Osteopathic Approach Muscle Energy Technique

Osteopathic Approach

Systematic assessment of a body’s physical restrictions. These restrictions are prioritized and released in a specific sequence dealing with the greatest restriction first. This area may be distant to the patient’s area of chief complaint. This total body approach is based on the principle that dominant areas of restrictions may cause excessive stresses on other areas of the body. These compensatory stresses are usually the areas that bring the patient in seeking relief of pain in that area. The success of this approach lies in the ability of the physical therapist to identify the patient’s chief restrictions

Muscle Energy Technique

Muscle Energy Technique is a direct technique originally developed by Fred Mitchel, Sr., DO. The purpose of this technique is to treat joint hypomobility (stiffness) and restore proper biomechanical and physiological function to the joint(s). Since it is an approach that is based on Somatic Dysfunction, the patient undergoes a whole body screening evaluation for joint hypomobility. The results are prioritized to find the most dominant dysfunction/restriction. The dominant segmental is then specifically localized using the motion barrier concept. Different patient positions are utilized to engage the restriction before asking the patient to perform an isometric contraction to pull the restricted segment into a new motion barrier. The isometric contraction is performed in a precisely controlled direction against a precisely controlled counterforce by the therapist. The result is improved spinal mobility without the need for passive manipulation. Muscle Energy Technique is effective for mobilizing restricted joints, relaxing hypertonic and spastic muscles as well as facilitating neuromuscular reorganization. It is an appropriate technique for patients whose symptoms are aggravated by certain postures or bodily positions. Each treatment session begins and ends with a screening technique to assess the outcome of the manual techniques. This can be rewarding for the patient as the experience changes in mobility with concomitant reduction in pain.

Positional Release Therapy

Positional Release Therapy is a manual technique that restores a muscle to its normal resting tone. Assessment of trigger points allows identification of hypertonic muscles that are creating somatic dysfunction. Patients are placed in positions that approximate the origin and insertion of the hypertonic muscle. In doing so the muscle spindle activation is inhibited thereby decreasing the amount of afferent impulses to the brain. This leads to less efferent impulses to the same muscle. These efferent impulses were attempting to protect the tissue from being over stretched. By interrupting this pathway, the patient’s muscle is allowed to relax and assume a normal resting tone. The process is completed by slowly and passively returning the patient to an anatomical neutral position without firing of the muscle spindle. The patient is then instructed in appropriate home stretching for the affected area to complete this integrated therapeutic approach.

Myofascial Release Technique

When attempting to understand what fascia is like in our bodies, the best analogy is to think about slicing a grapefruit in half. After removing the fruit from the rind, it is easy to see all of the individual compartments that are left. These translucent walls give shape and definition to the object. Fascia in our bodies acts very similar to these compartment walls. The function of fascia is to support and protect the following structures in our body: blood vessels, bones, muscles, organs and nerves. Fascia is one continuous layer of connective tissue spreading from head to toe, but in three dimensions. It is closely integrated with all structures in our body, all the way down to a cellular level. As we age we accumulate compounding stresses to our fascial system. Fascial restrictions from poor posture or habitual motions, not to mention traumatic events, can slowly influence the structural mobility of our body and pull us out of alignment. These stresses can create pain and dysfunction.Physical therapists trained in Myofascial release technique can reduce these restrictions by applying gentle pressure and mobilizing the tissues to reduce the viscosity of the ground substance between two fascia layers

Somatic Dysfunction
A functional model of musculoskeletal disorders states that biomechanical disturbances are a manifestation of the intrinsic properties of the tissues affected. The body’s ability to adapt to physiological stresses is demonstrated as loss of joint mobility, loss of tissue resiliency and gross changes in motion or postural symmetry. These physiological adaptations are collectively described as Somatic Dysfunction. Tissue restrictions in one area of the body can have a profound impact on other areas of the body. Effective musculoskeletal therapy should incorporate this concept with a sound understanding of the physiology and pathophysiology of somatic tissues.