Muscle Energy Techniques Explained
What are METs and how and when should they be used?
The purpose of today's blog is to explain the role of muscle energy techniques (METs) and to provide you with a clear understanding of when and why to employ this type of treatment.
Manual therapists usually have a toolbox of various techniques at their disposal to help release and relax muscles, which will then assist the client's body to promote the healing mechanisms.
METs, first described by Mitchell in 1948, are one such tool that if used correctly can have a major influence on the client's well-being.
Muscle Energy Techniques (MET's) - massage with motion is often one of the best tools a therapist has available
Definition: Muscle energy techniques (METs) are a form of osteopathic manipulative diagnosis and treatment in which the patient’s muscles are actively used on request, from a precisely controlled position, in a specific direction, and against a distinctly executed counterforce.
METs are unique in their application in that the client provides the initial effort and the practitioner just facilitates the process.
The primary force comes from the contraction of the client's soft tissues (muscles), which is then utilized to assist and correct the presenting musculoskeletal dysfunction.
This treatment method is generally classified as a direct form of technique as opposed to indirect, since the use of muscular effort is from a controlled position, in a specific direction, and against a distant counterforce that is usually offered by the therapist.
Some of the Benefits of METs
When teaching the concept of METs, one of the benefits I emphasize is their use in normalizing joint range, rather than in improving flexibility.
This might sound counterintuitive; what I am saying is if, for example, your client cannot rotate their neck (cervical spine) to the right as far as they can to the left, they have a restriction of the cervical spine in a right rotation.
The normal rotational range of the cervical spine is 80 degrees, but let’s say the client can only rotate 70 degrees to the right. This is where METs come in.
After an MET has been employed on the tight restrictive muscles, hopefully the cervical spine will then be capable of rotating to 80 degrees—the patient has made all the effort and you, the practitioner, have encouraged the cervical spine into further right rotation. You have now improved the joint range to “normal.”
This is not stretching in the strictest sense—even though the overall flexibility has been improved, it is only to the point of achieving what is considered to be a normal joint range.
Depending on the context and the type of MET employed, the objectives of this treatment can include:
Restoring normal tone in hypertonic muscles
Strengthening weak muscles
Preparing muscles for subsequent stretching
Increasing joint mobility
Restoring Normal Tone in Hypertonic Muscles
Through the simple process of METs, we as manual therapists try to achieve a relaxation in the hypertonic shortened muscles.
If we think of a joint as being limited in its ROM, then through the initial identification of the hypertonic structures, we can employ the techniques to help achieve normality in the tissues.
Certain types of massage therapy can also help us achieve this relaxation effect, and generally an MET is applied in conjunction with massage therapy.
I personally feel that massage with motion is one of the best tools a therapist has.
Strengthening Weak Muscles
METs can be used in the strengthening of weak or even flaccid muscles, as the clients are asked to contract the muscles prior to the lengthening process.
The therapist should be able to modify the MET by asking the client to contract the muscle that has been classiffied as weak, against a resistance applied by the therapist (isometric contraction), the timing of which can be varied.
For example, the patient can be asked to resist the movement using approximately 20–30% of their maximum capability for 5–15 seconds.
They are then asked to repeat the process five to eight times, resting for 10–15 seconds between repetitions. The client's performance can be noted and improved over time.
Preparing Muscles for Subsequent Stretching
In certain circumstances, what sport your client participates in will be determined by what ROM they have at their joints.
Everybody can improve their flexibility, and METs can be used to help achieve this goal. Remember that the focus of METs is to try to improve the normal ROM of a joint.
If you want to improve the client's flexibility past the point of normal, a more aggressive MET approach might be recommended.
This could be in the form of asking the client to contract a bit firmer than the standard 10–20% of the muscle’s capability. For example, we can ask the client to contract using, say, 40–70% of the muscle’s capability.
This increased contraction will help stimulate more motor units to fire, in turn causing an increased stimulation of the Golgi tendon organ (GTO).
This will then have the effect of relaxing more of the muscle, allowing it to be lengthened even further.
Either way, once an MET has been incorporated into the treatment plan, a flexibility program can follow.
Increasing Joint Mobility
One of my favorite sayings when I teach muscle testing courses is: “A stiff joint can become a tight muscle, and a tight muscle can become a stiff joint.”
Does this not make perfect sense?
When you use an MET correctly, it is one of the best ways to improve the mobility of the joint, even though you are relaxing the muscles initially.
The focus of the MET is to get the client to contract the muscles; this subsequently causes a relaxation period, allowing a greater ROM to be achieved within that specific joint.
This blog post is an edited extract from the course text Muscle Energy Techniques by Osteopath John Gibbons.
About NAT Courses
As a manual therapist or exercise professional, there is only one way to expand your business - education!
Learning more skills increases the services that you offer and provides more opportunity for specialization.
Every NAT course is designed to build on what you already know, to empower you to treat more clients and grow your practice, with a minimal investment in time and money.
About Niel Asher Education
Niel Asher Education is a leading provider of distance learning and continued education courses.
Established in the United Kingdom in 1999, we provide course and distance learning material for therapists and other healthcare professionals in over 40 countries.
Our courses are accredited by over 90 professional associations and national accreditation institutions including the National Academy of Sports Medicine (NASM) and National Certification Board for Therapeutic Massage and Bodywork (NCBTMB). Full details of all international course accreditations can be found on our website.
Printed course materials and other products offered on our websites are despatched worldwide from our 3 locations in the UK (London), USA (Pennsylvania) and Australia (Melbourne).
NAMTPT AWARD 2017
We are honored to have received the 2017 "Excellence in Education" Award from the National Association of Myofascial Trigger Point Therapists.
Since 1999 Niel Asher Education has won numerous awards for education and in particular for education and services provided in the field of trigger point therapy.
Award Winning Instructors
Niel Asher Healthcare course instructors have won a host of prestigious awards including 2 lifetime achievement honorees - Stuart Hinds, Lifetime Achievement Honoree, AAMT, 2015, and Dr. Jonathan Kuttner, MD, Lifetime Achievement Honoree, NAMTPT, 2014.
If you are a qualified/licensed manual therapist or exercise/fitness professional you can expand your credentials with NAT certification.
In addition to national accreditation for continued education, each course that we offer includes "NAT Learning Credits". By taking and completing courses you can accumulate NAT credits to qualify for NAT certification.
There are currently 3 levels of NAT certification. Certifying NAT is a valuable way to show your clients that you take continued education seriously, and to promote your skills and qualifications.
Niel Asher Technique
Since 1999 the Niel Asher Technique for treating trigger points has been adopted by over 100,000 therapists worldwide, and has been applied to the treatment of a number of common musculoskeletal injuries.
The Niel Asher Technique for treating frozen shoulder was first introduced and published in 1997 and has been widely adopted by therapists and exercise professionals working within elite sports and athletics.
Worldwide Free Shipping
Most of our courses are available as either "Printed" or 'Download" editions. When you purchase a download edition, you receive immediate lifetime access to all course material. Course texts can be downloaded and printed if required.
When you purchase a "Printed" edition, you will also receive free access to the download edition.
We ship Worldwide from locations in the USA, UK, and Australia. Most items are despatched within 24 hours and shipping is FREE for all orders over US$50.
This trigger point therapy blog is intended to be used for information purposes only and is not intended to be used for medical diagnosis or treatment or to substitute for a medical diagnosis and/or treatment rendered or prescribed by a physician or competent healthcare professional. This information is designed as educational material, but should not be taken as a recommendation for treatment of any particular person or patient. Always consult your physician if you think you need treatment or if you feel unwell.
- Trigger Points and Lower Back Pain
Treating Trigger Points for Back Pain - Dr. Jonathan Kuttner Lower Back Pain has reached epidemic proportions. Here...
- Trigger Point Therapy - Treating Achilles Tendinitis
Achilles Tendinitis - Trigger Point Therapy Achilles problems are amongst the most common issues that therapists...
- Thoracic Mobility - How To Avoid Injury
Simple Thoracic Mobility Exercise - Mike McGurn The thoracic spine plays a vital role in keeping the shoulders ...
- Stretching for Pain Relief - Pectoralis Major and Minor
Two Great Exercises for Loosening the Pecs Trigger points in the Pectoralis muscles are common and often develo...
- Trigger Point Therapy - Treating Spondylolisthesis
Trigger Point Therapy Treatment for Spondylolisthesis Spondylolisthesis can often be treated very effectively w...
- Trigger Point Therapy - Irritable Bowel Syndrome (IBS)
Rectus Abdominis Trigger Points Irritable bowel syndrome (IBS) is a common condition of the digestive system ...
- Trigger Point Therapy - Where to Start?
About NAT Home-Study Courses NAT courses are designed to provide continued education for qualified therapists, ...
- Trigger Point Overview - Rectus Abdominis
Rectus Abdominis Trigger Points - Dr. Jonathan Kuttner Latin rectus, straight; abdominis, of the belly/stoma...
- Trigger Point Therapy - Active, Latent and Transitional Trigger Points
How To Treat "Latent" Trigger Points Latent Trigger Points are like land mines - waiting silently under th...
- Shoulder Injuries - "Wear, Tear, and Repair" Syndrome
Shoulder Pain and Trigger Points Learn More Shoulder injuries are often more painful at night....
Share this post