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Reactive Neuromuscular Training: How & Why

Every athlete at EBA starts out with an injury screen and movement assessment. This assessment is to sift out any imbalances or flaws in movement patterns that may negatively impact performance or lead to injury. When we find these dysfunctions it's important to correct them as we lay the foundation to build upon during the athletes time with us.

Reactive Neuromuscular Training (RNT) is a training method that has been around for decades and has been proven through numerous studies to improve joint stability and balance; serving as an effective corrective exercise tool in rehab/prehabilitation strategies. It's a go-to method for us here at EBA because of it's effectiveness at creating habits that keep the athlete's movement patterns in check and their stabilizing muscles engaged, when and where they need to be.

The basis of RNT is training the brain to recruit and engage certain muscles in reaction to sensory input with a subconscious response. Creating an instinctual pattern that corrects dysfunctions and imbalances in movement patterns and fostering joint stability and improving neuromuscular control.

6 top RNT exercises used at EBA in no particular order:

  • Lateral band resisted split squat (abduction focus for valgus CEx)

  • Low lateral band resisted single leg RDL (ankle eversion focused for inversion CEx)

  • Hip circle trap bar dead lift or goblet squat (abduction focus for valgus CEx)

  • Antirotation drag (lateral sling and antirotational core CEx)

  • Band resisted RDL or KB swing (hip extension focus)

  • TKE or single leg squat (tracking and quad extension focus)

Dynamic Knee Valgus (DKV) is one of the top dysfunctions we see throughout our screening process that is flagged as needing CEx. This is when the knees dive in during the loading and/or landing phase of jumping, running, lunging, squatting, or any other dynamic movement. This is dangerous to the tendons and ligaments in and around the knee as it loads the joint unevenly and puts them at greater risk of major injuries such as ACL tears. Female athletes tend to present DKV more frequently due to their already greater Q angle; a result of the wider hip anatomy. Because of the frequency that we see DKV in our athletes the abduction focused RNT exercises listed are some of the most commonly used at EBA.

Hip extension is a specific movement that can be difficult to teach to younger or less experienced athletes and we find RNT to be extremely helpful in reenforcing this position.

There are endless ways to implement RNT which is what makes it so useful in so many different scenarios. Knowing how to properly implement and use this technique is key to having the intended effect on the athlete.

For example, if we’re looking at the first exercise listed, the lateral band resisted split squat, and assume we’re working with an athlete with dynamic knee valgus, it may present like this in a split squat.

If we are trying to correct valgus it’s important that we’re not assisting the knee in a way to “pull it into position” rather we’re adding resistance in the direction it’s already naturally falling so the athlete is forced to engage the muscles that are lacking in order to correct this stance, regain balance, and execute the movement.

Image on the left allows the athlete to engage the glute med and strengthen a weak stabilizer. Image on the right is simply pulling the knee out, which will actually engage the adductors, the very muscle that is already overactive.

Once you understand the premise of RNT, it can be a tool to use in various ways to activate muscles that maybe are underactive or weaker to build a pattern and habit that allows the athlete to gain strength in that area of need. Ultimately the goal is to help the athlete move more efficiently and effectively which will both improve their athletic performance and help prevent injuries.

Erin Bratcher | MS, CSCS, CES, PES

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