All About Neurokinetic Therapy, an Interview with John Goldthorp
I was doing sprints one day at the gym and noticed my right shoulder pain come back that I have felt on and off while running since my high school sports days. I feel a chronic, nagging pain in my right upper trapezius muscle. I walked into the office at the gym where Trainer, running coach, and Neurokinetic therapist John Goldthorp was working. “Why does my shoulder hurt when I run?” I asked. Instead of being like “how the hell should I know man,” John said “let’s find out!” and we scheduled a Neurokinetic Assessment for later in the week.
We talked about my pain history, past surgeries, sports played, exercise patterns, etc., and then he watched as I touched my toes, stood on one leg, and performed the overhead squat assessment. He then tested my ability to match his pressure as he tried various things like pushing my leg from the air to the table or moving one of my arms. In many cases, I was no match for the light pressure he was applying. Then, he would have me try something else, like press on the sore, tight knot in my right trap (where I suffer from chronic pain) and while I held pressure on that spot my leg suddenly worked 100x better and I could push back against his hand. We talked about what muscles were not working properly and were causing my right trap to take over all of the work (causing the tightness and chronic pain) and what I could do to retrain those muscles.
I thought the process was incredibly interesting and John very kindly agreed to answer some questions about the practice of Neurokinetic Therapy for me to share here. Enjoy!
Can you briefly introduce what Neurokinetic therapy is - or the main premise behind it - ?
Neurokinetic Therapy® (NKT) is an assessment and treatment system that addresses dysfunctional movement patterns stored in the brain. In addition, often by addressing dysfunctional movement patterns and relieving overworked muscles, pain may no longer have a reason to exist. The main idea is to reprogram how your body moves.
You are already a Certified Personal Trainer and Running Coach – when/why did you decide to add Neurokinetic Therapy to your credentials?
One of my favorite parts of my work is giving people hope. So many runners get beaten up by the sport that they love and I want them to enjoy it for a lifetime. By helping them move better and addressing their movement foundation, it is amazing what sort of progress can be made.
While, yes, you do have to put in the run training, the strength training, the mobility work and recovery properly, I've found that most people are attempting to do all of the "right things" on top of a foundation that cannot support that workload.
So, back in early 2013 I took my first NKT course because, even though I was getting pretty good results, I was getting stumped frequently enough that I knew I needed to learn more. And I hate not knowing the answer!
NKT has helped me understand movement on a much deeper level and has not only given me the tools to help folks get amazing results but also a supportive, cutting-edge community. I've used the community extensively to refer distance-based clients to local practitioners.
What are some of the most basic signs or symptoms you look for when taking a client through a Neurokinetic Assessment?
During a session, an NKT practitioner will utilize manual muscle testing to assess the function of a particular basic movement pattern. We're looking for dysfunctional movement patterns.If a pattern is not functional, then we will look for what might be compensating for that dysfunctional pattern.
A few of my favorite ways to figure out how someone may be compensating is to first take a detailed history. Ask about anything and everything that's happened to them - could be a fall, an accident, childbirth, a sprained ankle, significant dental or plastic surgery. Do you have any scars or tattoos? Time and time again the client completely discounts the meaning of that fall down the steps when they were 8 and, meanwhile, their body's been compensating ever since.
Another trick is to observe the client while I'm performing the muscle test. How are they able to match my pressure? Are they making a fist? Holding their breath? Lots of ways!
An obvious one is when a client has pain. For example, if you tell me you often experience side stitches when you run, I'm going to assess your diaphragm and breathing patterns to see if they are involved in a compensation pattern.
I came to you complaining of shoulder pain when I run, and chronic pain in my right upper trapezius. Can you talk a little bit about what you saw during my assessment, as well as why you prescribed the homework that you did for me?
As I mentioned earlier, it is super important to have a strong AND functional foundation in order to run well. So, I started by assessing the deepest muscles that stabilize your spine. Some call those muscles the "inner core" and their job is to fire reflexively when you move. Turns out they weren't functioning too well on their own. They needed help.
In your case, we found the right upper trapezius to be tight, overworking, and compensating for three very important muscles:
· The multifidus, one of the inner core muscles that stabilizes your back.
· The transverse abdominus, another inner core muscle that wraps around your midsection like a weight belt.
· The latissimus dorsi, a huge outer back muscle that opposes the upper trapezius.
Your homework was to simply massage the most tender spot on the upper trapezius and then activate those three muscles a couple of times each day. After enough repetition, your brain learned how to better use the appropriate muscles without relying on the upper trapezius.
What are some of the craziest or coolest outcomes you’ve had with clients?
One of my favorite things EVER, is to watch someone touch their toes right after telling me they haven't been able to touch their toes for 30 years or something like that. It's stunning. No stretching. No warm up. Just a better ability to recruit the muscles you need to access the pattern.
But while quick changes have the 'wow-factor', I am always deeply satisfied by seeing a client go from being broken down, unable to run without getting injured, to getting back out there and setting personal bests. It takes a lot of commitment, but if you love to run, you can do it!
I recently had a client who had a chronic pain spot in her lower back - she called it her pregnancy injury - evaporate after dealing with it for 10 years.
For runners, especially women who've had kids, one thing that can be completely resolved using NKT is the issue of a leaky bladder while running. Super frustrating, and often thought of as unavoidable, I recently wrote a blog post on this very issue!
Just last weekend, I found a client's forehead muscle (the frontalis) compensating for her deep abs (transverse abdominus). We both looked at each other, like, "did that really just happen?"
What do your personal workouts and your recovery look like; do you ever assign yourself any NK Therapy homework?
I don't assign myself NKT homework because it's very difficult to test yourself reliably. I have another practitioner assess me and assign me homework. Of course, that hasn't stopped me from nagging my wife (or an unsuspecting stranger) to test me with me guiding her through the process.
So, usually I'll start by doing any current NKT homework, then do a few reps of Anatomy in Motion drills to work on my gait patterning, then finish my movement prep with some lunges and crawling. After my main run, bike, or lift session, I'll re-do the NKT homework before turning my attention to …food!
One thing that may interest you is that I used to do a lot of foam rolling to address areas that were tight, but the same spots were tight every day. Now, since the definition of insanity is doing the same thing over and over again and expecting a different result, I realized I can stop doing that. Instead, I've focused on eliminating dysfunctional movement patterns with NKT and building my reflexive strength with some Original Strength drills. These days when I do use a foam roller in the evening to relax before bed, I notice very few tight painful spots!
What is the one thing you want people to know or understand about NKT who may have never heard of it before?
People need to know that they do not have to settle for being in movement related pain. They don't have to settle for playing the age card. They don't have to settle for "not able to". There are many cutting edge ideas out there in the world of movement and NKT is definitely one of them. Seek out a practitioner, get assessed and start making progress today!
About John Goldthorp:
John, recently named "Philly's Best Running Coach" by Philadelphia Magazine and founder of FixYourRun.com, has been coaching since 2001 and attempts to leave no stone unturned when working with his clients by looking for their unique gaps in performance, movement, and mental approach. Always viewing things holistically, he believes in quality before quantity, precision before progression, and has found those who strive to master the basics and move with grace generally win. In addition to his B.S. in Kinesiology from Penn State, he's a certified ACE Personal Trainer, a Functional Movement Screen Expert, Neurokinetic Therapy Level 2 practitioner, Road Runner Club of America and Precision Nutrition Level 1 certified. He currently works with clients at Optimal Sport 1315 in Center City, online at FixYourRun.com, and leads weekly group speed training sessions at PhillySurgeRunning.com.