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What do we mean when we talk of facilitated and inhibited muscles?

Often in workshops and just yesterday on Facebook, I encounter therapists inquiring about the meaning of muscle facilitation and inhibition. Why is this central nervous system process so important to bodyworkers. I'd like to hear what your take is and how you use it in a therapeutic setting.

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Comment by Erik Dalton on October 8, 2009 at 9:09pm: That's not off track at all Serge...but you do need some sleep.

Comment by SC on October 8, 2009 at 8:53pm: To Serge:
We all absorb life but we all process it in our own unique way, because we each have our own lessons to learn and obstacles to overcome. We all have strengths and weaknesses and our stressors know where to find our weak spots. Sometimes, I feel as though life is just a game we play with ourselves. Most of the time we seem to like scaring and hurting ourselves though. Maybe that's the game for our CNS to play!

Gee, I am off topic!! I think I need to catch up on sleep.

Comment by Serge Rivest on October 8, 2009 at 7:18pm: To SC, RE: "Fight of flight response is an ingrained defense mechanism in all species."

It makes sense indeed that the organism would try to preserve itself by avoiding the stressor. I guess individual differences would make different CNS perceive the threat differently and have a different reaction.

Comment by Erik Dalton on October 8, 2009 at 3:06pm: You are certainly in good hands. I also recommend co-treatment with a good Certified Advanced Rolfer....the two therapies work beautifully together. E-mail me if you need a referral....good luck dude!

Comment by SC on October 8, 2009 at 2:58pm: Erik-

In my original post, I mentioned being in PT because I was speaking from my experience regarding the Rhombs/Pecs battle discussion. The truth of the matter is that I am battling with pain at all 3 levels in my spine.( I guess since MDs can only handle a few square inches of a body at a time, I have learned to complain about only one issue at a time).Your opinion about what is going on at the thoracic level is still valuable and possibly correct. I was just think and writing out loud when I threw in the lumbar disc issue. Sorry about the confusion.

I am well aware of the scarcity of DO (MP) in the US so I was lucky when I discovered James Bucciarelli last year. He trained under Phillipe Druelle, the founder of: http://www.osteopathie-canada.ca/. My sister who is also an osteopath in France trained at the same place as Druelle (http://www.atman.fr/home). Sorry,the latter is in french! In nutshell, the video talks about introducing ostepathy in the work place since the french misnistry of health has finally decided to recognize Osteopathy as a valid therapie. It is of great interest to me since 90% of my work is in companies and I could use this knowledge. I just can't see myself going back to school for 5 or 6 years.

I only found James Bucciarelli last December at the time when my disc ruptured. Anyhow, I think I'll be in good hands with him, he does have about 5 years experience as a DO(MP) and has a M.ed in sports medecine since 1976. I just have to make a point in seeing him instead of DCs and PTs.

Comment by Erik Dalton on October 7, 2009 at 8:25pm: Yes, if you're problem is chronic low back pain, discs can certainly be a factor. I thought you were battling thoracic cage pain, i.e., between-the-blades. Of course, disc degeneration/osteophytes, etc. are much less common in the T-spine since the ribs prevent excessive motion.

DO's who've decided to do their residency in manual medicine are some of my favorite practitioners but very rare. Most choose to make more money pushing drugs, surgery, etc. The problem today is that pain management is finally gaining popularity as doctors realize they have inadequate tools to treat the baby-boomer's musculoskeletal complaints and decide to do manual therapy.

Therefore, we see a lot of DOs who've not done their residency in manual medicine placing ads in the yellow pages saying something like, "Specializing in Pain and Posture Problems". Regrettably, this group of osteopaths have only had one year's training in manual medicine and some schools only require a semester. Bottom line: Make sure you're USA osteopath did a three to four year residency in manual medicine and if possible is board certified as an FAAO.

Comment by SC on October 7, 2009 at 8:09pm: Erik,
I really appreciate you taking the time to give me an potential explanation of the structures at play in my complaint. I feel like it is time for me to go back to the books although I am much more of a kinesthetic learner! Your input makes sense and I wish that it was all there is to it but I suspect other underlying issues at this point (like disk degeneration maybe even a dormant virus). I suspected disk problems for my low back 5 years ago when I started to develop hip pain and a limp but it took the doctors the same amount of time to confirm the disk herniation and degeneration. That's what happens when you have a crappy health insurance. I am going to pay a visit to an osteopathic practitionner I have seen in the past , he might be able to help with this too. Thank you for your collegiality.

Comment by Serge Rivest on October 7, 2009 at 7:42pm: "We don't know why the CNS makes this decision."

Though, as I mentioned in the second post, would it be possible that when we have a need for agonist contraction and the antagonist is being stretched too far, triggering the stretch reflex, this would facilitate the antagonist (being pulled) and inhibit the agonist (pulling).

http://www.thestretchinghandbook.com/images/stretch_reflex.jpg

An example:

1. A person with Upper Crossed syndrome tries to stand upright.
2. The shoulder joint is out of alignment, the CNS decides to tell the rhomboid to contract to bring the shoulders back.
3. As the rhomboids contract, the pecs are being pulled backwards.
4. Because the pecs are short (as we know in upper crossed syndrome) the pull from the rhomboid is too much and the spindles in the pecs fire and trigger the stretch reflex for the pecs group.
5. The stretch reflex, which is an older reflex, *may* have priority over proper alignment of the joint which takes mental computing. Hence facilitating the pecs and inhibiting the rhomboids (to stop the pull and protect the short pecs)
6. This person is now stuck in a loop.

That's my theory anyway, I'd like if anyone can correct it.

Cheers

Comment by SC on October 7, 2009 at 7:36pm: Serge:
Responding to " The CNS for some reason, after receiving afferent stimulus from a receptor detecting a stress of some sort (mechanical, chemical, psychological, name it), makes the decision of increasing the stimulus. We don't know why the CNS makes this decision. Does anyone have an answer to that?"

We do know why:
Fight of flight response is an ingrained defense mechanism in all species.

here's more although I am sure you already know about this:http://www.thebodysoulconnection.com/EducationCenter/fight.html

Comment by Serge Rivest on October 7, 2009 at 7:17pm: Jaya: and I would also add Lombard's Paradox: http://en.wikipedia.org/wiki/Lombard's_Paradox

Let's go back to the original questions:

1. Muscle facilitation and inhibition, what does it really mean?

It means that the CNS for a reason or another, alter the efferent stimulus to the motor nerve which controls the muscle, affecting its tone.

Some of these reasons are within the scope of practice (ex: joint overapproximation) and some aren't (ex: psychological stress from a divorce). This is raising a few issues. First, we have to find out what is the cause of the facilitation, before we treat, or else we are just doing random bodywork with the hope of doing the right thing. This is not always obvious so we might have to go by elimination, starting with what you can do as a bodyworker. When, after a few sessions you are not getting any results, I believe it would be worth referring to another specialist that would address the other areas outside your scope. I'd like to know how long each of you spend on a client before realizing that what you are doing is not addressing the cause? Maybe that question should go on another topic. (moderator please)

How does that phenomenon occur?

The CNS for some reason, after receiving afferent stimulus from a receptor detecting a stress of some sort (mechanical, chemical, psychological, name it), makes the decision of increasing the stimulus. We don't know why the CNS makes this decision. Does anyone have an answer to that?

2. What are the symptoms? Is it muscle tightness? Is it jerky motor control? Is it loss of strength?

My understanding: Facilitated = Hight tone (tightness), Weak, and Jerky motor control. Inhibited = Low tone (too soft), weak (less strength), and Jerky motor control.

Can anyone correct me please?

3. How can the bodyworker find out if a muscle is facilitated or inhibited? Is there a special test?

Well, there are always the models like the crossed syndromes and the reflexes like reciprocal inhibition but aside what I've put in question 2, that is feeling the tightness and jerkyness during mobilization and observing imbalances visually I'm not aware of any other techniques.

4. What can we do about it?

Depends on the cause. If the cause can be addressed by bodywork, the information given by Erik in his DVD collection should be enough to treat the basics. If the person needs to learn how to move properly and stretch that is still something we can do. The last thing we can do to help our client would be to refer to another specialist when there is no improvement. (Though I don't know where that line is, 3 sessions??)

Thanks for your feedbacks!