Training Spinal, Cerebellar and Cortical Levels of Motor Control

The sensorimotor system covers the afferent, efferent and central processing components that maintain joint stability. Ligament injury disrupts mechanoreceptor input, changing reflex activation at the spinal level and voluntary movement at the cerebellar and cortical levels. A 2023 systematic review in Sports Medicine on brain neuroplasticity supports changes at central levels. For the spinal level, Eamonn uses wobble board and tilt board exercises that create small, fast changes in joint position in the sagittal and frontal planes, progressing to single leg stance. For the cerebellar and brainstem level, balance tasks are done with and without vision, including the BESS stances on foam and perturbations around the stance leg. For the cortical level, the target is the excessively inverted rearfoot at landing seen in people with a history of sprain. A linear progression of pogos, hops from the uninjured to the injured leg, side drops, BOSU landings and speed and agility drills retrains foot placement and control of ground reaction forces.