Muscle energy techniques are manual techniques involving the muscles own energy to lengthen the muscle fibres and remove the sustained contractions that cause the Trigger points. •Two aspects of MET are- i.their ability to relax an overactive muscle. ii.their ability to enhance stretch of a shortened muscle or its associated fascia when connective tissue or viscoelastic changes have occurred. There are 2 forms of MET: 1. Autogenic inhibition Post isometric relaxation Post facilitation stretching 2. Reciprocal inhibition MECHANISM OF ACTION Muscle energy is a direct and active technique; meaning it engages a restrictive barrier and requires the patient’s participation for maximal effect. •A restrictive barrier describes the limit in the range of motion that prevents the patient from being able to reach the baseline limit in his range of motion. As the patient performs an isometric contraction, the following physiologic changes occur:- i.Golgi tendon organ activation results in direct inhibition of the agonist’s muscles. ii.A reflexive reciprocal inhibition occurs at the antagonistic muscles. iii.As the patient relaxes, agonist and antagonist muscles remain inhibited allowing the joint to be moved further into the restricted range of motion. BENEFITS OF MET: •Restoring normal tone in hypertonic muscles •Strengthening weak muscles •Preparing muscle for subsequent stretching •Improved joint mobility INDICATIONS •Movement restriction due to muscle tightness. •Muscle hyperactivity. •Myofascial restrictions. CONTRAINDICATIONS •Fracture •Severe sprain •Severe strain •Open wounds •Severe osteoporosis •Avulsion injury •Metabolic bone •Unconscious patient •Non cooperative patient

1. MUSCLE ENERGY TECHNIQUE
Syeda Nusrath Fatima (MPT)

2. INTRODUCTION
• Muscle energy techniques are manual techniques involving the muscles own energy to
lengthen the muscle fibres and remove the sustained contractions that cause the Trigger
points.
• Two aspects of MET are-
i. their ability to relax an overactive muscle.
ii. their ability to enhance stretch of a shortened muscle or its associated fascia when
connective tissue or viscoelastic changes have occurred.

3. FORMS OF MUSCLE ENERGY TECHNIQUE
There are 2 forms of MET:
1. Autogenic inhibition
Post isometric relaxation
Post facilitation stretching
2. Reciprocal inhibition

4. AUTOGENIC INHIBITION MET
• Autogenic Inhibition METs work on the principle of autogenic inhibition.
Autogenic inhibition
It is the ability of a muscle to relax when it experiences a stretch or increased tension. Here,
both stretch and relaxation occur in the same muscle.
It is done by the GTO.
GTO within the same muscle senses the excess tension in the muscle and sends the
information of stretching to the CNS. Then it carries out the relaxation of the same muscle
in order to protect the muscle and tendon from the damage. Therefore, it is a protective
mechanism to protect the muscle from extreme tension and also to avoid muscle damages.

5. POST ISOMETRIC RELAXATION (PIR)
• Post Isometric Relaxation(PIR) is the effect of the decrease in muscle tone in a single or
group of muscles, after a brief period of submaximal isometric contraction of the same
muscle. PIR works on the concept of autogenic inhibition.
• After the isometric contraction, the patient is asked to relax and exhale. Following this, a
gentle stretch is applied to take up the slack till the new barrier.

6. Technique
PIR technique is performed as follows:
1.The hypertonic muscle is taken to a length just short of pain, or to the point where
resistance to movement is first noted.
2.A submaximal (10-20%) contraction of the hypertonic muscle is performed away from
the barrier for between 5 and 10 seconds and the therapist applies resistance in the
opposite direction. The patient should inhale during this effort.
3.After the isometric contraction, the patient is asked to relax and exhale.
4.Following this, a gentle stretch is applied to take up the slack till the new barrier.
5.Starting from this new barrier, the procedure is repeated two or three times.

7. POST FACILITATION STRETCHING (PFS)
• Post-facilitation stretch (PFS) is a technique that involves a maximal contraction of the
muscle at mid-range with a rapid movement to maximal length followed by a 15-second
static stretch.
• The hyper-tonic and shortened muscles are placed between a fully stretched and a fully
relaxed state. The patient is asked to contract the agonist using a maximum degree of
effort for 5–10 seconds while the therapist resists the patient’s force.

8. Technique
• The PFS technique is performed as follows:
• The hypertonic and shortened muscle is placed between a fully stretched and a fully
relaxed state.
• The patient is asked to contract the agonist using a maximum degree of effort for 5–10
seconds while the therapist resists the patient's force.
• The patient is then asked to relax and release the effort, whereas the therapist applies a
rapid stretch to a new barrier and is held for 10 seconds.
• The patient relaxes for approximately 20 seconds and the procedure is repeated between
three to five times.
• Instead of starting from a new barrier, the muscle is placed between a fully stretched and a
fully relaxed state before every repetition.

9. RECIPROCAL INHIBITION
• reciprocal inhibition relaxation is the relaxation of muscles on one side of a joint to
accommodate contraction on the other side of that joint.
• it involves the relaxation of antagonist muscle followed by stretching of the agonist
muscle.
• In reciprocal inhibition, increased tension of the agonist muscle causes the reflex
relaxation of the antagonist or opposite muscle.
• reciprocal inhibition also protects muscle from injuries.
• In reciprocal inhibition, muscle spindles are important.

10. Technique
The Reciprocal Inhibition MET technique is performed as follows:
1.The affected muscle is placed in a mid-range position.
2.The patient pushes towards the restriction/barrier whereas the therapist completely resists
this effort (isometric) or allows a movement towards it (isotonic).
3.This is followed by relaxation of the patient along with exhalation, and the therapist
applies a passive stretch to the new barrier.
4.The procedure is repeated between three to five times.

11. MECHANISM OF ACTION
• Muscle energy is a direct and active technique; meaning it engages a restrictive barrier
and requires the patient’s participation for maximal effect.
• A restrictive barrier describes the limit in the range of motion that prevents the patient
from being able to reach the baseline limit in his range of motion. As the patient performs
an isometric contraction, the following physiologic changes occur:-
i. Golgi tendon organ activation results in direct inhibition of the agonist’s muscles.
ii. A reflexive reciprocal inhibition occurs at the antagonistic muscles.
iii. As the patient relaxes, agonist and antagonist muscles remain inhibited allowing the
joint to be moved further into the restricted range of motion.

12. BENEFITS OF MET:
• Restoring normal tone in hypertonic muscles
• Strengthening weak muscles
• Preparing muscle for subsequent stretching
• Improved joint mobility

13. INDICATIONS
• Movement restriction due to muscle tightness.
• Muscle hyperactivity.
• Myofascial restrictions.

14. CONTRAINDICATIONS
• Fracture
• Severe sprain
• Severe strain
• Open wounds
• Severe osteoporosis
• Avulsion injury
• Metabolic bone
• Unconscious patient
• Non cooperative patient

15. THANK YOU