1. Unusual Situations in Muscle Testing zSubclinical Weakness zThe Indirect Muscle Test

2. Subclinical Weakness zThe “51%-er”

3. “51%-er” zInhibition Facilitation z 50% zTests WEAK Tests STRONG

4. “51%-er” zAssociated muscle yBut NOT all the time! zHow it shows up in the clinic y“Should be weak” yWithin the 5 Factors

5. Test for Subclinically Weak Muscle zNot really a TEST zRun the “5 Factors” checklist yTL each factor yIf Involved - Strong or Weak? zCORRECTION = 5 Factor Correction

6. Indirect Muscle Test zSubclavius - Cannot Test Directly

7. Subclavius

8. Indirect Muscle Test zLevator Ani - Probably Do Not Want to Test Directly

9. Levator Ani

10. Levator Ani - Muscle Test

12. Can I TL a muscle that is inhibited? zNO, a “weak” muscle does NOT TL! zHowever, we CAN TL the weakness!

13. How do you TL muscle weakness? zTL tells you WHERE the problem is LOCATED zWhere is the problem of an inhibited muscle located?

14. Subclavius - Indirect Mus. Test - Step 1 (any muscle)

15. Subclavius - Indirect Mus. Test - Step 1 (TL suspect mus.)

16. zIf the muscle is “WEAK”? zIf the muscle is “STRONG”?

17. “Activate the Muscle” - Step 2 zPatient contracts the Subclavius muscle zWeakness is now “transferred” to LOCATION of the Subclavius

18. Subclavius - Indirect Mus. Test - Step 3 (Re-test indicator)

19. zIf the muscle is “WEAK”? zIf the muscle is “STRONG”?

20. How do you TL muscle weakness? yFind an INDICATOR muscle xNormal muscle? yTL suspected weak muscle yCheck indicator xStrong? xWeak? yContract suspected weak muscle yTest indicator xStrong? xWeak?

45. Fixation Complexes What are they? Why do I Care? How do I Find them?

46. Fixation Complexes Are: zNOT Subluxations yMisalignment yAberrant motion zNO Motion yMay have normal alignment

47. Why Do I Care? zSome joints never seem to “go” zWhole sections of the spine palpate fixated zChronic problems but can’t find anything zAnd…

48. Fixation Complexes HIDE Subluxations!!!

49. Fixations Hide Subluxations zSubluxations Within Locked Areas zSubluxations Distant to Locked Areas zAlso, they will hide OTHER Fixation Complexes

50. Characteristics of Fixation Complexes zSubluxation yMAY show on x-ray yTL’s to Indicator m. yTL’s to Associated m. yChallenges with a single point contact yAdjusts with a single point contact z Fixation Complex yNOT show on x-ray yNO TL to Indicator m. yTL’s to Associated m. yChallenges with a TWO point contact yAdjusts with a TWO point contact

51. Muscle Weakness zSubluxation yAny muscle related to the subluxation can be weak yExample: xC5 subluxation could affect any C4, C5, C6 innervated muscle xMaybe even C3 & C7 z Fixation Complex yOnly ONE muscle (usually bilateral) is related to EACH fixation complex

52. Fixation Complex Muscle Relationships zFixation: zOcciput zUpper Cervical zLower Cervical zCervicothoracic zThoracic zThoracolumbar zLumbar z Muscle Weakness: z (B) Psoas z (B) Gluteus Maximus z (B) Popliteus z (B) Middle Deltoid z (B) Teres Major z (B) Lower Trapezius z (B) Neck Extensors

53. Unusual Relationships zLumbar Fixation zSacroiliac Fixation zSacrum Fixation z Neck Extensors y“Tested Together” yBilaterally Weak z Neck Extensors y“Tested Individually” yUnilaterally Weak z Neck Extensors y“Tested Individually” yBilaterally Weak

54. Why this relationship? zNormal Inhibitory Pattern zDemonstration zNOT normal when patient is being tested

55. How Do I Find Them? zBILATERAL Muscle Weakness yUsually zOf ONLY the 7 Muscles zIs a bilateral weakness of these 7 muscles ALWAYS a fixation complex? zMUST VERIFY with TL or Challenge!

56. Fixation Complex Scan yNeck Extensors - Tested Together yNeck Extensors - Tested Individually xOne side then the other (2 tests) yMiddle Deltoid yTeres Major yLower Trapezius yPopliteus yGluteus Maximus yPsoas

57. Neck Extensors - 1. Tested Together 2. Tested Individually (B)

58. Middle Deltoid - Supine

59. Teres Major

60. Lower Trapezius

70. Note: zThere are 7 muscles to test but 9 tests zWe only have to test one side if they are strong yCannot be bilaterally weak if one side is strong! zIf muscle tests weak THEN test the other side

71. Remember: zFixation: zOcciput zUpper Cervical zLower Cervical zCervicothoracic zThoracic zThoracolumbar zLumbar z Muscle Weakness: z (B) Psoas z (B) Gluteus Maximus z (B) Popliteus z (B) Middle Deltoid z (B) Teres Major z (B) Lower Trapezius z (B) Neck Extensors xAND...

72. Unusual Relationships zLumbar Fixation zSacroiliac Fixation zSacrum Fixation z Neck Extensors y“Tested Together” yBilaterally Weak z Neck Extensors y“Tested Individually” yUnilaterally Weak z Neck Extensors y“Tested Individually” yBilaterally Weak

73. Fixation Complex Analysis zStep 1: Find bilateral weakness zStep 2: TL appropriate area of the spine yIf (B) muscles are Strong? xFixation Complex yIf (B) muscles are STILL weak? x(B) Weak Muscles

78. Fixation Complex Analysis zStep 1: ID Top and Bottom of the Stack yAdjacent SP’s Opposite Directions Laterally zStep 2: ID the Anterior and Posterior Side yTop SP Left and Right zStep 3: ID the Primary Side yFacet Joints P-A

79. Adjusting Rule zIf it is a “Posterior Fixation,” adjust: ythe TOP vertebra and the one below. zIf it is an “Anterior Fixation,” adjust: ythe BOTTOM vertebra and the one above.

80. Sacral Fixation Analysis zStep 1: ID Top and Bottom of the Stack yAlready KNOW top and bottom of sacrum zStep 2: ID the Anterior and Posterior Side yS2 tubercle Left and Right zStep 3: ID the Primary Side ySacral ala P-A

82. Unusual Corrections zOccipital Fixation Complex yPalpate for tender nodule at Inferior Nuchal Line yLOC from nodule to glabella zSI Fixation Complex ySimply open up the joint zPosterior Sacral Fixation Complex yAdjust P-A & M-L at Sacral Ala

83. Right Posterior Sacral Fixation Complex

84. Left Anterior Sacral Fixation Complex

85. Unusual Corrections - Anterior Sacral Fixation Complex zSide lying - involved side UP zStabilize POSTERIOR side of sacrum zContact shoulder and PUSH yNOT THRUST! zTorques spine to move anterior sacrum posteriorly

86. Fixation Complex Analysis “Easy Method” zStep 1: Find bilateral weakness zStep 2: TL appropriate area of the spine yIf (B) muscles are Strong? xFixation Complex yIf (B) muscles are STILL weak? x(B) Weak Muscles xThen:

87. Just Challenge! zThe proper two bones will challenge yTo the associated muscle yTo an indicator muscle zTwo different bones zOpposite sides of the spine