Computerized Movement Imaging (CMI)

kinematic-analysis-of-humanWhat is CMI?
  • It is a relatively new diagnostic technology
  • This technology records you performing a set of physical activities. It then measures and analyzes the biomechanics of more than 35 key body movements.
  • Image capture uses a combination of infrared and video technologies to obtain sub-centimeter accuracy for consistent and repeatable results.
  • Movement measurement and analysis is computed instantly, in real-time.
  • Doctors can mine the wealth of data to focus on specific body regions and joints for a more detailed diagnosis.
  • Graphic data is synchronized with video recordings for immediate viewing to assist patient comprehension and training.
  • Results are immediately available in detailed or summarized formats for printing or e-mail.
  • CMI is portable and can be used in a wide range of athletic or clinical settings.
What Can CMI Tell Me? cmi-in-action
  • Sequence and timing of joint movements for proper kinematics
  • Comparisons of right and left sides for symmetry of movement
  • Ranges of Motion – for hyper and hypo mobility
  • Identifies dyskinesias (abnormal movements)
  • Calculates potential muscle weaknesses or spasms that could contribute to the patterns identified
How can I use CMI?stick-figure
  1. Screening – CMI can identify patterns of abnormal movement with a large number of people quickly. This allows you to focus additional attention on the people who need follow-up care
  2. Diagnosis – Correlations that are difficult or impossible to identify with physical examination give insights that are critically important. Joints that dip for just a brief moment are glaring abnormalities on the graphs.
  3. Training – Patients and athletes can repetitively use CMI to improve their biomechanics for preventing injuries, decreasing pain, and improving their performance. Video and graphical data give instant, detailed feedback.
  4. Complete Recovery – After the pain is gone, how do you know if a biomechanical problem is corrected? Stopping care prematurely can lead to a rapid relapse.  CMI shows you how to fix many issues fully and permanently.

How To Obtain a CMI Study? liim-exercise-room

The DxF is focused on improving human safety, health and performance by promoting diagnosis which seeks underlying causes using objective and holistic methods.  We do this through diagnostic programs of: testing, education and R&D which will ultimately result in a new system of human care.

img_0560As part of our Diagnostic Programs, the DxF is certifying doctors in performing CMI studies.  If you would like to be evaluated with this exciting new technology, contact us at: . We will put you in touch with a doctor certified in CMI procedures.  Testing may be performed at our state of the art facility in Ronkonkoma, NY near Islip McArthur Airport.

This article is not intended to offer a diagnosis or medical advice.  It is offered strictly for educational purposes.  Please consult members of your health care team directly to explore these or any other health care concepts.

Ankle Stability and Golf Putting


Many putting techniques, exercises, club heads and shaft lengths have striven to create as stable a base as possible.  The slightest variation on how the putter face strikes the ball will be magnified over the distances involved and make the difference between a birdie and a bogey.

Why Increase Lower Body Stability? Lower body stability is an often recommended technique to reduce variables when putting.  There is little need for the power generated by transferring force from the ground through the lower body and arms to the clubs when putting.  Without the need for the kinetic contributions from the legs for power, the lower body can be immobilized when putting to increase precision.

For those using a stable base technique (from the waist down), where can the instability or ‘wobbles’ come from?

  • Pelvis
  • Hips
  • Knees
  • Ankles
  • Feet

This article will focus on the ankles.

How Often Are Ankle Stabilizers Imbalanced or Weak? Over the past few years, I have tested ankle stabilizer muscles on over 1,000 athletes and patients….the majority of these people were very fit individuals (triathletes, crossfit competitors, etc.).  Fewer than a dozen had perfect ankle muscle strength and balance.

What Causes Ankle Instabilities Then? There are many possible causes.  Old ankle sprains that were not rehabilitated after healing, excessive ankle flexion and extension activities without sufficient attention to medial and lateral stabilizer exercises, bad shoes, nerve problems, worn heels, high heels, old fractures, living in an environment that is totally flat and level (i.e. always on floors, sidewalks, parking lots, etc. and no hillsides, grass tussocks, or clambering over rough terrain).  Anyone with plantar fasciitis, bunions, corns, calluses on their feet, shin splints, flat feet, excess pronation, high arches and more will very likely have abnormalities of strength and balance in their ankle stabilizing muscles.

Ankles at follow throughOne potential cause for lateral ankle instability with some golfers. is the excess strain that is put on the outside of the lead foot at the end of a drive.  If someone with this technique does not do a regular regimen of strengthening and shortening the muscles that are stretched with each drive, their left lateral foot will gradually get weaker and looser, with a tendency to wobble to the outside when they are trying to establish a stable base for putting.

Which Exercises Should I Do To Increase Ankle Stability? There are dozens of techniques and exercises promoted to improve stability of the lower body, many which will impact ankle stability.  Rather than doing all of them initially, test to find out:

1st – is there an ankle stability problem and then

2nd – which muscles are causing it.

The Diagnosis Foundation Maxim is. Diagnose The Cause 1st – Then Prescribe The Treatment. (Caveat – within the necessary time frame).  There are other posts in this web site that go into more detail on some of the stabilizer muscles of the ankle and gives clues to appropriate exercises.

How Do I Test For Ankle Stability?  Force plates that measure the stability of foot pressure between both feet or within each foot will give the level of detail necessary for golf putting.  These can measure static or dynamic loads and can record results in summarized numbers or with video recording of real-time results. Physical tests such as the ‘Star Excursion Test’ or instability amplifiers (such as one-legged stance on mini-trampolines or using wobble boards) are great diagnostic tools for some sports and can be excellent as a golf training method, but lack the precision needed for putting diagnosis.

Tib Ant - Sup view - half bodyHow Do I Test Which Muscles Are Weak? Manual muscle testing will be able to deliver the force vector nuances to differentiate which ankle muscles are involved.  This method also has the advantages of being very inexpensive and rapid.  The down side of manual muscle testing is that it will lack the precision of isokinetic or hybrid testing (hybrid testing involves a blend of manual and technology methods – a hand-held pressure gauge).

Isokinetic and hybrid testing methods have the disadvantage of being unable to achieve the necessary force vectors to isolate the individual muscles for strength. They also have the disadvantage of being much more expensive and take considerably longer to obtain results.

How Do I Improve The Strength Of The Weak Ankle Stabilizer Muscles?  It depends on the cause.  If we assume that there is no neurological, vascular, metabolic or anatomical factors making the muscle weak, and it just needs to be rehabbed.  Here are a few things to consider that will each contribute to improving ankle muscle strength.

  • Break up any trigger points or adhesions in the involved muscles and joints.
  • Lengthen the muscle as needed (if contracted)
  • Exercise the weak muscle specifically
  • Get the proper rest period after each exercise session to allow for new muscle growth.  More important if exercising a specific muscle intensely.
  • Supply the essential nutrients that your body needs to rebuild the new muscles (if essential nutrient lab testing is unavailable, at a minimum, supply the essential nutrients that muscle and ligament repair uses a lot of).
  • Use brief, intermittent splinting (tape, brace, support) for muscles that are too long and need to shorten.
  • Temporary, short-term orthotic use to help improve foot bony relationships and support ligament structures while remodeling.
  • Check footgear for proper fit, wear and support.

I would like to emphasize the importance of eliminating the bulk of the trigger points in the muscle you are about to train first. The tension feedback sensors within the muscles near any trigger points (i.e. spindle apparatus and golgi tendon organs) will be sending inappropriate feedback on the muscle fiber’s ability to contribute to work, exercises and hence growth.  Indeed, many times, the trigger points within a weak muscle may be the dominate factor preventing a muscle from expressing its full strength.

Exercise band - peroneus brevisNow, How Do I Exercise The Weak Muscles To Improve Ankle Stability For Putting?  Exercise bands can give you some very targeted, and thus rapid results.  If you review the muscle actions for each of the muscles listed with links above, you will see which direction the ankle moves under their influence.  Wrap a band around your forefoot and tie the other end around a stable anchor point such that the band will add resistance to the main action of each foot muscle.


Guitarists & Muscle Imbalances


Guitar FingersAny instrument that uses a limited set of motions for extended periods of time will be prone to developing muscle strength imbalances.  Guitarists do many biomechanically imbalanced activities such as:

  • The fret hand wrapping around the neck is held in extreme wrist flexion for extended periods of time with little to no wrist extension.
  • Some chords/fingerings utilize finger flexion to a much higher degree than finger extension.
  • Using a pick involves extensive thumb and index finger opposition (holding the pick)
  • The guitar may be suspended over one shoulder
  • The weight of the guitar is in front of the body’s center of gravity, requiring long-term arching the low back
  • The head may be held in extreme flexion to look at the hands, etc.

Low back painThese examples all demonstrate how one motion at a joint may be utilized to a much greater degree than it’s opposite (or antagonistic) motion.  Even as guitarist become more experienced and learn how to use less force, there will still be more exertion in one direction for many activities.   As the imbalanced exercise continues of months, years and decades, muscle strength imbalances will result.

Why Is Balanced Muscle Strength Important?

Neck painAll the muscles around any given joint need balanced strength pulling in each direction.  For example, the muscles that pull your fingers forward need strength comparable to the muscles that pull your fingers backward, to the outside, to the inside, into opposition, etc.  If one muscle around a joint is stronger or weaker than the rest, the bones of that joint will not remain properly centered.  Each time an imbalanced joint moves, it will tug to one side, leaving you at a mechanical disadvantage.  This imbalanced motion will stretch, scrape or pinch tissues abnormally, causing some damage.  As a result, your speed, power and endurance will suffer and your chance of developing pain and injuries increases.

Health Issues Guitarists Are Prone To

Hands in pain

  • Carpal tunnel syndrome – with tingling, pain or numbness in the hand and/or fingers
  • Tenosynovitis – With imbalances, the bursas around some tendons will experience excess pressure which irritates them leading to inflammation
  • Ganglion Cysts – the inflammation in some bursas can become so pronounced that lumps will develop in the wrist or hand
  • Thoracic Outlet syndrome – Guitar straps depressing the shoulder can cause pain which radiates from the shoulder down the arm.
  • Neck Radiating Neuralgia – Pain coming from pinched nerves in the neck
  • Lumbar strain – holding the weight of the guitar can imbalance muscles and cause low back pain.

Diagnosing Guitarist Health Issues

Muscle strength imbalances may be diagnosis by a trained specialist in Performing Arts Medicine and will typically involve a history, physical exam and testing specifically designed to look for muscle imbalances in the large to very small muscles of the hand.  In more advanced situations, this may include x-rays, MRI, EMG, nerve conduction studies.  It is important to work with a doctor who is experienced working with:

  • Muscle imbalances
  • Finger and hand issues
  • Musicians and the stresses each instrument is prone to

Play Better by Balancing Muscles 

Steve Vai playing guitarCorrecting muscle imbalances can also be used to help improve your performance.  Balanced muscles around each of the key joints will improve your SPRITE profile.  This means you will be capable of having better:



  • Speed
  • Power
  • Range
  • Independence
  • Technique
  • Endurance

Contact: Dr. John M. Wallman, DC to arrange an appointment to evaluate your music related biomechanics at  His background includes: 4 years at Manhattan School of Music; undergraduate studies of music education and; plays over a dozen instruments.  In his health care practice, he has specialized in Performing Arts Medicine and written the exercise manual “Finger Exercises for Musicians”.  He is President of the Diagnosis Foundation and practicing at Long Island Integrated Medical in Ronkonkoma, NY.

Functional Tests vs. Individual Muscle Tests: Different yet Complementary


Jumping executiveFirst, let’s describe what functional and individual muscle assessments are and their differences. Then we’ll get into why both of them are essential to a complete fitness development program.

What is Functional Muscle Testing

This is the type of assessments most of you have already experienced.  These are tests that are closely related to real world activities. such as:

  • How fast can you run?
  • How high can you, jump?
  • How much weight can you dead lift. press or pull?
  • How many of the following can you do: push ups, chin ups, squats, jumping jacks, etc. etc. etc.?

Whether you are a professional athlete, in the military, an emergency responder, in construction, a waiter, stock person, or involved in any job that requires some degree of physical capability, the scores you get on these tests will give you very good indications on how well you will do with their counterparts in real world careers.

What functional tests are not always so helpful on is distinguishing why you are getting those results.  Most of these tests will involve multiple muscles, joints and even multiple parts of the body.  Of the 5, 10 or 20 muscles involved in any of these functional tests, what is the rate limiting factor?  What muscle or joint fails first to allow you to distort into poor form, stretch a joint, experience pain or reflexive inhibition against further exertion?

Let’s take a simple functional test to demonstrate what I mean by this.  How high can you jump?  You do this functional test and receive a score of x number of inches.  Was the weak link limiting the height you were able to jump from: a weak glut max, one of the 4 hamstrings, 4 quads, soleus, gastroc, tibialis posterior or flexor hallucis longus?  Perhaps it was muscles in your back or even in your arms, etc. etc.?

If all of your muscles are well balanced, there is no weak link, continued development of height jumped may be best obtained through various jumping exercises.  If instead, all of the muscles involved in jumping are strong, but one is dramatically weak, continued jumping exercises are more likely to deliver limited improvement.

What is Individual Muscle Testing

This type of testing is not based so much on real world activities as much as it is based upon your anatomy.  These tests isolate as much as possible one muscle at a time to look for imbalances in strength.  Imbalanced muscles can be detected by comparing the strength of each muscle to its corresponding muscle on the opposite limb.  Imbalance evaluations can also be made by comparing each muscle with all of the other muscles crossing the same joint.

If you do a test on somebody’s Tibialis Posterior muscle for example and it comes up weak, that information isn’t so meaningful regarding what you will be able to do in your career.  It does tell you that your will have a weakness in one of the primary muscles that holds up the long arch of the foot and will have a tendency or outright issue with dropped arches, foot pronation, shin splints and excessive strain on the medial side of the knee.

Jumping goalie - MSGoing back to the example of the  functional test for jumping,  If all the individual muscles involved in jumping test normal, except that an imbalanced weakness is detected in the tibialis posterior, there is a significant chance that this weak link will limit jumping height.  This would tell you to put some extra time into exercises focused specifically on the tibialis posterior muscle.  It  is interesting to note that jumping exercises provide very little benefit on improving this muscle.  Correcting this weakness through a specific ankle exercise, you would typically find that jumping can improve, even though no direct jumping exercises have been done.

Functional & Individual Muscle Work is Complimentary

Functional and individual muscle testing and exercise activities are complimentary with many options for integrating both of them.

Implementation – For example, one option for how trainers could use individual muscle strength testing along with functional testing is: start each new client with a screen of individual muscle strength tests.  Any weakness identified are brought up to appropriate strength 1st through individual muscle strength exercises.  Then, you would proceed with functional testing and exercises to achieve your client’s goals.

The transition from individual muscle activities and functional activities need not be discreet, but could overlap with a gradual shift in emphasis.  Periodic testing of your client’s individual muscles would assure that imbalances are not developing from the inherent variability of muscular physiological responses to exercises, client exercise preferences or injuries.

Benefits to Trainers – The implementation example above demonstrates how you would be in a position to achieve superior results through a more versatile range of exercise programs.  This type of testing also enables clients to clearly see which muscles are weak and know that they receive the needed exercises.  This will help the client avoid painful exercises by avoiding activities that exceed what the weak links can handle, but will also increase client satisfaction, compliance and results.  All of these factors combined, fosters your ability to see more clients visits and receive more referrals.

Seminar - MSEducation

The Diagnosis Foundation offers courses on individual muscle strength testing in many different formats.  These courses are available for individuals or on a group basis, at our locations or through your own venue.

Weak tensor fascia latae muscle leads to…


TFL - 1.4 - BP3DBased on our findings in the Diagnosis Foundations screening program, weakness of the Tensor Fascia Latae (TFL) is very common.  What kinds of performance and health issues can you get from this?  Let’s look at TFL anatomy, actions, measurement methods along with the implications weak TFL strength can have on your athletic performance and health.

Anatomy – The TFL is located on the lateral side (outer side) of the pelvis and is superficial (towards the skin).  The top of the muscle attaches to the front 1/3 of the iliac crest (this is the top most part of the pelvis just below the waist).  The muscle is relatively short (shown in black) and runs 3-10″ down the lateral side of the thigh.  There it connects to the long fascia latae or iliotibial band (shown in blue) which runs down the side of the thigh and attaches to the lateral tibia, just below the knee.

TFL - Glut Max - Iliotibial band - YThe TFL along with part of the gluteus maximus form the two arms of the letter “Y”.  The long vertical portion of this complex is the iliotibial band.

Action – The actions of this muscle are dependant on if it is working alone or in conjunction with the gluteus maximus.  If it is working alone, the TFL performs a complex combination of the following motions.  It will abduct the thigh (lift to the side), flex the thigh (lift forward) and internally rotate the lower limb.  This results in the lower limb being lifted forward on the diagonal, half way between straight forward and straight to the side.  If the TFL works in concert with the gluteus maximus, it will abduct the lower limb or laterally flex the pelvis.

Diagnosis – Weakness in the TFL can be determined with manual muscle strength testing, careful observation of pelvis alignment during walking, standing, running and other tests. Supporting information can be gained through a detailed history as well as physical examination for neurological, vascular and orthopedic signs.  Measurement of TFL ranges of motion and exact muscle strength determinations are available with specialized equipment when required for more detailed examinations, insurance purposes or research.

Functional Implications – Let’s consider the functions of the TFL when working by itself, or when working in conjunction with a portion of the gluteus maximus. When working alone – TFL weakness, will result in compromised movement in the following situations:

  1. Flexion of the limb to the forward diagonal

When working with other muscles – TFL weakness will result in compromised movement in the following situations:

2. Lateral knee flexion/stability
3. Abduction of the lower limb
4. Lateral flexion of the pelvis
5. Forward rotation of the pelvis

Let’s look at each of these in a bit more detail.

1)  Flexion of the limb to the forward diagonal – When working by itself, the TFL is directly responsible for forward diagonal motion of the limb.  Forward kicks tn the outside diagonal as well as accelerating the body backward to the opposite diagonal will both use this muscle.  The TFL will also be involved in braking forward diagonal movement of the body as well as braking the relatively rarely used backward cross over kick or back roundhouse kick.

2) Lateral Knee Flexion/Stability – This stabilization function is accomplished in conjunction with a portion of the gluteus maximus muscle.  Although the knee joint does not have appreciable lateral flexion, the TFL / gluteus maximus combo provides critical stability of the knee in this direction.

3) Abduction of the lower limb – Straight sideward leg lifts or accelerating the body laterally to the opposite side will be the motions achieved by the coordinated action of the TFL and the tibial head of the gluteus maximus muscles.  These same actions are also achieved by the direction of the gluteus medius working by itself.

4) Lateral flexion of the pelvis to the same side – When used in conjunction with the tibial head of the gluteus maximus, the TFL will help flex the pelvis and body laterally to the same side.  This action also provides critical stability of the pelvis during one legged phase of walking or running.

5) Forward rotation of the pelvis – This motion is brought about by any of the following muscles: TFL; psoas; iliacus and rectus femoris of the quadriceps. This action is used in sit-ups or thigh flexion.

Injury Susceptibility – In addition to performance degradation, athletes with weak TFL muscles, will be susceptible to increased rates of injury in each of the 5 categories of functions listed above.

1 Flexion of the limb to the forward diagonal – Hip joint imbalances are a consequence of chronic weakness of the TFL.  The imbalances will place increased stress on the cartilage of the hip socket and femoral head and increase the rate of wear and tear on the joint.  When the imbalance is severe enough for a long enough period of time, the risk of developing cartilage degeneration, hip osteoarthritis and eventual need for hip replacement increases.

2) Lateral Knee Flexion/Stability – The TFL and the tibial head of the gluteus maximus provide the only muscular support of the lateral knee via the iliotibial band.  This provides critically important support for the lateral collateral ligament of the knee.  Chronic weakness of the TFL will result in excessive knee lateral movement, gradually stretching the lateral collateral ligament.  Over time, this ligament will become lax resulting in further excess mobility of the knee.  As the abnormal hypermobility persists, chronic sprains, cartilage erosion and osteoarthritis will develop eventually increasing the prospects of knee replacement surgery.

3) Abduction of the lower limb – In addition to the hip imbalance injury issue noted in #1 above, weakness of the TFL will contribute to decreased stability when walking.  This will increase the risk of falls as the severity of weakness progresses throughout a lifetime.  Falls are a major health issue with seniors frequently resulting in broken bones

4) Lateral flexion of the pelvis to the same side –  Weakness of the TFL (or gluteus medius or gluteus maximus tibial head) can result in the pelvis rocking side to side excessively when in the one legged stance phase of walking or running.  This excessive rocking will put increased pressure on the bursa’s in the hip region and increased friction on the iliotibial band.  This is one of the major causes of iliotibial band syndrome.

5) Forward rotation of the pelvis – Weakness of the TFL can contribute to the pelvis rotating more posteriorly than it should.  This will typically also result in a flattened low back.  These abnormal postures will put excessive strain on the low back muscles as they work in a mechanically disadvantaged position.  The lumbar discs will also receive increased pressure on them as the result of the posterior pelvis rotation and flattened low back.  If present to a sufficient degree for a long enough period of time the risk of developing disc degeneration, neuralgias and spinal osteoarthritis increases substantially.

Identification – Learn how to test for muscle strength imbalances with education certification courses offered by the Diagnosis Foundation.  Identifying muscle weakness early, enables you to correct these conditions before they reach a clinical state, when correction takes a minimal effort.

What is triskiaDXaphobia?


phobiaTriskaidekaphobia is the unpleasant feeling many experience with the number 13.

TriskiaDXaphobia is a closely related phobia or the fear of the last day of the introductory discount on the Diagnosis Foundation’s (DxF) Seminar Intensive – Weekend program.  The DxF will come to your facility in the NY Metro region and train up to 13 people in performing muscle strength testing on 13 individual muscles in the leg region in the course of a 13 hour seminar for a total price of $1300. (almost 80% off of our regular price of $450 per person!)

Man Flexing BicepsThe last day of this introductory pricing for the seminar Intensive weekend is…

Friday the 13th, January 2017.  Nothing to fear…just act soon to guarantee your price.   Read More

Set yourself apart for 2017

Learn how to test 13 muscle imbalances!
13 trained for $1300 expires January 13!

Diagnosis Foundation Screening Program Endorsed


“Knowledge is power.” Francis Bacon

Thank you to the NYIT Cross Country Team and their coach, Thomas Brouillard who has taken the time to contribute this unsolicited endorsement regarding our Balanced Muscle Strength Screening Program.

NYIT Athletics Logo





To our friends at Diagnosis Foundation,

On behalf of the New York Institute of Technology Cross Country program, I would like to thank Dr. John Wallman for volunteering his time to conduct a clinic with our team.  Dr. Wallman’s expertise and knowledge on the issue of muscle imbalances has been very insightful and an overall help to our athlete’s progress.  In running, often times the smallest things can cause injuries and the issue of muscle imbalances is a huge one in our sport.

The information that Dr. Wallman and his team has provided us has gone a long way in further developing our athletes so they can stay as injury free as possible while getting the most out of their potential.  We would love to continue to work with Dr. Wallman in the future.

On behalf of the Cross Country program, thank you very much again for your time and effort.


Thomas Brouillard
Head Men’s and Women’s Cross Country Coach
New York Institute of Technology
Office of Athletics and Recreation
Sports Complex
P.O. Box 8000
Old Westbury, NY 11568-8000

Seminar Intensive – Individual Muscle strength Testing – February 2014


Businesspeople ApplaudingDiagnosis Foundation (DxF) is holding the next Seminar Intensive on Individual Muscle Strength Testing for the legs in Miller’s Place, NY this coming February.  This critically important strength assessment method will help you focus your training, rehab and pre-hab program on what needs the most attention.  Find the weak links in the kinetic chain in order to prevent injuries and loss of valuable training days.

Seminar Intensive

  • Location: Miller Place, NY (Just east of Port Jefferson on the north shore of Long Island)
  • Attendance: 1 to a maximum of 6 per seminar
  • Schedule: Next Intensive – February 1 & 2, Saturday & Sunday from 9 am – 4 pm
  • Price: Early bird registration – $350 up until January 17, $400 up until January 31, $450 at the door

Content: This 12 hour seminar will cover the anatomy, bio-mechanics, physiology, procedures and legal environment to perform 12 key manual muscle strength tests* in the lower limbs.  Time will be allotted for Q & A as well as practicing the muscle tests.

This is the same educational content offered in the DxF’s 4 day Educational Seminar or our 4 week online self study course, but given at a faster pace.  Because of this pace, we are recommending this program for people who have some knowledge of exercise training or anatomy.  This program will be ideal for your staff and more knowledgeable clients.

Certification: The Seminar Intensive includes the educational content only.  It does NOT include the written, practical or applied certification exams.  The certification exams may be purchased separately if desired.

For additional information or to schedule your sessions:

*Muscle tests included in this seminar:

  • Biceps Femoris-Short head
  • Gluteus Maximus-Femoral head
  • Tibialis anterior
  • Tibialis posterior
  • Fibularis longus
  • Fibularis brevis
  • Rectus femoris
  • Tensor Fascia Latae
  • Psoas major
  • Gracilis
  • Pectineus
  • Gluteus medius

More Info:

Seminar Intensive – Balanced Muscle Strength testing: Legs
Even pros have muscle strength imbalances
What can cause muscle strength imbalances?
My muscle strength test is abnormal, what next?
Manual Muscle Strength Testing: Validity & Reliability
Seminar Intensive – Millers Place, NY
Online Self Study Course – $100
Online Certification Course – $300
4 day Education Seminar – $1000
5 day Certification Seminar – $1125
“Of these 36 [professional] players, 23 still showed significant muscular imbalance (64%). New trends in rational training could focus more on the risk of imbalance…”  Scandinavian Journal of Medicine & Science in Sports

Fall Prevention Screening



Senior hispanic man working on a white background
Senior hispanic man working on a white background

The Diagnosis Foundation (DxF) will be doing a Fall Prevention screening at the Sayville Public Library.  There are many factors contributing to falls, including:

  • Vision impairment
  • Obstructed environment
  • Equilibrium or inner ear impairment
  • Decreased proprioception (sensory awareness of body and joint position)
  • Decreased overall muscle strength & control
  • Decreased individual muscle strength or symmetry

There are diagnostic tests to look at each of these factors separately or in groups.  This screening will involve a brief assessment of overall risk of falling assessment along with a more in depth look at individual muscle strength and control.  Each person will be screened on muscle strength symmetry and control of 12 individual muscles in each leg.

Each screen takes 15 minutes to complete and participants with abnormal findings will be referred to their own health care providers for follow up.  Participants without providers or those needing recommendations for physicians who do individual muscle strength testing, differential diagnosis or treatment will be referred to the DxF DxProvider data base.

This screening is free but scheduling an appointment is highly recommended.

Importance: “Unintentional falls are a common occurrence among older adults, affecting approximately 30% of persons aged >65 years each year.” (1)  In the US, “in 2003, a total of 13,700 persons aged >65 years died from falls, and 1.8 million were treated in emergency departments (EDs) for nonfatal injuries from falls.” (2)

When: The event runs 3:00-5:00 pm on Thursday, December 12, 2013.

Where: At Sayville Library 88 Greene Ave. Sayville, NY 11782

Clothing: Wear comfortable clothing to sit, stand and lay down.  Shorts or pants recommended.

For additional info:

1 – Hausdorff JM, Rios DA, Edelberg HK. Gait variability and fall risk in community-living older adults: a 1-year prospective study. Arch Phys Med Rehabil 2001;82:1050–6.

2 – Retrieved from

Runners – Off Season Tune Up


Running Machine Woman at gym - MSRunning is a fantastic way to keep fit.  If you are an outdoor runner throughout the warmer months, the

off-season can signal an end to light clothing, a move to indoor running or ‘gasp’ a halt for the season.  No matter what you do during the colder months, this is a good time to get checked for the balance of your muscle strength so you can work on correcting the issues through the winter.

Running is notorious for exercising some leg muscles and not significantly working others.  Over time, this leads to strength imbalances for all the muscles surrounding your ankle, knee and hip joints.  Your leg flexors and extensors get an excellent workout with running, and gradually get stronger. Your leg abductors, adductors and rotators get hardly any exercise with running and their strength remains static.  Eventually, the stronger you get at running, the more imbalanced the muscles crossing each of your leg joints becomes.

This results in your joints tugging abnormally in one direction or another as you move. This leads to ligaments, tendons and connective tissues getting stretched. You might experience this as swelling in a joint after a run.

If more advanced, this might be experienced as soreness or pain. As the joint starts becoming loose or sloppy from the imbalanced muscle strength stretching tissues over and over, the bones will start to ride into places where they shouldn’t.  This can sometimes show up as a clicking sensation or sound as a bone slips into and out of position while sliding over cartilage or other soft tissue that it normally doesn’t.  Classical muscle imbalance injuries include: ilio-tibial band syndrome, plantar fasciitis, groin pull, hamstring strain, etc.

Put too much pressure on your leg when the bones are out of position like this, and you have a chance of cutting the cartilage or other tissue.  At this stage, you are doing significant damage to a joint.  Once the cartilage gets cut, the odds of repairing it fully decrease very significantly.  If left to continue, this type of damage is one of the causes of osteoarthritis.

What can be done to prevent this type of muscle strength imbalance injury? Get a check up on a regular basis to measure the strength of all the muscles crossing each of your leg joints.  Ask your doctor if they do testing for individual muscle strength (as opposed to testing groups of muscles).  Testing hip flexors or quadriceps are a group of muscle tests.  Testing psoas major or vastus lateralis are individual muscles.

Find out if your exercise program is not working out all your muscles evenly.  Then, over the winter, put some extra exercise attention to the muscles that are lagging behind.  This will not only prevent the classic runner’s injuries, it will also improve you speed and endurance for when the weather warms up again.

The Diagnosis Foundation (DxF) is a non-profit organization dedicated to promoting diagnostic testing to find underlying causes of disease and ways to improve athletic performance.  We are offering screening events in the mid Atlantic through New England regions to search for imbalanced muscle strength. The DxF also provides a free data base of health care providers who test and treat these types of conditions. The DxF also offers educational programs to help train doctors, therapists, trainers and the public in doing muscle strength testing.  For those who can get to Long Island, we have a 2 day, weekend seminar intensive to learn muscle strength testing this October 18 & 19.

Education is empowerment.  Run smarter…get healthier.