Soft Tissue Mobilization PDF

SOFT TISSUE MOBILIZATION AGUSTIYAWAN MUSCLE ENERGY TECHNIQUES (MET) Variations on the MET theme 1. Lewit’s postisometric relaxation method 2. Janda’s postfacilitation stretch method 3. Reciprocal inhibition variation 4. Str...

SOFT TISSUE MOBILIZATION AGUSTIYAWAN MUSCLE ENERGY TECHNIQUES (MET) Variations on the MET theme 1. Lewit’s postisometric relaxation method 2. Janda’s postfacilitation stretch method 3. Reciprocal inhibition variation 4. Strengthening variation Lewit’s postisometric relaxation method 1. The hypertonic muscle is taken, and find barrier point where resistance to movement is first noted 2. 2. Isometrically contracts the affected hypertonic muscle away from the barrier (agonist is used) 3. The degree of effort is very minimal, say 20% of his available strength 4. Patient is asked to exhale and relax completely 5. Muscle is taken to a new barrier with all slack removed but no stretch 6. Starting from this new barrier, the procedure is repeated two or three times Janda’s postfacilitation stretch method 1.Stronger isometric contraction than that suggested by Lewit 2.The shortened muscle placed in a mid-range position 3.Contracts the muscle isometrically, using a maximum degree of effort for 5–10 seconds while the effort is resisted completely 4.On release of the effort, a rapid stretch is made to a new barrier, without any ‘bounce’, and this is held for at least 10 seconds 5.The patient relaxes for approximately 20 seconds and the procedure is repeated between three and five times more Reciprocal inhibition variation 1.Mainly used in acute settings, where tissue damage or pain precludes the use of the usual agonist contraction (use of antagonist) 2.Muscle is placed in a mid-range position 3.Isometric or Isotonic muscle contraction 4.On ceasing the effort, the patient inhales and exhales fully, at which time the muscle is passively lengthened Strengthening variation 1.Also called isokinetic contraction (also known as progressive resisted exercise) 2.Patient starts with a weak effort but rapidly progresses to a maximal contraction of the affected muscle(s) 3.Find area of weakness during full movement range 4.Strengthening of weak musculature in areas of permanent limitation of mobility is seen as an important contribution in which isokinetic contractions may assist