About

The Shapiro method is an approach to assessing and addressing a variety of musculo-skeletal (MSK) problems that may cause patients to have pain and/or impaired function, both of which may range from mild to severe.  An under-appreciated component of symptom development may be the response of the peripheral or central nervous system to small changes often occurring in joint alignment and movement, referred to as somatic dysfunction.

Selective motor inhibition is believed to occur in response to input related to perceived alteration of optimal alignment and function of a specific structure or group of structures. This inhibition is removed immediately with correction of the somatic dysfunction, although the specific structure or structures participating in causing this motor inhibition is not understood fully.

Manual muscle testing (MMT) facilitates the identification of inhibited muscle actions (weakness) that appear to have specific patterns of inhibition for each somatic structure. Clinical experience has demonstrated repeatedly that successful treatment of a somatic dysfunction will remove inhibitory reactions on previously compromised motor actions, allowing a return to normal clinical strength. Thus, relatively brief manual muscle testing allows a concise determination of structures benefitting from treatment.

MMT provides immediate feedback regarding the success of the therapeutic intervention. A clinical benefit to this testing after treatment often occurs because the patient has had the experience of weakness found on exam; its resolution with successful correction of a somatic dysfunction often is accompanied by a rapid reduction in pain. Consequently, patient fears regarding living with pain, extensive disability, possible need for surgery and such, all may be allayed significantly.

Failure to correct malalignments causing inhibitory weakness increases the likelihood of additional negative consequences, often resulting in a “snowballing” effect. Commonly occurring examples include musculotendinous shortening and pain arising from soft tissue structures recruited to compensate for the inhibited muscles, which may be due to factors such as overuse and altered biomechanics. These occurrences often lower the threshold for developing additional somatic dysfunctions.

Musculotendinous (i.e., a muscle and its associated tendon attaching it to a bone) shortening is a common response to both injury and weakness. Successful realignment of a specific somatic dysfunction (e.g., joint malalignment) associated with a short- ened structure usually does not resolve the shortening. Additional measures, such as structure-specific stretching may be required. Consequently, following achievement of realignment, a further assessment of possible shortened musculotendinous structures is helpful in identifying treatment components.