Muscle energy technique
Muscle Energy Technique (MET) is a form of manual therapy used to treat musculoskeletal pain and dysfunction. It involves the use of gentle muscle contractions of the patient to relax and lengthen muscles and normalize joint motion. This technique is based on the principle that muscles are best relaxed after they are contracted, which is known as post-isometric relaxation. MET is commonly used by physical therapists, osteopathic physicians, and other trained healthcare professionals.
History
The concept of Muscle Energy Technique was developed in the 1950s by Fred Mitchell, Sr., an osteopathic physician. He observed that by actively using the muscles on one side of the body against a resistive force, the muscles on the opposite side would relax. This observation led to the development of MET as a therapeutic intervention.
Mechanism
MET operates on the principle of autogenic inhibition, where the Golgi tendon organ (GTO) is stimulated through isometric contraction, leading to a reflex relaxation of the muscle. This technique involves the patient actively using their muscles from a precisely controlled position, in a specific direction, and against a distinctly executed therapist counterforce.
There are several types of MET, including:
- Isometric: The patient performs a muscle contraction without changing the length of the muscle.
- Isotonic: The muscle changes length while contracting, either shortening (concentric) or lengthening (eccentric).
- Isolytic: The muscle lengthens while contracting due to an external force being greater than the force the muscle can generate.
Applications
MET is used to treat a variety of conditions, including:
- Muscle spasms and muscle tightness
- Decreased range of motion in joints
- Somatic dysfunction
- Improving muscular and fascial tension patterns
Procedure
A typical MET session involves the following steps: 1. The practitioner identifies a restricted joint or muscle. 2. The patient is positioned so that the muscle is in a precise starting position. 3. The patient is asked to contract the muscle gently against the therapist’s resistance, without moving the joint (isometric contraction). 4. The contraction is held for a specific duration, usually 5-10 seconds. 5. The patient relaxes, and the therapist moves the joint to its new barrier. 6. The process may be repeated, each time moving the joint into a further range of motion.
Benefits
MET is known for its gentle approach, making it suitable for many patients, including those who are sensitive to pain or have acute injuries. Benefits of MET include:
- Increased range of motion
- Decreased muscle tension and pain
- Improved muscular coordination and function
- Enhanced circulation
Limitations and Considerations
While MET is generally considered safe, it may not be suitable for all patients, such as those with certain musculoskeletal conditions or severe pain. It is important for practitioners to conduct a thorough assessment before proceeding with MET.
Training and Certification
Healthcare professionals interested in applying MET in their practice typically undergo specialized training and certification. This ensures they are proficient in the technique and understand its indications and contraindications.
Conclusion
Muscle Energy Technique is a valuable tool in the management of musculoskeletal conditions. Its gentle, patient-involved approach allows for effective treatment of pain and dysfunction, promoting overall physical well-being.
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Contributors: Prab R. Tumpati, MD