Manual Muscle Testing (MMT): Lower Body

Why Assessment?

All fitness, performance, and rehabilitation programs should start with an assessment. The goal of assessment is to refine technique selection, with the intent of improving client and patient outcomes.

This course describes potential additions to a comprehensive movement assessment that are most commonly referred to as "manual muscle testing" (a.k.a. MMT, MMTs, muscle testing, strength testing, muscle strength testing, strength assessment, strength measures, manual resistance, etc.). The tests included in this course are intended for muscles prone to inhibition (e.g. underactive, hypotonic, phasic, exhibiting muscle weakness, etc.).

When to Use Manual Muscle Tests:

It is important that the intent of manual muscle tests, the length of a muscle group, the activity of a muscle group, and the testing position are considered prior to their application. Any muscle that has adopted a compensatory change in length or activity (altered length/tension relationship) may test "weak", "with compensation", or "with pain".

For example, if an individual presents with an Excessive Forward Lean during an Overhead Squat Assessment , and goniometry confirms a loss of hip flexor extensibility, it is likely that manual resistance of the hip flexors would result in a finding of "weakness" or "with compensation". If the intention of manual muscle testing is to address muscles assessed as "weak" or "with compensation" with strengthening exercises, then we might assume that we should strengthen the hip flexors. But, this logic is flawed. Unfortunately, strengthening the hip flexors may increase activity, further decrease hip extension mobility (by contributing additional shortening), and may result in poor carry-over of results from session to session; even if strengthening the hip flexors results in initial improvements in hip flexor strength.

Although counter-intuitive based on manual muscle testing alone, we may improve hip flexor strength more by optimizing length-tension relationships with release and lengthening techniques for the hip flexors . For these reasons, manual muscle tests are likely best applied to muscles that are implicated as inhibited by a dynamic movement assessment (e.g. the Overhead Squat Assessment ), and performed as pre/post tests to confirm the effectiveness of selected activation, strengthening, stability, integration, and/or conditioning techniques.

The Brookbush Institute recommends that these assessments are added to the repertoire of all sports medicine professionals (personal trainers, fitness instructors, physical therapists, massage therapists, chiropractors, occupational therapists, athletic trainers, etc.).

Additional Courses:

For a complete introduction to manual muscle testing (for an active population) including definitions of specific terminology, "why?" manual muscle testing, basic procedures, comparing traditional versus Brookbush Institute recommended scoring, amount of external resistance, what muscles should be tested, length/tension relationships, defining a “good assessment,” and best use check out:

• Manual Muscle Testing: Introduction

For Upper Body Manual Muscle Tests

• Manual Muscle Testing: Upper Body

Manual Muscle Tests Covered in this Course:

• Gluteus Medius
• Gluteus Maximus
• Tibial Internal Rotators
• Tibialis Posterior
• Tibialis Anterior

Printable PDF of the Movement Assessment Template:

• Movement Assessment Template