MET, or Muscular Energy Technique, is a deep tissue technique developed in osteopathic practice. It uses energy produced through isometric contractions of muscles to restore muscle balance and function to reduce pain.
Isometric contractions are when your muscle contract without any movement. Examples of this could be holding a bag of shopping down by your side. Move the bag out to your side so it is horizontal to your shoulders and the muscles are both contracting and moving.
Muscle dysfunction can be caused by a number of factors – psychosocial (emotional and wellbeing), biochemical (nutrition and hormones) and biomechanical. The demands we make – through the activities (or lack of activities), work, daily life – can determine how our bodies adapt to them.
So how does MET work?
MET has been described as an “active muscular relaxation technique” or “manual resistance technique” (Leibenson, 1989).
In effect, therapists create alternating isometric muscle contractions against a resistance and muscle stretching (contract-relax). The aim is to release tension to enable the normal length and elasticity of muscles to be restored.
2 approaches to MET
Many muscles are paired, for example the quads and hamstrings. This means that the paired muscles cannot both contract and relax at the same time. MET uses this principle to give 2 ways to create the contract-relax effect. Using the quads and hamstrings as our example, where the hamstrings are dysfunctional:
Post Isometric Relaxation (PIR): The muscle is induced to make a mild isometric contraction, followed by a short relaxation period during which the range of movement (ROM) of the muscle is extended. This contract-relax cycle can be repeated before a final contraction is applied to underline the ROM that has been created.
Reciprocal Inhibition (RI): Sometimes a dysfunctional muscle might be such that it is not able to achieve an isometric contraction against resistance. In the example of the hamstrings the contract-relax PIR method would be difficult. In RI the contraction/resistance is instead applied to the paired quad muscles. Remember both pairs cannot do this at the same time. So, applying the contract-relax against the quads means that the hamstrings are compelled to relax.
Whether using PIR or RI, both approaches to MET begin by finding the ‘barrier’ position of the muscle. The barrier is the point where the ROM of the dysfunctional muscle starts to become tight.
MET and Rehabilitation
The effect of MET can be quite dramatic. A muscles ROM can be restored and pain can be reduced. MET applied to the adductor muscles at the groin are a good example. However, to maximise the effect of MET, rehabilitative stretching exercises need to be followed to maintain any functional improvement that is made. Without this, muscles can quickly returned to their pre-MET dysfunction. Rehabilitation can be seen as re-building muscle memory and reminding the effected muscles that they have more ROM and function than they think they have.
In the case of the adductor muscles this can include a series of lunges. Or hamstring and quad stretches for our example used in PIR and RI.
17 December 2015