1 Teaching Muscles Creatively and Effectively AMTA 2011 Schools Summit February 17-18, 2011 San...

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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@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 doesn’t insult anyone?” :)

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introduction2 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...

doesn’t 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?

“science”teachers

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 cont’d

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...

Don’t 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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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 don’t 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!