MUSCLE ENERGY TECHNIQUE(Modified from of PNF)

PRESENT BY-Debanjan mondal(mpt)

The voluntary contraction of the patient muscle in a precisely controlled direction, at varying level of intensity against a distinctly executed counter force applied by the operator. It is a active techniques in which the patient contributes the corrective force.

Origins of Muscle Energy

(1) Fred Mitchell Sr., D.O.– Originator of Muscle Energy

(2) A.T. Still• Emphasis on the role of muscles &

fascia

(3) T.J. Ruddy D.O.• Rapid Rhythmic Resistive Duction

(4) Carl Kettler D.O.• Lumbo-pelvic torsion, isometric

resistance

MET PIONEERS

T.J. Ruddy Fred Mitchell Snr

Karel LewitPhilip Greenman

Sandra YaleEdward Stiles

J. Goodridge and W. KucheraOthers

PRINCIPLE

(1) The operator’s force may exactly match the effort of the patient allowing no movement to occur ( isometric contraction). This isometric contraction in combination of:

a. RI of antagonist of the muscle being contracted.b. PIR of agonist of the muscle being contracted.

(2) The operator force may overcome the effort of the patient, thus moving the area or joint in the direction opposite to that in which the patient is attempting to move it (isotonic eccentric contraction, also known as an isolytic contraction).

(3) The effort of the patient is 20% of strength.

(4) The length of time the effort is held 7-10 seconds.

(5) The number of times the isometric contraction is repeated – 3 repetitions are optimal .( 3-5 repetitions)

(6) The direction in which the effort is made towards the resistance barrier or away from it. ( direct or indirect approaches)

(7) Incorporate a breath control & specific eye movements to enhance the effect of the contraction.

(8) MET utilise alone or in a sequence with other modalities such as PRT (strain & counterstrain), ischaemic compression/ inhibitory pressure technique of NMT.

(9) Restriction barrier, in acute condition , isometrics contractions is done at RB, but in chronic condition isometric contraction just away from the RB.

Barrier Concept

(a) Physiological: limit of active range.

(b) Anatomical: limit of passive range. (Going beyond anatomical barrier results in joint disruption).

(c) Restrictive: point in the range of motion where all of the slack is taken out.

(d) Muscle: spasm can be a cause or an effect of biomechanical changes.

BIND OR EASE CONCEPT

Bind – Going into restrictive barrier

Ease – Going away from restrictive barrier

Direct vs. Indirect Techniques

(1) Direct Techniques:

– The tissue is moved toward the barrier, on one or more planes.

– The direction of movement is toward the least mobile, most restricted, and most limited tissue.

– Muscle Energy is an example of “Direct Treatment Technique”.

(2) Indirect Techniques:

– The tissue is moved away from the barrier on one or more planes.

– The direction of movement is toward the most mobile, least restricted, and least limited tissue.

– Strain- Counterstrain is an example of“Indirect Treatment Technique”.

USES & EFFECT (Philip Greenman-1996)

(1) Lengthen a shortened, contractured or spastic muscle.

(2) To strengthen a physiologically weakeneg muscles or group of muscle.

(3) To reduce localized edema.

(4) Relieve passive congestion (the muscle are the pump of the lymphatic & venous system).

(5) To mobilize an articulation with restricted mobility.

(6) Trigger points

(7) Severe pain ( severe muscle spasm followed by acute somatic dysfunction – whiplash injury)

TYPES OF MUSCULAR CONTRACTION

(1) Isometric contraction

(2) Isotonic ( Isolytic) contraction

Concentric isotonic contraction

Eccentric isotonic contraction