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Active engagement techniques can be used in almost any region of the body. techniques are particularly well suited. Additionally, certain AE techniques work better than others in particular areas or specific conditions. The back is one region in which these techniques are not always appropriate because it can be too challenging to move the back in active motion with treatment. For example, it is very difficult to apply compression broadening methods to the back extensor muscles during their concentric contraction phase. The client would have to be actively extending the back while you push down on his or her back at the same time. Mechanically, it just doesn't work very well, so this is an area where you tend not to use AE techniques. On the other hand, with some specific back muscles these techniques prove quite useful. AE lengthening techniques are an effective way, for instance, to address the quadratus lumborum, which is one of the most important muscles to treat in many lumbar pain complaints. The neck is a perfect location to use these techniques for a wide variety of muscle pain complaints. Chronic muscle tension, as well as pain from acute injuries such as whiplash, is effectively addressed with AE techniques. Yet, not all approaches described here would work in this region. For example, you would find it challenging to perform compression broadening methods on the neck extensors during concentric neck extension. In contrast, it is highly effective and relatively easy to perform stripping techniques during eccentric neck flexion movements to the neck extensors with the client in a supine position. In most muscle disorders of the neck, the primary goal is to reduce muscular hypertonicity. Muscle lengthening techniques are most effective for this. AE techniques are particularly suited for use in the upper and lower extremities. In the extremities, the greatest percentage of musculo- tendinous soft-tissue injuries involve chronic overuse injuries. Both AE lengthening and broadening techniques excel at addressing overuse muscular injuries. Increasing tissue mobility and reducing fibrous adhesions is a key goal for these conditions. Using additional resistance when treating the extremities is often necessary. The extremities contain the largest and most powerful muscles in the body. In some cases, moving the weight of the limb in the active contraction does not require enough muscular effort to recruit a Longitudinal stripping with active eccentric lengthening to the elbow flexors using additional resistance from rubber tubing. Image courtesy of Orthopedic Massage: Theory & Technique (Elsevier, 2009) significant number of muscle fibers. In these cases, additional effort provided by resistance bands, hand- held weights, or manual resistance recruits enough muscle activity to make the AE techniques effective. CONCLUSION Using AE techniques greatly enhances the variety of treatment methods you can offer your clients. For those looking to improve muscle function or recover from various injuries, these techniques can help clients achieve their ideal treatment goals much sooner. Not only can you offer more to your clients with these techniques, but you will find that they greatly strengthen your understanding of kinesiology and mechanics in the body, putting your knowledge into action for optimum client results and your own increased clinical success. Assessment in Therapy and Orthopedic Massage: Theory and Technique. He teaches advanced clinical massage in seminars, online courses, books, and DVDs. Contact him at omeri@omeri.com. Whitney Lowe is the author of Orthopedic connect with your colleagues on massageprofessionals.com 39