Chuck Wolf: Muscle Energy Techniques

Excerpted from Insights into Functional Training

Leon Chaitow, founding Editor-in-Chief of the Journal of Bodywork and Movement Therapies, states in his book Muscle Energy Techniques:

“Muscle Energy Techniques are a class of soft tissue osteopathic (originally) manipulated methods that incorporate precisely directed and controlled, patient initiated, isometric and/or isotonic contractions, designed to improve musculoskeletal function and reduce pain.”

When people present with an injury or a dysfunction, tissue is often shortened, inhibited and weak. In the majority of cases, a joint is limited in motion, often caused by the body’s protective mechanism to guard and stiffen the weakened segment. In this instance, there is too much stability in the region, and to build more strength and stability is pointless for an effective, functional outcome.

Do not build stability on top of stability.

After considering the health and activity history and lifestyle of a client, Muscle Energy Techniques (MET) are often helpful to gain not only stimulation of the tissue, but also increased range of motion.

As Chaitow goes on to say:

“Structure and function are so intertwined that one cannot be considered without the other. The structure of a unit, or area, determines what function it is capable of. Seen in reverse, it is function that imposes demands on the very structures that allow them to operate, and which over time can modify the structure . . .”

He further says:

 “The number of sarcomeres in theory determines the distance through which a muscle can shorten and the length at which it produces maximum force . . . the stimulus for sarcomere length changes may be the amount of tension along the myofibril or the myotendon junction with high tension leading to an addition of sarcomeres and low tension causing a decrease.”

In a dysfunctional state resulting from injury or inactivity, limitations and compensations are rampant in our clients’ movement patterns. In open-chain reactions, restrictions cause a tight, shortened muscle, often accompanied by a degree of lengthening and weakening of the antagonists.

For instance, if a person is supine on a table and knee flexion is limited, in most cases the quadriceps will be shortened and the hamstrings will be lengthened and weak. This will not only limit knee flexion but will also inhibit the femoral translation as the femur glides forward on the tibia. The result is difficult and often painful knee flexion. If you use a closed-chain assessment such as an abbreviated single-leg squat, not only will the knee be limited in motion, but the ankle and hip will also be adversely affected with limited reactions.

If we look at the tissue through the lens of reciprocal inhibition, the agonist and antagonist relationship changes, as both quadriceps and hamstrings are firing to some degree to maintain the stability of the knee, ankle and hip.

There is a place for techniques such as MET in a corrective strategy paradigm. There is a need to combine the isolated link action to strengthen and mobilize tissue with the integrated patterns to gain both mobility and stability.

Muscle Energy Techniques (MET) is a term derived from the osteopathic, orthopedic and physiotherapy professions. Fred Mitchell, an osteopathic clinician, is known as the major contributor of this practice, with refinements from Vladimir Janda and Karel Lewit. Craig Liebenson referred to MET as “an active muscular relaxation technique” used to lengthen short, tight tissue and strengthen physiologically weakened muscles or groups of muscles.

The implementation of MET uses a relative isometric contraction against manual resistance that matches the energy the client is able to produce. As Liebenson states,

“When a muscle is isometrically contracted, its antagonist will be inhibited and will relax immediately following this. Thus, the anatagonist of a shortened muscle or group of muscles may be isometrically contracted in order to achieve a degree of ease and additional movement in the shortened tissues.”

To delve deeper into MET, seek out books by Leon Chaitow on Muscle Energy Techniques.

The use of MET is highly effective in early stages of a sport rehabilitation or a corrective exercise program. When a client produces a progressive force output against your resistance, not only will the tissue gain strength, but it will also lengthen. By resisting the distal bone segment of the joint, the tissue length will increase.

However, only doing this in one plane of motion does not offer full function of the tissue and joint mobilization. This relates to the muscle tissue, yet knowing the recent research on fascia, we must consider the principles for maintaining fascial strength, resiliency and fitness.

As discussed in Chapter Five, the Flexibility Highways, fascia is constantly adapting to the environment of forces and stresses within and applied to the tissues. Fascia has a high tolerance to resist forces and slowly adjusts or creeps as it changes its length. As the tissues adjust to forces and demands on them, the fascia will slowly lengthen to control and decelerate motion. By doing so, the fascia will become stronger, particularly when it is eccentrically loaded in three planes of motion.

Any postural position requires the fascial system to maintain the postural structure. Movement constantly remodels the extracellular matrix that comprises fascial tissue.

If collagen assists in maintaining the structure yet movement modifies the fascial consistency, collagen favors mobility, which will enhance the eccentric loading of tissue, resulting in stability of the tissue and joints. To attain the optimal loading, this must load in tri-plane positions for adaptation.

To apply this approach in the function layer of the Action Pyramid, we apply MET to resist the tissue in at least two planes of motion.

When you see improvements of greater range of motion and force production through lower discomfort, it is time to move to a traditional exercise.

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