In this article, I want to talk about muscle testing, specifically it’s utility within the confines of therapy and training, as well as address some of the shortcomings.
I want to start off by saying that muscle testing is absolutely scientifically valid, and when employed by a competent practitioner, can be an incredibly reliable assessment tool. I don’t plan on getting into the nitty-gritty details of the science behind it, but if you’re curious about the physiology behind muscle testing, give this a read:
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 it when I first was learning how to use manual muscle testing. 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 the most valuable tools we have for assessing neuromuscular function. 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.
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. 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, 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.
Patient is placed in an unstable position to begin with, creating excessive compensation.
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 fibers than we are intending to asses.
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 or inhibition, or to confirm our biases or expectations. It is to gather information in as accurate and reliable way as possible. A muscle showing as “weak” or “strong” is not the ultimate outcome. 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 and reliable way to assess neuromuscular function.
Muscle testing can be used to assess many different things, including specific muscle function, how muscles are functioning in relation to other muscles, and other neurological dysfunction coming from peripheral receptors, neurologic reflexes, organ dysfunction, meridian dysfunction, and cranial nerves/brain nuclei. Usually pain or difficulty with movement are the starting points. Our goal is to use muscle testing to locate the specific source of the pain or dysfunction, and clear it 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 dysfunction. I locate a dysfunctional golgi receptor in her iliolumbar ligament that seems to be driving the dysfunction. I clear out the neurological dysfunction, and retest the muscle. It now shows as facilitated, meaning it functions properly. 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 would 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 dysfunction 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.
Although muscle testing can be one the most powerful tools in our toolbox for assessing dysfunction, it also has its limitations. I always explain to clients that I work with, that while it is great if we can restore neurological function on the table, what matters more is whether or not these neurological fixes actually hold when put to the test in the real world.
Let’s say my client does a lunge and it doesn’t hurt initially after the correction. 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 affecting the dysfunctional rectus femoris. This time I find a pain receptor in her heel. I correct this dysfunction, and now 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. Beautiful.
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 the client falls apart as soon as they walk out the door and go back to their life routine. Even though we can clear all kinds of neurological dysfunctions, 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 intelligently can go a long way in helping to make corrections stick.
Muscle testing is a reliable and incredibly effective tool for assessing neurological dysfunction. If we address the neurological components feeding into our symptoms, whether it is pain or difficulty with movement, 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.