<Li> As the patient relaxes, agonist and antagonist muscles remain inhibited allowing the joint to be moved further into the restricted range of motion . </Li> <P> Despite the many claims made regarding the efficacy of these techniques, there are only two peer - reviewed studies that have shown that muscle energy techniques can significantly decrease disability and improve functionality in patients with disorders such as low back pain . </P> <P> Muscle energy techniques can be employed to reposition a dysfunctional joint and treat the affected musculature . Indications include, but are not limited to: muscular shortening, low back pain, pelvic imbalance, edema, limited range of motion, somatic dysfunction, respiratory dysfunction, cervicogenic headaches, and many others . </P> <P> These techniques are inappropriate when a patient has injuries such as fractures, avulsion injuries, severe osteoporosis, open wounds, or has metastatic disease . Additionally, because these techniques require active patient participation, they are inappropriate for any patient that is unable to cooperate . </P>

When is direct manipulation of the muscle used