THE RESEARCH SAYS . . . 

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Swirl Girl by Alden  Weissfeld          https://www.instagram.com/wasald/

You may have heard this tale before: A kind samaritan sees a man intently searching the ground near a lamppost and asks him what he is looking for. "My car keys" the man drunkenly replies, so the samaritan joins in the search. After a few minutes, the samaritan asks whether the man is certain that he dropped the keys near the lamppost. 

“No,” the man replies, is the reply, “I lost the keys somewhere across the street.” “Why look here?” asks the irritated helper. “I'd never find anything over there," the intoxicated man replies, "it's way too dark!” 

 

We can wonder if this is the attitude of mainstream researchers, who have spent much time and energy searching and re-searching for solutions to muscle inhibition where they ain’t. Any treatment that we have mentioned on this site has not been considered by these researchers.  

In medical journals, muscle inhibition or weakness is somewhat well-referenced, but the mechanisms that cause and sustain it remain a mystery. In 1984, researchers began to talk about a condition they called “arthrogenous” (joint-caused) muscle inhibition, [1] a condition of muscle weakness found after injuries and surgeries to joints. (“Arthrogenic” is the term in current use.) Muscle weakness is also associated with emotional [2] and organ [3] stress by other researchers, but none of these researchers seems to have taken into account the others.

Muscle weakness is included as one of the causes of named conditions like ankle instability, [4, 5] whiplash, [6, 7] tennis elbow, [8] runner’s knee, [9, 10] plantar fascitis [11] and iliotibial band syndrome. [12, 13] It is also listed as a cause of falls in the elderly. [14] Muscle weakness also predisposes affected areas to injury, and is a known contributor to osteoarthritis, [15–24] Over the long term then, it can be not just painful, but crippling.

Indeed, inhibited muscles are stated to be “rehabilitation resistant”, [25] unresponsive even to “intensive” [26] or “aggressive” [4] physical therapy treatments. Moreover, they will not strengthen even with dedicated exercise. [27] 

Treatments which block signals from emerging from involved joints like TENS, local anesthetic and cryotherapy (cold applications) will restore strength, but those results are temporary. [27–31]

In other words, the research says muscle inhibition is an incurable condition.  

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Bibliography

1. Stokes M, Young A. The contribution of reflex inhibition to arthrogenous muscle weakness. Clinical Science. 1984;67:7–14. http://sci-hub.cc/http://www.clinsci.org/content/67/1/7.abstract. Accessed 13 Jan 2017.

2. Stone J, Warlow C, Sharpe M. The symptom of functional weakness: a controlled study of 107 patients. Brain. 2010;133:1537–51. doi:10.1093/brain/awq068.

3. Hoffman J, Mendel R. Evaluation of Muscle-Organ Association, Part II. J Clin Chiro. 1977;III:42–60.

4. McVey ED, Palmieri RM, Docherty CL, Zinder SM, Ingersoll CD. Arthrogenic muscle inhibition in the leg muscles of subjects exhibiting functional ankle instability. Foot and Ankle International. 2005;26:1055. http://www.kines.umich.edu/sites/webservices.itcs.umich.edu.drupal.kinesprod/files/resource_files/AMI.pdf. Accessed 1 Jan 2013.

5. Palmieri-Smith RM, Hopkins JT, Brown TN. Peroneal activation deficits in persons with functional ankle instability. The American journal of sports medicine. 2009;37:982–988. https://ajs.sagepub.com/content/37/5/982.full. Accessed 25 May 2015.

6. Prushansky T, Gepstein R, Gordon C, Dvir Z. Cervical muscles weakness in chronic whiplash patients. Clin Biomech (Bristol, Avon). 2005;20:794–8.

7. Jull GA. Deep cervical flexor muscle dysfunction in whiplash. Journal of Musculoskelatal Pain. 2000;8:143–154. http://informahealthcare.com/doi/abs/10.1300/J094v08n01_12. Accessed 9 Dec 2012.

8. Coombes BK, Bisset L, Vicenzino B. Elbow flexor and extensor muscle weakness in lateral epicondylalgia. British Journal of Sports Medicine. 2012;46:449–453. http://bjsportmed.com/content/46/6/449.abstract. Accessed 27 Apr 2013.

9. Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. The Journal of orthopaedic and sports physical therapy. 2003;33:671–676. http://europepmc.org/abstract/MED/14669962. Accessed 27 Apr 2013.

10. Thomee R, Augustsson J, Karlsson J. Patellofemoral pain syndrome: A review of current issues. 1999.

11. Allen RH, Gross MT. Toe flexors strength and passive extension range of motion of the first metatarsophalangeal joint in individuals with plantar fasciitis. Journal of orthopaedic & sports physical therapy. 2003;33:468–478.

12. Fredericson M, Cookingham CL, Chaudhari AM, Dowdell BC, Oestreicher N, Sahrmann SA. Hip Abductor Weakness in Distance Runners with Iliotibial Band Syndrome. Clinical Journal of Sport Medicine. 2000;10:169. https://journals.lww.com/cjsportsmed/Abstract/2000/07000/Hip_Abductor_Weakness_in_Distance_Runners_with.4.aspx. Accessed 28 Sep 2018.

13. Arab AM, Nourbakhsh MR. The relationship between hip abductor muscle strength and iliotibial band tightness in individuals with low back pain. Chiropr Osteopat. 2010;18:1. doi:10.1186/1746-1340-18-1.

14. Konishi Y, Kasukawa T, Tobita H, Nishino A, Konishi M. Gamma loop dysfunction of the quadriceps femoris of elderly patients hospitalized after fall injury. Journal of Geriatric Physical Therapy. 2007;30:54–59.

15. Dekker J, Tola P, Aufdemkampe G, Winckers M. Negative affect, pain and disability in osteoarthritis patients: the mediating role of muscle weakness. Behaviour research and therapy. 1993;31:203–206. http://www.sciencedirect.com/science/article/pii/0005796793900734. Accessed 27 Apr 2013.

16. Gabler C, Kitzman PH, Mattacola CG. Targeting quadriceps inhibition with electromyographic biofeedback: a neuroplastic approach. Critical ReviewsTM in Biomedical Engineering. 2013;41:125–35.

17. Herzog W, Longino D, Clark A. The role of muscles in joint adaptation and degeneration. Langenbecks Arch Surg. 2003;388:305–15. doi:10.1007/s00423-003-0402-6.

18. Hurley MV, Scott DL, Rees J, Newham DJ. Sensorimotor changes and functional performance in patients with knee osteoarthritis. Ann Rheum Dis. 1997;56:641–8. doi:10.1136/ard.56.11.641.

19. Lewek MD, Rudolph KS, Snyder-Mackler L. Quadriceps femoris muscle weakness and activation failure in patients with symptomatic knee osteoarthritis. Journal of Orthopaedic Research. 2004;22:110–115. http://onlinelibrary.wiley.com/doi/10.1016/S0736-0266(03)00154-2/abstract. Accessed 27 Apr 2013.

20. O’Reilly S, Jones A, Doherty M. Muscle weakness in osteoarthritis. Current opinion in rheumatology. 1997;9:259–262. http://journals.lww.com/co-rheumatology/abstract/1997/05000/muscle_weakness_in_osteoarthritis.14.aspx. Accessed 27 Apr 2013.

21. Palmieri-Smith RM, Thomas AC. A neuromuscular mechanism of posttraumatic osteoarthritis associated with ACL injury. Exercise and sport sciences reviews. 2009;37:147–153. http://journals.lww.com/acsm-essr/Abstract/2009/07000/A_Neuromuscular_Mechanism_of_Posttraumatic.7.aspx. Accessed 1 Jan 2013.

22. Roos EM, Herzog W, Block JA, Bennell KL. Muscle weakness, afferent sensory dysfunction and exercise in knee osteoarthritis. Nature Reviews Rheumatology. 2010;7:57–63. http://www.nature.com/nrrheum/journal/v7/n1/abs/nrrheum.2010.195.html. Accessed 22 Jan 2014.

23. Slemenda C, Brandt KD, Heilman DK, Mazzuca S, Braunstein EM, Katz BP, et al. Quadriceps weakness and osteoarthritis of the knee. Annals of internal medicine. 1997;127:97–104. http://www.kinex.cl/Diplomados2012/Clases_Realizadas/Rodilla/rodilla%20nuevos%20papers/debilidad%20quadric%20en%20artrosis.pdf. Accessed 20 Feb 2013.

24. Van Baar ME, Dekker J, Lemmens JA, Oostendorp RA, Bijlsma JW. Pain and disability in patients with osteoarthritis of hip or knee: the relationship with articular, kinesiological, and psychological characteristics. The Journal of rheumatology. 1998;25:125–133. http://europepmc.org/abstract/MED/9458215. Accessed 27 Apr 2013.

25. Hart JM, Pietrosimone B, Hertel J, Ingersoll CD. Quadriceps activation following knee injuries: a systematic review. J Athl Train. 2010;45:87–97. doi:10.4085/1062-6050-45.1.87.

26. Hurley MV, Jones DW, Newham DJ. Arthrogenic quadriceps inhibition and rehabilitation of patients with extensive traumatic knee injuries. Clinical Science. 1994;86:305–310. http://www.clinsci.org/content/86/3/305.abstract. Accessed 11 Aug 2016.

27. Hart JM, Kuenze CM, Diduch DR, Ingersoll CD. Quadriceps Muscle Function After Rehabilitation With Cryotherapy in Patients With Anterior Cruciate Ligament Reconstruction. Journal of Athletic Training. 2014;49:733–9. doi:10.4085/1062-6050-49.3.39.

28. Rice DA, McNair P. Quadriceps Arthrogenic Muscle Inhibition: Neural Mechanisms and Treatment Perspectives. Seminars in Arthritis and Rheumatism. 2010;40:250–66. doi:10.1016/j.semarthrit.2009.10.001.

29. Rice DA. Quadriceps Arthrogenic Muscle Inhibition: Neurophysiological Mechanisms and Possible Therapeutic Interventions. Thesis. AUT University; 2012. http://aut.researchgateway.ac.nz/handle/10292/7199. Accessed 13 Oct 2017.

30. Sonnery-Cottet B, Saithna A, Quelard B, Daggett M, Borade A, Ouanezar H, et al. Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions. Br J Sports Med. 2018;:bjsports-2017-098401. doi:10.1136/bjsports-2017-098401.

31. Rice D, McNair PJ, Dalbeth N. Effects of cryotherapy on arthrogenic muscle inhibition using an experimental model of knee swelling. Arthritis Care & Research. 2009;61:78–83. http://onlinelibrary.wiley.com/doi/10.1002/art.24168/full. Accessed 3 Sep 2015.

32. Frost R. Applied Kinesiology: A Training Manual and Reference Book of Basic Principals and Practices. North Atlantic Books; 2002.

33. Walther DS. Applied Kinesiology Synopsis 2nd Edition. Systems DC Pueblo, CO; 2000. https://www.biblio.com/book/applied-kinesiology-synopsis-2nd-edition-david/d/463032299. Accessed 18 Aug 2017.

34. Jarvis, Kelly B. Chiropractic and all that Jazz. Dynamic Chiropractic. 1998;16.

Find out more about Effortless Rehab 

A common condition, commonly overlooked

Benefits of rebooting for athletes, dancers, teams, etc.

Secret of the least injured team in the NBA

What researchers have been saying about muscle inhibition

How can I best use this

new treatment?

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mind and muscle

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