OMM Muscle Energy Question/Help

[MedicineMike]

I get most of OMM thus far, but something that still trips me up is how to remember how to know what "side" to do ME techniques on.

For instance, if a patient is sidebent RIGHT (T5-T8), they are restricted in LEFT sidebending. so which way would you do the muscle energy techniques??

I get this confused literally every question I read! Is there an easy way to think about this?

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[Rollo]

It's a direct technique so you do the technique in the side that it is restricted.

Direct - engage the restriction
Indirect - engage the freedom

I remembered those two as direct technique, you're gonna directly go head on against the barrier. Think of the barrier as your enemies, or some attractive honeys at the bar on Friday night, and you're gonna directly engage them aka go hit on them.

In indirect, you'd engage the ease or the fat friend of the group.

Stupid analogy but whatever...

 

[Bacchus]

In the wise words of my professor (Rollo will know who), "Take them to the feather-edge of their barrier and tap them in the direction you want them to go." You should probably just follow Rollo's advice, though.

 

[MedicineMike]

In the wise words of my professor (Rollo will know who), "Take them to the feather-edge of their barrier and tap them in the direction you want them to go." You should probably just follow Rollo's advice, though.

I think I know the professor you speak of...

I remembered those two as direct technique, you're gonna directly go head on against the barrier. Think of the barrier as your enemies, or some attractive honeys at the bar on Friday night, and you're gonna directly engage them aka go hit on them.

In indirect, you'd engage the ease or the fat friend of the group.

Stupid analogy but whatever...

haha awesome.

 

[slammer922]

I dont do so well my long wordage, So I Remembered it as...
D E direct engage.
I D indirect disengage

Now naming somatic dysfunctions took me weeks to get.
Supination somatic dysfunction means u can't pronate? Now that's just dumb. Lol I def am enjoying omm tho it's kinda fun

 

[SLC]

I get most of OMM thus far, but something that still trips me up is how to remember how to know what "side" to do ME techniques on.

For instance, if a patient is sidebent RIGHT (T5-T8), they are restricted in LEFT sidebending. so which way would you do the muscle energy techniques??

I get this confused literally every question I read! Is there an easy way to think about this?

Side bend them left (while also engaging their other barriers: rotation and flexion/extension), and have them pull to the right against your resistance.

It's reciprocal inhibition: if you want to free up the musculature on one side of the vertebrae, you contract the contralateral musculature isotonically, this sends a relaxation reflex to the muscles on the dysfunctional side.

 

[123165]

Side bend them left (while also engaging their other barriers: rotation and flexion/extension), and have them pull to the right against your resistance.

It's reciprocal inhibition: if you want to free up the musculature on one side of the vertebrae, you contract the contralateral musculature isotonically, this sends a relaxation reflex to the muscles on the dysfunctional side.

A good thing to remember:

Name it for the way it likes to go. You would say T5-T7 N RrSL

The reason is this: This is the current position of T5-T7 (Stuck in Sidebending left and rotating right. ie it does not like to leave that position, it is difficult to sidebend right or rotate left. To do a direct technique (ME, HVLA) you need to engage the barrier by taking the body out of what it likes to do (ie opposite the diagnosis)

Diagnoses give where the body is currently at by convention.

Supination dysfunction means the limb is stuck in supination (ie cannot pronate well)

 

[premedmind]

T5-T8 NSrRl would be a group curve and the dysfunction is named for the freedom, i.e., the patient's freedoms are side bending right and rotating left, his restrictions are just the opposite: side bending left and rotating right.

To perform the ME technique you would stand on the side of the convexity, for a T5-T8 NSrRl, you would stand on the LEFT side, since side bending is to the right (producing a convex surface projecting to the left).

The whole principle behind ME is that you bring the patient to the "feathers edge" of his side bending and rotational barrier. Once you engage the barrier (ME is a direct - engaging barrier, and active technique - the patient does some work), the patient moves to his freedom of motion against the your counteractive isometrically applied force - the physician resists the patients movement to his or her freedom.

So, if we have a T5-T8 NSrRl, you will stand behind the patient, on the left side with his back facing you, MONITOR at the apex of the convexity with the index finger on right hand (at the posterior transverse process), SIDE-BEND the patient to his LEFT, and ROTATE him to his right (to an approximation of the "feather's edge" barrier). Then ask the patient to lift his left shoulder up to the ceiling (essentially you are asking the patient to move to his freedom - or right side bending). Resist his force for 3 seconds, then ask the patient to relax. Repeat this a total of 3 times with a passive stretch at the end. Reassess.

Some addl. notes: Since this is a group curve it is a neutral dysfunction (Type 1) and there is no flexion or side bending components - so you don't have to worry about flexion or side-bending. Type 1's are notated with the side bending component listed first, followed by the roation component (T6-T8 NSrRl) whereas Type 2 dysfunctions are notated with the ROTATION component written FIRST (T8 FRSl). The subscript for rotation left is omitted - side bending and rotation are coupled for Type 2 dysfunctions so it is understood that rotation is to the left.

Hope that helps. If there are any mistakes someone feel free to correct me. I took all of that off the top of my head and ME is pretty intricate so it's possible I made a mistake or two.

 

[thomprya]

disclaimer: im about 4 beers deep. I thought if it was a group dysfunction then the sidebending and rotation are to the same side eg. t4-7 SrRr. If the sidebending is made better or worse in flexion or extention then sidebending and rotation would occur in opposite directions and would only be one vertebra involved eg t3FSrRl

 

[Bacchus]

disclaimer: im about 4 beers deep. I thought if it was a group dysfunction then the sidebending and rotation are to the same side eg. t4-7 SrRr. If the sidebending is made better or worse in flexion or extention then sidebending and rotation would occur in opposite directions and would only be one vertebra involved eg t3FSrRl

A group dysfunction is a type 1 dysfunction in which sidebending and rotation are opposite. Single dysfunctions are type 2, sidebending and rotation the same.

If this is what you said, sorry, I just looked at the first few words.

 

[thomprya]

oops sounds like you are right, thats what I get for mixing two things I love....

 

[Bacchus]

oops sounds like you are right, thats what I get for mixing two things I love....

I feel you... I had several margaritas tonight 😉.