The Muscle Creator window lets you build new NURBS muscles. You typically need two objects to attach the muscle to, one for the start and one for the end. Locator curves for each end are created so that you can set the width of each side.
Typically, you want a Muscle Object shape node so that you can connect the muscle to the Muscle deformer. If you decide to, you can turn off this option, then convert the muscle to have a Muscle Object shape later.
A muscle is created. Depending on the orientation of your attach points, the muscle may be twisted or need its end points adjusted.
Two curves that look like locators appear at each end. These start and end points can be adjusted in the viewport to set the location of the muscle. (See Muscle components for information the muscle that appears in the viewport.)
Once the muscle is created, you can switch to the Edit tab for basic modeling and editing of the muscle.