Professionals using muscle testing based modalities often use specific language to describe the findings of neuromuscular assessments. When we perform a muscle test, we will use words like “strong,” “weak,” “inhibited,” or “facilitated” to describe how that muscle is functioning. Using certain words like these helps to create a narrative that is easy to understand when making sense of our pain, particularly when providing an explanation for clients. In this article, I want to highlight some of the differences between what we sometimes refer to as “weakness” versus “inhibition,” as well as highlight the importance of differentiating between the two.
Without clear definitions of these words, many things can get lost in translation between professionals and clients. This can create misunderstanding and incongruent expectations and outcomes, which can often lead to distrust. It is also important to consider how certain words and their associations might affect ours and clients’ experiences of pain or performance. Positive and negative associations of certain words can often create mental or psychological barriers that may compromise health and/or performance. Far too often I find fear-mongering to be a tactic used to create buy-in from clients, and this should be frowned upon. Our job as health and fitness professionals is to educate and empower our clients, not to manipulate them based on their self-limiting beliefs or fears. Finally, it is important to make sure that we keep things as accurate as possible. We must make sure to not oversimplify explanations to the point of being inaccurate or simply wrong altogether. When talking about pain or performance, context is everything. Education and accurate understanding go a long way in helping to facilitate healing and building long-term resiliency.
Weakness & Inhibition - What’s the Difference?
When I assess my clients, I will use muscle testing to determine baseline function of a given muscle. However, I also take into consideration the client’s goals, whether it is pain or performance based. Just because I find a muscle that tests as functional on my table, does not necessarily mean that my client will then have to ability to utilize that muscle effectively in a given exercise or movement pattern.
A strong muscle can still test as inhibited if I’m testing it in a specific context. To simply imply that a muscle is just “weak,” and that strengthening it will fix the issue is short-sighted and seldom helpful.
If I’m working with a world-record powerlifter who is dealing with knee pain, and his quadriceps test inhibited, does that mean his quads are weak? Of course not. The dude is a high performing athlete lifting boatloads of weight. But if he is having knee pain, clearly his quads can be functioning more optimally. His quads are strong, yet show as “inhibited” when their function is parsed out more specifically.
Conversely, if I’m testing a desk-jockey who lives a predominantly sedentary lifestyle, her quads might not show as “inhibited,” but she might not even be strong enough to perform a decent bodyweight squat. Is she strong in the context of movement or performance? Time and time again, I can restore neurological activity in a given muscle, only to find that as soon as we do something that challenges the muscle in a strength context, they are still “weak,” relatively speaking.
Hopefully this quick example illustrates that there is indeed a difference. A strong muscle test does not imply functional strength in the real world, and vice versa. An “inhibited” muscle test does not imply weakness in the real world, or vice versa. It is all context specific.
Why is Differentiation Important?
If we have miscommunication between the professional and the client, chances are likely that the relationship will not be built on trust. Trust is absolutely vital for success in helping clients achieve their desired outcome. I’ve noticed far too often that fear-mongering is the primary tactic of many other professionals, and I’ve had to spend much time re-educating my clients on the realities of their symptoms.
“Your back hurts because your core is weak.”
“You can never do squat ever again or you will get hurt.”
“You have to do deadbugs for the rest of your life if you want to stay out of pain.”
What kind of professional tells their clients these types of things!?!? None of these types of statements are based in reality whatsoever. They are simple, yet seldom-helpful narratives that practitioners, lazy at best and manipulative at worst, tell their clients to get their business. I’m so tired of it. Give context, educate your clients, be honest, and make sure that you communicate well to them in order to earn and garner their trust.
In the examples I highlighted above, the powerlifter might take exception to being referred to as “weak.” It might make him resent me. Perhaps it may actually shake his confidence. Maybe he starts to formulate beliefs that there is something wrong with him. Anxiety about pain might creep in from time to time. Analysis paralysis. And then the anxiety about the pain worsens the pain itself. This narrative is more common than you think. We need to be careful which words we use to describe our findings with clients, and put things into context so that we don’t create confusion. There are certain words that have a higher likelihood of creating negative associations or feeling threatening to clients or patients. These words can change their mental and/or psychological well-being, and make it that much more difficult to resolve the issue they are dealing with. Letting a client know that their quads aren’t functioning as well as they could in a given exercise and how to address it, is far more helpful than telling them their quads are weak and they need to strengthen them.
If I’m trying to communicate to my desk jockey client that her quads are testing as functional at the moment, but that her overall movement quality and strength could stand to be improved. I need to also make her aware that the chances of her getting hurt later in life might increase if she doesn’t also build up some functional strength. I would encourage her to get going with some sort of movement practice that she enjoys to encourage her to build up more strength and resiliency. It is imperative that we educate and share information in a way that takes into account individual circumstances. Blanket recommendations or fixes almost never work. The answer to most questions starting with, “What should I do if…” almost always can be answered with, “it depends.” As professionals, let’s make sure that we create enough context and educate our clients as accurately we can. As clients and patients, make sure to be weary of professionals who give you any sort of absolutes when it comes to explaining your pain.
Hopefully, I was able to coherently illustrate the differences between “weakness” and “inhibition,” as well as the importance of using language carefully, and providing context when educating ourselves and others. Human movement is an incredibly complex phenomenon, and remaining diligent in being authentic and empathetic are vital to moving the health and fitness industry forward.