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Muscle Energy Technique for the Tensor Fascia Latae

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, All Lower Quarter, All Manual Therapy, Hip EXT Firing Pattern, Muscle Energy

Muscle Energy Technique for the Tensor Fascia Latae

Muscle Energy Technique for the Tensor Fascia Latae

  • Therapist maintains firm contact on the right ischial tuberosity
  • Therapist’s right hand externally rotates the femur, extends the hip and then adducts the hip to the barrier
  • Subject is asked to abduct the hip for 5-7 seconds
  • Upon relaxation the therapist introduces
    further hip adduction to a new barrier
  • This is repeated 3-4 times
 

Muscle Energy Technique for the Iliopsoas

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, All Lower Quarter, All Manual Therapy, Hip EXT Firing Pattern, Muscle Energy, Pelvic Clocks, Supine Curl Up, Supine Heel slide

Muscle Energy Technique for the Iliopsoas

Muscle Energy Technique for the Iliopsoas

  • Therapist blocks subject’s left foot with his left foot
  • Therapist stabilizes the right ischial tuberosity with his left hand and IR the femur with his right
  • Therapist then applies traction and lifts the hip into extension
  • Subject attempts to flex the hip for 5-7 seconds
  • Upon relaxation the therapist lifts the leg into further hip extension to a new barrier while maintaining IR of the femur
  • This is repeated 3-4 times
 

Muscle Energy Technique to Stretch the Right Scalenes

in 3 Movement Tests Upper Quarter, 4 Manual Therapy Strategies, All Manual Therapy, All Upper Quarter, Muscle Energy

Muscle Energy Technique to Stretch the Right Scalenes

  • The patient’s head and neck, down to T2, are brought off the end of the table and supported by the therapist’s L forearm. The patient is instructed to grasp the table with their right hand to stabilize the first rib.
  • The therapist grasps the base of the occiput with the left hand and places their left shoulder against the patient’s forehead.
  • The therapist’s right hand is placed over the top of the patient’s right shoulder to further stabilize the first rib.
  • The therapist translates the patient’s head straight down towards the floor maintaining upper cervical spine flexion by keeping the patient’s chin down at all times. The therapist then adds side bending of the head to the left and rotation back to the right, maintaining the AP translation.
  • The patient is asked to take and hold a deep breath and raise the head up against the therapist’s L shoulder for 5 to 7 seconds.
  • Upon relaxation the therapist takes up the slack by increasing the AP translation, left side bending and right rotation.
  • This procedure is repeated 3 to 4 times.
  • Assessment of right to left translation of the typical cervical spine (C3-7) before and after treatment of the right scalenes helps to confirm your success with this treatment.

Muscle Energy Technique for FRS Dysfunctions T6-10

in 3 Movement Tests Upper Quarter, 4 Manual Therapy Strategies, All Manual Therapy, All Upper Quarter, Muscle Energy, Scapular Depression, Shoulder Abduction, Shoulder Circle, Supine Shoulder Flexion

Muscle Energy Technique for FRS Dysfunctions T6-10

For an FRS R from T6-10:

  • The patient places their R hand on their L shoulder and the therapist reaches under the patient’s R arm and grasps the patient’s L shoulder.
  • The therapist palpates the L side of the interspinous space monitoring the superior aspect of the inferior spinous process, ie., FRS R T8,9 the therapist monitors the superior aspect of the spinous process of T9 on the L side.
  • Initially the patient is sitting with their spine flexed and the therapist asks the patient to slowly sit up by pushing the belly forward to introduce extension from below up to the palpated interspinous space.
  • The therapist introduces slight L rotation down to the palpating finger.
  • The therapist then translates the patient from L to R to introduce L side bending without closing down and pinching at the interspinous space.
  • The patient attempts to R SB for 5-7 seconds which the therapist blocks.
  • When the patient relaxes the therapist repositions the patient to the new motion barrier by first standing up to decompress the segment, then rotating the patient to the L and finally translating the patient from L to R to the new L side bending barrier.
  • No pinching should be felt at the palpated segment by the therapist or the patient.
  • This entire sequence is repeated 3 to 4 times then mobility is reassessed.

Muscle Energy Technique for the Levator Scapulae

in 3 Movement Tests Upper Quarter, 4 Manual Therapy Strategies, All Manual Therapy, All Upper Quarter, Cervical Flexion Mobility, Manual Stretching, Muscle Energy

Muscle Energy Technique for the Levator Scapulae

To stretch the right levator scapulae:

  • The patient is left side lying with the head positioned in flexion, left side bending and left rotation.
  • The operator’s right hand is placed on the lateral aspect of the neck from C1 through C4 to stabilize the cervical spine. The operator’s left hand is placed over the patient’s right shoulder in front of the clavicle so that the shoulder can be brought into posterior tilt with depression of the medial border of the scapula. The patient’s right hand should be placed upon and remain on top of the right hip.
  • The patient is instructed to raise the right shoulder towards their ear which is resisted by the therapist for five to seven seconds.
  • Upon relaxation further posterior tilt and depression of the scapula are introduced by the therapist.
  • This procedure is repeated 3-4 times.

Muscle Energy Technique for ERS Dysfunctions of the Upper Thoracic Spine

in 2 Movement Tests Lower Quarter, 3 Movement Tests Upper Quarter, 4 Manual Therapy Strategies, All Lower Quarter, All Manual Therapy, All Upper Quarter, Cervical Flexion Mobility, Manual Stretching, Muscle Energy, Pelvic Clocks, Shoulder Abduction, Shoulder Circle

Muscle Energy Technique for ERS Dysfunctions of the Upper Thoracic Spine

For an ERS R from C7 to T5:

  • Patient places their R arm on your R leg with their whole arm resting and supported on your R thigh.
  • Place your R hand gently on top of their head and your L thumb on the L side of the interspinous space of the dysfunctional segment to monitor the motion barriers.
  • The patient is initially sitting in a slumped position, but with their head up. Ask the patient to sit up tall from below up by pushing their belly forward until you feel motion at your palpating L thumb.
  • Then with your R hand move the patient’s head from an extended position into flexion introducing flexion from above down to your palpating L thumb so that you create an apex for flexion at the dysfunctional segment.
  • L side bending is then introduced by translating your R leg to the R to create an apex for L side bending at your palpating L thumb.
  • The therapist then adds L rotation thru the head from above down to the dysfunctional segment making sure to go to just the feather edge and not beyond the motion barrier.
  • The patient is instructed to gently side bend their head to the R or pull their R arm down on your leg for 5-7 seconds.
  • When the patient relaxes you introduce additional L side bending to the new motion barrier by translating your R leg further to the R.
  • You repeat 3 to 4 times then reassess.

Supine Piriformis Self Stretch Above 90 Degrees

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Manual Therapy, Muscle Energy, Self Stretch

Supine Piriformis Self Stretch Above 90 Degrees

To Stretch the Left Piriformis:

  • Have the patient reach under the left leg and grasp underneath the ankle with their right hand and under their left knee with the left hand.
  • Instruct the patient to draw the left and ankle towards their right shoulder using both hands.
  • A stretch should be felt in the left buttocks.
  • Then have the patient push their left knee and ankle into both hands for 5-7 seconds, when the patient relaxes have them draw their left leg further up towards the right shoulder.
  • Have them repeat 3-4 times progressively drawing the left leg further up towards the right shoulder upon each relaxation.
  • Then have them repeat this exercise on the right side.

Piriformis Self Stretch Above 90 Degrees

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Manual Therapy, Muscle Energy, Self Stretch

Piriformis Self Stretch Above 90 Degrees

To Stretch the Left Piriformis:

  • Starting from the hands and knees position, the patient places the left foot across and underneath the trunk so that the arch of the foot is facing the ceiling with the left knee remaining outside of the trunk.
  • Have the patient stretch out the right leg straight behind them while keeping the pelvis straight.
  • Instruct the patient to gradually sink down until they feel a stretch in the left buttocks. You can have the patient either stay up with their elbows extended or have them come down to rest on their forearms.
  • Ask the patient to press their left leg straight down into the table or floor for 5-7 seconds, then relax and stretch further by sliding the right leg further back making sure that they keep the pelvis level.
  • Repeat a series of contract/relax efforts 3-4 times.
  • No pain should be felt in the left knee or low back during this exercise.

Piriformis Self Stretch Below 90 Degrees

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, 5 Home Exercise Strategy, All Home Exercises, All Lower Quarter, All Manual Therapy, Muscle Energy, Self Stretch

Piriformis Self Stretch Below 90 Degrees

To Stretch the Left Piriformis:

  • Have the patient place their left foot outside of their right knee and flat on the table.
  • The patient places their left hand over the left pelvis to stabilize and places the right hand over the lower left thigh, a towel or belt wrapped around the lower left thigh will also work.
  • Have the patient maintain an active contraction of the right leg to keep it straight.
  • Instruct the patient to slowly pull the left leg across until a stretch is felt in the left posterior hip area.
  • From this position a series of contract/relax efforts can be made for 5-7 seconds, progressively stretching into further adduction or the stretch can be maintained for 30 seconds and repeated 2-3 times.

Piriformis Stretch Above 90 Degrees of Hip Flexion

in 2 Movement Tests Lower Quarter, 4 Manual Therapy Strategies, Active Trunk Rotation, All Lower Quarter, All Manual Therapy, Manual Stretching, Muscle Energy, Rolling

Piriformis Stretch Above 90 Degrees of Hip Flexion

  • Therapist externally rotates the leg, then adducts the leg towards the opposite shoulder
  • Patient is instructed to push out with both the knee and ankle; if external rotation is more limited, push out with the ankle only
  • Upon relaxation the therapist adds further adduction and/or ER to the new barrier
  • Repeat 3 to 4 times
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