Lumbar Spine Mechanics and MET- An Osteopathic Review Part 2

The difference between MFR and MET

• MFR -- Myofascial release of connective tissue used to elongate muscle fascia of different layers.
                 -- Ischemic release – manual technique used to trigger point taut muscle fibers.
• MET -- Muscle energy technique of direct pressure into direction of barrier.
                         -- Gentle release of muscle tone to promote joint biomechanics.
                         -- Isometric contraction for 6-10 seconds only as strong as needed.
                         -- Autonomic reciprocal inhibition which inhibits certain muscles from contracting through the muscle spindles which play an important role in flexibility.

Palpation of anatomical landmarks


• Spinous process -- start at bottom and move up
                              -- lower dysfunctions drive higher dysfunctions (i.e. L4 will affect L2)
                              -- palpation for Type 1 dysfunction; Fryette’s 1st law
                              -- L4 correlates with iliac crest
• Transverse process (TPs) – thumb-width away from spinous process
                                            -- L1-L4 = finger width higher than correlating spinous process
                                            -- L5 = directly lateral to correlating spinous process
                                            -- palpation for Type 2 dysfunctions; Fryette’s 2nd law


Type of Dysfunctions

• Type 1  -- Multi-segmental concavity restriction found in neutral spine position; follows Fryette’s 1st law                                                                                         
             -- Causes: leg length, scoliosis, large wallet, pronation
             -- Primary culprit is side-bending musculature: erector spinae
• Type 2 – Single-segmental rotational restriction found in flexion or extension; follows Fryette’s 2nd law
              -- Causes: trauma, repetitive injury, poor mechanics, gardener or painter
              --Primary culprit is deep rotators: mutlifidus
              -- Big driver of Type 1 dysfunctions