NellroKil1!!ticTilerapy presents manual muscle testing used with a specific protocol specially designed to stimulate the body-mind complex to resolve injury, stress, and pain. Unlike other therapeutic approaches that treat only symptoms, :-.1euroKinetic Therapy goes to the source of the problem by reprogramming dysfunctional movement patterns. Written for beginning and experienced manual therapists, this book include� detailed photographs that demonstrate correct positioning accompanied by concise explanations and instructions for assessing and testing muscle function. Organized anatomically, each section introduces the muscles and corresponding tests for the neck, torso, and extremities with labeled anatomical iIIustratiol15 showing the relationships between the muscles and muscle groups. This book is an essential resource for practitioners seeking to complement their current practice with an innovative approach to treating the underlying causes of pain. "Among the numerous volumes of so-called therapeutic manuals in the field of neuromuscular assessment and treatment, few truly meet the dual standard of providing skill enhancement while resting on a firm scientific foundation. David Weinstock's NeuroKinetk Therapy not only meets this standard but raises it to a new level. Combining anatomical detail with superb illus trations and photos. the book carefully guides the practitioner in learning this subtle but very powerful form of therapy.... What a joy it is to move away from repetitive treatment to truly unwind the effects of injury, stress, and poor posture in our patients." 'l.h:ven I\all D( � \t/ (hirr'pL ciT.. \fil l \dlle\, (alif0rnlil
"David Weinstock's book enables both beginning and experienced manual therapists to expand on their assessment skills and to determine their subsequent treatment strategy.This extremely organized book filled with beautiful photos and illustrations helps to guide practitioners through a more speCific and meaningful approach to manual muscle testing. Weinstock brings together hIS incredible breadth of knowledge and experience in neuromuscular reeducation and manual therapy in this well-written, easy-to-follow book." (tndy i('wtN11-1 11,,11 Ilil larkspur, {a!lfornla
I, .llll;< I l I l t
\
'I C \1arin Physic.tl Therapy
"finally a manual written in accessible terms with end user results. The photos are clear and concise. Weinstock captures the essence and extreme importance of muscle testing for any physical practice. I have no doubt that this book will become a bible for all types of movement core therapists and educational programs. I have added it to the list of required reading for all students enrolled in our pilates certification programs." 'itdC} \ lIl'gr . ]
ilr,' t"r.lit Hr:'tt Pildtcs, Carll' \-1.ldcra. (alifornia
US $18.95 / $23.00 CAN ISBN 978-1-55643-877-6
Health/Bodywork North Atlantic Books Berkeley, California www.northatianllcbooks.com
9
Praise for NellroKinetic Therapy
"NellroKilletic Tllernpy is one of the best manual therapy instructional manuals available. The layout and photos make it easy to follow and understand. It is a great tool and will be useful in my practice, comple menting my work with chiropractic, Active Release Techniques, and Egoscue exercise." - Bruce Rizzo, DC, ART, My Chiro Care, Berkeley, California
"NeuroKinetic Therapy is an invaluable tool that will greatly enhance a personal trainer's repertoire and level of expertise. Clients often come to trainers with old injuries that have subsequently created compen satory patterns or muscular imbalances. NeLiroKi'letic Therapy provides detailed instructions for helping clients regain the muscular control and balance to perform to their potential. Easy to follow and under stand, the book shows the trainer how to accurately and effectively assess and test clients. The book's photographs allow the trainer to know precisely where to place pressure and how the client needs to be positioned so that the muscle test is effective. This manual is a great complement to any trainer's library." - David Phillips, CES, NASM certified personal trainer, Fit Bridge, Mill Valley, California
"Muscle testing is used in many disciplines but there has not been con sistency in how it is performed. In his new book NeuroKir,etic Therapy, David Weinstock clearly demonstrates this technique in a succinct and thorough manner. He covers testing of the individual muscles with clear images, including their anatomical origin, insertion, and actions. This book should be a part of any soft tissue specialist's library." - Douglas Kyle, DC, DABCO, ART, Marin Spine and Sport, Corte Madera, California
"NeuroKinetic Therapy clearly and thoroughly outlines muscle testing techniques along with related anatomy, but it is its use with the Neu roKinetic Therapy protocol that demonstrates how the approach is a step up from massage and strengthening models more traditionally applied. I defer to David for those difficult-to-unravel pain patterns, both professionally and personally, and always with success." - Caryl Sircus, physical therapist, Aquatic Therapy Associates, San Rafael, California
"Both concise and clear, this book breathes rehabilitation and thera peutic alignment. For a yoga instructor it provides a deeper skill set and knowledgeable platform from which to work and teach. [t can greatly assist your students' structural integrity as well as provide the capacity to heal any trauma that may be restricting the full range of motion or causing pain. This book is a treasure!" - James Higgins, yoga instructor, Yoga Studio, Mill Valley, California
NeuroKinetic Therapy An Innovative Approach to Manual Muscle Testing
David Weinstock
North Atlantic Books Berkeley, California
Copyright ©2010 by David Weinstock. Ali rights reserved. No portion of this book, except for brief review, may be reproduced, stored in a retrieval system, or transmitted in any form or by any means---electronic, mechan ical, photocopying, recording, or otherwise-without the written per mission of the publisher. For information contact North Atlantic Books. Published by North Atlantic Books 1'.0. Box 12327 Berkeley, California 94712 Cover photo by David Spindler Cover and book design by Jan Camp and Brad Greene Printed in the United States of America NeuroKilJet;c Tllerapy: A1I bmovalive Approach to Ma1lual Muscle Testing is sponsored by the Society for the Study of Native Arts and Sciences, a nonprofit educational corporation whose goals are to develop an educa tional and cross-cultural perspective linking various scientific, social, and artistic fields; to nurture a holistic view of arts, sciences, humani ties, and healing; and to publish and distribute literature on the rela tionship of mind, body, and nature. North Atlantic Books' publications are available through most bookstores. For further information, visit our Web site at www.northatlanticbooks.com or call 800-733-3000.
Library of Congress Cataloging-in-Publication Data Weinstock, David, 1951NeuroKinetic therapy: an innovative approach to manual mus· c1e testing I David Weinstock. p.; Col. Includes index. ISBN 978-1-55643-877-6 1. AppUed kinesiology-Handbooks, manuals, etc. 1.11tle.IDNLM: 1.
Kinesiology,
Applied-methods-Handbooks.
2.
Muscle
Strength-Handbooks. 3. Muscle Weakness-diagnosis-Hand books. 4. Muscle Weakness-therapy-Handbooks. 5. Muscles injuries-Handbooks. WB 39 W4248n 2009J RZ25l.A65.w45 2009 613.7-<1c22 2009015575 1 2 3 4 5 6 7 8 9 SHERIDAN 14 13 12 \I 10
To my teachers, colleagues, stlldents, and clients who have inspired the improvisations that comprise this work.
Acknowledgments
I would like to acknowledge the following people without whom this technique would not have evolved: Vernon Brooks, John Thie, Kendall and Kendall, Jocelyn Olivier (deep gratitude), Gale Ulvang, Howard Nemerov, Brian Edwards and Cissy Spindler (models), David Spindler Photography (beautiful photos and inspiring the project), William Crabtree and Isalina Chow (computer graphics on the anatomy illus trations), and especially Laurie Higginbotham without whose work this manual would not have materialized.
Table of Contents
Preface .. .
.
.
xiii
Introduction ..... xv
I.
Neck .
.
.
.
Neck Flexion ..
.
1
.
.1
.
Unilateral Sternocleidomastoid (SCM) Longus Colli
.
.
.
.
.
.
.
.
.
2
. 2
Scalene, Medial . . 3 .
.
Scalene, Anterior .
.
.
.
.. 3
Bilateral Neck Extension . Unilateral Neck Extension
.
.
.
.
.
4
.
.
.
Rotation of the Cervical Spine . Trapezius, Upper •
.
.
.
5
.
.
.
. 5 .
. 6 .
Muscle Group Actions of the Neck Neck Flexors
.
.
.
Trapezius, Middle
.
.
.
.
.
.
.
.
.
.
... 9 .
.
10
Latissimus Dorsi-Bent Arm . . .
.
.
.
.
13
Levator Scapula ..... 14 Rhomboids . . .
.
.
DeltOid, Anterior
7
.
.
9
8
Latissimus Dorsi-Straight Arm
Teres Major .
.
.
Upper Extremities ..
Trapezius, Lower
.
.. 7
.
Neck Extensors
II.
.
15 .
.
.. 16 .
Deltoid, Middle .. .. 17 .
.
.
.
.
.
.
. 11
12
.
Deltoid, Posterior Coracobrachialis Teres Minor
.
Infraspinatus
.
.
.
Supraspinatus Subscapularis
.
.
.
.
.
.
.
.
18
.
19
.
21
.
.
.
.
20
.
.
.
.
.
.
.
.
.
.
22
.
23
.
Pectoralis Major Clavicular Pectoralis Major Sternal Pectoralis Minor
.
Serratus Anterior
.
.
.
.
Biceps, Long Head
.
.
Biceps, Short Head Brachialis
.
.
.
.
.
Triceps, Lateral Brachioradialis
.
.
.
.
.
.
.
24
2S
.
27
.
.
.
.
26
.
.
.
.
.
28
.
.
29
.
29
Triceps, Long Head Triceps, Medial
.
.
.
.
.
.
.
.
.
.
.
.
30
.
.
.
.
.
31
.
.
.
.
.
31
Flexion of Humerus
.
.
.
Extension of Humerus
30
.
.
.
Abduction of Humerus Adduction of Humerus
32
.
.
.
.
32
.
.
.
.
.
.
33
.
.
.
.
.
33
Horizontal Adduction of Humerus
.
.
.
.
.
34
.
.
.
.
.
34
.
.
.
36
.
.
Horizontal Abduction of Humerus Pronator Teres Supinator
.
.
.
.
.
.
.
.
.
.
3S
3S
Flexor Carpi Radialis
.
.
.
.
.
36
Extensor Carpi Radialis Longus Extensor Carpi Radialis Brevis Flexor Carpi Ulnaris
.
.
.
Extensor Carpi Ulnaris Flexion of the Wrist
.
.
.
.
.
.
.
.
.
.
.
38 .
.
40
39
.
.
.
.
37
Extension of the Wrist
.
Abduction of the Wrist Adduction of the Wrist
.
.
.
40
.
.
.
.
.
.
41
.
.
.
.
.
41
Flexor Digitorum Superficialis Flexor Digitorum Profundus Extensor Digitorum
.
.
Flexor Pollicis Longus
.
.
.
.
Flexor Pollicis Brevis
.
.
Extensor Pollicis Brevis Adductor Pollicis
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
42
.
43
.
.
.
45
.
.
.
45
.
46
.
.
.
47
.
48
Abductor Pollicis Longus
.
.
.
.
49
.
Thumb-to-Finger Opposition •
.
44
.
Extensor Pollicis Longus
.
.
.
.
.
.
50
.
Muscle Group Actions of the Upper Extremities Elevators of the Scapula
.
.
Depressors of the Scapula
.
Protractors of the Scapula Retractors of the Scapula
.
.
.
.
.
.
.
.
.
.
51
.
52
.
.
.
52
.
Upward Rotators of the Scapula
.
.
.
Downward Rotators of the Scapula
.
.
.
.
53 .
.
.
53
Medial (Internal) Rotators of the Humerus Lateral (External) Rotators of the Humerus Flexors of the Humerus
.
.
.
Extensors of the Humerus
.
Abductors of the Humerus Adductors of the Humerus
.
.
.
.
.
.
.
.
.
.
Extensors of the Elbow
.
.
.
.
.
.
.
.
.
.
.
59 .
.
.
.
.
.
57 57 .
Horizontal Adductors of the Humerus .
.
.
56
.
Horizontal Abductor of the Humerus
Flexors of the Elbow
.
55
.
.
51
.
.
.
59
.
.
.
.
.
.
.
.
58 .
58
.
.
.
54 55
.
.
.
51
Supinators of the Forearm Pronators of the Forearm Flexors of the Wrist
.
.
.
Extensors of the Wrist
.
.
Abductors of the Wrist Adductors of the Wrist
.
.
.
.
.
.
.
.
.
60
61
.
.
60
.
.
.
61
.
.
.
.
.
.
62
.
.
.
.
.
62
Abductors of the Thumb and Digits Adductors of the Thumb and Digits Extensors of the Thumb and Digits Flexors of the Thumb and Digits
III. Torso
.
.
Rectus Abdominis Torso Rotation
.
.
.
.
.
.
.
.
.
66
.
Obliques, Internal
.
.
.
.
.
.
Iliacus
.
.
.
.
72
.
.
.
.
.
.
.
.
.
.
.
.
.
.
63
.
.
.
.
.
63
.
.
.
.
.
.
.
64
64
.
.
.
.
.
.
67
.
.
.
70 71
73
Rotation of the Thoracic Spine Lumbar Rotation
.
.
Lumbar Extension •
.
69
.
Quadratus Lumborum .
.
68
.
.
Transverse Abdominis
Psoas
.
65
.
Obliques, Side-Lying and Standing .
.
.
65
.
.
Obliques, External
.
.
.
.
.
.
.
.
.
.
.
.
.
.
74
75 76
.
Muscle Group Actions of the Torso Torso Flexors
.
.
Torso Extensors
.
.
.
.
.
.
77 .
.
78
Side-Bending Muscles Torso Rotators
.
.
.
.
.
.
80
.
.
.
.
79
.
.
.
77
IV. Lower Extremities Hip Flexion
.
.
.
Hip Extension
.
.
.
.
82
.
.
.
.
Gluteus Maximus Gluteus Medius
.
.
.
Gluteus Minimus
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
91 .
.
Sartorius
.
.
.
.
.
.
.
.
85
.
.
.
.
.
86
.
.
.
.
.
89
.
.
.
Adductor Magnus .
.
.
.
.
.
.
.
92
90
.
.
.
.
92
.
.
.
93
.
94 95
.
Rectus Femoris
.
.
.
.
Vastus Medialis Vastus Lateralis Biceps Femoris
96
.
Vastus Intermedius
.
.
.
.
.
.
.
.
.
.
98
.
.
.
.
.
99
.
.
.
.
97
100
.
Semitendinosus and Semimembranosus Hamstrings Group Popliteus
.
.
.
.
.
Gastrocnemius Soleus
.
.
.
.
.
81
91
.
Adductor Longus
.
.
88
.
Adductor Brevis
Gracilis
.
83
.
.
Obturator Externus
Pectineus
.
84
.
Obturator Internus
Adduction
.
.
.
Tensor Fascia Latae Piriformis
.
81
.
.
.
.
.
.
.
.
.
.
104
102
103 .
.
.
105
Tibialis Posterior Tibialis Anterior Peroneus Tertius
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
106 107 108
.
.
.
.
.
101
Peroneus Longus and Brevis Inversion of Foot Eversion of Foot
.
.
.
.
.
.
.
.
.
.
.
.
.
. 109
110
.
111
Flexor HaIIucis Longus ... 112 .
.
Extensor HaIIucis Longus Extensor Digitorum .
.
.
.
.
.
.
.
114
115
.
Flexor Digitorum Longus . •
.
.
.. 116
.
Muscle Group Actions of the Lower Extremities . .
Lateral (External) Rotators of the Hip .. .
.
117
.
Medial (Internal) Rotators of the Hip . . 117 .
Flexors of the Hip .
.
.
.
.
.
.
.
Adductors of the Hip
.
118
.
Extensors of the Hip ... Abductors of the Hip
.
.
118
.
. 119
.
.
. . 119 .
Lateral (External) Rotator of the Knee Medial (Internal) Rotators of the Knee
.
.
.
.
.
.
.
120
.
.
.
120
Flexors of the Knee ... 121 .
.
Extensors of the Knee
.
.
.
.
Dorsiflexors of the Ankle
.
.
Plantarflexors of the Ankle Invertors of the Foot Evertors of the Foot
v.
.
.
.
.
.
121
.
.
.
.. 122 .
.
.
.
122
123
.
.
.
.
.
123
Miscellaneous Tests
Forward Gait
.
.
.
.
.
125
Lateral Movement . .
.
.
.
Abduction Integration . Adduction Integration
.
125 .
.
.
.
126
.
.
.
.
126
Index ..... 127 About the Author .... 131 .
.
.
.
.
.
125
.
.
.
117
22
~
NeuroKinetic Therapy
SUPRASPINATUS Supine and Prone A t t a c h m e n t s : Supraspinous fossa of scapula and Greater tubercle of humerus
A c t i o n : Abduction o f humerus
Core:
Thoracic
Antagonist: Humeral adductors Synergist: Middle deltoid, wrist extensors,
and humeral abductors
Humerus is abducted 10-15° and lifted slightly off the table. Resist abduction superior to the wrist.
A r m at side, elbow locked. Resist first 15° of abduction.
Core:
Thoracic
Antagonist: Extensors, abductors, horizontal
abductors,
and lateral
rotators of the humerus Synergist: Flexors, horizontal
adductors,
adductors, and
medial
rotators of the humerus
Client's palm is facing you. A i m the back of his hand t o w a r d the opposite shoulder. Resist at wrist.
Pectoralis Major Clavicular detail
Client's palm is facing the floor. Resist downward movement at the wrist.
65
125
