Janda has shown that before any attempt is made to strengthen weak muscles using exercise, any hypertonicity in their antagonists should be addressed by appropriate treatment, for example by stretching using Muscle Energy Technique (to be described in future articles).
Stretching and releasing a tight hypertonic muscle leads to an automatic regaining of strength of its antagonists. If the hypertonic muscle is also weak it commonly regains strength following stretch/relaxation.
Chiropractic rehabilitation expert, Craig Liebenson states:
‘Once joint movement is free, hypertonic muscles relaxed, and connective tissue lengthened, a muscle-strengthening and movement coordination program can begin. It is important not to commence strengthening too soon because tight, overactive muscles reflexively inhibit their antagonists, thereby altering basic movement patterns. it is inappropriate to initiate muscle strengthening programs while movement performance is disturbed, since the patient will achieve strength gains by use of ‘trick’ movements’.
A Common Phenomenon Even Amongst Athletes
Just how common such imbalances are was illustrated by Schmid who studied the main postural and phasic muscles in 8 members of the male Olympic ski teams from Switzerland and Liechtenstein.
He found that amongst this group of apparently superbly fit individuals fully 6 of the 8 had demonstrably short right iliopsoas muscles, while 5 of the 8 also had left iliopsoas shortness and the majority also displayed weakness of the rectus abdominus muscles. The conclusion was that athletic fitness offers no more protection from muscular dysfunction than does a sedentary lifestyle.
Important Notes on Palpation/Assessment of Short Muscles
When the term 'restriction barrier' is used in relation to soft tissue structures it is meant to indicate the first signs of resistance (as palpated by sense of ‘bind’, or sense of effort required to move the area, or by visual or other palpable evidence) not the greatest possible range of movement obtainable.
As an example let us take evaluation for shortness of the adductors of the thigh, as described by John Goodridge D.O. Before starting ensure that the patient/model lies supine, so that the nontested leg is abducted slightly, heel over end of table. The leg to be tested is close to the edge of table. Ensure that the tested leg is straight, not in rotation, knee in full extension.
1. ‘After grasping the supine patient's foot and ankle, in order to abduct the lower limb, the operator closes his eyes during the abduction, and feels, in his own body, from his hand through his forearm, into his upper arm, the beginning of a sense of resistance’.
2. ‘He stops when he feels it, opens his eyes, and notes how many degrees in an arc, the patient's limb has travelled.’
Goodridge is trying to establish that you sense the very beginning of the end of range of free movement, where easy motion ceases and effort on the part of the operator moving the part begins. This ‘barrier’ is not a pathological one, but represents the first sign of resistance, the place at which tissues require some degree of passive effort to move them.
This is also the place at which a sense of what is called ‘bind’ can be palpated.
Try this exercise several times, so that you get a sense of where resistance begins.
Then do the exercise again as described below.