by martin meyer sports physiotherapist · muscle energy used to correct- pubic dysfunction...
TRANSCRIPT
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Muscle Energy Techniques
By
Martin Meyer
Sports Physiotherapist
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Muscle Energy
Used to correct-
pubic dysfunction
Ilio-sacral dysfunction
Sacro-iliac dysfunction
Lx spine dysfunction
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Definitions
Agonist muscle- a muscle that causes movement to occur. It creates the normal range of movement in a joint by contracting
Antagonist muscle- a muscle that acts in opposition to the movement generated by the agonist and is responsible for returning a limb to its initial position.
Ie for knee extension range- Quad is agonist
Hams antagonist
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Rationale
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Components of neuromuscular system
Muscle spindle
Found within muscle fibres
sensitive to passive or active stretch. Can control dynamic length of muscle through stretch reflex
excitatory
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Golgi tendon
Found in tendons of muscle
Detects tension within muscle
Stimulation causes inhibition of
muscle via flexor reflex loop
Inverse stretch reflex
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Inhibitions
Reciprocal Inhibition
Stimulation of the agonist leads to relaxation of the antagonist
Use of stretch reflex
20-40% MVC
Contracting quads at end H/S length to improve h/s length
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Autogenic Inhibition
Stimulation of the antagonist leads inhibition of the antagonist
Stimulation of Golgi tendon
MVC contraction
Contracting h/s at end range h/s length to improve h/s length
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How does MET works?
Using muscle contractions to stimulate the inhibitions to relax/lengthen muscle
Using muscle contractions to pull on muscle attachments to re-align bones/joints
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Assessment
Integrate MEAx into normal assessment of Lx spine and pelvis
Systematic approach to looking at pelvis
Understand subjective asterix points relevant to SIJ
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Crucial Anatomical Landmarks
ASIS
Pubic Crest
PSIS
Sacrotuberous Lig
Ischial Tuberosity
Spine of S2
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Functional assessment tests
Gillet (Stork) test
Forward flexion test
Squish test
Seated flexion test
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Gillet (Stork) Test
Palpate PSIS and Spine of S2
Patient Movement Hip flexion to horizontal
Normal PSIS moves down relative to S2
Abnormal PSIS moves up as sticks on sacrum
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Forward flexion test
Palpate PSIS Left and right
Patient Movement Forward flexion
Normal Both PSIS move equally
Abnormal One PSIS moves up as sticks on sacrum
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Squish test
Palpate Ilium
Therapist Movement Move hand down in in J shape along glide of SIJ
joint
Normal Ilium glides smoothly into movement,
unrestricted.
Abnormal Feel for boggy vs bony end feel
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Functional tests don’t tell you what is wrong.
They identify which is the problematic side
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Need to decide….
The type of pelvic dysfunction is based on palpation of landmarks..
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Palpation ASIS
up or down
Outflare or inflare
Pubic crest Up or down
PSIS Up or down
Ischial tuberosity Up or down
Sacrotuberous Ligament Tight or loose
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UPSLIP
DOWNSLIP
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ANTERIOR ROTATED
POSTERIOR ROTATED
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OUTFLARE
INFLARE
INFLARE
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ASIS PSIS Pubic Crest
Ischial
Tuberosity
Sacrotub. lig
ASIS to umbilicus
upslip Up Up Up Up Loose -------downslip Down Dow
n Down Down Tight -------
Anterior rot
Down Up Down? down? Loose -------
Posterior rot
Up Down
Up? Up? Tight -------
Outflare ------- ------ --------- -------- -------- increased
Inflare ------- ------ --------- -------- -------- decreased
Elevated/decend pubes
------- ------ Up/down --------- -------- --------
Interpretation of Findings