ATNR and Twisting

I’ll never forget the first time my brain clumped together the visual information I was seeing of a struggling twisting Yurchenko with the primitive reflexes I learned in PT school. I’m not sure why this instant was the first as I immediately thought of the hundreds of other times I had seen this unusual pattern, but I have some theories. I was visiting a gym known for their conceptual learning strategies. I had an entire week to observe and analyze practice, specifically the athlete I was accompanying.

One of the local athletes had the most clear block and lift off the table, she had great rotation, yet she wasn’t quite making her twist around. The snap shot of her twist initiation remains as a freeze frame at the forefront of my brain - the reflexive pattern with one elbow bent and her head turned the opposite direction with the arm extending out as with the Asymmetric Tonic Neck Reflex (ATNR.) 

How many times have we heard or said a correction about the head turning the opposite direction or “twisting in opposite directions”? A new understanding, or at least theory was developing in my brain. If the initiation of the twist is started by a change in head position, and the ATNR reflex is not properly integrated, the side the athlete hopes to turn towards is going to flare out and slow the potential twisting action. 

This was only a quick moment for the athlete. She was able to pull in tightly and complete most of the rotation in the end, but what was going on for the first moment of activation? Was there a moment of reflex before voluntary movement kicked in? Will this stall in the initiation of twisting diminish her ability to complete the skill? 

This started my deep dive back into primitive reflexes. As a pediatric physical therapist, the 'neurological world' has always been at the forefront of my problem solving. How had I missed this? What other consequences result from retained primitive reflexes and where might we see them in gymnastics? Everything from attention to coordination can be attached to these primitive patterns.

What is a primitive reflex and why do we have them? These reflexes are our bodies’ way of supporting our needs in the world when we don’t have the capacity to complete the necessary movements on our own, physically or cognitively. We have reflexes that assist with feeding and protecting our head, visual attention, and movement. These are essential to survival in the first months of life, but as our bodies and brains develop, voluntary action takes over and they become redundant. Our systems are supposed to integrate them out of use like a shadow fading into darkness; however, sometimes remnants of them peak through. They can show up when we are stressed or alarmed as their first intent is protection and survival, but this lingering can inhibit proper development. 

The Asymmetrical Tonic Neck Reflex (ATNR) is one of the earliest primitive reflexes we develop and integrate. Its onset is at birth or within the first two months and it is only typically present until 4-6 months. I remember this reflex most for its association with hand-eye attention at the earliest stages of life. As the head is rotated, the arm and leg to the side of the eyes extend, placing anything in hand directly in the infants' visual field. If the reflex persists, this automatic patterning of extension can interfere with rolling, crawling, and balance. If it is retained into childhood, things like walking, sitting posture, isolation of body segments, and even reading and writing can be impaired. 

It is easy to assume that a gymnast, especially a high level gymnast, does not struggle with this  inefficiency within the body; however, I believe that the early specialization of gymnasts can lead to a false sense of ability in some of these categories. Gymnasts have shown me time and time again that they are well practiced in certain movement patterns, but completely uncoordinated with novel tasks. This distinction in ability to adapt and motor plan is one of the greatest factors, I believe, in true athleticism and potential. 

Could there be a pattern of gymnasts with atypically integrated ATNR? I asked my sister the other day if it was common for soccer players to have mixed laterality, meaning that they use their right hand but their left foot or interchange between them. She said it was not that common; however, within the gymnastics world, I have noticed this occurrence fairly regularly. If we are starting to tally the potential signs - poor balance (with novel tasks), mixed laterality, difficulty catching a ball, difficulty crossing midline, ADD/ADHD characteristics; it is worth looking into. Are we seeing a higher percentage of these things compared to age norms; and if so, can participation in gymnastics inhibit and/or facilitate the proper integration of this primitive reflex (or any maladaptive reflex pattern)? 

Simple tasks such as crawling and turning the head can both check for and work on integration of the ATNR in young children working with physical therapists. The collapsing of the opposite elbow is a distinct sign of a poorly integrated reflex. Gymnasts are so practiced in weight bearing through their upper extremities, and have ample attention on maintaining straight arms - do they require a higher threshold test? More intricate movement combinations to notice a lingering reflex pattern? 

These athletes are seemingly functioning at levels of motor abilities far above the norm, yet there is a hitch at these outer reaches of potential. It is strange to think of something so high level as dysfunctional. Maybe its not a dysfunction but a boundary to be trained. The reflex integrated well enough to function day to day and even get to a certain level of gymnastics; however, do these reflexes always remain within us, we just don’t push the limits often enough to elicit responses? If this is the case, how do we train to get ahead of this? 

I think we need a reframe. We are no longer identifying a problem to create a solution, we are identifying systems with potentials and specifying training to maximize these areas. How do we mimic the movement patterns eliciting these responses and thus identify the edges of an athletes ability? We need to press the system right up to the edge in order to train it. We cannot fault the athlete for their biology, but we can try to understand it and train the systems within that biology for optimal performance.