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Muscle Energy Techniques By Martin Meyer Sports Physiotherapist

By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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Page 1: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

Muscle Energy Techniques

By

Martin Meyer

Sports Physiotherapist

Page 2: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

Muscle Energy

Used to correct-

pubic dysfunction

Ilio-sacral dysfunction

Sacro-iliac dysfunction

Lx spine dysfunction

Page 3: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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

Page 4: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

Rationale

Page 5: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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

Page 6: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

Golgi tendon

Found in tendons of muscle

Detects tension within muscle

Stimulation causes inhibition of

muscle via flexor reflex loop

Inverse stretch reflex

Page 7: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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

Page 8: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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

Page 9: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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

Page 10: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

Assessment

Integrate MEAx into normal assessment of Lx spine and pelvis

Systematic approach to looking at pelvis

Understand subjective asterix points relevant to SIJ

Page 11: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

Crucial Anatomical Landmarks

ASIS

Pubic Crest

PSIS

Sacrotuberous Lig

Ischial Tuberosity

Spine of S2

Page 12: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

Functional assessment tests

Gillet (Stork) test

Forward flexion test

Squish test

Seated flexion test

Page 13: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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

Page 14: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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

Page 15: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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

Page 16: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

Functional tests don’t tell you what is wrong.

They identify which is the problematic side

Page 17: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

Need to decide….

The type of pelvic dysfunction is based on palpation of landmarks..

Page 18: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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

Page 19: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

UPSLIP

DOWNSLIP

Page 20: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

ANTERIOR ROTATED

POSTERIOR ROTATED

Page 21: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

OUTFLARE

INFLARE

INFLARE

Page 22: By Martin Meyer Sports Physiotherapist · Muscle Energy Used to correct- pubic dysfunction Ilio-sacral dysfunction Sacro-iliac dysfunction Lx spine dysfunction

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