Joe Muscolino The Art and Science of Kinesiology

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Comment by Joseph E. Muscolino on December 14, 2009 at 8:07am

Hi Jacqueline. Welcome. :)
Yes, my first recommendation would be to always try to figure out the actions of a muscle by reasoning them out from the line of pull of the muscle relative to the joint it is crossing. A muscle is nothing more than a pulling machine (I say that with all respect for muscles). IF you can see the direction of the fibers of the muscle, it gives you the line of pull. Simply picture placing a rubber band in place of the fibers and picture what the rubber band would do if it pulled in toward its center. Once you see this for a muscle, then extrapolate it to ALL the muscles that cross that joint in the same location (i.e., anteriorly, posteriorly, laterally, etc) with the same direction of fibers (i.e., vertically or horizontally).
This requires you to have to memorize the attachments of the muscle. Other than a muscle whose name tells you its attachments (e.g., coracobrachialis), there is no way around that. SO... spend a lot of time looking at pictures of muscles and try to see their general location.
Beyond this, I strongly recommend the 3rd edition of my The Muscular System Manual. Besides beautiful illustrations with muscles and bones drawn over photos of real people, and an excellent intro chapter that explains what I have written above more thoroughly, there is an interactive CD included in the book that allows for any combination of muscles to be placed on the base figure of the person with the bones drawn in; and it allows you to change the opacity of the muscle to be able to see through it and see what is deep to it. No one has anything like it. And, the book comes with downloadable MP3 files that have the overviews of the muscle groups and the specific attachments and actions that you can listen to with an iphone, blackberry, or any other such device. If you go to my website (www.learnmuscles.com), there is a link to the publisher to order it. Otherwise, you can go to Amazon.com or barnesandnoble.com etc.
BTW, there are also a number of interactive exercises that come with the book and there are also a number sitting on my website (just go to the "quiz yourself" page).
Please let me know how you do. :)

Comment by Jacqueline M Curan on December 14, 2009 at 7:19am

Joe I'm a new therapist, been in practice for 6 months. My most difficult issue is kinesiology. I can't seem to remember all of the actions of the muscles. Do you have any sugggestions?

Comment by Thomas Myers on December 13, 2009 at 5:42am

Yeah, Erik, so I hate forms people fill out in the waiting room, hate to be given such forms - boxes people into an illness mode "let's see, do I have arthritis?" rather than a developmental, integrated mode "I wonder what's going to happen?" My interview form is a blank sheet of paper.

Comment by Stephen Jeffrey on December 12, 2009 at 11:30am

Joseph, yes free flow, vitally importantant.

Eric " Soon, something (consciously or unconsciously) kicks-in and you suddenly sense direction that may lead to the key lesion." and
"The energy of the room changes when the body's innate wisdom allows your unconscious to join in...love those moments." ...Me to !

30 mins for specific injury work yes!..... but to get in that special "zone" Eric discribes above = where some real multilevel healing can free flow and intigrate needs more time imo.

Comment by Erik Dalton, Ph.D. on December 12, 2009 at 10:15am

I find history-taking to be a pretty natural event. The first session "meet & greet" must be focused, but follow-up sessions are, as Tom says, more 'playful'. We chat it up while assessing landmarks, exploring tissues and taking notes when the time seems right. Talk & touch keeps us in the 'moment' and allows them to relax and become involved in the process. Soon, something (consciously or unconsciously) kicks-in and you suddenly sense direction that may lead to the key lesion.

A problem I've had to deal with during the history intake is mentally "boxing" a client's condition. After many years of practice, I sometimes get the feeling that I've seen it all and, as a result, sometimes catch myself daydreaming as they spout out symptoms . I've already decided what's wrong with them and I'm ready to get it on. But during the assessment, I realize, I was headed down the wrong path. This is when I back up and begin reviewing their history more carefully.

Whitney made a good point about the time factor. Sometimes, working in a time-restricted setting helps forge a bond where two people find themselves more motivated to come together and solve the problem as one. The energy of the room changes when the body's innate wisdom allows your unconscious to join in...love those moments.

Comment by Joseph E. Muscolino on December 12, 2009 at 6:58am

I would add to this that even though the symptoms are theirs, it is our job to put everything into an order that makes sense so we can create the clinical picture, i.e., make an accurate assessment. For that reason, the order in which you gather the history is very important. Having said that, we do want the client to be able to recount with accuracy and ease their history, but I do not think that asking them to recount it in a certain order would necessarily be "burdensome." In the rare case where it is, then certainly let them free flow if needed to recount the information, keeping in mind the logistics of life in that they are being charged for the time that you are spending doing the history with them...

Comment by Stephen Jeffrey on December 11, 2009 at 11:50pm

Homeplay = compliance. I like the sound of that.

3. "Ask clients to recall their symptoms in reverse order, starting from the present".

The symtoms belong to the client, the order of revelation should therefore be theirs ? why make their revelation unecessarily burdensome ? Why seek to dominate this process by imposition ?

Comment by Joseph E. Muscolino on December 11, 2009 at 11:01pm

Hmm... I would be interested in first starting with the bigger picture of the world of stretching.

In other words, stretching musculature can be done because of a "mechanical" component (viscoelastic change) and a neural component (neural inhibition component). Stretching techniques that "primarily" rely on the mechanical component might be divided into static and active (aka dynamic) stretching. Stretching techniques that "Primarily" rely on the neural inhibition component are CR (contract relax, aka PIR, post-isometric relaxation) and AC (agonist contract) stretching (the term PNF, proprioceptive neuromuscular facilitation, is often used for the either of these, especially the first). Etc, etc...

Would anyone like to continue this breakdown/organization and/or add to it???

Comment by Robert Downes on December 11, 2009 at 5:30pm

Here is my first attempt to "parameterize" the various stretching models (just a rough draft). I will start with NASM Static Stretching.

Name: Static Stretching (specifically the NASM protocol)

Originator: NASM

Theory: Mechanically "decreases a muscle's passive resistance to a stretch force. Appears to affect the viseoelastic component of neuromyofascial tissue. Neurologically appears to decrease motor neuron excitability, possibly through the inhibitory effects from the Golgi tendon organs-autogenic inhibition as well as possible contribution from the Renshaw recurrent loop (NASM)."

Research: Brady, et al. static and active stretching improved hamstring flexibility with static stretching producinfg 2x as much ROM as compared to active stretching. Davis, et al. static v. PNF. Only static stretching produced significant ROM. On the topic of static stretching before activity, the Nelson et al. study was called into question because of causing possible fatigue. Young and Behm, Church, et al., Knudson, et al., and Church, et al., were either open to interpretation or found no adverse effect on subsequent activity (NASM). In re: to warm-up before static stretching the NASM protocol states that it is not neccessary, although NASM does state to do Self Myofascial Release prior to static stretching.

Program Design: Frequency-usually daily/ Sets-Not Applicable/ Reps-1 to 4/ Duration of Reps-20 to 30 seconds and up to 60 seconds for people 65 years old and above

Precautions: Special Populations a/o Neuromuscular disorders

Contraindications: Acute muclse injury, strain, or tear of muscle targeted to be stretched a/o Acute rheumatoid arthritis.

Opinion of:

Anectdotal Evidence/Success or Failure with:

Other:

Comment by Thomas Myers on December 11, 2009 at 5:21pm

Homework has such a negative connotation and tends to reduce 'patient compliance'. I seek something that is playful for the client to do, on whatever level - they are more likely to do it!

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