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