Patent Publication Number: US-2017360332-A1

Title: Gait mechanics for use in facilitating enhanced muscle contractile capabilities

Description:
RELATED APPLICATIONS 
     This application claims priority under 35 U.S.C. 119 (e) to U.S. Provisional Patent Application Ser. No. 62/350,575, entitled “GAIT MECHANICS FOR USE IN FACILITATING ENHANCED MUSCLE CONTRACTILE CAPABILITIES”, filed Jun. 15, 2016, and is related to U.S. patent application Ser. No. 15/065,665, entitled “METHODS, SYSTEMS AND KITS FOR ENHANCED MUSCLE CONTRACTILE CAPABILITIES”, filed Mar. 9, 2016, the disclosure of which is hereby incorporated by reference in its entirety. 
    
    
     TECHNICAL FIELD 
     The disclosure generally relates to methods, systems and kits for maintaining and improving the gait and gait mechanism of a subject. 
     BACKGROUND OF THE INVENTION 
     Conventional muscle treatment is based on the diagnoses and treatment of muscle pain and weakness in hopes of limiting pain and improving an individual&#39;s ability to exercise and physically perform. Where pain is the issue, pain medications and anti-inflammatories are prescribed and in some cases injected into a problematic area. Conventional techniques also attempt to directly lengthen or change a muscle via stretching, heating, kneading and/or foam rolling the target muscle. These techniques are dictated by identification and treatment on the specific muscle, or muscle location of the pain or weakness. 
     Techniques have also been developed on the principle that human movement and exercise is fundamental to health and that loss of muscle contractile efficiency may be demonstrated as a loss of motion and a decrease in physical performance. This is particularly true during aging, where our movement patterns tend to deteriorate and become more dysfunctional. Identification and treatment of muscle pain and weakness is a persistent problem, particularly when related to the aging process, in need of additional solutions. 
     The present disclosure and embodiments described herein are directed toward providing novel solutions to improving and maintaining an individual&#39;s muscle contractile abilities. 
     The present invention is directed toward overcoming one or more of the problems discussed above. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The described embodiments will be readily understood by the following detailed description in conjunction with the accompanying drawings. 
         FIG. 1  shows an illustration of raising the set-point via a strain/tissue deformation versus stress/stimulus graph. 
         FIG. 2  shows a flow diagram consistent with one embodiment described herein. 
     
    
    
     SUMMARY OF THE INVENTION 
     Embodiments herein include the identification and characterization of 43 primary movement patterns (herein “pattern(s)”) that account for movement in the human body. The classification of the 43 patterns is based on each pattern&#39;s function. Each pattern includes a primary muscle and one or more secondary muscles. The 43 movement patterns provide a bilateral hierarchy within and between each pattern, which allows for a pre-determined and sequential treatment schedule for any one muscle in a subject. 
     Use of the pre-determined and sequential schedule is combined with application of a muscle specific stress, testing, and treatment to the muscle. All embodiments herein include application of at least a muscle specific stress. As discussed in greater detail below, a muscle specific stress (MSAS, for example) is required to lock-in a target muscle for subsequent treatment. Addition of a general stress to the muscle specific stress compounds the stress relationship, and draws out the locked-in state of the muscles being stressed, tested and treated. However, a general stress is only useful in combination with a muscle specific stress. As such, all embodiments herein are based on the 43 movement patterns, and the application of at least a muscle specific stress, and where deemed appropriate, a general stress. Where both a general stress and muscle specific stress are applied together within the 43 movement patters, the combination is called a compound stress. 
     Embodiments herein provide for the application of a compound stress to a subject, within the identified bilateral hierarchy, so as to activate and lock-in a target muscle in the subject for testing and, if necessary, treatment. General stressors include, for example, various exercise regiments based on a subject&#39;s gait. Muscle Specific Stressors (MSAS) are established for each of the 43 muscle pattern&#39;s based on a muscle pattern&#39;s primary function (see below). As such, and in one embodiment, a subject participates in a gait based exercise regiment, followed by a muscle pattern hierarchy determined MSAS, where the muscle that was stressed by MSAS undergoes further testing and, if necessary, treatment, in accordance with the description herein. 
     Through the application of compound stressors, and the testing, and treatment based on the muscle pattern hierarchy, embodiments herein provide methods and systems for raising the tolerance and/or stability of one or more muscles in a subject. In some embodiments, the methods and systems are designed to enhance the contractile efficiency of some or all of a subject&#39;s muscles. In still other embodiments, the methods and systems herein are designed to tie a subject&#39;s 43 muscle groups into a subject&#39;s central pattern generator (CPG) so as to better orchestrate the subject&#39;s rhythmic movement patterns, for example the subject&#39;s gait. 
     DESCRIPTION 
     Muscle specific stress application, using the methods, systems and kits described herein, initially cause a target muscle to exceed its current set-point level, thereby creating inhibition in that target muscle. Once inhibition has been achieved, the target muscle is ready for transition to an activated state, also referred to herein as the muscle being ‘locked in.’ 
     A specific stress can be re-applied to the target muscle after the muscle has been activated, which will respond in the absence or with a lower state of inhibition to the applied stress. This process of stressing (and then treating) a target muscle allows for an increase in the target muscle&#39;s set-point towards the target muscles current maximum tolerance and stability level. The establishment of a new set point for the target muscle ultimately widens the physiological operating window of the target muscle. These methods, systems and kits described herein may be repeated over a period of time to incrementally increase a target muscle&#39;s set point (see  FIG. 1 ). As referred to herein, a widening of the physiological operating window of a target muscle means that the muscle has increase contractile efficiency and has an improved ability to tolerate greater amounts of force. As a target muscle is specifically stressed and treated, that target muscle enters a “locked-in state” where the cycle of treatment becomes more effective than for a similarly treated muscle not in a “locked in” state. 
     A process of facilitating the “locking in” state for a muscle (or group of muscles) can be achieved by application of a general stress, for example requiring a subject to move at an escalating gait over the course of a predetermined amount of time, prior to application of the specific stress. The combination of a general stress and a muscle specific stress is referred to herein as compounding the stress or simply as a compound stress. Where the compound stress is focused on the subject&#39;s gait pattern, the general stress is not only facilitating the “locked in” state for a muscle, but it is also providing an overall benefit for the subject&#39;s rhythmic-based mobility (not found when a specific stressor is applied in the absence of the general stressor). Note that a general stress does not “lock-in” a target muscle, rather a general stress draws-out the locked-in pattern. As such, a general stress is always provided or accompanied by a specific stress, but not vice versa. A general stress is applied and combined with a specific stress at the health practitioners discretion. Only upon adding a general stress to a specific stress does the stress become a compound stress. 
     In this embodiment, therefore, the subject undergoes a compound stress, is tested and then treated, as described more fully below, to facilitate tying the subject&#39;s muscle groups into the subject&#39;s central pattern generator, which orchestrates the rhythmic movement patterns necessary for the subject&#39;s gait. In various aspects, the general stress can be applied to the subject prior to the testing and treatment of each bilateral muscle pattern, for example, general stress, specific stress, testing, treatment on muscle group 1, general stress, specific stress, testing, treatment on muscle group 2, general stress, specific stress, testing, treatment on muscle group 3, and so on. 
     Methods For Activating a Target Muscle: 
     Generally, methods disclosed herein provide for the application of stress, and thereby treatment, in a pre-determined priority based on the hierarchy of muscles between each pattern, i.e., a muscle&#39;s macro-pattern. In addition, this hierarchy of muscles extends within the patterns themselves thereby establishing a micro-pattern wherein each muscle within a pattern has a hierarchy including one primary muscle and one or more secondary muscles. The patterns are ordered bilaterally from left to right (left first, then right). 
     Embodiments herein provide that each of the identified 43 movement patterns have one primary muscle (a subject has 43 primary muscles) and a corresponding number of secondary muscles. As such, the hierarchy between a subject&#39;s muscles described herein can be described between muscle patterns, between primary muscles, as well as within a pattern itself (one primary and a number of secondary muscles). A macro-pattern is the overall hierarchy between all 43 movement patterns, and a micro-pattern is the hierarchy between muscles within any one muscle pattern. All patterns are bilateral. 
     The hierarchy of muscles within the human body provides an unexpected window, from and during which, one or more of a subject&#39;s muscles, within a pattern, is more effectively treated to enhance that muscle groups set point. The hierarchy can also be utilized to methodically enhance the set point of individual patterns including some or all of a subject&#39;s muscles and thereby facilitate the subject&#39;s musculature in general or facilitate maintenance of a subject&#39;s musculature against aging and health defects (this is particularly true, where a compound stress is applied to the subject so as to improve the subject&#39;s rhythmic movement patterns necessary for the subject&#39;s gait, a typical problem of aging). 
     As such, each macro- and micro-pattern has been mapped herein to identify the order within which each muscle, after being stressed, is first tested and then, after weakness is identified, treated. In this manner each muscle within the body, targeted or not, can be treated in a way to maximize the effectiveness of the treatment. Within the compound stress, it is the muscle specific stress that is hierarchy specific, where the general stress is applied in a similar manner for all muscles (as is described further below). 
     In some embodiments the hierarchy established and mapped in the present disclosure is between two or more patterns, i.e., between any two or more primary muscles. In one embodiment, the hierarchy provides a muscle specific stress and treatment hierarchy for any two, three, four, five, six, seven, . . . forty one, forty two, forty three primary muscles in the absence of a pattern&#39;s secondary muscles. As such, priority is mapped to start the process at a first primary muscle and extend through the macro-pattern of all the primary muscles (43). Testing and treatment of a subject&#39;s macro-pattern then includes bilaterally challenging each pattern via muscle specific stress application (left first, then right), a prioritized primary muscle to identify a bilateral weakness. When a primary muscle requires treatment (see below) the treatment is applied. Regardless, once bilateral testing and treatment (if necessary) is concluded on the first or most prioritized primary muscle, the health care professional moves onto the next highest prioritized muscle group, testing for bilateral weakness. This process holds true for the hierarchy of the 43 primary muscles (see Table 1). In some embodiments all 43 primary muscles are tested and treated in the order as disclosed in Table 1, from 1-43. In other embodiments, a primary muscle is tested and treated in an order where the primary muscle having a lower group number is always tested and treated prior to a next primary muscle, for example from 1, 7, to 9. In this way a health care professional may wish to treat a primary muscle of group 22 and deem it appropriate to start the process at the primary muscle of group 3, then 4-9, then 15-22, for example. At no time would the process start with a priority number higher than the target group primary number, e.g., 27, 25 then 22, for example. However, a health care professional may deem it necessary or advantageous to continue treatment beyond the target number, for example continue on from 22 to treat 27-31 and 40-43 (in order). In some instances where the subject has been treated via the methods described herein or is an elite athlete, fewer primary muscles may need to be tested and treated. It is also envisioned that the health care professional start the process and move bilaterally from group 1 to group 22 (in this example). 
     In another embodiment, priority is mapped to start the bilateral process at a first muscle in the first muscle group, i.e., the group&#39;s left primary muscle, and extend through that group&#39;s secondary muscle hierarchy, the micro-pattern. In some embodiments, the process is then continued to the first muscle, primary muscle, in the next prioritized pattern. Embodiments herein include establishing the hierarchy between two or more of the 43 patterns, three or more of the 43 total patterns, four or more of the 43 total patterns (4/43) and so on (5/43), (6/43), (7/43), (8/43), (9/43), (10/43) . . . (42/43), (43/43). In this way, the hierarchy has been identified for and between all 43 patterns (primary and secondary muscles) providing a pattern that establishes enhanced treatment for all muscles within all 43 patterns. 
     In some embodiments, the application of a stress is used in conjunction with muscle weakness testing (AMC&amp;S) and treatment to effectively treat all muscles within all 43 patterns in the disclosed herein hierarchy. However, any combination can be achieved as long as the processes herein follows the hierarchy established and described, i.e., started with a pattern&#39;s primary muscle and, where appropriate, that pattern&#39;s secondary muscles, in a pattern prioritized above the next to be treated pattern&#39;s primary, and where appropriate, secondary muscles. As noted for the macro-pattern, the micro-patterns are established bilaterally. So, the hierarchy begins with the left primary muscle and moves to the pattern&#39;s right primary muscle, then to the left highest secondary muscle and then right highest secondary muscle, and so on. 
     As such, a first muscle (left, primary) in a pattern having the highest priority of the 43 patterns (referred to herein as pattern 1) has been identified all the way through to the last muscle (a right, secondary muscle) in the lowest priority pattern (referred to herein as muscle pattern 43). Typically and unexpectedly, maximum benefit is achieved for any one muscle group when compound stressor application and testing is applied to the associated muscles within the macro- and micro-patterns, and more beneficially when stressor and testing is applied to the muscle group after the muscles in one or more higher priority pattern is first stressed according to embodiments of the present disclosure. Further, the criteria of maximum benefit for a muscle group is achieved when stress and testing is applied to the muscle in the heretical order of two or more higher priority patterns prior to the muscle pattern within which the target muscle resides, more beneficially three or more patterns, etc. until all of the muscles within all of the higher priority patterns have been activated or locked-in. So for example, if a secondary muscle in pattern 7 is the target muscle (e.g., injured), the muscles within the first 6 patterns and then within pattern 7 would first be compound stressed or tested prior to activation (bilaterally). 
     Note also that the disclosure herein also contemplates a process where, using the example above, the first 6 pattern&#39;s primary and secondary muscles are treated in order (after a stress), bilaterally, followed by the 7 group&#39;s primary muscle and then hierarchy of secondary muscles within pattern 7, in order, including the target muscle. 
     As discussed above, there are two types of stress application, general and specific. As discussed above, specific stress application is established for each of the 43 muscle pattern&#39;s based on a muscle pattern&#39;s primary function. One such specific stress application is accomplished by a Muscle Specific Applied Stress (MSAS). MSAS is described in detail in PCT/US16/21607 (Methods, Systems and Kits for Enhanced Muscle Contractile Capabilities), which is incorporated herein by reference for all purposes. The following description focuses on general stress application in combination with MSAS, or compound stress application. 
     A general stress application in accordance with the present disclosure is through exercise. In most aspects, the exercise is based either on the specific function of the muscle groups or on an individual&#39;s gait or gait mechanics. A general stressor is applied by a health care professional. A health care professional for purposes herein refers to licensed and non-licensed providers and includes: medical doctors, doctors of osteopathy, doctors of chiropractic, doctors of physical therapy, massage therapists, nurses, trainers, strength and conditioning coaches and the like. 
     The inventor&#39;s philosophy recognizes that certain general stressors can be used to negatively affect the contractile capabilities of any of the above discussed muscle patterns. This is particularly relevant for the aging process, where, as we age, we become more dysfunctional in our movement patterns. An aging subject&#39;s movement pattern becomes less effective in function, and the muscle&#39;s ability to contract effectively during the gait movement process is altered. By using gait, in combination with a MSAS, a muscle&#39;s weakness can be exposed via AMC&amp;S testing, and undergo corresponding treatment using the hierarchy within the 43 muscle patterns (see below and Table 2). The treatment is highly effective as it both treats the subject&#39;s muscles to be more functionally effective as well as ties the subject&#39;s muscle groups into the subject&#39;s central pattern generator, which orchestrates the rhythmic movement patterns necessary for the subject&#39;s gait. As such, a compound stressor both improves muscle function and improves the mechanics of that subject&#39;s gait (and limits the dysfunctions of a gait associated with aging). 
     By using a subject&#39;s gait as a general stressor in the compound stress, repeated muscle activation, testing and treatment, ultimately trains the muscles to move from a dysfunction gait pattern to a functional gait pattern, which is then reinforced each time the subject utilizes the function of gait. 
     Although not wishing to be held to any one theory, Applicant believes that the repetitive nature of compound stress, testing, and treating, ties the muscles required to accomplish a functional gait pattern to a deep network of neurons in the spinal cord called the Central Pattern Generator. The rhythmic movements that occur with gait, or other like general stressor, are governed by the Central Pattern Generator in the spinal cord. With continued performance of the embodiments therein, the programming in the Central Pattern Generator, and thereby the motor neurons, is modified to instruct the muscles to a more functional gait pattern. As this relates to aging, the embodiments herein allow for the reprogramming of the muscle patterns to a functional gait pattern, thereby stopping, if not reversing, the downward progression of muscle function or dysfunction associated with aging. 
     As such, and in one embodiment, a general stressor is combined with a specific stressor. The general stressor, for example, gait mechanics, is applied in a consistent manner for a subject in need thereof. The primary focus in this embodiment is to stress the subject&#39;s muscle pattern through implementation of a high speed walk on a treadmill. The high speed pace of the walk, takes away the subject&#39;s ability to compensate for the weaknesses during gait, i.e., a dysfunctional gait, thereby exposing the weak links that have led to the compensatory motions associated with their normal gait pattern. 
     For purposes herein, a high speed walk, is a walk that on a scale of 1 to 10, with 1 being a slow stroll and 10 being a jog, would constitute a 5 or faster, and in some cases a 6, 7 or 8 or faster. The speed of the walk is somewhat dependent on the subject, but in most instances is meant to require enough stress be put on the subject&#39;s muscles, that the weak muscles cannot compensate for a weakened or dysfunctional muscle. A dysfunctional gait pattern for purposes herein is a gait pattern that, when compared to a subject&#39;s normal gait pattern or a standardized gait, results in pain, diminished power, diminished strength, or a gait pattern outside the typical two period pattern (double limb support and single limb support). In typical embodiments, the high speed walk is performed for 15 seconds to 2 minutes and more typically from 30 seconds to one minute, or until it is clear that the subject&#39;s muscles have been stressed sufficiently to avoid one muscle compensating for any other muscle. In some aspects, the speed of the walk is increased over a period of about 15 seconds to one minute until the subject can no longer maintain the walking gait pattern (typically performed on a treadmill that the subject and/or health professional can control). 
     Also for purposes herein, not all gait stressors need be performed on a treadmill. In some cases, in which there is a significant weakness in the clients muscular system, performing a gait around the office, track, hallway, etc. is sufficient to establish the required stress. 
     Once a subject undergoes the gait stressor, he or she is promptly challenged by the muscle specific stress (MSAS) as established by the 43 muscle patterns. In order to determine whether a muscle is showing weakness based on the compound stress, several assessment techniques can be used. In one embodiment, Active Muscle Contract and Sustain Test (AMC&amp;S) is utilized to identify a target muscle&#39;s weakness. Note that the MSAS and AMC&amp;S are performed in conjunction with each other, and can be altered such that embodiments contemplate: general stressor, MSAS, AMC&amp;S and treatment, or general stressor, AMC&amp;S, MSAS and treatment. Both AMC&amp;S and MSAS are muscle specific and based on the same 43 muscle pattern. 
     Typically a AMC&amp;S is a muscle testing technique that is specific to embodiments described herein. AMC&amp;S involves a specific force application of a specific magnitude and rate of force application, set-up and delivered by a health care specialist (see Example 2). The health care specialist assesses the target muscle&#39;s ability to react to and meet that force. AMC&amp;S is not a manual muscle “break” test or manual muscle test used as an indication of the body&#39;s response to a chemical substance, nor a change in its energetic field, nor a positional post isometric relaxation technique. AMC&amp;S testing is performed in order of the 43 patterns as established in Table 1. 
     In accordance with the present disclosure, after an appropriate compound stressor period, AMC&amp;S is promptly initiated by the health care practitioner placing the subject in the proper testing position for muscle pattern 1, for example. The subject must relax and then hold the muscle against an applied stress with maximal effort. The health care practitioner takes care not to force the target muscle in multiple directions and should only use passive motion in the plane that matches the applied testing force (for example, adduction on posterior tibialis). It is also important that the subject utilize unconscious control as much as possible and avoid consciously interfering with the muscle&#39;s reaction to the applied stress through compensatory motion. Note that the subject&#39;s testing position is dictated by his or hers available Range of Motion (“ROM,”) therefore the testing positions will be different with each subject. This may require the health care professional to challenge all testing positions in a pattern (Example 2). 
     In one embodiment herein, prior to the assessment, a Passive Comparative Assessment of Mobility (CAM) is performed. CAM is a range of motion assessment that is specific to embodiments disclosed herein. CAM is a specific force application leading to the measurement of active or passive limb motion from a designated start position/posture, through a designated plane and direction, to the end of the limb motion. The measurement is then compared to the mirror image limb motion for the limb on the opposite side of the body. CAM is not a joint range of motion examination performed to evaluate passive tissue stability, joint surface pathology, ligamentous integrity, etc. CAM is typically used on a first visit to a health care professional prior to the AMC&amp;S. However, CAM is optional for all other embodiments as described herein. 
     Once a subject is shown to be properly stressed by the compound stress, and specific muscles locked in, and the weak muscles are identified through use of AMC&amp;S via the predetermined muscle patters, the embodiments herein contemplate treatment of said muscles via a Digital Force Application To Muscle Attachment Technique (DFAMAT) or a Positional Isoangular Contraction (PIC) technique (Table 3). 
     Typically a treatment in PIC is an activation technique specific to embodiments described herein. PIC involves a specific limb position/orientation (based on the macro and micro patterns shown and discussed herein) and direction of motion generated by the subject, into a barrier to that motion, set-up and maintained by a health care specialist. The health care specialist may use their hands and body to hold/guide limb orientation/positions and provide the barriers to motion during the isoangular contraction. PIC is not a muscle energy technique, strain/counter-strain technique or a post isometric relation technique. 
     Typically a treatment through DFAMAT is also an activation technique specific to embodiments described herein. DFAMAT involves a specific force application to a target muscle using the health care professional&#39;s fingers. The health care professional applies direct pressure perpendicular to a target muscle&#39;s attachment (tendons, aponeuroses) using the tips of the fingers instituting motion creating subtle tension on the attachment tissues, followed with motion lines that are perpendicular to each other, maintaining the tension for a duration of 1 to 4 seconds per site, and more typically 1 to 2 seconds per site, releasing and then re-initiating the process, moving along the width/length of the target muscle attachment. DFAMAT is not a soft tissue evaluation nor a manipulation to release trigger points, adhesions, Active Release Technique, move body fluids to and from tissue sites, etc. 
     Note that DFAMAT is not used to evaluate and interpret the state of soft tissues, nor to create a relaxation response for the target muscle. The premise of DFAMAT is that it stimulates sensory receptors that in turn increase motor neuronal pool activation to the target muscle associated with the attachment. This represents the opposite effect that most, if not all, massage techniques are attempting to achieve as an outcome (relaxation). 
     In accordance with the present disclosure and DFAMAT, a treatment is applied to the target muscle via palpation to the relevant bone where the target muscle is attached. Identification of the target muscle attachment point requires specific palpation such that as micro-pattern of muscles is being tested then re-tested. Other treatment procedures for increasing a target muscle&#39;s set point include isometric and isotonic contractions and the like. Treatments may also include the injection (e.g. intramuscular, intradermal, intravenous) or ingestion of an appropriate biologic. 
     Biologics contemplated for use herein on an activated or locked-in muscle include: autologous and non-autologous stem cells, anti-inflammatories including anti-rheumatic drugs, immunosuppressants like Methotrexate and azathioprine, anti-cytokines to reduce inflammation like anti-Tumor Necrosis Factor (anti-TNF), medications to repair muscle damage like steroids, platelet-rich plasma or bone-marrow aspirate, chemotherapeutics for treatment of cancer residing in the muscle, for example melanoma (Alemtuzumab, for example), and the like. 
     Once a subject has undergone a general stress, AMC&amp;S test, MSAS and appropriate treatment according to the predetermined 43 muscle patterns (bilateral), the subject can be treated likewise over a course of days, weeks or years. In some embodiments, the combination of general stress, MSAS, testing and treatment can be performed once a day, twice a week, or once a week, for example. The gait stress, in combination with the MSAS, testing and treatment regiments described herein, tie the subject&#39;s muscles into the subject&#39;s CPG. 
     In order to maximize the effect of the general stressor, the gait stress may be performed by the subject between the testing and treatment of each muscle pattern, so for example, a subject may perform a high speed walk for 30 seconds, have AMC&amp;S testing, MSAS, and DFAMAT treatment performed on the muscles, bilaterally, on the first muscle pattern (1). Once complete, the subject would be required to perform a second high speed walk for another 30 seconds, have AMC&amp;S testing, MSAS, and DFAMAT treatment performed on the muscles in accordance with the second muscle pattern (bilaterally). This process of gait stress, MSAS, testing and treatment could be performed on each muscle pattern, 1-43, or according to the patterns previously discussed above (for example, where a returning client has come in, moving from pattern 1 to 7 to 8 to 30). 
     In another example, and as shown in  FIG. 2 , and in some aspects shown herein, gait mechanics are facilitated in a subject  200  by exposing the subject to MSAS for a highest priority muscle pattern, one for example, bilaterally  202 . The muscles are tested by AMC&amp;S  204  and, where required, treated using DFAMAT  206 . For this subject, the combination of specific stress, testing and treatment establishes the priority for the pattern  208 . The entire muscle pattern can be performed, bilateral macro or bilateral micro, using MSAS, AMC&amp;S and DFAMAT. 
     In some embodiments, and where applicable, the subject is then exposed to an escalating speed treadmill for 15 seconds to 2 minutes and more typically 30 seconds to one minute. In some embodiments, the goal of the treadmill stressor is to keep the subject from keeping up with the treadmill speed  210 . The subject is then tested using AMC&amp;S (weak)  212  specifically stressed using MSAS and treated using DFAMAT  214  over the same previously used MSAS, AMC&amp;S and DFAMAT pattern. The subject would then have the next highest priority muscle group undergo the same iteration of Gait stress, AMC&amp;S, MSAS, and DFAMAT. This pattern would hold for all 43 muscle patterns or any combination of the 43 muscle patterns (in correct hierarchy). 
     In some circumstances, where the health care professional feels the need, the challenged muscle pattern is again stressed by MSAS, tested, and treated  216 . In this embodiment, the subject would undergo (in muscle pattern hierarchy): MSAS, AMC&amp;S, DFAMAT, prior to moving on to the next muscle pattern. This re-exposure will be performed until the MSAS holds strong. 
     When the muscles in the muscle pattern have been sufficiently treated, he or she may always move onto the next muscle pattern. In this aspect, the gait stress may be re-applied 218. By combining the specific and general stressors, the subject will have trained his or her muscles to be in-tune with the Central Pattern Generator, and thereby begin the process of moving their gait to a more functional gait pattern. 
     The combination of general stressor, specific stressor, testing, treatment through the hierarchy of the 43 muscle patterns provides an excellent tie for facilitating and correcting a subject&#39;s gait patterns and overall functional capabilities. This methodology has proven particularly effective at correcting and improving gait patterns in subjects that have dysfunction gait mechanics due to aging or are dysfunction due to injury. 
     In an additional embodiment, the muscle pattern need not strictly follow 1-43, but could include skipped muscles as long at the pattern is performed in the previously described 1-43 direction, 2, 8, 16, 35 . . . and not the opposite direction, 37, 28, 14, 2, for example. Also note, a general stressor is always combined with a muscle specific stressor. A muscle specific stressor need not always be combined with a general stressor. So for example, in some embodiments, a health care professional may determine that muscle patterns 1-7 only require MSAS, AMC&amp;S and DFAMAT. At muscle patterns 8 and 9, the health care professional may add the general stressor to the MSAS, AMC&amp;S and DFAMAT, before returning to the MSAS, AMC&amp;S and DFAMAT pattern for muscle patterns 10-42. Typically, in this embodiment, bilateral muscle weakness in a muscle pattern alerts the health care professional that the general stressor, MSAS, AMC&amp;S and DFAMAT is required (groups 8 and 9 in this example). As such, in some embodiments, MSAS, AMC&amp;S and DFAMAT is performed until bilateral muscle weakness is exposed, and then the muscle pattern is subjected to gait testing, MSAS, AMC&amp;S and DFAMAT. As can be imagined, other testing and treatment techniques can be replaced for AMC&amp;S and DFAMAT as disclosed herein, in these embodiments. 
     While the invention has been particularly shown and described with reference to a number of embodiments, it would be understood by those skilled in the art that changes in the form and details may be made to the various embodiments disclosed herein without departing from the spirit and scope of the invention and that the various embodiments disclosed herein are not intended to act as limitations on the scope of the claims. 
     EXAMPLES 
     Example 1 
     Movement Pattern Hierarchy and Tables 2-3 Showing Illustrative Tests 
     The following hierarchy has been established for the 43 movement patterns as classified for purposes herein. This hierarchy from pattern 1 to 43 represents the macro-pattern: 
                     TABLE 1                  (Movement Patterns, Left then Right)                         Group/Pattern               Number   Muscle Pattern Macro-Order   Primary Muscle                                 1   Trunk Rotation   Transverse Abdominis - Lower               Division       2   Trunk Flexion   Psoas Minor       3   Hip Flexion   Psoas Major: Lumbar Division       4   Hip Rotation   Obturator Externus       5   Spinal Sidebend   Longissimus Thoracis       6   Downward Rotation of the Scapula   Levator Scapula: Superior Division       7   Humeral External Rotation   Infraspinatus: Superior Division       8   Spinal Extension   Intertransversatii: Lumborum       9   Hip Extension   Gluteus Maximus: Iliac Division       10   Humeral Extension and Adduction   Latissimus Dorsi: Iliac Division       11   Humeral Internal Rotation   Subscapularis: Superior Division       12   Elbow Extension   Triceps Brachii: Medial Division       13   Upward Rotation of the Scapula   Upper Trapezius: Clavicular               Division       14   Humeral Abduction   Supraspinatus: Fossa Division       15   Protraction of the Scapula   Pectoralis Minor: Inferior Division       16   Horizontal Adduction   Pectoralis Major: Sternal Division       17   Elbow Flexion   Brachialis       18   Hip Adduction   Adductor Magnus: Oblique Division       19   Hip Abduction   Gluteus Medius: Anterior Division       20   Knee Extension   Rectus Femoris: Straight Division       21   Knee Flexion   Semitendinosus       22   Supination of the Foot   Posterior Tibialis: Fibular Division       23   Plantarflexion   Medial Soleus       24   1 st  Ray Dorsiflexion   Anterior Tibialis: Tibial Division       25   Pronation   Peroneus Brevis: Lateral Division       26   Dorsiflexion   Peroneus Tertius: Lateral Division       27   1 st  Ray Plantarflexion   Peroneus Longus: Metatarsal               Division       28   Big Toe Extension   Extensor Hallucis Longus: Fibular               Division       29   Toe Extension   Extensor Digitorum Longus: Lateral               Division       30   Big Toe Flexion   Flexor Hallucis Longus: Fibular               Division       31   Toe Flexion   Flexor Digitorum Longus: Lateral               Division       32   Cervical Flexion   Longus Capitis       33   Cervical Rotation   Multifidus Cervicis: Inferior Fibers       34   Cervical Extension   Semispinalis Capitis       35   Cervical Sidebend   Posterior Scalene       36   Wrist Extension with Abduction   Extensor Carpi Radialis Longus:               Abductor Division       37   Wrist Flexion with Abduction   Flexor Carpi Radialis Longus:               Abductor Division       38   Forearm Supination   Anconeus: Ulnar Division       39   Forearm Pronation   Pronator Teres: Humeral Division       40   Extension and Abduction of the Thumb   Extensor Pollicis Longus: Ulnar               Division       41   Flexion and Abduction of the Thumb   Flexor Pollicis Longus       42   Finger Extension   Extensor Digitorum: Medial               Division       43   Finger Flexion   Flexor Digitorum Profundus: Medial               Division                    
Hierarchy within a Movement Pattern (Micro-Pattern) (Bilateral, Left first and then Right):
         Pattern 1 (Trunk Rotation):   Transverse Abdominis Lower Division
           Internal Oblique: Anterior Division   External Olique: Anterior Division   Semispinalis Thoracis   Transverse Abdominis: Upper Division   Sternalis   4 th  Rectus: Lateral Division   4 th  Rectus: Medial Division   
           Pattern 2 (Trunk Flexion):   Psoas Minor
           Pyramidalis   1 st  Rectus Abdominis   2 nd  Rectus Abdominis   3 rd  Rectus Abdominis   
           Pattern 3 (Hip Flexion)   Psoas Major: Lumbar Division
           Psoas Major: Thoracic Division   Psoas Major: Diaphragmatic Division   Iliacus Major   Iliacus Minor   Tensor Fascia Latae: Posterior Division   Tensor Fascia Latae: Anterior Division   
           Pattern 4 (Hip Rotation)   Obturator Externus
           Quadratus Femoris   Piriformis   Gemellus Inferior   Gemellus Superior   Adductor Minimus   Obturator Internus   
           Pattern 5 (Spinal Sidebend)   Longissimus Thoracis
           Longissimus Lumborum   Internal Obliques: Lateral Division   External Obliques: Lateral Division   Iliocostalis Thoracis   Iliocostalis Lumborum   Multifidus Thoracis   Multifidus Lumborum   Quadratus Lumborum: Spinal Division   Serratus Posterior: Inferior Division   Serratus Posterior: Superior Division   Quadratus Lumborum: Costal Division   
           Pattern 6 (Downward Rotation of the Scapula)   Levator Scapula: Superior Division
           Levator Scapula: Inferior Division   Rhomboid Minor   Rhomboid Major   
           Pattern 7 (Humeral External Rotation)   Infraspinatus: Superior Division
           Infraspinatus: Superior-Middle Division   Infraspinatus: Inferior-Middle Division   Infraspinatus: Inferior Division   Teres Minor   
           Pattern 8 (Spinal Extension)   Intertransversarii Lumborum
           Interspinalis Lumborum   Spinalis Thoracis   Spinalis Lumborum   Rotatores Thoracis   Rotatores Lumborum   
           Pattern 9 (Hip Extension)   Gluteus Maximus: Iliac Division
           Gluteus Maximus: Sacral Division   Gluteus Maximus: Coccygeal Division   
           Pattern 10 (Humeral Extension and Adduction)   Latissimus Dorsi: Iliac Division
           Latissimus Dorsi: Lumbar Division   Latissimus Dorsi: Thoracic Division   Teres Major: Inferior Division   Teres Major: Superior Division   Tricep Brachii: Long Head   
           Pattern 11 (Humeral Internal Rotation)   Subscapularis: Superior Division
           Subscapularis: Superior/Middle Division   Subscapularis: Inferior/Middle Division   Subscapularis: Inferior Division   
           Pattern 12 (Elbow Extension)   Triceps Brachii: Medial Division
           Triceps Brachii: Lateral Division   Articularis Cubiti   
           Pattern 13 (Upward Rotation of the Scapula)   Upper Trapezius: Clavicular Division
           Upper Trapezius: Scapular Division   Middle Trapezius   Lower Trapezius   Serratus Anterior: Superior Division   Serratus Anterior: Inferior Division   Subclavius: Lateral Division   Subclavius: Medial Division   
           Pattern 14 (Humeral Abduction)   Supraspinatus: Fossa Division
           Supraspinatus: Spinal Division   Posterior Deltoid: Medial Division   Posterior Deltoid: Lateral Division   Middle Deltoid: Posterior Division   Middle Deltoid: Anterior Division   Anterior Deltoid: Acromial Division   Anterior Deltoid: Clavicular Division   
           Pattern 15 (Protraction of the Scapula)   Pectoralis Minor: Inferior Division
           Pectoralis Minor: Superior Division   
           Pattern 16 (Horizontal Adduction)   Pectoralis Major: Sternal Division
           Pectoralis Major: Clavicular Division   Pectoralis Major: Costal Division   Bicep Brachii: Long Head   Bicep Brachii: Short Head   Coracobrachialis: Inferior Division   Coracobrachialis: Superior Division   
           Pattern 17 (Elbow Flexion)   Brachialis
           Brachioradialis: Superior Division   Brachioradialis: Inferior Division   
           Pattern 18 (Hip Adduction)   Adductor Magnus: Oblique Division
           Adductor Magnus: Vertical Division   Adductor Longus: Superior Division   Adductor Longus: Inferior Division   Adductor Brevis   Pectineus   Gracilis   
           Pattern 19 (Hip Abduction)   Gluteus Medius: Anterior Division
           Gluteus Medius: Posterior Division   Gluteus Medius: Anterior Division   Gluteus Minimus: Anterior Division   Gluteus Minimus: Posterior Division   
           Pattern 20 (Knee Extension)   Rectus Femoris: Straight Division
           Rectus Femoris: Reflected Division   Vastus Intermedius: Medial Division   Vastus Intermedius: Lateral Division   Vastus Medialis: Superior Division   Vastus Medialis: Middle Division   Vastus Medialis: Inferior Division   Vastus Lateralis: Superior Division   Vastus Lateralis: Middle Division   Vastus Lateralis: Inferior Division   Articularis Genu   
           Pattern 21 (Knee Flexion)   Semitendinosus
           Semimembranosus: Lateral Division   Semimembranosus: Medial Division   Biceps Femoris: Short Head   Biceps Femoris Long Head: Fibular Division   Biceps Femoris Long Head: Tibial Division   Sartorius   Popliteus   
           Pattern 22 (Supination)   Posterior Tibialis: Fibular Division
           Posterior Tibialis: Tibial Division   
           Pattern 23 (Plantarflexion)   Medial Soleus
           Lateral Soleus   Lateral Gastroc   Medial Gastroc   Plantaris   
           Pattern 24 (1 st  Ray Dorsiflexion)   Anterior Tibialis: Tibial Division
           Anterior Tibialis: Interossei Division   
           Pattern 25 (Pronation)   Peroneus Brevis: Lateral Division
           Peroneus Brevis: Posterior Division   
           Pattern 26 (Dorsiflexion)   Peroneus Tertius: Lateral Division
           Peroneus Tertius: Anterior Division   
           Pattern 27 (1 st  Ray Plantarflexion)   Peroneus Longus: Metatarsal Division
           Peroneus Longus: 1st Cuneiform Division   
           Pattern 28 (Big Toe Extension)   Extensor Hallucis Longus: Fibular Division
           Extensor Hallucis Longus: Interoseii Division   Extensor Hallucis Brevis   
           Pattern 29 (Toe Extension)   Extensor Digitorum Longus: Lateral Division
           Extensor Digitorum Longus: Medial Division   Extensor Digitorum Brevis   Dorsal Interoseii 2-5   
           Pattern 30 (Big Toe Flexion)   Flexor Hallucis Longus: Fibular Division
           Flexor Hallucis Longus: Interosseii Division   Flexor Hallucis Brevis: 1 st  Cuneiform Division   Flexor Hallucis Brevis: Cuboid Division   Flexor Hallucis Brevis: 3 rd  Cuneiform/Tensonal Division   Adductor Hallucis Longus: Oblique Head   Adductor Hallucis Longus: Transverse Head, Lateral   Adductor Hallucis Longus: Transverse Head, Medial   Abductor Hallucis Longus: Invertor Division   Abductor Hallucis Longus: Adductor Division   
           Pattern 31 (Toe Flexion)   Flexor Digitorum Longus: Lateral Division
           Flexor Digitorum Longus: Medial Division   Flexor Digitorum Brevis: Lateral Division   Flexor Digitorum Brevis: Medial Division   Quadratus Plantae: Lateral Division   Quadratus Plantae: Medial Division   Lumbricals: 5-2   Plantar Interoseii: 5-3   Abductor Digiti Minimi   Flexor Digiti Minimi Brevis   
           Pattern 32 (Cervical Flexion)   Longus Capitis
           Longus Colli: Superior Oblique Fibers   Longus Colli: Vertical Fibers   Longus Colli: Inferior Fibers   Mylohyoid   Sternohyoid   Rectus Capitis Anterior   
           Pattern 33 (Cervical Rotation)   Multifidus Cervicis: Interior Fibers
           Multifidus Cervicis: Superior Fibers   Sterno-cleadomastoid: Sternal Fibers   Sterno-cleadomastoid: Clavicular Fibers   Longissimus Capitis   Longissimus Cervicis   Splenius Capitis: Occipital Fibers   Splenius Capitis: Mastoid Fibers   Splenius Cervicis   Iliocostalis Cervicis   Rotatores Cervicis   Rectus Capitis Posterior Major   Obliques Capitis Inferior   
           Pattern 34 (Cervical Extension)   Semispinalis Capitis
           Semispinalis Cervicis   Spinalis Capitis   Spinalis Cervicis   Interspinalis Cervicis   Obliques Capitis Superior   Rectus Capitis Posterior Minor   
           Pattern 35 (Cervical Sidebend)   Posterior Scalene
           Middle Scalene   Anterior Scalene   Anterior Intertransversarii   Posterior Intertransversarii   Omohyoid   Rectus Capitis Lateralis   
           Pattern 36 (Wrist Extension with Abduction)   Extensor Carpi Radialis Longus: Abductor Division
           Extensor Carpi Radialis Longus: Extensor Division   Extensor Carpi Ulnaris Longus: Adductor Division   Extensor Carpi Ulnaris Longus: Extensor Division   Extensor Carpi Radialis Brevis   
           Pattern 37 (Wrist Flexion with Abduction)   Flexor Carpi Radialis Longus: Abductor Division
           Flexor Carpi Radialis Longus: Flexor Division   Flexor Carpi Ulnaris Longus: Adductor Division   Flexor Carpi Ulnaris Longus: Flexor Division   Palmaris Longus   
           Pattern 38 (Forearm Supination)   Anconeus: Ulnar Division
           Anconeus: Olecranon Division   Supinator: Olecranon Division   Supinator: Ulnar Division   
           Pattern 39 (Forearm Pronation)   Pronator Teres: Humeral Division
           Pronator Teres: Ulnar Division   Pronator Quadratus: Proximal Division   Pronator Quadratus: Distal Division   
           Pattern 40 (Extension and Abduction of the Thumb)   Extensor Pollicis Longus: Ulnar Division
           Extensor Pollicis Longus: Septal Division   Extensor Pollicis Brevis: Radial Division   Extensor Pollicis Brevis: Septal Division   Abductor Pollicis Longus: Radial Division   Abductor Pollicis Longus: Ulnar Division   
           Pattern 41 (Flexion and Abduction of the Thumb)   Flexor Pollicis Longus
           Abductor Pollicis Brevis   Flexor Pollicis Brevis   Adductor Pollicis: Oblique Head   Adductor Pollicis: Transverse Head   Interosseus Pollicis   Opponens Pollicis: Flexor Division   Opponens Pollicis: Abductor Division   
           Pattern 42 (Finger Extension)   Extensor Digitorum: Medial Division
           Extensor Digitorum: Lateral Division   Extensor Indicis   Extensor Digiti Minimi   Dorsal Interoseii: 1-4   
           Pattern 43 (Finger Flexion)   Flexor Digitorum Profundus: Medial Division
           Flexor Digitorum Profundus: Lateral Division   Flexor Digitorum Superficialis: Medial Division   Flexor Digitorum Superficialis: Lateral Division   Lumbricals: 4-1   Palmar Interoseii: 4-2   Flexor Digiti Minimi   Abductor Digiti Minimi: Flexor Division   Abductor Digiti Minimi: Abductor Division   Oponens Digiti Minimi Manus: Flexor Division   Oponens Digiti Minimi Manus: Abductor Division   Palmaris Brevis   
               

     
       
         
           
               
             
               
                 TABLE 2 
               
             
            
               
                   
               
               
                 Illustrative DFAMAT 
               
            
           
           
               
               
               
               
            
               
                 DFAMAT Pattern 
                   
                   
                   
               
               
                 Number/Muscle 
                 Origin 
                 Insertion 
                 Tips 
               
               
                   
               
               
                 1 (Transverse 
                 Thoraco-lumbar 
                 Linea alba below 
                 Spinous process of 
               
               
                 Abdominis: Lower 
                 fascia, anterior ¾ of 
                 umbilicus and into the 
                 T12-L5 and sacrum 
               
               
                 Fibers) 
                 iliac crest and lateral 
                 pubic symphysis 
                 Anterior ¾ of iliac 
               
               
                   
                 inguinal ligament 
                   
                 crest 
               
               
                   
                   
                   
                 Inguinal ligament 
               
               
                   
                   
                   
                 Superior to pubic 
               
               
                   
                   
                   
                 bone 
               
               
                   
                   
                   
                 Up linea alba to 
               
               
                   
                   
                   
                 umbilicus 
               
               
                 2 (Internal Obliques: 
                 Lateral ⅔ of inguinal 
                 With transverse 
                 Sidelying, palpate 
               
               
                 Anterior Fibers) 
                 ligament and anterior 
                 abdominis into crest 
                 xyphoid process, 
               
               
                   
                 iliac crest 
                 of pubis and into linea 
                 down linea alba to 
               
               
                   
                   
                 alba through an 
                 umbilicis. 
               
               
                   
                   
                 aponeurosis 
                 Palpate from xyphoid 
               
               
                   
                   
                   
                 process down and out 
               
               
                   
                   
                   
                 along costal cartilage 
               
               
                   
                   
                   
                 of ribs 
               
               
                   
                   
                   
                 Palpate anterior ¾ of 
               
               
                   
                   
                   
                 superior iliac crest 
               
               
                   
                   
                   
                 Palpate spinous 
               
               
                   
                   
                   
                 processes of T12-L5 
               
               
                 3 (Exterior Obliques: 
                 Interdigitates surface 
                 Into linea alba 
                 Sidelying, use 
               
               
                 Anterior Fibers) 
                 of ribs 5-8 
                 through aponeurosis 
                 xyphoid process as 
               
               
                   
                   
                   
                 landmark, move up 
               
               
                   
                   
                   
                 and over to 5 th  rib, 
               
               
                   
                   
                   
                 anterior to the serratus 
               
               
                   
                   
                   
                 Palpate anterior aspect 
               
               
                   
                   
                   
                 of ribs 5-8; angling 
               
               
                   
                   
                   
                 back towards the 
               
               
                   
                   
                   
                 spine 
               
               
                   
                   
                   
                 Palpate 
               
               
                   
                   
                   
                 superior/anterior ½ of 
               
               
                   
                   
                   
                 ilium to ASIS 
               
               
                   
                   
                   
                 Supine, palpate down 
               
               
                   
                   
                   
                 aponeurosis and 
               
               
                   
                   
                   
                 inguinal ligament 
               
               
                 4 (Semispinalis 
                 Arise from transverse 
                 1-10 thoracic and 
                 Spinous processes 
               
               
                 Thoracis) 
                 process of all thoracic 
                 lower 4 cervical 
                 from C4 down to T10 
               
               
                   
                 vertebrae 
                 spinous processes 
                 Palpate transverse 
               
               
                   
                   
                   
                 processes from C7- 
               
               
                   
                   
                   
                 T1 to T12 
               
               
                 5 (Transverse 
                 Cartilage of lower 6 
                 Linea alba superior to 
                 Supine, palpate 
               
               
                 Abdominis: Upper 
                 ribs 
                 umbilicus 
                 xyphoid process, 
               
               
                 Fibers) 
                   
                   
                 palpate along cartilage 
               
               
                   
                   
                   
                 of ribs to angle 
               
               
                   
                   
                   
                 Down linea alba from 
               
               
                   
                   
                   
                 xyphoid to umbilicus 
               
               
                 6 (Sternalis) 
                 Manubrium and 
                 Superior medial fascia 
                 Supine, palpate at 
               
               
                   
                 inferior-medial 
                 of 4 th  rectus 
                 inferior-medial 
               
               
                   
                 clavicle 
                   
                 clavicle and moving 1 
               
               
                   
                   
                   
                 inch lateral on 
               
               
                   
                   
                   
                 clavicle 
               
               
                   
                   
                   
                 Palpate superior- 
               
               
                   
                   
                   
                 medial portion of 4 th   
               
               
                   
                   
                   
                 section of the rectus 
               
               
                   
                   
                   
                 abdominis 
               
               
                 7 (Rectus Abdominis; 
                 From 3 rd  section of 
                 Into costal-cartilage of 
                 Supine, use xyphoid 
               
               
                 Fourth Section 
                 rectus abdominis 
                 6 th  and 7 th  rib 
                 process as landmark, 
               
               
                 Lateral) 
                   
                   
                 move across to 
               
               
                   
                   
                   
                 anterior portion of 6 th   
               
               
                   
                   
                   
                 &amp; 7 th  rib 
               
               
                   
                   
                   
                 Palpate down lateral 
               
               
                   
                   
                   
                 aponeurosis and 
               
               
                   
                   
                   
                 across inferior 
               
               
                   
                   
                   
                 attachment 
               
               
                   
                   
                   
                 Palpate up linea alba 
               
               
                   
                   
                   
                 to xyphoid process 
               
               
                 8 (Rectus Abdominis: 
                 From 3 rd  section of 
                 Into cartilage of 5 th  rib 
                 Supine, use xyphoid 
               
               
                 Fourth Section: 
                 rectus abdominis: 
                 and side of xyphoid 
                 process as landmark, 
               
               
                 Medial) 
                 lateral half 
                 process 
                 move across and up to 
               
               
                   
                   
                   
                 lower level of 5 th  rib 
               
               
                   
                   
                   
                 against sternum 
               
               
                   
                   
                   
                 Palpate down lateral 
               
               
                   
                   
                   
                 aponeurosis and 
               
               
                   
                   
                   
                 across inferior 
               
               
                   
                   
                   
                 attachment 
               
               
                   
                   
                   
                 Palpate up linea alba 
               
               
                   
                   
                   
                 to xyphoid process 
               
               
                 9 (PSOAS MINOR) 
                 Anterior-lateral 
                 The pectineal line, the 
                 Xyphoid process to 
               
               
                   
                 bodies of T12 &amp; L1 
                 ilio-pectineal 
                 anterior body of T12, 
               
               
                   
                 (L2) vertebrae and 
                 eminence and the iliac 
                 L1 &amp; L2 
               
               
                   
                 associated disc 
                 fascia 
                 Move down, palpate 
               
               
                   
                   
                   
                 deep to superior 
               
               
                   
                   
                   
                 ramus of pubis and 
               
               
                   
                   
                   
                 inguinal ligament 
               
               
                 10 (Pyramidalis) 
                 Front of pubis and 
                 Linea alba midway 
                 Supine, palpate 
               
               
                   
                 anterior pubic 
                 between pubic bone 
                 superior medial pubic 
               
               
                   
                 ligament 
                 and umbilicus 
                 bone 
               
               
                   
                   
                   
                 Up linea alba 1/3 up 
               
               
                   
                   
                   
                 toward umbilicus 
               
               
                   
                   
                   
                 Angle downward to 
               
               
                   
                   
                   
                 lateral pubis 
               
               
                   
                   
                   
                 Always palpating into 
               
               
                   
                   
                   
                 muscle belly when 
               
               
                   
                   
                   
                 working abdominal 
               
               
                   
                   
                   
                 wall 
               
               
                 11 (Rectus 
                 Inner origin of 2 nd   
                 Pubic crest and 
                 Supine, use umbilicus 
               
               
                 Abdominis: First 
                 section of rectus 
                 symphysis. Also 
                 as a landmark, find 
               
               
                 Division) 
                 abdominis 
                 lateral expansion to 
                 fascial line just below 
               
               
                   
                   
                 opposite side 
                 Palpate across to 
               
               
                   
                   
                   
                 aponeurosis 
               
               
                   
                   
                   
                 Follow downward to 
               
               
                   
                   
                   
                 pubic bone 
               
               
                   
                   
                   
                 Across pubic bone 
               
               
                   
                   
                   
                 and back up linea alba 
               
               
                   
                   
                   
                 Always palpating into 
               
               
                   
                   
                   
                 muscle belly when 
               
               
                   
                   
                   
                 working abdominal 
               
               
                   
                   
                   
                 wall 
               
               
                 12 (Rectus 
                 From 1 st  section of 
                 Into 2 nd  section of 
                 Find bottom of 2 nd   
               
               
                 Abdominis: Second 
                 rectus abdominis 
                 rectus abdominis 
                 level 
               
               
                 Division) 
                   
                   
                 Palpate across, up side 
               
               
                   
                   
                   
                 of aponeurosis 
               
               
                   
                   
                   
                 Palpate for superior 
               
               
                   
                   
                   
                 fascia, palpate across 
               
               
                   
                   
                   
                 and down linea alba 
               
               
                   
                   
                   
                 Always palpating into 
               
               
                   
                   
                   
                 muscle belly when 
               
               
                   
                   
                   
                 working abdominal 
               
               
                   
                   
                   
                 wall 
               
               
                 13 (Rectus 
                 From 3 rd  section of 
                 Into 4 th  section of 
                 Supine, use umbilicus 
               
               
                 Abdominis: Third 
                 rectus abdominis 
                 rectus abdominis 
                 as landmark, find top 
               
               
                 Section) 
                   
                   
                 of 2 nd  level 
               
               
                   
                   
                   
                 Palpate across, up side 
               
               
                   
                   
                   
                 of aponeurosis 
               
               
                   
                   
                   
                 Palpate for superior 
               
               
                   
                   
                   
                 fascia, palpate across 
               
               
                   
                   
                   
                 and down linea alba 
               
               
                   
                   
                   
                 Always palpating into 
               
               
                   
                   
                   
                 muscle belly when 
               
               
                   
                   
                   
                 working abdominal 
               
               
                   
                   
                   
                 wall 
               
               
                 14 (PSOAS Major: 
                 Bodies and Anterior 
                 Lesser trochanter of 
                 Supine, flex involved 
               
               
                 Lumbar Fibers) 
                 surface of transverse 
                 the femur 
                 hip by bending knee 
               
               
                   
                 processes of L2-L5 
                   
                 and have client exhale 
               
               
                   
                   
                   
                 Small circles to move 
               
               
                   
                   
                   
                 abdominal contents to 
               
               
                   
                   
                   
                 the side 
               
               
                   
                   
                   
                 Active hip flexion to 
               
               
                   
                   
                   
                 confirm 
               
               
                   
                   
                   
                 Palpate L2-L5 
               
               
                   
                   
                   
                 transverse processes 
               
               
                   
                   
                   
                 and bodies 
               
               
                   
                   
                   
                 Palpate above 
               
               
                   
                   
                   
                 adductor longus 
               
               
                   
                   
                   
                 tendon into lesser 
               
               
                   
                   
                   
                 trochanter 
               
               
                 15 (PSOAS Major 
                 Bodies and transverse 
                 Lesser trochanter of 
                 Supine, flex involved 
               
               
                 Thoracic Fibers) 
                 processes of T12 &amp; 
                 the femur 
                 hip and have client 
               
               
                   
                 L1 
                   
                 exhale 
               
               
                   
                   
                   
                 Small circles to move 
               
               
                   
                   
                   
                 abdominal contents to 
               
               
                   
                   
                   
                 the side 
               
               
                   
                   
                   
                 Active hip flexion to 
               
               
                   
                   
                   
                 confirm 
               
               
                   
                   
                   
                 Palpate T12 &amp; L1 
               
               
                   
                   
                   
                 transverse processes 
               
               
                   
                   
                   
                 and bodies 
               
               
                   
                   
                   
                 Palpate above 
               
               
                   
                   
                   
                 adductor longus 
               
               
                   
                   
                   
                 tendon into lesser 
               
               
                   
                   
                   
                 trochanter 
               
               
                 16 (PSOAS Major: 
                 Right crus: upper 3 
                 Central tendon; mid- 
                 Supine, palpate from 
               
               
                 Diaphragmatic Fibers) 
                 lumbar bodies 
                 central part of 
                 xyphoid process to rib 
               
               
                   
                 Left crus: upper 2 
                 xyphoid process 
                 cage 
               
               
                   
                 lumbar bodies 
                   
                 Have patient exhale to 
               
               
                   
                   
                   
                 relax diaphragm and 
               
               
                   
                   
                   
                 deflate lungs 
               
               
                   
                   
                   
                 Press fingers into 
               
               
                   
                   
                   
                 where diaphragm 
               
               
                   
                   
                   
                 connects with thorax 
               
               
                   
                   
                   
                 Palpate diaphragm 
               
               
                   
                   
                   
                 down to angle of 
               
               
                   
                   
                   
                 ribcage 
               
               
                   
                   
                   
                 Palpate associated 
               
               
                   
                   
                   
                 lumbar bodies 
               
               
                 17 (Iliacus) 
                 Anterior surface of 
                 Lesser trochanter of 
                 Supine, client flexes 
               
               
                   
                 iliac crest 
                 femur 
                 hip with femur 
               
               
                   
                   
                   
                 externally rotated 
               
               
                   
                   
                   
                 Curl fingers into iliac 
               
               
                   
                   
                   
                 fossa 
               
               
                   
                   
                   
                 Confirm through 
               
               
                   
                   
                   
                 active hip flexion 
               
               
                   
                   
                   
                 Palpate above 
               
               
                   
                   
                   
                 adductor longus 
               
               
                   
                   
                   
                 tendon into lesser 
               
               
                   
                   
                   
                 trochanter 
               
               
                 18 (Iliacus Minor) 
                 Anterior surface of 
                 Lesser trochanter of 
                 Client flexes hip with 
               
               
                   
                 iliac crest 
                 femur 
                 femur externally 
               
               
                   
                   
                   
                 rotated 
               
               
                   
                   
                   
                 Curl fingers into iliac 
               
               
                   
                   
                   
                 fossa palpating 
               
               
                   
                   
                   
                 superficial belly 
               
               
                   
                   
                   
                 Palpate above 
               
               
                   
                   
                   
                 adductor longus 
               
               
                   
                   
                   
                 tendon into lesser 
               
               
                   
                   
                   
                 trochanter 
               
               
                 19 (Tensor Fascia 
                 Anterior portion of 
                 Into ilio-tibial tract 
                 Supine, up and into 
               
               
                 Latae Posterior 
                 outer lip of iliac crest 
                 just below joint 
                 iliac crest posterior to 
               
               
                 Fibers) 
                   
                 capsule 
                 ASIS 
               
               
                   
                   
                   
                 Palpate at insertion 
               
               
                   
                   
                   
                 into IT-Tract 
               
               
                   
                   
                   
                 Superior portion of 
               
               
                   
                   
                   
                 lateral condyle 
               
               
                   
                   
                   
                 Palpate insertion of 
               
               
                   
                   
                   
                 IT-band into lateral 
               
               
                   
                   
                   
                 condyle of tibia 
               
               
                 20 (Tensor Fascia 
                 Anterior portion of 
                 Into ilio-tibial tract 
                 Supine, up and into 
               
               
                 Latae Anterior Fibers) 
                 outer lip of iliac crest 
                 just below joint 
                 iliac crest just off 
               
               
                   
                   
                 capsule 
                 ASIS 
               
               
                   
                   
                   
                 Palpate at insertion 
               
               
                   
                   
                   
                 into IT-tract 
               
               
                   
                   
                   
                 Superior portion of 
               
               
                   
                   
                   
                 lateral condyle 
               
               
                   
                   
                   
                 Palpate insertion of 
               
               
                   
                   
                   
                 IT-band into lateral 
               
               
                   
                   
                   
                 condyle of tibia 
               
               
                   
               
            
           
         
       
     
     Example 2 
     Illustrative AMC&amp;S Tests 
     1. Micro-Order 1, AMC&amp;S Test 
     Transverse Abdominis Lower Fibers 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: posterior-lateral side of involved ilium to hold end range spinal rotation   Action Hand: contact on medial side of involved knee   **maintain endrange rotation       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Head in headpiece   Flex hip to 90 degrees, with knee slightly flexed.   Cross lag across uninvolved thigh to create spinal rotation       

     Applied Force:
         Maintain spinal rotation through stabilizing hand until testing force is applied   Counter rotation force through involved leg to create opposite side spinal rotation       

     Internal Oblique: Anterior 
     Tester Position:
         Body: Stand on involved side   Leg across thigh   Stabilizing Hand: Grab uninvolved shoulder   Action Hand: anterior side of involved shoulder just below clavicle   **maintain end range rotation and neutral spine       

     Client Position:
         Supine, Flex trunk to 90 degrees with feet on the table and knees slightly bent   Feet shoulder width apart   Cross arms across chest and raise elbows to 90 degrees of shoulder flexion in order to maintain spinal neutral   Fully rotate trunk to involved side while maintaining spinal neutral       

     Applied Force:
         Extension through same side rotation       

     External Oblique: Anterior AMC&amp;S Test 
     Tester Position:
         Body: Stand on uninvolved side   Leg across thigh   Stabilizing Hand: Grab involved shoulder   Action Hand: anterior side of involved shoulder just below clavicle   **maintain end range rotation and neutral spine       

     Client Position:
         Supine, flex trunk to 90 degrees with feet on the table and knees slightly bent   Feet shoulder width apart   Cross arms across chest and raise elbows to 90 degrees of shoulder flexion in order to maintain spinal neutral   Fully rotate trunk to opposite side while maintaining spinal neutral       

     Applied Force:
         Counter-rotation       

     Semispinalis Thoracis 
     Tester Position:
         Body: Stand on same side of muscle being tested   Leg over posterior hip across to involved side   Grab anterior aspect of both shoulders to assist in extension and opposite rotation   Stabilizing Hand: Maintain end range extension and rotation by holding uninvolved side shoulder up   Action Hand: move hand to posterior shoulder on uninvolved side       

     Client Position:
         Prone, arms to side   Extend and fully rotate thorax to opposite side       

     Applied Force:
         Counter-rotation       

     Transverse Abdominis: Upper 
     Tester Position:
         Body: Stand on uninvolved side   Leg across thigh   Stabilizing hand: under mid-thoracic spine to assist in extension and rotation of spine   Action Hand: Grab posterior aspect of involved shoulder to maintain opposite rotation: shift to anterior side of involved shoulder just below clavicle       

     Client Position:
         Supine, feet shoulder width apart   Cross arms across chest   Flex trunk 20 degrees with feet on table   Fully rotate trunk to opposite side while maintaining neutral position of the spine       

     Applied Force:
         Counter-rotation       

     Sternalis 
     Tester Position:
         Body: Stand on uninvolved side   Leg across thigh   Stabilizing hand: under mid-thoracic spine to assist in opposite rotation   Action Hand: Grab posterior aspect of involved shoulder to maintain opposite rotation: shift to anterior side of involved shoulder just below clavicle       

     Client Position:
         Supine, feet on the table and knees slightly bent   Feet shoulder width apart   Cross arms across chest   Crunch up through thoracic spine to flex trunk 20 degrees   Fully rotate trunk to opposite side   Fully exhale       

     Applied Force:
         Counter-rotation force       

     Rectus Abdominis: 4th Lateral 
     Tester Position:
         Body: Stand on uninvolved side   Leg across thigh   Stabilizing hand: under mid-thoracic spine to assist in extension and rotation of spine   Action Hand: Grab posterior aspect of involved shoulder to maintain opposite rotation: shift to anterior side of involved shoulder just below clavicle       

     Client Position:
         Supine, feet on the table with knees slightly bent   Feet shoulder width apart   Cross and raise arms from chest   Flex trunk 45 degrees   Fully rotate trunk to opposite side while maintaining spinal neutral       

     Applied Force:
         Counter-rotation       

     Rectus Abdominis: 4th Medial 
     Tester Position:
         Body: Stand on involved side   Leg across thigh   Stabilizing hand: under mid-thoracic spine to assist in extension of spine   Action Hand: Anterior side of involved shoulder just below clavicle       

     Client Position:
         Supine, with feet on the table and knees slightly bent   Feet shoulder width apart   Cross and raise arms from chest   Flex trunk 45 degrees   Slightly rotate trunk to opposite side while maintaining spinal neutral       

     Applied Force:
         Extension       

     2. Micro-Order 2, AMC&amp;S Test 
     Psoas Minor 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Stabilize under involved glute/sacrum in order to maintain posterior pelvic tilt   Action Hand: wrap around ankle       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Externally rotate involved leg   Flex and slightly adduct hip toward midline of the body (maintaining external rotation of the femur) to drive a posterior pelvic tilt and spinal flexion       

     Applied Force:
         Extend and slightly abduct thigh through oblique plane to create anterior pelvic tilt and spinal extension       

     Pyramidalis 
     Tester Position:
         Body: Stand on involved side   Leg across shin**   Stabilizing Hand: stabilize across back guiding thorax into end range of trunk and spinal flexion   Action Hand: anterior side of involved shoulder just below clavicle       

     Client Position:
         Supine, with feet on the table and knees slightly bent   Feet shoulder width apart   Reach arms behind back   Fully flex trunk and spine   Slightly rotate trunk to opposite side       

     Applied Force:
         Extension       

     Rectus Abdominis: 1st 
     Tester Position:
         Body: Stand on involved side   Leg across thigh   Stabilizing Hand: stabilize across back guiding thorax into end range of spinal flexion   Action Hand: anterior side of involved shoulder just below clavicle       

     Client Position:
         Supine, with feet on the table and knees slightly bent:   Feet shoulder width apart   Cross arms across chest   Flex trunk 90 degrees   Slouch shoulders downwards to enhance spinal flexion   Slightly rotate trunk to opposite side       

     Applied Force:
         Extension       

     Rectus Abdominis: 2nd 
     Tester Position:
         Body: Stand on involved side   Leg across thigh   Stabilizing Hand: stabilize across back guiding thorax to maintain spinal neutral   Action Hand: anterior side of involved shoulder just below clavicle       

     Client Position:
         Supine, with feet on the table and knees slightly bent   Feet shoulder width apart   Cross and raise arms from chest   Flex trunk 90 degrees   Slightly rotate trunk to opposite side while maintaining spinal extension       

     Applied Force:
         Extension       

     Rectus Abdominis: 3rd 
     Tester Position:
         Body: Stand on involved side   Leg across thigh   Stabilizing Hand: stabilize across back guiding thorax to maintain spinal neutral   Action Hand: anterior side of involved shoulder just below clavicle       

     Client Position:
         Supine, with feet on table and knees slightly bent   Feet shoulder width apart   Cross and raise arms from chest   Flex trunk 75 degrees   Slightly rotate trunk to opposite side while maintaining spinal neutral       

     Applied Force:
         Extension       

     3. Micro Order 3, AMC&amp;S Test 
     Psoas Major: Lumbar Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Stabilize anterior side of involved thigh to maintain knee extension   Move to opposite ASIS   Action Hand: grab lower leg at ankle       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Externally rotate involved leg   Fully abduct leg, maintaining external rotation and knee extension   Flex and adduct leg through oblique plane toward opposite thorax       

     Applied Force:
         Hip Extension and abduction through oblique plane       

     Psoas Major: Thoracic Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Stabilize anterior side of involved thigh to maintain knee extension, switch to opp ASIS   Action Hand: grab lower leg at ankle       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Externally rotate involved leg   Fully abduct leg, maintaining external rotation and knee extension   Flex hip 30 degrees       

     Applied Force:
         Hip Extension       

     Psoas Major: Diaphragmatic 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Stabilize anterior side of involved thigh to maintain knee extension: switch to opp ASIS   Action Hand: grab lower leg at ankle       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Externally rotate involved leg   Fully abduct leg, maintaining external rotation and knee extension   Flex hip 10 degrees       

     Applied Force:
         Hip Extension       

     Iliacus 
     Tester Position:
         Body: Stand on involved side   Leg across thigh   Stabilizing Hand: Stabilize anterior side of involved thigh to maintain knee extension   Action Hand: grab lower leg at ankle       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Externally rotate involved leg   Fully flex hip maintaining external rotation and knee extension       

     Applied Force:
         Hip Extension       

     Iliacus Minor 
     Tester Position:
         Body: Stand on uninvolved side*   Stabilizing Hand: Stabilize anterior side of involved thigh to maintain knee extension   Action Hand: grab lower leg at ankle       

     Client Position:
         Supine, anchor thorax by wrapping arms around end of table   Externally rotate leg   Fully flex then adduct leg through oblique plane maintaining external rotation and knee extension       

     Applied Force:
         Hip Extension and abduction through the oblique plane       

     Tensor Fascia Latae: Posterior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Stabilize anterior side of involved thigh to maintain knee extension   Action Hand: grab lower leg at ankle       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Internally rotate involved leg   Fully abduct involved leg, maintaining internal rotation and knee extension   Fully flex hip from abducted position       

     Applied Force:
         Hip Extension       

     Tensor Fascia Latae Anterior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Stabilize anterior side of involved thigh to maintain knee extension   Action Hand: grab lower leg at ankle       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Internally rotate involved leg   Fully abduct involved leg, maintaining internal rotation and knee extension   Fully flex hip from abducted position       

     Applied Force:
         Hip Extension and adduction through the oblique plane       

     4. Micro Order 4, AMC&amp;S Test 
     Obturator Externus 
     Tester Position:
         Body: stand on involved side   Leg across opposite thigh   Stabilizing Hand: lateral side of involved knee   Action Hand: cup involved heel       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Flex involved hip   Fully externally rotate the femur at the hip with tibia just below parallel to the table       

     Applied Force:
         Internal rotation       

     Quadratus Femoris 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: lateral side of involved knee   Action Hand: cup involved heel       

     Client Position:
         Supine, Anchor thorax by wrapping arms around top of table   Flex hip 75°,   Fully externally rotate the femur at the hip. Tibia parallel to the table       

     Applied Force:
         Internal rotation       

     Piriformis 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: Involved PSIS   Action Hand: grab involved ankle       

     Client Position:
         Prone, flex knee 90°   Abduct involved thigh to tissue tension   Fully externally rotate the femur at the hip       

     Applied Force:
         Internal rotation       

     Gemellus Inferior 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: Involved PSIS   Action Hand: grab involved ankle       

     Client Position:
         Prone, flex knee 90°   Abduct thigh 30°   Drop knee off side of table to create 20° of hip flexion   Brace against thigh   Fully externally rotate the femur at the hip       

     Applied Force:
         Internal rotation       

     Gemellus Superior 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: Medial aspect of involved thigh (reach around)   Action Hand: grab involved ankle       

     Client Position:
         Prone, flex knee 90°   Abduct thigh 30°   Drop knee off side of table to create 45° of hip flexion   Fully externally rotate the femur at the hip       

     Applied Force:
         Internal rotation       

     Adductor Minimus 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: Involved PSIS   Action Hand: grab involved ankle       

     Client Position:
         Prone, legs straight   Flex knee 90°   Adduct involved leg to tissue tension   Fully externally rotate the femur at the hip       

     Applied Force:
         Internal rotation       

     Obturator Internus 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: uninvolved ASIS   Action Hand: lateral side of involved knee       

     Client Position:
         Supine, slide to edge of the table on involved side   Flex knee 100 degrees to level of opposite knee   Place plantar aspect of foot against side of table   Flex, abduct and externally rotate femur at hip       

     Applied Force:
         Flexion and Adduction       

     5. Micro Order 5, AMC&amp;S Test 
     Longissimus Thoracis 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved thorax, up and in to inferior rib cage   Start by setting pelvis in neutral   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, slide body to the top of the uninvolved side of the table   Anchor uninvolved side arm around upper corner of table   Sidebend thorax on ilium   Cross involved side arm on chest   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Longissimus Lumborum 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved ilium, up and in to inferior iliac crest   Start by setting pelvis in neutral   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, slide body to the top of the uninvolved side of the table   Anchor uninvolved side arm around upper corner of table   Sidebend thorax on ilium   Cross involved side arm on chest   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Internal Oblique: Lateral 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: stabilize involved thigh   Action Hand: Lateral side of involved shoulder       

     Client Position:
         Supine, with feet on table with knees slightly bent   Feet shoulder width apart   Cross arms   Flex trunk 90 degrees   Fully rotate trunk to opposite side   Laterally bend at trunk through plane of shoulders toward involved side       

     Applied Force:
         Opposite sidebend: through plane of shoulders       

     External Oblique: Lateral 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved ilium pressing up and in to iliac crest   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, Cross arms on chest   Elevate legs 20 degrees with knees straight   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Iliocostalis Thoracis 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved thorax pressing up and in to inferior rib cage   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, legs straight   Internally rotate leg on involved side   Cross arms on chest   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Iliocostalis Lumborum 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved ilium pressing up and in to inferior iliac crest   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, legs straight   Internally rotate leg on involved side   Cross arms on chest   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Multifidus: Thoraco-Lumbar 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved thorax pressing up and in to inferior rib cage   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, legs straight   Externally rotate leg on involved side   Cross arms on chest   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Multifidus: Lumbo-Sacral 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved ilium pressing up and in to inferior iliac crest   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, legs straight   Externally rotate leg on involved side   Cross arms on chest   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Quadratus Lumborum Spinal Fibers 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved ilium pressing up and in to inferior iliac crest   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, legs straight   Cross arms on chest   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Serratus Posterior: Inferior 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: stabilize involved thigh   Action Hand: Lateral side of involved shoulder       

     Client Position:
         Supine, feet on table with knees slightly bent   Feet shoulder width apart   Cross arms   Flex trunk 90 degrees   Fully rotate trunk to involved side   Laterally bend at trunk through plane of shoulders toward involved side   Fully exhale       

     Applied Force:
         Opposite sidebend: through plane of shoulders       

     Serratus Posterior: Superior 
     Tester Position:
         Body: Stand on same side of muscle being tested   Leg across hip to brace involved side   Grab anterior aspect of both shoulders to assist in extension and opposite rotation   Stabilizing Hand: Maintain end range extension and rotation by holding involved side shoulder up   Action Hand: move hand to posterior shoulder on uninvolved side       

     Client Position:
         Prone, arms to side   Fully extend and rotate thorax to opposite side   Fully exhale       

     Applied Force:
         Counter-rotation       

     Quadratus Lumborum Costal Fibers 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved ilium pressing up and in to inferior iliac crest   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, legs straight   Cross arms on chest   Take both legs to involved side to create 10 degrees of spinal sidebend*       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     6. Micro Order 6, AMC&amp;S Test 
     Levator Scapula Superior Division 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior-lateral side of involved wrist to maintain humeral external rotation and downward rotation of the scapula   Action Hand: Medial side of involved elbow       

     Client Position:
         Supine, slide to edge of the table to allow scapula to retract off the side of the table   Rotate head to ipsilateral side   Flex elbow 90 degrees   Externally rotate and adduct humerus   Downwardly rotate the scapula       

     Applied Force:
         Abduct humerus to upwardly rotate the scapula       

     Levator Scapula Inferior Division 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior-lateral side of involved wrist to maintain humeral external rotation and downward rotation of the scapula   Action Hand: Medial side of involved elbow       

     Client Position:
         Supine, slide to edge of the table to allow scapula to retract off the side of the table   Rotate head to ipsilateral side   Flex elbow 90 degrees   Adduct humerus   Downwardly rotate the scapula       

     Applied Force:
         Abduct humerus to upwardly rotate the scapula       

     Rhomboid Minor 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior-lateral side of involved wrist to maintain humeral external rotation and downward rotation of the scapula   Action Hand: Medial side of involved elbow       

     Client Position:
         Supine with elbow flexed to 90 degrees   Abduct humerus 20 degrees   Externally rotate humerus   Downwardly rotate the scapula       

     Applied Force:
         Abduct humerus to upwardly rotate the scapula       

     Rhomboid Major 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior-lateral side of involved wrist to maintain humeral external rotation and downward rotation of the scapula   Action Hand: Medial side of involved elbow       

     Client Position:
         Supine, slide to edge of the table to allow scapula to retract off the side of the table   Flex elbow 90 degrees   Abduct humerus 20 degrees   Downwardly rotate the scapula       

     Applied Force:
         Abduct humerus to upwardly rotate the scapula       

     7. Micro Order 7, AMC&amp;S Test 
     Infraspinatus Superior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior-lateral side of involved shoulder   Action Hand: Around involved wrist   Brace involved elbow on thigh*       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Adduct humerus 120 degrees   Fully externally rotate humerus       

     Applied Force:
         Internally rotate humerus       

     Infraspinatus Superior-Middle Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior-lateral side of involved shoulder   Action Hand: Around involved wrist   Brace involved elbow on thigh*       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Adduct humerus 90 degrees   Fully externally rotate humerus       

     Applied Force:
         Internally rotate humerus       

     Infraspinatus Inferior-Middle Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior-lateral side of involved shoulder   Action Hand: Around involved wrist   Brace involved elbow on thigh*       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Abduct humerus 45 degrees   Fully externally rotate humerus       

     Applied Force:
         Internally rotate humerus       

     Infraspinatus Inferior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior-lateral side of involved shoulder   Action Hand: Around involved wrist   Brace involved elbow on thigh*       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Abduct humerus 30 degrees   Fully externally rotate humerus       

     Applied Force:
         Internally rotate humerus       

     Teres Minor 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior-lateral side of involved shoulder   Action Hand: Around involved wrist   Brace involved elbow on thigh*       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Adduct humerus   Fully externally rotate humerus       

     Applied Force:
         Internally rotate humerus       

     8. Micro Order 8, AMC&amp;S Test 
     Intertransversarii 
     Tester Position:
         Body: Stand on same side of muscle being tested**   Grab anterior aspect of both arms to assist in extension and opposite rotation   Stabilizing Hand: Maintain end range extension and rotation by holding uninvolved side shoulder up and back   Action Hand: move hand to posterior-inferior thorax on uninvolved side   Leg across involved thigh to stabilize pelvis       

     Client Position:
         Prone, hands behind head   Fully extend and rotate thorax to opposite side       

     Applied Force:
         Flexion       

     Interspinalis Lumborum 
     Tester Position:
         Body: Stand on same side of muscle being tested   Grab anterior aspect of both arms to assist in extension   Stabilizing Hand: Maintain end range extension by holding involved side shoulder up*   Action Hand: move hand to posterior-inferior thorax on involved side   Leg across involved thigh to stabilize pelvis       

     Client Position:
         Prone, hands behind head   Fully extend spine       

     Applied Force:
         Flexion       

     Spinalis Thoracis 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved thorax pressing up and in to inferior rib cage   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved       

     Client Position:
         Supine, legs straight   Legs together, arch spine   Cross arms on chest   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Spinalis Lumborum 
     Tester Position:
         Body: Stand on uninvolved side   Stabilizing Hand: stabilize uninvolved ilium pressing up and in to inferior iliac crest   Action Hand: reach arm under knees, grabbing inferior-lateral side of involved knee       

     Client Position:
         Supine, legs straight   Legs together, arch spine   Cross arms on chest   Take both legs to involved side to create end range spinal sidebend       

     Applied Force:
         Opposite sidebend   Keep body flat in plane of the table       

     Rotatores Thoracis 
     Tester Position:
         Body: Stand on uninvolved side   Anchor Leg across uninvolved thigh*   Stabilizing Hand: stabilize under involved side thorax   Action Hand: brace posterior shoulder on uninvolved side       

     Client Position:
         Seated with lower legs off table   Flex trunk 90 degrees   Cross arms   Extend through thoracic spine   Slightly rotate to opposite side       

     Applied Force:
         Flexion       

     Rotatores Lumborum 
     Tester Position:
         Body: Stand on uninvolved side   Anchor leg across uninvolved thigh   Stabilizing Hand: stabilize across involved side ASIS   Action Hand: brace posterior shoulder on uninvolved side       

     Client Position:
         Seated with lower legs off table   Flex trunk 90 degrees   Cross arms   Extend through lumbar spine   Slightly rotate to opposite side       

     Applied Force:
         Flexion       

     9. Micro Order 9, AMC&amp;S Test 
     Gluteus Maximus: Iliac 
     Tester Position:
         Body: stand on involved side   Stabilizing hand: anterior, lower ⅓rd of involved thigh   Action hand: posterior, lower ⅓rd of involved thigh**       

     Client Position:
         Prone, 90 degrees of knee flexion   Abduct thigh to tissue tension   Fully extend hip through plane of the thigh       

     Applied force:
         Hip flexion through plane of the thigh       

     Gluteus Maximus: Sacral 
     Tester Position:
         Body: stand on involved side   Stabilizing hand: anterior, lower ⅓rd of involved thigh   Action hand: posterior, lower ⅓rd of involved thigh**       

     Client Position:
         Prone, 90 degrees of knee flexion   Slight abduction of involved thigh   Fully extend hip       

     Applied force:
         Hip flexion       

     Gluteus Maximus Coccygeal 
     Tester Position:
         Body: stand on involved side   Stabilizing hand: anterior, lower ⅓rd of involved thigh   Action hand: posterior, lower ⅓rd of involved thigh**       

     Client Position:
         Prone, 90 degrees of knee flexion   Internally rotate involved thigh   Fully extend hip       

     Applied force:
         Hip flexion       

     10. Micro Order 10, AMC&amp;S Test 
     Latissimus Dorsi Iliac Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on posterior scapula   Action Hand: around involved wrist       

     Client Position:
         Prone with elbow extended   Sidebend to involved side   Internally rotate humerus   Extend then adduct the involved humerus       

     Applied Force:
         Abduction of the humerus       

     Latissimus Dorsi Lumbar Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on posterior scapula   Action Hand: around involved wrist       

     Client Position:
         Prone with elbow extended   Sidebend to involved side   Internally rotate humerus   Extend the involved humerus       

     Applied Force:
         Flexion of the humerus       

     Latissimus Dorsi Thoracic Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on posterior scapula   Action Hand: around involved wrist       

     Client Position:
         Prone with elbow extended   Sidebend to involved side   Internally rotate humerus   Extend and Adduct involved humerus       

     Applied Force:
         Flexion and Abduction of the humerus through the oblique plane       

     Teres Major Inferior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on posterior side of involved scapula   Action Hand: posterior-medial side of involved elbow       

     Client Position:
         Prone with elbow flexed 90 degrees   Place involved hand on ipsilateral PSIS   Extend and horizontally abduct involved humerus       

     Applied Force:
         Flexion and horizontal Adduction of the humerus       

     Teres Major Superior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on posterior side of involved scapula   Action Hand: posterior-medial side of involved elbow       

     Client Position:
         Prone with elbow flexed 120 degrees   Place involved hand on ipsilateral thorax   Extend and horizontally abduct involved humerus       

     Applied Force:
         Flexion and horizontal Adduction of the humerus       

     Tricep Long Head 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on posterior scapula   Action Hand: around involved wrist       

     Client Position:
         Prone with elbow extended   Palm down   Extend the involved humerus       

     Applied Force:
         Flexion of the humerus       

     11. Micro Order 11, AMC&amp;S Test 
     Sub Scapularis Superior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior-inferior side of involved shoulder   Action Hand: Around involved wrist   Brace involved elbow on thigh*       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Abduct humerus 120 degrees   Fully internally rotate humerus       

     Applied Force:
         Externally rotate humerus       

     Sub Scapularis Superior-Middle Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior-inferior side of involved shoulder   Action Hand: Around involved wrist   Brace involved elbow on thigh*       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Abduct humerus 90 degrees   Fully internally rotate humerus       

     Applied Force:
         Externally rotate humerus       

     Sub Scapularis Inferior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior-inferior side of involved shoulder   Action Hand: Around involved wrist   Brace involved elbow on thigh*       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Abduct humerus 30 degrees   Fully internally rotate humerus       

     Applied Force:
         Externally rotate humerus       

     12. Micro Order 12, AMC&amp;S Test 
     Tricep Medial Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on posterior-medial side of distal humerus   Action Hand: around involved wrist   Brace involved humerus on thigh*       

     Client Position:
         Supine with elbow extended   Abduct humerus 90 degrees   Fully pronate forearm   Fully extend the elbow       

     Applied Force:
         Elbow flexion       

     Tricep Lateral Head 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on posterior-medial side of distal humerus   Action Hand: around involved wrist   Brace involved humerus on thigh*       

     Client Position:
         Supine with elbow extended   Abduct humerus 90 degrees   Fully supinate forearm   Fully extend the elbow       

     Applied Force:
         Elbow flexion       

     Articularis Cubiti 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior shoulder at AC-joint   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow flexed   Fully pronate forearm       

     Applied Force:
         Elbow flexion       

     13. Micro Order 13, AMC&amp;S Test 
     Upper Trapezius Clavicular Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on underside of AC joint at armpit to maintain upward rotation of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended   Rotate head to uninvolved side   Fully internally rotate the involved humerus to protract scapula   Abduct humerus then drive upward rotation of the scapula       

     Applied Force:
         Adduction to downwardly rotate the scapula*       

     Upper Trapezius Scapular Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on underside of AC joint at armpit to maintain upward rotation of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended   Rotate head to uninvolved side   Internally rotate involved humerus to protract scapula   Flex and abduct involved humerus 45 degrees   Upwardly rotate the scapula       

     Applied Force:
         Adduction to downwardly rotate the scapula*       

     Middle Trapezius 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on anterior side of AC joint to maintain retraction of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended and head in headpiece with scapula off the table   Horizontal Abduction of the humerus to drive retraction of the scapula       

     Applied Force:
         Horizontal Adduction to protract the scapula       

     Lower Trapezius 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior to the AC joint   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended and head in headpiece with scapula off the table   Flexion and Horizontal Abduction of the humerus through the oblique plane to drive upward rotation and retraction of the scapula       

     Applied Force:
         Extenson and Horizontal Adduction through the oblique plane to drive protraction and downward rotation of the scapula       

     Serratus Anterior Upper Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on posterior-superior humerus to maintain protraction of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended and palm up   Abduct humerus 90 degrees   Horizontally adduct involved humerus 45 degrees   Lift arm to drive protraction of the scapula       

     Applied Force:
         Horizontal Abduction to retract the scapula       

     Serratus Anterior Lower Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on underside of AC joint at armpit to maintain upward rotation of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended and head in headpiece with scapula off the table   Palm up   Fully flex involved humerus       

     Applied Force:
         Humeral Extension       

     Subclavius Lateral Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on underside of AC joint at armpit to maintain upward rotation of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended   Internally rotate humerus   Flex and fully abduct involved humerus   Upwardly rotate the scapula       

     Applied Force:
         Adduction to downwardly rotate the scapula       

     Subclavius Medial Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on underside of AC joint at armpit to maintain upward rotation of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine, with elbow extended and palm up   Flex and fully abduct involved humerus   Upwardly rotate the scapula       

     Applied Force:
         Humeral Adduction to downwardly rotate the scapula       

     14. Micro Order 14, AMC&amp;S Test 
     Supraspinatus Fossa Division 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Anterior to AC joint   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended   Fully internally rotate involved humerus to protract the scapula   Abduct humerus 30 degrees       

     Applied Force:
         Adduct the humerus       

     Supraspinatus Spinal Division 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Posterior* to the AC-joint   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended   Abduct humerus 30 degrees       

     Applied Force:
         Adduct the humerus       

     Posterior Deltoid Medial Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: around involved wrist   Action Hand: Grab humerus above the elbow       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Fully internally rotate humerus   Horizontally abduct humerus 20 degrees   Abduct humerus to tissue tension       

     Applied Force:
         Adduct humerus       

     Posterior Deltoid Lateral Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: around involved wrist   Action Hand: Grab humerus above the elbow       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Fully internally rotate humerus   Abduct humerus to tissue tension       

     Applied Force:
         Adduct humerus       

     Middle Deltoid Posterior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: around involved wrist   Action Hand: Grab humerus above the elbow       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Slightly internally rotate humerus   Abduct humerus to tissue tension       

     Applied Force:
         Adduct humerus       

     Middle Deltoid Anterior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: around involved wrist   Action Hand: Grab humerus above the elbow       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Slightly externally rotate humerus   Abduct humerus to tissue tension       

     Applied Force:
         Adduct humerus       

     Anterior Deltoid Scapular Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: around involved wrist   Action Hand: Grab humerus above the elbow       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Internally rotate humerus   Flex and abduct humerus toward ear       

     Applied Force:
         Extend and Adduct humerus       

     Anterior Deltoid Clavicular Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: around involved wrist   Action Hand: Grab humerus above the elbow       

     Client Position:
         Supine, slide to edge of the table   Flex elbow 90 degrees   Externally rotate humerus   Flex and abduct humerus toward ear       

     Applied Force:
         Extend and Adduct humerus       

     15. Micro Order 15, AMC&amp;S Test 
     Pectoralis Minor Inferior Division 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Posterior to AC-joint to maintain protraction and downward rotation of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended   Externally rotate humerus   Flex humerus 90 degrees   Depress, then protract the scapula through oblique plane       

     Applied Force:
         Flexion and horizontal abduction through the oblique plane to retract and posteriorly rotate the scapula       

     Pectoralis Minor Superior Division 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Posterior to AC-joint to maintain protraction and downward rotation of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended   Externally rotate humerus   Flex humerus 90 degrees   Depress, then protract the scapula through horizontal plane       

     Applied Force:
         Horizontal abduction to retract the scapula       

     16. Micro Order 16, AMC&amp;S Test 
     Pectoralis Major Sternal Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on anterior side of distal clavicle to maintain retraction of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended and head in headpiece with scapula off the table   Internally rotate humerus   Horizontally adduct the humerus   maintain retraction of the scapula       

     Applied Force:
         Horizontal Abduction of the humerus       

     Pectoralis Major Clavicular Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on anterior side of distal clavicle to maintain retraction of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended and head in headpiece with scapula off the table   Internally rotate humerus   Horizontally adduct and flex the humerus through the oblique plane   Maintain retraction of the scapula       

     Applied Force:
         Extend and horizontally abduct the humerus through the oblique plane       

     Pectoralis Major Costal Division 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: on anterior side of distal clavicle to maintain retraction of the scapula   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended and head in headpiece with scapula off the table   Internally rotate humerus   Horizontally adduct and extend the humerus through the oblique plane   Maintain retraction of the scapula       

     Applied Force:
         Flex and Horizontally Abduct the humerus through the oblique plane       

     Biceps Brachii Long Head 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: posterior humerus, superior to elbow   Action Hand: around involved wrist       

     Client Position:
         Supine, with head in headrest and scapula off the table   Supinate forearm with elbow slightly flexed   Fully flex humerus       

     Applied Force:
         Extend the humerus       

     Biceps Brachii Short Head 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior shoulder inferior to AC joint   Action Hand: Around involved wrist       

     Client Position:
         Supine, slide to edge of the table   Supinate forearm   Fully flex elbow       

     Applied Force:
         Elbow extension       

     Coracobrachialis Superior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior to the AC joint*   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended   Palm up   Abduct humerus 30 degrees   Flex humerus 20 degrees       

     Applied Force:
         Extend the humerus       

     Coracobrachialis Inferior Fibers 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Anterior to the AC-joint**   Action Hand: around involved wrist       

     Client Position:
         Supine with elbow extended   Fully externally rotate humerus   Abduct humerus 30 degrees   Flex humerus 20 degrees       

     Applied Force:
         Extend and abduct the humerus through the oblique plane       

     17. Micro Order 17, AMC&amp;S Test 
     Brachialis 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior shoulder at AC-joint   Action Hand: Around involved wrist       

     Client Position:
         Supine, slide to edge of the table   Forearm in neutral   Fully flex elbow       

     Applied Force:
         Elbow extension       

     Brachioradialis Superior Division 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior shoulder at AC-joint   Action Hand: Around involved wrist       

     Client Position:
         Supine, slide to edge of the table   Pronate forearm   Fully flex elbow       

     Applied Force:
         Elbow extension       

     Brachioradialis Inferior Division 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: anterior shoulder at AC-joint   Action Hand: Around involved wrist       

     Client Position:
         Supine, slide to edge of the table   Supinate forearm   Flex elbow 90 degrees       

     Applied Force:
         Elbow extension       

     18. Micro Order18, AMC&amp;S Test 
     Adductor Magnus Oblique Fibers 
     Tester Position:
         Body: stand at the base of the client on involved side   Stabilizing Hand: opposite ankle   Action Hand: grab involved ankle from above   **Do not force external rotation       

     Client Position:
         Supine, legs straight   Hands behind head   Fully externally rotate involved femur   Move both legs to create end-range adduction on involved side   **Watch for pelvic hike       

     Applied Force:
         Abduction   **maintain knee extension       

     Adductor Magnus Vertical Fibers 
     Tester Position:
         Body: stand at the base of table   Stabilizing Hand: opposite ankle   Action Hand: grab involved ankle from below       

     Client Position:
         Supine, legs straight   Hands behind head   Move both legs to create end-range adduction on involved side   **Watch for pelvic hike       

     Applied Force:
         Abduction   **maintain knee extension       

     Adductor Longus Superior 
     Tester Position:
         Body: stand at the base of the table   Stabilizing Hand: opposite ankle   Action Hand: grab involved ankle from below       

     Client Position:
         Supine, legs straight   Hands across chest   Fully externally rotate involved femur   Flex hips: Femur 10 degrees from table   Move both legs to create end-range adduction on involved side   **Watch for pelvic hike       

     Applied Force:
         Abduction   **maintain knee extension       

     Adductor Longus Inferior 
     Tester Position:
         Body: stand at the base of the table   Stabilizing Hand: opposite ankle   Action Hand: grab involved ankle from below       

     Client Position:
         Supine, legs straight   Hands across chest   Flex hips: Femur 10 degrees from table   Move both legs to create end-range adduction on involved side       

     Applied Force:
         Abduction   **maintain knee extension       

     Adductor Brevis 
     Tester Position:
         Body: stand at the base of the table   Stabilizing Hand: opposite ankle   Action Hand: grab involved ankle from below       

     Client Position:
         Supine, legs straight   Hands across chest   Fully internally rotate involved femur   Flex involved hip: Femur 10 degrees from table   Fully adduct the femur at the hip while maintaining internal rotation   **Watch for pelvic rotation       

     Applied Force:
         Abduction   **maintain knee extension       

     Pectineus 
     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: opposite ankle   Action Hand: grab involved ankle       

     Client Position:
         Supine, legs straight   Hands across chest   Fully externally rotate involved femur   Flex the involved hip 30 degrees   Adduct to midline while maintaining external rotation       

     Applied Force:
         Extension and Abduction through the oblique plane   **maintain knee extension       

     Gracilis 
     Tester Position:
         Body: stand at the base of the client on involved side   Stabilizing Hand: opposite ankle   Action Hand: grab involved ankle from below       

     Client Position:
         Supine, legs straight   Hands behind head   Fully internally rotate involved femur   Move both legs to create end-range adduction on involved side       

     Applied Force:
         Abduction   **maintain knee extension       

     19. Micro Order 19, AMC&amp;S Test 
     Gluteus Medius Anterior Fibers 
     Tester Position:
         Body: stand at the base of the client on involved side   Stabilizing Hand: opposite ASIS or thigh   Action Hand: grab involved ankle       

     Client Position:
         Supine, legs straight   Hands behind head   Fully internally rotate involved femur   Fully abduct the femur at the hip while maintaining internal rotation       

     Applied Force:
         Adduction   **Maintain knee extension       

     Gluteus Medius Posterior Fibers 
     Tester Position:
         Body: stand at the base of the client on involved side   Stabilizing Hand: opposite ASIS or thigh   Action Hand: grab involved ankle       

     Client Position:
         Supine, legs straight   Hands behind the head   Fully externally rotate involved femur   Fully abduct the femur at the hip while maintaining external rotation       

     Applied Force:
         Adduction   **Maintain knee extension       

     Gluteus Medius Middle Fibers 
     Tester Position:
         Body: stand at the base of the client on involved side   Stabilizing Hand: opposite ASIS or thigh   Action Hand: grab involved ankle       

     Client Position:
         Supine, legs straight   Hands behind the head   Fully abduct the femur at the hip       

     Applied Force:
         Adduction   **Maintain knee extension       

     Gluteus Minimus Anterior Fibers 
     Tester Position:
         Body: stand at the base of the client on involved side   Stabilizing Hand: opposite ASIS or thigh   Action Hand: grab involved ankle       

     Client Position:
         Supine, legs straight   Hands behind the head   Fully internally rotate involved femur   Flex hip 25 degrees   Fully abduct the femur at the hip while maintaining internal rotation       

     Applied Force:
         Adduction   **Maintain knee extension       

     Gluteus Minimus Lateral Fibers 
     Tester Position:
         Body: stand at the base of the client on involved side   Stabilizing Hand: opposite ASIS or thigh   Action Hand: grab involved ankle       

     Client Position:
         Supine, legs straight   Hands behind the head   Fully externally rotate involved femur   Flex hip 25 degrees   Fully abduct the femur at the hip while maintaining external rotation       

     Applied Force:
         Adduction   **Maintain knee extension       

     20. Micro Order 20, AMC&amp;S Test 
     Rectus Femoris Straight Head 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Brace involved thigh   Action Hand: grab lower leg at ankle       

     Client Position:
         Supine, hands behind head   Fully flex hip with end range knee extension       

     Applied Force:
         Hip Extension       

     Rectus Femoris Reflected Head 
     Tester Position:
         Body: Stand on involved side   Stabilizing Hand: Brace involved thigh   Action Hand: grab lower leg at ankle       

     Client Position:
         Supine, hands behind head   Internally rotate involved leg   Fully flex hip with end range knee extension       

     Applied Force:
         Hip Extension       

     Vastus Intermedius: Medial 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: posterior thigh behind knee joint   Action Hand: anterior tibia       

     Client Position:
         Supine, hands behind head   Flex involved hip to tissue tension   Fully internally rotate involved tibia   Tibia parallel to table       

     Applied Force:
         knee flexion       

     Vastus Intermedius: Lateral 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: posterior thigh behind knee joint   Action Hand: anterior tibia       

     Client Position:
         Supine, hands behind the head   Flex involved hip to tissue tension   Fully externally rotate involved tibia   Tibia parallel to table       

     Applied Force:
         knee flexion       

     Vastus Medialis: Upper 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: lateral side of involved knee   Action Hand: grab involved calcaneus       

     Client Position:
         Supine, hands behind head   Flex hip 60° and flex knee 110° so that heel is at level of opposite knee   Fully externally rotate femur with slight abduction   Internally rotate tibia and plantarflex foot       

     Applied Force:
         Internal rotation of femur at hip       

     Vastus Medialis: Middle 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: lateral side of involved knee   Action Hand: grab involved calcaneus       

     Client Position:
         Supine, hands behind head   Flex hip 45° and flex knee 75° so that heel is at opposite mid shin level   Fully externally rotate femur with slight abduction   Internally rotate tibia and plantarflex foot       

     Applied Force:
         Internal rotation of femur at hip       

     Vastus Medialis: Lower 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: lateral side of involved knee   Action Hand: grab involved calcaneus       

     Client Position:
         Supine, hands behind head   Flex hip 20° and flex knee 20° so that heel is at level of opposite ankle   Fully externally rotate femur with slight abduction   Internally rotate tibia and plantarflex foot       

     Applied Force:
         Internal rotation of femur at hip       

     Vastus Lateralis: Upper 
     Tester Position:
         Body: stand on uninvolved side   Stabilizing Hand: medial side of involved knee   Action Hand: grab involved calcaneus       

     Client Position:
         Supine, hands behind head   Flex hip 60° and flex knee 110° so that heel is at level of opposite knee   Fully internally rotate femur with slight adduction   Externally rotate tibia and plantarflex foot       

     Applied Force:
         External rotation of femur at hip       

     Vastus Lateralis: Middle 
     Tester Position:
         Body: stand on uninvolved side   Stabilizing Hand: medial side of involved knee   Action Hand: grab involved calcaneus       

     Client Position:
         Supine, hands behind head   Flex hip 25° and flex knee 75° so that heel is at opposite mid shin level   Fully internally rotate femur with slight adduction   Externally rotate tibia and plantarflex foot       

     Applied Force:
         External rotation of femur at hip       

     Vastus Lateralis: Lower 
     Tester Position:
         Body: stand on uninvolved side   Stabilizing Hand: medial side of involved knee   Action Hand: grab involved calcaneus       

     Client Position:
         Supine, hands behind head   Flex hip 20° and flex knee 20° so that heel is at level of opposite ankle   Fully internally rotate femur with slight adduction   Externally rotate tibia and plantarflex foot       

     Applied Force:
         External rotation of femur at hip       

     Articularis Genu 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: posterior side of involved knee   Action Hand: grab distal, anterior aspect of involved tibia       

     Client Position:
         Supine, hands behind head   Flex hip 20° and flex knee 20°       

     Applied Force:
         Hip extension while maintaining knee flexion       

     21. Micro Order 21, AMC&amp;S Test 
     Semitendinosus 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: grab involved midfoot on medial side   Action Hand: posterior calcaneus on involved side       

     Client Position:
         Supine, with hands behind head   Flex involved hip 80°   Slightly internally rotate and adduct femur   Dorsiflex and fully internally rotate the foot   Full knee flexion       

     Applied Force:
         knee extension       

     Semimembranosus Lateral 
     Tester Position:
         Body: stand at base of table   Stabilizing Hand: grab involved midfoot on medial side   Action Hand: posterior calcaneus on involved side       

     Client Position:
         Supine, with hands behind head   Flex involved hip 45°   Slightly externally rotate and abduct femur   Dorsiflex and fully internally rotate the foot   Flex knee 90°       

     Applied Force:
         knee extension       

     Semimembranosus Medial 
     Tester Position:
         Body: stand at base of table   Stabilizing Hand: grab involved midfoot on medial side   Action Hand: posterior calcaneus on involved side       

     Client Position:
         Supine, with hands behind head   Flex involved hip 45°   Slightly internally rotate and adduct femur   Dorsiflex and fully internally rotate the foot   Flex knee 90°       

     Applied Force:
         Knee extension       

     Bicep Femoris: Short head 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: grab involved midfoot on medial side   Action Hand: posterior calcaneus on involved side       

     Client Position:
         Supine, with hands behind head   Flex hip 80°   Slightly internally rotate and adduct femur   Dorsiflex and fully externally rotate the foot   Full knee flexion       

     Applied Force:
         knee extension       

     Bicep Femoris: Long head Fibular 
     Tester Position:
         Body: stand at base of table   Stabilizing Hand: grab involved midfoot on medial side   Action Hand: posterior calcaneus on involved side       

     Client Position:
         Supine, with hands behind head   Flex involved hip 45°   Slightly internally rotate and adduct femur   Dorsiflex and fully externally rotate foot   Flex knee 90°       

     Applied Force:
         knee extension       

     Bicep Femoris: Long head Tibial 
     Tester Position:
         Body: stand at base of table   Stabilizing Hand: grab involved midfoot on medial side   Action Hand: posterior calcaneus on involved side       

     Client Position:
         Supine, with hands behind head   Flex involved hip 45°   Dorsiflex and fully externally rotate foot   Flex knee 90°       

     Applied Force:
         knee extension       

     Sartorius 
     Tester Position:
         Body: stand on involved side   Stabilizing Hand: involved foot   Action Hand: Posterior aspect of distal tibia       

     Client Position:
         Supine, with hands behind head   Flex knee 120 degrees   Flex, abduct and externally rotate femur at hip   Place ankle just above uninvolved knee   Internally rotate tibia       

     Applied Force:
         Knee extension while maintaining abducted/externally rotated position       

     Popliteus 
     Tester Position:
         Body: stand at base of table   Stabilizing Hand: grab calcaneus   Action Hand: medial forefoot       

     Client Position:
         Supine   Flex involved hip and knee 45°   Internally rotate tibia through foot       

     Applied Force:
         External rotation of the tibia through the foot       

     22. Micro Order 22, AMC&amp;S Test 
     Posterior Tibialis Fibular Division 
     Client Position:
         Supine, flex hip 45°, flex knee 90°   Plantarflexion and inversion of the foot.   Full adduction of the foot       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: base of heel   Action Hand: medial aspect of the forefoot       

     Applied Force:
         abduction of the foot       

     Posterior Tibialis Tibial Division 
     Client Position:
         Supine, flex hip 45°, flex knee 90°   Plantarflexion of the foot.   Full adduction of the foot       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: base of heel   Action Hand: medial aspect of the forefoot       

     Applied Force:
         abduction of the foot       

     23. Micro Order 23, AMC&amp;S Test 
     Medial Soleus 
     Client Position:
         prone, knee flexed to 90°   adduction of the foot   full plantarflexion of the foot (point foot up and in)       

     Tester Position:
         Body: stand on side of leg being tested   Stabilizing Hand: back of calcaneus   Action Hand: ball of foot (1st met head)       

     Applied Force:
         dorsiflexion of the ankle about the talo-crual joint axis       

     Lateral Soleus 
     Client Position:
         prone, knee flexed to 90°   Abduction of the foot   full plantarflexion of the foot (point foot up and out)       

     Tester Position:
         Body: stand on side of leg being tested   Stabilizing Hand: back of calcaneus   Action Hand: ball of foot (4th and 5th met heads)       

     Applied Force:
         dorsiflexion of the ankle about talo-crual joint axis       

     Lateral Gastroc 
     Client Position:
         supine, flex hip 45°, flex knee 90°   External rotation of the foot   full ankle plantarflexion (point foot down and out)       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: anterior, superior aspect of the forefoot   Action Hand: back of the calcaneus       

     Applied Force:
         Knee extension       

     Medial Gastroc 
     Client Position:
         supine, flex hip 45°, flex knee 90°   Internal rotation of the foot   full ankle plantarflexion (point foot down and in)       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: anterior, superior aspect of the forefoot   Action Hand: back of the calcaneus       

     Applied Force:
         Knee extension       

     Plantaris 
     Client Position:
         supine, flex hip 45°, flex knee 90°   full ankle plantarflexion (point foot down)       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: anterior, superior aspect of the forefoot   Action Hand: back of the calcaneus       

     Applied Force:
         Knee extension       

     24. Micro Order 24, AMC&amp;S Test 
     Anterior Tibialis Tibial Division 
     Client Position:
         Supine, flex hip 45°, flex knee 90°   Adduction and inversion of the foot   Full dorsiflexion of the foot about the talocrural joint axis (through the 1st met)       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: base of heel   Action Hand: Superior, medial aspect of the forefoot       

     Applied Force:
         Plantarflexion of the foot about the talo-crural joint axis       

     Anterior Tibialis Interosseous Division 
     Client Position:
         Supine, flex hip 45°, flex knee 90°   Inversion of the foot   Full dorsiflexion of the foot about the talocrural joint axis (through the 1st met)       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: base of heel   Action Hand: Superior, medial aspect of the forefoot       

     Applied Force:
         Plantarflexion of the foot about the talo-crural joint axis       

     25. Micro Order 25, AMC&amp;S Test 
     Peroneus Brevis Lateral division 
     Client Position:
         Supine, flex hip 45°, flex knee 90°   Plantarflexion, abduction and eversion of the foot       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: base of heel   Action Hand: lateral aspect of the forefoot       

     Applied Force:
         Adduction of the foot       

     Peroneus Brevis Posterior Division 
     Client Position:
         supine, flex hip 45°, flex knee 90°   Plantarflexion and abduction of the foot   Slight eversion of the foot       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: base of heel   Action Hand: lateral aspect of the forefoot       

     Applied Force:
         Adduction through the plane of foot       

     26. Micro Order 26, AMC&amp;S Test 
     Peroneus Tertius Lateral Division 
     Client Position:
         Supine, flex hip 45°, flex knee 90°,   Abduction &amp; eversion of the foot   Full dorsiflexion of the foot about talo-crural joint axis       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: base of heel   Action Hand: Superior, lateral aspect of the forefoot       

     Applied Force:
         Plantarflexion of the foot about the talo-crural joint axis       

     Peroneus Tertius Anterior Division 
     Client Position:
         Supine, flex hip 45°, flex knee 90°   Eversion of the foot   Full dorsiflexion of the foot about the talo-crural joint axis       

     Tester Position:
         Body: stand at the base of the client   Stabilizing Hand: base of heel   Action Hand: Superior, lateral aspect of the forefoot       

     Applied Force:
         Plantarflexion of the foot about the talo-crural joint axis       

     27. Micro Order 27, AMC&amp;S Test 
     Peroneus Longus Metatarsal Division 
     Client Position:
         supine, flex hip 45°, flex knee 90°   Plantarflexion, abduction and eversion of the foot.   Full plantarflexion and eversion of the 1st met (point foot down and out)       

     Tester Position:
         Body: stand at the side of the client&#39;s involved foot   Stabilizing Hand: base of heel   Action Hand: Under 1st met head       

     Applied Force:
         Dorsiflexion and inversion of the foot (up and in) through the 1st metatarsal head       

     Peroneus Longus Cuneiform Division 
     Client Position:
         supine, flex hip 45°, flex knee 90°   Plantarflexion and eversion of the foot   Full abduction of the foot       

     Tester Position:
         Body: stand at the side of the client&#39;s involved foot   Stabilizing Hand: base of heel   Action Hand: lateral aspect of the forefoot       

     Applied Force:
         adduction of the foot       

     28. Micro Order 28, AMC&amp;S Test 
     Extensor Hallucis Longus Fibular Division 
     Client Position:
         Supine, leg straight   Dorsiflexion with inversion of the foot.   Extension of the distal phalanx of hallux (driving ankle dorsiflexion)       

     Tester Position:
         Body: Stand at base of the client   Stabilizing Hand: Brace proximal phalanx of hallux   Action Hand: brace dorsal surface of distal phalanx       

     Applied Force:
         Plantarflexion of distal phalanx of hallux   **do not force dorsiflexion of proximal phalanx       

     Extensor Hallucis Longus Interosseous Division 
     Client Position:
         Supine, leg straight   Dorsiflexion of the foot   Extension of the distal phalanx of hallux (driving ankle dorsiflexion)       

     Tester Position:
         Body: Stand at base of the client   Stabilizing Hand: Brace proximal phalanx of hallux   Action Hand: brace dorsal surface of distal phalanx       

     Applied Force:
         Plantarflexion of distal phalanx of hallux   **do not force dorsiflexion of proximal phalanx       

     Extensor Hallucis Brevis 
     Client Position:
         Supine, leg straight   Dorsiflexion of the foot   Dorsiflexion of proximal phalanx of the hallux (driving ankle dorsiflexion)       

     Tester Position:
         Body: Stand at base of the client   Stabilizing Hand: Brace 1st metatarsal head   Action Hand: brace proximal phalanx of hallux       

     Applied Force:
         Plantarflexion of the proximal phalanx of the hallux 29. Micro Order 29, AMC&amp;S Test       

     Extensor Digitorum Longus Lateral Division 
     Client Position:
         Supine, leg straight   Dorsiflexion with eversion of the foot.   Extension of the middle and distal phalanges of lateral two toes (driving ankle dorsiflexion)       

     Tester Position:
         Body: Stand at base of the client   Stabilizing Hand: Brace proximal phalanges of lateral 2 toes   Action Hand: brace dorsal surface of middle and distal phalanges of lateral 2 toes       

     Applied Force:
         Simultaneous plantarflexion of the middle and distal phalanges of lateral 2 toes   **do not force dorsiflexion of proximal phalanx       

     Extensor Digitorum Longus Medial Division 
     Client Position:
         Supine, leg straight   Dorsiflexion with eversion of the foot.   Extension of the middle and distal phalanges of medial two toes (driving ankle dorsiflexion)       

     Tester Position:
         Body: Stand at base of the client   Stabilizing Hand: Brace proximal phalanges of medial 2 toes   Action Hand: brace dorsal surface of middle and distal phalanges of medial 2 toes       

     Applied Force:
         Simultaneous plantarflexion of middle and distal phalanges of the medial 2 toes   **do not force dorsiflexion of proximal phalanx       

     Extensor Digitorum Brevis 
     Client Position:
         Supine, leg straight   Dorsiflexion of foot   Dorsiflex proximal phalanx of 2nd, 3rd &amp; 4th toes (driving ankle dorsiflexion)       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace plantar surface of foot   Action Hand: brace dorsal surface of proximal phalanx of the middle 3 toes       

     Applied Force:
         Plantarflexion of the proximal phalanx of the middle 3 toes       

     1st Dorsal Interossei 
     Client Position:
         Supine, leg straight   Foot Neutral   Extend and abduct the proximal phalanx of the 2nd toe       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 2nd metatarsal   Action Hand: brace medial aspect of proximal phalanx of 2nd toe       

     Applied Force:
         Adduction of the proximal phalanx of the 2nd toe toward the midline of foot*       

     2nd Dorsal Interossei 
     Client Position:
         Supine, leg straight   Foot Neutral   Extend and abduct the proximal phalanx of the 2nd toe       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 2nd metatarsal   Action Hand: brace lateral aspect of proximal phalanx of 2nd toe       

     Applied Force:
         Adduction of the proximal phalanx of 2nd toe toward the midline of the foot*       

     3rd Dorsal Interossei 
     Client Position:
         Supine, leg straight   Foot neutral   Extend and abduct the proximal phalanx of the 3rd toe       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 3rd metatarsal   Action Hand: brace lateral aspect of proximal phalanx of 3rd toe       

     Applied Force:
         Adduction of the proximal phalanx of the 3rd toe toward the midline of the foot       

     4th Dorsal Interossei 
     Client Position:
         Supine, leg straight   Foot Neutral   Extend and abduct the proximal phalanx of the 4th toe       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 4th metatarsal   Action Hand: brace lateral aspect of proximal phalanx of 4th toe       

     Applied Force:
         Adduction of the proximal phalanx of the 4th toe toward the midline of the foot       

     30. Micro Order 30, AMC&amp;S Test 
     Flexor Hallucis Longus Fibular Division 
     Client Position:
         Supine, leg straight   Plantarflexion and inversion of the foot.   Full Plantarflexion of distal phalanx of the hallux (driving ankle plantarflexion) (Point big toe down and in)       

     Tester Position:
         Body: Stand to the side of involved foot   Stabilizing Hand: Brace proximal phalanx of the hallux   Action Hand: brace plantar surface of distal phalanx of the hallux       

     Applied Force:
         Dorsiflexion of the distal phalanx of the hallux   **do not force plantarflexion of proximal phalanx       

     Flexor Hallucis Longus Interosseous Division 
     Client Position:
         Supine: leg straight   Plantarflexion of the foot   Full Plantarflexion of distal phalanx of the hallux (driving ankle plantarflexion) (point big toe down)       

     Tester Position:
         Body: Stand to the side of involved foot   Stabilizing Hand: Brace the proximal phalanx of the hallux   Action Hand: brace plantar surface of distal phalanx of the hallux       

     Applied Force:
         Dorsiflexion of the distal phalanx of the hallux   **do not force plantarflexion of proximal phalanx       

     Flexor Hallucis Brevis 1st Cuneiform Division 
     Client Position:
         Supine, straight leg   Plantarflexion of the foot   Plantarflexion and Inversion of the proximal phalanx of the hallux (relative to midline of the foot)       

     Tester Position:
         Body: Stand to the side of involved foot   Stabilizing Hand: Brace 1st metatarsal   Action Hand: brace the inferior, lateral aspect of the proximal phalanx of the hallux       

     Applied Force:
         Dorsiflexion and Eversion of the proximal phalanx of the hallux (relative to midline of the foot)       

     Flexor Hallucis Brevis Cuboid Division 
     Client Position:
         Supine, straight leg   Plantarflexion of the foot   Plantarflexion and Eversion of the proximal phalanx of the hallux (relative to midline of the foot)       

     Tester Position:
         Body: Stand to the side of the involved foot   Stabilizing Hand: Brace the 1st metatarsal   Action Hand: brace the inferior, medial aspect of the proximal phalanx of the hallux       

     Applied Force:
         Dorsiflexion and Inversion of the proximal phalanx of the hallux (relative to midline of the foot)       

     Flexor Hallucis Brevis 3rd Cuneiform Division 
     Client Position:
         Supine   Plantarflexion of the foot   Plantarflexion of the proximal phalanx of the hallux       

     Tester Position:
         Body: Stand to the side of involved foot   Stabilizing Hand: Brace 1st metatarsal   Action Hand: brace proximal phalanx of hallux       

     Applied Force:
         Dorsiflexion of the proximal phalanx of the hallux       

     Adductor Hallucis Oblique Head 
     Client Position:
         Supine, leg straight   Plantarflexion of the foot   Plantarflexion and adduction of the proximal phalanx of the hallux       

     Tester Position:
         Body: Stand to the side of involved foot   Stabilizing Hand: Brace 1st met   Action Hand: brace proximal phalanx of the hallux       

     Applied Force:
         Abduction of the proximal phalanx of hallux       

     Adductor Hallucis Transverse Head: Lateral Division 
     Client Position:
         Supine, leg straight   Plantarflexion of the foot   Plantarflexion and inversion of the 4th,and 5th mets with plantarflexion at the 1st MTP-joint       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: brace the 1st met head   Action Hand: Brace dorsum of 4th and 5th metatarsal heads       

     Applied Force:
         Dorsiflexion and eversion of the 4th and 5th metatarsals       

     Adductor Hallucis Transverse Head: Lateral Division 
     Client Position:
         Supine, leg straight   Plantarflexion of the foot   Plantarflexion and inversion of the 4th,and 5th mets with plantarflexion at the 1st MTP-joint       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: brace the 1st met head   Action Hand: Brace dorsum of 4th and 5th metatarsal heads       

     Applied Force:
         Dorsiflexion and eversion of the 4th and 5th metatarsals       

     Abductor Hallucis Longus Supinator Division 
     Client Position:
         Supine, flex hip 45° and flex knee 90°   Plantarflexion of the foot   invert the forefoot on the rearfoot   Adduct the forefoot on the rearfoot       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace the calcaneus   Action Hand: medial aspect of hallux and 1st met       

     Applied Force:
         Abduction of the forefoot on rearfoot through the hallux   Abductor Hallucis Longus Adductor Division       

     Client Position:
         Supine, flex hip 45° and flex knee 90°   Plantarflexion of the foot   Adduct of the forefoot on the rearfoot       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace the calcaneus   Action Hand: medial aspect of hallux and 1st met       

     Applied Force:
         Abduction of the forefoot on rearfoot through the hallux       

     31. Micro Order 31, AMC&amp;S Test 
     Flexor Digitorum Longus Lateral Division 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot   Plantarflex distal phalanges of lateral 2 toes (driving plantarflexion of the foot) (point toes down and in)       

     Tester Position:
         Body: Stand at side of involved foot   Stabilizing Hand: Brace middle phalanges   Action Hand: plantar surface of distal phalanges       

     Applied Force:
         Dorsiflex distal phalanges of lateral 2 toes       

     Flexor Digitorum Longus Medial Division 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot   Plantarflex distal phalanges of medial 2 toes (driving ankle plantarflexion) (point toes down and in)       

     Tester Position:
         Body: Stand at side of involved foot   Stabilizing Hand: Brace middle phalanges   Action Hand: plantar surface of distal phalanges       

     Applied Force:
         Dorsiflex distal phalanges of medial 2 toes       

     Flexor Digitorum Brevis Lateral Division 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot   Plantarflexion of middle phalanx of lateral 2 toes.   Maintain extension of distal phalanx       

     Tester Position:
         Body: Stand at side of involved foot   Stabilizing Hand: Brace proximal phalanx of lateral 2 toes   Action Hand: brace base of middle phalanges       

     Applied Force:
         Dorsiflexion of the middle phalanx of the lateral 2 toes while maintaining extension of the distal phalanx       

     Flexor Digitorum Brevis Medial Division 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot   Plantarflexion of the middle phalanx of medial 2 toes.   Maintain extension of distal phalanx       

     Tester Position:
         Body: Stand at side of involved foot   Stabilizing Hand: Brace proximal phalanx of the medial 2 toes   Action Hand: brace base of middle phalanges       

     Applied Force:
         Dorsiflexion of the middle phalanx of medial 2 toes while maintaining extension of the distal phalanx       

     Quadratus Plantae Lateral Head 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot   Plantarflex proximal phalanges of 4th and 5th toes while maintaining extension of middle and distal phalanx       

     Tester Position:
         Body: Stand at side of involved foot   Stabilizing Hand: Brace metatarsal heads of lateral 2 toes   Action Hand: brace base of proximal phalanges of lateral 2 toes       

     Applied Force:
         Dorsiflexion of the proximal phalanx of lateral 2 toes while maintaining extension of middle and distal phalanges       

     Quadratus Plantae Medial Head 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot   Plantarflexion of the proximal phalanges of 2nd and 3rd toes while maintaining extension of middle and distal phalanges       

     Tester Position:
         Body: Stand at side of involved foot   Stabilizing Hand: Brace metatarsal heads of medial 2 toes   Action Hand: brace base of proximal phalanx of medial 2 toes       

     Applied Force:
         Dorsiflexion of the proximal phalanx of medial 2 toes while maintaining extension of middle and distal phalanges       

     4th Plantar Lumbrical 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot*   Extension of the proximal phalanx of the 5th toe while maintaining extension of the middle and distal phalanges       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 5th metatarsal head   Action Hand: brace base of proximal phalanx of 5th metatarsal while maintaining middle and distal extension       

     Applied Force:
         Dorsiflexion of the 5th toe       

     3rd Plantar Lumbrical 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot*   Extension of the proximal phalanx of the 4th toe while maintaining extension of the middle and distal phalanges       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 4th metatarsal head   Action Hand: brace base of proximal phalanx of 4th metatarsal while maintaining middle and distal extension       

     Applied Force:
         Dorsiflexion of the 4th toe       

     2nd Plantar Lumbrical 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot*   Extension of the proximal phalanx of the 3rd toe while maintaining extension of the middle and distal phalanges       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 3rd metatarsal head   Action Hand: brace base of proximal phalanx of 3rd metatarsal while maintaining middle and distal extension       

     Applied Force:
         Dorsiflexion of the 3rd toe       

     1st Lumbrical 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot*   Extension of the proximal phalanx of the 2nd toe while maintaining extension of the middle and distal phalanges       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 2nd metatarsal head   Action Hand: brace base of proximal phalanx of 2nd metatarsal while maintaining middle and distal extension       

     Applied Force:
         Dorsiflexion of the 2nd toe       

     3rd Plantar Interossei 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot   Plantarflexion of the proximal phalanx of the 5th toe       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 5th metatarsal   Action Hand: brace medial aspect of proximal phalanx of the 5th toe       

     Applied Force:
         Dorsiflexion of the proximal phalanx of the 5th toe       

     2nd Plantar Interossei 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot   Plantarflexion of the proximal phalanx of the 4th toe       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 4th metatarsal   Action Hand: brace medial aspect of proximal phalanx of the 4th toe       

     Applied Force:
         Dorsiflexion of the proximal phalanx of the 4th toe       

     1st Plantar Interossei 
     Client Position:
         Supine, leg straight   Plantarflexion with inversion of the foot   Plantarflexion of the proximal phalanx of the 3rd toe       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace 3rd metatarsal   Action Hand: brace medial aspect of proximal phalanx of the 3rd toe       

     Applied Force:
         Dorsiflexion of the proximal phalanx of 3rd toe       

     Abductor Digiti Minimi 
     Client Position:
         Supine, hip flexed 45 degrees with 90 degrees of knee flexion   Plantarflexion of the foot.   Abduction of the forefoot on rearfoot       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace the calcaneus   Action Hand: Lateral and distal aspect of 5th metatarsal       

     Applied Force:
         Adduction of the forefoot on the rearfoot       

     Flexor Digiti Minimi Brevis 
     Client Position:
         Supine, leg straight   Plantarflexion of the foot   Flexion and abduction of the proximal phalanx of 5th toe   Keep distal phalanx extended       

     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace the 5th metatarsal   Action Hand: brace base of 5th proximal phalange       

     Applied Force:
         Dorsiflexion and adduction of the proximal phalanx of 5th toe       

     32. Micro Order 32, AMC&amp;S Test 
     Longus Capitis 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand on back of head   Action Hand: brace hand on front of head       

     Client Position:
         Supine, tuck chin to flex head on neck   Rotate 20° toward uninvolved side   Fully flex cervical spine       

     Applied Force:
         extend head on neck through plane of the head       

     Longus Colli: Superior Oblique Fibers 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand on contralateral side of head   Action Hand: brace hand on ipsilateral side of head       

     Client Position:
         Supine, fully rotate head to uninvolved side   Extend head on neck (Chin up)   Fully flex neck on trunk       

     Applied Force:
         extend neck on trunk through sagittal plane       

     Longus Colli: Vertical Fibers 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand on contralateral side of head   Action Hand: brace hand on ipsilateral side of head       

     Client Position:
         Supine, fully rotate head to uninvolved side   Extend head on neck (Chin up)   Flex neck on trunk 25 degrees       

     Applied Force:
         extend neck on trunk through sagittal plane       

     Longus Colli: Inferior Oblique Fibers 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand on contralateral side of head   Action Hand: brace hand on ipsilateral side of head       

     Client Position:
         Supine, fully rotate head to uninvolved side   Extend head on neck (Chin up)   Flex neck on trunk 5 degrees       

     Applied Force:
         extend neck on trunk through sagittal plane       

     Mylohyoid 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand on back of head   Action Hand: brace hand on front of head       

     Client Position:
         Supine, tuck chin to flex head on neck   Rotate 20° toward uninvolved side   Clench teeth with tongue to the roof of the mouth   Fully flex cervical spine       

     Applied Force:
         extend head on neck through plane of the head       

     Sternohyoid 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand on back of head   Action Hand: brace hand on front of head       

     Client Position:
         Supine, Rotate head 20° toward uninvolved side   Extend head on neck (chin up)   Clench teeth with tongue to the roof of the mouth   Fully flex cervical spine       

     Applied Force:
         Extend neck through plane of the head       

     Rectus Capitis Anterior 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace on back of the head   Action Hand: brace anterior side of head       

     Client Position:
         full flexion of head on neck and neck on trunk   Rotate head 45° to contralateral side       

     Applied Force:
         Extend head on neck through oblique plane       

     33. Micro Order 33, AMC&amp;S Test 
     Multifidus Cervicis Inferior Division 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite ear   Action Hand: brace around involved ear       

     Client Position:
         Full rotation of neck to opposite side   Lateral Flexion of neck to involved side   Tuck Chin       

     Applied Force:
         Laterally flex neck though plane of table       

     Multifidus Cervicis Superior Division 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite ear   Action Hand: brace around involved ear       

     Client Position:
         Full rotation of neck to opposite side   Lateral Flexion of neck to involved side   Chin Up       

     Applied Force:
         Laterally flex neck through plane of table       

     Sternocleidomastoid Sternal Fibers 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite ear   Action Hand: brace palm of hand over temporal bone       

     Client Position:
         Supine, Extend head on neck   Rotate 45° to contralateral side   Fully flex neck on trunk       

     Applied Force:
         Extend neck on trunk in sagittal plane       

     Sternocleidomastoid Clavicular Fibers 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite ear   Action Hand: brace around involved ear       

     Client Position:
         Supine, Extend head on neck   Rotate 45° to contralateral side   Fully flex neck on trunk       

     Applied Force:
         extend and sidebend neck on trunk though oblique plane       

     Longissimus Capitis 
     Tester Position:
         Body: Stand on involved side of the body   Stabilizing Hand: Brace hand on contralateral side of head: use elbow to brace thoracic spine   Action Hand: Posterior side of head       

     Client Position:
         Prone, full rotation to involved side   full extension of neck on trunk then head on neck       

     Applied Force:
         Flex head on neck in sagittal plane (Separate mastoid from TP&#39;s)       

     Longissimus Cervicis 
     Tester Position:
         Body: Stand on involved side of the body   Stabilizing Hand: Brace hand on contralateral side of head: use elbow to brace thoracic spine   Action Hand: Posterior side of head       

     Client Position:
         Prone, full rotation to involved side   Full extension of neck on trunk   Flex head on neck       

     Applied Force:
         flex neck on trunk through the sagittal plane (separate TP&#39;s)       

     Splenius Capitis 
     Tester Position:
         Body: Stand on involved side of the body   Stabilizing Hand: Brace uninvolved side of head: use elbow to brace thoracic spine   Action Hand: posterior-lateral side of head       

     Client Position:
         Prone, fully extend cervical spine   Fully rotate to involved side   Extend head on neck       

     Applied Force:
         flex head through Sagittal plane       

     Splenius Cervicis 
     Tester Position:
         Body: Stand on involved side of body   Stabilizing Hand: Brace uninvolved side of head: use elbow to brace thoracic spine   Action Hand: Posterior-lateral side of head       

     Client Position:
         Prone, fully extend cervical spine   Fully rotate to involved side   Tuck chin       

     Applied Force:
         flex head through sagittal plane       

     Iliocostalis Cervicis 
     Tester Position:
         Body: Stand on involved side of body   Stabilizing Hand: Brace uninvolved side of head: use elbow to brace thoracic spine   Action Hand: Lateral side of head       

     Client Position:
         Prone, tuck chin   Rotate head to look over involved shoulder       

     Applied Force:
         flex head through oblique plane       

     Rotatores Cervicis 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite ear and skull   Action Hand: brace around involved skull       

     Client Position:
         Full rotation of neck to opposite side   Lateral flexion to involved side   Chin up       

     Applied Force:
         Counter-rotation of head and neck       

     Rectus Capitis Posterior Major 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite side skull   Action Hand: brace around involved skull       

     Client Position:
         Full flexion of neck on trunk   Extend head on neck   Rotate head 45° to ipsilateral side       

     Applied Force:
         Rotate head to contralateral side       

     Obliques Capitis Inferior 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite ear   Action Hand: brace around involved ear       

     Client Position:
         full flexion of head on neck and neck on trunk (chin down)   Full rotation of head to ipsilateral side       

     Applied Force:
         Rotate head to contralateral side       

     34. Micro Order 34, AMC&amp;S Test 
     Semispinalis Capitis 
     Tester Position:
         Body: Stand on involved side of body   Stabilizing Hand: anterior side of head: use elbow to stabilize thoracic spine   Action Hand: Brace hand on back of skull       

     Client Position:
         Prone, rotate 20° to uninvolved side   Extend head   Fully extend cervical spine       

     Applied Force:
         flex head and neck through plane of head       

     Semispinalis Cervicis 
     Tester Position:
         Body: Stand on involved side of the body   Stabilizing Hand: anterior side of head: use elbow to stabilize thoracic spine   Action Hand: Brace hand on back of skull       

     Client Position:
         Prone, rotate 20° to uninvolved side   Fully extend cervical spine   Flex head on neck       

     Applied Force:
         Flex neck on trunk through plane of head       

     Spinalis Capitis 
     Tester Position:
         Body: Stand on involved side of the body   Stabilizing Hand: Anterior side of skull   Action Hand: Brace hand behind ear on skull       

     Client Position:
         Prone, slightly rotate to involved side   extend cervical spine 20°   extend head on neck       

     Applied Force:
         flex head on trunk in sagittal plane in cocking motion       

     Spinalis Cervicis 
     Tester Position:
         Body: Stand on side of body   Stabilizing Hand: Brace opposite shoulder   Action Hand: Brace hand behind ear on skull       

     Client Position:
         Prone, slightly rotate to involved side   Flex head on neck   Extend cervical spine 20°       

     Applied Force:
         flex head sagittal plane       

     Interspinalis Cervicis 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around front of head   Action Hand: posterior side of head on involved side       

     Client Position:
         Extension of head and neck       

     Applied Force:
         Cervical flexion       

     Obliques Capitis Superior 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around uninvolved side of skull   Action Hand: brace posterior skull on involved side       

     Client Position:
         Full rotation of head to contralateral side   Flexion of neck on trunk   Flexion of head on neck       

     Applied Force:
         extend head obliquely toward opposite ear       

     Rectus Capitis Posterior Minor 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around uninvolved side of skull   Action Hand: brace around involved side skull       

     Client Position:
         Slight flexion of neck on trunk   Full extension of head on neck (chin up)   Slight rotation to involved side       

     Applied Force:
         Flex head on neck       

     35. Micro Order 35, AMC&amp;S Test 
     Posterior Scalenes AMC&amp;S Test 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand on uninvolved side of head above ear   Action Hand: brace hand on involved side of head above ear       

     Client Position:
         Supine, grab sides of table   rotate head 20° to uninvolved side   Slightly flex cervical spine   Flex and fully side bend neck on thorax through oblique plane   Chin up       

     Applied Force:
         laterally flex and extend neck on thorax through oblique plane       

     Middle Scalenes 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand on uninvolved side of head above ear   Action Hand: brace hand on involved side of head above ear       

     Client Position:
         Supine, grab sides of table   rotate head 20° to uninvolved side   Slightly flex cervical spine   Flex and fully side bend neck on thorax through oblique plane   Chin up       

     Applied Force:
         laterally flex neck on trunk through oblique plane with force coming from anterior to the ear       

     Anterior Scalenes 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite side of head   Action Hand: brace hand on involved side of head       

     Client Position:
         Supine, flex cervical spine 45°   rotate 20° away   Fully sidebend neck   extend head on neck (chin up)       

     Applied Force:
         Laterally flex neck on trunk in oblique plane       

     Anterior Intertransversarii 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite side of head   Action Hand: brace around involved side of head       

     Client Position:
         Slight rotation of head to involved side   Lateral flexion of neck to same side   Tuck Chin       

     Applied Force:
         Laterally flex neck coronal plane       

     Omohyoid 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around opposite side of head   Action Hand: brace around involved side of head       

     Client Position:
         Full flexion of neck on trunk   20 degrees of rotation to opposite side   Capital extension   Shrug involved shoulder   Teeth clenched with tongue to roof of mouth       

     Applied Force:
         Laterally flex and extend neck on trunk through oblique plane       

     Rectus Capitis Lateralis 
     Tester Position:
         Body: Stand distal to body   Stabilizing Hand: Brace hand around uninvolved side of head   Action Hand: brace around involved side of head       

     Client Position:
         Lateral flexion of head on neck       

     Applied Force:
         Laterally flex head on neck through coronal plane       

     36. Micro Order 36, Muscle Test 
     Extensor Carpi Radialis Longus: Abductor Division 
     Client supine
         Full Elbow flexion with forearm pronated*   Abduct/Radial Deviate hand at wrist and fully extend wrist emphasizing pressure through the 2nd met       

     Force: Wrist Flexion with Adduction/Ulnar Deviation (Force through 2nd met) 
     Extensor Carpi Radialis Longus: Extensor Division Muscle Test 
     Client supine
         Full Elbow flexion with forearm pronated*   Fully extend wrist emphasizing pressure through the 2nd met       

     Force: Wrist Flexion (Force through 2nd met) 
     Extensor Carpi Ulnaris: Adductor Division
         Client supine   Full Elbow flexion with forearm pronated*   Adduct/Ulnar Deviate hand at wrist and fully extend wrist emphasizing pressure through the 5th met   Force: Wrist Flexion with Adduction/Ulnar Deviation (force through 5th met)       

     Extensor Carpi Ulnaris: Extensor Division
         Client supine   Full Elbow flexion with forearm pronated*   Fully extend wrist emphasizing pressure through the 5th met   FORCE: Wrist Flexion (Force through 5th met)       

     Extensor Carpi Radialis Brevis
         Client supine   Full Elbow flexion with forearm pronated*   Fully extend wrist emphasizing pressure through the 3rd met   FORCE: Wrist Flexion with Adduction/Ulnar Deviation (Force through 3rd met)       

     37. Micro Order 37, Muscle Test 
     Flexor Carpi Radialis: Abductor Division
         Client supine   90° Elbow flexion with forearm supinated   Abduct/Radial Deviate and fully flex hand at wrist emphasizing pressure through 2nd met       

     Force: Wrist extension with adduction/ulnar deviation (Force through 2nd met) 
     Flexor Carpi Radialis: Flexor Division
         Client supine   90° Elbow flexion with forearm supinated   Fully flex hand at wrist emphasizing pressure through 2nd met       

     Force: Wrist extension (Force through 2nd met) 
     Flexor Carpi Ulnaris: Adductor Division
         Client supine   90° Elbow flexion with forearm supinated   Adduct/Ulnar Deviate and fully flex hand at wrist emphasizing pressure through 5th met       

     Force: Wrist extension with adduction/ulnar deviation (Force through 5th met) 
     Flexor Carpi Ulnaris: Flexor Division
         Client supine   90° Elbow flexion with forearm supinated   Fully flex hand at wrist emphasizing pressure through 5th met       

     Force: Wrist extension (Force through 5th met) 
     Palmaris Longus
         Client supine   90° Elbow flexion with Supination and full wrist flexion   Point fingers and thumb together (eagles beak)       

     Force: Wrist extension 
     38. Micro Order 38, Muscle Test 
     Anconeus: Ulnar Division
         Client supine   Fully extend elbow and supinate forearm       

     Force:
         Pronate forearm, maintaining elbow extension       

     Anconeus: Olecranon Division
         Client supine,   Flex elbow 45° and supinate forearm       

     Force:
         Pronate forearm, with elbow flexed 45°       

     Supinator: Olecranon Division Muscle Test
         Client supine   Supinate forearm with 90 degrees of elbow flexion       

     Force: Pronate forearm 
     Supinator: Ulnar Division
         Client supine   Supinate forearm with full elbow flexion       

     Force: Pronate forearm 
     39. Micro Order 39, Muscle Test 
     Pronator Teres: Humeral Division
         Client supine   Elbow extension with full pronation of forearm       

     Force: Supination of forearm 
     Pronator Teres: Ulnar Division
         Client supine   Flex elbow 45° with full pronation of forearm       

     Force: Supination of forearm 
     Pronator Quadratus: Proximal Division
         Client supine   Elbow flexed 90° with full pronation of the forearm (hand straight)       

     Force: Supination of forearm 
     Pronator Quadratus: Distal Division
         Client supine   Full flexion of the elbow and full pronation of the forearm       

     Force: Supination of Forearm 
     40. Micro Order 40, Muscle Test 
     Extensor Pollicis Longus: Ulnar Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Extend distal phalanx of thumb with metacarpal abducted and radial deviation of the hand at the wrist   Brace proximal phalanx       

     Force: Flex distal phalanx on proximal phalanx 
     Extensor Pollicis Longus: Septal Division Muscle Test
         Client supine   Elbow flexed 90 Degrees forearm pronated   Extend distal phalanx of thumb with metacarpal abducted and radial deviation of the hand at the wrist   Brace proximal phalanx       

     Force: Flex distal phalanx on proximal phalanx 
     Extensor Pollicis Brevis: Radial Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Extend and abduct proximal phalanx while flexing distal phalanx of thumb   Radial deviation of the hand at the wrist   Brace 1st metacarpal       

     Force: Flex and adduct proximal phalanx of the thumb 
     Extensor Pollicis Brevis: Septal Division
         Client supine   Elbow flexed 90 Degrees with forearm pronated   Extend and abduct proximal phalanx while flexing distal phalanx of thumb   Radial deviation of the hand at the wrist   Brace 1st metacarpal       

     Force: Flex and adduct proximal phalanx of the thumb 
     Abductor Pollicis Longus: Radial Division
         Client supine   Elbow flexed 90 degrees with forearm supinated   Abduct and extend 1st metacarpal (maintain flexion of distal phalanx)   Radial deviation of the hand at the wrist   Brace trapezium       

     Force: Flex and Adduct 1st metacarpal 
     Abductor Pollicis LonguS: Ulnar Division
         Client supine   Elbow flexed 90 degrees with forearm pronated   Abduct and extend 1st metacarpal (maintain flexion of distal phalanx)   Radial deviation of the hand at the wrist   Brace trapezium       

     Force: Flex and Adduct 1st metacarpal 
     41. Micro Order 41, Muscle Test 
     Flexor Pollicis Longus
         Client supine   Elbow flexed 90 degrees with forearm supinated and wrist flexion   Flex distal phalanx on flexed proximal phalanx and adducted metacarpal   Brace proximal phalanx       

     Force: Extend distal phalanx on proximal phalanx 
     Abductor Pollicis Brevis
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex/abduct radial side of proximal phalanx of thumb forward and toward base of 5th met   Maintain extension of the distal phalanx       

     Force: extend/adduct proximal phalanx 
     Flexor Pollicis Brevis
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex proximal phalanx of thumb toward 5th met head   Maintain extension of the distal phalanx       

     Force: Extend proximal phalanx away from 5 th    
     Adductor Pollicis Oblique Head
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and Adduct ulnar side of thumb toward junction at the base of the 4th and 5th metacarpals   Maintain Extension of distal phalanx of the thumb.       

     Force: Extend proximal phalanx 
     Adductor Pollicis Transverse Head
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and Adduct ulnar side of thumb toward 3rd metacarpal   Maintain extension of distal phalanx of thumb.       

     Force: Extend proximal phalanx 
     Interoseii Pollicis
         Client supine   Elbow flexed 90 degrees with forearm supinated   Flex and Adduct thumb toward 2nd metacarpal   Maintain extension of the distal phalanx of the thumb.       

     Force: Extend proximal phalanx 
     Opponens Pollicis Flexor Division
         Client supine   Elbow flexed 90 degrees with forearm supinated   Flex and Abduct 1st metacarpal by touching tip of thumb to 5th finger   Extend the proximal phalanx of thumb.       

     Force: Extend 1st metacarpal 
     Opponens Pollicis Abductor Division
         Client supine   Elbow flexed 90 degrees with forearm supinated.   Flex and Abduct 1st metacarpal by touching tip of thumb to 5th finger   Extend the proximal phalanx of thumb.       

     Force: Adduct 1st metacarpal 
     42. Micro Order 42, Muscle Test 
     Extensor Digitorum Medial Division
         Client supine   Elbow flexed 90 degrees with forearm pronated and slight wrist flexion**   Extend 4th and 5th digits (1 at a time)   Maintain extension at inter-phalangeal joints       

     Force: Flex base of proximal phalanx of 4th and 5th digits
         *Grip fingers as a whole       

     Extensor Digitorum Lateral Division
         Client supine   Elbow flexed 90 degrees with forearm supinated and wrist extended   Extend 2nd and 3rd digits (1 at a time)   Maintain extension at inter-phalangeal joints       

     Force: Flex base of proximal phalanx of 2nd and 3rd digits
         *Grip fingers as a whole       

     Extensor Indicis
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Extend and adduct 2nd digit       

     Force: Flex and abduct 2nd digit 
     Extensor Digiti Minimi
         Client supine   Elbow flexed 90 degrees with forearm supinated   Extend and adduct the 5th digit       

     Force: Flex and abduct the proximal phalanx of the 5th digit through sagittal plane 
     4th Dorsal Interossei
         Client supine   Elbow flexed 90 degrees with forearm supinated   Extend and abduct 4th digit toward 5th       

     Force: Adduct 4th digit toward 3 rd    
     3rd Dorsal Interossei
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Extend and abduct 3rd digit toward 4th       

     FORCE: Adduct 3rd digit toward 2nd 
     2nd Dorsal Interossei
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Extend and abduct 3rd digit toward 2nd       

     Force: Adduct 3rd digit toward 4 th    
     1st Dorsal Interossei
         Client supine   Elbow flexed 90 degrees with forearm supinated   Extend and abduct 2nd digit toward 1st       

     Force: Adduct 2nd digit toward 3 rd    
     43. Micro Order 43, Muscle Test 
     Flexor Digitorum Profundus Medial Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated and slight wrist extension**   Flex distal phalanx while extending proximal and distal phalanx of 4th and 5th digits       

     Force: Extend distal phalanx of 4th and 5th digits 
     Flexor Digitorum Profundus Lateral Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated and slight wrist extension   Flex distal phalanx while extending proximal and distal phalanx of 2nd and 3rd digits       

     Force: Extend distal phalanx of 2nd and 3rd digits 
     Flexor Digitorum Superficialis: Medial Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated and slight wrist extension**   Flex middle phalanx while extending distal phalanx of the 4th and 5th digits       

     Force: Extend middle and distal phalanx of 4th and 5th digits 
     Flexor Digitorum Superficialis: Lateral Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated and slight wrist extension   Flex middle phalanx while extending distal phalanx of the 2nd and 3rd digits       

     Force: Extend middle and distal phalanx of 2nd and 3rd digits 
     4th Lumbrical
         Client Supine   Elbow flexed 90 Degrees with forearm supinated   Flex and adduct 5th digit   Brace base of proximal phalanx of 5th metacarpal while maintaining middle and distal extension   Force: Extension of the 5th digit       

     3rd Lumbrical
         Client Supine   Elbow flexed 90 Degrees with forearm supinated   Flex 4th digit   Brace base of proximal phalanx of 4th metacarpal while maintaining middle and distal extension   Force: Extension of the 4th digit       

     2nd Lumbrical
         Client Supine   Elbow flexed 90 Degrees with forearm supinated   Flex 3rd digit   Brace base of proximal phalanx of 3rd metacarpal while maintaining middle and distal extension   Force: Extension of the 3rd digit       

     1st Lumbrical
         Client Supine   Elbow flexed 90 Degrees with forearm supinated   Flex 2nd digit   Brace base of proximal phalanx of 2nd metacarpal while maintaining middle and distal extension   Force: Extension of the 2nd digit       

     3rd Palmar Interossei
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and adduct proximal phalanx of 5th digit toward 4th       

     Force: Extend and Abduct 5th digit away from 4 th    
     2nd Palmar Interossei
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and adduct proximal phalanx of 4th digit toward 3rd       

     Force: Extend and Abduct 4th digit away from 3rd 
     1st Palmar Interossei
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and adduct proximal phalanx of 2nd digit toward 3rd       

     Force: Extend and Abduct 2nd digit away from 3 rd    
     Flexor Digiti Minimi
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex proximal phalanx of the 5th digit       

     Force: Extend proximal phalanx of 5th digit 
     Abductor Digiti Minimi Flexor Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and abduct the proximal phalanx of 5th digit       

     Force: Extend proximal phalanx of 5th digit 
     Abductor Digiti Minimi Abductor Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and abduct proximal phalanx of 5th digit down and away from ulna       

     Force: Extend and adduct proximal phalanx of 5th digit 
     Oponens Digiti Minimi Manus Flexor Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and abduct 5th metacarpal       

     Force: Extend 5th metacarpal 
     Oponens Digiti Minimi Manus Abductor Division
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and abduct 5th metacarpal       

     Force: Extend and adduct 5th metacarpal 
     Palmaris Brevis
         Client supine   Elbow flexed 90 Degrees with forearm supinated   Flex and adduct 5th metacarpal to Approximate toward 1st metacarpal       

     Force: Separate 5th metacarpal from 1st 
     Systems and Kits 
     Embodiments provided herein also include systems and kits for facilitating and enhancing the maintenance of a subject&#39;s muscle set-points. 
     Kits in accordance with the present disclosure include exercise instructions and corresponding exercise equipment for properly stressing (exercise) a subject&#39;s muscle using the same basic macro and micro hierarchy shown above. Kits may include an instruction sheet and figures showing the exercise order for maximum benefit for any one muscle pattern or for any two or more patterns, up to instructions for all 43 movement patterns. Kits also may include instructions sheets and figures on MSAS for each muscle in the 43 movement patterns. Optionally, appropriate exercise equipment for general stress to a primary or secondary muscle is provided in a kit. Exercise equipment may include a treadmill. Exercise equipment in some aspects is designed to support ACM&amp;S. 
     Systems in accordance with the present disclosure include kits and memory/computing devices for keeping track and personalizing a subject&#39;s muscle contractile profile at any one time. For example, a computer that stores and updates a subject&#39;s treatment and/or exercise status based on the embodiments herein. The memory/computing device could track muscle set points (primary and secondary) based on a health care professional&#39;s input. Objective criteria could be used for input based on the health care professional assessment and overall treatment or exercise regimes developed based on a subject&#39;s status. In addition, video of the subject&#39;s gait over a period of time may be included, where the video can be used to verify improvement to the subject&#39;s gait. 
     An Illustrative Embodiment 
     A patient having pain or muscle dysfunction comes to the office for enhanced muscle treatment in accordance with the embodiments described herein. The patient is new to the office and has not previously been treated by the health care professional. The patient is initially stressed using MSAS for muscle pattern 1 (macro and micro, bilateral). MSAS in this case establishes the priority of pattern 1 for the new patient. MSAS on pattern 1 is followed by testing and treatment of each muscle in the pattern using AMC&amp;S and DFAMAT. At this point the patient has had a specific stress, test, and treatment for every muscle in muscle pattern 1 (performed bilaterally). This process is repeated for every pattern up to pattern 43. At any given time, at the discretion of the practitioner, the patient is then put on an escalating speed treadmill for one minute, such that the patient is unable to keep up by the end of the minute. The health care professional notes any obvious dysfunction in the patient&#39;s gait for up to a one minute period. The patient is now tested by the AMC&amp;S, and pattern 1 is now demonstrated to have weakness. The MSAS is then applied, the client will be treated via DFAMAT for every muscle in muscle pattern 1. Pattern 1 will be treated fully through the progressive implementation of MSAS, AMC&amp;S and DFAMAT until the primary muscle stays strong after the MSAS (see previous embodiment). At this point the health care profession has determined that muscle pattern 1 has been sufficiently activated and treated to move onto muscle pattern 2. The health care professional determines if it beneficial to repeat the gait stress to draw out pattern 2. In this illustration, utilizing the gait stress, the health care professional works his or her way through all 43 muscle patterns, both macro and micro. The patient has completed the process and made significant strides at effectively treating the patient&#39;s dysfunctional gait. 
     The patient returns in one week or a reasonable time period determined by the practitioner, to continue the process. On the second visit, utilizing the gait stress, the health care professional continues to work through the macro pattern (primary muscles) for each of the 43 muscle groups, bilaterally. This process continues over a period of several months, where the patient&#39;s muscles are being tied back into the patient&#39;s CPG. In addition, because the patient is now using a functional gait, the patient&#39;s gait pattern continues to improve even in the absence of new treatment sessions.