Here is the discussion for those of you who didn't click on the link
As an Athletic Trainer manual muscle testing was covered in my education and was always incorporated into the evaluations we were taught. As I’ve grown as a practitioner and dove into numerous subjects (primarily different types of movement assessment) I’ve gradually moved away from manual testing to the point that I rarely ever use it.
I have certifications in the Functional Movement Screen, Selective Functional Movement Assessment, and NASM’s Corrective Exercise Specialist. The Functional Movement Systems train of thought is to correct movement patterns and not solely focus on individual joints and structures (if we normalize the pattern the parts will follow). The NASM speaks more on activating individual muscles then integrating them into patterns (inhibit, lengthen, activate, integrate).
I’m at stand still in my assessment and treatment methods. I believe the traditional method of manual muscle testing can be very misleading in terms of the information it gives us (pain could simply be inhibiting the muscle, one muscle could be inhibited or facilitated due to the activity of a synergist/antagonist, etc). I’m currently halfway between the Functional Movement System’s train of thought and that of NASM.
What is everyone’s thought on manual muscle testing and how you incorporate it into your assessment and treatment? My next course will most likely be Neurokinetic Therapy which explores a slightly different way of looking at manual muscle testing and its relationship with the motor control center.
Thoughts on this would be great! Thanks everyone!
I have certifications in the Functional Movement Screen, Selective Functional Movement Assessment, and NASM’s Corrective Exercise Specialist. The Functional Movement Systems train of thought is to correct movement patterns and not solely focus on individual joints and structures (if we normalize the pattern the parts will follow). The NASM speaks more on activating individual muscles then integrating them into patterns (inhibit, lengthen, activate, integrate).
I’m at stand still in my assessment and treatment methods. I believe the traditional method of manual muscle testing can be very misleading in terms of the information it gives us (pain could simply be inhibiting the muscle, one muscle could be inhibited or facilitated due to the activity of a synergist/antagonist, etc). I’m currently halfway between the Functional Movement System’s train of thought and that of NASM.
What is everyone’s thought on manual muscle testing and how you incorporate it into your assessment and treatment? My next course will most likely be Neurokinetic Therapy which explores a slightly different way of looking at manual muscle testing and its relationship with the motor control center.
Thoughts on this would be great! Thanks everyone!
Brad Muse MA, AT, CES, CIDN
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3 replies
I've found MMT to be minimally useful in the clinic. The only times I use it for ortho patients are to look at knee extension strength post surgery. I also look at hip abduction and hip ER if I think there might be asymmetries. I rarely grade it and usually am looking for an obvious difference left to right. Other than that I focus on what I see and what the patient tells me they feel. Natural movements aren't controlled by single muscles so it doesn't make sense to me to try and isolate them for testing or treatment.
I'm with Matt on this one. I rarely use pure MMT, it is misleading as unless a patient has true disuse atophy, it's not real weakness, it's mostly inhibition or impaired motor control due to perceived threat. I'd rather pre and post test some sort of litmus test for function. I also do not treat a lot of post op patients and haven't in years, but even then, unless they've been immobilized for a while, rarely are they truly weak.
In the end if you test someone "weak" with or without pain, and you intervene and they automagically get stronger, they were not weak to begin with.
In the end if you test someone "weak" with or without pain, and you intervene and they automagically get stronger, they were not weak to begin with.
I agree with Erson and Matt, except that I would argue it is relevant for differential diagnosis when there is suspicion of neurological compromise. Once neurological weakness is ruled out, the value MMT is modest.
I would suspect most of you regular blog readers out there would progressed similarly in your own clinical decision making, but I wanted to take a poll to find out.
Now that you've answered, chime in below or on the facebook page and state why or why not you use MMT. Also, guess what my answer was, if you didn't read the forum post.
Interested in live cases where I apply this approach and integrate it with pain science, manual therapy, repeated motions, IASTM, with emphasis on patient education? Check out Modern Manual Therapy!
Keeping it Eclectic...
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