Muscle energy techniques (MET) involve voluntary contractions of a patient's muscles in a controlled direction at varying intensities. MET can be used to lengthen shortened muscles, strengthen weakened muscles, reduce edema, and improve joint mobility. The document outlines the basic concepts and types of MET, including isometric and isotonic techniques. It discusses the muscle makeup, applications, indications, precautions, and variations of MET. Studies have found MET to be effective at decreasing pain and increasing range of motion for neck and back pain conditions.

1. MUSCLE ENERGY TECHNIQUES (MET)

2. Muscle energy technique is a manual therapy procedure
that involves voluntary contraction of patient’s muscle in a
precisely controlled direction, at varying levels of
intensity.
DEFINITION OF MUSCLE ENERGY-

3. USES OF MUSCLE ENERGY
▪ Use to lengthen a shortened, contractured or spastic
muscle to strengthen a physiologically weakened
muscle or group of muscles.
▪ To reduce localised edema.
▪ Relieve passive congestion.
▪ Mobilize a joint with restricted mobility, myofascia and
trigger points.

4. MUSCLE MAKE-UP
 Muscle is made up of extrafusal &
intrafusal fibers.
 extrafusal- during rest, some contracts
while others rests, so whole muscle dosen’t
contract.
 intrafusal- monitor length and tone of
muscle
- innervated by gamma fibers
 Golgi tendon apparatus
*lies with extrafusal fibers
*sensitive to muscle tension
*as muscle contracts -> tension builds
up in GTA -> GTA inhibit alpha motor neuron
output ->> muscle relaxes.

5. Basic Concepts -
▪ Patients contractions in conjunction with therapists
effort result in:
1.Isometric contraction
▪ Therapist Force applied = Patient Force applied
2.Isotonic Eccentric contraction
▪ Therapist Force applied > Patient Force applied
3.Isotonic Concentric contraction
▪ Therapist Force applied < Patient Force applied

6. Basic Concepts-
▪ Operator – Direct Method
▪ Patient contracts agonist muscle
▪ Chronic conditions
▪ Operator – Indirect Method
▪ Patient contracts antagonist muscle
▪ Acute conditions

7. 2 TYPES OF MET-
ISOMETRIC MUSCLE ENERGY TECHNIQUES
(AUTOGENIC INHIBITION)

8. ISOTONIC MUSCLE ENERGY TECHNIQUES (Reciprocal Inhibition)
▪ When an agonist muscle contracts and shortens, its antagonist must relax and
lengthen so that motion can occur under the influence of the agonist muscle.
▪ The contraction of the agonist reciprocally inhibits its
antagonist allowing smooth motion.
▪ The harder the agonist contracts, the more
inhibition in the antagonist, causing relaxation.

9. SURROUNDING TISSUES-
▪ MET also influences the surrounding fasciae, connective tissues
and interstitial fluids >> alters muscle physiology.
▪ When ms. contracts > length & tone alters > influnces
biomechanical, biochemical & immunologic functions.
▪ Ms. Contraction requires energy > metabolic process results in
CO2, lactic acid, other metabolic wastes that must be transported
and metabolized.

10. APPLICATIONS OF MUSCLE ENERGY
TECHNIQUES

11. INDICATIONS OF MET-
Lengthen shortened ,contractured , &
spastic muscle.
 strengthen weakened muscle or group of
muscle.
 malposition of bony elements.
Restoration of joint motion assosiated with
joint
dysfunction.

12. PRECAUTIONS OF MET –
Unknown pathology
Stress fractures
Strains infections and diseases
causing musculoskeletal pain
 osteoporosis or tumors in the area
of treatment.

13. CONTRAINDICATIONS OF MET –
Acute musculoskeletal injuries.
Unset or unstable fractures.
Unstable or fused joints.
- GOOD RESULTS OF MET DEPENDS ON – accurate diagnosis,
appropriate levels of force, and sufficient localization.
- POOR RESULTS OF MET DEPENTS ON – inaccurate diagnosis,
improperly localised force, or forces that are too strong.

14. Variations of MET
▪ Lewit’s Post-isometric Relaxation
▪ Hypertonic muscle is taken to a length
short of pain / resistance
▪ Patient contracts (10-25%) muscle for
5 – 10 seconds while therapist
supplies equal force
▪ Patient relaxes and muscle is taken to
new range of motion
▪ Starting from gained ROM, repeated 2-
3 times

15. ▪ Janda’s Post-facilitation Stretch
▪ Affected muscle is placed in a midrange
position
▪ Patient contracts (90-100%) for 5 – 10
seconds
▪ Rapid stretch to new ROM and hold for
10 seconds
▪ Relax for 20 seconds and repeated 3 – 5
times
▪ Sensations of warmth and weakness may
be experienced for a short time with this
method

16. ▪ Reciprocal
Inhibition Method
- Affected muscle is
placed in mid-
range
- Patient contracts
isometrically or
isotonically for 5 –
10 seconds
- Muscle is passively
lengthened
- Repeated 2 – 3 times

17. DIFFERENCE B/W THE TWO-
JANDA’S PFS LEWIT’S PIR
STARTS AT MIDRANGE AT BARRIER
TYPE OF CONTRACTION STRONGER
LESS STRONGER THAN
PFS
ACTION ON TISSUES
TAKES TISSUE BEYOND
THE BARRIER, ATTEMPTS
TO PLACE STRETCH ON
STRUCTURES
TAKES TISSUES TO A NEW
BARRIES OF RESISTANCE.

18. • In 2012, a comparative study on effectiveness of Muscle Energy Technique and Static
Stretching for Treatment of subacute Mechanical Neck Pain by Richa Mahajan concluded
that MET was superior than static stretching in decreasing pain intensity and increasing
active cervical range of motion.
International Journal of Health and Rehabilitation Sciences
Volume 1 Number 1
▪ Noelle M et al studied Short-Term Effect of Muscle Energy Technique on Pain in
Individuals with Non-Specific Lumbopelvic Pain and concluded that subjects receiving
MET demonstrated a decrease in VAS worst pain over the past 24 hours, thereby
suggesting that MET may be useful to decrease LPP over 24 hours.
The Journal of Manual & Manipulative therapy
Volume 17 Number 1