After much training, certifications, and experience in a variety of reputable kinesiology systems, I have seen many people using manual muscle testing (MMT) for personal use or use within certain modalities. While I acknowledge and respect that there are a variety of approaches to muscle testing, more often than not I am amazed that many cannot name the muscle they are using, have no concept of neurological disorganization or other factors that can affect the outcome of the test, and worst of all, don't seem to care. Without adequate training, muscle testing can often lead to mistakes and misperceptions about this extremely helpful tool. It's important that we use it knowledgeably and with understanding of its basic principles.

Understanding MMT

Manual muscle testing is used for a variety of purposes in health care by medical, osteopathic, chiropractic, physical therapy, rehabilitation, and athletic training professionals and is indicated in anyone with suspected or actual impaired muscle performance. Identification of specific impaired muscles or muscle groups provides information for proper treatments.

Sometimes referred to as "break" tests, the aim is to evaluate the muscle's ability to resist a gradually increasing pressure and may test different aspects of neuromuscular control against fixed resistances. It is considered an important tool for assessing the muscular causes of movement dysfunction making it an essential prerequisite for planning treatment or monitoring the effectiveness of a particular treatment and the client's progress or regression in that treatment.

Clients are asked to hold a position against a therapist's resistance while stabilizing the proximal part of the area being tested to reduce compensatory action by muscles other than those being tested. Resistance needs to be applied gradually ("hold" or "don't let me move you") in the opposite direction of muscle being tested and both sides should be tested to provide a comparison. Consistent and accurate test positions, accurate joint placement, and avoiding the use of use of compensatory muscles results in an increased reliability in using MMT as an evaluation tool.

Evaluating Strength

While MMT is a relatively quick and inexpensive method of evaluating strength, it is sometimes considered subjective. One of the problems central to muscle testing is called the "frame of reference" or the subjective judgment of the tester and it's an extremely important factor because it relates inter-examiner reliability to the use of muscle testing as a diagnostic or assessment tool.

The subjective judgment in the amount of resistance applied during the test is directly proportionate to the validity of a muscle test. This, as well as improper testing procedure, inter-examiner bias and agendas, and neurological disorganization can all have an effect on achieving accurate responses and can call the efficacy of the test into question.

Dr. George Goodheart adapted the contraction muscle test developed by the physiotherapy professors Kendall, Kendall, and Wadsworth to audit and expand the chiropractic realm. He correlated the muscles to the meridian system and developed strengthening techniques based on oriental theory and supplementation to correct the imbalances he found.

This was the beginning of the connection of various strengthening techniques for the correction of weak muscles which included working with blood and energy flow, nutrition, emotions, meridians, and acupuncture points. Information from your body's "software" system relays messages from the subconscious to the surface for consideration and indication of what type of treatment might bring healing or "balance."

Applied Kinesiology

In addition to standard orthopedic and neurologic assessments, applied kinesiology (AK) practitioners use MMT to identify what are believed to be immediate neurological responses to a variety of challenges and treatments. Tests of maximum force are actually less relevant to this use. It is also at this point that muscle testing can depart from the traditional, and enter into the realm of the energetic. A variety of "challenges" can mean anything from food to a supplement to a thought, feeling or an emotion, or what type of modality or treatment is needed. It is also at this point where those testing often have the least amount of training.

A concept developed by Goodheart, Walther, and Ferreri, neurological disorganization (switching) is understood to be neurological confusion sometimes related to a cranial imbalance or the loss of gait organization as well as dural torque or coaxial energetic torque resulting in interference in the craniosacral primary respiratory system. There are specific protocols within AK to correct these issues. Switching can also be associated with polarity imbalances which can lead to a reversal of signals in mental orientation or biological issues such as medications.

Forms of Switching

According to Charles Krebs, PhD, it is believed that there are two distinct types of switching which are based on a neurological perspective: switching related to general stress which causes a reversal of the output of cortical processing and deep level switching which occurs in the brainstem and limbic areas involved with survival. The first can usually be resolved fairly quickly but deep level switching is most often caused by psycho-emotional factors common in those who have suffered trauma. Being unable to correct these problems place accurate muscle testing outside the realm of the average user and there are very few training programs that address these issues in depth.

It is well documented that stress, especially severe stress or trauma, can negatively affect the human body and this includes the musculature. In my 20-plus years of experience using a wide variety of kinesiology programs and especially when working with those diagnosed with PTSD, deep level switching occurs more frequently than one would believe and often does not always reveal itself during standard forms of pre-testing. Whatever form of switching is happening, being unable to a) discern it and b) correct it will often result in inaccurate test outcomes.

There are many facets of using this tool properly no matter what the purpose is. The practical knowledge of the anatomy and physiology of the muscles being used, proper muscle testing position and procedure, and an understanding of neurological disorganization and how to correct it are among the most basic for anyone using manual muscle testing in their practice.

Resources

• Conable K, Rosner A. A narrative review of manual muscle testing and implications for muscle testing research. J Chiropr Med, 2011; 10(3): 157–165.
• Frese E , Brown M, Norton B. Clinical reliability of manual muscle testing: middle trapezius and gluteus medius muscles. Physical Therapy, 1987; 67:1072-1076.
• Frost R. Applied Kinesiology, a training manual and reference book of basic principles and practices. Berkeley: North Atlantic Books, 2002.
• Kendall FP, McCreary EK, et al. Muscles, testing and function with posture and pain. Baltimore: LWW, 2005.
• Krebs C. Understanding Switching in the Body and the Brain: What Does It Mean? Touch for Health Kinesiology Conference, 2005.
• Muscolino J. Kinesiology, the skeletal system and muscle function. St Louis: Mosby Elsevier, 2006.
• Walther DS. Applied Kinesiology, Synopsis, 2nd Edition. Shawnee Mission: Systems DC, 1988-2000.