In order to assess a correct diagnosis of possible muscle issues it is very important to follow this steps:
1. Palpation of the muscle group (if the muscle is in a superficial layer, it can be analyzed individually): muscle tone, presence of trigger points and local pain.
2. Passive tensioning of the muscle group: this step would give you information about stiffness when stretched (muscle tense in short position), limitation of movement and presence of pain.
3. Isometric contraction: strength is assessed by comparing both sides and presence of pain due to contraction.
It is important to say that the differential diagnosis of muscles issues is difficult to realize as many times the symptomatic muscle group is not the main altered one, but it is antagonist muscle group. As well, it is important to note that the muscles are not assessed individually, but by muscle groupings to facilitate the diagnosis of altered muscle chains. These groupings are as follows:
- Flexor group of the forelimb:
- Ascending trapezius
- Omotransverse, bracheocephalic
- Rhomboids of the head and neck
- Latissimus dorsi
- Deltoid
- Teres minor
- Biceps brachii
- Brachial
- Carpal-radial flexor, carpal-ulnar flexor, deep digital flexor and superficial digital flexor
- Extensor group of the forelimb:
- Descending trapezius
- Deep pectoral
- Latissimus dorsi
- Supraspinatus, infraspinatus
- Triceps brachii and Biceps brachii
- Extensor carpi-radialis, common digital extensor, lateral digital extensor, carpal-ulnar extensor and oblique extensor carpus
- Hind limb flexor group:
- Psoas major and iliac
- Rectus femoris
- Sartorius
- Tensor fascia lata
- Adductors
- Pectineus
- Popliteus
- Gastrocnemius
- Superficial digital flexor, deep digital flexor, lateral digital flexor and caudal tibial
- Hind limb flexor group:
- Gluteus medius and gluteus superficial
- Piriform
- Biceps femoris, semitendinosus and semimembranosus
- Gracilis
- Quadriceps femoris
- Gastrocnemius
- Long digital extensor, lateral digital extensor, short digital extensor, cranial tibial
- Thoracic – lumbo – pelvic group:
- Lumbo-sacral mass
- Erector chest muscles (thoracic spinalis and ileocostalis)
- Splenium
- Psoas major, psoas minor and iliac
- Perivertebral muscles (multifidus, intertransverse, interspinous and rotator ribs)
- Rectus abdominis, transverse abdominis, internal oblique and external oblique abdomen and sternal muscles