Muscle energy technique

Muscle energy technique was developed by American osteopathic physician Fred L. Mitchell Sr. Mitchell first outlined and published the principles underlying the technique in 1948, then refined it in the 1950s as a method for correcting pelvic alignment. He later expanded its application to the spine and the joints of the arms and legs. A method used around the same time by osteopathic physician T. J. Ruddy (Ruddy), involving rhythmic muscle contractions against resistance, also influenced the technique.

His son, Fred Mitchell Jr., subsequently continued teaching and writing about it, while Czech physician Karel Lewit organized similar principles under the name 'post-isometric relaxation' and introduced them across Europe. When Britain's Leon Chaitow presented the technique in book form, it spread beyond osteopathy to become widely used by physical therapists and massage professionals as well.

The word 'energy' in the name means that treatment uses force generated by the recipient's own muscles, rather than force applied solely by the practitioner.

This technique takes advantage of the brief period when a muscle relaxes immediately after contracting. There are two main approaches.

• Post-isometric relaxation — The muscle being stretched is contracted and then relaxed. The idea is that the muscle briefly becomes more relaxed immediately after the contraction. The Golgi tendon organ, a sensory receptor where muscle and tendon meet, is described as contributing to this response.
• Reciprocal inhibition — The muscle opposite the one being stretched is contracted. This approach uses the body's reflex in which the opposing muscle naturally relaxes when one muscle contracts. It is used when the muscle being stretched is painful or has just been injured, making it difficult to contract directly.

In osteopathy, this technique is used to address joints as well as muscles. If a spinal segment or the pelvis does not move easily in one direction, contracting the muscles that move that joint in a precise direction is considered to help the joint return to its proper position. A defining feature of this technique is that it moves the joint using the recipient's muscle force rather than forcibly pushing it into place.

Using the hamstrings at the back of the thigh as an example, the process goes as follows.

1. Find the first point of resistance — With the recipient lying down, the practitioner slowly raises the leg while keeping it straight. They stop at the first point where a pulling sensation is felt. They do not force the stretch to its limit. 2. Contract gently — The recipient gently pushes the leg toward the treatment table. They use only about 10–20% of their maximum strength, while the practitioner applies equal opposing force to support the leg and keep it from moving. This is held for about 3–5 seconds. 3. Relax and breathe out — The recipient completely releases the contraction and breathes out. 4. Move to the new point of resistance — The practitioner raises the leg a little farther to take up the slack gained during relaxation, stopping again at the new first point of resistance. 5. Repeat — This process is repeated 3–5 times.

There is very little sensation of painful stretching during treatment. Instead, many people say they are surprised to feel their leg rise noticeably farther after each contraction.

• People whose stiff hamstrings make it difficult to bend forward
• People whose stiff neck makes turning their head uncomfortable
• People who feel that their lower back or pelvis is twisted to one side
• People who are uncomfortable with treatments involving strong pressure or forceful twisting
• People looking for flexibility exercises they can also do on their own before or after exercise

• Use only a very small amount of force. It is easy to assume that pushing harder will help the muscle relax more, but a lighter contraction makes it easier to engage only the intended muscle precisely. If the practitioner says, "Push just gently," use even less force than you might expect.
• Do not hold your breath. Breathing comfortably during the contraction and exhaling slowly as you relax helps the muscle release more easily.
• Speak up right away if it hurts. If you feel a sharp, tingling sensation or pain during the contraction, the angle or direction needs to be changed.
• You can try it at home, too. Loop a towel around your foot and stretch your hamstrings, then gently push your foot against the towel for 3–5 seconds, relax, and stretch a little farther.

PNF stretching also uses the principle of contracting and relaxing muscles, but it originated in rehabilitation and tends to use relatively strong contractions and large movements. Muscle energy technique uses very light force and places particular emphasis on identifying the precise direction of joint movement and the first point of resistance. It also resembles joint mobilization in addressing both muscles and joints, but the difference is that joint mobilization moves the joint with the practitioner's hands, while muscle energy technique moves it using the recipient's muscle force.