What is Muscle Energy Technique (MET)

Over the weekend I had a continuing education course for physical therapy to continue my license. The course dealt with using manual therapy, specifically muscle energy technique (MET), to correct problems of the pelvic girdle, sacrum, and lumbar spine. I have taken many courses over the years to learn my specialty of MET and I am very partial to the courses and education provided by Michigan State’s Osteopathic medical school and their manual medicine series. Michigan state has given me the knowledge and skill to treat my physical therapy clients outside of insurance, because of the great outcomes I get. The course I took was not a Michigan State course but it did provide a great review of the knowledge I already have along with reminding me how powerful MET is. Using physical therapy and MET is how I get such great outcomes far and above the norms and is why I can be an independent practitioner and not have to deal with insurance.

What exactly is MET? Muscle Energy Technique (MET) is defined as a form of soft-tissue treatment in which the patient’s muscles are actively used, on request, from a precisely controlled position, in a specific direction, and against a distinctly executed therapist-applied counterforce. The key defining element of MET is the use of an isometric contraction before subsequent stretching or movement of restricted tissues. What this means is if you have a sacrum/tailbone that is stuck in an abnormal position for example, I can put your body in a specific position and use your own muscle contraction to put the sacrum back in place. I can do this with your pelvis and the vertebra up and down the spine.

Using MET not only puts the bones back in the appropriate positions it also resets the normal length of the muscles that are involved in locking the bones into the abnormal position. When bones and joints are in abnormal positions this can cause muscles to shut down and significant pain that can become chronic unless the dysfunction is fixed appropriately.

Using manual therapy and MET takes time when done appropriately. I spend at least an hour evaluating leg length, the pelvic girdle, SI joints, lumbar spine, pubic symphysis, muscle strength and tightness. I then give physical therapy exercises that are very specific to help hold my adjustments in place that are a complement to the manual therapy. Treating by this method, in my opinion, can only be done appropriately on a cash based manner because of the time and attention involved. Insurance gets in the way of the best care I know I can give. In the long run, I am much cheaper than other treatment methods because my clients usually respond very quick and my goal is to have the pain mostly gone within 4 visits.

I am very passionate about what I do and using MET has allowed me to help many people and achieve great outcomes. I am greatly appreciative to all the instructors I have had over the years that have furthered my career and given me the knowledge to help people in pain.

Why Become A Case Of Failed Lower Back Syndrome?

Low back surgery is not something you should take lightly and one should understand what back surgery is trying to accomplish.  Back surgery is performed to either decompress and take pressure off a nerve to reduce leg pain or to stabilize unstable joints.  Having surgery completely changes the anatomy and how a normal spine works effecting the appropriate feedback loops into the system for muscle and joint control.  Often people go into surgery thinking all the pain will be gone.  This is not always the case.  Remember, surgery is done to either decompress the nerves or to stabilize the joints.  What happens if the pain that is being generated is not always coming completely from a nerve pinch or the instability of the joints?  In this situation, the pain will often still be present after surgery and the patient experiences failed lower back syndrome.  You don’t have to have surgery to experience a failed lower back either.  You may be someone that has been searching for pain relief without success; trying therapy, chiropractic care, injections all without help.  Often people that experience failed lower back syndrome have certain dysfunctions of the lumbar spine and pelvis that were never addressed properly.  If it is these dysfunctions that were involved in causing the pain in the first place, having surgery does not eliminate them, therefore pain often comes back or never goes away.  People with low back pain often have abnormal tailbone positions along with flexion (FRS) and extension (ERS) dysfunctions of the lumbar spine, dysfunction at the pubic symphysis, hip shear dysfunctions, a short leg pelvic tilt syndrome, and muscle imbalance of the trunk and lower extremities.  These abnormal spinal positions are called somatic dysfunctions.  Often, somatic dysfunctions are not treated by chiropractors or general physical therapy very well.  This is because identifying the somatic dysfunctions takes a very specific type of segmental diagnosis that is performed with osteopathy.  Once the dysfunctions are diagnosed and treated, then a specific strengthening and stretching program needs to be established to help prevent the return of pain and dysfunction.  Many people in society suffer from low back pain and it does not have to be this way.  What is often missing is the appropriate diagnosis of dysfunction with proper treatment with osteopathy.  Don’t let yourself become a failed lower back statistic.  Come to Wright Physiotherapy and get the appropriate treatment. 

Using Manual Therapy To Treat The Spines Of Student Athletes

Over the years I have treated many student athletes for about every injury and body part you could think of.  A lot of them have been post-surgical ACL reconstruction, ankle surgeries, shoulder surgeries along with the typical sprains and strains of every body part.  It is always fun because young adults tend to heal very well and they are motivated.  Post-surgical therapy takes time because you have to let the body go through its normal processes of healing with the inflammatory response, swelling, early stages of movement and eventual strengthening.  I always say you promote the healing process with therapy after surgery, you can’t force the healing process.  You let the body do its job and we as therapist promote and guide the healing along for the most efficient recovery possible. 

I have enjoyed post-surgical rehab but I find it quite simple at this time, and what I really enjoy is treating students that have not had surgery.  I especially enjoy treating students that have back and neck pain that won’t go away or basically an injury to the spine.  I often treat cases that have not responded to chiropractic care or have had physical therapy without much help and meds really haven’t done anything to help either.  Why do I like these difficult cases so much?  Honestly, I like them because they are not difficult cases at all, and as long as you make the right diagnosis, treat the problem correctly, the pain usually goes away very quickly.  Again, young adults heal very well and if you treat with the appropriate manual therapy, they respond quite quickly.  For example, I had a young lady not too long ago that injured herself in gymnastics doing a tumbling skill.  She had pain in her low back into her left hip.  She was walking with a limp and had a hard time standing upright.  This went on for a month or two without much help.  When she came to me all she needed was the appropriate manual therapy with corrections of a rotated sacrum along with abnormal rotations of her lumbar spine.  These dysfunctions were not allowing her to walk upright and were causing her glute muscles to shut down.  Because she is young she healed very fast after the appropriate treatment and a few exercises to engage the correct muscles.  I saw her two visits.  Another case was similar with a young student woke one morning with low back pain and hip pain that would not go away.  He was actually recommended to have surgery on his hip.  He came to me and also had rotations in his sacrum and lumbar spine along with some other dysfunctions present.  He was back to normal after 6 visits.  If he had not come to me who knows what the outcome would have been.  Again he was recommended for surgery and all it really took was the correct diagnosis and treatment to fix him.  Another example is a young man came to me after having pain in his shoulder and neck for years.  He had many kinds of treatment and nothing helped.  The problem was he had not had the appropriate manual therapy of his thoracic, cervical spine and shoulder.  All he had was therapy utilizing strengthening exercises and stretching and chiropractic care many times without much help.  Once I appropriately treated him with manual therapy his symptoms went away.

Next time your student athlete is having pain that won’t go away think about the type of treatment they have had.  If they have not had good manual therapy then that may be the next step to take. 


Physical therapy in Newark, Granville, and Pataskala, OH Areas

IMG_0166Are you looking for physical therapy or a physical therapist in Newark, Granville, or Pataskala, OH? If you answered yes to this, then you have come to the right place. Dr. Dan Wright is a Doctor of Physical Therapy and a physical therapist in the Newark, Granville, and Pataskala, OH area. He is a specialist in relieving pain and improving movement problems, and he can help you return to the activities you enjoy. Call us today to schedule an appointment 740-707-0354 or to answer any questions you may have. Thank you.

Physical therapists and personal trainers working together


Physical therapists are the experts in the field of movement and musculoskeletal injuries. We evaluate, diagnose, make assessments, and treat to get people back to their original level of functioning, but we are not the only skilled profession that is very in tune with how people move and function. Personal trainers are also highly skilled professionals that spend significant time with their clients watching how they move and perform physical activity. They are highly knowledgeable on muscles, how they work, and the kinds of activities to get the muscles strengthened back in shape. Physical therapists and personal trainers should have a symbiotic relationship and not work against each other. It is not a competition. We both want to keep people healthy. I have become a better physical therapist working with personal trainers and athletic trainers over the years. I know my limitations as a physical therapist when it comes to treating patients and getting them back to being as functional as possible. I am very good at making diagnoses when a patient comes to me with an orthopedic injury and I can get them back to a high level of function, but sometimes my skill level will only take the patient so far. For example a patient comes to me with, let’s say, a shoulder or low back injury. I will treat using manual therapy and appropriate exercises to reduce pain and hopefully completely rid the patient of pain, but sometimes I am not able to take the patient to the next level of healing due to the equipment I have at hand. In those situations I rely on personal trainers to use their knowledge and skill to complete the healing process using either more intensive exercises or cross fit training in a gym. Also, physical therapists and personal trainers can be good referral sources for each other. A personal trainer that has been injured can come to me and I can treat them, so they can return to the gym as quick as possible allowing them to work and make money. An injured personal trainer cannot make a living. When this happens trust is built between the personal trainer and myself. The personal trainer learns the healing powers of osteopathic manipulation, and I learn the skill of the personal trainers so I can refer my patients to them for quality training and they can also refer to me with injured clients.  A win win situation for both!

Importance of manual therapy


Medical science has grown by leaps and bounds with the discovery of new drug treatments, surgical procedures, and even improved diagnostic testing. This is all wonderful and has been able to help improve the lives of many patients, but what about patients who do not need surgery and medication is not helpful? It is often forgotten that what some patients really need is a healing touch. OMT (osteopathic manipulation technique) is a hands on manual medicine approach using hands to diagnose, treat and prevent injury. Physical therapists providing OMT will use specialized treatment techniques to stretch muscles, move joint, and relieve pain with gentle pressures. Sometimes OMT can prevent the need for surgery and the use of pain medications. People of all ages and backgrounds can benefit from OMT manual medicine to reduce pain, increase rom, and improve mobility. It works extremely well for patients that have muscle and joint pain also known as musculoskeletal injuries.

Here is an example of how OMT manual therapy can be very helpful. I recently had a gentleman with a shoulder problem. He had a hard time being able to lift his arm up over his head, and it was painful when trying to do so. He was told surgery was his only option. During his first visit I told him not only would I be able to help him but I could do it in 2 visits. I evaluated his shoulder using my hands to touch and feel what was wrong and was able to immediately start treating. His shoulder lacked the normal mobility it should have, which created pinching on his rotator cuff causing pain. I used OMT manual therapy to stretch and normalize his shoulder movement over 2 visits which allowed for complete resolution of symptoms. He now has normal use of his shoulder without pain. Remember, he was told surgery was his only option, and I fixed him in 2 visits that last 1 hour each. That is the power of OMT. Another example is a lady came to me due to having extreme pain in her low back and right hip for 4 years. She works at Walmart and has a physical job. She was sent for therapy and she, luckily, decided to come to Wright Physiotherapy because other therapy had not helped in the past. After examining her I began to treat her low back and hip using, again, OMT manual therapy. She had abnormal rotations in her lumbar spine and sacrum that needed to be corrected out. She came back the next week with almost 100% relief. She said she noticed significant pain reduction the night of the first visit. She came to therapy 3 visits and was ready to be on her own. Wow, complete relief after only 3 visits of physical therapy. It can be amazing! Those are just a couple examples of how manual therapy using OMT can be very helpful and life changing. If therapy has not been helpful in the past then it is time to try Wright Physiotherapy for better results!

Piriformis syndrome


Have you ever had pain in your rear end, or a tingle down the back of your leg that tends to get worse with pressure on the back of the leg, such as with sitting or even with walking? This can be occurring due to a condition called piriformis syndrome. The piriformis muscle is located in the rear end area and functions to extend, externally rotate, and abduct the hip. It is involved in providing stability to the hip. The sciatic nerve can run underneath or directly through the piriformis and can also be involved if the piriformis muscle becomes dysfunctional.

What can be done to help alleviate the pain from piriformis syndrome? Strengthening and stretching of the piriformis and hip is a typical treatment in physical therapy along with modalities such as electrical stimulation and ultrasound. This may or may not be helpful. What needs to be looked at is WHY the piriformis is dysfunctional. The piriformis becomes dysfunctional due to over use that occurs from abnormal function of the hip and low back. When the glute max and glute medius hip muscles are inhibited and aren’t doing their job because of somatic dysfunction of the low back, the piriformis is one of the muscles that becomes overworked to help stabilize the hip and pelvis. This creates the overuse syndrome of the piriformis, and since the sciatic nerve runs underneath or through the piriformis muscle it can be aggravated causing sciatica down the leg.

Training in osteopathy and manual therapy is imperative to getting proper diagnosis and correction of the pathology. This is due to the spine needs to be looked at for abnormal movement mechanics that causes the glute max and medius muscles to shut down. Explained earlier, when these muscle shut down the piriformis becomes overused, dysfunctional and painful. What will be done at wrightphysiotherapy is the spine dysfunction will be diagnosed and treated using manual therapy. This will let the glute max and medius muscles start working correctly, and then the appropriate exercises will be given to maintain the corrections and to strengthen the system promoting the continued appropriate function of the muscles. When this is done, the piriformis muscle use lessens, letting it relax and calm down. This reduces irritation and the symptoms go away. Unless hands on manual therapy is performed, the body has a very hard time allowing symptom reduction to occur. Manual physical therapy at wrightphysiotherapy is the best option for pain reduction fast!

Physical therapy using manual therapy for treatment of pain.

Hands on manual therapy using osteopathic manipulation techniques is the most effective way to treat orthopedic pain!  The philosophy of osteopathy is to treat the body using manipulation to get the body to function as efficiently as possible, and then work on appropriate strengthening exercises to prevent the pain from returning.  For example, with low back pain the movement of the individual vertebra in the low back need to be improved for normal function and then appropriate core strengthening and stretching needs to be done to allow the body to heal efficiently.