The first description of the muscle energy technique is attributed to Fred Mitchell Sr., who first published his work in 1958. This publication was a summary of his work from the 1940s and 1950s. He described “one method of correction” using the effort of an extrinsic guiding operator as the activating force plus the use of respiration and muscular cooperation. However, a similar technique was developed independently by Kabat et al., called proprioceptive neuromuscular facilitation (PNF). PNF, although similar to muscle energy, was not widely known at the time Mitchell published his work.

The first techniques were directed at the pelvis, specifically targeting the sacroiliac joints, which at that time were considered immovable. As the muscle energy technique developed and grew, more of the spine was incorporated, then the extremities. In 1970, Mitchell began to teach his principles in a 5-day tutorial. In 1981, the existing five osteopathic medical schools began teaching these tutorials. This technique has now become part of the standard osteopathic manipulation therapy (OMT) curriculum in all osteopathic medical schools (1). Its popularity has crossed over into physical therapy and some athletic training programs, where many of these clinicians become trained in this technique to apply in their clinical settings.

Muscle energy is classified as a direct technique in which the restrictive barrier is actively engaged to contract a muscle in a precisely controlled fashion against a distinct counterforce (2). It can be used to stretch out tight muscles and fascia, or mobilize a restricted joint. When treating segmental dysfunctions using muscle energy, eight essential steps must be followed (3):

If these steps are not followed, the treatment will be ineffective. Typical errors include failing to monitor the segment during treatment, using too much force or too short a duration of contraction by the athlete, not allowing for complete relaxation before or not engaging the new barrier, and/or not retesting after the treatment is completed (3).

Engaging a restrictive barrier and then using an isometric contraction causes inhibition of the
agonist muscle through the Golgi tendon organ (GTO) (1). Muscle energy technique uses the GTO’s reciprocal inhibition of the agonist and, to a lesser extent, antagonist muscle. This brief relaxation allows for a further engagement of the restrictive barrier. In 1967, Houk and Henneman demonstrated the GTO’s sensitivity to minute changes in tension of the tendon and its complementary functioning with the muscle spindle fiber to execute a smooth, coordinated motor performance. This reciprocal relationship modulates muscular tension (3).

The treatment goal of muscle energy, as it is with many other manipulative techniques, is to restore the normal physiologic motion to the joint or area. By using muscle energy, the clinician can continue treating the restrictive barrier until the normal physiologic barrier is regained. By its actions on the GTO and muscle spindle, muscle energy can reduce the tone of hypertonic muscles and reestablish normal muscle resting length. This is especially important in regions that have chronic pain that cause muscular restrictions, hypertonicity, and spasm.