Research and News
Posts tagged shoulder
Systematic review supports use of elastic resistance exercise for shoulder impingement
Mar 9th
Shoulder impingement is a common cause of chronic shoulder pain that can be treated with exercise. Impingement can be caused by a structural narrowing of the space between the humeral bone and acromion of the scapula, or by a muscle imbalance of the rotator cuff and/or scapular stabilizer muscles. These types of impingement are referred to as structural and functional, respectively.
Thera-Band® resistance band exercises are commonly used in rehabilitation of shoulder impingement. In fact, nearly 75% (9 out of 13) of the studies in a systematic review of physiotherapy exercises for impingement included elastic resistance exercise for the rotator cuff and scapula. In their review, Kromer and colleagues found that passive treatments (such as modalities only) are not effective and cannot be justified when treating shoulder impingement.
The authors found that physiotherapist-led exercises were as effective as surgery for shoulder impingement. In addition, home-based exercises were as effective as physiotherapy interventions, although manual therapy in the clinic may provide additional short-term relief. Based on these conclusions, Thera-Band resistance band exercises in the clinic or home can be an effective and safer alternative to surgery.
Kromer TO, et al. Effects of physiotherapy in patients with shoulder impingement syndrome: a systematic review of the literature. J Rehabil Med. 2009;41(11):870-80.
The Best Exercises for Rotator Cuff Strengthening
Mar 2nd
For years, the debate has continued on the ‘best’ exercises for strengthening shoulder muscles. Using electromyography (EMG) to measure muscle activity, researchers have attempted to determine which exercises have the highest levels of muscles activity for strengthening exercises. Several studies have examined EMG of common shoulder exercises to find the best exercises to strengthen the rotator cuff; in particular, the supraspinatus muscle. The “empty can” or “full can” exercises have been the most commonly performed exercise for supraspinatus strengthening, but controversy still exists in the literature.
While high muscle activation levels are often desirable, what’s more important is the relative activation of other muscles during the movement. For example, Dr. Michael Reinold and colleagues suggested in their 2007 paper that a good rotator cuff exercise should produce the greatest supraspinatus activity while minimizing the deltoid activation. Theoretically, reducing deltoid activation decreases the upward shear of the humerus during arm elevation, which may be desirable when prescribing exercise to strengthen the suprapsinatus in impingement patients.
In a study published in Medicine and Science and Sports and Exercise, subjects performed 5 isometric exercises in random order while measuring the EMG activity of the deltoid, supraspinatus, and infraspinatus. The exercises were: full can, empty can, prone elevation, elastic external More >
Thera-Band® resistance or dumbbells? New research supports both in the clinic
Feb 7th
The debate of elastic resistance versus isotonic resistance
Elastic resistance is commonly used in rehabilitation exercises, and has been shown to increase strength and function in over 100 randomized controlled trials (www.thera-bandacademy.com). Even with this amount of clinical evidence, elastic resistance is sometimes criticized because of the difficulty in quantifying intensity. Despite the fact that force elongation charts are available to quantify elastic resistance intensity, it is sometimes difficult to use these clinically. Because of this limitation, few studies have compared elastic and isotonic resistance directly because of the intensity-dosing issue.
Quantifying EMG and RPE of elastic and isotonic resistance
Researchers in Denmark compared elastic and isotonic dumbbell resistances for muscle activation and perceived exertion levels. Healthy females performed 3 different exercises with standard dumbbells ranging from 2 to 7.5 kg, and Thera-Band elastic tubing (red, green, blue, black and silver). The researchers developed a chart comparing isotonic and Thera-Band elastic resistance stretched 125 to 150%.
Thera-Band® elastic color Isotonic Resistance Red 2 kg Green 3 kg Blue 4 kg Black 5 kg Silver 7.5 kgEach subject randomly performed 3 exercises with both types of resistance: standing lateral raise, shoulder external rotation at 0° of abduction, and seated wrist extension. The elastic tubing was stretched More >
Early Thera-Band® strengthening for rotator cuff tear repair may speed recovery
Feb 3rd
The rotator cuff is crucial for proper function of the shoulder and activities of daily living (ADL). Full-thickness rotator cuff tears require surgical repair and a lengthy recovery, often lasting 6 months or more. Early physical therapy exercises are very conservative, focusing more on allowing the repair to heal. For fear of re-injury, dynamic resistance exercise is sometimes avoided for the first 4 months post-op. Swedish researchers investigated if accelerated rehabilitation after full-thickness rotator cuff tear surgery was safe and beneficial. In their prospective, randomized and controlled trial, one group of 7 patients underwent traditional physical therapy, while another group of 7 patients performed accelerated physical therapy, utilizing dynamic elastic resistance earlier in the rehabilitation protocol. Patients in the accelerated group removed their slings after 4 weeks to begin gentle motion and early strengthening against aquatic resistance. They also initiated elastic resisted internal rotation and external rotation at 8 weeks. Both groups received clinical and home exercise programs. The researchers concluded that the accelerated group had slightly faster recovery than traditional therapy without any adverse effects. While these results are encouraging, further research with more subjects is obviously needed.
Klintberg IH, et al. Early loading in physiotherapy treatment after full-thickness rotator cuff repair: a prospective randomized More >
Preventing shoulder impingement in overhead workers with Thera-Band® resistance bands
Jan 26th
Shoulder impingement is common in people who perform repetitive overhead work. For example, as many as 70% of construction workers report shoulder pain, compared to 25% of the general population. Physical therapy researchers studied shoulder pain in 240 construction workers. In their prospective study, ½ of the workers participated in a home exercise program designed to prevent shoulder injuries, while the other half served as controls. The home program included stretches and exercises with elastic resistance to strengthen the shoulder. Exercises were performed every other day, beginning with 3 sets of 10, progressed to 3 sets of 20. At the end of the 2 year study, the workers participating in the exercise program had fewer injuries than the non-exercising control group; in fact, the workers not performing the exercise program were 1 ½ times more likely to have a shoulder injury. An exercise program with Thera-Band elastic resistance may be beneficial in reducing shoulder injuries in overhead workers.
Visit the Thera-Band Academy Shoulder Impingement resource center here.
