Muscle Energy Techniques (MET’s)
Osteopathic medicine is thought to have developed Muscle Energy Techniques (MET’s) over the years. Muscle Energy Technique (MET's) are frequently used to assess and treat dysfunctional tissues. There are many variants of Muscle Energy Technique (MET’s), and in general, they utilise knowledge of the principles of how we move and basic anatomy and physiology. Muscle Energy Techniques are yet another form of fascial release technique, of which there are many variants, including 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. Hence, therapists need to have a detailed understanding of which technique to use with any given patient presentation. Two such version of MET’s are Post Isometric Relaxation (PIR) and Reciprocal Inhibition (RI).
To explain the principles of PIR and RI one needs to understand a little about the involved anatomy and physiology. 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 and how rapidly change occurs. 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 a few seconds, the Golgi tendon organs within the stretched muscle 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 tissues. Once muscles tissues have become relaxed, it is possible to stretch them.
Post Isometric Relaxation (PIR)
The principles of PIR where outlined above and are based on 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. In the case of acute tissue trauma, one would not use PIR as it is likely to cause further tissue damage as a result of the subject contracting the damaged tissues. Otherwise, the technique can be employed to significant effect, provided the patient has no contraindications to massage therapy. The method is particularly suitable when one has to perform treatment on a fully clothed person. 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 seen. PIR tends to be applied differently to chronic conditions or tissues. Typically, the therapist would stretch the affected tissues to the point of “bind” and then reduce the stretch to just before this point is felt, before then continuing with the technique as usual. On the final application of Post Isometric Relaxation (PIR), the therapist will usually take the muscle(s) tissues to the point of bind and then hold this position.
Reciprocal Inhibition (RI)
The principles of RI were outlined earlier and are based on the effect that muscle spindles have on a muscles antagonist. One is not likely to employee this technique if it results in the antagonist muscle being placed in a highly shortened position, as this could result in painful muscles spasm. As with PIR the method can be employed to significant effect, provided the patient has no contraindications to massage therapy. Reciprocal Inhibition (RI) is particularly suitable when one has to perform treatment on a fully clothed person. In the case of RI, the therapist will again take the target muscle(s) to the point of tissue bind or just before this occurs in chronic cases. The subject is then asked to contract the antagonist muscle(s) isometrically. Again as with PIR, breathing can also be utilised and the patient 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. On the final application of the method, the therapist will take the muscle(s) tissues to the point of bind and then hold this position.
Chiropractic and Massage Registrations
All of our practitioner's hold relevant professional industry registrations and or memberships. Our principal Chiropractor Terry Davis MSMA holds additional memberships and registrations for Massage Therapy with the Complementary & Natural Health Council (CHNC) and is BTEC Level 5 Clinical Sports and Remedial Massage Therapy qualified and holds professional membership with the Sports Massage Association (SMA):-