Muscle Energy

Question 1

autogenic inhibition

Answer 1

recruiting the same muscles that are tight

Question 2

reciprocal inhibition

Answer 2

recruiting the opposite muscles

Question 3

documenting MET

Answer 3

“Objective: MET for ERSL”

“for” =positional dx
“in” =movement barrier

Question 4

Freyette’s Laws

Answer 4

1: when the spine is neutral, sidebending and rotation occur in opposite directions
2: when the spine is flexed or extended, sidebending and rotation occur to the same side
3: when motion is introduced in one plane, available motion in the other planes is restricted

Question 5

type I motion

Answer 5

when sidebending and rotation occur in OPPOSITE directions

Question 6

type II motion

Answer 6

when sidebending and rotation occur in the SAME direction

c-spine possesses type II motion ONLY

Question 7

“flexed lesions” C2-7

Answer 7

with the pt. positioned supine in neck extension:

• palpate along the articular pillar bilaterally
• note post prominent TP (ex: R C4)
• L facet is stuck OPEN (upsloped): the vertebra is forced into R rotation during extension
• physiologic L rotation and SBing are limited; L facet can’t close

position= flexed, rotated and SB R (FRSR)
movement barrier= ext, rotation and SB L (ERSL)
tx: same as movement barrier (MET is a direct technique)

Question 8

flexed lesion treatment

Answer 8

• extend c-spine to level of involved segment
• back off to “interbarrier zone” (IBZ)
• introduce rotation to barrier then IBZ
• SB to barrier then IBZ
• resist isometric contraction in any direction for 6-10 s no more than 20%
• repeat 3-5X

Question 9

extended lesions C2-7

Answer 9

with pt. positioned supine or seated in neck flexion:

• palpate along articular pillar bilat
• note post prominent TP (ex: R C5)
• R facet is stuck closed (downsloped): the vertebra is forced into R rotation during flexion
• physiologic L rot and SB are limited; L facet can’t open

position=ERSR
movement barrier=FRSL
tx: FRSL

Question 10

extended lesion treatment

Answer 10

• flex c-spine to level of involved segment, IBZ
• introduce rotation to barrier, IBZ
• sidebend, IBZ
• resist isometric contraction is any direction or 6-10 s no more than 20%
• repeat 3-5X

Question 11

direct or indirect technique?

Answer 11

depends on SINNS and patient response model

ex: movement barrier ERSL (stuck open L)
stretch/stiff–> direct (close 4/5)
sharp/pinch pain–> indirect first- try to resolve dysfunction by going opposite to the barrier (open 4/5)

Question 12

PIR

Answer 12

=postisometric relaxation

releasing tone and relaxing spasm (esp. acute)

contraction at mid range rather than barrier (more than 20% but less than 35%)
followed by stretch (chronic) (fibrotic)

immediately stretching after contraction for at least 10-30 seconds before allowing rest period of 30s

Question 13

modified PIR

Answer 13

contraction–>relaction–>pt assisted stretch repeated until no more gain in tissue length

Question 14

common errors

Answer 14

• too much/too little force
• inappropriate counterforce direction-
• wrong position
• moving to new position too soon after contraction
• wrong instruction
• fails to maintain stretch long enough