page 1 of 5 Advanced Soft Tissue Techniques, Part 2 Mel Cash, BA, MISRM

PRACTICE SESSION:Muscle Energy Technique

Time to PracticeWatch Advanced Soft Tissue Techniques, Part 2 on Muscle Energy Techniques to see Mel Cash show you examples of how to apply the Muscle Energy Technique on different parts of the body. Below is a list of a few areas of the body on which you could practice the technique. When you go through the practice sessions, remember to apply the hand techniques that work best for you!

Steps for the Muscle Energy Technique (MET): This technique works safely on fit, strong healthy muscles that are commonly tight from over-training or lack of stretching.

• Stretch the muscle.• Conduct an isometric contraction for a certain amount of time.• Have the client relax and breathe in.• When they breathe out, take up the slack and move into a full stretch. However, if the client has gone through muscle trauma, instead of

moving the muscle to full stretch, move slowly to the next barrier position.

BE AN ARTIST and work out the best way for you to use the Muscle Energy Technique (MET). This technique works best when muscles are shortened. If you try MET on a muscle of normal and healthy length, it won’t do anything, making this technique safe! The common use this technique is as a Post-Isometric Relaxation (PIR), which helps with the release of tension in a muscle. Avoid using this technique on a muscle that is still in an acute phase of healing, as you may cause more harm than good. As you go through this handout, try using the technique in a variety of ways, be creative, and you’ll get excellent results.

Lower Limb

Quadriceps (0:04 – 0:53) • Flex the client’s knee andask them to press the leg towards you for the isometric

contraction. Hold the gently resisted contraction.• When they relax and exhale, gently increase the stretch past the barrier.

Rectus Femoris (0:53- 3:02)Have the client lying flat or in extended position of the trunk (propped on elbows.)

• Hold the client’s knee with the lower limb resting on your shoulder and stretch in that position.

• Follow the steps similar to the quadriceps release.

PRACTICE SESSION: MUSCLE ENERGY TECHNIQUE (continued)

page 2 of 5 Advanced Soft Tissue Techniques, Part 2 Mel Cash, BA, MISRM

Gastrocnemius (6:05 – 7:27) [Front of the body]• Lift the leg and place your hand above the knee. • Use your arm as a lever and stretch out the gastrocnemius. • For the isometric contraction, have the client press against your arm. • When they relax, stretch the gastrocnemius further.

Hamstring (8:22 – 10:34)• Put one of your hands on the heel and the other hand above their knee. • Feel the barrier of the muscle and get in a good stance for a solid base so the client can

resist you strongly. • Hold the position for a few seconds. • When the client is fully relaxed, move the leg to a new barrier position. • For PIR, have the client push the leg down and when they relax, push the leg to the full

stretch.

Gastrocnemius [Back side] (10:35 – 11:20)• Use your knee as a barrier and have the client push their foot against you.• When they relax and breathe out, stretch the foot further.

Psoas and Rectus formis (11:55- 17:34)• Have the lower limbs of the client on the end of the table and have the client bring their knee to their chest. With this position, it’s

mostly used to observe the client’s hip angle for the soleus and the knee angle for the rectus femoris.

Psoas (13:30 - 15:22)• Support your client’s knee by placing your knee behind it. • When the client breathes out, have the client push limb against your knee.

Rectus Femoris (15:23 - 17:34) • Make sure the knee stays in a consistent position and prevent the knee from raising up.• Have the client kick against your leg which is in front of their leg.• When they breathe out, have them pull their knee back.

PRACTICE SESSION: MUSCLE ENERGY TECHNIQUE (continued)

page 3 of 5 Advanced Soft Tissue Techniques, Part 2 Mel Cash, BA, MISRM

Piriformis (6:06- 7:41)When hip is flexed beyond 60 degrees, the piriformis becomes an inward rotator versus an outward rotator.

• Stretch the knee towards the opposite shoulder.• Apply an outward rotation to find the barrier position.

Adductors (8:47- 10:50)Control the degree of rotation of the leg, or you’ll be treating a different muscle.

• If it’s a large or heavy leg, change your body position so you can use your body to stretch the adductors.

• When you hit the barrier position, you’ll see the opposite leg start rotating. When you feel that barrier position, that’s where you want to stop.

Quadratus Lumborum (0:04 - 3:21)• Put the client’s leg in a criss-crossed position. (The leg you’re not working on goes under

the leg you are working on.)• Lift the legs into a bit of hip flexion.• When the client feels the stretch, have the client pull the legs gently to the center.

Another Method:• Have client put their hands behind their head. • Raise the shoulder and put your hand on the client’s bottom rib and the the other hand is

on the ilium. Twist their body gently until you reach the barrier position. • As they breathe out, have them roll towards you.

Tensor Fascia Lata (TFL) (3:23 - 4:03)• Raise the leg not being worked on, and bring the other leg across as shown in the image.• Bring the leg across to reach the (TFL). Have the client relax and then increase the stretch.

Gluteus Maximus (4:05 – 5:46)• Have the client’s hands at their side.• Bring the knee up towards their shoulder. • Have the client press towards you, hold, then have them relax while you stretch it further. • If the client’s other leg is rising up, press the leg down.

Gluteus Medius and Minimus (5:47 - 6:04)• Bring knee to the opposing shoulder instead. • Follow instructions for glueteus maximus.

Low Back, Hips, Pelvis

PRACTICE SESSION: MUSCLE ENERGY TECHNIQUE (continued)

page 4 of 5 Advanced Soft Tissue Techniques, Part 2 Mel Cash, BA, MISRM

Rotator cuff (0:05- 2:17) [lying down]• Abduct the shoulder and place your arm on the shoulder. • Rotate the arm and when you feel the shoulder girdle start moving, stop.• Support the client’s wrist so they can press against your thumb for contraction. • Have them breathe in and as they breathe out, ask them to push into your fingers (down

towards the floor.)

Brachialis (2:31 - 4:50) [sitting up]• Position the client’s arm across their back. • When the client feels the start of a stretch, stop. • Have the client pull the arm forward towards their back and have them breathe in and out

as you bring the arm back for a stretch.

Upper Back, Neck and Shoulder

Infraspinatus Muscle and Teres Minor Muscle (4:51 - 6:31)• Place arm over client’s shoulder girdle and lightly support the arm. • Combine PIR and PCR to relax the muscles. • Have the client press the back of their wrists on your thumb and to take a breath in.• On the exhale, let the weight of their forearm relax into a stretch.

Posterior Neck Muscles (6:39 - 8:34)• Have the client raise their head as far as they can, until they reach the barrier position. • Use your arms to support the client’s head and have the client push their head gently into

your arms.• When the client breathes out, have them bring their chin towards the chest.

Rotator cuff (2:30 – 3:17) [sitting up]• Put your hand on the client’s shoulder area. • Relax their arm on your leg.• Position the arm using gravity.• Complete contraction and hold techniques.

Levator scapulae (8:35- 9:50)• Put your abdomen against their head for support and to help them relax their head.• As the client breathes out, have them slightly move their head down to the right hip and

relax.

PRACTICE SESSION: MUSCLE ENERGY TECHNIQUE (continued)

page 5 of 5 Advanced Soft Tissue Techniques, Part 2 Mel Cash, BA, MISRM

Upper Trapezius (9:51 – 10:45) [On the side]• Apply a passive stretch and when you see the client’s head lift up a bit, you’re at the barrier

position.• Have them complete an isometric stretch by having them lift their head ¼ inch from the

table.• Stretch the muscle in different positions of side flexion.

Wrist Extensors and Flexors (0:04 - 2:00)• Have the client’s arms come off the table. • Flex the wrist, but be gentle with it, since you don’t want to overload the short muscles. • For the Extensors: Put your leg and hand next to the back of the wrist for consistent

resistance and gently push the wrist to stretch it.• For the Flexors: Put your hand on top of the front of the wrist and gently push the wrist to

stretch it.

Triceps (3:32 - 4:22) [sitting up]• Extend and abduct the shoulder joint.• Have the client press their elbow against your hand and breathe.• As they breathe out, increase the range of movement by gently pulling the arm towards

you.

Chest and Upper Limb

Subscapularis (2:01 - 3:30)• Abduct the shoulder and and when you feel movement around the subscapulara area,

you’ve reached the barrier position.• Use your thumb to press inside the wrist and have the client breathe and push their arm

back against your hand. • When the client reaches the full position, hold the position for a few seconds.

Pectoralis Major (4:30 - 5:34)Elevate the client a bit, by putting a towel in between the shoulder blades.

• Place your hands over the client’s shoulder.• Have client push their shoulders up towards the ceiling and hold the position for a few

seconds.• When they breathe out and relax, gently press their shoulders down.

Pectoralis Minor (5:35 - 6:10)Elevate the client a bit, by putting a towel in between the shoulder blades.

• Push the shoulder blades back to a 45 degree angle. • Follow the advice for the pectoralis major.