In 1985 and 1986, this author [ Walter H. Schmitt, Jr., D.C. ] first presented his findings regarding 1) doctor started and 2) patient started muscle testing, calling these “gamma 1” and “gamma 2” type testing, respectively. These terms were based on the supposition that the two different types of gamma motorneurons were involved in the two different types of testing. Who knows if this is, in fact, true?
In 1990, Dr. John Bandy and I realized that they were each doing a different type of test and calling it “gamma 2” testing. In fact, they now had three types of testing.
What were we to call the third type of testing? Certainly not “gamma 3” because there is no such thing as a gamma 3 motorneuron. They had painted themselves into a corner (or at least, Walther had) by trying to describe a procedure in anatomical terms when there is only speculative evidence that the gamma motorneurons are implicated. It is far better to describe these procedures in descriptive terms such as
- “Doctor started testing” (gamma 1 / eccentric),
- “Patient started testing to maximum” (gamma 2 / concentric), or
- “Patient started submaximal testing” (concentric submaximal)
Equally appropriate terms could be “eccentric testing”, “concentric testing to maximum contraction”, and “concentric testing submaximal” respectively.
From 1985 to 1990 we have used the terms “gamma 1 and 2” and it was time to change these. For simplicity’s sake, and for continuity’s sake, we are trying to call the three types of testing “G-1″, G-2”, and “G-2 submaximal”.
In 1999, we are calling the three types of testing
- Type 1 (G-1),
- Type 2 (G-2), and
- Type 3 (G-2 submaximal).
In the future, we should all we can to avoid such pitfalls by labelling what we do in descriptive terms. Take for instance Therapy localization – it describes where we are going to direct our therapy. We can always use abbreviations for record keeping, such as “TL”, but we need to define these abbreviations whenever we write so that people who are not familiar with our language can read our papers.
Walter H. Schmitt, Jr., D.C.
Initial screening for type (1, 2, 3)
- Identify a weak muscle.
- Test with G-1, G-2 to maximum, and G-2 submaximal tests.
G-1 (Type 1) is performed with a (static) maximum contraction and the practitioner performing the muscle test.
G-2 (Type 2) is muscle test performed by the practitioner at the end of a moving action – by the testperson – along the muscle vector.
G-2 submax (Type 3) is performed with G-2 in action (testperson moves the limb in the muscle moving vector) while the practitioner meets the moving limb halfway in action and muscle tests.
[ Hans Boehnke ]
With a G-2 submaximal weakness (Type 3), you know that either the patient has:
- a reaction to injury,
- an immune system involvement – usually allergy, and/or
- a centering the spine problem – See discussion Issue 6 of Uplink.
With G-2 weakness (Type 2) a significant problem is arising from supra-segmental (supraspinal) centers. This could be:
- Cranial or TMJ faults,
- Systemic chemical imbalances,
- Emotional stress circuits, etc.
When you identify the type(s) of weaknesses present, you are in the ball park of the patient’s problem. Once you have identified that a muscle shows two or three types of weakness, you can continue with the easier to perform G-1 type testing. [ Uplink issue 6 ]
Richard Utt with Applied Physiology extended these three positions into 7 contraction into extension and 7 extension into contraction posiotions in his programm ‘Holographic muscle testing’.
Reproduction of Issue 13, Uplink by Walter H. Schmitt, Jr., D.C.
Stop the Pain NOW
In this issue of THE UPLINK we will discuss the three pain and injury related techniques which are represented by G-2 submaximal (Type 3) weaknesses.
- Correcting these first clears up many other problems.
- Testing a weak muscle for the three types of muscle weakness continues to be the most important first step in guiding the doctor to the most efficient treatment strategy.
Weakness All the Way Down – When all three types of muscle weakness (G-1, G-2, and G-2 submaximal, or Types 1, 2, and 3) are present, you must consider the following:
- Injury or trauma – recent or ancient (In this issue.)
- Centering the Spine problem – Pituitary NL TLs or tonic labyrinthine reflexes are dysfunctional; emotional NVs positive. See previous issues ‘Uplink’.
- Immune system involvement – See previous issues ‘Uplink’.
Screening for Injurie’s Effects
In this issue we will focus on
- Injury Recall Technique [IRT],
- Nociceptor-Stimulation Blocking technique [NSBT], and
- Set Point Technique [SPT]
One or more of these techniques is indicated when there is a history of major injury or trauma, either recent or ancient. The need for IRT, NSBT, and/or SPT will persist (even for years) until the proper correction is made. But one correction is usually permanent.
There is a simple decision making process for deciding which technique is most appropriate:
- G-2 submaximal (Type 3) weakness is present.
- Autogenic Facilitation [AF] muscle spindle stretching.
a) No indicator change: IRT.
b) Indicator change:
_ 1. Activating pain == general weakness: NSBT
_ 2. No pain or activating pain == no weakness: SPT
Locating the Problem Area
- In IRT >> rubbing over injury site strengthens.
- In NSBT or SPT >> pinching over injury site strengthens.
Once you have determined that there may be a history of injury problem by G-2’s and AF testing, you must determine which areas of previous injury are involved. It may be quite obvious, especially in the acute post-trauma period. But often, there are numerous potential areas of previous injury to consider, especially in untreated patients.
As discussed in Issue 6 of THE UPLINK, the location for IRT is determined when a weak muscle strengthens with rubbing the skin over the site to be treated.
In NSBT or SPT, the opposite is true: pinching the skin over the site in need of treatment will strengthen a weak muscle. The only exception to this rule is when pinching the skin over an acute injury creates excessive pain. (These patients always need NSBT.)
NSBT and SPT utilize Acupuncture Head Points (AHPs) – also called B & E points. See AHP chart in Issue 8 of THE UPLINK for locations.
Nociceptor-Stimulation Blocking Technique (NBST)
Used immediately after an injury up to days or weeks after an injury.
It is used in conjunction with:
- An area which hurts immediately after an injury.
- An area which hurts when pressure is applied.
- Pain on movement.
- Presence of pain causes general weakness. The weakness from pain may be present immediately after injury, induced by direct pressure or by movement.
- Pain induced weakness shows indicator change on Therapy Localization (TL) – testperson touching spot – or doctor tapping to an ipsilateral AHP:
_ a. To relieve pain immediately after injury – Tap the related AHP until the pain is reduced.
_ b. If weakness is induced by pressure or movement – Tap related AHP while intermittently activating pain (about once every 2-3 seconds.)
- Tap until pain reduction is maximized.
Set Point Technique (SPT)
- Area of previous injury may be recent or ancient. Pain may be present or absent. There is a weakness, AND there is a change on AF application (muscle spindle stretching).
_ a. TL to area shows no indicator change.
_ b. TL to associated AHP shows no indicator change.
- Simultaneous TL to area of injury plus TL to or tap to an ipsilateral AHP is positive. Tap 50 – 100 times on AHP while patient maintains TL to area of injury.
Case histories using IRT, NSBT & SPT
CASE HISTORY #1: A middle aged woman was seen three weeks post-surgically following a tibial plateau fracture. She had much pain with any movement to knee. A weak PMC was found with all three types of weakness.
- AF (read: muscle spindle stretching) did not strengthen. Rubbing the medial tibia and infrapatellar areas strengthened. Thus IRT was performed to these areas. The PMC was still weak, but AF now strengthened.
- Pinching over the medial tibia (Pes Anserinus) as well as the lateral tibia and the popliteal fossa area strengthened. Search for NSBT or SPT.
- Pressure to the medial tibia caused general weakness, negated by TL to GB-1 (indicator change). The NSBT was performed.
- Pressure to the lateral tibia and popliteal areas caused no weakness. The SPT was performed by tapping ST-1 while the patient TLed the lateral tibia, and by tapping UB-1 while TLing the popliteal area.
The patient was pain free on all movements and also had greater ranges of motion.
CASE HISTORY #2: – A teenage girl presented five months post-auto accident in which she hit her head, elbow, knee, and hip, and had whiplash. She complained of continuous dizziness, headaches, and neck pain since the accident.
Chiropractic adjustments and basic AK had given temporary reduction of symptoms.
- The right PMS showed G-1, G-2, and G-2s weakness but AF (muscle spindle stretching) strengthened == no IRT.
- Pinching over each of the injured areas strengthened the right PMS.
- Pressure to each of the injured areas caused no indicator change. SPT was performed for each of the injured areas, each responding to a different AHP.
- An internal frontal cranial fault was also corrected. Immediately following these corrections.
She reported no dizziness, no headache, and no neck pain for the first time since the accident.