Another New Distraction: Neurocog

Knee rehab is rife with shallow work. Historically, we have been distracted by the idea of "neuromuscular control" -- people standing on unstable surfaces with a 30 deg knee flexion angle, being perturbed, in search of the holy grail of hamstring co-contraction.

And we forgot to ask people to bend and straighten their knee. To develop knee extensor strength -- THE KEY TO KNEE HEALTH. We now (again) have to use isokinetic devices to tell us what the knee extensor strength is because we have lost the skill and ability to program and observe movement that develops and is indicative of that strength & capacity. Note: I am not saying it isn't important to inform RTS with objective measurement. I am saying that many clinicians now rely on those occasional measures solely because they do not have the ability to design in session challenges / progressions that ask the patient to demonstrate and express the necessary capacities and movement competencies. 

Now, there is a new distraction: Neurocog. We are going to enhance your RTP journey by distracting you with visual and auditory tasks while you bend and straighten your knee. 

To me, it looks like we are going down a very similar path of not doing the work that needs to be done. We latch onto a term and task that sounds clinical and sciency -- it may even have relevance at some point in the process. But it will command our attention (and ego) too soon and distract us from the fundamental quality movement that must be done first to build the infrastructure and body awareness that allow us to manage our respective sporting environments. Basic LE capacity to manage bodyweight on a single leg must come before the layering of additional meaningful variables. 

Can you define the functional strength targets and capacities that should be consistently and repeatedly demonstrated before you layer on visual and auditory complexity?? Will you be distracted by shallow work that masquerades itself as clinically important activity?

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