Massage & Bodywork

MARCH | APRIL 2018

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A B M P m e m b e r s e a r n F R E E C E a t w w w. a b m p . c o m / c e b y r e a d i n g M a s s a g e & B o d y w o r k m a g a z i n e 89 CONCLUSION Learning about muscles that change their actions when the position of the body changes might seem trivial or esoteric. But it is actually fundamental to not only our understanding of muscle function, but also our ability to apply our hands-on assessment and treatment skills. For example, understanding the rotation capability of the anterior scalene informs how we perform our orthopedic assessment test for the anterior scalene syndrome version of thoracic outlet syndrome. It explains why Adson's test for this condition has the client ipsilaterally rotate to stretch the anterior scalene, but why the alternative anterior scalene syndrome orthopedic test, Halstead's test, has the client contralaterally rotate the neck instead. Either end range will stretch the anterior scalene. As another example, understanding the piriformis's change of function determines how we stretch it. In anatomic position, we need to medially rotate the thigh to stretch it, but if the thigh is sufficiently flexed, we now need to move the client's thigh into lateral rotation to stretch it. Understanding and being able to figure out muscle function, regardless of the position of the body, empowers us to be able to critically think through, understand, and see muscle function, which in turn allows us to understand postural and movement dysfunctions, as well as the mechanics of hands-on assessment and treatment techniques. Armed with this knowledge, we will be better equipped to help treat our clients and have a successful clinical orthopedic manual therapy practice. Joseph E. Muscolino, DC, has been a manual and movement therapy educator for more than 30 years. He is the author of multiple textbooks, including The Muscular System Manual: The Skeletal Muscles of the Human Body (Elsevier, 2017); The Muscle and Bone Palpation Manual with Trigger Points, Referral Patterns, and Stretching (Elsevier, 2016); and Kinesiology: The Skeletal System and Muscle Function (Elsevier, 2017). He is also the author of 12 DVDs on manual and movement therapy and teaches continuing education workshops around the world, including a certification in Clinical Orthopedic Manual Therapy (COMT), and has created Digital COMT, a video streaming subscription service for manual and movement therapists, with seven new video lessons added each and every week. Visit www.learnmuscles.com for more information or reach him directly at joseph.e.muscolino@gmail.com. CRITICALLY THINKING TO FIGURE OUT MUSCLE ACTIONS The ability to understand muscle actions is incredibly simple. It is dependent on a few concepts that most every therapist learned in their first science class at school, but perhaps never applied once the class was over. 1. When a muscle contracts, it pulls. 2. A movement of the body can be described as occurring in a plane. 3. Most movements (axial movements) occur around an axis. Simply put, when a muscle contracts, it creates a pulling force that can move a body part within a plane, and assuming that the movement is an axial movement (most movements are), then that movement occurs within the plane around an axis. If these concepts sound familiar, then you are empowered to be able to critically think through, understand, and see muscle function. All we need to do is look at the line of pull of the muscle and see what plane it is in and where it is relative to the axis at the joint; this will tell us the joint motion created by the muscle in the plane around the axis. Knowing these fundamental basics of kinesiology allows you to figure out the action or actions of any muscle of the body, regardless of the position the body is in when the muscle contracts. Posterior views of the right piriformis. 8A: When the thigh is in anatomic position, the piriformis is a lateral rotator of the thigh at the hip joint. 8B: When the thigh is flexed 90 degrees, the piriformis becomes a medial rotator of the thigh. Permission Joseph E. Muscolino. 8A 8B

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