Erik Dalton Blog

Spindle-Stim Techniques for Cross Syndromes

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Turning on weak muscles When our bodies are chronically injured or declining, one way of
protecting ourselves is to tighten our muscular systems. Prolonged tightening combined with
gravitational exposure may lead to inefficient movement and
 Spindle-Stim Techniques for Cross Syndromes

Turning on weak muscles

When our bodies are chronically injured or declining, one way of protecting ourselves is to tighten our
muscular systems. Prolonged tightening combined with gravitational exposure may lead to inefficient
movement and slumping. There are many massage modalities that help improve posture by relieving
spasticity in tight facilitated muscles and activating tone in neurologically weakened muscles. Graded
exposure stretching using contract-relax techniques is one of the more popular ways to address muscular
imbalance problems via reciprocal innervation. However, in many cases, the therapist may need to manually
stimulate tone in chronically weakened or atrophied muscles, particularly in clients suffering sensory motor
amnesia, where there is a brain-body disconnect. To this end, a myoskeletal technique I call “Spindle-Stim”
can be a valuable tool.

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 Spindle-Stim Techniques for Cross Syndromes

Image 1. Upper & Lower

Cross Syndromes

I’ve found this fast-paced spindle stimulating maneuver particularly effective when treating clients with
postural ergonomic stress, as seen in Dr. Vladimir Janda’s Upper and Lower Cross Syndromes (Image 1).
Janda’s cross syndrome patterns may generally be described as weakening and lengthening of posterior
chain muscles, such as the rhomboids, serratus anterior, and gluteals, and tightening and shortening of
opposing anterior muscles, such as the pectorals and iliopsoas. Janda’s cross syndromes are not clinically
flawless, but they do offer a simplified roadmap to aid us in assessing weak postures that, left untreated, may
lead to chronic neck and back pain.

Clients develop these syndromes for many reasons, from prolonged sitting to midbrain hardwiring issues.
Even the memory of an injury and the pain associated with it can cause the body to behave as though it was
still injured. This locks the client into the very posture that afforded them avoidance at the time. Likewise,
those engaged in job-related sustained or repetitive postures develop muscular imbalances seen in clinic
every day. Before using Spindle-Stim to address such issues, it helps to understand the neurology of this
muscle spindle stimulation technique. From there, you can begin to assess, treat, and reassess to determine
if the therapeutic intervention has helped.

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Image 2.
Sudden lengthening of the extrafusal fibers triggers a mild stretch reflex contraction as the
intrafusal fibers try and maintain a constant length-tension relationship.

Muscle spindles and the stretch reflex

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 Spindle-Stim Techniques for Cross Syndromes

Muscles are recruited through the activation of spindle cells, which are stretch receptors housed within the
muscle belly. As the muscle is loaded, the muscle spindle stretches to match the extent of the load. The
spindle then sends a signal to the spinal cord, which commands the same muscle to contract. Recall that the
contractile tissues within a muscle that generate skeletal movement are called extrafusal fibers and the
intrafusal fibers have the important task of maintaining a smooth length-tension balance with the extrafusal
fibers (Image 2). With this in mind, we’re equipped to begin the assessment and treatment steps of Spindle-
Stim.

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 Spindle-Stim Techniques for Cross Syndromes
Image 3.a)
ASSESS: Therapist’s left hand braces the client’s sacrum as she actively extends her leg as
high as possible. Therapist records range of motion.

Image 3.b)
TREATMENT: With client’s leg in a “figure 4” position, therapist soft fists apply a fast-paced
gluteal oscillating maneuver for 2 minutes and then reassesses for improved hip extension.

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 Spindle-Stim Techniques for Cross Syndromes

For the assessment, I typically begin by asking the client to perform specific active movement tests, making
note of any range of motion restrictions (Images 3.a and 4.a). Testing side-to-side, if I discover a muscle
group that appears to have a weak firing pattern, I log the information in my SOAP notes, treat the area, then
reassess. The treatment itself focuses on using soft fingers, fists, or forearms to create a rapid length change
in the agonist muscle’s extrafusal fibers (Images 3.b and 4.b). This, in turn, stimulates intense firing of the
intrafusal fibers, which are valiantly trying to maintain a constant length-tension relationship with the muscle
being stretched.

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Image 4.a) ASSESS: Palms

facing down, the client is asked to extend each arm toward the ceiling while therapist assesses
and records range of motion.

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Image 4.b)
TREATMENT: With client in a handcuff hold, the therapist’s extended finger’s perform a fast-
paced oscillating maneuver to the rhomboids, lower traps and posterior rotator cuff for 2 minutes
and then assesses for improved shoulder girdle retraction.

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 Spindle-Stim Techniques for Cross Syndromes

In the Spindle-Stim technique descriptions (Images 3.b and 4.b) I can also make use of movement
enhancers, such as forced inhalation-exhalation and slow pelvic tilting maneuvers, to boost the therapeutic
effect. Instead of focusing on getting the tight muscles to relax, the idea here is to persuade the weak muscles
to tighten and contract properly. This increases joint stability by reciprocally relaxing the hypercontracted
spastic muscle, thus affording better overall muscle balance.

Summary

By moving in all directions across the muscle belly, the Spindle-Stim maneuver triggers a mild stretch reflex
that helps protect the muscle from injury. I’ve found that stimulating this stretch reflex not only aids in
strengthening the weak agonist muscles by restoring resting tone, but also facilitates improved
communication between the inhibited muscle and the client’s nervous system. In the beginning, this fast
stretch produces a relatively short-lived contraction of the agonist muscle and inhibition of the antagonist
muscle. However, over a series of sessions, these effects appear to last longer, particularly when clustered
with graded exposure stretching techniques and specific home retraining advice.

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