Jan 2015 10

Muscle Energy Technique

By: Dave Wheeler

In previous blog posts I've looked before at both general massage techniques and soft tissue release. Today's blog continues the occasional series looking at the massage profession and its methods by looking at Muscle Energy Technique (MET).

MET is used by Sports Massage Therapists and Osteopaths to help improve a persons range of motion, usually where that lack of range of motion is causing discomfort or stopping a person doing something that they want to do.

MET helps relieves over-tense muscles and restore shortened muscles to normal length. By improving the elasticity of the muscles and tendons, range of movement at the joints can be improved.

 

muscle energy technique

 

Muscles that can be treated with MET

MET works on loads of different areas of the body. Ankle, knee, hip, elbow and shoulder joints can all have their range of movement improved using the technique; it's also great on the spine - especially near the top (the neck) and near the bottom (the lower back).

Muscles that are commonly treated with MET are:

  • calves
  • tibialis anterior (the strip of muscle at the outside front of your lower leg)
  • hamstrings
  • quadriceps (the muscles at the front of your thigh)
  • adductors (the ones running up the inside of your thigh)
  • ITB (the band of muscle on the outside of your leg)
  • QL, at the lower back
  • piriformis (one of the outward rotators of the hip)
  • upper trapezius and levator scapula
  • lats
  • all of the muscles around the shoulder joint!

To be honest, though, pretty much any muscle or joint can be treated with MET by a trained  sports massage therapist or osteopath that knows what they're doing.

 

Elements of the Muscle Energy Technique

MET relies on the therapist finding what's called the barrier position or point of bind. This is where the elasticity of a given muscle starts to become restricted.

(To be accurate, it's usually the point where the fascia surrounding the muscle starts to become restricted.)

The patient then attempts controlled movement against a force applied by the therapist in order to stretch out the restriction.

There are 2 "flavours" of MET based on 2 naturally occuring phenomena within the body. Which one your therapist uses will depend on whether the muscle is injured in any way or not.

 

1. Post Isometric Relaxation 

Post Isometric Relaxation (PIR) is used when muscles are healthy and undamaged.

To understand what the technique involves, it's useful to look at each of the words in its name:

  • post = after
  • isometric = normal muscle contraction when the muslce shortens to pull on a limb
  • relaxation = when a muscle stops working hard and lengthens out

The idea behind MET PIR is to engage the muscle against a resistance applied by the therapist (usually around 10% of normal effort from the client is all that's needed) for 10 seconds or so. The client then stops applying force and the muscles relax. At this point the muscle will start to relax and will be able to be stretched out passively by the therapist to a new point of bind.

MET PIR can be used 2 or 3 times in a row to get maximum after that. It's not usually worth doing more than that - the law of diminishing returns kicks in.

Because PIR involves making the muscle being treated contract, it's only suitable on muscle that won't be damaged by contraction - in other words, healthy tissue.

 

2. Reciprocal Inhibition (RI)

Reciprocal inhibition is the simple and obvious idea that if a muscle is contracting, then the muscle that does the opposite movement must be "switched off" and stretching out.

For example, if you bend your elbow, your biceps are engaged (theyr'e the muscles that are contracting and pulling on the lower arm to cause the movement), then your triceps will be completely switched off and streching out.

Using RI as a way of performing MET means that even damaged muscles can be stretched out, and normal range of movement restored to joints - because that injured muscle isn't going to be put under the strain of contracting.

 

Treatment, Rehab and MET

Most of my clients will be familiar with me using MET - it's one of the technqiues that I use quite a lot to ease out tense muscles and restore range of motion.

As ever, if you think I can help, give me a call.