started using my NKT assessment to see what dysfunctional relationships we could find. Using NKT protocols I found that the R QL was inhibited and the L QL was facilitated. Due to the R QL being inhibited and neurologically under-active the contralateral TFL had to compensate to support the body during gait and when cycling. This compensation had caused the TFL to effectively “burn out”. To reset this dysfunction I had to treat the cause not the symptom, this meant releasing the L QL. I used dry needling therapy to released the L QL. I also needled the L TFL to down regulate its compensatory behaviour. We then activated the R QL. After this reset the TFL had become more functional and the pain had reduced from a 7/10 to a 2/10. With a little bit of corrective homework this client will be back up and riding pain free very soon.

Stomach Scars and Shoulder Pain

A strongman athlete came in complaining about left shoulder pain. They were worried as they had about 10 days until their next comp. After discussion and some ROM assessment, we decided to use some NKT testing to assess the shoulder. This client had mentioned that their shoulder started to hurt after doing bench press last session. One of the first muscles I test when I am working with shoulder pain is the Latissimus Dorsi as its quite often dysfunctional. I tested the left lat, it was weak. I will usually immediately test the other side to check if its a unilateral or bilateral weakness. I tested the R lat and it was also weak. Having bilateral (both sides) weakness or pain generally means we are looking for a central interrelated cause that mightn’t necessarily be close to the source of pain.

I decided to continue to assess the shoulder before going too deep into looking for the REAL cause of pain.

After further testing, I found the that the Left pec minor and triceps for facilitated for an inhibited Lat. Basically, this was a compensation pattern that had developed for this athlete to continue to train. If the lat wasn’t weak the likelihood of this dysfunction occurring would be minimal.

I still had some work to do as I needed to find out WHY the lats were weak.

After further discussion, we found a scar on the client's stomach. I tested the lats against the scar on the stomach and sure enough, there was a relationship. The scar was facilitated for bilateral Lat weakness.

We released the scar, released the left pec minor and tricep and then activated both lats.

We retested the shoulder. Full Rom was restored and the pain was gone!.

This client had some specific scar work to do but they should be fine to compete in 10 days time as long as their diligent with their dysfunction management. 

Weak Core and Over Working Toes

A client came in with ongoing lower back pain. After having a chat and doing some movement assessment I noticed that the client had bilateral hallux valgus, which is effetely bunions (where big toes face towards the second toe). Just to note though the hallux valgus wasn't at a chronic stage. Recognising this I continued to do my NKT assessment. I found the TVA and Multifidus weak. No wonder they had lower back pain, they didn’t have the motor control in the intrinsic core to create stability. I decided toes if there was a relationship between the hallux valgus and the lower back pain. Using NKT protocols I tested the TVA and Multifidus against the Transverse Head of Adductor Hallucis. The TVA and Multifidus improved in function and connectivity. I then released adductor hallucis and distracted the Metatarsophalangeal joint. We then activated the TVA. After the treatment we retested the core and back. All became strong and the pain went from a 8/10 down to a 2/10. The client will need to do some released work on the foot and avoid wearing pointy shoes from now one, but they will make a speedy recovery. 

ACL Scars and Weak Hamstrings

A young athletic footballer came in after being referred by a friend. They had been dealing with leg “weakness” and “heaviness” in their right leg for about 18months after having an ACL reconstruction on their right knee. We did some investigation around the knee and hip. We found that the scar below his knee that the surgeons used to pull his new ACL through was facilitated and neurologically over-active. This facilitation made the same side glute max and medial hamstrings, painful, inhibited and neurologically under-active. Using NKT protocols we released the scar and activated the Glute and Hamstrings. We then retested. The glute and hamstrings were now functional and pain free. This client will need to back off the loading for 2 weeks whilst they work on the scar and gain motor control back into the leg. Once this dysfunction has been reprogrammed they’ll be back to 100% once again.

A tip for anyone that has had ACL surgery. If your the scar on your leg below your knee feels “weird” or  “awkward” then you’ll probably (100% chance) have some sort of dysfunction. Its very likely that the hamstrings they grafted will be inhibited. If you have constant hamstring tension in that one leg or it feels heaps weaker then the other, try doing some light friction massage on the scar for 30sec followed by light activation of the hamstring. Do this twice a day for 2 weeks and watch the difference it’ll make! Just don’t do it before exercise or training as you need to earn the right to use your hamstring again. If you overload a weak hamstring it will tear.

If you have any concerns about your post ACL leg / hamstring please feel free to book in for an NKT assessment. 

"I Woke Up Now I Can't Turn My Neck"

A Crossfit athlete came in complaining about headaches not being able to turn their neck. Apparently, they woke up like that. I asked them to clench their jaw and try to turn their head. They had a full range of motion. So it was apparent that we weren’t dealing with a neck issue as much as we were dealing with a jaw issue.

After discussion, we found out that they had done pistols the day before. I investigated further and started testing the R quad. We found a very under-active VL and Gmax. We then tested these muscles against the jaw. We found a relationship was present. After using NKT protocols we found that the R Masseter was facilitated and the right VL and Gmax were Inhibited. We released the jaw and activated the quad and glute. The client now had full ROM in their neck again and their headaches had gone.

My thoughts on the dysfunction. Due to doing such a high threshold exercise in the pistol squat on a neurologically under-active leg, the right masseter had become overworked to the point where it reached its neural edge, (effectively the point of no return)

For the brain and body to continue to do pistols it had to recruit other muscles as a secondary compensation pattern. This is why the cervical rotators (SCM and Splenius Capitis ) tightened up creating the reduced ROM.