There are two types of dysfunction that I encounter daily that go unnoticed by most healthcare practitioners. Most clinicians use a manual manipulation model based on moving, stretching or manipulating structures in the body (whether they be muscles, fascia or joints) to place them into a more balanced alignment. This is usually based on a visual ideal of what balance looks like. Because only medical doctors can legally diagnose issues, assessment becomes the most important diagnostic tool available to someone like me. There is an art to assessment that can be cultivated based on experience but is limited by the tools available to us. About 10 years into my practice I wanted a way to improve my assessment skills gain more information about how the musculoskeletal system was supposed to function so I could more deeply understand the dysfunctions that I had problems resolving clinically. I found that assessing strength using manual muscle tests is a way one can check the function of specific muscles and with the right understanding even go further to find the source of muscle inhibition patterns.
How it shows up
Muscle inhibition happens on a few levels. The original model of mechanical compression of a nerve root has been found to be a less consistent cause of muscle inhibition than originally thought but when damaged enough, a nerve will indeed cease to transmit a signal and you get true muscle inhibition where there is no “strength” to control a muscle or movement. More common and less understood are two sources of inhibition related to movement or muscle compensation patterns.
There is one structural and predictably reflexive level that more enlightened manual therapists access in order to provide a more holistic view and application of techniques often termed regional interdependence. This is where an imbalance in one structure will beget a predictable imbalance in a structure elsewhere in the body. There are laws of Spinal motion as well as lesser known reflexive fixation patterns in key bones (keystones) in the body. The atlas is an example of a bone that has long been known to be an important structure that when integrated into a neutral position, causes a systemic trickle down and release in many locked structures all over the body.
the other type of inhibition occurs when there is dysfunction in the processing of signals throughout the nervous system wherein the errors cause muscle weakness. These processing errors are usually caused by trauma. Trauma can come from chemical, emotional or physical sources (acute or repetitive) and each one is interpreted as a threat exactly the same way in the nervous system. When these dysfunctional pathways are stimulated in the nervous system, muscle weakness occurs exactly like Pavlov’s dogs conditioned response is triggered by the sound of the bell. Certain stresses regardless of physical, chemical or emotional will trigger a relational inhibition response to muscles in the body. In order to provide complete resolution of neuromuscular and musculoskeletal dysfunction, these underlying dysfunctions must be taken into account prior to manual tissue manipulation. I’ve often found the most recalcitrant fixations and stubborn hypertonic muscles to be created by a neurological compensation pattern that can be released without any physical exertion because they were neurogenic in nature. Most therapists attempt to reverse the effects of this function via postural manipulation where I go to the source of the dysfunction. The outcome is always that less physical manipulation is needed and will yield greater results then physical work alone.
My cutting edge blend of neurological and orthopedic manipulation is one that addresses the issues that often linger after expert rehab or treatments. I look for and find the things that others don’t that are preventing the body from a full recovery. The limits of massage therapy and manual therapy don’t apply when you can address the neuromuscular inhibition patterns that create musculoskeletal dysfunction.