Townsend Letter Alternative Medicine Magazine



  FREE e-Edition


 EDTA Chelation Therapy


 E-mail List

From the Townsend Letter
June 2018

Manual Muscle Testing for Tension-Type and Cervicogenic Headaches
by Scott Cuthbert, DC
Search this site

Page 1, 2

Figure 2. Sternocleidomastoid MMT and muscle


Figure 3. Anterior scalene MMT and muscle


Figure 4. Deep neck flexor MMT


Figure 5. Upper trapezius MMT and muscle


Figure 6. Cervical extensor (unilateral) MMT and muscle


Figure 7. Cervical extensor (bilateral) MMT and muscle

Manual Muscle Testing Management of Cervicogenic and Tension-Type Headache
During the past 3,000 years many diagnostic methods have been developed to discover the causes of human pain. In l972, a significant step forward in the evaluation of neurological disturbances related to functional-structural impairments was made by Goodheart.48 The system consists of the examiner manually pressing on the vertebra in various directions and locations, and immediately testing a muscle to determine change of strength. Goodheart named this procedure the "vertebral challenge." It has been widely used by doctors practicing applied kinesiology, and by thousands of other clinicians and therapists around the world who practice some portion of the applied kinesiology methodology, with significant success. It provides the opportunity for evaluating chiropractic subluxations, joint dysfunctions, osteopathic lesions, and body-wide articular dysfunctions in an effective, efficient manner.

Figure 8. Manual muscle tests are designed to replicate the primary vector of motion of a muscle while minimizing the contribution of secondary mover muscles. There is an ideal starting position and vector of testing force that places the cervical muscle being tested as the prime mover and the synergists at a disadvantage during the test. Accurate MMT must be done with a high level of anatomical and physiological knowledge.47


Figure 9. Head and neck muscular dysfunction, recognized as critical in patients with head and neck pain, involves the disruption of what Dr. Panjabi terms the stability system of the spine. Improper stabilization responses may serve as a perpetuating factor in patients.3


Figure 10. Sensorimotor "challenge" is a diagnostic procedure unique to Applied Kinesiology manual muscle testing that is used to determine the body's ability to cope with external stimuli, which can be physical, chemical, or emotional.  After an external stimulus is applied, muscle-testing procedures are done to determine a change in the muscle strength as a result of the stimulus.

Chronic Pathologies ConferenceThe challenge method is the one used in applied kinesiology to determine the precise vector of any manipulative treatment. When the challenge is applied to an abnormally functioning vertebra, a skeletal muscle associated with the dysfunction will become temporarily very strong, as observed on manual muscle testing, for a period of many seconds to minutes.
Because MMT identifies neuromuscular dysfunction in the muscle, the directional preference of a local or remote joint dysfunction can be identified by applied kinesiology challenge.12 If the sternocleidomastoid muscle on the right is inhibited (and related to a suspected cervical joint dysfunction and headache), a challenge of the C6 vertebra from lateral to medial may immediately strengthen the sternocleidomastoid. This is the subluxation responsible, and the direction necessary for correction, of the sternocleidomastoid muscle impairment.
The most common reason for muscle inhibition (an inability to generate adequate force for the optimal execution of movement) is direct physiological and pathological changes to the muscle's innervation. In recent years, both chiropractic and manual medical research and theory have highlighted the role of muscles, joints, and nerves in the function of the neuro-musculoskeletal system. This system has been described as the Primary Machinery of Life49 as it is how we, and all tissues within us, move and communicate. If we are not capable of diagnosing this fundamental problem in the muscles of the head and neck, we are missing a fundamental component of headache dysfunction, thereby making the treatment of this complex neuromusculoskeletal pain disorder that much more difficult.

Several hundred studies have shown that cervicogenic or tension-type headache pain is associated with muscle inhibition, the detection of which makes MMT for cervicogenic headache and neck dysfunctions invaluable in clinical practice. Functional pathology of the muscle system is the most common clinical finding in tension-type and cervicogenic headache pain patients presenting to chiropractors, osteopaths, neurologists, rheumatologists, orthopedists, massage and physical therapists.16 Yet this disorder of the muscle system is routinely ignored in the diagnosis and treatment of these patients.
In the triad of health model of health care (namely holistic and integrative health care), many factors that disturb and influence muscle function in the head and neck may be "challenged" or "therapy localized," including joint dysfunctions, reflex points, lymphatic and vascular receptors, meridian points, cranial dysfunctions, the origin and insertion of the muscles, proprioceptors within the muscle, myofascial kinematic interconnections with the lower body, foot and gait disturbances, and many more. Each of these elements in the patient's adaptation to injury or pain must be addressed if an integrated, holistic and interdisciplinary method to manage the complexities of headache pain is to be realized.

Page 1, 2

SUPPORTThe Townsend Letter is dedicated to examining and reporting on functional and integrative medicine. Our editorial content depends on support from readers like you, and we would appreciate your help to keep this content forthcoming. Please take this opportunity to contribute $50, or choose one of the other amounts listed on the next page, and ensure that our independent voices keep up the good fight against the skeptics, who would like to silence us and eliminate your medical freedoms.

References .pdf

Dr. Scott Cuthbert is the author of Whiplash Dynamics and Manual Muscle Testing (2017), Applied Kinesiology Essentials: The Missing Link in Health Care (2013), and Applied Kinesiology: Clinical Techniques for Lower Body Dysfunctions (2013), the content of which forms the basis for this article. Dr. Cuthbert is a 1997 graduate of Palmer Chiropractic College (Davenport) and practices in Pueblo, Colorado. He has published 13 Index Medicus clinical outcome studies and literature reviews, and 50 peer-reviewed articles on chiropractic and manual muscle testing approaches.

Consult your doctor before using any of the treatments found within this site.

Subscriptions are available for Townsend Letter, the Examiner of Alternative Medicine
magazine, which is published 10 times each year. Search our pre-2001 archives for further information. Older issues of the printed magazine are also indexed for your convenience.
1983-2001 indices ; recent indices. Once you find the magazines you'd like to order, please
use our convenient form, e-mail, or call 360.385.6021.


Fax: 360.385.0699

Who are we? | New articles | Featured topics | e-Edition |
Tables of contents
| Subscriptions | Contact us | Links | Classifieds | Advertise |
Alternative Medicine Conference Calendar | Search site | Archives |
EDTA Chelation Therapy | Home

© 1983-2018 Townsend Letter
All rights reserved.
Website by Sandy Hershelman Designs