Book Review: Muscle Energy Techniques - Leon Chaitow

Like with a lot of books that I read, I had this book on the shelf for a little while before I read it. I read Chaitows Positional Release companion to this book last year and enjoyed it. This book was no different. I really enjoyed this book, and when reading the initial two - three chapters it reminded me of when I first read Sahrmann's "Diganosis of Movement Impairment Syndromes" as I had a lot of ah ha moments.

Muscle Energy Techniques (MET) are a specific technique of stretching, that can also be applied to many joint mobilizations also. It is originally accredited to Fred Mitchell Snr. It has many different forms, such as, Post-Isometric-Relaxation (PIR), Reciprocal Inhibition (RI), Isotonic Concentric, Isotonic Eccentric, and Slow Eccentric Isotonic Stretch (SEIS). Right now you are probably like WHAT?? So I will try to summarise each of the above techniques.

Post Isometric Relaxtion:
- Take target muscle to its first sign of resistance
- Contract target muscle (agonist) against the practitioners force
- Force used is only 20% of the clients maximum strength
- Hold Contraction for 7-10 seconds
- Patient is ask to inhale, and the exhale and stop contraction
- Practitioner takes mucsle to its next barrier (acute), or through the next barrier (if chronic) and holds this stretch from any where to 5-60 secs, depending if the condition is acute or chronic - Repeat another 3 times until no further gain is made

Reciprocal Inhibitional:
- Take target muscle to its first sign of resistance
- Contract the opposing muscle (antagonist) of target muscle (quads to stretch hamstings) against the practitioners force
- Force used is only 20% of the clients maximum strength
- Hold Contraction for 7-10 seconds
- Patient is ask to inhale, and the exhale and stop contraction
- Practitioner takes mucsle to its next barrier (acute), or through the next barrier (if chronic) and holds this stretch from any where to 5-60 secs, depending if the condition is acute or chronic - Repeat another 3 times until no further gain is made

Isotonic Concentric (Toning Weak Musculature):
- Take target muscle to mid range

- Contract target mucsle

- The patient overcomes the practioners resistance. The client slowly builds up to using maximum force.

- Hold Contraction for 3-4 seconds

- Repeat 5-7 times

Isotonic Eccentric (Stretching Fibrotic Tissue):

- Take target muscle to first sign of resistance

- The Practitioner overcomes the patients force. Less than maximum force is applied at first. Subsequent contractions build towards maximum, if tolerable.

- Hold Contraction for 2-4 seconds

- Repeat 3-5

Slow Is0tonic Eccentric Stretch (Toning Weak Antagonists, and Preparing tight/stiff antagonists to inhibited muscles for stretching):

- Take target muscle to first sign of resistance

-The Practitioner SLOWLY overcomes the patients force of antagonist to target muscle. Less than maximum force is applied at first. Subsequent contractions build towards maximum, if tolerable.

- Hold Contraction for 3-5 seconds

- Stretch target muscle for 30 seconds at new resistance barrier

- Repeat 3-5 times

All the above are extremely effective methods for achieveing many goals, such as, deactivation of trigger points, toning of weak antagonists, breaking down scar tissue, increasing range of motion, and joint mobilization.

The fact that MET can be applied in a gentle way, makes it a great technique for acute injuries, and also when dealing with older more fraile clients.

Chapter 4:
In chapter 4 Gary Fryer talks about the research to support MET. Why does it work? Fryer talks about three main theories on what may be happening to the muscles, and connective tissue with using MET.

1. A reflex Muscle Relaxation
2. A Viscoelastic or Muscle property change
3. An increase tolerence to stretch

Out of the three above Fryer believes that an increase tolerance stretch seems to be the most likely theory.

Fryer also talked about the need for more research on the optimal lenght of time and force of contraction, how long to how each subseqent stretch, and optimal number of repetitions for the use of MET. He did state that contract-relax techniques did seem to have a better outcome on increases in flexibility, than static stretching.

Chapter 5:
Chaitow goes over many different assessments and MET Techniques that can be used to correct certain dysfunctions that showed up in the assessments.


Chapter 6:
Chaitow goes over MET techniques for joint mobilization. His MET techniques for depressed and elevated ribs, cervical spine, thoracic spine, and pelvis are all excellent.


Chapter 7:
Chaitow goes over the hypothesis of Trigger point (TrP) formation. He goes on to described how his Integrated Neuromuscular Inhibited Technique (INIT) is very effective at deactivating TrPs. INIT is ischaemic compression, followed by a positional release technique, which is followed by an MET stretch. It is used to great effective for treating and eliminating TrPs and tender points.


Chapter 8:
Craig Liebenson talks about how he integrates MET into his methodology.


Chapter 9:
Eric Wilson talks about how he integrates MET into his treatment of low back pain patients.


Chapter 10:
Sandry Fritz discusses how to use MET in a massage therapy setting.


Chapter 11:
Ken Crenshaw, Ron J Porterfield, and Nathan Shaw discuss how they are integrating MET into their rehabiliation of their athletes as Athletic Trainers.


Conclusion:
I truly enjoyed this book. I would recommend it to any clinician looking to further enhanced their knowledge of MET and its many benefits.



Stay Strong,
RB

An Interview with TJ Lensch

1. TJ thank for your time. Could you give my readers your background, and how you came to be a strength and conditioning coach?

It was surely not the typical route that most have had to go but it started with a general interest in exercise at the middle school level. From there in high school I was always seeking out information on various strength and conditioning practices to improve my own development as an athlete. What really helped was having my father as a coach. He attended clinics and was able to get some great stuff from the University of Iowa, Iowa State, and other great coaches. I went to speed and strength camps throughout high school and picked up a lot great habits from them.
Upon continuing football in college, I really narrowed my focus on becoming a strength and conditioning coach. I attended as many seminars and visited as many coaches as I could, taking advantage of vacations to meet some great people in the field across the country. I was taking on personal clients and writing programs for other athletes from late high school and throughout college. I then took an internship at IFAST with Bill Hartman and Mike Robertson and learned an overwhelming amount from them. From there I took what I knew and presented it to the athletic staff at Northwestern College (IA) and was appointed to my current position as Head Strength and Conditioning coach overseeing football. I also collaborate with volleyball, wrestling and am in charge of two high school S&C programs.


2. What, in your opinion, is the biggest problem you see within the fitness industry today?

Being satisfied. With all the great research, practical evidence, and results people are putting out, why are there still people stuck in the dark ages with their programs? I have seen handfuls of programs from D3 to D1 that 2 days on the program can trump the volume of single joint exercises I do in 3 months. Some coaches reach a certain level and they are satisfied with what they read, how they train, and what they need to know since it got them there. This mind set is killing the profession and these people are putting out GA’s whom are only spreading this mentality. As a young coach it can be extremely upsetting to see coaches stuck in their ways which makes me appreciate those whom are evolving with the information and getting it out for others to benefit.


3. You interned with Mike Robertson and Bill Hartmann at IFAST. What was that experience like?

These great individuals have done more for me in terms of setting my mind on the right path than I could ever have hoped. They were pretty much like talking to open books full of information on the various aspects of movement, strength training, and communication, an often over looked part of coaching. I was exposed to a wide variety of clients which was a great way of seeing the different methods of attaining all the individual goals. Being there really helped me see the importance of integrating what you get from a very extensive evaluation and applying it to a program that always far exceeded the athlete’s expectations. If there was one thing I learned right away it was you don’t know ANYTHING. Read, practice, and teach it. Teaching someone how to do something properly will ensure that you actually know how to do it.


4. Who has had the biggest influence on you as a coach?

I think you can say Mike and Bill are a given from the past question. Another coach that impacted me early on in college was Dos Remedios. I went to College of the Canyons and spent an entire day there soaking up everything. He was even gracious enough to talk about any aspect of his program with me thereafter. He had nothing to hide and all the results to prove what he preaches. Of course all the coaches that I have met and interned with have had an extremely high influence on what I do. You are a product of who you learned from and exposing yourself to as many people as possible will help you sift through the good and bad. I would however consider another big influence on me as a coach is being an athlete and participating in sports in general. With a lot of emphasis on what program is best and development, being able to understand the mental and psychological demands of sport is remarkable. Having gone through the demands of a sport and having a good idea as to when you have to regulate or modify training is very important. Often times they are capable of much more than what they think they are capable during certain times of the year, especially in-season.

5. Sometimes there seems to be a huge gap between some physical therapists and strength and conditioning coaches. How in your opinion can this gap be bridge?

Just from my experience and from who I have learned from, the bridge is becoming more of an old screen door. Old screen doors have holes letting more and more in and out but still do the job enough to keep out the big things. Just from the short time I have been “in the field” it seems like S&C coaches are taking more and more little things (prehab, FMS, PNF…) but are still apprehensive to the bigger components of each other. This would include more extensive evaluations and not putting load to dysfunction for S&C coaches. I think communication and willingness to change would make the transition seamless. With the great specialist out there (McGill, Sahrmann, Cook) and progressive coaches getting results with these concepts, more people will not be so hesitant to open that door. Because if you get results that is all that matters. The result is Winning! You win when athletes are healthy, improving performance, and are prepared.

6. What are you all-time favourite books in the following areas:

- Strength Training: Block Adaptations in Sports Training by Viru Physical Therapy (Covers everything on how certain means effects the body and appropriate times to do so)

- Rehabilitation: The Athletes Shoulder by Andrews, Wilk, Reinold (If your athletes have shoulder problems...get this book!)

- Nutrition: Precision Nutrition by Berardi/Omnivore’s Dilemma by Pollan (One is a sound program that I continue to have great results with, the other is getting me to watch where my food comes from not just what it is)

- Business: How to Win friends and Influence People by Carnegie (Will expose some simple things you are doing that could be holding back your business, relationships, life)

- Random: Season of Life by Marx (what being a “man” really means. Inspirational but not preachy at all)


7. What do you do to for your continuing education (Seminars attended etc)?

There are a lot of great smaller college Midwest coaches that visiting them is always a great learning experience. I attend a few local seminars and try to get to one bigger one every year. There are also great online seminars that you can “attend” which are great for people on a college budget. I also hold a performance training class at nights at a local facility. Here I educate clients on importance of proper warm up, mobility, strength training, and of course train them. I just find getting out and seeing how coaches are handling several athletes like I do is much more valuable than hearing how they do it.

8. What resources that are out there, would you recommend to young up and coming coaches (Podcasts, Websites, Blogs, Products)

Once you shuffle through some of the junk that the internet spits out it is easy to find some great on line resources. Strengthcoach.com has great articles and hands down the greatest forums. A couple of other great sites include SBcoachescollege and Precision Nutrition.

For Blogs a generally read several: Mike Robertson, Bill Hartman, Tony Gentilcore, Alwyn Cosgrove, Nate Green, Mike Boyle and a few more.

Not a huge pod cast guy but a couple that I really love to listen to most often are In the Trenches podcast (Robertson) and The Strength Coach Podcast (Boyle).

9. If you could chose one exercise, and one exercise only, what would it be and why?

Well, if you are going to use the word exercise and not lift, I am going to have to say forward sled pushes. I know this question has been asked and this is a popular answer but there are so many reasons why this is useful. Your ability to train the localized muscle groups under load that are heavily involved in running is a big plus. You also have the ability to alter work/rest to develop several energy systems. You can also use it to promote efficient loaded movement and posture (neutral spine, lower body PAL mechanics) by just doing the exercise with perfect form as well as identify faulty patterns (abduction of the up leg, rotating torso).

10. Could you give my readers a basic summary of what your methodology on training is (eg. how do you assess, and design, and periodize programs)?

Assess- With athletes ranging to about 100+ I integrate assessment measures into the workouts. This includes FMS movements built into the warm up in order to constantly assess progress in the movement pattern throughout the program. I will give an extensive evaluation to critical players and injured athletes.

Design/Periodization- The joint by joint approach is very evident in my design. I believe in foam rolling, warm up, mobility, speed, lift...K.I.S.S.!! I buy heavily into block periodization for advanced athletes and concurrent approach with developmental ones. I believe in using appropriate means throughout the training stage (General, General Specific, Specific). I find the volume of unilateral training increasing more and more in relation to bi lateral this off season and have had zero muscular issues via training, spring ball, running.

11. Last question. What advice would you give to young coaches, like myself getting into the field?

Train people. The more people I train, the more I find what works for certain populations. Education is a lifelong process and a lot of what you need to know in this industry are things you will have to seek on your own and won’t get in class. Take advantage of your free time and meet people doing what you wish you were. Observe them, intern, volunteer with them. If you don’t have a list of goals you will not be able to justify your current efforts. Sit down, write it down, and do everything in your power to get it done, then repeat. And finally, take advantage of any opportunity that will get you closer to where you want to be. You aren’t going to start your career where you wish you could end up.

RB: TJ, thank you so much for your time. Where can my readers find out more about you, and any projects that you may have coming up?

TJ: You can visit me at http://www.tjlensch.blogspot.com/. Currently working on getting a couple more articles out about physical preparedness and getting my teams ready to dominate their Summer programs. If you have any questions or comments feel free to shoot me an email.

Mastering The Deadlift

Here is a great 3 part article series on the technique of deadlifting and its many variations by Eric Cressey.

Eric is one of the top Strength and Conditioning coaches in the field, and one strong guy.

I think every young coach starting off in the industry, or any coach for that matter, should read this series.

Enjoy,

RB

Mastering The Deadlift Part 1

Mastering The Deadlift Part 2

Mastering The Deadlift Part 3

An Interview with Kevin Neeld

1. Kevin thank for your time. Could you give my readers your background, and how you came to be a strength and conditioning coach?

I’ve had a passion for ice hockey since the sport was introduced to me when I was 7. After spending hundreds of hours working on my stick skills and maneuverability with my older brother outside, I became know for being a player with great hands, seeing the ice well, and being indescribably slow. Short, overweight, and slow isn’t exactly the physical profile top programs look for. When I was 13, I started training pretty seriously and, within a single Summer of excessive dedication, starting catching coaches’ attention with my speed. That year I finished 2nd on a team in points that I had been laughed off of the year prior. That was really the first time I had witnessed/experienced the incredible benefits that training can have on a player’s development.

Training has been a huge part of my success as a player. I’m very fortunate in that I knew from that age that I wanted to pursue a career in helping athletes with the determination, but without the physical ability to compete at the highest level possible, to fulfill their potential. The last 12 years has just been a continuation of that dream: reading everything I can get my hands on, volunteering as much time as I can, coaching as much as possible, and building a network of people that I can learn from.


2. What, in your opinion, is the biggest problem you see within the fitness industry today?

A LACK of education. Hear me out. I completed my program at Delaware with a 3.9 gpa and finished my graduate degree at Umass Amherst (a Top 5 Kinesiology Program in the US) with about the same. With that preface, of the nearly 200 undergraduate and graduate credits I took in 6 years, I think I took about 9 that contributed to anything I do as the Director of Athletic Develoment at Endeavor. If people are serious about training, they need to educate themselves by attending seminars, watching DVDs and reading books/manuals from other top professionals in the field, and getting a ton of experience by volunteering in settings that mirror what they want to do for a career.
Academia has limited application to do what most people in the athletic development industry do on a daily basis and most certifications, I’m sorry to say, are a joke. I know people that have the NSCA’s CSCS that I wouldn’t let train my dog and uncertified coaches that are brilliant and well-experienced. It’s frustrating to get into arguments with people that get all their information from infomercials and “muscle magazines”. Contuining to learn, grow, and develop is paramount to be successful in this industry.


3. You work with a lot of hockey players. Could you give my readers an idea of what it is like to coach this population?

A ton of fun. Except for a few minor exceptions, every player I work with is HIGHLY motivated. They don’t need to be sold on the benefits of training. They show up, listen well, and work hard. From a coaching standpoint, I couldn’t ask for anything more. The only problem I have is that some love the game so much (or have been convinced of this necessity by people that don’t know what they’re talking about) that they spend TOO much time on the ice, which inhibits their development. The prevention of adductor and hip flexor strains, hip labral injuries, sports hernias, and other shoulder injuries is a huge part of what I do, which are injuries somewhat unique to hockey players.


4. Who has had the biggest influence on you as a coach?

Michael Boyle, Eric Cressey, Chris Boyko (UMass Amherst), and Brijesh Patel have taught and continue to teach me more about strength and conditioning than I could ever put into words. I highly recommend that anyone reading this reads EVERYTHING that any of those people have ever written and buy everything they’ve ever sold. I guarantee it’ll change the way you train people.



5. Sometimes there seems to be a huge gap between some physical therapists and strength and conditioning coaches. How in your opinion can this gap be bridge?

As I mentioned above, I think education is key. Many physical therapists are hesitant to refer people to strength and conditioning coaches because so many strength and conditioning coaches (and personal trainers) end up hurting people. If people on the training side of things take some time to educate themselves on injury prevention and volunteer some time shadowing a PT to learn more about the profession, I think the relationship between the two will improve.

With that said, it’s easy for PTs to look back and say “you shouldn’t have done this, because now you’re hurt.” From a training standpoint, clients need to be pushed. There is an inherent risk associated with this and sometimes, despite our best efforts, injuries happen. Hindsight is 20/20. Foresight isn’t so great. It sends clients mixed messages if every PT (or doctor for that matter) bad mouths strength and conditioning coaches everytime someone comes in with an injury. Unfortunately, the lack of education on the part of the training industry generally justifies this stand point by PTs and doctors. In general, we need to know more about what they do, and they need to know more about what we do.


6. What are you all-time favourite books in the following areas:

- Strength Training: At the risk of being vague, EVERYTHING from Michael Boyle, Eric Cressey, Mike Robertson, and Bill Hartman are great investments. I also think Christian Thibaudeau’s books provide a lot of great program design information.


-Physical Therapy Rehabilitation: Diagnosis and Treatment of Movement Impairment Syndromes by Shirley Sahrmann, Anatomy Trains by Thomas Myers, and Muscles: Testing and Function with Posture and pain by Florence Kendall are great reads. Kinesology of the Musculoskeletal System by Donald Neumann was recommended to me by Shirley Sahrmann a couple years ago. It’s an incredible resource to have to look up specific questions, but it’s a pretty intimidating bathroom read!


- Nutrition: Precision Nutrition by Dr. John Berardi


- Business: The 7 Habits of Highly Effective People and The 8th Habit by Stephen Covey, Million Dollar Habits by Brian Tracy, and How to Win Friends and Influence People by Dale Carnegie are ALL must reads for anyone that works with people.


7. What do you do to for your continuing education (Seminars attended etc)?

I have a never ending list of textbooks related to physical therapy and neural aspects of movement that I’m slowly working my way through as a way to better understand the way the human body moves from a scientific stand point. I also keep in regular contact with many of the people I’ve mentioned above through email, buying their products, and reading their free stuff online. I make it a point to attend as many seminars as I can. For the hockey crowd, there’s an annual Boston Hockey Summit at Northeastern that I’ll never miss as long as they continue to have it. I also highly recommend a new site that I run along with Michael Boyle, Sean Skahan (Anaheim Ducks) and Mike Potenza (SJ Sharks), http://hockeystrengthandconditioning.com/. There are over a dozen coaches that work with NHL and NCAA hockey players with a great perspective on how to develop great athletes. It’s the single-best hockey training resource out there. The Perform Better Summit’s are another great choice for seminars.


8. What resources that are out there, would you recommend to young up and coming coaches (Podcasts, Websites, Blogs, Products)?

StrengthCoach.com, HockeyStrengthandConditioning.com, KevinNeeld.com (haha), EricCressey.com, NickTumminello.com, SBCoachesCollege.com, mboyle1959.wordpress.com, BillHartman.net, RobertsonTrainingSystems.com, BoddickerPerformance.com, and brianstpierretraining.com. That’s far from an all-inclusive list, but that should get you started!


9. If you could chose one exercise, and one exercise only, what would it be and why?

The reverse lunge. It’s my favorite lower body exercise because it improves single-leg strength and mechanics in an acceleration pattern and reinforces core stability and potentially grip strength (if you’re holding dumbbells). Naturally, I would never write a training program with just one exercise, but this is definitely a great lower body exercise that I think everyone should include.

Reverse Lunge

10. Could you give my readers a basic summary of what your methodology on training is (eg. how do you assess, and design, and periodize programs)?

We use the Functional Movement Screen and a selection of other movement and ROM tests to assess hip and shoulder ROM and control. In general we use an undulating periodization model, with changes to the Set x Rep scheme every week. Every exercise is paired or “tripled” with other exercises to make the most out of our rest periods. For example, I just had a group of hockey players leave that started their session with: A1) Broad Jump (Discontinuous): 3 x 6; A2) Seated Psoas Lift: 3x15s/side; A3) 135° Pec Stretch: 2 x 30s/side. They’d cycle through these three exercises until they’ve completed all the reps. Our programs are all set up: Foam Roll, Dynamic Warm-Up, Speed, Power, Strength, Conditioning.

11. Last question. What advice would you give to young coaches, like myself getting into the field?

Find a good mentor and spend as much time as you can learning from them. My internships under Chris Boyko and Eric Cressey taught me more about how to train athletes than anything else I’ve ever done. As I mentioned, they continue to be invaluable mentors to me

Kevin, thank you so much for your time. Where can my readers find out more about you, and any projects that you may have coming up?
My pleasure! Your readers can check out my site http://KevinNeeld.com; I regularly post training info and let people know about other projects I’m working on and great products to look for. They can check out http://Ice-Hockey-Training.com for more information on my books, programs, and videos. I also recommend that anyone that works with hockey players (or that wants to) invest in a membership to http://HockeyStrengthandConditioning.com. The forums are hopping and get responses from many of the top hockey strength coaches in the world. In fact, there was recently a job posting for a Hockey Strength and Conditioning position in Switzerland. It’s rapidly growing from an incredible hockey training information resource to an incredible networking resource. If anyone has questions about that site or anything else I’m happy to answer them.