{"id":1595,"date":"2021-04-21T15:19:00","date_gmt":"2021-04-21T15:19:00","guid":{"rendered":"https:\/\/www.osmosis.org\/blog\/?p=1595"},"modified":"2025-10-01T11:42:38","modified_gmt":"2025-10-01T19:42:38","slug":"omm-question-of-the-day-joint-muscle-energy","status":"publish","type":"post","link":"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy","title":{"rendered":"OMM Question of the Day: Joint Muscle Energy"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_80 ez-toc-wrap-center counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">In This Article<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\/#The_correct_answer_to_todays_OMM_Question_is%E2%80%A6\" >The correct answer to today&#8217;s OMM Question is&#8230;<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\/#C_Engage_her_barrier_by_taking_her_AA_joint_into_right_rotation\" >C. Engage her barrier by taking her AA joint into right rotation<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\/#Incorrect_answer_explanations\" >Incorrect answer explanations<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\/#A_Engage_her_barrier_by_taking_her_OA_joint_into_flexion_left_sidebending_and_right_rotation\" >A. Engage her barrier by taking her OA joint into flexion, left sidebending and right rotation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\/#B_Engage_her_barrier_by_taking_her_AA_joint_into_left_rotation\" >B. Engage her barrier by taking her AA joint into left rotation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\/#D_Engage_her_barrier_by_taking_her_C4_into_extension_left_sidebending_and_left_rotation\" >D. Engage her barrier by taking her C4 into extension, left sidebending and left rotation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\/#E_Engage_her_barrier_by_taking_her_C4_into_extension_right_sidebending_and_right_rotation\" >E. Engage her barrier by taking her C4 into extension, right sidebending and right rotation<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\/#Main_Explanation\" >Main Explanation<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\/#Major_Takeaway\" >Major Takeaway<\/a><\/li><\/ul><\/nav><\/div>\n\n<p class=\"wp-block-paragraph\"><strong><em>Today&#8217;s OMM question involves a 34-year old patient who&#8217;s experiencing neck pain. What&#8217;s the optimal way to set up a muscle energy treatment for her cervical spine somatic dysfunctions?<br><\/em><\/strong><br>A 34-year-old woman presents to your clinic with two weeks of neck pain. She describes a dull ache along the right side of the back of her neck. She has had no recent injuries. She has no past medical history. Her temperature is 37.7 \u00baC (99.9 \u00baF), pulse is 78\/min, respirations are 14\/min, blood pressure is 126\/79 mmHg. On osteopathic structural exam, her occipitoatlantal (OA) joint has a deep right sulcus which evens out on flexion. Rotation of her atlantoaxial (AA) joint is restricted in rightward rotation. Her C4 vertebra is extended, sidebent left and rotated left.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Which of the following would be a correct way to set up a muscle energy treatment for her cervical spine somatic dysfunctions?<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>A. Engage her barrier by taking her OA joint into flexion, left sidebending and right rotation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>B. Engage her barrier by taking her AA joint into left rotation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>C. Engage her barrier by taking her AA joint into right rotation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>D. Engage her barrier by taking her C4 into extension, left sidebending and left rotation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>E. Engage her barrier by taking her C4 into extension, right side bending and right rotation<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><br>Scroll down for the correct answer!<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-rich is-provider-embed-handler wp-block-embed-embed-handler wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Osmosis.org at Alabama College of Osteopathic Medicine\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/0HfjhvaqvMs?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"The_correct_answer_to_todays_OMM_Question_is%E2%80%A6\"><\/span>The correct answer to today&#8217;s OMM Question is&#8230;<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"C_Engage_her_barrier_by_taking_her_AA_joint_into_right_rotation\"><\/span>C. Engage her barrier by taking her AA joint into right rotation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Before we get to the&nbsp;<strong>Main Explanation<\/strong>, let&#8217;s look at the incorrect answer explanations. Skip to the bottom if you want to see the correct answer right away!<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Incorrect_answer_explanations\"><\/span>Incorrect answer explanations<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">The incorrect answers to today&#8217;s OMM Question are&#8230;<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"A_Engage_her_barrier_by_taking_her_OA_joint_into_flexion_left_sidebending_and_right_rotation\"><\/span>A. Engage her barrier by taking her OA joint into flexion, left sidebending and right rotation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Her OA joint is flexed, sidebent left and rotated right. Taking her into this position would be in her direction of freedom. In order to treat with muscle energy you would position her exactly opposite of this.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"B_Engage_her_barrier_by_taking_her_AA_joint_into_left_rotation\"><\/span>B. Engage her barrier by taking her AA joint into left rotation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">She is restricted in rightward rotation, so her somatic dysfunction at the AA joint is leftward rotation. Placing her into leftward rotation here would engage her freedom of motion rather than her barrier.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"D_Engage_her_barrier_by_taking_her_C4_into_extension_left_sidebending_and_left_rotation\"><\/span>D. Engage her barrier by taking her C4 into extension, left sidebending and left rotation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">At C4 she is extended, sidebent left and rotated left. In order to treat with muscle energy you would position her exactly opposite of this in order to engage her barrier (restriction in motion).<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"E_Engage_her_barrier_by_taking_her_C4_into_extension_right_sidebending_and_right_rotation\"><\/span>E. Engage her barrier by taking her C4 into extension, right sidebending and right rotation<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">At C4 she is extended, sidebent left and rotated left. In order to treat with muscle energy you would place her into right sidebending and right rotation, as well as flexion rather than extension.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Main_Explanation\"><\/span>Main Explanation<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Rotation and sidebending always go in opposite directions at the OA joint. For assessing the &nbsp;atlantoaxial (AA) joint, you flex the neck to engage the joint and then test only rotation. For the cervical spine, you also need to assess flexion\/extension, sidebending and rotation. In the cervical spine, sidebending and rotation almost always occur to the same side.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When treating with muscle energy, remember to position the patient directly opposite of their somatic dysfunction (their freedom of motion), so as to engage their barrier (their restriction of motion). As &nbsp;you slowly engage the barrier for 3-5 seconds, instruct the patient to gently resist by returning their head toward neutral (i.e. moving it in the direction of their freedom of motion). Treatment of the AA joint with muscle energy involves only rotation in the neutral plane (though you test motion with the neck flexed to the joint).<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\"><div class=\"wp-block-embed__wrapper\">\n<iframe loading=\"lazy\" title=\"Fibrous, cartilage, and synovial joints\" width=\"500\" height=\"281\" src=\"https:\/\/www.youtube.com\/embed\/9ccJ8iIjWMA?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><em><a href=\"https:\/\/www.osmosis.org\/learn\/Fibrous,_cartilage,_and_synovial_joints\"><\/a><strong><a href=\"https:\/\/www.osmosis.org\/learn\/Fibrous,_cartilage,_and_synovial_joints\" target=\"_blank\" rel=\"noreferrer noopener\"><u>\u2192 Learn more about fibrous, cartilaginous, and synovial joints.<\/u><\/a><\/strong><\/em><\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Major_Takeaway\"><\/span>Major Takeaway<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">In order to treat with muscle energy, bring the patient to their barrier by placing them opposite of their somatic dysfunction. For treatment at the AA joint, keep the neck neutral, avoid sidebending, and rotate them opposite of their somatic dysfunction to engage their barrier.<\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em><strong>_________________________<\/strong><\/em><\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><a href=\"https:\/\/www.osmosis.org\/plans\" target=\"_blank\" rel=\"noreferrer noopener\"><img loading=\"lazy\" decoding=\"async\" width=\"700\" height=\"250\" src=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/08\/1.png?w=700\" alt=\"Osmosis sign up ad\" class=\"wp-image-288\" srcset=\"https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/08\/1.png 700w, https:\/\/www.osmosis.org\/blog\/wp-content\/uploads\/sites\/2\/2024\/08\/1.png?resize=300,107 300w\" sizes=\"auto, (max-width: 700px) 100vw, 700px\" \/><\/a><\/figure>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><em><br><strong>Want more OMM Questions as well as practice questions for USMLE\u00ae Step 1 and Step 2 CK?<\/strong><\/em> <em><strong>Try Osmosis today! Access your&nbsp;<a href=\"https:\/\/www.osmosis.org\/login?type=create\" target=\"_blank\" rel=\"noreferrer noopener\">free trial<\/a>&nbsp;and find out why millions of current and future clinicians and caregivers love learning with us.<\/strong><\/em><\/p>\n\n\n\n<p class=\"has-text-align-center wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Today&#8217;s OMM question involves a 34-year old patient who&#8217;s experiencing neck pain. What&#8217;s the optimal way to set up a muscle energy treatment for her cervical spine somatic dysfunctions?A 34-year-old woman presents to your clinic with two weeks of neck pain. She describes a dull ache along the right side of the back of her [&hellip;]<\/p>\n","protected":false},"author":202,"featured_media":1596,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[11,20,16],"tags":[],"class_list":["post-1595","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-comlex","category-exam-prep","category-do"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v23.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>OMM Question of the Day: Joint Muscle Energy - Osmosis Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.osmosis.org\/blog\/omm-question-of-the-day-joint-muscle-energy\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"OMM Question of the Day: Joint Muscle Energy - Osmosis Blog\" \/>\n<meta property=\"og:description\" content=\"Today&#8217;s OMM question involves a 34-year old patient who&#8217;s experiencing neck pain. What&#8217;s the optimal way to set up a muscle energy treatment for her cervical spine somatic dysfunctions?A 34-year-old woman presents to your clinic with two weeks of neck pain. 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