1. | www.massagemag.com | December 2014 | MASSAGE Magazine | 45
A Kinesthetic Approach to Address
Muscle Weakness
D
id you know that most people, including professional
athletes, have a significant number of muscles that
test weak? Weakness is very common—even in
seemingly strong individuals. Although there have not
been clinical studies that indicate widespread muscle weakness,
muscle weakness is considered common in general, with multiple
potential causes, many of which are very medically based. In 30
years of manual muscle testing, chiropractor and kinesiologist
and developer of Targeted Muscle Testing Cassius Camden Clay,
D.C., has tested clients ranging from average folks to professional
athletes to yoga masters—and he said he has found just two adults
whose muscles did not test weak.
Strong, functional body movement requires healthy nerve
signal conduction and a healthy flow of the body’s fluids, including
blood, lymph and cerebral spinal fluid. When any of these flows
are significantly blocked, a muscle tests weak. Muscles will
also become reflexively weak to prevent injury to themselves or
associated joints.
Targeted Muscle Testing is an assessment technique that helps
practitioners learn where to find common, important muscle
weaknesses. Targeted Muscle Testing also detects whether or not
the treatment has been effective. Did the weak muscle become
instantly strong after treatment? Targeted Muscle Testing will
answer that question.
PHOTOS:CHRISSAVAS
by Barbara Sharp, L.M.T.
Targeted Muscle
Testing
MASSAGEmagazine | December 2014 | pg 44 —reprinted with permission

2. | www.massagemag.com | December 2014 | MASSAGE Magazine | 4746| MASSAGE Magazine | December 2014 | www.massagemag.com |
“It gives me the ability to
work smarter, not harder,
and to show my massage and
personal training clients that
their dysfunction may not be a
result of their activities, just the
result of inactivated muscles,”
said massage therapist Maggie
Alfieri, who is massage program
director at Atlanta School of
Massage in Atlanta, Georgia, as
well as an orthopedic massage
instructor at the school.
When massage therapists
learn to feel and address
weakness in addition to muscle
tightness, treatment outcomes
improve. Because spasmed areas
often compensate for weak
areas, if weakness is treated
first, spasm may resolve. For
example, a spasmed piriformis,
which can contribute to
sciatica, will commonly test
weak. The spasmed portions
overcompensate for the adjacent,
weak muscle sections. When
those adjacent muscle sections
are strengthened, spasm and
sciatica dissipate.
Development
Manual muscle testers base
their work on the seminal 1949
publication of Muscles, Testing
and Function by the husband-and-
wife team of physical therapists
Henry and Florence Kendall. The
field was further advanced in
the 1960s by George Goodheart,
D.C., as he developed Applied
Kinesiology.
Clay has used muscle testing
and assisted yoga stretching
from Thai massage, first in his
chiropractic practice and later
while teaching. Since 1993, Clay
has found that palpating with a
light kinesthetic touch allows
him to notice subtle variations
in skin tone and quickly identify
areas of weak muscle function.
The skin over weak muscle
sections feels flaccid or mushy, while skin over strong muscle
sections feels toned and springy. This approach is now called
subtle muscle palpation.
Through this palpation, Clay realized that traditional
muscle testing misses more muscle weakness than it finds.
Especially in large- to medium-sized muscles, the entire
muscle may not be weak; however, isolated muscle sections,
and especially the bellies of these sections, commonly test
weak.
Clay developed Targeted Muscle Testing in order to verify
weak muscle sections discovered through subtle muscle
palpation but missed in standard muscle testing—and in
cases of muscle overlap, to help differentiate which muscle is
weak. Clay has taught these concepts to hundreds of students,
including Stephen Warren, a bodywork instructor in Surfside
Beach, South Carolina, who now uses Targeted Muscle Testing
and its treatment corollary, Quick Self Fixes, in class to keep
his students “engaged, amazed, and aware,” he said, and added,
“The bottom line is that they work, and the students can feel
that they work.”
In action
This kinesthetic approach incorporates more than just
testing individual muscles. Analyzing posture, gait and other
functional movement is the first part of the assessment. The
goal is to determine which muscles are not moving in fluidity
and strength and are causing observable dysfunction.
The practitioner uses the Targeted Muscle Tests to
identify the specific cause(s) of the posture, balance or gait
dysfunction. For instance, a weak quadratus lumborum on
one side causes a person doing the downward facing dog
yoga posture to be asymmetrical. Strengthen the quadratus
lumborum, and the pose becomes instantly symmetrical.
Other examples include performing a deep squat with better
symmetry after strengthening hip flexors; a pushup with no
shoulder pain after strengthening pectoralis major; and a more
balanced and flowing gait in general.
“I use Targeted Muscle Testing when clients come in with
pain or lack of range of motion,” said Woodstock, Georgia,
massage therapist Lisa Schudel, L.M.T. “I muscle test first to
find weaknesses, then I show the client the correlated self-fix,
and then retest the muscle to see if the fix helped.”
Following muscle strengthening, massage is more
successful in both releasing fascia and promoting relaxation.
Andrew Still, M.D., D.O., the founder of osteopathy, taught
that life is physical matter, constant motion and innate
intelligence. These concepts underlie how and why Targeted
Muscle Testing works. When space is re-established in exactly
the correct places, the body’s needed fluid or nerve conduction
is restored, and associated muscles will subsequently test
2 Targeted Muscle Tests
1 2
Quick Self Fixes are a series of self-
care connective tissue stretches and joint
movements that strengthen Targeted
Muscle Tests.
1. Biceps Brachii, Long Head Division
Tester instructs the person to stand and
hold the arm being tested:
• Straight out to the front of the shoulder
• Parallel to the floor, at a 90-degree angle
• Elbow locked straight
• Palm facing upward
Tester stands in front of the person and
braces the person’s opposite shoulder to
prevent the person from falling forward
during this test.
Tester contacts the person’s forearm just
before the wrist on the palm side.
Tester instructs the person to “Hold
strong upward.”
Tester feels for the person’s muscle to
engage and then applies pressure to push
the arm downward while the person resists
upward.
This action is done for one, two and
four seconds, escalating the pressure
and duration each time to evaluate initial
strength, core strength and sustained
strength. If the test fails at any time, do not
continue.
The Quick Self Fix for this muscle test is
the Biceps Tendon Fix.
2. Upper Trapezius, Scapular Division,
Medial Zone
Tester instructs the person to stand and
hold the arm being tested:
• Diagonally upward to the front from
shoulder level, at a 135-degree angle
from floor
• Elbow locked straight
• Palm facing downward
• Hand positioned so that it crosses the
person’s midline by 10 degrees
Tester stands in front of the person on the
opposite side being tested and braces the
person’s opposite shoulder to prevent the
person from falling forward during this test.
Tester contacts the person’s forearm just
before the wrist and on top of the forearm
with the person’s palm facing downward.
Tester instructs the person to “Hold
strong upward.”
Tester feels for the person’s muscle to
engage and then applies pressure to pull
the arm downward while the person resists
by holding the arm upward.
This action is done for one, two and four
seconds, escalating the pressure and dura-
tion each time to evaluate initial strength,
core strength and sustained strength. If the
test fails at any time, do not continue.
The Quick Self Fix for this muscle test is
the Cranial Fix.
Visit www.quickselffixes.com and click
the sign-up button on the home page to
see these tests, plus three more, on video.
For each online muscle test, you can also
learn a corresponding Quick Self Fix.
More information, including books and
DVDs, on both Targeted Muscle Testing
and Quick Self Fixes, is available at the
same URL. —Barbara Sharp, L.M.T.
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strong. Targeted Muscle Testing gives the therapist an
opportunity, said Alfieri, “to become consciously aware of
how differently we hold our bodies in strength.”
Correct pressure
As with any palpation technique, muscle testing requires
practice, training and skill. Most muscle tests use arms
or legs as levers in open space, giving a huge advantage to
the muscle tester. If the client is able to hold a full muscle
contraction while resisting correct pressure, the muscle test
is strong. If the client is not able to hold firm against the
pressure, the muscle fibers in line with that contraction are
considered weak.
The term correct pressure is key. People have naturally
varying strength levels, both person-to-person and muscle-
to-muscle. Muscle spindle cells and Golgi tendon organs can
abruptly make a strong muscle go weak to prevent injury
when physically overstressed. The tester must first meet that
person’s existing strength, and only then challenge—but
not overpower—it. Testing should never be painful, and an
injured muscle should not be directly tested. Any persisting
weakness that does not respond to normal treatment may
also be caused by tissue injury, swelling, neurological
disorders and other conditions. If a weak muscle does not
become strong using gentle means within your scope of
practice, refer the person out to a chiropractor trained in
Applied Kinesiology, or to the client’s medical doctor.
Massage, chiropractic, osteopathy, physical therapy
and assisted stretching are all bodywork methods that
have successfully turned muscles instantly strong. After
treatment, muscles should be retested to confirm that the
treatment reactivated strength. Then the client should
repeat the formerly problematic movement or posture. In
one case example, a client was having difficulty performing
a standard biceps curl. Subtle muscle palpation identified
weakness in the medial anterior shoulder. However,
the deltoid and biceps brachii muscles tested strong.
Coracobrachialis tested weak. After coracobrachialis was
strengthened using a self-manipulation of the clavicle, the
client was able to strongly and properly perform the exercise.
In addition, sports massage therapists can apply Targeted
Muscle Testing to activate muscles before exercise or
competition, thus reducing the potential for injury and
improving performance outcomes.
Barbara Sharp is a licensed massage therapist in Marietta,
Georgia, with 20 years of experience. She found Targeted
Muscle Testing, Quick Self Fixes (www.quickselffixes.com)
and assisted yoga postures from Thai massage so helpful
that she expanded her class note-taking skills into writing
three full curriculums to help others have a written resource to
learn from and reference. M
Learn more about Targeted Muscle Testing’s treatment
options for yourself, in “Quick Self Fixes,” by Barbara
Sharp, L.M.T., at massagemag.com/quickselffixes.]
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