Muscle Activation Technique

I heard about this form of treatment in a recent Training Beta podcast. Does anyone have any experience with it? I've had horrible inflexibility my entire life, and I'm convinced that several tendonitis episodes are rooted in muscle tightness. It sounds too good to be true, and the sessions are not cheap. Denver is the headquarters of this operation, so there are lots of practitioners here. Any thoughts on effectiveness/costs/number of sessions? I was quoted $155 for an hour session!

Relax, dude. I am just asking for opinions. I'm not endorsing it, nor did I say I was going.

I have no experience with MAT but it sounds different than traditional PT to me. I have had Active Release Technique performed on me and can vouche that it can provide immediate symptomatic relief. I wouldn't be surprised if MAT were to be a good addition to a PT regimen as well. Sorry I'm not more informative, just voicing that traditional PT isn't the only way. But if funds are limited and you can't afford to experiment, you may be better off giving your money to the PT.

I took a 2 day seminar from the developer, Greg Roskopf, about 12 years ago when he was just getting started. Haven't listened to the trainingbeta podcast yet, but this is what my memory serves me: I didn't feel it was bullshit. It is essentially a form of muscle energy technique; such techniques are regularly used by mainstream PTs. However, Roskopf's techniques are definitely different than the (little) I learned in standard MET while working in outpatient sports medicine.

The premise behind MAT as far as I understand it is that either muscle tightness or reduced neural drive create a circular loop of reinforcing each other, leading to altered biomechanics and pain/injury. I believe I remember Roskopf saying his technique can identify which muscle in a group is causing the problem, and it is often not the one(s) you would think given the visual biomechanical analysis. Anyhow, I think the theory of reduced neural drive is only one among several for the causes behind musculoskeletal dysfunction (at least if you talk to other types of healthcare professionals).

Anyhow, unfortunately I do not have any actual results of the treatment, although I did see videos of many of his clients before and after. Their biomechanical changes were fairly remarkable. That said, such client outcomes would probably be cherry picked out for marketing reasons. Also, I do not know what those visual biomechanical results would indicate about their actual pain or function long term.

I don't know what tendon problems you are having or why you assume tightness is the leading cause. Tendon injuries are usually multi-faceted in origin and in fact still poorly understood on some levels when you come right down to it. So, MAT might or might not be helpful to you, but I do think $155 a session is pretty pricey when the outcome is uncertain.

MAT is the real deal. It's done more for me than any doctor or physical therapy did. It seem to be more popular with professional athletes, Peyton Manning claimed it saved his career after his neck issues. Check out matjournal.com/

Great guys, thanks for the constructive feedback. I've been researching it fairly heavily for the last week, and I really haven't found anything negative (aside from the cost). I agree that this isn't really comparable to most traditional PT. Either way, I went ahead and scheduled an appointment with one of Roskopf's early students, who's now a master level practitioner himself. There are cheaper options, but he seems legit and I think the cost is worth the potential benefits.

Aerili, my issues aren't really in the tendons. Actually, I'm not suffering from any real issue at the moment. About a year and a half ago I had a pretty serious phase of what I guess was some sort of impingement problem in my rotator cuff. I saw a physical therapist and I did some work to restrengthen various parts of my lower back. The issue was mostly related to poor posture and pretty serious muscle imbalances. The worst of it went away, but I do still get inflammation and soreness from time to time. Additionally, I've gotten to the point in my climbing where hip flexibility is becoming a real hindrance. There are just some moves I can't do because I'm so damn inflexible in my hips! My guess is that this is all somehow related, but we'll see what the MAT guy has to say. I'll report back.

Climbing friend,

MAT = slapping your muscle with a frozen fish of considerable size

I went in for my first appointment yesterday. Truthfully, and coming from someone who is perpetually skeptical of these sorts of things, I was blown away. Nearly every position he put me in was tight and weak, but with just a few targeted prods of a seemingly unrelated muscle group, he'd re-test my flexibility and strength to find marked changes. For instance, I've never been able to properly lift my arms above my head, and climbing has really only made it worse. Leaving yesterday, I could do this comfortably (not perfect yet though). A year of dedicated yoga, PT, and deep tissue massage has brought some improvement, but this was immediate and obvious.

The real test will be the medium to long term, i.e., are these effects only short-term (like a massage)? I've scheduled another appointment one month out. He says athletes with good diet/sleep/stress levels generally respond quickly and need far fewer sessions for real lasting results.

As a former massage therapist, he also cautioned me against deep-tissue work, and prolonged stretches, like those done in Yin Yoga. I've been practicing Yin for a year now, and while I have seen some results, the flexibility in my hips and shoulders have remained relatively the same. The MAT argument is that a tight muscle doesn't need lengthened (the methods of massage and yoga), but that the opposing muscle group is inactive and weak, creating an overcompensation scenario and muscle imbalance. As I said, I've been doing Yin at least 2x/week, so it would be a change to drop this. Any experiences there?

I don't know if everyone is just drinking the Kool-Aid or what, but this guy is routinely booked solid for 6 weeks out. Clearly people must be seeing some real results. And as rockdude points out, a ton of local pro athletes (Manning for sure) routinely use these guys.

evan h wrote: The MAT argument is that a tight muscle doesn't need lengthened (the methods of massage and yoga), but that the opposing muscle group is inactive and weak, creating an overcompensation scenario and muscle imbalance.

this is inline with experts in other fields and not so controversial anymore. Dr. Stuart McGill for example gives examples as to why tight hamstrings should no be stretched in certain contexts of athletic performance.

Evan, it's a little late but any chance you could measure some aspects of your flexibility yourself and then see how that changes after the MAT?

Maybe measure sit and reach, hip turnout, shoulder extension? Something objective and seperate from the MAT practitioner. Aerlii could probably offer better suggestions for measurements.

I had a single MAT session years ago and got put off when he tried to sell me on herbal supplements. But if it really works I might try again.

I did think Meridian stretching worked, but it's expensive and painful and only got me a little bit more flexibility. If cash and time was unlimited I'd still be doing it.

Thanks for sharing your experience. I listened to that episode too and was really curious about MAT. And skeptical. Do you have exercises that were prescribed to you after or do you just go back in a month to reassess?

Mark E Dixon wrote:Evan, it's a little late but any chance you could measure some aspects of your flexibility yourself and then see how that changes after the MAT? Maybe measure sit and reach, hip turnout, shoulder extension? Something objective and seperate from the MAT practitioner. Aerlii could probably offer better suggestions for measurements. I had a single MAT session years ago and got put off when he tried to sell me on herbal supplements. But if it really works I might try again. I did think Meridian stretching worked, but it's expensive and painful and only got me a little bit more flexibility. If cash and time was unlimited I'd still be doing it.

Mark, this is a good idea, and I'll try and do this before the next appointment. There was progress made, but there's plenty left to improve. He did very little selling of his work, and certainly no selling of supplements. I didn't get the impression that he needed much promotion, considering he's probably over-booked, if anything.

Marcin, I wasn't prescribed any specific exercises. When I asked about deep stretching, he said to favor resistance (opposition) instead. For instance, hand-foot matches are nearly impossible for me, so I've been stretching like mad. Instead (and not revolutionary here), I should be strengthening the weak muscles associated with that movement, perhaps using therabands to resist lifting my leg. This is no doubt done by PT's, so there is some overlap.

Thanks for the reply. I'm surprised there is no homework that it's just the treatment. Will keep an eye out and curious about your results.

I listened the Macke podcast and wanted to try it out, so tried a few sessions over 3 weeks. Unfortunately, I didn't see any noticeable improvement in stability, movement or strength. Currently I am healthy, climbing well and not dealing with any significant movement issues, but I have 2 older injuries (left shoulder impingement/ low back) I thought might have created imbalances.

Like any modality, there is probably a wide-range of difference in how the work is applied by the therapist. This reality tempts me to try someone else.

What I see as flaws: they didn't give any at-home exercises to strengthen what was "weak". I asked for some and he responded that was not the intent. This seems like a pretty big gap to not offer some self-care options or enough input so I could reactivate a muscle myself if it seemed off. Note- I have knowledge in anatomy so completely capable of locating a muscle and/or attachment.
They reinforced the McGill ideas about stretching and resistance, but he was negative about some of the range of motions activities and mobility I do as warm-ups (some of the stuff Steve Bechtel recommends which come from dan john, Pavel and other well-regarded trainers.

In some of the tests I could not discern the difference in weak vs strong. This was odd to feel similar on both sides internally and be told one side was weak. Or to not feel a difference before and after activation.

Anways, YMMV. But I think some skepticism is warranted regarding this modality. It could be a strong placebo affect...

Climbing friend,

Use the frozen-fish slapping technique, and toughen yourself up.

I heard the same podcast, found the one guy who does MAT in New Zealand, and have had two sessions so far. My bullshit meter was on high alert but bugger me if this doesn't seem to have cleared up a couple of issues -instantly. I'm fully prepared to change my mind on this, but for the time being it seems to have helped my lower back pain and evened up my hip rotation.

I also asked about maintenance exercises and nothing doing on that front so far, which I don't like the look of.

I sure as hell can't say anything approaching definitive, but I'm cautiously optimistic. We'll see if I still say that in six months.

Climbing friend,

I am finding that the application of a 4 kg frozen wild caught salmon direct to the bicep, lat, and posterior shoulder capsule, is bringing me great refreshment and muscle tone and balance! My muscles go as free as a cold mountain stream!

Sounds like a new acupuncture with placebo effect.

I had some lower back pain last week, the kind where you walk like your 85 all bent over. Got an appointment and afterwards it was about 60% better, the next day almost all gone. I am sold but I have been sold for about two year, No Drugs and Dr. or BS just improvements.

Any updates?

I wanted to weigh in on this as well, having recently used the services provided by the MAT specialists myself.

Background: medical physician with extensive history of personal musculoskeletal injuries over the years

My story was effectively what I believed to be medial epicondylosis, which I had been wrestling with for several years. I had read all the literature that was available, including Macleod's book. I had gone through multiple cycles of therapy (RICE, stretching, negative eccentric therapy), and was frustrated by my overall lack of meaningful progress.

Having experienced referred pain before, I couldn't help but wonder if trigger points, or another etiology was involved. To make a long story short, I went with minimal expectations, hoping there was something that I hadn't though of was in play.

As described above, there is no hard sale with these folks. People are coming in of their own free will, and generally paying out of pocket. I was impressed by the time and thoroughness of the guy working with me, and felt results after the first session. To answer some of Mark's questions, they performed extensive ROM testing at all sites, and also performed muscle strength testing per their protocol.

I can tell you that I do not entirely understand the rationale behind what they are doing, but I can also let you know that what they are doing is not over-hyped bunk. It works, or I would not have gone back. Three sessions later, what I suspected has been confirmed, and the issue affecting me was "upstream" from my elbow, specifically somewhere in my shoulder.

If you want to think about it in a simplified manner, try this: you have an injury and over time you compensate for that by the way you biomechanically carry yourself (protection mechanism). That, coupled with the intense stress of use/overuse involved in climbing and training for climbing, allow reinforcement of that subtle change, leading to alteration in force distribution/load over time. Certain movements change, and to compensate you start inadvertently using muscules/tendons differently/more often than you normally would, and set up a vicious cycle.

Sorry if I can't draw you a diagram, but I would say if you are a climber with "chronic" issues, than this is worth a shot. Why? Because NSAIDs, ice, stretching, steroid shots, prolotherapy/plasma are not addressing the underlying issue, which is how your body is distributing load to your various joints. If you want an immediate example, think about how great other parts of your body start to feel if you walk with a limp for a week or two (back/other hip may hurt etc). To those who suggest placebo effect, I would say that the issue with body work of any kind and evidence based medicine (depending on how much credit you still believe that has) is how do you measure how it is delivered (control) or effect. Osteopathy, acupuncture, and a variety of other modalities do not lend themselves to how we generally "test" cause/effect - that is just how it is.

I have nothing but good to say about this program, and would recommend it wholeheartedly. Some may prefer prolotherapy/plasma but honestly, the science behind that is not particularly solid, and I will stand by results over speculation any day. This being said, I still endorse RICE for acute injuries, and would likely not seek the assistance of MAT for something I did to myself several weeks ago.

Hope this helps.