Hip & PelvisMuscle Energy Technique (MET)Technique-specific guide
PNA Clinical Application Guide
Hamstring MET
What changes when Muscle Energy Technique (MET) meets the hip & pelvis? Start with the patient's movement, assess safely, and see what the re-test reveals.
3 specific variationsClinical re-test built in
Specific variations
How this technique is applied in the hip & pelvis
Each variation below is written so you can follow patient setup, contact, direction, dose and the re-test that decides whether the technique earned a place in the plan.
01
Hip & PelvisIliopsoas / hip flexor complex
Iliopsoas — MET
One question matters more than the name of this variation: will the patient notice a useful change in Hip extension, walking stride and Thomas-position response.? The careful re-test gets the final word.
The change we are looking for
Improve hip-extension tolerance when hip-flexor guarding or shortness is clinically relevant.
Primary target
Iliopsoas / hip flexor complex
The movement that tells us
Hip extension, walking stride and Thomas-position response.
Patient focus
Improve hip-extension tolerance when hip-flexor guarding or shortness is clinically relevant.
Therapist verifies
Hip extension, walking stride and Thomas-position response.
Success signal
Keep the technique only if the re-test shows a meaningful improvement in hip extension, walking stride and thomas-position response. without symptom worsening.
Full clinical application
1
Position the patient
Modified Thomas-style position or side-lying with the pelvis stabilized. Move the treated hip gently toward extension until the first comfortable barrier.
2
Set the contact
Stabilize the pelvis to prevent anterior tilt; support the distal thigh.
3
Apply the technique
Ask the patient to gently flex the hip toward the ceiling against resistance. Relax, then allow a small increase in hip extension without lumbar extension.
4
Dose & re-test
3–5 contractions of 5–10 seconds at about 10–20% effort. Re-test: Hip extension, walking stride and Thomas-position response.
Clinical pearl
The pelvis is the reference point. If it anteriorly tilts, the technique becomes a lumbar-extension movement.
Safety / avoid
Avoid forcing hip extension in acute anterior hip pain or after surgery without clearance.
02
Hip & PelvisAdductor muscle group
Hip Adductors — MET
One question matters more than the name of this variation: will the patient notice a useful change in Hip abduction, adductor-related pain and side-step/squat tolerance.? The careful re-test gets the final word.
The change we are looking for
Improve painful/restricted hip abduction when adductor tone is clinically relevant.
Primary target
Adductor muscle group
The movement that tells us
Hip abduction, adductor-related pain and side-step/squat tolerance.
Patient focus
Improve painful/restricted hip abduction when adductor tone is clinically relevant.
Therapist verifies
Hip abduction, adductor-related pain and side-step/squat tolerance.
Success signal
Keep the technique only if the re-test shows a meaningful improvement in hip abduction, adductor-related pain and side-step/squat tolerance. without symptom worsening.
Full clinical application
1
Position the patient
Supine with the opposite leg stable. Abduct the treated hip to the first comfortable barrier while keeping the pelvis level.
2
Set the contact
Support the distal thigh/leg and stabilize the opposite pelvis.
3
Apply the technique
Ask the patient to gently pull the leg inward into adduction against resistance. Relax, then take up a small amount of additional abduction.
4
Dose & re-test
3–5 contractions of 5–10 seconds at low effort. Re-test: Hip abduction, adductor-related pain and side-step/squat tolerance.
Clinical pearl
Keep the pelvis from rolling toward the treated side; otherwise the apparent gain is pelvic motion.
Safety / avoid
Avoid aggressive abduction with acute groin injury or adductor tear.
03
Hip & PelvisPosterior hip external rotators
Piriformis / Deep External Rotators — MET
One question matters more than the name of this variation: will the patient notice a useful change in Hip internal rotation, seated figure-four tolerance and the patient's functional task.? The careful re-test gets the final word.
The change we are looking for
Improve selected hip internal-rotation/adduction tolerance when posterior hip guarding is relevant.
Primary target
Posterior hip external rotators
The movement that tells us
Hip internal rotation, seated figure-four tolerance and the patient's functional task.
Patient focus
Improve selected hip internal-rotation/adduction tolerance when posterior hip guarding is relevant.
Therapist verifies
Hip internal rotation, seated figure-four tolerance and the patient's functional task.
Success signal
Keep the technique only if the re-test shows a meaningful improvement in hip internal rotation, seated figure-four tolerance and the patient's functional task. without symptom worsening.
Full clinical application
1
Position the patient
Supine with the hip flexed comfortably. Move gently toward internal rotation/adduction until the first non-painful barrier.
2
Set the contact
Stabilize the pelvis and control the knee/distal thigh.
3
Apply the technique
Ask the patient to gently push the knee outward toward external rotation/abduction against resistance. Relax, then take up the new comfortable range.
4
Dose & re-test
3–5 low-effort contractions of 5–10 seconds. Re-test: Hip internal rotation, seated figure-four tolerance and the patient's functional task.
Clinical pearl
Posterior hip pain has many possible sources; do not label all of it 'piriformis syndrome.'
Safety / avoid
Stop if the position reproduces strong distal neural symptoms.
Safety / do not apply when…
Avoid in acute muscle tear/hematoma.
Clinical rule
A technically correct technique is not automatically a useful technique. Keep it only when the patient's pain, range or function improves in a clinically meaningful way, then transfer that gain into active movement, loading or self-management.
