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ISBN 978-0443064968. Buy on Amazon http://bit.ly/bLrEug 12. Sady SP, Wortman M, Blanke D. Flexibility training: Ballistic, static or proprioceptive neuromuscular facilitation? Archives Physical Medicine Rehabilitation 1982;63:261–263 13. Tubbs RS, Caycedo FJ, Oakes WJ, Salter EG. Descriptive anatomy of the insertion of the biceps femoris muscle. Clinical Anatomy 2006;19(6):517–521

14. Condon S,Hutton R. Soleus muscle electromyographic activity and ankle dorsiflexion range of motion during four stretching procedures. Physical Therapy 1987;67:24–30 15. Joanson I. Low force chiropractic adjustment and post isometric muscle relaxation for the ageing cervical spine: A case study and literature review. British Journal of Chiropractic 2001;5(3):50–59 16. Burns DK, Wells MR. Gross range of motion in cervical spine: The effects of osteopathic muscle energy technique on asymptomatic subjects. Journal of the American Osteopathic Association 2006;106(3):137–142 17. Lewit K, Simons D. Myofascial pain: Relief by post-isometric relaxation. Archives of Physical Medicine and Rehabilitation 1984;65:452–456 18. Wilson E, Payton O, Donegan-Shoaf L,Dec K. Muscle energy technique in patients with acute low back pain: A pilot clinical trial. Journal of Orthopaedic and Sports Physical Therapy 2003;33:502–512 19. Sharman M, Cresswell A,

Riek S. Proprioceptive neuromuscular

facilitation stretching mechanisms and clinical application. Sports Medicine 2006;36(11):929–939 20. Nelson KC, Cornelius WL.The relationship between isometric contraction durations and improvement in shoulder range of motion. Journal Sports Medicine Physical Fitness 1991;31(3):285–358 21. Shrier I, Gossal K. Myths and truths of stretching. Physician and Sports Medicine 2000;28:N8 22. Funk DC, Swank AM, Mikla BM, Fagan TA, Farr BK. Impact of prior exercise on hamstring flexibility: A comparison of proprioceptive neuromuscular facilitation and static stretching. Journal of Strength and Conditioning Research 2003;17(3):489–492 23. Taylor DC, Dalton JM, Seaber AV, Garrett WE. Viscoelastic properties of muscle tendon units. American Journal of Sports Medicine 1990;18(3):300–309.

BOX 3: TIPS FOR CLINICIANS CONDUCTING MET AND PNF

1. Know your anatomy Make sure you understand the origin, insertion and action of the target muscle. Then you will be able to place the limb in the most appropriate position to achieve the stretch. 2. Have a clear image of what you are trying to achieve You should know whether you hope to increase the muscle length or strength or recruitment. 3. Understand the stage of healing of the injury This is important because then you can determine whether a specific technique is appropriate in the first place and it will guide you towards the best approach to adopt (e.g. use of a 25% or 75% contraction). 4. Understand the possible side effects of your treatment For instance, remember that a 25% contraction decreases the risk of pain, tissue damage and provocation of muscle cramps. 5. Clinically reason your treatment Always assess the injury and decide the appropriate method of treatment for each individual. 6. Do not over-stretch over-enthusiastically There is a tendency to provide increased resistance or force resistance barrier which is likely to result in increased tissue provocation.

FURTHER READING Stone J. Muscle energy techniques. Athletic Therapy Today 2000;5(5):25 Surburg PR, Schrader JW. Proprioceptive neuromuscular facilitation techniques in sports medicine: A reassessment. Journal Athletic Training 1997;32(1):34–39 Wiemann K, Hohn K. Influences of strength, stretching and circulatory exercises on flexibility parameters of the human hamstrings. International Journal of Sports Medicine 1997;18:340–343.

TEST YOUR LEARNING

n When and how do you apply MET? n When and how do you apply PNF? n What is the difference between MET and PNF?

THE AUTHOR

Claire Farquharson MSc MCSP PGCHE works as a chartered physiotherapist and senior lecturer at Edge Hill University. She has a background in both sports science and sports massage

and has worked in professional rugby league and basketball. online

Launch the extra by clicking on the image

n Simple animation showing how muscle stretch receptors and Golgi tendon organs work (credit to Arthur Prochazka of University of Alberta)

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sportEX dynamics 2010;25(Jul):12-16