| www.massagemag.com | December 2014 | MASSAGE Magazine | 45

A Kinesthetic Approach to Address Muscle Weakness

Did you know that most people, including professional athletes, have a significant number of muscles that test weak? Weakness is very common—even in seemingly strong individuals. Although there have not

been clinical studies that indicate widespread muscle weakness, muscle weakness is considered common in general, with multiple potential causes, many of which are very medically based. In 30 years of manual muscle testing, chiropractor and kinesiologist and developer of Targeted Muscle Testing Cassius Camden Clay, D.C., has tested clients ranging from average folks to professional athletes to yoga masters—and he said he has found just two adults whose muscles did not test weak.

Strong, functional body movement requires healthy nerve signal conduction and a healthy flow of the body’s fluids, including blood, lymph and cerebral spinal fluid. When any of these flows are significantly blocked, a muscle tests weak. Muscles will also become reflexively weak to prevent injury to themselves or associated joints.

Targeted Muscle Testing is an assessment technique that helps practitioners learn where to find common, important muscle weaknesses. Targeted Muscle Testing also detects whether or not the treatment has been effective. Did the weak muscle become instantly strong after treatment? Targeted Muscle Testing will answer that question.

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by Barbara Sharp, L.M.T.

Targeted Muscle Testing

MASSAGE magazine | December 2014 | pg 44 —reprinted with permission

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“It gives me the ability to work smarter, not harder, and to show my massage and personal training clients that their dysfunction may not be a result of their activities, just the result of inactivated muscles,” said massage therapist Maggie Alfieri, who is massage program director at Atlanta School of Massage in Atlanta, Georgia, as well as an orthopedic massage instructor at the school.

When massage therapists learn to feel and address weakness in addition to muscle tightness, treatment outcomes improve. Because spasmed areas often compensate for weak areas, if weakness is treated first, spasm may resolve. For example, a spasmed piriformis, which can contribute to sciatica, will commonly test weak. The spasmed portions overcompensate for the adjacent, weak muscle sections. When those adjacent muscle sections are strengthened, spasm and sciatica dissipate.

DevelopmentManual muscle testers base

their work on the seminal 1949 publication of Muscles, Testing and Function by the husband-and-wife team of physical therapists Henry and Florence Kendall. The field was further advanced in the 1960s by George Goodheart, D.C., as he developed Applied Kinesiology.

Clay has used muscle testing and assisted yoga stretching from Thai massage, first in his chiropractic practice and later while teaching. Since 1993, Clay has found that palpating with a light kinesthetic touch allows him to notice subtle variations in skin tone and quickly identify areas of weak muscle function. The skin over weak muscle

sections feels flaccid or mushy, while skin over strong muscle sections feels toned and springy. This approach is now called subtle muscle palpation.

Through this palpation, Clay realized that traditional muscle testing misses more muscle weakness than it finds. Especially in large- to medium-sized muscles, the entire muscle may not be weak; however, isolated muscle sections, and especially the bellies of these sections, commonly test weak.

Clay developed Targeted Muscle Testing in order to verify weak muscle sections discovered through subtle muscle palpation but missed in standard muscle testing—and in cases of muscle overlap, to help differentiate which muscle is weak. Clay has taught these concepts to hundreds of students, including Stephen Warren, a bodywork instructor in Surfside Beach, South Carolina, who now uses Targeted Muscle Testing and its treatment corollary, Quick Self Fixes, in class to keep his students “engaged, amazed, and aware,” he said, and added, “The bottom line is that they work, and the students can feel that they work.”

In actionThis kinesthetic approach incorporates more than just

testing individual muscles. Analyzing posture, gait and other functional movement is the first part of the assessment. The

goal is to determine which muscles are not moving in fluidity and strength and are causing observable dysfunction.

The practitioner uses the Targeted Muscle Tests to identify the specific cause(s) of the posture, balance or gait dysfunction. For instance, a weak quadratus lumborum on one side causes a person doing the downward facing dog yoga posture to be asymmetrical. Strengthen the quadratus lumborum, and the pose becomes instantly symmetrical. Other examples include performing a deep squat with better symmetry after strengthening hip flexors; a pushup with no shoulder pain after strengthening pectoralis major; and a more balanced and flowing gait in general.

“I use Targeted Muscle Testing when clients come in with pain or lack of range of motion,” said Woodstock, Georgia, massage therapist Lisa Schudel, L.M.T. “I muscle test first to find weaknesses, then I show the client the correlated self-fix, and then retest the muscle to see if the fix helped.”

Following muscle strengthening, massage is more successful in both releasing fascia and promoting relaxation. Andrew Still, M.D., D.O., the founder of osteopathy, taught that life is physical matter, constant motion and innate intelligence. These concepts underlie how and why Targeted Muscle Testing works. When space is re-established in exactly the correct places, the body’s needed fluid or nerve conduction is restored, and associated muscles will subsequently test

2 Targeted Muscle Tests1 2

Quick Self Fixes are a series of self-care connective tissue stretches and joint movements that strengthen Targeted Muscle Tests.

1. Biceps Brachii, Long Head Division Tester instructs the person to stand and hold the arm being tested:• Straight out to the front of the shoulder• Parallel to the floor, at a 90-degree angle• Elbow locked straight• Palm facing upward

Tester stands in front of the person and braces the person’s opposite shoulder to prevent the person from falling forward during this test.

Tester contacts the person’s forearm just before the wrist on the palm side.

Tester instructs the person to “Hold strong upward.”

Tester feels for the person’s muscle to engage and then applies pressure to push the arm downward while the person resists upward.

This action is done for one, two and four seconds, escalating the pressure and duration each time to evaluate initial strength, core strength and sustained strength. If the test fails at any time, do not continue.

The Quick Self Fix for this muscle test is the Biceps Tendon Fix.

2. Upper Trapezius, Scapular Division, Medial Zone Tester instructs the person to stand and hold the arm being tested:

• Diagonally upward to the front from shoulder level, at a 135-degree angle from floor• Elbow locked straight • Palm facing downward • Hand positioned so that it crosses the person’s midline by 10 degrees

Tester stands in front of the person on the opposite side being tested and braces the person’s opposite shoulder to prevent the person from falling forward during this test.

Tester contacts the person’s forearm just before the wrist and on top of the forearm with the person’s palm facing downward.

Tester instructs the person to “Hold strong upward.”

Tester feels for the person’s muscle to engage and then applies pressure to pull the arm downward while the person resists by holding the arm upward.

This action is done for one, two and four seconds, escalating the pressure and dura-tion each time to evaluate initial strength, core strength and sustained strength. If the test fails at any time, do not continue.

The Quick Self Fix for this muscle test is the Cranial Fix.

Visit www.quickselffixes.com and click the sign-up button on the home page to see these tests, plus three more, on video. For each online muscle test, you can also learn a corresponding Quick Self Fix.

More information, including books and DVDs, on both Targeted Muscle Testing and Quick Self Fixes, is available at the same URL. —Barbara Sharp, L.M.T.

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strong. Targeted Muscle Testing gives the therapist an opportunity, said Alfieri, “to become consciously aware of how differently we hold our bodies in strength.”

Correct pressureAs with any palpation technique, muscle testing requires

practice, training and skill. Most muscle tests use arms or legs as levers in open space, giving a huge advantage to the muscle tester. If the client is able to hold a full muscle contraction while resisting correct pressure, the muscle test is strong. If the client is not able to hold firm against the pressure, the muscle fibers in line with that contraction are considered weak.

The term correct pressure is key. People have naturally varying strength levels, both person-to-person and muscle-to-muscle. Muscle spindle cells and Golgi tendon organs can abruptly make a strong muscle go weak to prevent injury when physically overstressed. The tester must first meet that person’s existing strength, and only then challenge—but not overpower—it. Testing should never be painful, and an injured muscle should not be directly tested. Any persisting weakness that does not respond to normal treatment may also be caused by tissue injury, swelling, neurological disorders and other conditions. If a weak muscle does not become strong using gentle means within your scope of practice, refer the person out to a chiropractor trained in Applied Kinesiology, or to the client’s medical doctor.

Massage, chiropractic, osteopathy, physical therapy and assisted stretching are all bodywork methods that have successfully turned muscles instantly strong. After treatment, muscles should be retested to confirm that the treatment reactivated strength. Then the client should repeat the formerly problematic movement or posture. In one case example, a client was having difficulty performing a standard biceps curl. Subtle muscle palpation identified weakness in the medial anterior shoulder. However, the deltoid and biceps brachii muscles tested strong. Coracobrachialis tested weak. After coracobrachialis was strengthened using a self-manipulation of the clavicle, the client was able to strongly and properly perform the exercise.

In addition, sports massage therapists can apply Targeted Muscle Testing to activate muscles before exercise or competition, thus reducing the potential for injury and improving performance outcomes.

Barbara Sharp is a licensed massage therapist in Marietta, Georgia, with 20 years of experience. She found Targeted Muscle Testing, Quick Self Fixes (www.quickselffixes.com) and assisted yoga postures from Thai massage so helpful that she expanded her class note-taking skills into writing three full curriculums to help others have a written resource to learn from and reference. M

Learn more about Targeted Muscle Testing’s treatment options for yourself, in “Quick Self Fixes,” by Barbara Sharp, L.M.T., at massagemag.com/quickselffixes.]

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