Teaching Muscles Creatively and Effectively

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Teaching Muscles Creatively and Effectively

• AMTA
• 2011 Schools Summit
• February 17-18, 2011
• San Francisco, California

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teaching muscles creatively and effectively

• Joseph E. Muscolino
• www.learnmuscles.com
• jemredd_at_optonline.net
• AMTA School Summit Conference
• San Francisco, CA
• February, 2011
• All illustrations reproduced with kind permission
  from Mosby of Elsevier Science, and the massage
  therapy journal

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professional opinions offered...

• Follow the man who seeks the truth beware of
  the man who has found it.
• What good is a philosopher, if he doesnt insult
  anyone? )

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introduction

• 2 hours to cover this subject... )
• All good questions ask the same question.
• There is no right or wrong way, but there might
  be better and worse ways...
• ...rules versus guidelines
• You must make the guidelines that are presented
  and discussed today fit into the constraints of
  your curriculum... or must you?

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preview four big ideas

• Teach Critical Thinking!
• This can only occur if you give the student a
  fundamental understanding of how muscles
  function.
• Marry Science Content with Hands-on Content and
  apply to real life case studies! - Integrate and
  Apply!
• Teach Dynamically!
• Have Great Resources!

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preview order of topics

• Part One Principles of fitting muscles into the
  curriculum
• Part Two Teaching muscles Content
• Part Three Putting it all together more than
  just attachments and actions
• Part Four Review

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part one

• principles of fitting muscles into the curriculum

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what makes a school good or great?

• passing rates on exams?
• placement in the workplace?
• intelligent graduates?
• caring and compassionate graduates?
• clinically competent graduates?
• do what you love and the money will follow...
• teach the students well and they will...

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elements of an excellent clinical massage
therapist

• good hands, heart, and brain
• knowing versus understanding
• knowledge versus wisdom
• Do you teach critical thinking?

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why do we teach muscles?

• Because we have to...
• To pass an exam...
• Because it truly is part of the mix of the
  knowledge base needed to be a competent massage
  therapist.

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what science content does an MT need?

• Work backwards...
• It depends
• regular massage therapist
• clinical massage therapist
• clinical medical massage therapist
• clinical orthopedic massage therapist

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when should we teach muscles?

• early in the curriculum...
• later in the curriculum...
• doesnt matter...

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early in the curriculum

• Advantages/disadvantages of early...?
• Only in the science classes, or reinforced in
  hands-on classes?
• reinforce terminology and visualizing muscles (as
  well as other structures)
• Marry your hands-on and science curricula into
  one curriculum!
• ...you complete me. )

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where should muscles be taught?

• In a room with desks...
• In a room with massage tables...

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questions about teachers

• Should a teacher teach one class really well, or
  should s/he teach a number of classes?
• Should the teacher be full time or be part time
  with a private hands-on practice?
• Who should teach muscles?
• scienceteachers
• massage therapists
• other manual/movement therapists (DCs, DOs, NDs
  PTs)
• Bigger picture Can the teacher integrate and
  apply science with hands-on?

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critical thinking and application

• If we memorize our anatomy (muscle
  attachments)...
• we can figure out our physiology (muscle
  actions)...
• we can figure out our pathophysiology (what range
  of motion is restricted if a muscle is tight?,
  etc.)...
• we can figure out how to assess (palpation, check
  range of motion)...
• we can figure out how to treat (massage strokes,
  heat, stretch, etc.)...

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critical thinking and application contd

• Anatomy - physiology - pathophysiology -
  assessment - treatment
• It all hinges on critical thinking...if we want
  our graduates to be competent clinical orthopedic
  massage therapists!

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what skills should the teacher possess?

• Knowledge of the content...
• Understanding of the content...
• Hands-on experience...
• Ability to fit the content into the larger
  picture.
• (Ability to teach dynamically / people skills)

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how much should we pay the teacher?

• More...
• Less...
• You get what you pay for...

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how should teaching muscles fit...

• ... into the broader context of the
  musculoskeletal (neuromyofascial-skeletal)
  system?
• There are two major focuses of teaching muscles
• Attachments and actions (and maybe innervations)
• True Kinesiology - The larger context of how
  the musculoskeletal system works.
• Marry them together!

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how should teaching muscles fit...

• ... into the broader context of the entire
  science curriculum?
• Anatomy and physiology can be divided into
  musculoskeletal and visceral.
• Which is more important to you?
• Devote more resources there.

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how should teaching muscles fit...

• ... into the broadest context of your entire
  curriculum?
• Should muscles be taught separately?
• Should they be integrated into the hands-on
  content?

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how much time should we spend teaching muscles?

• What are our objectives?
• Regular massage therapist 5-100 hours
• Clinical orthopedic massage therapist 300 hours
  or more
• Can support by the hands-on classes affect these
  numbers?
• What about the argument over class hours versus
  learning outcomes?

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part two

• teaching muscles - content

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what is the orderof the content?

• BIG PICTURE first, then details, details,
  details, details to fill in the picture, then
  return to the BIG PICTURE.
• Tell them what you are going to tell them.
• Tell them.
• Tell them what you told them.

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order of content...

• Terminology
• Bones
• bones/bony landmarks/joints - or -
  bones/joints/bony landmarks
• Broader kinesiology concepts of the muscular
  system
• THEN the muscles...

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when teaching muscles, start with the big picture

• Start with BIG PICTURE of broader kinesiology
  concepts
• then teach BIG PICTURE of functional (action)
  groups
• then go back and teach the details... in other
  words, detailed attachments and perhaps more
  detailed actions.
• Then re-emphasize the BIG PICTURE.

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WHAT IS THE BIG PICTURE OF HOW A MUSCLE FUNCTIONS?

• Keep it simple!
• A MUSCLE IS A PULLING MACHINE.
• Nothing more, nothing less.
• When a muscle contracts, it pulls in toward its
  center.
• It tries to shorten.
• Does it?

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pulling machine
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shortening contractions
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reverse action
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reverse action example
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reverse action of deltoid
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do we always want a muscle to shorten?
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another stabilizer example
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other roles of muscles

• Roles include being movers (agonists),
  antagonists, stabilizers (fixators),
  neutralizers, support muscles...
• Understanding the coordination of these roles...
• Understanding concentric, eccentric, isometric
  contractions...

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relate to the anatomy
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use analogies, give examples
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and...

• Dont forget the nervous system...
• neural patterning
• muscle spindle reflex
• Golgi tendon organ reflex
• reciprocal inhibition reflex

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now teach the muscles

• Should we teach muscles one at a time...
• ...or start with the BIGGER PICTURE of FUNCTIONAL
  GROUPS

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flexors of the elbow joint

• (anterior view)

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flexors of the elbow joint

• (anterior view)

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(No Transcript)
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now teach the musclesone at a time

• Start with the easiest muscles first.
• Use the 5-Step Approach

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how to teachone muscle at a time?

• 5-Step Approach
• 1. Look at the name of the muscle.
• 2. Get a mental picture of the muscle...
• What joint is crossed Where it crosses the
  joint How it crosses the joint
• 3. Use mental picture to figure out the actions.
• 4. Go back and memorize the specific attachments.
• 5. Place muscle into broader context.

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brachialis
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what aspects of muscles should we teach?

• Attachments and actions (and innervations)?
• Functional groups?
• Myofascial units/meridians?
• Palpation?
• How to stretch?
• (How to strengthen them?)

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how do we use critical thinking to palpate?
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levator scapulae and rhomboids palpation
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pectoralis minor palpation
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what musclesshould we teach?

• Some of them? / All of them?
• If we dont have time to teach all of them...
• Teach some very well, but at least touch on all
  of them to provide a complete picture.

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how do we teach muscles?

• Auditory
• lecture, discussion, Socratic method
• Visually
• manuals, texts, overhead/PPt, e-media
• Kinesthetic
• demonstration, movement, rubber band approach,
  including skits, hands-on palpation, building
  muscles in clay
• And integrate applications case studies, etc.
• And reinforce in the hands-on classes.

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make it visual!!!

• serratus anterior

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part three

• putting it all together
• more than just attachments and actions...

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apply...

• Understanding and apply to concepts such as
• tight muscle, loose muscle
• strong muscle, weak muscle
• decreased range of motion
• trigger points
• pain
• etc.

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ex treating trigger points
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can the student not see the forest for the trees?

• Big picture and minutiae
• Learning only attachments and actions is like
  learning the abcs. The point is not to simply
  know the alphabet, but to be able write
  sentences, paragraphs, even great novels!

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what are our resources?

• Books (versus) in-class manuals
• an attachment/action book AND a true
  kinesiology textbook
• DVDs, interactive CDs, auditory MP3 files
• Websites for students
• Instructor manuals, image banks, PPt lectures,
  test banks
• Skeletons, wall charts, models, building muscles
  in clay
• Instructor in-services, curriculum consultant

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resource questions

• Do your resources help you to achieve your needs?
• Does your curriculum help you to achieve your
  needs?
• If not, why not change?
• What would it take to change?

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part four

• review

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review four big ideas

• Teach Critical Thinking!
• This can only occur if you give the student a
  fundamental understanding of how muscles
  function.
• Marry Science Content with Hands-on Content and
  apply to real life case studies! - Integrate and
  Apply!
• Teach Dynamically!
• Have Great Resources!