Research and News
Posts tagged shoulder
Thera-Band® products featured in evidence-based shoulder rehabilitation
Nov 29th
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Shoulder impingement and rotator cuff injuries often respond well to physical therapy exercises. The success of the exercise program will depend on an accurate clinical assessment and an evidence-based approach to prescribing appropriate interventions. Two expert physical therapists and clinical researchers published an excellent review on the rehabilitation of shoulder impingement syndrome and rotator cuff injuries in the British Journal of Sports Medicine.
Drs. Todd Ellenbecker and Ann Cools offer a well-detailed description of the literature behind range of motion limitations, scapular dyskinesis, and muscle balance. Both authors have published extensively in these areas of clinical research, giving them an excellent perspective at translating evidence into practice by sharing their expertise. Ellenbecker and Cools provide some unique exercises for restoring shoulder muscle balance, including the “external rotation oscillation” exercise using Thera-Band® tubing and a FlexBar®. Dr. Ellenbecker recently completed an EMG study on this exercise, finding moderate levels of infraspinatus muscle activation. Another exercise researched by Dr. Ellenbecker, a 90-90 plyometric external rotation with a Thera-Band soft weight was highlighted in the article as well, and was featured previously on the Academy blog.
Simple and effective Thera-Band More >
Shoulder Impingement Rehabilitation Exercise Protocol
Nov 16th
Shoulder impingement is a very common cause of shoulder pain. Impingement occurs when the humerus ‘impinges’ on the acromion of the shoulder, reducing the subacromial space (SAS). Impingement may result from structural causes such as bony deformation of the acromion, or as a functional result of shoulder instability and weakness. While therapeutic exercise is a standard treatment for functional impingement, no “gold standard” rehab protocol exists.
Dr. John Kuhn of Vanderbilt Sports Medicine in Tennessee published a systematic review of exercises used to treat shoulder impingement. This review of 11 randomized controlled trials strongly suggests that exercise improves symptoms in patients with impingement syndrome. Dr. Kuhn concluded that exercise was as effective as surgery in treating shoulder impingement and a home program can be as effective as supervised exercise.
His review, published in the Journal of Shoulder and Elbow Surgery, provided several suggestions for an impingement rehab protocol based on the literature:
1. Exercises should include daily range of motion exercises and stretching
2. Scapular and rotator cuff strengthening with Thera-Band elastic resistance bands should be performed 3 times a week for 3 sets of 10 with a progressive increase in resistance and repetitions to 3 sets of 20. Specific exercises are listed below:
Rotator Cuff Exercises with More >
Evidence-based exercise prescription for Thera-Band® shoulder exercises
Oct 21st
Shoulder rehabilitation exercises are commonly performed with Thera-Band® resistance bands and dumbbells. Electromyography (EMG) is commonly used to quantify the muscle activity of these exercises to help clinicians determine which exercises are most effective at activating muscle. Several studies have been published that evaluate the EMG levels of common shoulder exercises. Unfortunately, it’s difficult to compare the results of these studies since they often 1) assess different muscles; 2) use different intensities and types of resistance; 3) quantify the level of contraction differently; and 4) use different analysis techniques. In addition, these studies are typically performed on healthy individuals without shoulder pathology, limiting our understanding of the effects of these exercises on shoulder patients. These issues all limit our evidence-based clinical decision making.
Dr. Rafael Escamilla of the Andrews Institute for Orthopedics and Sports Medicine in Florida published an excellent review of shoulder function and muscle activation studies in Sports Medicine. Dr. Escamilla and his colleagues described relevant biomechanics and function of the rotator cuff, deltoid, and scapular muscles. His colleagues then reviewed 8 EMG studies evaluating various shoulder exercises, modes of resistance, and muscles. Exercises with ‘high’ to ‘very high’ activation (> 41% maximum contraction) were identified.
Download the Thera-Band exercises here.
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EMG evidence helps support evidence-based practice with Thera-Band
Oct 7th
Electromyography (EMG) is a helpful tool for clinicians to decide which exercise would be best for their patients rehabilitation. Many studies have investigated the muscle activation levels of elastic resistance, including Thera-Band® resistance bands. Dr. Todd Ellenbecker of Physiotherapy Associates in Scottsdale, Arizona, investigated the EMG levels of 2 Thera-Band exercises he uses in his clinic. “We use these exercises on our patients, yet we don’t exactly know the muscle activation levels,” Dr. Ellenbecker noted, “EMG testing will help us make better clinical decisions for exercise prescription.”
Dr. Ellenbecker presented his findings at the 2010 Thera-Band Research Advisory Committee (TRAC) meeting. 21 subjects performed an external rotation oscillation with the FlexBar® exerciser and a Thera-Band Band Loop Wall Walk. The researchers measured surface EMG levels of the deltoid, rotator cuff and scapular stabilizers. Interestingly, both exercises produced similar levels of activation. The most active muscle for both exercises was the infraspinatus of the rotator cuff, which had moderate activation levels. Interestingly, the ratios of the upper trapezius to lower trapezius were over 1:1 for both exercises. “That’s important because we like to bias the lower trapezius, which is usually weaker than the upper trapezius in shoulder patients,” said Dr. Ellenbecker. His research helps More >
Thera-Band® exercise program successful in treating occupational shoulder impingement
Aug 6th
Several studies have shown that exercise programs including Thera-Band® resistance bands are effective at reducing the pain and dysfunction in patients with shoulder impingement. These patients often exhibit muscle imbalances of the scapular and rotator cuff muscles, leading to subacromial impingement. Overhead workers are particularly prone to shoulder impingement due to the demands of their job. Physical therapists in Brazil established a specific treatment program for 14 men in the school supply industry with chronic subacromial impingement syndrome averaging over 2 years duration of symptoms.
The 8-week program was performed and supervised by a physiotherapist in a treatment room at the work site twice a week. The patients were assessed for subjective pain and function before and after the program that include the following standardized sequence:
- Cryotherapy. Ice packs applied to anterior and posterior shoulder for 20 minutes
- Stretches. 3 sets of 30 seconds with 30 seconds rest between repetitions, performed on both shoulders for upper trapezius, posterior shoulder, and pectoralis minor (corner stretch)
- Thera-Band strengthening program: performed on both shoulders using progressive Thera-Band color-coded resistance bands . Participants began with mild tension on the band and stretched to approximately one-third the original resting length with 1 minute rest between sets for 3 sets of 10 More >
