Hello, everyone. I’ve noticed that my page on the Muscle Energy Technique is one of my pages that gets the most traffic from search engines. It seems like a topic people are really searching for answers on, so I figured I’d try to explain some more of the specifics.
I use the Muscle Energy Technique, or MET for short, to realign my SI joints. Technically speaking, what I am doing is using muscle contractions to pull my hip bones back into place, relative to my sacrum, or the base of my spine.
When my SI joints are out of place, it means that one hip bone has rotated forward in relation to the spine, and the other has rotated backwards. (Because the pelvis one big ring, one hip bone will always go in the opposite direction from the other).
How do you know what you’re correcting?
How to know which way your hips are rotated is not something you should expect to be able to tell right away. For me, I had a physical therapist establish that my hips were rotated the same way over several weeks’ worth of visits. So I learned what it felt like, and my PT told me that as long as I felt my hips were still rotated that way, it was okay for me to use the protocol she’d taught me to correct them.
So again– the purpose of my blog is to help get you started, and figure out what you should be looking for from a professional who can help teach you these things in person. I don’t expect you to come away from this post ready to perform MET on yourself. So, for general informational purposes, let me go on.
What are you actually doing?
In order to understand MET, you need to understand that all of the muscles in your body have something called origin and insertion points.
Generally speaking, when a muscle contracts, that means it’s shortening. It’s pulling one bone, as part of a joint, closer to another.
For example, when you flex your bicep, that muscle is getting shorter. It’s lifting your forearm up closer to your upper arm, pulling them closer together. Where the bicep starts, up by your shoulder, is the origin. And where it attaches to the forearm is the insertion.
Another example is when you lift your leg up in front of you to take a step. That happens because your hip flexors are getting shorter, pulling your leg bone up towards to your hip bone.
The origin is the “anchor” or “base” of a muscle– the part that doesn’t move.
And the insertion point of a muscle is on the bone that is going to move.
So, where your hip flexors attach to your hip bone, it’s the origin. And where they attach to your leg bone is the insertion.
SO. How does this relate to MET?
When you perform MET, you are actually using resistance to switch the origin and insertion point of a muscle.
Huh?
A muscle can contract both ways. Its origin and insertion points can switch, depending on what the body needs to do.
So let’s go back to those hip flexors. Under normal circumstances, if you contract those muscles, they will pull the leg bone (insertion) up towards the hip bone (origin).
However, if you use a form of resistance against the leg so that it can’t move, the muscle can perform the opposite function. With the leg bone unmoving, it can actually become the origin for the hip flexors, which will then pull in the hip bone instead. This makes the hip bone the insertion, for this muscle contraction.
So, if you want to use the hip flexors to pull the hip bone forward, towards the leg bone, you can use a gentle form of resistance, such as a foam roller or even your hands. This is what you would do on the side where your hip bone had rotated backwards, and you wanted to bring it back into position.
And on the side that your hip bone is rotated forward?
You can use the exact same principle to bring the other hip bone back into alignment (remember they rotate in opposite directions from each other).
So, if one of your hip bones has rotated backward in relation to the sacrum, the other one will be forward.
To bring it back, you can engage the muscles in the back of the hip– the ones that normally lift your leg up behind you and bend your knee.
Again, you can use a foam roller or your hands to stop your leg from actually moving. So, when you contract these muscles (the hip extensors and hamstrings) they will pull on your hip bone and pull it back.
What does this look like?
You are lying on your back on a comfortable surface, that isn’t too hard or too soft (both can actually push your joints back out of alignment).You can play around with what works for you. (I use my stretching table, but technically speaking, you can just put exercise mats on the floor or even use your bed, if those work for you. We’re all different, and I’m starting to believe that very few people’s joints are as hypermobile as mine).
And, as I said, you can either use your hands or a foam roller to create resistance, and make it so your legs don’t move. (I need to get some visuals up, I know).
In a nutshell:
Hip bone that is backwards– contract hip flexors (muscles in front of the hip) and bring it forwards.
Hip bone that is forwards– contract hip extensors (muscles in back of the hip) and bring it backwards.
Okay, I hope this helps. I know this is a super complicated concept, so please do not be discouraged. It took me years to even find a physical therapist who taught me about it, but I hope that by writing about it, and letting you know it’s even out there, I can speed up the process for you.
Good luck!
Related posts:
Key Points of My Recovery:
- #6 When someone finally told me only one SI joint could lock up at a time
- #7 Learning to adjust my own SI joints
- #8 Discovering chiropractic adjustments had been re-spraining my ligaments the entire time (and switching to using only MET)
Some thoughts on hypermobile joints
What happens when an SI joint gets stuck? (a more detailed explanation of the rotation of the hip bones)
My Sacroiliac Joint Saga 
How often can/should you do this. I feel like I’m in pain all the time, I’m not sure when I’m when I start to loose my adjustment. I’ve been seeing a chiropractor, but think I’m stopping after reading your posts. Thank you!!!
LikeLike
You are welcome! Have you tried working with a physical therapist? It can be hard to find someone who’s knowledgeable about the SI joint, but once you do it’s totally worth it. The exercises on my blog are not meant to be a substitute for PT— they’re meant to get you started in the right direction.
I wouldn’t expect you to be able to teach yourself how to use the Muscle Energy Technique on your own. It’s really important to know which way your hips are rotated before you try to correct them, or else you can potentially make things worse.
So wif you work with a PT, they can help you figure out which pattern of imbalance you want to be correcting.
Once my PT taught me how to do this, and identified what my pattern of imbalance was, she told me not to do it more than once a day to start out with, because overdoing it could cause problems too. But as the weeks went on, I built up more of a tolerance, and corrected my alignment any time I needed to.
LikeLike
P.S. sorry for the multiple edits to my comment— I tried to answer your question via the WordPress app on my phone and it didn’t go very well!
LikeLike
Hello, I’ve had lower back issues for 20 years and believe the root cause is my SI joint. I’ve gone to the chiropractor for years in the past, but he focused on upper cervical and I think I’m done there. I just had my first trip to a massage therapist this week, and she showed me how my hips were out of alignment. The day she adjusted me, my right leg pointed straight while walking, it has always angled slightly to the right. The next few days feel like I’ve gone backwards, I have less mobility and more pain on the right side.
Have you had any experience with massage therapy versus physical therapy? Any input?
LikeLike
Hi Shane,
I hate to sound totally negative, but I personally have only had bad experiences with massage therapists trying to work on the SI joints. I don’t feel that most massage therapists have had enough training to know what to do with the SIJ’s. Of course, when someone says they are doing an “adjustment” this can mean any number of things, so I don’t know what your MT did. But if you felt better temporarily and then worse afterward, this could be a sign that whatever she did was too vigorous for your body, and likely put more strain on your ligaments than they could handle. It doesn’t sound to me as though she was using the Muscle Energy Technique.
Personally, I found that I couldn’t even receive massage to the muscles directly surrounding the SI joint. Even the most gentle of techniques could still cause my joints to move out of alignment and lock up. I know that I personally have extremely hypermobile joints, so this may not be as much of an issue for everyone.
It took me a long time to work out a routine with the one massage therapist I really trust, but even to this day, I don’t have her work directly on the muscles around the SI joint. Luckily, I’m able to get by with having her work on other areas, and making sure that I stick to a careful stretching routine. Here’s a post that talks more about this: https://sijointsaga.com/2017/10/16/massage-sacroiliac-joint/
I think it’s a much better idea to see a physical therapist with experience in treating the SI joint. Unfortunately, as anyone reading my blog probably knows, they can be hard to find. But they are out there! The Muscle Energy Technique, when done properly, should be gentle and won’t cause you to experience any setbacks.
LikeLike
I totally get and agree with everything above, but I can’t wrap my head around which leg needs to push and which needs to pull if laying in supine position (I have a chronic right posterior hip rotation) — have you found a video that explains this well?
LikeLike
Hi Kayla, glad the post was helpful. Before trying MET on yourself, though, it’s really important to consult a good PT to check which way your pelvis is rotating. There are other patterns of imbalance that you can have, other than the ones I describe here. You can actually make things worse if you try to correct the wrong thing.
BUT to answer your question– yes, I did find a video where the person is contracting the muscles to correct the imbalance I describe here. It’s in this post: https://sijointsaga.com/2017/10/10/muscle-energy-sacroiliac/
LikeLike
Hi Christy, I’ve had this exact problem now for over 3 years and have been given exercises by a physio which have just aggravated it! So firstly thank you so much for sharing this, its just what I need! Secondly, how long should each M.E.T session go on for?
LikeLike
Hi Ray, I’m glad my blog could help. That is a great question — the answer can be very individual, however. Check out this post for more: https://sijointsaga.com/2019/09/02/dos-and-donts-for-the-muscle-energy-technique/
LikeLike
Have you tried steriod injection for your SIJ pain? If yes did it work? I will be getting and injection but not sure if it will help me.
LikeLike
Hi Mahnoor, I personally didn’t try the injections. Some people do find them helpful, although they are not completely without risks.
You can read more about SI injections in this post series: https://sijointsaga.com/2018/02/19/lidocaine-injections/
LikeLike
Hi Christy,
i’m trying to picture what you are saying “Hip bone that is backwards– contract hip flexors (muscles in front of the hip) and bring it forwards.” Can you do a little diagram?
LikeLike