Let's talk about Muscle Energy Technique. Is it just another fad?

The Muscle Energy Technique (MET) is a manual procedure that uses controlled, voluntary isometric contractions of a targeted muscle group and is widely advocated by authors in the field of osteopathy and chiropractic. 

Muscle energy techniques are used to treat somatic dysfunction, muscular hypertonicity, and pain. But, does it really work and is there any strong evidence for it?

MET is a form of osteopathic manipulative diagnosis and treatment in which the patient's muscles are actively used on request, from a precisely controlled position, in a specific direction, and against a distinctly executed physician counterforce. It was first described in 1948 by Fred Mitchell, Sr, D.O.  

Muscle energy techniques are used to treat somatic dysfunction, especially decreased the range of motion, muscular hypertonicity, and pain. MET is claimed to be useful for lengthening a shortened muscle, improving range of motion at a joint and increasing drainage of fluid from peripheral regions.


Image credit: https://www.slideshare.net/venus88/met-lecture

Muscle energy procedures, and related post-isometric procedures such as proprioceptive neuromuscular facilitation (PNF), have been demonstrated to be more effective than static stretching for improving the extensibility of shortened muscles. MET is safe, effective, easy to use, and easy to teach to patients for self-use.

Like many manual therapeutic approaches, the efficacy and effectiveness of MET is under-researched, and there is little evidence to guide practitioners in the choice of the most useful technique variations (such as number of repetitions, strength of contraction, duration of stretch phase), causing frustration for those endeavouring to integrate relevant evidence into practice.

A limited, but growing number of studies show positive change following MET intervention.

Although there are many variations of the application of MET, with most authors in the field of osteopathy advocating a post-isometric stretch for increasing muscle length, the recommended duration for the passive stretch component varies. A typical application of MET for the purpose of lengthening a shortened muscles involves the following steps:

Simon Bartold
Director of Bartold Clinical