MET is one of the most popular forms of osteopathic manipulative diagnosis and treatment. The diagnosis is determined after examining for: segmental positional faults(Type I dysfunctions) and movement limitations(Type II dysfunctions). When the diagnosis is made, the practitioner must properly position the joint(finding movement barriers in 3 different planes) in preparation for the patient’s active isometric muscle contraction. The practitioner repositions that joint following each controlled contraction to gain motion. It was first described in 1948 by Fred Mitchell, Sr, D.O.* and has been refined over the 60+ years since then. While pain is the most common reason for the patient to seek treatment, MET is specifically directed at joint dysfunction. By resolving these limitations, the practician can successfully improve: somatic dysfunction such as decreased range of motion, edema, muscular hypertonicity, sacroiliac dysfunction, respiratory dysfunction, pain, etc.
Since the treatment is directed at engaging motion restriction directly, it is categorized in the family of direct techniques with high velocity thrust technique. But it is far more gentle and does not carry the risk of injury found with thrust technique.
Physiological mechanism: The isometric contraction is known to produce the following physiologic changes:
- Golgi tendon organ activation results in direct inhibition of agonist muscles
- A reflexive reciprocal inhibition occurs at the antagonistic muscles
- As the patient relaxes, agonist and antagonist muscles remain inhibited allowing the joint to be moved further into the restricted range of motion.
It is also theorized that the controlled contraction causes the evacuation of metabolites that could maintain muscle fibers in a dysfunctional hypertonic state.
*“Glossary of Osteopathic Terminology”. American Association of CollegesOsteopathic Medicine. April 2009. p. 28.
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