Every somatic dysfunction has a soft tissue component. The understanding of this paradigm is essential when approaching a person who is suffering from pain, acute injury or chronic conditions.
In fact, the soft tissue is the widest spread component within the human body, any element which is not ‘skeleton’, is considered ‘soft tissue’. This term refers to all those structures which connect, surround and support the organs or other components of the organism such as fibrous, fat and connective tissue, fascia, ligaments, tendons, nerves, blood and, of course, the muscles. These structures play a fundamental role in keeping the balance between health and dysfunction and they may be considered the first direct source of pain or well-being.
The state of the soft tissue may have an influence over the well-being of an individual, but at the same time, the soft tissue is also strongly affected by the general state of the body itself. This is not only due to the relationship between different anatomical structures, but also to the connection between mind and body.
Every day within the clinical practice a therapist has to face abnormal or unusual soft tissue conditions. For this reason, it is fundamental to use different approaches and techniques for the evaluation or the treatment of this kind of dysfunction
One of these techniques is called the Muscle Energy Technique. This was introduced in the 1940’s by Dr. T.J. Ruddy and later developed upon by Dr. Fred L. Mitchell during the 1950’s, both were American osteopaths and are considered the ‘fathers’ of the ‘Muscle Energy Techniques’.
Despite the date of discovery and the development of these techniques being over 70 years ago, the treatment is still relevant and the scientific community shows a constant and expanding interest in the methods. Almost every therapist as well as trainer or athlete should know the benefits that are achievable with these different Muscle Energy Techniques.
This group of techniques is a powerful tool for the manipulation of the soft tissue component and for the treatment of limited or painful articulations. They can be used to relax and to lengthen shortened or spastic muscles, to improve the strength of weakened muscles, to reduce local oedema, to increase the mobility of restricted joints or to decrease the pain from trigger points and myofascial restrictions.
The procedure of Muscle Energy Techniques allows the patient to voluntarily activate their muscles from a defined controlled position in a very specific direction, while the therapist applies the precise amount of resistance which plays as counterforce. The isometric contraction is then followed by stretching or movement of the restricted tissues. Accuracy is essential in this process, the therapist must select the precise muscle, choose the suitable direction and intensity of resistance in order to achieve maximum results from the technique.
During the execution of this method a minimum amount of strength is required. The effect is directed mainly to one specific muscle; however it influences all the surrounding structures which are functionally and anatomically connected to it. Therefore, all the connected soft tissues are involved but it also has an affect on the relationship with the bony segments.
Thanks to the reverberating connections established between muscle fibers and the Central Nervous System, the contracted muscle provides continuous feedback to the brain, which regulates the muscular tone. This involuntary system is regulated by two proprioceptors which are located in and around the tendons and the muscle fibers. These two receptors, the muscle spindle and the golgi tendon organs, react to changes in length and tension of the muscles. They assist with the regulation of muscular tone in agonist and antagonist muscles and with general coordination.
There are several different studies in progress looking into the physiological mechanisms involved in the Muscle Energy Techniques. However, by using post-isometric relaxation and reciprocal inhibition, the final physiological effect on muscle and myofascial structures, is an increased tolerance to stretching, which results in relaxation and muscle lengthening. This means that through the application of these techniques, every muscle or tissue which is shortened, contracted or painful as well as every restricted joint, will positively react to relax, decrease the amount of pain and increase the amount of movement.
The Muscle Energy Techniques are certainly not the only methods for the treatment of muscular and joint dysfunctions, and are not necessarily sufficient to obtain good results if used in isolation. However, integrating their use with ordinary clinical practice brings several advantages for both the patient and the therapist. Thereby, an appropriate use of Muscle Energy Techniques will likely enhance the level of almost any treatment, improving it in terms of comfort and quality of results.
The Muscle Energy Techniques are useful and valuable processes that are versatile and reliable in several different settings. From the muscular imbalance of the young athlete to the arthrosic conditions of the elderly population as well as being safe and effective with chronic spinal conditions such as post surgical, they can be used for a variety of different patients and conditions.
The participation of the patient is essential during the technique, the patient is actively involved controlling the intensity and the timing of the contraction. The effort which is required is minimal, the techniques are completely pain free and even the slightest discomfort is avoided, so comfort is guaranteed for both the patient and the therapist.
These combined factors make Muscle Energy Techniques a powerful tool, relatively simple yet very effective, with immediate and visible results for the patient.
