pronation and full supination ( the best position for it to effectively contract , given its actions ), and then flex the forearm against our resistance . It is crucially important that our resistance is placed against their distal forearm , not their hand . If we add our resistance to the client ’ s hand , their radial deviators ( extensors carpi radialis longus and brevis ) will engage , making it harder to discern the brachioradialis from these adjacent muscles ( Figure 4 ). By understanding basic principles of anatomy and physiology , we can reason through how to most effectively palpate and assess our clients .
The essence of evaluating new knowledge against established principles of anatomy and physiology is that we are empowered by critical thinking . Of course , this requires first learning anatomy , which is often not as well taught and learned as might be desirable . But , if the time is spent to learn and understand anatomy , physiology can be figured out . If physiology is understood , then pathophysiology can be figured out . If the mechanics of pathophysiology are understood , then assessment can be figured out . And if assessment is known , then treatment can be figured out . It all stems from spending the time to first truly learn anatomy . Perhaps the most effective way to become a more effective clinical orthopedic massage therapist is not to continually frequent continuing education workshops , not to continually read every research study that is published , and not to spend hundreds of hours testing new techniques on our clients , but to spend more time going over the basics of anatomy and then critically thinking from there .
Conclusion
This article could be construed as being negative on educators and authors , given their role as authorities . I as the author of this article am fully aware of the irony of being the author-ity as you read this . However , it is not the knowledge or the authority that is the danger ; most authorities fervently believe in what they are teaching and have an extensive knowledge base .
Figure 4A . When engaging the brachioradialis to palpate it , resistance should be placed against the client ’ s distal forearm , not hand .
Figure 4B . If the client attempts to radially deviate the hand at the wrist joint , the extensor carpit radialis longus and brevis would contract , making it difficult to palpate and discern the brachioradialis from these muscles .
The danger comes when we place blind trust in them . When we treat them as a sage on the stage , or perhaps a sage on the page . Similarly , this article should not be construed as being against scientific research ; I am also a firm advocate for research . But we need to be aware of the limitations of relying too heavily on research when making treatment choices ; if for no other reason because research is rarely complete . And certainly , there is nothing wrong with being creative in our practice by introducing and trying new treatment techniques , we just need to be mindful to not constantly subject our clients to the newest technique that is the flavor of the month .
Most every technique must have something valid within it , if not many things ; otherwise , it would not last very long in the world of manual and movement therapies . However , if every technique were as effective as its proponents state , why isn ’ t everyone doing that technique ? A logical conclusion might be that each technique has something to offer , but does not offer the solution to every problem for every client . Therefore , our role is to learn as many techniques as possible , adding the elements of each one to our tool box of therapies . Then , with the wise judgment that comes from experience , we can learn how to reason through which combination of assessment and treatment tools to use in each case for the best improvement of the client who is on our table .
Joe will present in person Clinical Orthopedic Manual Therapy in Sydney 8-11 June 2023 . For more information visit terrarosa . com . au
Dr Joe Muscolino has been a manual and movement therapy educator for more than 35 years . He is the author of extensive online streaming video content on anatomy , physiology , and kinesiology , as well as assessment and treatment skillsets for manual therapists and movement professionals . He has created Learn Muscles Continuing Education ( LMCE ), with over 2,800 video lessons , with new video lessons added every week . He has also created Master Classes in Muscle Anatomy ( MAMC ), Bone and Joint Anatomy ( BAJAMC ), Kinesiology ( KMC ), and Visceral Anatomy ( VAMC ). And he has created an Anatomy Master Class Curriculum for massage and other manual and movement therapy educational institutions . He is the author of multiple textbooks , including The Muscular System Manual : The Skeletal Muscles of the Human Body ( Elsevier , 2017 ); The Muscle and Bone Palpation Manual with Trigger Points , Referral Patterns , and Stretching ( Elsevier , 2016 ); and Kinesiology : The Skeletal System and Muscle Function ( Elsevier , 2017 ). And he teaches continuing education workshops around the world , including a certification in Clinical Orthopedic Manual Therapy ( COMT ). Visit www . learnmuscles . com for more information , or you can reach him directly at joseph . e . muscolino @ gmail . com .
FIGURE CREDITS Figures 1A and 2B : Illustrated by Giovanni Rimasti
Figures 1B , 2A , 4 from Muscolino JE : Kinesiology , The Skeletal System and Muscle Function , 2ed . St . Louis , Elsevier / Photography by Yanik Chauvin . Artwork by Lightbox Visuals Communications Inc . / Illustrated by Giovanni Rimasti
Figure 3 reprinted from understanding and working with myofascial trigger points , body mechanics column article , mtj , spring 2008 issue . Illustrated by Jeannie Robertson .
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