Research and News
Posts tagged shoulder
A better exercise for trapezius muscle balance?
Aug 29th
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Trapezius muscle balance is important for normal shoulder function. Often in patients with impingement, the lower trapezius is much weaker than the upper trapezius. Traditional exercises to strengthen the lower trapezius such as prone shoulder flexion may cause further impingement, creating a “catch 22” for clinicians: Is there a better exercise for the lower trapezius that doesn’t impinge the shoulder?
Scientific Advisory Board member, Sue Falsone, PT, ATC, Vice President of Athletes’ Performance in Phoenix presented a pilot study of EMG activation of the upper and lower portions of the trapezius muscle during prone flexion with a cuff weight and 3 novel Thera-Band® tubing exercises at the 13th annual TRAC meeting in San Francisco, California.
The “vector” principle of elastic exercise prescription creates vectors of resistance more specific to muscle function. Vector exercises for lower trapezius were developed to create a line of resistance in the direction of the fibers of the lower trapezius, and in the opposite direction of its action of retraction and depression.
In Falsone’s pilot study, 10 healthy subjects without shoulder pain performed these 4 exercises in random order while Noraxon surface EMG More >
Rotator cuff patients benefit from Thera-Band exercises
Jun 29th
Rotator cuff disease is the most common cause of shoulder pain in primary care (Ostor et al. 2005) and includes diagnoses such as bursitis, impingement, and rotator cuff tendinosis. Several studies featured in the Academy Blog have described how effective Thera-Band® exercises are in treating shoulder conditions, particularly when combined with manual therapy.
Researchers in Australia completed an extensive study on patients with rotator cuff disease over 3 ½ years and published their findings in the British Medical Journal. 120 patients in Melbourne meeting eligibility criteria were randomly assigned to either a home exercise and manual therapy or a placebo-controlled group receiving only sham ultrasound. 14 experienced physiotherapists at 12 centers were trained to provide both interventions.
The intervention program was published in a separate paper in 2007. Download their protocol here. The exercise and manual therapy group received 10 sessions of individualized standard treatment over 10 weeks including a twice-daily home exercise program with Thera-Band exercise bands. At the end of the first 10 weeks, there was no significant difference in pain or function between the experimental and control groups; they both significantly improved.
They continued the home exercise each day for 12 weeks after the initial 10 visits. After 22 weeks, the exercise More >
Long term benefits from Thera-Band exercises for shoulder pain
Feb 9th
Last year, I reported on a study from Norway comparing elastic resistance exercises with shockwave therapy in patients with shoulder pain. In that 2009 study, the researchers reported on the outcomes of 194 patients randomly assigned to 12 weeks of exercise using elastic resistance or 4 to 6 treatments of radial extracorporeal shockwave treatment (RESWT). Their paper reported on the 18-week outcomes, finding nearly twice as many subjects in the exercise group significantly improved their pain and disability levels compared to the shockwave group (64% vs. 36%). In addition, there were no significant differences between the groups in function or range of motion. Download the exercise protocol here.
Recently, Engebretsen and colleagues provided their 1-year follow-up in the journal Physical Therapy. One year after the intervention, there was no significant difference between the groups: both the exercise and RESWT groups significantly improved in pain levels, disability, function, and range of motion. In other words, while the shockwave therapy was less effective than exercise in the short term, there were no long-term differences between the treatments.
The authors noted a greater tendency of patients in the exercise group to return to work and to require fewer additional treatments than the RESWT group. Unfortunately, the More >
Clinical management of “frozen shoulder” features Thera-Band products
Jan 19th
Frozen shoulder, or “adhesive capsulitis,” affects nearly 5% of the population. It remains a painful, debilitating and difficult-to-treat diagnosis. Dr. Phil Page and Andre Labbe published a paper in the North American Journal of Sports Physical Therapy that reviewed the current concepts in physical therapy treatment for frozen shoulder patients. They reviewed interventions such as modalities, passive motion, manual techniques, soft tissue mobilization, kinesiological taping, and therapeutic exercise. The Thera-Band® Shoulder Sling exercise was featured as a way to help restore normal motor patterns of the trapezius during abduction in frozen shoulder patients.
REFERENCE: Page P, Labbe A. Adhesive capsulitis: use the evidence to integrate your interventions. 2010. N Am J Sports Phys Ther. 5(4):266-273.
Visit the Thera-Band Academy Frozen Shoulder Resource Center
Rehabilitation for Shoulder Instability Update
Dec 2nd
Shoulder instability is a common cause of shoulder pain. Shoulder instability patients have been traditionally diagnosed from 2 groups: from traumatic, unilateral instability, resulting in surgery (TUBS), or atraumatic, bilateral multi-directional instability best managed with rehabilitation (AMBR). However, a new classification scheme suggests there are 3 groups of shoulder instability patients: 1. Traumatic structural; 2. Atraumatic structural; 3. Muscle patterning / non-structural. Traumatic shoulder dislocation (Group 1) is best managed through surgery. Atraumatic structural instability (Group 2), while best managed through rehabilitation, may improve with surgery after failed rehab. However, surgical intervention in Group 3 patients with non-structural instability often results in failure.
Jaggi and Lambert provide an excellent review of the examination and management of all 3 groups of instability. In their article, the authors describe physical therapy management of Type 2 and 3 shoulder instability, including biofeedback, postural taping, and rotator cuff strengthening with elastic bands and dumbbells. In addition, exercise balls and wobble boards serve as unstable surfaces to “enhance neuromuscular control at a reflex level. They emphasize that core stability is a vital component to rehabilitation of Type 3 (“muscle patterning”) shoulder instability. According to the authors, rehabilitation of Type 2 and 3 shoulder instability requires an average of 6 months of rehabilitation. More >
