Assessment and Treatment of Muscle Imbalance

Phil Page, MS, PT, ATC, CSCS, trained under the guidance of Dr. Vladimir Janda and has taught the Janda approach at national and international workshops. A certified kinesiotaping practitioner, Page is currently working toward his doctorate in kinesiology at Louisiana State University in Baton Rouge, where his research focuses on EMG and muscle imbalance. He is also director of clinical education and research for Thera-Band products.   Page and his wife, Angela, live in Baton Rouge with their four children. In his free time, he enjoys spending time with his family, fishing, and cooking.   Clare C. Frank, DPT, is an orthopedic clinical specialist in private practice in Los Angeles. She serves on the clinical faculty for Kaiser Permanente Movement Science Fellowship in Los Angeles. She also serves as a guest lecturer at the local universities and teaches throughout the United States and internationally.      Frank studied under and taught with Dr. Vladimir Janda. She is a certified instructor of the Janda approach to musculoskeletal pain syndromes, a certified kinesiotaping practitioner, and a certified instructor of Kolar’s approach to dynamic neuromuscular stabilization.   Frank is board certified in orthopedic physical therapy and a fellow of the American Academy of Orthopedic Manual Physical Therapy. Robert Lardner, PT, was born in Nigeria in 1961. His first career was as a professional ballet and modern dancer after studying at the Rambert Academy outside London, England. He graduated from the department of physical therapy, Lund’s University, Sweden in 1991. He studied with Professors Janda, Lewit and Kolář from the Czech Republic, who are pioneers of functional rehabilitation and manual medicine.   Lardner worked in several inpatient and outpatient rehabilitation facilities in Sweden prior to moving to the United States in 1992. He was a staff physical therapist at McNeal Hospital, Clearing Industrial Clinic, and a physical therapy supervisor at Mercy Hospital. He also was in charge of physical therapy services at a number of private outpatient and sports clinics.   Lardner is currently in private practice in Chicago and teaches various rehabilitation seminars throughout the United States and Europe.

Part I. The Scientific Basis of Muscle Imbalance

Chapter 1. Structural and Functional Approaches to Muscle Imbalance

Intrinsic Versus Extrinsic Fuction

Muscle Balance in Function and Pathology

Muscle Imbalance Paradigms

Summary

Chapter 2. The Sensorimotor System

Sensorimotor Hardware and Software

Neuromuscular Aspects of Postural Stability and Joint Stabilization

Pathology in Proprioception

Summary

Chapter 3. Chain Reactions

Articular Chains

Muscular Chains

Neurological Chains

Summary

Chapter 4. Pathomechanics of Musculoskeletal Pain and Muscle Imbalance

Pathology of Musculoskeletal Pain

Pathomechanics of Muscular Imbalance

Causes of Muscle Tightness and Weakness

Janda’s Classification of Muscle Imbalance Patterns

Summary

Part II. Functional Evaluation of Muscle Imbalance

Chapter 5. Posture, Balance, and Gait Analysis

Muscle Analysis of Standing Posture

Evaluation of Balance

Evaluation of Gait

Summary

Chapter 6. Evaluation of Movement Patterns

Janda’s Basic Movement Patterns

 Additional Movement Tests Complementary to Janda’s Tests

Selected Manual Muscle Tests

Summary

Chapter 7. Muscle Length Testing

Muscle Length Assessment Technique

Lower-Quarter Muscles

Upper-Quarter Muscles

Hypermobility

Summary

Chapter 8. Soft-Tissue Assessment

Characteristics of Trigger Points

Assessment of Trigger Point or Tender Point Chains

Scars

Myofascia

Summary

Part III. Treatment of Muscle Imbalance Syndromes

Chapter 9. Normalization of Peripheral Structures

Central Indirect techniques

Local Direct techniques

Summary

Chapter 10. Restoration of Muscle Balance

Factors Contributing to Muscle Weakness

Additional Treatment Techniques for Muscle Weakness

Factors Contributing to Muscle Tightness

Additional Treatment Techniques for Muscle Tightness

Summary

Chapter 11. Sensorimotor Training

Role of Sensorimotor Training in Janda’s Treatment

Sensorimotor Training Components

Sensorimotor Training Progression

Summary

Part IV. Clinical Syndromes

Chapter 12. Cervical Pain Syndromes

Regional Considerations

Common Pathologies

Case Study

Summary

Chapter 13. Upper-Extremity Pain Syndromes

Regional Considerations

Assessment

Common Pathologies

Case Study

Summary

Chapter 14. Lumbar Pain Syndromes

Regional Considerations

Common Pathologies

Sacroiliac Dysfunction

Assessment

Management of Low Back Pain Syndromes

Case Study

Conclusion

Summary

Chapter 15. Lower-Extremity Pain Syndromes

Regional Considerations

Assessment

Common Pathologies

Case Study

Summary