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Assessment and Treatment of Muscle Imbalance

Assessment and Treatment of Muscle Imbalance


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    Assessment and Treatment of Muscle Imbalance: The Janda Approach blends postural techniques, neurology, and functional capabilities in order to alleviate chronic musculoskeletal pain and promote greater functionality. Developed by Vladimir Janda, respected neurologist and physiotherapist, the Janda approach presents a unique perspective to rehabilitation. In contrast to a more traditional structural view, the Janda approach is functional—emphasizing the importance of the sensorimotor system in controlling movement and chronic musculoskeletal pain syndromes from sports and general activities. Assessment and Treatment of Muscle Imbalance: The Janda Approach is the only text to offer practical, evidence-based application of Janda’s theories.

    Filled with illustrations, photos, and step-by-step instructions, Assessment and Treatment of Muscle Imbalance uses a systematic approach in presenting information that can be used in tandem with other clinical techniques. This resource for practitioners features the following tools:

    • A rationale for rehabilitation of the musculoskeletal sytem based on the relationship between the central nervous system and the motor system
    • A systematic method for the functional examination of the muscular system
    • Treatment processes focusing on the triad of normalization of peripheral structures, restoration of muscle balance, and facilitation of afferent systems and sensorimotor training
    • The role of muscle imbalance and functional pathology of sensorimotor systems for specific pain complaints, including cervical pain syndrome, upper- and lower-extremity pain syndromes, and low back pain syndromes

    Assessment and Treatment of Muscle Imbalance provides an evidence-based explanation of muscle imbalance. The step-by-step Janda system of evaluation is explained—including analysis of posture, balance, and gait; evaluation of movement patterns; testing of muscle length; and assessment of the soft tissue. The text explores treatment options for muscle imbalance through facilitation and inhibition techniques and sensorimotor training to restore neuromuscular function. It also includes four case studies examining musculoskeletal conditions and showing how the Janda approach compares with other treatments. This text combines theory, evidence, and applications to assist clinicians in implementing the Janda approach into their practice.

    Assessment and Treatment of Muscle Imbalance: The Janda Approach focuses on the neurological aspects of muscle imbalance that are common causes of pain and dysfunction in sports and occupational activities. By distilling the scientific works of Vladimir Janda into a practical, systematic approach, this unique resource will assist health care providers in treating patients with musculoskeletal complaints as well as exercise professionals in developing appropriate exercise prescription and training programs.


    A reference for physical and manual therapists, athletic trainers, personal trainers, massage therapists, chiropractors, and physiatrists. A textbook for physical therapy students learning theory and application of skills for care in rehabilitation of muscle imbalance.

    Table of Contents

    Part I. The Scientific Basis of Muscle Imbalance

    Chapter 1. Structural and Functional Approaches to Muscle Imbalance
    Intrinsic Versus Extrinsic Fuction
    Muscle Balance in Function and Pathology
    Muscle Imbalance Paradigms

    Chapter 2. The Sensorimotor System
    Sensorimotor Hardware and Software
    Neuromuscular Aspects of Postural Stability and Joint Stabilization
    Pathology in Proprioception

    Chapter 3. Chain Reactions
    Articular Chains
    Muscular Chains
    Neurological Chains

    Chapter 4. Pathomechanics of Musculoskeletal Pain and Muscle Imbalance
    Pathology of Musculoskeletal Pain
    Pathomechanics of Muscular Imbalance
    Causes of Muscle Tightness and Weakness
    Janda’s Classification of Muscle Imbalance Patterns

    Part II. Functional Evaluation of Muscle Imbalance

    Chapter 5. Posture, Balance, and Gait Analysis
    Muscle Analysis of Standing Posture
    Evaluation of Balance
    Evaluation of Gait

    Chapter 6. Evaluation of Movement Patterns
    Janda’s Basic Movement Patterns
    Additional Movement Tests Complementary to Janda’s Tests
    Selected Manual Muscle Tests

    Chapter 7. Muscle Length Testing
    Muscle Length Assessment Technique
    Lower-Quarter Muscles
    Upper-Quarter Muscles

    Chapter 8. Soft-Tissue Assessment
    Characteristics of Trigger Points
    Assessment of Trigger Point or Tender Point Chains

    Part III. Treatment of Muscle Imbalance Syndromes

    Chapter 9. Normalization of Peripheral Structures
    Central Indirect techniques
    Local Direct techniques

    Chapter 10. Restoration of Muscle Balance
    Factors Contributing to Muscle Weakness
    Additional Treatment Techniques for Muscle Weakness
    Factors Contributing to Muscle Tightness
    Additional Treatment Techniques for Muscle Tightness

    Chapter 11. Sensorimotor Training
    Role of Sensorimotor Training in Janda’s Treatment
    Sensorimotor Training Components
    Sensorimotor Training Progression

    Part IV. Clinical Syndromes

    Chapter 12. Cervical Pain Syndromes
    Regional Considerations
    Common Pathologies
    Case Study

    Chapter 13. Upper-Extremity Pain Syndromes
    Regional Considerations
    Common Pathologies
    Case Study

    Chapter 14. Lumbar Pain Syndromes
    Regional Considerations
    Common Pathologies
    Sacroiliac Dysfunction
    Management of Low Back Pain Syndromes
    Case Study

    Chapter 15. Lower-Extremity Pain Syndromes
    Regional Considerations
    Common Pathologies
    Case Study

    About the Author

    Phil Page, MS, PT, ATC, CSCS, trained under the guidance of Dr. Vladimir Janda and has taught the Janda approach at national and international workshops. A certified kinesiotaping practitioner, Page is currently working toward his doctorate in kinesiology at Louisiana State University in Baton Rouge, where his research focuses on EMG and muscle imbalance. He is also director of clinical education and research for Thera-Band products.


    Page and his wife, Angela, live in Baton Rouge with their four children. In his free time, he enjoys spending time with his family, fishing, and cooking.


    Clare C. Frank, DPT, is an orthopedic clinical specialist in private practice in Los Angeles. She serves on the clinical faculty for Kaiser Permanente Movement Science Fellowship in Los Angeles. She also serves as a guest lecturer at the local universities and teaches throughout the United States and internationally.   


    Frank studied under and taught with Dr. Vladimir Janda. She is a certified instructor of the Janda approach to musculoskeletal pain syndromes, a certified kinesiotaping practitioner, and a certified instructor of Kolar’s approach to dynamic neuromuscular stabilization.


    Frank is board certified in orthopedic physical therapy and a fellow of the American Academy of Orthopedic Manual Physical Therapy.

    Robert Lardner, PT, was born in Nigeria in 1961. His first career was as a professional ballet and modern dancer after studying at the Rambert Academy outside London, England. He graduated from the department of physical therapy, Lund’s University, Sweden in 1991. He studied with Professors Janda, Lewit and Kolář from the Czech Republic, who are pioneers of functional rehabilitation and manual medicine.


    Lardner worked in several inpatient and outpatient rehabilitation facilities in Sweden prior to moving to the United States in 1992. He was a staff physical therapist at McNeal Hospital, Clearing Industrial Clinic, and a physical therapy supervisor at Mercy Hospital. He also was in charge of physical therapy services at a number of private outpatient and sports clinics.


    Lardner is currently in private practice in Chicago and teaches various rehabilitation seminars throughout the United States and Europe.


    “A practical text for clinicians treating patients with musculoskeletal complaints.”

    SciTech Book News (March 2010)

    “An excellent book and a fitting tribute to Janda - well done! I attended several of Janda's courses in the UK over a period of many years and his influence on my professional life was significant.”

    Christopher Norris, PhD, MSc, MCSP, MBAcC -- Director of Norris Associates

    "This would make a useful addition to every clinician’s library—especially physical therapists, chiropractors, osteopaths, and all those using hands-on therapies."

    Journal of Bodywork and Movement Therapies

    "…a thorough, well-organized, and well-written summary of the Janda approach to muscle imbalance."

    Journal of Orthopedic and Sports Physical Therapy

    "With its modest price tag and practical insights of both assessment and treatment of muscle imbalance, I would recommend this book to any practitioner or student planning to treat MSK disorders."

    Manual Therapy

    This book "provides a lot of useful information that is different from the typical treatment approaches taught in most physical therapy schools and it can only help give clinicians insights that may help them treat their patients."

    Orthopedic Physical Therapy Practice