Osteopathic manipulative medicine involves an assortment of manual techniques and is utilized by many osteopathic physicians to treat a wide range of conditions. Low back pain is a common complaint encountered by many clinicians and proves to be challenging to diagnose and treat. Studies have shown about 85% of patients presenting with low back pain complaints are unable to be provided with a precise diagnosis for their symptoms. As specific etiologies are less commonly identified, continuous pain leading to limitations in activities results in decreased quality of life for patients. Muscle energy techniques (MET) have been an essential tool in correcting structural restrictions leading to low back pain, especially related sacral dysfunctions.

These techniques were initially developed by Dr. Fred Mitchell, Sr. and later refined by Dr. Fred Mitchell, Jr., both osteopathic physicians. MET maneuvers employ an isotonic contraction produced by the patient to engage the dysfunction and is restricted by the physician with a counterforce. Each contraction is repeated three to five times with a relaxation and stretch phase in between as the physician moves the patient in a controlled motion until meeting the next barrier. The isometric contraction creates a reciprocal inhibition and relaxation of the antagonistic muscle, effectively treating soft tissue restrictive barriers and mobilizing joints. This process, in turn, reduces pain and improves circulation. Sacral motion within the SI joint can produce several dysfunctions: anterior torsion, posterior torsion, and unilateral flexion or extension dysfunctions. This article will discuss how to diagnose such sacral dysfunctions and describe muscle energy techniques used to correct such dysfunctions.