One cause of somatic dysfunction is postulated to derive from chronically contracted muscles which affect the body’s normal range of movement. Muscle energy is a direct, active treatment with broad applications to any part of the body restricted in motion. In treatment, the manual osteopath engages the restrictive barrier and asks the patient to voluntarily move from a precisely controlled position. The osteopath exerts an equal and opposite force to the patient's active force from a certain position and in a specific direction. During the patient’s effort, the physician provides an isometric counterforce for 3 to 5 seconds and then allows the muscle to relax for 3 to 5 seconds. A new restrictive barrier is then engaged and the process is repeated 2 to 4 times. The result is repeated isometric contractions with passive range of motion through the barrier after each isometric contraction.
The goal of muscle energy technique is to increase joint mobilization and increase the length of contracted muscles. Because no thrusting is done, this procedure has a very low likelihood of producing complications and can be used where HVLA technique is contraindicated. The mechanism of action of muscle energy is thought to be related to the reciprocal inhibition of agonist/antagonist muscles and the Golgi tendon reflex. When a stretch reflex excites one muscle, reciprocal innervation causes simultaneous inhibition of the antagonist muscle. The Golgi tendon organ reflex is an inhibitory reflex that can cause relaxation of a muscle when excessive tension is placed on the Golgi tendon organ through either stretching or contracting the muscle. Muscle energy is contraindicated in patients with low vitality, fractures, unstable joints, and recent surgery.
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