Muscle Energy Techniques 3rd Edition by Leon Chaitow | PDF Free Download.
As the art and science of neuromusculoskeletal care evolve, it is becoming increasingly clear that manual techniques are essential in the proper management of patients with problems in this area.
What is less easily measured, however, is the impact of the degree of skill with which these techniques are applied on the outcome of management.
Most clinicians who use manual techniques in the treatment of dysfunction in the locomotor system would agree, however, that the level of skill with which a practitioner applies a certain technique is of the utmost importance in the success of any management strategy.
Intuition would tell us that a clinician with limited skill and a limited variety of methods in his or her armamentarium would be less effective, especially for a difficult case, than one who possesses wide-ranging knowledge and ability.
It has been said that "you can't learn manual skills from a book". However, you can build upon an existing body of knowledge, skill and experience with a written source that introduces new methodology and instructs in the scientific basis and proper application of one's current methodology.
In addition, a written source of high-quality, clinically applicable information can be an xcellent source of support material when one is taking an undergraduate or postgraduate course in manual therapy. Dr. Chaitow has produced such a book.
One of the unique aspects of manual therapy that one discovers early on in practice is that no two patients are alike and no two locomotor systems are alike.
As a result, each patient requires a highly individualized approach that addresses his or her unique circumstances.
This means that one must be meticulous about identifying those specific dysfunctions, be they joint, muscle or otherwise, that are most important in producing the disorder from which the patient suffers, and choosing those specific treatment approaches that are most likely to correct the identified dysfunctions.
Muscle energy techniques (METs) are among the most valuable tools that any manual clinician can have in his or her tool box. There are many reasons for this.
First, METs have a wide application. This is exemplified by the presence in this edition of chapters specific to massage therapy, physical therapy and athletic training.
METs can be applied to muscle hypertonicity and muscle tightness, but can be equally effectively applied to joint dysfunction and joint capsule adhesions.
They can be applied to little old ladies or high level athletes, and anyone in between. Important modifications must be made for each application and each individual, as is demonstrated in this book.
But because the method is as flexible as it is, the clinician is provided with a tool that he or she can modify for a variety of types of dysfunction, and a variety of types of patients. Second, METs can be applied in a gentle manner.
In manual therapy, we always want to be as gentle as possible, in a way that still provides effective correction of dysfunction.
MET, particularly when applied to muscle hypertonicity and to joint dysfunction, is both gentle and effective.
For those of us who use thrust techniques, METs also represent a different method of applying joint manipulation that is well tolerated by the apprehensive patient, or the acute situation. And, MET has been shown to be equally effective as thrust techniques.
Third, METs actively involve the patient in the process. One of the essential ingredients in a successful management strategy involves empowering the patient to take charge of his or her own recovery.
This means that the patient must not be a passive recipient of treatment, but rather and active participant. Unlike many manual procedures, with METs the patient must be involved in every step, contracting at the appropriate time, relaxing at the appropriate time, engaging in eye movements, breathing, etc.
METs allow the clinician to apply corrective measures while at the same time beginning the process of transferring responsibility to the patient.
Finally, METs are effective. As Dr. Fryer demonstrates in his chapter, the research into the clinical efficacy of METs is in it's infancy. And he also points out the interesting challenges to effective research in this area.
However, Dr. Fryer also reveals that those studies that have begun to assess whether METs have an impact on clinical outcome have suggested that, when an overall management strategy includes the use of skilled METs, patients benefit to a greater degree than when these methods are not included.
In this book, not only is this research presented, but also, in Dr. Liebenson's chapter, the reader is instructed as to how these techniques can be incorporated into the overall rehabilitation strategy.
I can say for myself that I could not imagine how I would attempt to manage the majority of patients that I see without METs at my disposal.
But, for all these benefits of METs to be realized, one must apply them with skill and precision. And they must be applied in the context of a management strategy that takes into consideration the entire person.
This book represents an important step in this direction.
What has surprised and excited me most about the content of this third edition is the speed with which research and new methods of using MET have made the previous edition relatively out of date.
It's not that the methods described in previous editions are inaccurate, but rather that the theoretical explanations as to how MET 'works' may have been over-simplistic.
The diligent research, much of it from Australia, that is outlined by Gary Fryer DO in Chapter 4, reveals mechanisms previously unsuspected, and this may well change the way muscle energy methods are used clinically.
In addition, increasingly refined and focused ways of using the variety of MET methods are emerging, and excitingly many of these are from professions other than the usual osteopathic backgrounds.
MET emerged initially from osteopathic tradition, but what has become clear is just how well it has travelled into other disciplines,
with chapters in this book variously describing MET usage in chiropractic rehabilitation, physical therapy, athletic training and massage contexts.
For example: In Chapter 8 a chiropractic perspective is offered by Craig Liebenson DC, in which MET is seen to offer major benefits in rehabilitation.
The evolution of the methods outlined in that chapter also crossfertilize with the pioneering manual medicine approaches as taught by Vladimir Janda MD and Karel Lewit MD, with both of whom Liebenson trained.
These East European giants collaborated and worked with some of the osteopathic developers of MET. The clinical use of MET in treating acute lowback pain in physical therapy settings, as described in detail in Chapter 9, has identified very precise MET applications in which acutely distressed spinal joints have been successfully treated and rehabilitated.
Captain Eric Wilson PT Dsc, author of that chapter, gained his MET knowledge from impeccable sources at Michigan State University's School of Osteopathic Medicine.
There are fascinating descriptions in Chapter 11 of MET as used by athletic trainers Ken Crenshaw, Nate Shaw and Ron Porterfield in the context of a professional baseball team's (Tampa Bay Devil Rays) need to help their athletes to remain functional, despite overuse patterns that would not be easily tolerated by normal mortals.
Chapter 10 provides a respite from extremes of pain and overuse and illustrates the efficiency with which MET can be incorporated into normal therapeutic massage settings.
Here Sandy Fritz MS describes incorporation of these safe and effective approaches in ways that avoid breaking the natural flow of a traditional bodywork setting.
From my own perspective I am increasingly exploring the dual benefits gained by use of slow eccentric isotonic contraction/ stretches (see Chapters 3 and 5), and of the remarkably efficient 'pulsed' MET methods devised by Ruddy (1962) over half a century ago and described in Chapters 3 and 6.
In short, the expanded content of this third edition highlights the growing potential of MET in multidisciplinary and integrated settings and,
by offering an updated evidence base, takes us closer to understanding the mechanisms involved in its multiple variations.
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