Reactive Neuromuscular Training (RNT) for Dynamic Stability


Stability is the ability of your body to return to its original state after a disturbance. To maintain dynamic stability during physical activities, you need adequate strength to support your body, along with the ability to react quickly, to shift your weight into the right position at the right time to avoid undesired movements. Reactive neuromuscular training (RNT) is an innovative training method that uses specific exercises to foster dynamic stability, and to restore it after an injury.

Proprioception and Dynamic Stability


Stability relies on proprioception, the ability to sense your body’s spacial position relative to gravity. Proprioceptors are sensory neurons located in your muscles, tendons and ligaments. They provide feedback to your brain from their locations throughout your body, evoking appropriate neuromuscular reactions to restore and maintain stability.

Reactive neuromuscular training (RNT) improves neuromuscular mobility and stability by training the neuromuscular system to recruit and engage certain muscles at the beginning of a movement, to foster joint integrity and stabilize the body during movement. RNT is based on postures, not movement patterns. It focuses on the quality of movement rather than the quantity.

Causes of Dynamic Instability

Failure of your muscles to fire in specific and coordinated patterns results in suboptimal dynamic movement. It can undermine stability and keep you from performing at your peak. It can also set you up for both acute and repetitive overuse injuries.

Efficient motor patterns can be compromised by an injury, or by imbalances acquired through asymmetrical sports and day-to-day activities. For example, when driving your car, you use your right leg to accelerate and brake, while your left leg remains dormant. When bowling, batting, throwing or serving a tennis ball, one side of your body does most of the heavy lifting.

Over time, you create imbalances in your musculoskeletal system that affect your static and dynamic stability and reduce the efficiency of movement patterns in general. Coaches and trainers use stretching, cuing and resistance exercises to try to restore symmetry and stability, but those approaches are often not enough to offset fundamental imbalances.


Benefits of RNT


The primary purpose of reactive neuromuscular training is to enhance the unconscious interpretation of signals sent from the proprioceptors to the central nervous system (CNS), and to facilitate their integration into appropriate motor responses.

The benefits of RNT include:

  • Improved joint stability
  • Enhanced neuromuscular coordination
  • Increased neuromuscular control
  • Enriched kinesthetic and proprioceptive awareness
  • Improved athletic performance
  • Quicker response time
  • Successful post-injury return to sport
  • Reduced risk of injuries

Rather than training the muscles, RNT trains the brain to react to sensory input with an automatic subconscious response, tapping into instinct to react to applied forces in ways that override faulty motor patterns.

RNT Exercise Progression

RNT encompasses a variety of rehabilitation exercises designed to restore dynamic stability and refine motor control. RNT techniques are meant to be used in conjunction with other rehab methods, to promote optimal function after an injury or to eliminate faulty motor patterns developed over time.

Once a baseline is established, RNT exercises progress through three distinct stages:

  • Static Stabilization: This phase uses isometric exercises to develop stabilization for static motor control and posture.
  • Transitional Stabilization: The second phase uses controlled concentric and eccentric contractions, moving joints through their full range of motion to stimulate mechanoreceptors.
  • Transitional Stabilization: The second phase uses controlled concentric and eccentric contractions, moving joints through their full range of motion to stimulate mechanoreceptors.

RNT techniques enable therapists to accelerate the recovery process and return injured athletes to their respective sports with higher performance and reduced injury risk.


KINEO System for RNT

KINEO is a special type of equipment designed to bridge the gap between assessment and training. As an intelligent loading system, it enables therapists to assess strength and muscle imbalances and continuously monitor the rehabilitation process. Detailed reports are instantly generated to provide necessary data for establishing and executing successful reactive neuromuscular training programs.

While there are many ways to approach RNT without specialized equipment, KINEO takes the guesswork out of RNT, and gives us quantitative feedback to ensure the patient attains optimal results.

Reactive Neuromuscular Training at NYDNRehab

The sports medicine team at NYDNRehab recently added a full line of KINEO intelligent load equipment to our growing array of advanced technological tools. By coupling the latest sophisticated technologies with up-to-the-minute rehabilitation techniques, we are able to give our patients superior results in the shortest possible time.

At NYDNRehab, we have the tools, training and expertise to provide athletes and active patients with reactive neuromuscular training, to keep you moving at your very best.


In this instance, an athlete was originally diagnosed with minor quadriceps muscle strain and was treated for four weeks, with unsatisfactory results. When he came to our clinic, the muscle was not healing, and the patients’ muscle tissue had already begun to atrophy.

Upon examination using MSUS, we discovered that he had a full muscle thickness tear that had been overlooked by his previous provider. To mitigate damage and promote healing, surgery should have been performed immediately after the injury occurred. Because of misdiagnosis and inappropriate treatment, the patient now has permanent damage that cannot be corrected.

The most important advantage of Ultrasound over MRI imaging is its ability to zero in on the symptomatic region and obtain imaging, with active participation and feedback from the patient. Using dynamic MSUS, we can see what happens when patients contract their muscles, something that cannot be done with MRI. From a diagnostic perspective, this interaction is invaluable.

Dynamic ultrasonography examination demonstrating
the full thickness tear and already occurring muscle atrophy
due to misdiagnosis and not referring the patient
to proper diagnostic workup

Demonstration of how very small muscle defect is made and revealed
to be a complete tear with muscle contraction
under diagnostic sonography (not possible with MRI)


Complete tear of rectus femoris
with large hematoma (blood)


Separation of muscle ends due to tear elicited
on dynamic sonography examination

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