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MUSCLE ENERGY

Tony L. Marek, A.T.,C., M.S.


L-4 L-5 Flexion Dysfunction
• FRSL--Flexed Right • L-4 & L-5 usually act
Sidebent Left in pairs and usually
• FLSR--Flexed Left rotate opposite of the
Sidebent Right sacral torsion (right
backward sacral
torsion usually causes
FLSR of L-4 & L-5
L-3
FLSL & FRSR
ELSL & ELSL
• Lesion changes with • Lesion changes with
movement into movement into
extension, indicates flexion, indicates
segment(s) stuck in segment(s) stuck in
flexion extension
L-3 thru L-5
• Nerve root • Disc pathology
implications • Increased back pain
• Referred leg pain vs. referred leg pain
• Weakness associated
with nerve root
Facet Pathology
• Extension pain with • Sidebending pain to
limited rotation same side usually
pathology indicates facet
• Feels better with closed/stuck on that
flexion side
Muscle Energy
• Anatomical Considerations
• Assessment
– manual (“hands on”) evaluation
• Treatment
– treat what you see--look for patterns
– treat dysfunction vs. pain
– treat whole body vs. segments
• Pain Referral
– dysfunction on opposite side
– inhibited tissue
• Joint Interrelationships
– pelvis
– pubis
– sacrum
– ischial tuberosity
– thoracolumbar
• Iliopsoas
– release technique
– sciatic
– lumbar hypo-
mobility
– SI joint
• Iliocostalis/
Lumborum
– 11 & 12 ribs
– shortness of breath
– limited left and
right rotation
• Upslip
– iliopsoas
– QL
– ankle/limited dorsi
flexion
– ischial tuberosity
– inflare
• Downslip
– trauma
– pelvic floor
dysfunction
– hip/pelvic pain with
walking
– outflare
• Iliopsoas
– upslip
– inflare
– sciatic
– lumbosacral
dysfunction
• Quadriceps Group
– femoral nerve
– anterior iliac rotation