In the latest (Nov/Dec 2008) issue of Massage & Bodywork Magazine, there is an article entitled “Sports Injuries: Breakthrough Methods in Treatment” by Karta Purkh Singh Khalsa. There is a lot of great information in this article, but something strikingly lacking is the use of MET (Muscle Energy Technique) in treating these injuries. I can see great value in the manual techniques that Mr. Khalsa describes, but have to argue that those should come after MET has been employed.
As my work has grown, I have moved away from a purely manual approach – in the sense that I used to do it all myself. Teamwork is key, and in this case your teammate is your client; more specifically, their brain. If their brain is holding tension or inhibiting a muscle, it can take quite a bit of work to get it to normalize, and often the effects are short-lived. You can be much more successful when you engage the client from within, instead of simply inflicting
a fix upon them.
In addition, MET reduces the irritability of the tissue so that the subsequent work is less uncomfortable. And it creates conditions in which I don’t have to work so hard. I prefer to work from the inside out on a client instead of the outside in.
There is no “I” in TEAM, but there is “A MET”!
This also helps to start the process of rebalancing the joint. Sherrington’s Law of the Reciprocal Inhibition of Muscles…
“When one set of muscles is stimulated (our agonist, or target muscle), muscles opposing the action of the first (antagonists) are simultaneously inhibited.”
…is important to understand. Many novice therapists make the mistake of only working the sore muscles. Often the soreness is caused by excess eccentric load caused by hypertonic muscles on the other side of the joint. In simple terms, they are sore because they are exhausted from resisting the tension of the opposing muscles. They are also weak (inhibited) because of the hypertonicity of their antagonists. Relax that tension and the load on the sore muscles is decreased. MET is great because that is exactly how it works – by balancing the muscles on both sides of the joint.
Incidentally, MET improves the communication between the brain and the muscles and clears dysfunctions such as the negative feedback loop created by a trigger point (TrP). I always use MET to reduce TrP activity prior to more aggressive and painful techniques such as cross-fiber friction or sustained (ischemic) compression. Sometimes MET alone is enough all by itself, but even when it isn’t, almost every time the irritability is reduced so that the other techniques cause much less discomfort to the client.
Yet another effect is that MET retrains the brain as to what the state of the tissue is and how it should be. It allows the brain to do a reset of the proprioceptors. Ultimately, it will be the new and healthier movement patterns that allow the work to endure.
So I will close with the immortal words of Snoopy.
“Get MET, it pays!”
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