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Side-bending Muscle Energy Technique (MET) for the cervical spine

This is an excerpt from Spinal Manipulations and Mobilization Techniques by John Gibbons.

This PIR technique will predominantly encourage lengthening of the muscles involved with cervical spine side bending and shoulder girdle elevation—the upper trapezius and levator scapulae muscles. This MET will encourage lengthening of the muscles but will also promote the cervical facet joints opening and closing; therefore, it can be classified as an articular technique as well as a soft-tissue technique.

Place the patient’s left cervical spine into a right-side bending position until a point of bind is felt. From this position, ask the patient to take a breath in, and on the out breath ask them to either side bend the cervical spine to the left or elevate the left shoulder against a resistance for approximately 10 seconds. Alternatively, you can request the patient to perform both actions at the same time against your resistance (figure 7.31).

Figure 7.31. The patient is asked to side bend the cervical spine to the left, or elevate the left shoulder, or sometimes both.
Figure 7.31. The patient is asked to side bend the cervical spine to the left, or elevate the left shoulder, or sometimes both.

Another way of communicating the technique is to ask the patient to bring their ear to their shoulder, or the shoulder to the ear, against a resistance, holding for 10 seconds. After the 10-second contraction, ask the patient to relax, take a breath in, and on the relaxation phase, the cervical spine is taken further into a right-side bend (figure 7.32). If the cervical side bending causes any discomfort, the shoulder can be taken into further depression, because this will also have the effect of lengthening the upper trapezius.

Figure 7.32. The therapist guides the cervical spine into right-side bending to lengthen the upper trapezius.
Figure 7.32. The therapist guides the cervical spine into right-side bending to lengthen the upper trapezius.

For an RI method, take complete control of the patient’s cervical spine and shoulder as described above. From this position, ask the patient to reach slowly toward their lower left leg with their left hand, until a point of bind is felt (figure 7.33).

Figure 7.33. The patient is asked to depress the shoulder girdle, activating the lower trapezius; this will relax the upper trapezius through RI.
Figure 7.33. The patient is asked to depress the shoulder girdle, activating the lower trapezius; this will relax the upper trapezius through RI.

This approach will activate the lower trapezius, as the patient is causing a depression of the left shoulder girdle. This will induce an inhibition of the left upper trapezius, allowing a safe way of lengthening because it will override the activation of the muscle spindles.

More Excerpts From Spinal Manipulations and Mobilization Techniques

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