Tuesday, December 9, 2008

Muscle Energy Technique

M.E.T. is an osteopathic joint mobilization technique developed by Fred Mitchell & Phillip Greenman from Michigan U.S.A. It is a gentle, safe technique that uses a series of muscle contractions/relaxations to restore motion & reduce pain/spasticity. Most techniques are designed for the spine.
As the years go by, I find myself using it less & less. Not because it's ineffective. It's just that the more I understand function, the more I see the lumbar & cervical spines being hit takers for some other joint(s). I mainly use it for sprains directly to the spine from a sports injury. It's particularly soothing to cervical sprains from wrestling & football. MET fits in well with the functional approach. With manipulation, the practitioner is driving through a dysfunction. MET is a triplanar approach. That is, when resistance is felt in one plane, the A.T. backs off & goes to another plane.
I'm not sure if M.E.T. has any advantage over manipulation. I don't do manipulation- it's rare that I have roentenograms/bone scans to rule out a fx. One thing the A.T. must always be cautious of is being hell bent on increasing passive ROM. Measurable improvements do not always coincide with measurable pain improvements. I am always more concerned with the pain free ROM I have assisted the athlete with.
My suggestion to A.T.'s is to be a good detective & look for the trouble makers. Jimmy Cyriax told us decades ago that the cause of a dysfunction can be 1" or 1 yard away from the pain. We have the advantage of sitting and watching the athlete compete- other health care practitioners don't get that, and that is a HUGE advantage. Joint dysfunction magnifies itself under fatigue, making the compensations more visible.
"Hit takers & trouble makers"- a good topic for GAIN '09?

5 comments:

Brian said...

Great explanation..! I'm a PT/ATC working in pro rugby in Ireland...I find physios here using Grade IV techniques on C-spines on many players regularly which I think is quite scary...I use MET as well and I think it's an effective tool to improve ROM...you're prob aware of the tutorials on the NATA site regarding this topic....thanks again for a forum to exchange thoughts/opinions...

Sorry to change the topic but what are your thoughts on kinetic chain rehab for an ACL deficient athlete? Especially with increasing Pes Anserine muscle deceleration and Post glut med activation, hamstring tone, etc.....

Joe Przytula said...

Hey Brian. I was suprised MET is known in the UK. In fact, the US PT's are kind of following your lead with manipulation, offering Masters degrees in manipulation.

As far as ACL rehab, I believe rehab it as you see it; according to the dysfunction that is presented. Keep them up on their feet if you want to get rid of edema as quick as possible. I think the hamstring is over rated as an ACL stabilizer. As the knee extends beyond 70 degrees, they lose their ability to produce posterior shear. By the way, I will give an example of a hamstring strain exercise in the near future. Have you checked out Vern/Dean Benton's article on hamstrings on his website?

Brian said...

Thanks for your reply..actually I'm American and a Penn State grad...! Been over here for 5 years now...I've noticed that schools back home are doing that...Yes, muscle energy is not taught nor are there many con ed courses compared to manipulation over here...interesting how peoples brains are wired here...the concept of active movement as a means to skin the cat is foreign here...I think that is one of our strengths especially in the population we deal with...Mind you the athletic training population doesn't really exist here like home so I think that has something to with it...you referring to the article suggesting frontal plane movement can usually be performed safely before sagittal...?

Brian said...

That was supposed to say athletic training profession over here....! Been a long day!

KP said...

Joe - concerning the Vern/Dean Benton article: I can't wait to see what you have to say when you weigh in on the hamstring rehab topic. I think that's a great article and I've had some great success incorporating some of the ideas it presents into my daily practice with some of our track kids.