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Flashcards in Principles Of ME Deck (26)
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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



Serious tissue damage

No consent

Hematologists diseases w/ inflammation

Muscle spasms


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.



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