Presentation slides on myofascial release and muscle energy techniques. Our workshop ran from our St John Street Clinic in Manchester on 30th September 2017.
A detailed presentation from our Trigger Point Therapy workshop for sport's and massage therapist's. This event was held at our St John Street clinic on the 30th April 2016.
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.
The intention of this Slideshow presentation is to show the therapists the benefit of adding this modality into a typical massage session. Define, benefits, techniques, and end results are shown and demonstrated.
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
A detailed presentation from our Trigger Point Therapy workshop for sport's and massage therapist's. This event was held at our St John Street clinic on the 30th April 2016.
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.
The intention of this Slideshow presentation is to show the therapists the benefit of adding this modality into a typical massage session. Define, benefits, techniques, and end results are shown and demonstrated.
Muscle energy technique, a manual therapy technique with a long term history and 8 variations which can be used in various condition to treat muscle as well as joints. This slide show consists of detailed history, variations/types and summary of MET in detail.
A valuable presentation on myofasical release and muscle energy techniques for sport's and massage therapist's. This presentation is from our workshop event at the St John Street clinic on the 27th February 2016.
What is ESWT:
Shockwave Therapy is a noninvasive method that uses acoustive waves to treat varies musculoskeletal conditions.
Extracorporeal = outside body.
Shockwave = intense, short energy wave travelling faster than speed of sound.
Well-controlled mechanical insult to tissue.
Fast pain reliever and restore mobility.
Introduction to muscle energy techniques (METs)Fared Alkordi
Â
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
This topic contains the core topic in Biomechanics which serves as the foundation for curriculum of Undergraduate and Post graduate Physiotherapy students.This presentation aims at the clarification of foundational concepts.
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
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.
Commonly used Manual therapy technique by Physiotherapists,Osteopaths .useful in treating many of the soft tissue ailments and also a very useful tool in Sports physiotherapy.This deals with the basic concept of mayofascial release technique and its types ,indications ,basic concept of fascia,its functions.
A chronicle on muscle strengthening:
MMT is a procedure for the evaluation of strength of individual
muscle or muscles group, based upon the effective performance of a movement in relation to the forces of gravity or manual resistance through the available ROM.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
A valuable presentation on myofasical release and muscle energy techniques for sport's and massage therapist's. This presentation is from our workshop event at the St John Street clinic on the 27th February 2016.
What is ESWT:
Shockwave Therapy is a noninvasive method that uses acoustive waves to treat varies musculoskeletal conditions.
Extracorporeal = outside body.
Shockwave = intense, short energy wave travelling faster than speed of sound.
Well-controlled mechanical insult to tissue.
Fast pain reliever and restore mobility.
Introduction to muscle energy techniques (METs)Fared Alkordi
Â
The use of Muscle Energy Techniques (METs) to reduce muscle pain and improve muscle length. Types, physiological mechanisms and practical techniques in clinical settings.
This topic contains the core topic in Biomechanics which serves as the foundation for curriculum of Undergraduate and Post graduate Physiotherapy students.This presentation aims at the clarification of foundational concepts.
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
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.
Commonly used Manual therapy technique by Physiotherapists,Osteopaths .useful in treating many of the soft tissue ailments and also a very useful tool in Sports physiotherapy.This deals with the basic concept of mayofascial release technique and its types ,indications ,basic concept of fascia,its functions.
A chronicle on muscle strengthening:
MMT is a procedure for the evaluation of strength of individual
muscle or muscles group, based upon the effective performance of a movement in relation to the forces of gravity or manual resistance through the available ROM.
Brian Mulligan described novel concept of the simultaneous application of therapist applied accessory mobilizations and patient generated active movements
muscles of face $ muscles of mastications are discriped from embryology to their funtions and effect of muscles in causing malocclusion $ understanding how to correct them by orthodontic appliances by using muscle physiology.
This ppt contains an elaborate description of muscles, focussing on muscles of mastication. both main muscles and accessory muscles have been described along with palpation of each. A brief is given about disorders.
Presentation slides from our Introduction to Spinal Mobilisations workshop. This was delivered on the 20th January 2018 in our St John Street Clinic, Manchester.
Describes the overview of the skeletal muscles, its description, functons, and properties. It also inccludes the gross organization of the skeletal system.
Presentation slides from the Running Assessment and Analysis workshop. This workshop was held in our St John Street Clinic, Manchester on the 25th November 2017.
Presentation slides from our most recent workshop, held at our St John Street clinic on Saturday 26th November. This workshop provides you with both a theoretical and practical range of knowledge needed so that you can offer Pilates based exercises to your patients as part of a rehabilitation programme.
A valuable presentation on Exercise Prescription for sports and massage therapist's. A presentation from our workshop event at the St John Street clinic on the 8th October 2016.
A great presentation on the basics of running assessment and analysis for sports and massage therapists. The course ran on the 9th July 2016 at our St John Street Clinic in Manchester.
A great presentation on how to ace a massage therapy interview for sports and massage therapist's. Presentation from our workshop event at the St John Street clinic on the 8th August 2015.
A great presentation on taping and posture for sports and massage therapist's. Presentation from our workshop event at the St John Street clinic on the 10th September 2015.
A great presentation on joint mobilisation and manual therapy for sports and massage therapist's. Presentation from our workshop event at the St John Street clinic on 12th December 2015.
More from Katie Emmett đ Myofascial Decompression Therapy (10)
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
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R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patientâs body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
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According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
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Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
5. Aims of today
@Physiocouk #manchesterphysio facebook.com/physiocouk
â Learn and understand fascia structures and it's anatomy
â Learn the different Myofascial release techniques and how to
perform them
â Learn the different types of Muscle Energy Techniques
â Learn the handling of METs and when to use them
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Definition
⢠Safe and effective hands-on technique that works on the fascia
to release restrictions
⢠Based on both massage work and gentle stretching
works gently through the skin into the fascia surrounding the
muscles
⢠Applied with a static, prolonged pressure to restricted tissue
⢠Aims to release tension and stretch out restricted parts of the
fascia. Deeper layers can be reached as fascia releases
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Definition
âMyofascial Release is a specialised physical and manual therapy used for the effective treatment and
rehabilitation of soft tissue and fascial tension and restrictionsâ
Myofasical Release UK
âMyofascial release is a manipulative treatment that attempts to release tension in the fascia due to
trauma, posture, or inflammation. Connective tissues called fascia surround the muscles, bones, nerves,
and organs of the body. Points of restriction in the fascia can place a great deal of pressure on nerves
and muscles causing chronic pain.
Practitioners of myofascial release employ long stretching strokes meant to balance tissue and muscle
mechanics and improve joint range of motion in order to relieve painâ
Spine-health
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What is Fascia
⢠Fascia is a layer of fibrous tissue that surrounds groups of
muscle, bone, blood vessels and nerves
⢠It binds some structures together, while permitting other
structures to glide smoothly over each other
⢠Fascia is classified depending on itâs distinct layers, functions
and anatomical position â superficial, deep or visceral
⢠Fascia are dense regular connective tissues, containing
closely packed bundles of collagen fibres orientated in a
wavy pattern parallel to the direction of pull
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Anatomy - Fascia
⢠Consists of cells and extra- cellular matrix (ECM) mainly fibroblasts and macrophages.
⢠The ECM is made up of fibres, predominantly collagen and elastin and ground
substance
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Anatomy - Fascia
Collagen is the fibre that makes fascia tough and durable. It is inelastic and provides
tensile strength and integrity. It is stronger than steel!
Elastin - allows the fascia to stretch and absorb shock
Ground substance is a viscous gel which provides the immediate environment of every
cell in the body
â˘It is similar to egg whites in it's consistency.
â˘it is able to distribute forces whilst maintaining its shape
â˘contains sensory receptors, mechano, chemo, noci and thermo receptors and
therefore is a proprioceptive material
â˘contains myofibroblasts which are able to contract in smooth muscle type manner
and these are responsive to stimulation and involved with wound healingautonomic
nervous system (ANS)
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There are three types of muscle tissues:
⢠Skeletal- striated, tubular and multi-nucleated
fibres.
⢠Cardiac- striated, branched and uni-nucleated
fibres.
⢠Smooth muscles- spindle-shaped, non-striated,
uni-nucleated fibres.
Anatomy âMuscle tissue
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Anatomy âMuscle tissue
⢠All muscle tissues have a superficial covering of vary thicknesses
of fascia, made of connective tissue and laced with adipose
tissue.
Other terms you may hear:
⢠A singular muscle
fibre is referred to as
a myofibril and
contains thick and
thin myofilaments.
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Anatomy âMuscle tissue
Types of muscular tissue
It is Important to know the orientation of each muscle tissue when applying
Myofascial release and METâs as the direction/angle force may change
accordingly.
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Anatomy âMuscle tissue
Muscle Spindle Fibres
Sensory receptors within the muscle belly that detect changes to the length of
a muscle. This information is relayed to the central nervous system and is
processed by the brain to determine the positions of body parts.
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Anatomy âMuscle tissue
Golgi Tendon Organs
Are located in the tendon of skeletal musculature. They detect changes to the
tension of the muscle providing proprioceptive feedback to the brain. They
prevent damage by inhibiting contracting muscles if the force is great enough
that there's a risk of tissue damage.
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Function of fascia
Physical
⢠To reduce friction
⢠Provide a sliding environment for muscles
⢠Suspend organs in their âproperâ place
⢠Transmit movement from muscles to bones
⢠Provide a supportive and protective environment for nerves
and blood vessels as they pass through and between muscles.
⢠Facilitates circulation â lymph and blood
⢠Provides support and connection
⢠Physiological adaptable - plastic
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Communication
⢠Mechanical pull and vibration â through the concept of
âtensegrityâ
⢠Fascia has piezoelectric force. i.e changing mechanical force in
to electric energy
â˘A sensory proprioceptive organ receiving and responding to
mechanical and chemical information via receptors. These
sensory nerves also communicate with the ANS influencing blood
flow and muscle tone.
Function of fascia
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Movement facilitator
⢠Reduced friction at macro and micro level
⢠Distributor of forces/shock absorber
⢠Enhances force generated by muscle contraction â rebound
⢠Provides a pre-tensioned background tone making muscle
contraction more effective and efficient ( feel like being shrink
wrapped)
⢠Pre tensioned tone allows for maximum response during fight
or flight
Function of fascia
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⢠Age and injury can cause an increase of laying down of collagen,
increased cross linkages and restrictions (adhesions)
⢠Fascia increases its density and looses its ability to slide freely
when:
⢠Trauma and injury
⢠Infections or disease
⢠Over and under use
⢠Ischaemia
⢠Local and systemic inflammation
⢠Tissue dehydration
⢠Emotional stress and centralised pain
Fasica â why does it go wrong?
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Fasica â why does it go wrong?
For example: injury â micro tearing and fibrosis formation will
affect
⢠Electrical conductivity in fascia
⢠Cell to cell communication
⢠Interfere with freedom of movement of fascial planes and
communication properties
⢠Sensitisation of nerve endings
⢠Influence plastic adaptation
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Aims and Benefits
Myofascial Release can decreases Pain: it is claimed that this technique can release
the bodyâs natural painkillers, endorphins, by allowing the blood, lymph and nerve
receptors to work efficiently so pain is relieved.
It helps to strengthen the immune system. When fascia is restricted, the lymphatic
flow is slowed down, which affects the immune system (the bodyâs first line of defence
against infection and primary aid to healing).
Myofascial Release increases the circulatory flow of lymph and therefore hastens
healing of injuries or infections.
Myofascial Release Technique can work to relieve pressure which may be caused by
fascial adhesions pressing on the nerves. Keeping a healthy circulatory system reduces
stress on the heart and can prevent painful cramps, brings nutrients to the cells and
takes away the waste; Myofascial Release Technique increases circulation and assists
this process.
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Release guidelines
⢠Gentle and sustained, pressure should be applied for a specific period of time
â a minimum of 90 â 120 seconds
⢠This amount of time permits fascia to naturally elongate and return to normal
resting length which will restore the healthy status quo, giving greater
flexibility, mobility and eliminating pain.
⢠Techniques applied for less than 2 minutes will temporarily lengthen the
elastic fibres in the muscles and fascia and the tissues will feel looser for a
while but gradually tighten up again.
⢠It is like stretching a rubber band â if stretched for a short time it will quickly
spring back to its original shape but if left stretched around an object for
some time it will remain permanently lengthened.
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Anatomy Trains â Tom
Myers
Theory
â˘Theory of fascial lines.
â˘Structures are grouped together in recognised fascial lines and
when one structure is released the benefits may be present
further along the line.
â˘The point of restriction may be away from the point of pain.
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Anatomy Trains â Tom
Myers
Superficial Back Line (SBL)
⢠Function is to support the body in full upright extension
⢠With the knees extended the line is continuous
⢠It has a higher degree of slow twitch endurance muscle
fibres and extra heavy sheets of fascia to overcome the
postural demands.
⢠There is no deep back line although some aspects of the
SBL are deeper than others. There is no consistent and
connected layer deeper than the SBL
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Anatomy Trains â Tom
Myers
Superficial Front Line
⢠Function is to balance the SBL and provide
tensile support from the top to lift those parts
of the skeleton which extend forward of the
gravity line (pubis, ribcage and face)
⢠Viewing the patient from the side reveals the
state of imbalance between the SFL & SBL
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Anatomy Trains â Tom
Myers
Deep Front Line
⢠Infused with slow twitch endurance muscle fibres, the DFL
provides stability and subtle positioning changes to core
structure.
⢠Failure of the DFL does not cause an acute change but more
functional restriction over a period of time which may
appear in another line.
⢠Its role in surrounding the heart and lungs has a significant
effect upon respiration.
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Manual Handling and Body
Position
Posture
⢠Bed height
⢠Stance
⢠Patient position
⢠Use different parts of your hands/ arms to apply pressure
⢠Keep arms straight to utilise body weight when applying
pressure/resistance.
⢠Move from the hips and knees as much as possible
⢠Oil (or cream)- only needs to be a little bit.
Look after yourself before you look after the patient!
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Post Treatment
Very common for people to experience post Rx soreness for up to 72
hours after treatment.
Side effects can include:
⢠Bruising
⢠Redness
⢠Tenderness/Increased Sensitivity
⢠Increased symptoms
⢠Aching similar to DOMS
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Post Treatment Irritation
Causes
⢠The release of toxins/waste products from muscular tissue
⢠Neurological sensitisation
⢠Increased blood flow and micro trauma can lead to bruising and
redness
Advice
⢠Reassure the patient it's a normal response to be sore after soft tissue
treatment
⢠Advise them to use ice (safely)
⢠Recommend they drink water to keep hydrated
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Palpation
Finding fasciaâŚ
1.Rest hand lightly on forearm â do not press into the arm. This
is the superficial fascia
2. Allow your hand to sink into the forearm, this is the deep
fascia - the fascia of the forearm extensors
3.Withdraw out of the fascial layersâŚ..
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METâs Definition
⢠"A manual medicine treatment procedure that involves the voluntary
contraction of muscles in a controlled direction, at varying levels of
intensity, against a counterforce applied by the operator.ââ
(Greenman 1996)
⢠âMuscle Energy Techniques are a manipulative treatment in which
patients muscles are actively used on request from a precisely
controlled position, in a specific direction and against a distinctly
executed counterforce.â (Ward 2003)
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METâs Types
⢠With Isometric METs- the muscle/limb is moved until a barrier of
resistance is reached.
⢠The isometric contraction is performed and held for 3-5 seconds.
⢠The muscle is then allowed to fully relax (this can also take a few
seconds)
⢠Passive mobilisation is then used to stretch the muscle/limb until a
new barrier of resistance is reached.
⢠The contraction/relaxation cycle is then repeated until normal
movement is restored or no further benefit is gained (usually 3-5
repetitions at most).
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METs: Isometric Contraction
Reciprocal Inhibition
Method
⪠Resistance is applied by the therapist
⪠The patient produces an isometric
contraction of the muscle group that
opposes the affected muscle
⪠The contraction is held
⪠The patient then relaxes and a stretch
can be applied to the affected muscle.
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METs: Isometric Contraction
Reciprocal Inhibition: Example
E.G. Hip Adductor Injury.
â˘Hip abduction is resisted by the therapist
â˘Agonist group (hip abductors) contract
â˘Antagonists (hip adductors) are inhibited as a
result
â˘Relaxation/Lengthening occurs in the adductors
(affected) muscle group
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METs: Isometric Contraction
Post Isometric Relaxation
Method
⢠Resistance is applied by the
therapist
⢠The patient produces an isometric
contraction of the affected muscle
⢠They then relax and a stretch can
be applied
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METs: Isometric Contraction
Post Isometric Relaxation
Theory
⢠Strong muscle contraction excites
Golgi tendon organs
⢠This causes inhibition of the motor
neurone to the muscle
⢠When the muscle contraction
stops the muscle relaxes and
lengthens as a result of this
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Post Isometric Relaxation: Example
E.G. Hip Adductor Injury
â˘Resistance is applied against Adduction of the
hip
â˘Isometric contraction occurs
â˘When the muscle relaxes it will lengthen
â˘And the hip can be passively stretched further
in to abduction
METs: Isometric Contraction
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METs: Eccentric
Contraction
Method
â˘The patient contracts the affected muscle while the therapist applies a
force stronger than the force of contraction.
â˘This results in the muscle being lengthened whilst contracting.
Theory
â˘Golgi tendon organs are excited by the contraction of the muscle. The
muscle is also being stretched/lengthened during the contraction
⢠So when the muscles relaxes, these effects combine and this results in a
lengthening/relaxation of the muscle.
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METs: Concentric
Contraction
Method
â˘Therapist applies a resistance, the patient concentrically contracts the
affected muscle and moves through range of movement against the
resistance.
â˘This movement is then performed repeatedly
Theory
â˘This causes increased motor activity to a muscle which increases tone
â˘Over time alongside strengthening exercise hypertrophy would occur.
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METs:
Contraindications and Precautions
All of the Contraindications and Precautions mentioned previously for MFR
Other things to consider due to involvement of active muscle contractions:
⢠Recent or acute muscle strains or tears.
⢠Following reconstructive surgery (graft can be taken from other leg).
⢠High pain scale.
⢠Hypermobility.
⢠Individuals under the age of 18 as intense stretching may disturbed
growth plate activity.
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Case Study: Neck Pain
PC/HPC: 25 year old female with an onset of neck pain and stiffness 1/12 following a
RTC. Feels worse in the mornings and aggravated by sitting for long periods. Scores
her pain 7/10 on the VAS scale.
SH: Work- Solicitor 85% desk based. Spends large amounts of time commuting in
the car and traveling on trains.
Hobbies- attends the gym 2-3 times a week. Not able to go since the accident
PMH: None
DH: Analgesics
Objective signs- increased uft tone R>L, Limited in all ROM of CX SP, TOP posterior
neck muscles, uft and rhomboids, active TP in R uft, no neurological symptoms to
note.
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Case Study: Neck Pain
Objective signs
⢠Increased uft tone R > L
⢠Limited in all ROM of CX SP
⢠TOP posterior neck muscles, uft and rhomboids
⢠Active TP in R uft,
⢠No neurological symptoms to note
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Case Study: Hamstring
PC/HPC: 30 year old male, 4/10 pain into R hamstring when running. Felt âpullâ
2/52 ago towards the end of a 5k run. Instant pain and unable to continue to run.
No instant swelling or bruising. Pain eased 3/7 after â tried running but still feels
pain. Also reports an increase of constant tightness.
SH: Work- Shop assistant. On feet all day. Training for Manchester 10k
PMH: L Shoulder surgery from cycling accident
DH: Nil to note
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Objective signs-
⢠Sway back posture
⢠Reduced range in R hamstring in 90/90 test
â˘-ve neuro symptoms on SLR
⢠Palpation : area of adhesion located mid hamstring-
tender on deep palpation.
Case Study: Hamstring
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Case Study: Shoulder Pain
PC/HPC: 45 year old Male with and 8/12 History of Right shoulder pain
that onset insidiously, coincided with being busier at work and doing
longer hours.
SH: Work- Desk based- pain gets worse through the day
Hobbies- Golf- unable to play due to pain
PMH: Hypertension
DH: Ramipril, Occasional Ibuprofen
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Case Study: Shoulder
Objective signs
â˘Protracted shoulder posture with increased Tx Kyphosis
â˘Limited ROM of the right shoulder and the neck
â˘Positive outcome on impingement tests
⢠Patient indicates pain refers to the elbow
â˘Tenderness on palpation of the right shoulder joint, pectorals rotator cuff,
traps and thoracic spine musculature
â˘Increased muscle tone and trigger points in the pecs and traps
â˘Muscle weakness- on all shoulder movements
â˘Joint stiffness in the right shoulder
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Evidence: METs
The Immediate Effects of Muscle Energy Technique on Posterior
Shoulder Tightness: A Randomized Controlled Trial (Moore et al.
2011)
⢠Investigated the immediate effects of METs on shoulder horizontal
adduction and internal rotation ROM
⢠Used Asymptomatic baseball players as their study sample
⢠Compared 3 groups: MET for horizontal abductors, MET for external
rotators and a control group
⢠Found significant improvements in ROM using horizontal abductor
METs
⢠Suggests benefits for injury prevention and rehabilitation.
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Evidence: METs
The effect of isolytic contraction and passive manual stretching on
pain and knee range of motion after hip surgery: A prospective,
double-blinded, randomized study (Parmar et al. 2011)
⢠Compared Isolytic (Eccentric) MET to passive manual stretching for knee
ROM.
⢠Used individuals post hip surgery following a fracture.
⢠Assessed knee ROM and pain (VAS)
⢠Found significant improvements in ROM using both treatment
techniques
⢠MET group had significantly better reductions in pain
⢠Suggests METs are a better technique as they impact on ROM and pain.
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Evidence: METs
Muscle Energy Technique Versus Corticosteroid Injection for
Management of Chronic Lateral Epicondylitis: Randomized Controlled
Trial With 1-Year Follow-up (KßçßkĹen et al. 2013)
⢠Compared an isometric MET (resisted pronation) to Corticosteroid injections
⢠Used patients with symptomatic Lateral Epicondylitis (Tennis Elbow)
⢠Followed up at 6, 26 and 52 weeks to assess short and long term impact
⢠Cortisone injections showed better improvements in pain, grip strength and
function initially but longer term follow-up found more benefit from METs
⢠METs are a better long term treatment for Lateral epicondylitis than
Cortisone.
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Evidence:MFR
Benefits of Massage-Myofascial Release Therapy on Pain, Anxiety,
Quality of Sleep, Depression, and Quality of Life in Patients with
Fibromyalgia (Castro- Sanchez et al. 2010)
⢠A randomised controlled trial, used an experimental and placebo
group
⢠Recruited patients diagnosed with FMS aged 18 â 65 years
⢠Experimental group underwent a protocol of massage-
myofascial release therapy during a weekly 90-minute session
for 20 weeks
⢠Pain was assessed with the Visual Analog Scale (VAS), which
assesses the pain intensity and degree of relief experienced by
the patient (score of 0â=âno pain; 10â=âunbearable pain)
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Evidence:MFR
Results:
â˘The experimental group significantly improved pain, anxiety, quality of
sleep, and quality of life
⢠The treatment reduced the sensitivity to pain at sensitive points, mainly
at the lower cervicals, gluteal muscles, and right greater trochanter.
â˘Release of fascial restrictions in these patients also reduces anxiety levels
and improves sleep quality, physical function, and physical role
â˘Massage-myofascial program can be considered as an alternative and
complementary therapy that can achieve transient improvements in the
symptoms of these patients.
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Evidence:MFR
Effectiveness of Myofascial release in the management of chronic
low back pain in nursing professionals (S.Ajimsha et al, 2013)
Results:
â˘MFR group performed better than the control group in 8 weeks and 12
week
â˘McGill Pain questionnaire and Ouebec Back Pain Disability Scale was used
to assess
â˘MFR reported 53.3% reduction in pain compared to control groups 26.1%
at 8 weeks
â˘MFR group reported 29.7% reduction in functional disability compared to
9.8% by control group at 8 weeks
â˘This study provides good evidence that MFR when used along side specific
back exercises
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References
The Immediate Effects of Muscle Energy Technique on Posterior Shoulder Tightness: A Randomized
Controlled Trial. Stephanie D. Moore, Kevin G. Laudner, Todd A. Mcloda, Michael A. Shaffer, Journal of
Orthopaedic & Sports Physical Therapy, 2011 Volume:41 Issue:6 Pages:400â407.
The effect of isolytic contraction and passive manual stretching on pain and knee range of motion after
hip surgery: A prospective, double-blinded, randomized study. Shraddha Parmar, Ashok Shyam, Shaila
Sabnis, Parag Sancheti, Hong Kong Physiotherapy Journal, Volume 29, Issue 1, June 2011, Pages 25â30
Muscle Energy Technique Versus Corticosteroid Injection for Management of Chronic Lateral
Epicondylitis: Randomized Controlled Trial With 1-Year Follow-up. Sami KßçßkĹen, Halim Yilmaz, Ali SallÄą,
Hatice UÄurlu, Archives of Physical Medicine and Rehabilitation, November 2013, Volume 94, Issue 11,
Pages 2068â2074
Ward R.C. et al. Foundations of Osteopathic Medicine. 2nd Edition. Baltimore, MD: Williams and Wilkins,
2003. (page 881)
Greenman P. Principles of Manual Therapy. 2nd ed. Baltimore, MD: Williams & Wilkins; 1996.
87. Thanks for coming!
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