← Kinesiology & Muscles – MBLEx Exam Prep

MBLEx Massage Therapy Exam Study Guide

Key concepts, definitions, and exam tips organized by topic.

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Kinesiology & Muscles: MBLEx Exam Prep Study Guide


Overview

Kinesiology is the study of human movement, encompassing muscle anatomy, joint mechanics, and functional movement patterns. For the MBLEx exam, you must understand how muscles work together to produce movement, identify specific muscles and their actions, and apply this knowledge to clinical massage therapy practice. Mastery of these concepts forms the foundation for client assessment and effective treatment planning.


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Muscle Actions & Joint Movement


Fundamental Movement Terms


Joint movements describe the motion occurring at a specific articulation. Every movement has an opposite action, and understanding these pairs is essential for the exam.


| Movement | Definition | Opposite |

|---|---|---|

| Flexion | Decreases angle between two bones | Extension |

| Abduction | Movement away from midline | Adduction |

| Supination | Palm faces anteriorly/upward | Pronation |

| Dorsiflexion | Dorsum of foot toward shin | Plantarflexion |

| Inversion | Sole turns inward (medial border elevates) | Eversion |

| Circumduction | Cone-shaped circular movement | N/A |


Key Terms

  • • Flexion – Decreases the joint angle between two bones
  • • Extension – Increases the joint angle between two bones
  • • Abduction – Movement of a limb away from the midline
  • • Adduction – Movement of a limb toward the midline
  • • Supination – Forearm rotation so palm faces anteriorly (upward)
  • • Pronation – Forearm rotation so palm faces posteriorly (downward)
  • • Dorsiflexion – Bringing the top of the foot toward the shin
  • • Plantarflexion – Pointing the foot downward (away from shin)
  • • Inversion – Turning the sole of the foot inward toward midline
  • • Eversion – Turning the sole of the foot outward away from midline
  • • Circumduction – Combined flexion, extension, abduction, and adduction in a circular pattern

    • Circumduction Details

  • • Produces a cone-shaped arc of movement
  • • Occurs at ball-and-socket joints (hip, shoulder) and condyloid joints (wrist, MCP joints)
  • • Does NOT occur at hinge joints (elbow, knee)

    • > Watch Out For: Dorsiflexion and plantarflexion are ankle-specific terms. Do not confuse dorsiflexion (toes toward shin = decreased anterior angle) with general flexion rules. The ankle is an exception where "flexion" is not the standard terminology used clinically.


    > Watch Out For: Supination vs. pronation — use the memory cue: SUPination = SUPine position = palm UP. Pronation = palm down (prone-like).


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    Muscle Anatomy & Terminology


    Muscle Attachment Points


  • • Origin – The fixed, proximal attachment point; does not move during contraction
  • • Insertion – The movable, distal attachment point; moves toward the origin during contraction

    • > Watch Out For: The origin is generally proximal and fixed; the insertion is distal and mobile. However, in open vs. closed chain movements, the "fixed" end can reverse. The exam typically tests the standard anatomical definition.


    Types of Muscle Contraction


    | Contraction Type | Length Change | Joint Movement | Example |

    |---|---|---|---|

    | Concentric | Shortens | Yes | Bicep curl upward phase |

    | Eccentric | Lengthens | Yes | Bicep curl lowering phase |

    | Isometric | No change | No | Holding a position statically |


  • • Concentric – Muscle shortens while producing force; muscle overcomes resistance
  • • Eccentric – Muscle lengthens while producing force; controls/decelerates movement against gravity or resistance
  • • Isometric – Muscle generates tension without changing length; no joint movement occurs

    • Muscle Role Classifications


  • • Agonist (Prime Mover) – The muscle primarily responsible for producing a specific movement
  • • Antagonist – The muscle that opposes the agonist; controls speed and range of movement
  • • Synergist – Assists the agonist in producing movement or eliminates unwanted movements caused by the agonist

    • Key Connective Tissue Term

  • • Tendon – Band of fibrous connective tissue attaching muscle to bone
  • • Ligament – Connects bone to bone (not muscle-related but a common exam distractor)

    • > Watch Out For: Tendons attach muscle to bone. Ligaments attach bone to bone. These are frequently confused on exams. A tendon is an extension of the muscle's fascia; a ligament stabilizes joints.


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    Specific Muscle Identification


    Rotator Cuff — SITS Muscles


    The four rotator cuff muscles stabilize the glenohumeral joint by compressing the humeral head into the glenoid fossa.


    Memory Aid: SITS

    | Muscle | Primary Action |

    |---|---|

    | Supraspinatus | Initiates abduction (first ~15°); assists deltoid |

    | Infraspinatus | Lateral (external) rotation of humerus |

    | Teres Minor | Lateral (external) rotation of humerus |

    | Subscapularis | Medial (internal) rotation of humerus |


    > Watch Out For: The supraspinatus initiates abduction but is NOT the primary abductor — the deltoid is. The supraspinatus assists and initiates the movement. The subscapularis is the only rotator cuff muscle that internally rotates; the other three all externally rotate.


    Hamstring Group


    | Muscle | Origin | Insertion | Actions |

    |---|---|---|---|

    | Biceps Femoris | Ischial tuberosity (long head), linea aspera (short head) | Head of fibula | Knee flexion, hip extension |

    | Semimembranosus | Ischial tuberosity | Posterior medial tibia | Knee flexion, hip extension |

    | Semitendinosus | Ischial tuberosity | Medial tibia (pes anserine) | Knee flexion, hip extension |


    Primary Actions: Hip extension + Knee flexion


    > Watch Out For: The biceps femoris is the only hamstring that inserts on the fibula (laterally). The semimembranosus and semitendinosus insert medially on the tibia.


    Hip Flexors


  • • Iliopsoas = Iliacus + Psoas Major

    • - Insertion: Lesser trochanter of the femur

    - Primary action: Hip flexion (most powerful hip flexor)

    - Additional psoas action: Lumbar spine extension/anterior pelvic tilt when tight


    Sternocleidomastoid (SCM)


  • • Origin: Sternum and clavicle
  • • Insertion: Mastoid process of temporal bone
  • • Actions:

    • - Bilateral: Flexes the neck (cervical flexion)

    - Unilateral: Laterally flexes neck to the same side; rotates face to the opposite side


    > Watch Out For: The SCM rotates the face to the OPPOSITE side from which it contracts — this is a common trick question. Unilateral lateral flexion goes to the SAME side.


    Gastrocnemius & Calf Muscles


    | Muscle | Joint Crossed | Primary Action |

    |---|---|---|

    | Gastrocnemius | Biarticular (knee + ankle) | Plantarflexion; assists knee flexion |

    | Soleus | Monoarticular (ankle only) | Plantarflexion |


  • • The gastrocnemius is the primary "toe-off" muscle during gait
  • • The soleus is more active during walking; gastrocnemius during running/jumping

    • Trapezius Muscle — Three Regions


    | Region | Primary Action | Shared Action |

    |---|---|---|

    | Upper Trapezius | Elevates scapula | Upward rotation |

    | Middle Trapezius | Retracts scapula | Upward rotation |

    | Lower Trapezius | Depresses scapula | Upward rotation |


    All three parts assist in upward rotation of the scapula.


    > Watch Out For: The trapezius has three distinct functional regions with different actions. Upper = elevation, Middle = retraction, Lower = depression — but ALL assist in upward scapular rotation.


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    Applied Kinesiology & Functional Anatomy


    Length-Tension Relationship


  • • A muscle produces optimal force at its resting (mid) length
  • • Force production decreases when the muscle is either:

    • - Too shortened – active insufficiency

    - Too lengthened – passive insufficiency

  • • Clinical application: Muscles held in chronically shortened or lengthened positions lose strength and efficiency

    • Reciprocal Inhibition


  • • Definition: When an agonist contracts, the nervous system neurologically inhibits the antagonist to allow smooth movement
  • • Clinical Relevance: Chronically tight agonists can inhibit and weaken their antagonists

    • - Example: Tight hip flexors (iliopsoas) inhibit and weaken the gluteus maximus

    - Example: Tight upper trapezius inhibits lower trapezius


    Quadratus Lumborum (QL) — "The Hip Hiker"


  • • Location: Deep to the erector spinae; connects iliac crest to 12th rib and lumbar vertebrae
  • • Action: Elevates the ilium (hikes the hip) on the same side when spine is fixed; lateral flexion of lumbar spine
  • • Clinical note: Commonly implicated in low back pain; often hypertonic in postural imbalances

    • Psoas Major & Anterior Pelvic Tilt


  • • A tight psoas major:

    • - Pulls the lumbar spine into extension (hyperlordosis)

    - Tilts the pelvis anteriorly

    - Weakens/inhibits the gluteus maximus (via reciprocal inhibition)

  • • Commonly seen in people who sit for prolonged periods

    • IT Band (Iliotibial Band)


  • • Structure: Thick band of fascia running along the lateral thigh
  • • Path: Iliac crest → lateral tibia (Gerdy's tubercle)
  • • Proximal attachments:

    • - Tensor Fasciae Latae (TFL)

    - Gluteus Maximus

  • • Clinical relevance: IT band syndrome is common in runners; caused by repetitive friction at the lateral knee

    • > Watch Out For: The IT band is fascia, not a muscle. It cannot be "stretched" like a muscle. Massage therapists work the TFL and gluteus maximus to address IT band tension.


    Serratus Anterior


  • • Action: Protracts the scapula; holds scapula against thoracic wall; assists in upward rotation
  • • Weakness results in: Scapular winging — the medial border of the scapula lifts away from the thoracic wall
  • • Innervation: Long thoracic nerve (clinically significant — injury to this nerve causes winging)

    • Gluteus Medius vs. Gluteus Minimus


    | Muscle | Location | Actions | Clinical Note |

    |---|---|---|---|

    | Gluteus Medius | Superficial | Hip abduction, medial rotation | Common injection site |

    | Gluteus Minimus | Deep to medius | Hip abduction, medial rotation | Assists same actions as medius |


    > Watch Out For: Both the gluteus medius and minimus perform abduction and medial rotation. The gluteus medius is the primary mover and most common injection site. The minimus is the deeper, smaller muscle that assists.


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    Common Exam Pitfalls — Master List


    > Watch Out For:

    > - Agonist vs. Antagonist — The antagonist does not simply "relax"; it actively controls movement speed and range

    > - Origin vs. Insertion — Origin = proximal/fixed; Insertion = distal/mobile

    > - Tendons vs. Ligaments — Tendons = muscle to bone; Ligaments = bone to bone

    > - Isometric contractions produce force but NO joint movement and NO length change

    > - Eccentric contractions are when the muscle is lengthening but still producing force (e.g., slowly lowering a weight)

    > - SCM rotation — rotates face to the OPPOSITE side

    > - Supraspinatus initiates abduction but the deltoid is the primary abductor

    > - Subscapularis is the only rotator cuff muscle that INTERNALLY rotates (all others externally rotate)

    > - Reciprocal inhibition means tight muscles can WEAKEN their antagonists — a key clinical concept


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    Quick Review Checklist


    Before your exam, confirm you can answer YES to each of the following:


  • • [ ] I can define and distinguish agonist, antagonist, and synergist
  • • [ ] I can describe concentric, eccentric, and isometric contractions with examples
  • • [ ] I know the difference between a tendon (muscle to bone) and ligament (bone to bone)
  • • [ ] I can define and correctly identify: flexion, extension, abduction, adduction, circumduction, supination, pronation, dorsiflexion, plantarflexion, inversion, eversion
  • • [ ] I know the SITS muscles of the rotator cuff and the primary action of each
  • • [ ] I know the three hamstring muscles, their origin (ischial tuberosity), and primary actions (hip extension + knee flexion)
  • • [ ] I know the iliopsoas inserts on the lesser trochanter and is the primary hip flexor
  • • [ ] I can describe the three parts of the trapezius and their distinct actions
  • • [ ] I understand the SCM's bilateral vs. unilateral actions (especially that it rotates the face to the OPPOSITE side)
  • • [ ] I can explain the length-tension relationship and why it matters clinically
  • • [ ] I can explain reciprocal inhibition and give a clinical example
  • • [ ] I know the QL is the "hip hiker" and that a tight psoas contributes to anterior pelvic tilt
  • • [ ] I know the IT band is fascia with TFL and gluteus maximus attaching proximally at Gerdy's tubercle
  • • [ ] I know serratus anterior protracts the scapula and its weakness causes scapular winging
  • • [ ] I can distinguish the actions and locations of gluteus medius vs. gluteus minimus

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    Focus your review on the relationships between muscles and movements — the MBLEx frequently presents clinical scenarios requiring you to identify which muscle is involved based on its action, location, or dysfunction.

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