What is Muscle Energy Technique (MET)?
Muscle Energy Technique (MET), like other myofascial release and soft-tissue therapy techniques, has its origins in Osteopathic medicine. Such methods aim to assess and treat dysfunctional soft-tissues and improve mobility, function and even pain. Muscle Energy Techniques are yet another form of fascial release technique, of which there are many variants, known more generally as Myofascial Release (MFR). However, each type of fascial release technique works slightly differently, and practitioners need to know when it is or is not appropriate to use any given method. It is possible to make aliments far worse or even create new symptoms if one applies the wrong technique in any given circumstance. Hence, therapists need to have a detailed understanding of which method to use with any given consumer presentation. Two such versions of MET’s are Post Isometric Relaxation (PIR) and Reciprocal Inhibition (RI). MET is just one of the many treatment methods available at TotalMSK.
How do Muscle Energy Techniques work?
Muscle Energy Techniques work by utilising principles of anatomy, physiology and movement to in effect use the energy of muscles and specific techniques to create a type of myofascial release. To explain the principles of PIR and RI, one needs to understand a little about the involved anatomy, physiology and human movement. One, therefore, needs to understand the stretch reflex and the role of muscle spindles and the Golgi tendon organs. Muscles spindles are sensitive to changes in length (stretch) and how rapidly such changes occur. Golgi tendon organs are sensitive to prolonged changes in tissue tension. When a muscle is stretched the muscle spindles within the muscle transmit increased nerve impulses to the posterior horn cell within the spinal cord. The increased nerve transmissions then result in increased nerve impulses to the anterior horn cell, which in turn results in a protective contraction of the stretched muscle. Within split seconds, the Golgi tendon organs within the stretched muscle tissues detect a prolonged change in tissue tension and to avoid tissue damage the Golgi tendon organs transmit increased nerve impulses to the posterior horn cells. These increased nerve impulses produce an inhibitory effect on the anterior horn cell, which relaxes the muscle tissues. Once muscles tissues have become relaxed, it is possible to stretch them. If these processes did not happen, then we would be incapable of movement. In essence, movement works by muscles and tissues, applying contractile forces to bones and joint structures. The only way to achieve movement is by alternating muscles contractions. For example, to bend or flex the knee, the hamstrings will contract, and the quadriceps will relax. The exact opposite is true for extending or straightening the leg; however, movement is far more complicated than this. These principles of movement can be used by a suitably qualified and experienced therapist to treat dysfunctional tissues with MET.
MET - Post Isometric Relaxation (PIR)
As was discussed earlier, the principles underpinning Post Isometric Relaxation (PIR) relate to the effect that the Golgi tendon organ has on a sustained muscle stretch. How this technique is employed will depend on many factors, including whether the condition is acute or chronic and if the subject has recent tissue trauma. PIR can produce excellent results when applied correctly by qualified practitioner and in the right circumstances. The method is particularly suitable when one has to perform treatment on a fully clothed person, as the technique is not a form of massage and direct skin contact is not necessary. In general, PIR involves stretching tissues to a specific point of “bind” and then asking the subject to contract the tissues, with varying degrees of strength and duration. Practitioners can use breathing techniques to aid in the application of this treatment method. PIR can be applied multiple times or until no further improvement occurs. PIR tends to be applied differently to chronic conditions or tissues, and again a suitably qualified practitioner will know this.
MET - Reciprocal Inhibition (RI)
The principles of Reciprocal Inhibition (RI), were outlined earlier and are based on the effect that muscle spindles have on a muscle(s) antagonist, or opposing muscle(s). Again, a suitably qualified therapist will know when it is better to use Reciprocal Inhibition with a consumer over Post Isometric Relaxation. As with PIR, the method can be employed to significant effect, provided the consumer has no contraindications to massage therapy. Again, Reciprocal Inhibition (RI) is particularly suitable when one has to perform treatment on a fully clothed person, as direct skin contact is not necessary. In the case of RI, the therapist will again generally take the target muscle(s) to the point of tissue bind, though this may not always be the case. The consumer then contracts the antagonist muscle(s) isometrically. Again as with PIR, breathing can also be utilised and the consumer can be asked to take a deep breath and then as they slowly breathe out the therapist can stretch the tissues further until the new point of “bind” is reached. A therapist can then repeat the technique until there is no further improvement.
Massage and Myotherapy Registrations
Terry brings over 15 years of experience working in the MSK field back to Australia from the UK. His training covers a wide variety of treatment methods and soft tissue therapy (STT) skills. Terry's main area of interest lies in trauma and myofascial pain relief. He also taught as a senior course coach on one of the first myotherapy courses in Brisbane and is highly qualified. His skills are now available at the Morningside clinic, where he works as a Myotherapist.