Jeffrey R. Cram, PhD and Maya Durie, MEd, CMT
Abstract
The history of muscle pain and dysfunction is viewed through the lens
of a four factor theory of histologic (tissue related) issues,
psychologic (emotional) issues, sensory motor (movement) issues and
biomechanical (postural) issues. The historical antecedents of both
bodywork and surface electromyography are reviewed.
Key words: Surface EMG, SEMG, bodywork, trigger points, posture, emotions, movement.
Note: Parts of this article have appeared in The History of SEMG, Jour App Psychophys and Biof, In Press.
Humans have had to deal with sore muscles since the beginning of
time. Initially, muscle assessments and treatments were conducted by
hand and during the last century, the use of electronic instruments came
into play.
To put muscle function and the clinical use of Surface
electromyography (SEMG) into a perspective of history, is seems prudent
to utilize a broad nomothetic net or conceptual framework. In Clinical
Applications for Surface Electromyography, Kasman, Cram and Wolf (1998)
consider chronic muscle dysfunction from a four fold perspective:
Histologic (Tissue related issues); Psychologic (Psychophysiology and
Emotions), Sensorimotor (Movement) and Mechanical Dysfunction
(Cumulative Trauma, Posture etc). In this article we will provide a
brief historical overview related to each of these four areas. This will
provide a deep background for the emergence of the clinical use of
SEMG, including information on the history of body work,
psychophysiology, rehabilitation and the emergence of electricity and
SEMG instrumentation.
We will begin with issues pertaining to the tissues of the body. The
muscle, as an organ system, contains many sensory mechanisms. The muscle
spindles tell the nervous system about the instantaneous length and
force of contraction of segments of muscle tissue. The golgi tendon
organ measures the actual force which the muscle is exerting and the
rufini nucleus of the joints informs the nervous system of the
relationship of angles of the bones. However, it is the free nerve
ending within the muscle that senses local pain. And it is metabolic
disturbances such as too much (lactic) acid or too much internal
pressure due to swelling, congestion or edema, which activate the free
nerve ending.
From a clinical point of view, up until the last two centuries,
palpation and observations about movement and posture were the only
tools available for assessing muscle oriented pain. Through the manual
sense of touch, the practitioner can learn to feel many things. Is the
muscle tissue hard to the touch? Does it feel stiff? Does it have lumps,
tough fibers, etc. or is it soft, supple and relaxed? What does the
fascia feel like? Is there a normal cranial-sacral rhythm? As you move
the body passively through its range of motion, does it seem restricted
suggesting a shortened muscle resting length? During active movement,
does it appear that the body is using the correct muscles for the
movement or is there a substitution pattern? Is the patient afraid of
movement due to pain? Has a trauma become lodged in the nervous system
or even the muscle tissue itself? Can one see or feel problems with
ligament laxities or joint fixations? These are just some of the
examples of questions we want to address, both by hand and by
instrument. . Thus, one could think of body work as a means to help
normalize the disturbance of tissue that might foster and create muscle
pain and SEMG as an instrumented way of assessing some of these
conditions.
More Read Info : The History of Muscle Dysfunction and SEMG
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