Victor Forge
Muscle inhibition is a condition that is not widely recognised by modern medicine. It occurs when a muscle receives no or distorted neurological input, causing it to feel sluggish and lack range of motion. This can lead to further injuries and decreased performance as the inhibited muscle cannot stabilise the injured joint, resulting in chronic or recurrent injuries. Inhibition can be caused by danger messages communicated from the body to the spinal cord, known as afferent input. Messages from the spinal cord control muscle tone, and balanced muscle tone is too complex to be processed by the brain, so we rely on spinal reflexes for most of our movements. Techniques such as Muscle Energy Technique (MET) and Post Facilitation Stretch (PFS) can be used to treat muscle inhibition and improve range of motion.
Characteristics and Values of Actions that Inhibit Muscles
| Characteristics | Values |
|---|---|
| Medical term | Muscle inhibition |
| Cause | No or distorted neurological input |
| Cause | Danger messages communicated from the body to the spinal cord |
| Cause | Inhibitory signals flooding the spinal cord |
| Effect | Muscles feel sluggish and lack range of motion |
| Effect | Joint instability |
| Effect | Increased vulnerability to injury |
| Effect | Inhibits rehabilitation |
| Treatment | Muscle Energy Techniques (MET) |
| Treatment | Isometric exercises |
| Treatment | Post Facilitation Stretch (PFS) |
| Treatment | Rapid deafferentation techniques |
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What You'll Learn
Autogenic Inhibition and Reciprocal Inhibition MET
Muscle Energy Techniques (MET) are advanced soft tissue techniques used to treat mechanical neck pain (MNP). MET is a form of manual therapy, widely used in osteopathy, that uses a muscle's own energy in the form of gentle isometric contractions to relax and lengthen the muscle. MET is an active technique in which the patient is also an active participant. It was developed in 1948 by Fred Mitchell, Sr, D.O.
Autogenic Inhibition MET and Reciprocal Inhibition MET are two types of MET. If a sub-maximal contraction of the muscle is followed by stretching of the same muscle, it is known as Autogenic Inhibition MET. This technique is often seen during static stretching, such as during a low-force, long-duration stretch. After 7 to 10 seconds, muscle tension increases and activates the GTO response, causing the muscle spindle in the stretched muscle to be inhibited temporarily, which makes it possible to stretch the muscle further. The muscle spindle is located within the muscle belly and stretches along with the muscle itself. When this occurs, the muscle spindle is activated and causes a reflexive contraction in the agonist muscle (known as the stretch reflex) and relaxation in the antagonist muscle. Autogenic Inhibition MET is more beneficial than Reciprocal Inhibition MET in improving pain, range of motion, and functional disability in patients with sub-acute and chronic mechanical neck pain.
On the other hand, if a sub-maximal contraction of a muscle is followed by stretching of the opposite muscle, then this is known as Reciprocal Inhibition MET. Reciprocal inhibition is a neuromuscular process in which muscles on one side of a joint relax to allow the contraction of muscles on the opposite side, enabling smooth and coordinated movement. This concept was introduced by Charles Sherrington, a pioneering neuroscientist, and is also referred to as reflexive antagonism in some allied health fields. Sherrington observed that when the central nervous system signals an agonist muscle to contract, inhibitory signals are sent to the antagonist muscle, encouraging it to relax and reduce resistance. This mechanism, known as reciprocal inhibition, is essential for efficient movement and helps prevent muscle strain by balancing forces around a joint. Joints are controlled by two opposing sets of muscles called extensors and flexors, which work in synchrony for smooth movement. Reciprocal inhibition facilitates ease of movement and is a safeguard against injury.
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Muscle weakness and muscle inhibition
Muscle weakness can be caused by muscle inhibition, which is when a muscle receives no or distorted neurological input. This can lead to further injuries and decreased performance as the inhibited muscle cannot stabilise the injured joint, causing the injury to become chronic or recurrent.
Muscle inhibition occurs when danger messages are communicated from the body to the spinal cord, a process known as "afferent input". This results in the muscle being unable to fully contract and can lead to muscle weakness as the muscle can only get as strong as it can contract. Inhibited muscles are still able to be trained and worked out, however, the muscle will only get stronger if it can contract fully. For example, if one muscle in a group is contracting fully, the range of motion in that joint can become limited, and the body will sense the joint instability and tighten the opposing muscle to protect the joint.
To increase the signal to an inhibited muscle, isometric exercises can be performed. These are contractions of a specific muscle or group of muscles against a stationary object or with gravity. For example, to increase the signal to the gluteus medius, one can stand or lie down and push their leg into a wall with 10% effort for about 6 seconds, rest, and repeat for at least 6 repetitions.
Muscle energy techniques, such as the Reciprocal Inhibition MET technique, can be used to cause relaxation and lengthening of the muscles and improve the range of motion in joints. This technique involves placing the affected muscle in a mid-range position and having the patient push towards a restriction or barrier while the therapist resists this effort isometrically or allows movement towards it. This is followed by relaxation and exhalation, and then the therapist applies a passive stretch to a new barrier. This procedure is repeated several times.
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Muscle Energy Techniques (MET)
MET is based on the concepts of autogenic inhibition and reciprocal inhibition. Autogenic inhibition is when a sub-maximal contraction of a muscle is followed by stretching of the same muscle. Reciprocal inhibition is when a sub-maximal contraction of a muscle is followed by stretching of the opposite muscle. These two types of inhibition occur when certain muscles are inhibited from contracting due to the activation of the Golgi tendon organ (GTO) and the muscle spindles. The GTO, located between the muscle belly and its tendon, senses increased tension when the muscle contracts or stretches. When the muscle contracts, the GTO is activated and responds by inhibiting this contraction (reflex inhibition) and contracting the opposing (antagonist) muscle group.
The Reciprocal Inhibition MET technique is performed as follows: The affected muscle is placed in a mid-range position. The patient pushes towards the restriction/barrier, and the therapist completely resists this effort (isometric) or allows movement towards it (isotonic). This is followed by the relaxation of the patient along with exhalation, and the therapist applies a passive stretch to the new barrier. The procedure is repeated between three to five times and then five times more.
MET can be used by healthy individuals to maintain muscle flexibility and prevent injury. It can also be used to treat problems such as pain-inhibited movement of the neck, shoulders, and back. MET can be applied to any joint in the body except the cranium. Many athletes use MET as a preventative measure to guard against future injury of muscles and joints.
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Arthrogenic Muscle Inhibition (AMI)
The AMI is often resistant to traditional rehabilitation techniques, which leads to persistent neuromuscular deficits following ACL reconstruction. To better treat AMI following ACL injury and ACL reconstruction, it is important to understand the specific neural pathways involved in AMI pathogenesis, as well as the changes in muscle function that may impact movement biomechanics and long-term structural alterations to joint tissue. Overall, AMI is a critical factor that limits optimal rehabilitation outcomes following ACL injury and ACL reconstruction.
The prevention of knee stiffness following ligament reconstruction is a key area of research in understanding the role of AMI. For example, a single bout of vibration-induced hamstring fatigue has been found to reduce quadriceps inhibition and coactivation of knee muscles after ACL reconstruction. This suggests that AMI may be a factor in the recovery process for ACL injuries.
The assessment of AMI by physical examination in the supine position during isometric contraction is feasible, as demonstrated by electromyography. This can help identify the presence and extent of AMI, which is important for developing effective treatment plans.
Muscle inhibition occurs because of danger messages communicated from the body to the spinal cord. This communication is called "afferent input". If something inhibits our muscles, we are vulnerable to injury. These injuries may not heal if the inhibited muscle can't stabilise the injured joints, leading to chronic or recurrent injuries.
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Spinal reflexes and afferent input
Spinal reflexes are an important evolutionary adaptation that allows for faster actions and reactions. They allow us to move and react without conscious attention. For example, when a waiter's tray is unexpectedly loaded with weight, a spinal reflex is automatically initiated to keep the tray stable. This is achieved by activating the muscle spindle's Ia afferents, which have their cell bodies in the dorsal root ganglia of the spinal cord.
The spinal reflex circuit includes peripheral afferents, a network of spinal interneurons, and motoneurons. The excitability of motoneurons and interneurons in the ventral horn influences the frequencies, latencies, amplitudes, and durations of flexion, withdrawal, and guarding responses to nociceptive input. Spinal reflexes can be initiated by non-proprioceptive receptors and proprioceptors. For instance, the flexor reflex is initiated by cutaneous and pain receptors, as seen when we withdraw our hand after touching a hot stove.
Afferent input is crucial in muscle inhibition. Muscle inhibition occurs due to danger messages communicated from the body to the spinal cord, which then controls muscle tone. Every muscle fibre, even at rest, receives 50 messages per second, and up to 500 messages per second during full contraction. Muscle inhibition can lead to further injuries and decreased performance if not addressed. Techniques like Muscle Energy Technique (MET) and Post Facilitation Stretch (PFS) aim to address muscle inhibition and improve muscle relaxation, lengthening, and range of motion.
Reciprocal inhibition, a neuromuscular process, is essential for efficient and smooth movement. It involves the contraction of one muscle followed by the stretching of the opposite muscle, preventing simultaneous contraction of opposing muscles, which could lead to muscle tears. This process is facilitated by inhibitory signals sent to the antagonist muscle, allowing it to relax and reduce resistance. Reciprocal inhibition is the basis for muscle energy techniques used in physical therapy to address inflammation, pain, and muscle spasms.
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Frequently asked questions
Muscle inhibition is when a muscle is receiving no or distorted neurological input. This can lead to muscle weakness and injury.
Messages from the spinal cord control muscle tone. If there is a disruption in the sensory input, the motor side of the system may shut off to protect the joint. This can be caused by damage to ligamentous, boney, and mensical structures, as well as swelling and pain.
Muscle inhibition can be treated with muscle energy techniques (MET) such as autogenic inhibition and reciprocal inhibition. Isometric exercises can also help increase muscle signal and range of motion.
