Muscle Weakness Patterns

Neurology Corner

Muscle Weakness Patterns, Indicator Points, and Their Meaning

Richard Belli, D.C., D.A.C.N.B.

A common concern of beginning applied kinesiology practitioners is that they have developed an impressive armamentarium of tools, but do not have an understanding of exactly when to apply them. This can lead to such frustration that the practitioner will quit or minimize use of these tools. This is why it is so important to understand the underlying cause of the patient's complaint and exactly what is necessary to correct it. A typical scenario such as cerebellum dysfunction demonstrates how this can happen. The cerebellum, having a large autonomic effect, can cause muscle weakness patterns that will indicate visceral dysfunction as well as pituitary and pineal dysfunction. The patient may present with pelvic categories, cranial faults and multiple meridian involvement, as well as many other applied kinesiology findings, making it easy to see how one can be tricked into treating secondary effects over and over, never getting to the primary cause of the problem.

There are gross muscle patterns that are the result of neurological areas and viscera, which are easily used for analytic purposes. Additionally, there are acupuncture points that correlate with the major neurological and visceral systems that make valuable indicators. These are valuable tools that, when combined with standard diagnostic and physiological testing, make identification of the primary cause of the patient's complaint more direct and effective. Also, these tools, in conjunction with an understanding of the physiology of the dysfunctional system and what the muscle weakness type means (G‑1, G‑11, G‑Il submax), will help make treatment more direct.

The major functional areas or systems that will result in distinct muscle weakness patterns are the cerebral cortex, cerebellum, vagal motor nucleus, limbic system, reticular formation, intermediolateral cell column of the spinal cord, and viscera. Additionally, flexor withdrawal and crossed extensor thrust patterns (that are the result of injury to soma or viscera) are often present and complicate things, making it necessary to understand them so the examiner will not be misled. Also, spinal centering patterns are very important, but due to their complexity, are not within the scope of this paper. Walter Schmitt, Jr., D.C., has done extensive work in this area, making his documents an invaluable reference. There are other functional areas that are either minor players in the scheme, or the identifiable patterns are not completely understood.

A dysfunctional cortex will present with a pattern of weakness commonly termed a pyramidal distribution. The pattern of weakness is due to ipsilateral loss of cortical inhibition of the upper body flexors and lower body extensors with a resultant reciprocal inhibition of the lower body flexors and upper body extensors. The cortex is primarily driven by receptors contralaterally so therapy will typically apply to the contralateral side of the pyramidal distribution. The indicator point to confirm cortical dysfunction is unilateral therapy localization to the emotional neurovascular reflex on the side of the pyramidal distribution. The cerebellum has many functions which the loss of can cause decreased motor coordination, hypertonicity or hypotonicity, labyrinthine dysfunction as well as autonomic concomitants. Cerebellum dysfunction, for muscle testing purposes, is most easily identified by a pattern of hemispherical extensor weakness (all of the extensors weak on the same side). The cerebellum is driven by ipsilateral receptors, so typically therapy will be administered to the same side of weakness. The indicator point to confirm cerebellum dysfunction is unilateral therapy localization to bladder‑1.

Although descending neurological controls modulate the intermediolateral cell column, it is capable of dysfunction as a separate entity. Dysfunction of the intermediolateral cell column, because it is a motor system, will present as hemispherical flexor weakness (weakness of all flexors on the same side). Because the neurolymphatic reflexes are a neurological extension of the intermediolateral cell column, it is typical to find that most or all of them will therapy localize on the same side as the flexor weakness. When the intermediolateral cell column dysfunctions as a separate entity, it is typically from loss of receptor input from the contralateral side. Therefore, treatment will typically be directed to the contralateral side. The indicator point to confirm intermediolateral cell column dysfunction is unilateral therapy localization to K27 on the side of hemispherical flexor weakness.

A more diffuse area of the central nervous system located in the mesencephalon, metencephalon, and myclencephalon is the reticular formation. This system has many functions, but because of its involvement in the righting mechanism with the vestibular mechanism and nuclei as well as cerebellum, dysfunction is commonly demonstrated by weakness of upper body extensors and lower body flexors tested bilaterally. The indicator point to confirm dysfunction in this area is governing vessel‑27.

The vagal motor nuclei, because it innervates all of the viscera, will be demonstrated as bilateral weakness of the muscles associated to the involved viscera. A delineating factor between vagal motor nucleus dysfunction and primary visceral dysfunction is that vagal dysfunction will typically show multiple bilateral patterns. Vagal nerve dysfunction can be confirmed by therapy localization to conception vessel‑24.

The muscle weakness pattern that is typically associated to the limbic system and emotional complexes are a consequence of facilitation of muscles necessary for the fetal position. In other words, think of the position that individuals will take when they are under severe emotional stress, depressed or feeling defeated. They take a position that is similar in many respects to the fetal position, or the fetal position itself. Depending on the severity of the perceived emotional stress, the patient may spend time in the fetal position, or walking around in a semi‑fetal position such as with the head down and shuffling gait. When one goes into the fetal position, the knees are pulled to the chest and the trunk curled forward, indicating facilitation of the anterior trunk muscles and inhibition of the posterior trunk muscles. The muscle weakness pattern will be upper and lower body extensors when tested bilaterally. The indicator points for this pattern are bilateral therapy localization to the emotional neurovascular points such as the manner used in Neuro Emotional Technique.

As a result of sensory and nociceptive feedback into the central nervous system, dysfunctional viscera typically present with a bilateral weakness pattern. Determining whether the apparent visceral dysfunction is primary or secondary is the important aspect. Typically, if visceral dysfunction is primary, the pulse diagnosis points and alarm points will therapy localize. If other indicator points therapy localize in addition to pulse points and alarm point, suspect that viscera is not the primary area of dysfunction.

Primarily, the type of muscle weakness (G‑1, G‑11, G‑II submax) and the treatment modalities associated to them determine treatment to all of the aforementioned functional areas. If you are not familiar with these types of muscle weaknesses or the modalities associated to them, please refer to the many writings of Walter Schmitt, Jr., D.C., concerning the topic.

Because every human system affects another, tools such as the acupuncture indicator points are most valuable. The indicator points of the related system will typically therapy localize only when it is of primary concern and not a compensatory pattern. This makes therapy localization of indicator points, in combination with weak muscle patterns, valuable in determining the culprit in the patient's problem.

Combining tools such as those presented here, along with other standard diagnostic and physiological testing, allows the applied kinesiology practitioner to practice at the level of effectiveness and efficiency that the technique was originally and so beautifully designed to accomplish.