Research and News
Dr. Phil Page
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Posts by Dr. Phil Page
Exercises after Achilles tendon reconstruction: an EMG-based progression
Oct 13th
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Post-operative rehabilitation depends on 3 people: the surgeon, the patient, and the therapist. Obviously, the surgeon must be technically proficient, the patient must be compliant, and the therapist must promote healing without damaging the surgical repair. Orthopedic surgeons often have therapists follow specific rehabilitation protocols, usually based on tissue-healing timeframes.
Tim Tyler PT ATC
Prescribing therapeutic exercise at the appropriate dosage is essential since some tissue stress is necessary to facilitate proper healing; however, too much stress can damage the repair. Little is known about the stresses to tissues during Achilles tendon exercises. Thera-Band® Academy Scientific Advisory Board member Tim Tyler, PT ATC presented EMG analysis data on common Achilles exercises at the 2011 TRAC Annual Meeting.
Ten healthy subjects performed several common exercises, including Thera-Band resisted plantar flexion. The EMG activation levels are reported as a percentage of a maximal contraction:
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Thera-Band Plantar Flexion
Seated toe raise : 11%
- Single-leg balance on Wobble Board : 25%
- Prone ankle pumps : 38%
- Plantar flexion with red Thera-Band exercise band : 45%
- Walking : 47%
- Lateral Step-up : 60%
- Single leg heel raise : 112%
- Single leg jump : 112%
While EMG levels are not a direct measure of More >
Cervicogenic Headache Treatment: What’s the Evidence?
Oct 11th
Janda's Upper Crossed Syndrome
How many of your patients with neck pain suffer from headaches as well, or vice-versa? Cervicogenic headaches are characterized by unilateral headache radiating from the posterior to anterior head, unilateral upper cervical pain and facet “locking,” which is often aggravated by sustained neck positions. Cervicogenic headaches are thought to result from a convergence of sensory input from the upper cervical spine into the trigeminal nucleus. Interestingly, these patients often exhibit Janda’s Upper Crossed Syndrome.
I recently published a review article on the assessment and management of cervicogenic headaches in the International Journal of Sports Physical Therapy. The article describes the assessment of posture, range of motion, muscle length, muscle strength, joint mobility, breathing patterns, and trigger points. A special test, the Cervical Flexion-Rotation test, can help confirm the diagnosis with ~90% accuracy.
Based on my review of the literature, I recommend a multi-modal layered approach to cervicogenic headaches (or any chronic musculoskeletal pain syndrome for that matter): modalities, manual therapy, and therapeutic exercise. For cervicogenic headache patients, modalities such as TENS, cryotherapy, or low-level laser therapy can be helpful. Spinal manipulative therapy has been shown effective for cervicogenic headache patients in several studies. Other manual therapies such as instrument-assisted soft More >
Does the new Thera-Band Stretch Strap increase flexibility?
Oct 10th
Stretching interventions are important to restore normal muscle length and joint range of motion (ROM). Contract-relax stretching has been shown more effective than static stretching to increase muscle flexibility. PNF-style contract-relax stretching requires a partner to provide resistance for a pre-stretch contraction, followed by passive movement into the newly acquired ROM. Stretching straps are sometimes used as an assistive device to help hold a limb in place for a static stretch. Unfortunately, most straps are rigid and therefore provide only static stretching.
The new Thera-Band® Stretch Strap has inherent elasticity combined with rigidity to support both static and contract-relax stretching. Thera-Band Academy Scientific Advisory Board member, Dr. David Behm and his students at Memorial University of Newfoundland in Canada tested the efficacy of the Thera-Band Stretch Strap in increasing hamstring flexibility compared to a partner-assisted stretch. He presented his findings at the 2011 TRAC meeting in San Francisco. They evaluated acute hip ROM as well as movement and reaction time before and after different stretching interventions, randomized on separate days.
Both stretching conditions with the Thera-Band Stretch Strap and with partner-assisted stretching significantly improved hamstring flexibility and impaired performance immediately after stretching. Dr. Behm concluded that the Thera-Band Stretch Strap provides similar improvements in ROM to partner-assisted stretching, More >
Does Biofreeze reduce hand pain in massage?
Oct 6th
Biofreeze® topical analgesic has been shown to reduce pain in patients with neck pain, low back pain, and knee osteoarthritis. Massage therapists often use Biofreeze with massage. According to Dr. Tiffany Field at the University of Miami, hand massage reduces pain and increases grip strength. Dr. Field wanted to know if applying Biofreeze after hand massage had an additive effect in subjects with hand pain.
Twenty adults with a variety of hand pain diagnoses received weekly 10-minute massages from a massage therapist and instruction in home-based self-massage between weekly visits. Half of the subjects received Biofreeze in addition to their hand massage and were instructed to apply it to their hands as well. After 4 weeks, the groups using Biofreeze significantly increased in grip strength and decreased in pain compared to the group not receiving Biofreeze.
Dr. Field concluded that adding Biofreeze to a massage therapy protocol resulted in significant benefits compared to massage alone. Her results were presented at the 2011 TRAC meeting in San Francisco.
Read the abstract of her study here: Hand pain is reduced by massage therapy plus Biofreeze® Topical Analgesic
Click here to learn more about all the research presented at TRAC 2011
More >
Biofreeze reduces pain and improves function in knee osteoarthritis patients compared to placebo
Oct 4th
Dr. Robert Topp at Marquette University has published several studies on the mechanisms of Biofreeze® topical analgesic, as well as exercise interventions using Thera-Band resistance in knee osteoarthritis patients. At TRAC 2011, Dr. Topp presented research on the efficacy of Biofreeze in 20 patients with knee osteoarthritis. The patients had either Biofreeze or a placebo gel applied to their knee; each then performed 5 functional tasks and subsequently reported their pain levels.
The subjects performed significantly better on the 6-minute walk and timed chair-stand when Biofreeze was applied. Applying Biofreeze also significantly reduced pain during the timed chair stand, timed up-and-go, as well as going up and down stairs.
Dr. Topp concluded that Biofreeze topical analgesic resulted in 30% less pain than a placebo during high-load functional tests in patients with knee osteoarthritis.
Read the abstract of his study here: The effect of 3.5 % menthol gel on knee pain and functioning among patients with knee osteoarthritis
Click here to learn more about all the research presented at TRAC 2011
Listen to a podcast interview with Dr. Topp about his project by clicking on the link below:
Standard Podcast
