Principles Of ME Flashcards
Ropey vs boggy muscle feel
Ropey = chronic dysfunction
Boggy = acute dysfunction
Indications for Muscle energy
Relax hypertonic muscles
Stretch tight fascial planes
Mobilize restricted joints
Strengthen weak muscles
Regain muscle balance
Decrease pain from muscle imbalances
Contraindications for ME
Fractures
Dislocations
Serious tissue damage
No consent
Hematologists diseases w/ inflammation
Muscle spasms
Entrapments
Patients w/ low vitality
Basic ME concepts
Patient is placed in position to act towards restrictive barrier
Physcian counter force matched patient contraction force (isometric contractions)
Ways ME can be used
Patient direct cooperation
Respiratory assistance
- use inhalation and exhalation in combination
Ocular assistance
- really only used in cervical ME after trauma
Types of ME
Post isometric relaxation (uses direct restricted barrier with muscles)
Joint mobilization w/ muscles: (moves bones in specific directions)
Reciprocal inhibition: (uses contraction of the antagonist muscle to forcefully relax the agonist muscle)
Crossed extensor reflex: (patient contracts opposite muscle while you work on the intended muscle)
Two types of relaxation in ME
Voluntary and therapeutic (or involuntary)
Myofascial shortening
Increasing muscle mass while also increasing fibrous tissue mass
- can affect passive and active ROM
End feel
Sensation evoked when moving the body toward the barrier
Anatomical barrier = soft/springy feel
Restrictive barrier = rough/solid feel
Feather edge of the barrier
The beginning of the restrictive barrier. NOT the end point.
Starting treatment point of ME since it disarms the defense neurological mechanisms of the body
Direct mechanism behind post isometric relaxation
Contraction stretches surrounding tissues of the joint /muscles
Golgi tendon organs sense the change in tension and cause a reflexive relaxation of the agonist muscle fibers
Direct mechanisms behind reciprocal inhibition
Contraction towards the restrictive barrier causes antagonist muscles to contract. This in turn causes the dysfunctional muscles to reflex during repositioning phase.
Most common sequela of OM
Muscle stiffness/soreness
Somatovisceral vs viscerosomatic reflexes
Somato: somatic problems lead to changes in visceral structures
Viscero: visceral problems lead to neuromuscular dysfunctions
How long is the force during ME maintained?
Usually 5 seconds (until the contraction is palpable at the appropriate location)
Difference between abduction and adduction hip ME
Abduction = patient will try to abduct against physician adducting. STABILIZE IPSILATERAL PELVIS
Adduction = patient tries to adduct against physician abducting. STABILIZE THE CONTRALATERAL LEG
Tight hamstrings ME
Patient is supine and physician sits at the same side of the table as the extremity to be treated
- patient distal leg is on the physician shoulder and the physician hands are just above the patients knee stabilizing
- patient brings heel down and pushes away from physician. Afterwards physician flexes and extends patient knee towards the new featheed edge
Treatment of tight quadriceps
Physician flexes lower leg to the barrier and then the patients flexes leg against physician force
Afterwards the physician moves the patient towards the new featheredge
Internal and external hip rotation ME
Compare ROM of both sides and determine restricted side (site of somatic dysfunction)
- can be done supine or prone
Patient moves in the direct of the somatic treatment name
Physician moves in the opposite side
- when doing prone, make sure to stabilize the ipsilateral pelvis*
Piriformis ME
Piriformis is the primary hip external rotator.
Because the patient is placed with affected leg crossed over the good leg, the physcian actually moves the patient internal rotation where the patient externally rotates against.
STABLIZE HIP
Tibiofemoral motion
Medial surface of the joint internally rotates tibia during flexion (short leg)
Medial surface of the joint externally rotates tibia during extension (Long leg)
Tibial dysfunction screening
Patient sits at table with legs hanging off
- physician dorsiflexion ankle at about 90 degrees and then internally and externally rotates tibia looking for differ cents in end feel and ROM.
Tibiotalar joint facts
Plantar flexion = 10-55 degrees
Dorsiflexion = 5-40 degrees
5x more likely to sprain ankle if the ankle joints are inflexible
More common dysfunctions are found with plantar flexion (less stable)
Cuboid vs navicular bones facts
Inversion ankle sprains often cause cuboid and navicular bone droppage
Navicular drops = external rotation of bone and the lower portion moves inward
Cuboid drops = internal rotation of bone and the lower portion moves outward
Problems with the navicular causes decreased inversion
Problems with cuboid causes decreased eversion
Navicular (externally rotated) bone drop ME
One hand of physician stabilizes the patients talus, with the other hand on the navicular bone
Physician induces internal rotation/ eversion of the navicular bone to the restrictive feathered edge
Patient inverts the foot to match the pressure
Cuboid (internally rotated) bone drop
One hand of physician stabilizes the patients talus, with the other hand on the navicular bone
Physician induces external rotation/ inversion of the navicular bone to the restrictive feathered edge
Patient everts the foot to match the pressure
