Muscle Energy Technique (MET) uses controlled, patient-initiated muscle contractions to improve musculoskeletal function and reduce pain. Developed in 1948, MET employs isometric contractions to induce autogenic or reciprocal inhibition, relaxing muscles and increasing range of motion. There are three main types of MET: post-isometric relaxation, post-facilitation stretching using autogenic inhibition; and reciprocal inhibition MET involving agonist/antagonist muscle pairs. MET is used to treat muscle tightness, pain and limited joint mobility from various musculoskeletal conditions.
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
Electric stimulation works by mimicking the natural way by which the body exercises its muscles. The electrodes attached to the skin deliver impulses that make the muscles contract. It is beneficial in increasing the patient's range of motion and improves the circulation of the body.
Presentation slides from our recent workshop on Myofascial Release. This workshop was delivered from our St John Street Clinic in Manchester on Saturday 17th March.
Cyriax, a manual therapy technique, used to treat the soft tissue related pain. invented by James Cyriax who also coined the term "orthopedic medicine". There are various techniques described by Cyriax under the concept which are; infiltration, deep friction massage, manipulation and traction.
Electric stimulation works by mimicking the natural way by which the body exercises its muscles. The electrodes attached to the skin deliver impulses that make the muscles contract. It is beneficial in increasing the patient's range of motion and improves the circulation of the body.
Presentation slides from our recent workshop on Myofascial Release. This workshop was delivered from our St John Street Clinic in Manchester on Saturday 17th March.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
Myofascial release refers to the manual
technique for stretching the fascia and
releasing bonds between fascia and
Lintegument, musles,and bones, with the goal of
eliminating pain, increasing range of motion
and balancing the body.
The voluntary contraction of the patient muscle in a precisely controlled direction, at varying level of intensity against a distinctly executed counter force applied by the operator. It is a active techniques in which the patient contributes the corrective force
Taping a therapeutic and a protective approach by physiotherapist having various types; Kineso, McConnell, Rigid, Neutral tape, Mulligan taping techniques.
this slideshow states brief about taping techniques with elaboration of Kinesiotaping technique
McConnell taping technique: 05/04/2020
Other taping techniques: 08/04/2020
Introduction to muscle energy techniques (METs)Fared Alkordi
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
Commonly abbreviated as SDC. It is one of the electrodiagnostic method used in physiotherapy to detect presence or absence of excitable nerve fibers in a muscle.
Re-education means educating something, which is already known by an individual.
Here the patient knows the activities or movements or functions that has, to be performed but due to his ailment or diseased pathology he could not perform it properly.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
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
Muscle Energy Technique (MET) with variant and techniques.Anjali Parmar
muscle energy technique with post-isometric contraction and reciprocal inhibition, isotonic and isokinetic contraction. with all variants and techniques described.
A type of manual therapy in which the muscle or the joint is altered and placed in a position of comfort for certain duration after which the pain disappears completely or gets reduced. this slide show explains about the principles, mechanism and Phases of PRT
Myofascial release refers to the manual
technique for stretching the fascia and
releasing bonds between fascia and
Lintegument, musles,and bones, with the goal of
eliminating pain, increasing range of motion
and balancing the body.
The voluntary contraction of the patient muscle in a precisely controlled direction, at varying level of intensity against a distinctly executed counter force applied by the operator. It is a active techniques in which the patient contributes the corrective force
Taping a therapeutic and a protective approach by physiotherapist having various types; Kineso, McConnell, Rigid, Neutral tape, Mulligan taping techniques.
this slideshow states brief about taping techniques with elaboration of Kinesiotaping technique
McConnell taping technique: 05/04/2020
Other taping techniques: 08/04/2020
Introduction to muscle energy techniques (METs)Fared Alkordi
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
Commonly abbreviated as SDC. It is one of the electrodiagnostic method used in physiotherapy to detect presence or absence of excitable nerve fibers in a muscle.
Re-education means educating something, which is already known by an individual.
Here the patient knows the activities or movements or functions that has, to be performed but due to his ailment or diseased pathology he could not perform it properly.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
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
Muscle Energy Technique (MET) with variant and techniques.Anjali Parmar
muscle energy technique with post-isometric contraction and reciprocal inhibition, isotonic and isokinetic contraction. with all variants and techniques described.
-MET is a type of osteopathic manipulative treatement used in osteopathic therapy, physical therapy, massage therapy and occupational therapy.
- A form of 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 physician counterforce. 1.Dr. TJ Ruddy:
first osteopathic doctor to use muscle energy in the
1940’s and 1950’s, he referred to it as resistive duction,
which he defined as a series of muscle contractions against
resistance; used techniques mainly in the C‐spine.2.Dr. Fred Mitchell, Sr.: has been titled the Father of
muscle energy.
-He took Dr. Ruddy’s principles and incorporated them into manual medicine to any body region/ articulation.
-He believed that pelvis was the key to musculoskeletal system.
How to use Muscle Energy Techniques.pptxSyedaMunazza2
this PPT describes the fundamental principles of Muscle Energy Techniques used in physical rehabilitation of individuals with spasms, contractures, hypotonicity and weakness. Physiotherapy an do wonders when applied corretly.
Mobility and Flexibility of soft tissues (muscles, tendons, fascia, joint capsule, and skins) surrounding the joint along with adequate joint mobility, are necessary for normal ROM.
Mobility: is the ability of segments of the body to move through range of motion for functional activities.
Flexibility: is the ability to move a single joint or series of joints smoothly and easily through an unrestricted, pain –free ROM.
;Passive movements are those which are performed by therapist. It is also called Passive Range of motion (PROM). It is divide into Five types .Also passive movements can be done by mechanically.
Aerobic exercise is a mode of conditioning which helps our body to use more oxygen and maintaining healthy heart rate.
In this ppt I explain about equipment's which we used during exercise
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
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VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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2. • Muscle energy techniques are a class of soft
tissue osteopathic (originally) manipulation
methods that incorporate precisely directed
and controlled, patient initiated, isometric
and/or isotonic contractions, designed to
improve musculoskeletal function and reduce
pain
3. • MET was developed in 1948 by Fred Mitchell,
Sr, D.O
• MET uses a muscle’s own energy in the form
of gentle isometric contractions to relax the
muscles via autogenic or reciprocal inhibition
and lengthen the muscle.
• As compared to static stretching which is a
passive technique in which the therapist does
all the work, MET is an active technique in
which the patient is also an active participant.
4. • MET is based on the concepts of Autogenic
Inhibition and Reciprocal Inhibition.
• If a sub-maximal contraction of the muscle is
followed by stretching of the same muscle it is
known as Autogenic Inhibition MET
• if a sub maximal contraction of a muscle is
followed by stretching of the opposite muscle
then this is known as Reciprocal Inhibition
MET.
5. • Autogenic and reciprocal inhibition both occur
when certain muscles are inhibited from
contracting due to the activation of the Golgi
tendon organ (GTO) and the muscle spindles.
• These two musculotendinous proprioceptors
located in and around the joints and muscles
respond to changes in muscle tension and
length, which helps manage muscular control
and coordination.
6. • The GTO, located between the muscle belly
and its tendon, senses increased tension when
the muscle contracts or stretches. When the
muscle contracts, the GTO is activated and
responds by inhibiting this contraction (reflex
inhibition) and contracting the
opposing (antagonist) muscle group. This
process is known as autogenic inhibition
7. Mechanism
• The GTO response plays an important role in flexibility.
• When the GTO inhibits the (agonist) muscle’s
contraction and allows the antagonist muscle to
contract more readily, the muscle can be stretched
further and easier.
• Autogenic inhibition is often seen during static
stretching, such as during a low-force, long-duration
stretch. After 7 to 10 seconds, muscle tension increases
and activates the GTO response, causing the muscle
spindle in the stretched muscle to be inhibited
temporarily, which makes it possible to stretch the
muscle further.
8. • The muscle spindle is located within the
muscle belly and stretches along with the
muscle itself. When this occurs, the muscle
spindle is activated and causes a reflexive
contraction in the agonist muscle (known as
the stretch reflex) and relaxation in the
antagonist muscle. This process is known
as reciprocal inhibition.
9. • Types of MET:
• Autogenic Inhibition MET
– Post Isometric Relaxation (PIR)
– Post Facilitation Stretching (PFS)
• Reciprocal Inhibition MET
10. • Autogenic Inhibition MET
• As already mentioned Autogenic Inhibition
METs work on the principle of autogenic
inhibition.
• The two major and well-known types of MET
that are based on the concept of autogenic
inhibition are Post Isometric Relaxation
(PIR)and Post facilitation Stretching (PFS)
11. • Post Isometric Relaxation (PIR)
• Post Isometric Relaxation is a technique that
was later developed by Karel Lewitt.
• 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.
12. PIR technique
• The hypertonic muscle is taken to a length just short of
pain, or to the point where resistance to movement is first
noted.
• 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.
• After the isometric contraction, the patient is asked to relax
and exhale while doing so. Following this, a gentle stretch is
applied to take up the slack till the new barrier.
• Starting from this new barrier, the procedure is repeated
two or three times.
13. • Post Facilitation Stretch (PFS)
• Post Facilitation Stretch (PFS) is a technique
developed by Janda . This technique is more
aggressive than PIR but is also based on the
concept of autogenic inhibition.
•
14. 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.
15. CONTINUE
• The patient relaxes for approximately 20
seconds and the procedure is repeated
between three to five times and five times
more.
• Instead of starting from a new barrier, the
muscle is placed between a fully stretched and
a fully relaxed state before every repetition
16. Reciprocal Inhibition MET
• Reciprocal Inhibition MET is different from the
above two techniques in that it involves the
contraction of one muscle followed by
stretching of the opposite muscle, because
contrary to PIR and PFS, Reciprocal Inhibition
MET as the name implies is based on the
concept of Reciprocal Inhibition.
17. • The affected muscle is placed in a mid-range
position.
• The patient pushes towards the
restriction/barrier whereas the therapist
completely resists this effort (isometric) or
allows a movement towards it (isotonic).
• This is followed by relaxation of the patient
along with exhalation, and the therapist
applies a passive stretch to the new barrier.
• The procedure is repeated between three to
five times and five times more.
18. Indication
• Relaxation and lengthening of the muscles
• Improve range of motion (ROM) in joints.
• Guard against future injury of muscles and
joints.
• It is mainly used by individuals who have a
limited ROM due to facet joint dysfunction in
the neck and back, and for broader areas such
as shoulder pain, scoliosis, sciatica
asymmetrical legs, hips or arms, or to treat
chronic muscle pain, stiffness or injury
19. • Muscle energy techniques can be employed to
reposition a dysfunctional joint and treat the affected
musculature. Indications include, but are not limited
to: muscular shortening, low back pain, pelvic
imbalance, edema, limited range of motion, somatic
dysfunction, respiratory dysfunction, cervicogenic
headaches and many others.
• These techniques are inappropriate when a patient has
injuries such as fractures, avulsion injuries,
severe osteoporosis, open wounds, or has metastatic
disease. Additionally, because these techniques require
active patient participation, they are inappropriate for
any patient that is unable to cooperate.
20. Key points about modern MET
• The practitioner/therapist's force may exactly
match the effort of the patient (so producing an
isometric contraction) allowing no movement
to occur - and possibly producing as a result a
physiological neurological
• Response (via the Golgi tendon organs)involving
a combination of reciprocal inhibition of the
antagonist(s) of the muscle(s) being contracted,
as well as post isometric relaxation of the
muscle(s) which are being contracted
21. • The practitioner / therapist's force may
overcome the effort of the patient, thus
moving the area or joint in the direction
opposite to that in which the patient is
attempting to move it (this is an isotonic
eccentric contraction, known, when
performed rapidly, as an isolytic contraction).
A slowly performed isotonic eccentric stretch
has the effect of toning the muscle being
stretched in this way, while inhibiting its
antagonist(s), allowing it/them to be more
easily stretches
22. • The practitioner / therapist may partially
match the effort of the patient, thus allowing,
whilst slightly retarding, the patient's effort
(and so producing a toning effect by means of
the isotonic concentric, isokinetic,
contraction).
23. • Whether the contraction should commence
with the muscle or joint held at the resistance
barrier or short of it - a factor decided largely
on the basis of the degree of chronicity or
acuteness of the tissues involved How much
effort the patient uses - say, 20% of strength,
or more, or less.
• The length of time the effort is held in 7-10
seconds, or more, or less
24. • Whether, instead of a single maintained
contraction, to use a series of rapid, low
amplitude contractions (Ruddy's rhythmic
resisted reduction method, also known as
pulsed muscle energy technique)
• The number of times the isometric
contraction (or its variant) is repeated - three
repetitions are thought to be optimal
25. • The direction in which the effort is made
towards the resistance barrier or away from it,
thus involving either the antagonists to the
muscles or the actual muscles (agonists)
which require 'release' and subsequent
stretching (these variations are also known as
'direct'and 'indirect' approaches.
26. • Whether to incorporate a held breath and/ or
specific eye movements (respiratory or visual
synkinesis) to enhance the effects of the
contraction. These tactics are desirable if
possible