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Know some Muscle Energy Technique for Anterior and Posterior Ilium

What Is Muscle Energy Technique?

In 1948, Fred Mitchel Sr, D.O. developed a type of osteopathic manipulative medicine (OMM) known as the "Muscle Energy Technique (MET)." MET improves musculoskeletal function by mobilizing joints, stretching tight muscles and fascia, reducing pain, and improving circulation and lymphatic flow (Waxenbaum, 2020). In simple terms, MET is a hands-on approach to treatment that uses the therapist's manual resistance to help the patient move their muscles. Hence, it is believed to work by mobilizing adhesions and restoring normal joint motion. As a result, MET provides pain relief, improves function, and reduces muscle tension. While the exact mechanisms are still being studied, there's plenty of anecdotal evidence to suggest that MET can be an effective treatment for various conditions.

What Are Some Common Active Technique Treatments Aside from Muscle Energy Technique?

There are many different types of Active Technique treatments, but some of the most common include:

Myofascial release: This involves applying gentle pressure to the fascia (the connective tissue surrounding muscles) to release tension and improve blood flow. There has been some debate about myofascial release, with some questioning its efficacy. However, a growing body of research suggests that myofascial release therapy can benefit many conditions.

• Muscle stripping: This technique uses manual resistance to "strip" or lengthens muscles. So, what is muscle stripping? Muscle stripping is a technique that uses manual pressure and movement to separate and stretch the muscle fibers. This is said to help improve blood circulation and promote the healing of injured muscles.

It's used to treat a variety of issues, such as Tendonitis, Muscle pain, Scar tissue, Stress, Fractures, Muscle Knots

Furthermore, muscle stripping is a massage used to treat muscle pain and tension. It is believed to work by breaking up knots and adhesions in the muscles, which can relieve pain and improve flexibility. This procedure is generally performed on the abdomen, hips, and thighs. To perform muscle stripping, the therapist will first apply a layer of oil to the area that needs treatment. They will then use their fingers or a tool to massage and stretch the muscles, which helps break down any knots or tension. This process is repeated until the therapist is satisfied with the results.

Moreover, the side effects of muscle stripping can vary depending on the individual but may include swelling, bruising, pain, and numbness. In some cases, patients may experience temporary difficulty walking or standing.

Nevertheless, muscle stripping is often used to treat chronic pain, tension headaches, and carpal tunnel syndrome. It can also be helpful for athletes who are looking to improve their performance and reduce the risk of injury.

• Isometric holds: In this treatment, the therapist will ask the patient to contract their muscles against resistance for a certain period. This treatment is thought to help relieve muscle tension because it causes the muscle fibers to stretch and recoil. This helps break down the knots or adhesions that can form in the muscle tissue, leading to pain and tension.

You'll need to find a sturdy surface like a table or countertop to do an isometric hold. Place your hand on the surface and squeeze your hand and forearm muscles as hard as you can for 10 seconds. Release and rest for 10 seconds, then repeat the hold for another 10 seconds. Do this for a total of three rounds.

So, what are the risks of isometric holds? Well, like any type of exercise, there is always a risk of injury. If you're not careful, you could end up straining or even tearing your muscles. That's why it's important to start slowly and gradually build up the intensity of your holds.

Another thing to watch out for is cramping. If you hold your muscles in a static position for too long, you might start to experience cramps. This is usually nothing to worry about, but you should speak to your therapist if the cramps are severe or persistent.

There are a few occasions when you should avoid doing isometric holds. If you're pregnant, have high blood pressure, or are recovering from surgery, it's best to speak to your musculoskeletal specialist before starting this treatment. Additionally, it's important to stop and consult your musculoskeletal specialist as soon as possible if you experience any pain or discomfort during an isometric hold.

How Can Muscle Energy Technique Help With Anterior and Posterior Ilium Pain?

Here are some ways on how Muscle Energy Technique (MET) can help with anterior and posterior ilium pain:

Stretching the muscle helps to lengthen it and improve flexibility. When the muscle is flexible, it can work more efficiently and with less tension. This can help to reduce pain and discomfort.

Breathing helps to control muscle tension and relaxation. It also helps improve blood circulation, providing more oxygen and nutrients to the muscle. This can further reduce pain and discomfort, as well as improve healing.

To maximize the effects of MET, you can also do follow-up self-massage at home. Self-massage helps break up scar tissue and adhesions, which can cause pain and restrict movement. It also helps to increase blood circulation and improve healing.

Does Muscle Energy Technique Have Any Side Effects?

There are some risks associated with using Muscle Energy Technique. As with any physical therapy, there is always a chance of injury. You could pull a muscle or even damage your joint if you're not careful.

Another thing to be aware of is that MET can be pretty intense. Some people find it uncomfortable, and it can take a while to get used to the sensation. It's important to start slowly and build up your tolerance gradually.

As with any musculoskeletal treatment, always consult a musculoskeletal specialist like Paula Nutting before starting MET. They can advise you on whether it's the right choice and help you avoid any possible side effects.

How to Address Anterior and Posterior Ilium Pain?

Anterior and Posterior Ilium Pain can be addressed through stretching, breathing, and self-massage. Stretching is key to releasing tension in the muscle and preparing it for movement. A good stretch technique is important to elongate the muscle without causing pain or discomfort.

Breathing is also essential for effective MET. You need to ensure you're breathing deeply and rhythmically to get the most out of the stretch.

Finally, self-massage is a great way to release any tension that has built up in the muscle. A good massage technique will help increase blood flow and reduce inflammation.

How Can I Stretch Effectively?

There are a few things to keep in mind when stretching effectively.

First, always warm up your muscles before stretching. This can be done by taking a light jog, jumping jacks, or simply marching in place.

Second, be sure to hold each stretch for at least 20 seconds. This will allow the muscle to relax and lengthen.

Third, don't bounce as you stretch. This can cause the muscle to tear and may lead to injury.

How Can I Stretch Effectively?

When using Muscle Energy Techniques, breathing deeply and rhythmically is important to achieve the best results.

Not only does this help to relax the body and clear the mind, but it also helps move the energy around the body correctly.

Deep diaphragmatic breathing is done by contracting the stomach muscles to push the air out of the lungs. It allows you to use 100% of your lung capacity and increases your lung efficiency.

How Can I Self-Massage Effectively?

There are a few ways to self-massage effectively. One is to use a massage ball or foam roller to target specific muscles. Another is to use your hands to massage the affected area. And finally, you can use a technique called compression massage, which involves pressing down on the muscle with your fingers or thumbs. 

Watch This Video and Subscribe to Learn More!

Searching for effective techniques to resolve your patient's hip pain? Paula Nutting, Your Musculoskeletal Specialist, discusses Anterior and Posterior Ilium pain relief using Muscle Energy Technique (MET). Try it now! click here

https://www.youtube.com/watch?v=zLQnZ2CqghY

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References

Stenersen, B., & Bordoni, B. (2022, January). Osteopathic manipulative treatment: Muscle energy procedure - cervical vertebrae. National Library of Medicine. Retrieved July 7, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK560706/

Cleveland Clinic. (2022, March 30). Diaphragmatic breathing exercises & benefits. Retrieved July 7, 2022, from https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing

Physiopedia. (2022, April 13). Muscle energy technique. Retrieved July 7, 2022, from https://www.physio-pedia.com/Muscle_Energy_Technique

Fleckenstein, J. (2010, February 11). Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: Results of a cross-sectional, nationwide survey - BMC musculoskeletal disorders. BioMed Central. https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-11-32

Muscle Energy-Technique-for-Shoulder Rotator Cuff Pain Chapmans Reflexes

Muscle Energy Technique (MET) for Shoulder Rotator Cuff Pain

Overview 

Learn Muscle Energy Technique Shoulder Rotator Cuff Pain today. If you’re suffering from rotator cuff pain, don’t worry! It’s completely treatable. For those with shoulder pain due to rotator cuff tendonitis, inflammation, or impingement, applying a Muscle Energy Technique (MET) may be just what you need to treat your condition and get back to your daily activities without pain interfering with your quality of life. In fact, our recommended treatment is one of the most effective non-surgical solutions available today.

Muscle Energy Technique for Shoulder Rotator Cuff Pain- Chapmans Reflexes Blog Image

Related Article: Neck and Shoulder Office Exercise

Why do we need rotator cuff muscles?

According to Athwal (2017), the rotator cuff is a set of four muscles that form a "cuff" over the head of the humerus via tendons. The scapula leads to the four muscles that make up the following muscles:

Rotator Cuff Muscles and four parts- Chapmans Reflexes Blog Image

Photo courtesy of A.D.A.M., INC.

The larger and lesser tuberosities are where the rotator cuff tendons join to the humeral head. These muscles altogether allow the rotator cuff to perform its important role of arm lifting and rotation as well as the stabilization of the shoulder's ball within the joint (Maruvada et al., 2021)

What is a Muscle Energy Technique (MET)?

Muscle Energy Technique (MET) is a type of soft tissue manipulation used to treat muscle imbalances and other issues. This was developed by Fred Mitchell, Sr. and Fred Mitchell, Jr. In MET, small contractions are used to stretch a tight muscle while they’re in their shortened state. The purpose of MET is to gain control over trigger points and improve mobility in muscles with limited range of motion. MET is an active approach in which the patient acts as in active participation, as opposed to static stretching, which is a passive technique in which the therapist does all of the work.

MET can be beneficial for improving stability in both shoulders. Athletes who perform overhead movements, like baseball pitchers or swimmers, tend to experience shoulder pain due to injuries like rotator cuff tears or labral problems. While steroids injections can help reduce shoulder pain and inflammation caused by these conditions. They only treat symptoms—not underlying causes of shoulder pain. In addition, it may have negative side effects if not administered correctly by professionals.

Related Article: Muscle Energy Technique Your Therapist Does For You

When should you use muscle energy technique (MET)?

Muscle Energy Techniques can be utilized for any issue where the goal is to relax and lengthen muscles while also improving joint range of motion (ROM). Almost any joint in the body can be safely treated with METs. A lot of athletes employ MET as a prophylactic treatment to avoid muscle and joint injury in the future. It is mostly utilized by those who have limited range of motion in their neck and back owing to facet joint dysfunction. Likewise, for larger issues including shoulder discomfort, scoliosis, sciatica, asymmetrical legs, hips, arms. It could also treat persistent muscular pain, stiffness, or injury.

Muscle Energy Technique (MET) for Shoulder Rotator Cuff Pain

How do you perform Muscle Energy Technique (MET)?

Muscle energy technique is effective for shoulder pain relief and it's easy to learn which is why its use in recent years have increased. Here's how you can do it for your patients. 

Physical Examination (Muscle Energy Technique Shoulder)

You will have to look at the natural range or passive range of movement of the patient. Have your client lie supine and you move their arm into abduction to a 90° angle.

External rotation of the shoulder, natural range or passive range of motion ROM should be between 80 and 90° degrees-Chapsman Reflexes Blog Image

Bend the elbow and passively check for external rotation of the shoulder as seen in the photo below. You are assessing their current ROM or the limits to their range of motion, normal range should be between 80 and 90°. If the range of external rotation is less than these numbers it can indicate that either the pectoralis major, the latissimus dorsi, and/or the teres major may be inhibited and shortened, which decreases this range performed within the upper extremity.

Next, check the internal range of the arm. Move the arm passively into internal rotation. The normal range is 70° to 90° with any limitations perhaps coming from dysfunctions in either or both the subscapularis or teres minor muscles. We also note for any ‘hard end feel’ which may indicate bony issues which means we would do further joint assessments.

internal rotation, internal range of the arm should be between 70 and 90° degrees- Chapsman Reflexes Blog Image

Performing Muscle Energy Treatment (MET) Shoulder

Move their forearm into an external rotation to perform MET. It is important that you stop at the first point where you feel restriction of the tissues. This is called Point of Bind and is at this length of the tissues that we get optimum results. They contract back towards internal rotation at 40% of the effort and no more; it is an isometric contraction where you are stabilizing the wrist and elbow to keep the joints motionless. This contraction is held for approximately 7 to 10 seconds. Ask your patient to take a deep cleansing breath and as they exhale they stop applying pressure of the muscle contraction. Keep in mind that it's important that their arm doesn't move. You will still be holding the wrist and elbow through the entire procedure and finding a new point of bind after each of the post-contraction relaxation phases.

Post-contraction Relaxation Phase

This time called Post-contraction Relaxation is when the tissues that had been contracting relax even further. We stay in limb ‘stiffness’ for up to 90 seconds and in this time the muscles relax even further so that we find the new passive end range or apply our new point of bind. Ask the patient to apply the contraction into internal rotation, still at 30% to 40% of their effort. This contraction again should be a minimum of 7 - 10 seconds. We get them to take cleansing breaths on each exhalation to improve the parasympathetic effect on the tissues; they can relax their muscle contraction as they breathe out.

Important Notes

Do the technique 3 times to see the most effective changes. Tell them to take a deep cleansing breath and that they relax the muscle contractions as they exhale. We reassess the ROM of external rotation after the third contraction and relaxation phase and we should see greater evidence of improved length through that range of motion.

This is a gentle technique for patients that feel pain and/or for those with issues in their range of motion. You might not want to use this treatment when there's a bony block when you test out the ranges. Be aware that if there's a joint restriction, we'd apply a mobilization technique or we'll adjust something deeper into that joint capsule.

Related Article: Best Pain-Free Subscapularis Massage for Shoulder Pain

Watch this Video

Here's the most effective video where you can see how to do this Muscle Energy Technique. It's a simple yet effective way to address the restrictions created by hypertonic internal rotators and gives more balance to their external rotator counterparts! Watch to go through these steps so you can practice from your clinic and also what homecare you can offer your patients when they are not in your practice.

References

Athwal, G. S. (2017, March). Rotator Cuff Tears. American Academy of Orthopaedic Surgeons. Retrieved February 20, 2022, from https://orthoinfo.aaos.org/en/diseases--conditions/rotator-cuff-tears-frequently-asked-questions/

Maruvada, S., Madrazo-Ibarra, A., & Varacallo, M. (2021, May 8). Anatomy, Rotator Cuff - StatPearls. NCBI. Retrieved February 20, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK441844/

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