Muscle energy techniques

Muscle Energy Technique. Muscle energy techniques are also used by osteopaths to treat dysfunctional joints and the spine. Patients perform a combination of movements such as pushing s arnst manual resistance, then relaxing and stretching the muscle at several points in the limb s motion. Such techniques can be used with various joints of the hody such as the hip, knee, and shoulder. The technique can help decrease joint restriction and restore hill range of motion. 

Fred Mitchell, Sr, performed extensive woik with sacral motion and its relation to gait. He was a leader in the development of the Muscle Energy technique. He developed the technique based on some theories of a technique developed by T. J. Ruddy, an ophthalmologist. The technique was called Resistive Duction and had been used in the treatment of eye disorders. Tutorials were developed to teach Muscle Energy tech-niques to osteopathic college faculty and practicing osteopathic physicians. 

As a physician, Fred Mitchell, Sr, DO, FAAO, first formulated muscle energy technique. Later, in cooperation with Neil Pruzzo, DO, and Peter Moran, DO, he developed a tutorial program A collection of descriptive techniques was published in An Evaluation and Treatment Manual of Osteopathic Muscle Energy Procedures in 1979. Dr. Mitchell s work appears to have been based on that of another osteopathic physician, T. J. Ruddy, DO, who used pulse-timed procedirres in and around the head and neck as treatment. 

Many osteopathic practitioners had used similar techniques over the decades, but the work by Mitchell, Moran, and Pruzzo was the first coordinated, unifying work. Since then, another work, Outline of Muscle Energy Techniques by Keimeth Graham, DO, has become available. Dr. Mitchell s son, Fred Mitchell, Jr., DO, FAAO, has recently developed a series of books detailing the theory and practice of muscle energy in a comprehensive fashion. 

Dr. Graham also notes some of the most common errors made by physicians when they are first learning and practicing muscle energy techniques ... 

Graham K. Outline qj Muscle Energy Techniques. Tulsa, OK ... 

This section describes muscle energy techniques used to treat dysfunctions of the occipi-toatlantal joint, rotational dysfunctions of the atlantoaxial joint, and single dysfunctions of a typical cervical vertebral joint. The procedure should be repeated as many times as is necessary to restore motion to the physiological barrier. However, the techniques are usually repeated a minimum of three times, with the motion barrier engaged at each repetition. 

FIG. 27-1 Muscle energy technique for a dysfunction in flexion of the occipitoatiantai joint. 

FIG. 27-3 Muscle energy technique for atlantoaxial rotation restriction. 

FIG. 27-4 Muscle energy technique for dysfunction in extension of a typioai oervioai vertebra. (A) Note position of monitoring finger. (B) Rotation is introduced into barrier to motion of a typioai oervioai vertebra. 

Alyssa was treated with gentle soft tissue techniques and muscle energy techniques at the first visit. Counterstrain was used on a tender point found at C3 on the left. The mother was shown how to gently stretch the neek into side bending to the left and was instrueted to do this several times during the day. On eaeh return visit, Alyssa showed gradual improvement. There was no evidence of contracture of any muscles, which could have led to permanent disability. 

Treatment consisted of stretching of the paravertebral muscles on the left and muscle energy techniques to help stretch those muscles. The two somatic dysfunctions were treated with muscle energy and high-velocity, low-amplitude (HVLA) thrusting technique with resolution. 

This chapter describes the application of muscle energy techniques to group curves and single-segment somatic dysfunctions in the lumbar spine. For the described techniques, the patient lies on Ws side on the table or in a modified Sims position. The transverse processes of the segment to be treated are oriented either upwards or downwards, according to the precise technique. 

CHAPTER 49 MUSCLE ENERGY TECHNIQUES FOR THE LUMBAR SPINE... 

The diagnosis of sacral dysfunction may appear to be very complex. However, with attention to the combined findings of positional and motion examination, It Is possible to discern a specific diagnosis. The system that is used is based on the Mitchell model and not on the Strachan sacral model. Both systems are valid, but the more specific application of muscle energy technique requires the findings described. 

This section describes muscle energy techniques for sacrum and pelvic somatic dysfunctions. 

FIG. 61-1 Muscle energy technique for anterior iliac-innominate-pelvic dysfunction, patient prone. 

FIG. 61-4 Muscle energy technique for inferior iliac-innominate-pelvic shear. 

FIG. 61-6 Muscle energy technique for superior pubic dysfunction. 

FIC. 61-7 Muscle energy technique for treating unilateral sacral flexion dysfunction. 

FIG. 61-8 Muscle energy technique for treating forward sacral torsion dysfunction. 

Left piriformis syndrome was diagnosed and was treated with osteopathic manipulation. The sacral shear was treated with a muscle energy technique and the tender points were treated with counterstrain. She was given a piriformis stretch to perform at home three time daily. She experienced immediate improvement after the treatment. 

FIG. 71-1 Muscle energy technique for treatment of inhalation restriction of first rib pump handie motion. 

FIG. 71-5 Muscle energy technique for treatment of exhalation restriction of the sixth through tenth ribs (bucket handie motion). 

Other restricted motions of the wrist or hand may be treated in a similar fashion by taking the joint to the barrier to motion, having the patient push against isometric resistance toward the freedom of motion, relax, and repeat the process three times. Any muscle energy technique may be followed by a passive stretch. 

Muscle energy techniques are designed to treat and relax the various muscles of mastication—those that open and close the jaw, and those that move it from side to side. 

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