Assessing Movement: Shifting the Paradigm
In this article, we are going to talk about muscle testing, specifically its utility within the confines of therapy and training, and how it can be an invaluable tool in assessing movement. Outside of joint range of motion, pain levels, and/or subjectively analyzing various movement patterns, there are very few ways that we go about attempting to assess and quantify movement. Essentially, what we are trying to do is identify areas of the body that lack functional capacity, and assign exercises and treatments that will help address the low hanging fruit and improve those areas. This is the whole reason we assess, to give us some semblance of guidance with treatment and training.
The biomechanics community (especially all you PRI nerds out there - good shit y'all!) has done a great job slowly shifting away from the outdated paradigms still prevalent in fitness. We’re finally turning the corner when it comes to recognizing that glute activation won’t always remedy back pain, that your knees can in fact move over your toes without exploding, and that the spine can safely move and bear load in positions other than neutral. We’re making progress.
Yet despite how far we’ve come, I still think we can do better. Assessing movement goes deeper than just bones and muscles, joint angles and muscular force output, and breathing and internal pressure dynamics. While biomechanical factors like range of motion are obviously important and can inform us, they fail to take into account many other pieces of the puzzle that can affect movement and our capacity to respond appropriately to any given movement. Biomechanics focuses in on the structural components of movement. We also need to take into account the role that nervous system plays in movement. This can include things like reflexes and receptor inputs, as well as deeper subconscious material like emotional trauma or injuries. Taking into account the structural components (bones, joints, ligaments, muscles, etc.) and also having an appreciation for the nervous system’s role in managing and controlling those components is paramount. We need to account for software as well as the hardware, and how they affect each other.
How can we measure or assess movement in a way that takes into account these neurological, physiological, and emotional components? Enter manual muscle testing.
What is Muscle Testing?
Muscle testing comes in many forms, and can be utilized many different ways. The general idea of muscle testing is to manually apply resistance to a muscle or group of muscles, and based on how they respond (weak, strong, locked, etc.), we can better determine many things. There are many different techniques that utilize muscle testing in some form as part of assessment and treatment. To my knowledge, most of them if not all of them are based on Applied Kinesiology. Needless to say, there are many ways to test muscles, and many ways to interpret how muscles respond to testing, and how that information can be used to inform our treatment and training strategies.
Muscle testing is a bit of a misnomer. Muscle testing shows us how both our physical structure and nervous system are responding to stress. Stress includes any and all stimuli, external and internal, physical, mental, and emotional. So when we are muscle testing, we are not just simply testing a specific muscle, but we are more-so testing how both the nervous system and physical structure are responding to stimuli/stress. The primary role of the nervous system is to gather information through our senses and provide appropriate muscular and physiological responses to our environmental stressors in order to help us maintain homeostasis. Homeostasis is balanced either through increased signaling to muscles to contract/relax (to create movement), or to stimulate glandular production (to balance chemical/hormonal/cellular processes). While we can utilize muscle testing to focus on the musculoskeletal system and the relationships between individual structural pieces, it is impossible to separate the body from the brain and nervous system. Muscles simply do what the nervous system tells them to do. It then stands to reason that old injuries, internal physiology, emotions, past traumatic experiences, and core values and belief systems all can affect how the brain signals muscular activity, and therefore directly impact our biomechanics and movement.
Unfortunately, as with anything, the techniques involved in the world of muscle testing modalities can be subject to poor application by inexperienced practitioners. Because of this, muscle testing is often dismissed, particularly in the scientific-method-obsessed circles within the health and fitness industry. It’s simply dismissed as unreliable pseudo-science voodoo, not because it isn’t valid, but because it isn’t understood.
I was not very good at using muscle testing as an effective tool for assessment when I first started learning it. But it is important to understand that just because the science has yet to catch up and the widespread acceptance and use of muscle testing is not there yet, does not mean that muscle testing and the many modalities that use it should be dismissed. Instead, they should continue to be explored because the clinical evidence is overwhelmingly positive. I can personally attest to this. I contend that muscle testing is one of the most valuable tools we have for assessing movement. The more thorough an understanding we have in regards to neuromuscular function, the better we can direct our treatments for pain, plans for rehabilitation, and protocols for training.
Reliability
Generally speaking, muscle testing used as a means of assessing the function and overall health of specific areas and systems of the body depends on:
The current state of the nervous system of the practitioner
The current state of the nervous system of the patient/client/athlete
How these two nervous systems interact.
The above can be influenced and affected by various factors, which are often not taken into account and therefore can lead to testing being less reliable. Some common mistakes that can lead to unreliable testing are:
The practitioner is not grounded and in a space that is conducive to allowing the patient’s nervous system to relay accurate information. (The practitioner’s biases and expectations, physical and emotional state, and sometimes even just a general lack of authenticity - a lack of trust, can greatly influence how a muscle test will read).
The patient presents with a dysfunction that the practitioner also has. (If so, it can sometimes be the case, particularly when it comes to unhealed emotional trauma, that the two nervous systems can unconsciously pick up on this, and testing outcomes can be affected).
Too much or too little force applied by the practitioner.
The client does not feel safe and supported and therefore cannot enter a parasympathetic state (there can be many reasons for this).
Practitioner is unstable, and poor leverage can greatly affect the application of pressure during testing.
Wrong position of the joint, which will ultimately test different muscle fibers or patterns than we are intending to assess.
Eyes, hyoid, and talus position all have direct neurological effects on global muscle function.
Practitioner or client is hypertonic or neurologically switched.
Client moves distal flexors or extensors as compensation to create stability.
Moving the skin can affect test results.
Client can place the hand on the dysfunctional receptor field and affect the test results.
Remember that the goal of a muscle test is not to simply show facilitation (strength) or inhibition (weakness), or to confirm our biases or expectations. It is to gather information in as accurate and reliable way as possible. Intention is a powerful influencer in how nervous systems communicate. A muscle showing as “weak” or “strong” is not the ultimate outcome; it guides our understanding of how the body is compensating. Muscle function is constantly shuffling based on stimuli the nervous system is receiving. Thus a muscle might test as “strong” one minute, and “weak” the next, having potentially been affected by something as subtle as a comment or thought shared between the practitioner or client. Ultimately we simply want to parse out how these neurological compensations are behaving so that we can treat the highest priority dysfunctions and have the best treatment results. If muscle testing is applied in a way that takes into account all of the above factors, more often than not muscle testing is the most specific, dynamic, and powerful ways to assess movement and nervous system response.
Utility
Muscle testing can be used to assess many different things, including specific muscle function, how muscles are functioning in relation to other muscles, joint-loading response, and other neurological compensation coming from peripheral receptors, neurologic reflexes, organ reflexes, energy dysregulation, and emotions, experiences, memories, and trauma processed by the limbic brain. Usually pain or difficulty with movement are the symptomatic starting points for some sort of therapeutic intervention. Our goal is to use muscle testing to locate the specific source of the pain or dysfunction, and provide the appropriate treatment in order to relieve symptoms. I typically tend to utilize muscle testing within the context of improving movement capacity and performance. Let’s use a strength training example:
I’m teaching a new client how to perform lunges. As she lunges back, I see her over rotating her pelvis and not going all the way down. She informs me that her knee hurts just below her patella every time she performs a lunge. Knowing some of the muscles that are involved during a lunge, I put my client up on the table to assess potential causes of her knee pain.
I find that her rectus femoris (primary hip flexor and one that has direct connections to the knee) is not functioning well. When I palpate, the muscle feels very tight, and when I perform a muscle test, it shows severe inhibition. I apply different stimuli around her body trying to locate the potential source of the inhibition. I locate an overstimulated Golgi receptor in her iliolumbar ligament that seems to be driving the dysfunction. I clear/reset the less-than-optimal neurological feedback loop (compensation), and retest the muscle. It now tests as facilitated (strong). Upon palpation, I notice a significant improvement in muscle tone. I ask my client to lunge again. No more pain.
The aberrant signal coming from her iliolumbar ligament was creating inhibition of the rectus femoris, and the inhibition of the rectus femoris was causing the brain to create pain at the knee. As soon as the function of the muscle is restored, the brain recognizes improved function at the knee and no longer sends a pain signal. The implications with this type of an approach are profound. Traditionally, we might feel the muscle, notice it feels tight, and perform a release of the muscle using something like a foam roller or a targeted stretch. This might temporarily reduce the tension in the muscle, and we could try a lunge again. It may or may not feel better. In my experience, probably not.
Just because a muscle is tight or painful does not mean that it needs to be stretched or released. That approach would assume that the reason for the tightness or pain resides within the muscle itself, which is rarely the case. In the above scenario, since the compensation pattern creating the muscle tension is coming from a pelvic ligament, no amount of stretching or foam rolling will resolve the issue. Muscle testing allows us to be far more thorough and specific when assessing pain and dysfunction. The extent to which we can assess what systems of the body goes far deeper than even an example like the one above. I often work with clients and athletes who have emotional stressors and old [mostly unconscious] traumatic memories showing up in their bodies and affecting biomechanics very often.
Shortcomings?
Although muscle testing can be one of the most powerful tools in our toolbox for assessing dysfunction, it also has its own set of limitations. I always explain to clients that I work with, that while it is great if we can restore neurological function on the treatment table, what matters more is whether or not our assessment and intervention actually hold up when putting your body to the test in the real world. Depending on your level of capacity, we can set whatever movement standards we want. Our movement assessments can include anything ranging from single leg stance or a toe touch to something as specific as a golf swing, jump shot, or barbell bench press. Muscle testing will reveal the lowest hanging fruit in any pattern we want. Wait…that’s another beneficial aspect of muscle testing…
Going back to our earlier example, let’s say my client does a lunge and it doesn’t hurt initially after our intervention. No more pain. However, after 2 more sets of 12 repetitions, the knee is starting to hurt again. I put her back up on the table and the rectus femoris is testing as inhibited again. I recheck the iliolumbar ligament problem I previously cleared and find that the correction has held. I scan to see what else might be creating weakness in the rectus femoris. This time I find an overactive pain receptor in her heel. After resetting the neurological feedback loop (compensation), the muscle normalizes again. No more knee pain. I have my client go through 3 more sets of lunges to really put the corrections to the test. This time she holds up, and the pain stays gone. *chef’s kiss* This is our goal, to utilize a back and forth process of assessing, correcting, and re-assessing. Over time, this is the best way to make progress with your training while ensuring things are not getting too out of balance or dysfunctional.
Hopefully this illustrates what I often find to be the biggest shortcoming of muscle testing based modalities: not taking the corrections far enough in terms of practical application. Corrections in my clinic don’t mean diddly squat if my client falls apart as soon as they walk out the door and go back to their normal life routine. Even though we can clear all kinds of unwanted neurological compensation patterns, it is still imperative that we continue to build resiliency in order to more thoroughly work through all the potential causes of dysfunction. Training regularly and with purposeful intention can go a long way in helping to make corrections stick and build resiliency.
If that’s the biggest shortcoming, I’d argue it’s a pretty damn impressive tool in our toolbox. There are a lot of muscle-testing based techniques out there. Traditional Applied Kinesiology, Touch for Health, Neuromuscular Reprogramming (NMR), Dynamic Neuromuscular Assessment (DNA), Proprioceptive Deep Tendon Reflex (P-DTR), Neurokinetic Therapy (NKT), Muscle Activation Technique (MAT), etc. The list goes on. Some of these modalities are better than others. I’ll be very transparent and say that P-DTR and DNA are the cream of the crop in terms of scope, depth of information, and array of practical interventions.
The real utility of muscle testing is limited by the level of knowledge and experience of the practitioner using it. Muscle testing is an assessment tool than it is a treatment. Treatments can include tissue work, neurological work, energy work, movement, emotional clearing, trauma processing, or any other number of modalities. Personally, I use a combination of almost all of these. As a practitioner, no matter what skills and techniques you have in your toolbox, muscle testing can provide an effective roadmap for guiding how to best apply treatments and training strategies.
In Conclusion…
Muscle testing is a reliable and incredibly effective tool for assessing neurological dysfunction. If we account for all of the factors feeding into our symptoms, whether it is pain, difficulty with movement, physiological symptoms, or emotional stress, we will have much better outcomes than if we only address the tissue and hardware components. Like any technique, muscle testing still has its limitations, and is best used in conjunction with other techniques to have the greatest effect. For those of you, especially other health and fitness professionals, who are more curious about muscle testing and possibly exploring how it can help you become a better therapist or trainer, please don’t hestitate to reach out to me directly. I’d be happy to help answer questions, and provide additional resources.