Introduction and Definition: The Facts

It is a manual therapy technique that uses a muscle's own energy to relax and lengthen the muscle through autogenic and reciprocal inhibition.

• Technique developed in 1948 by Fred Mitchell
• Based on autogenic and reciprocal inhibition cencepts

Indicationf for MET

MET can be used in the following situations:

• Conditions were the aim is to relax and lengthen the muscle
• Increasing joint range of motion
• Injury prevention to the joints and muscles
• Those with facte joint dysfunction in the neck and back; shoulder pain, scoliosis, asymmetrical legs, hips and arms
• Treatment of chronic muscle pain, stiffness and or injury

Autogenic Inhibition and Reciprocal Inhibition

Autogenic inhibition involves stretching of a submaximally contracted muscle. Reciprocal inhibition involves stretching of an antagonist following agonist submaximal contraction. For autogenic and reciprocal inhibition to happen, some muscles are inhibited following the activation of Golgi tendon organ (GTO) and muscle spindles. GTO and muscle spindles are musculotendinous proprioceptors in and around the joints. They respond to changes in muscle tension and length and this helps in muscular control of coordination.

Facts about autogenic and reciprocal inhibition:

• GTO is located in the muscle belly and its tendon
• Detects increased tension when a mucle contracts or stretches
• Activated GTO following muscular contraction or stretch inhibits the muscle's contraction (reflex inhibition) and allows contraction of the antagonist
• Improves flexibility by allowing agonist to be stretched further
• Usually seen during static stretches e.g. in low force, long-duration stretch
• Following contraction for about 10 seconds, tension in the muscle increases and activates GTO response
• Activation of GTO response temporarily inhibits muscle spindles (located in the muscle belly) in the stretched muscle, allowing further stretch of the agonist


• Activation of muscle spindles results in reflexive contraction of agonist muscle (stretch reflex) and relaxation of antagonist muscle to pruduce a reciprocal inhibition

Types of MET in Detail

Autogenic Inhibition

The two major types of Autogenic Inhibition MET are:

• Post Isometric Relaxation (PIR):

  This is a technique developed by Karel Lewitt. It refers to the decrease in muscle tone following a brief period of submaximal isometric contraction of the same muscle. The following is how to perform PIR:

  • Stretch the hypertonic muscle to a length before it starts paining or to the point of noticeable resistance
  • Ask the patient/client to submaximally contract (about 10%-20% of their normal contraction) their muscle away from the barrier fo about 5sec to 10 sec
  • Therapist applies resistance in the opposite direction and ask the client/patient to inhale during this effort
  • Ask the client/patient to exhale and relax following the isometric contraction
  • Follow this by a gentle stretch to take up the slack till the new barrier
  • Repeat the procedure for 2 or 3 times, starting from a new barrier

• Post Facilitation Stretching (PFS)

This is a technique developed by Janda. It is a more aggressive compared to PIR. However, it is still base don autogenic inhibition. The following is how to perform a PFS:

• Placing the hypertonic/tigh muscle between full stretch and a full relaxation
• Ask the client/patient to contract their agonist using a maximmum degree of effort for 5-10 sec while resisting the movement
• Ask the patient to relax and release the effort. During this time a therapist applies a rapid stretch to a new barrier and hold for about 10 sec
• Allow the client/patient to relax for about 20 sec before repeating the procedure for about 5 times
• Repeat the whole procedure again for 3-5 sets of about 5 repetitions, starting from between a fully stretched and fully relaxed muscle state as before

Reciprocal Inhibition

This involves contraction of agonist followed by stretching of antagonist. The following is how to perform Reciprocal Inhibition:

• Place affected muscle in mid-range position
• Ask the client/patient to push toward the restriction/barrier against therapist to create isometric or isotonic contraction
• Follow client/patient relaxation together with exhalation, while a therapist applies a passive stretch to a new barrier
• Repeat the procedure between 3-5 times and five times more i.e. 5 sets of 3-5 repetitions

Chimwemwe is a physiotherapist with experience in Malawi, Botswana and New Zealand. He currently holds professional registration with Australian Health Practitioner Regulation Agency (AHPRA), Botswana Health Professions Council (BHPC) and the Physiotherapy Board of New Zealand (PBNZ). Currently he is a practicing physiotherapist in New Zealand.

Disclaimer

Information on this page is for educational purposes only, for specific medical advice please consult a licenced healthcare professional.