Have you taught those boring muscles lately? And those dreaded origins and insertions?
And when students get to the exam they are frazzled and sad? Why do we do the same things over and over and wonder why students don’t recall what we teach them? Muscles are one of the most dynamic tissues of the body so let’s teach them dynamically!
Working in healthcare for the past decade has taught me that patient “buy in” usually leads to better outcomes. Interestingly enough, students are the same way. So why not let them pick some of the muscles they have to learn? They can choose based on personal or occupational interest. For example, if your group is interested in occupational therapy, focus on muscles that are involved in activities of daily living. Are they mostly nursing students? Include muscles commonly strained by nurses in their daily practice from poor lifting mechanics or improper conditioning. This could incentivize strengthening to prevent future injuries. Student buy in may develop into personal investment, which enhances their compliance and advances their outcomes. Follow this formula, and see what happens!
Formula 1: Buy in > Personal Investment > Compliance > Improving Outcomes
It is also important to think about the breadth of material to cover. It’s not essential that students learn every specific muscle and attachment, and an operational method may enhance recall. Consider the following four step process starting with motion and ending with the muscle. First, focus on the motion desired. Second identify the plane of motion and axis of rotation. Third, isolate the line of action. Fourth, label the primary movers. A possible fifth addition could be offering an everyday example.
Formula 2: Motion Desired > Plane of Motion/Axis of Rotation > Line of Action > Primary Mover
If students have difficulty identifying the plane of motion and axis of rotation, have them poke a pencil through the middle of a large index card. Then place the index card in the plane of motion desired. If the body part contacts the card while going through the full range of motion, they’re in the wrong plane. The axis of rotation will automatically be perpendicular to the plane of motion for easy identification.
Next, they overlay a piece of string to identify a logical line of action across the joint.
Using this method, students can isolate the muscles in that region responsible for the action. As a bonus, they can suggest an example of how that muscle is used in everyday life.
If you have the students pick a few of their own muscles too, be sure they are able to complete the process despite the muscle’s obscurity. I have always included a few interesting muscles for their action, shape or function. For example, the gluteus medius not only performs hip abduction, but also executes hip internal rotation due to its line of action. The temporalis not only functions in mandibular elevation but also retraction. The piriformis, besides being a cute pennant shaped muscle, is the only gluteal muscle with a sole proximal attachment on the sacrum. If you have some high level students, dare them to discover how the gluteus maximus can perform knee extension! How else could a patient with an above knee amputation negotiate stairs in a reciprocal fashion? And if that’s not fun enough, challenge them to identify the motion that occurs if one muscle attachment is fixated and the other is not. For instance, if the distal end of the Biceps Brachii is fixated, by placing the hand under a table, then the trunk will flex forward (unfixed). Try it with other muscles too! Muscles are dynamic and should be taught that way. Because in the end, we want our students to look like this!
John Zubek is a Doctor of Physical Therapy and is an Assistant Professor of Physiology at Michigan State University.