Muscle Activation Technique (MAT) Therapy

[CSta]

I'm in my 5th week of MAT therapy, and because this method of treatment is relatively new I thought I'd describe what's happened so far, in case anyone was considering seeing an MAT specialist.

I decided to consult an MAT specialist because my hamstrings were often sore and slow to recover after exercise even when I did not increase the number of repetitions or the load. Also, my lower back ached, and there was (and still is) a spot right next to a vertebrae that hurts when I push on it with my thumb. I had previously consulted two medical doctors and a physical therapist, each of whom did seemed uncertain of the problem's cause and the solution. Their collective recommendation was to change my back exercises and to stretch. When Kurz endorsed MAT in his most recent article in the injury section, I decided to give it a try.

In general, an MAT specialist will help you identify muscular imbalances (left leg stronger than right leg, for example) and muscular weaknesses. An MAT specialist will tell you that correcting imbalances and weaknesses is important because they can lead to "sudden" injury or chronic pain.

My therapy began with a full-body analysis, which took about 1 hr 20 mins to complete. The specialist looked at how I walked, my standing posture, my weight distribution (I put 16 more pounds of pressure on my right foot compared to the left--you stand on two scales to figure this out), the flexibility of my joints, and my ability to resist force (he would ask me to raise and hold my leg in a certain position as he pressed on it, for example). My body's imbalances and weaknesses were many. The key ones include hips that twist slightly, imbalanced weight distribution, over pronation (feet), and several muscle weaknesses and reduced ranges of motion, particularly in the feet and legs.

The first 5 weeks of therapy have focused on my feet and legs. The first part treated was my toes. My toes displayed weakness; I was unable to keep them curled when the MAT specialist attempted to uncurl them. Treatment involved him rubbing or squeezing my toes and various points on my feet. I believe the MAT specialist was "massaging" the tendons. After 3 or 5 minutes of this, he retested my toe strength, and I was (surprisingly) able to resist his force.

Such weirdness has occurred each treatment session. Other foot and leg muscles/tendons were rubbed (it's quite painful by the way), and weaknesses instantly (i.e., not over time) disappeared and the range of motion in the relevant joints improved noticeably. I have been given home exercises to do, and thankfully they don't take more than 5-10 minutes to perform. They consist of dynamic exercises with a very stretchable elastic band and isometrics. These exercises are not strenuous. for example, the isometrics are to be done so that I apply no more force than is necessary to feel the muscle contract. I'd put it at about 15% of 1RM. I do 6 repetitions, each of which is held for 6 seconds.

Although each time a treatment "works" I am surprised, one muscle/treatment in particular really baffled me. For as long as I can remember, even back in early childhood, I have not been able to flex the inner calf muscle on my left leg. When I have attempted to flex this muscle, I feel as though I can't figure out where the muscle is, as if I have no awareness of that part of my body. I mentioned this in passing to the MAT specialist at the beginning of a session. After 2 to 3 minutes of (painful) rubbing, I was able to flex the darn thing. I couldn't do so as well as I could with its right-leg counterpart, but I could flex it, and I felt like I knew where the muscle was. A few sessions have passed since then, and I've been doing homework for it, and now I have no problem flexing the muscle. It feels strong.

More weirdness on the calf muscle: After I was first able to flex the calf muscle, the MAT specialist had me lie down on something called a Total Gym, which is basically a board on ballbearings that slides up and down an inclined track (you can adjust the incline). He had me perform heel lifts with the left leg. They were very easy (I was nearly horizontal), and I did them for about 30 seconds. Immediately thereafter, I could no longer flex the muscle; the muscle also re-displayed the weakness it had before the treatment. After another treatment, though, I was able to flex it again. This process has continued, with the goal being to build up the weak calf muscle's endurance.

Still more: After the MAT specialist treats the calf muscle and re-tests it, he also re-tests something else. I lay on my back, bring my left arm close to my side, elbow locked, shoulder on the mat, the then attempts to pull the arm away from my body (parallel to the ground). When the calf muscle displays strength, I can resist the MAT specialist's attempt to pull my arm. When the calf muscle displays weakness, I am unable to resist the MAT specialist's pull. That phenomenon continues to baffle me. How can a calf muscle affect a lat?

That's about it for now. Oh, my back is better by the way, but there is still much more to do. We're still haven't gotten above the knee, really.

[Thomas Kurz]

I believe the MAT specialist was "massaging" the tendons. After 3 or 5 minutes of this, he retested my toe strength, and I was (surprisingly) able to resist his force.

This massaging of points on muscles, most often of their origins and attachments, activates them. A neurological term for this is "facilitation."

A general comment: If you had a serious sudden injury, or are rehabbing after a surgery, it is best if the MAT specialist you see is also a Physical Therapist. Anybody can take courses of MAT but Physical Therapists (and surgeons too, obviously) understand all implications of an injury. They know properties of damaged tissues, regularities of healing, and what can go wrong.

[CSta]

A second full-body analysis was performed last week. The core and lower-body weaknesses that have been treated have been eliminated. The differences in range of motion in my feet and legs/hips have been reduced substantially, but have not been completely eliminated. There is more work to be done there, but for now, those issues have lower priority. A substantial weakness and limited range of motion was discovered in my right arm/shoulder, which is my dominant side. I cannot rotate my forearm clockwise as well as I can with my left. My right thumb and index finger also displayed weakness. Also, laying on my back, when I placed my hand/fist up to my shoulder with my elbow at my side, I was unable to resist the MAT therapist's effort to pull my hand/forearm upward away from my shoulder.

The forearm weakness and limited range of motion was treated yesterday. Before it was treated, however, the MAT therapist performed a strength test for my left back/side that he had not performed before. I laid on my back, legs together with my left foot pointing leftward and the right foot neutral; legs were locked; the therapist moved my legs to the left such that my left foot was closer to my left shoulder; he put his left hand just below my right arm pit and applied pressure; with his right arm/hand he grabbed my lower legs and attempted to straighten me out of my slightly curved position. I could not resist his force. As with other weakness, it felt like I didn't know how to contract whatever muscles were necessary to resist his force. He straightened me quite easily.

The treatment for my right forearm consisted of rubbing the top of the forearm close to the elbow. (My thumb and index finger were treated as well.) The weakness and range of motion improved, although more work needs to be done. But again, there was a surprise. The therapist retested my back, and I was able to resist his force. Treatment of my thumb, index finger, and my forearm on the right strengthened my back and side on the left.

[CSta]

I've entered phase 2 of my MAT therapy. Last week, the MAT therapist had me hold various positions (such as standing one leg) and perform various movements: lunges (front, back, side, squats (one leg, two legs), jumps (front, back, side; one leg, two legs), and others. Based upon my level of stability, he has prepared a workout to do from 3 to 7 days a week to begin strengthening the muscles that have been treated. With the exception of crunches, all exercises are performed one limb at a time, and they are all single-joint exercises. Reps = 20, and the load is very light, about 20% to 30% of 1RM. My homework therapy exercises are to precede and follow the workout.

I'll be posting the workouts on my thread, CSta's Workout Log.

My therapy sessions will now be less frequent, once every three weeks rather than once a week. I still have weaknesses to be discovered (we discovered one just last night), but the major ones have been addressed. I generally I feel much sturdier than I used to, particularly with respect to my left foot, which has been the primary source of my problems.