Muscle Energy - Sheet1

Question 1

Shoulder Girdle ME

Answer 1

Sternoclavicular Joint Treatment
Position
Patient is supine. Operator stands on the side of the dysfunction
and abducts the patient’s shoulder to 45 degrees while monitoring
motion at the sternoclavicular joint.
Lock-out
Operator slightly extends and externally rotates the arm until the
motion barrier is reached.
Action
Patient is instructed to lift their arm toward the ceiling, activating
the pectoralis muscles to pull the clavicle laterally and inferiorly.
The operator isometrically resists motion. Contraction is held for
three seconds and then the patient is instructed to relax.
Reposition/Recheck
Engage the new
barrier by further
extending and
externally rotation
the arm.
Repeat a total of
three times or until
the desired result is
attained. Recheck
motion at the SC
joint.

Question 2

Elbow and Foreaem Girdle ME

Answer 2

Posterior Radial Head Treatment
This  treatment  is  used  for  radial  head dysfunctions  that  resist 
forearm supination. 
Position
Patient is supine. Operator stands on dysfunctional side, cups the 
patient’s  elbow  with  one  hand  and  grasps  the  patient’s  wrist  with 
the other.
Lock-out
Operator places the forearm into supination to engage the motion 
barrier.
Action
The  patient  is  asked  to  pronate  their  forearm  while  the  operator 
isometrically resists motion.
Contraction is held for three seconds and the patient is instructed 
to relax.
Reposition/Recheck
Engage  the  new 
barrier  by  further 
supinating  the 
forearm.
Repeat  a  total  of 
three  times  or  until 
the  desired  result  is 
attained. Recheck.

Question 3

Anterior Radial Head Treatment

Answer 3

This treatment is used for radial head dysfunctions that resist
forearm pronation.
Position
Patient is supine. Operator stands on side of dysfunction, cups the
patient’s elbow with one hand and grasps the patient’s wrist with
the other.
Lock-out
Operator places the forearm into pronation to engage the
motion barrier.
Action
The patient is requested to supinate their forearm while the
operator isometrically resists motion. Contraction is held for three
seconds and the patient is instructed to relax.
Reposition/Recheck
Engage the new barrier by further pronating the forearm.
Repeat a total of three times or until the desired result is attained.

Question 4

Flexed or Extended Wrist Treatment

Answer 4

Flexed Or Extended Wrist Treatment
Position
Patient is seated. Operator stands in front of patient grasping the
dysfunctional wrist with both hands.
Lock-out
For a flexed wrist, the operator induces wrist extension to engage
the motion barrier. For an extended wrist, the operator induces
wrist flexion to the motion barrier.
Action
The patient is asked to oppose (flex or extend) while the operator
isometrically resists motion.Contraction is held for three seconds
and the patient is instructed to relax.
Reposition/Recheck
The new barrier is engaged by further extending or flexing the wrist.
Repeat a total of three times or until the desired result is attained.
Recheck wrist motion.

Question 5

Isolytic Fascial Plane Milking Technique

Answer 5

Isolytic Fascial Plane “Milking” Technique
This technique can be adjusted to address the other muscle
groups/myofascial structures of the upper extremity. Isometrics or
isotonics may be utilized if, in the judgment of the operator, the
isolytic force is inappropriate
Position
The patient is supine. Operator sits on edge of table on side of
dysfunction. Cup the patient’s elbow to produce a fulcrum, and flex
the forearm. Grasp the patient’s wrist with other hand.
Lock-out & Action
The patient is instructed to flex their elbow and tense their biceps,
opposing the counterforce of the operator’s hand at his wrist. The
operator applies a quick short isolytic extension to the patient’s
forearm to release any myofascial lesions.
Repeat/Recheck
Patient instructed to tense their bicep again, which is overcome by
the operator. This can be repeated until the desired result is
attained. Tissue texture of the upper extremity is reassessed