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:

1. Cryotherapy. Ice packs applied to anterior and posterior shoulder for 20 minutes
2. 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)
3. 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 repetitions. Click here to see the shoulder impingement exercise protocol.

Patients performed stretching and strengthening exercises on both shoulders since many impingement patients exhibit deficits on both shoulders. They were also given education about reducing loads on the shoulder, as well as the use of ice at home.

After the 2-month intervention, the patients significantly improved their subjective ratings of pain and disability. In addition, 50% of the patients were pain-free, despite an average 2 year length of symptoms. While this study is limited by the lack of a control group and small sample size, these results support the effectiveness of this specific program using Thera-Band resistance bands in workers with shoulder impingement.

In conclusion, the authors noted, “…this therapeutic intervention may be relatively easy to be performed in many industries and may be effective to reduce symptoms and ultimately decrease the amount of sick leave.”.

The Thera-Band Shoulder Rehab kit includes Thera-Band resistance tubing and illustrated exercise manual and DVD, as well as Biofreeze® topical analgesic for pain before and after a shoulder exercise program.

REFERENCE Camargo PR, et al. Effects of strengthening and stretching exercises applied during working hours on pain and physical impairment in workers with subacromial impingement syndrome. Physiother Theory Pract. 2009 Oct;25(7):463-75.

Visit the Thera-Band Academy Shoulder Impingement Resource Center here

Previously, German researchers created a strength and proprioceptive training program using Thera-Band elastic resistance and Stability Trainers. The results, published in 2003 noted improvements in strength and proprioception. The authors felt that a balance training component was important to prevent fall-related injuries in persons with hemophilia.

More recently, researchers at the University of Tennessee Health Sciences Center created an individualized 6-week program using Thera-Band resistance in 33 patients with bleeding disorders. They used 3 levels of progression based the participant’s strength. Download the Thera-Band exercise protocol here. The patients then used a specific color of Thera-Band resistance corresponding to the prescribed intensity (% of an isometric manual muscle test). Subjects also performed stretching and cardiovascular exercise.  A physical therapist supervised the program 2 days a week. At the end of the 6-week program, there were no injuries, pain, edema, or bleeding episodes reported. The patients significantly improved their range of motion, strength, and cardiovascular status without causing additional hemarthrosis.

This individualized exercise program using Thera-Band resistance in hemophilia was safe and effective; however, the study was limited by a small sample size and presence of additional health conditions among subjects. As reported by Heilberg et al (2003) the addition of a proprioceptive training component to Thera-Band strengthening may provide additional benefits, though more research is needed.

 Reference: Mulvany R et al. Effects of a 6-week, individualized, supervised exercise program for people with bleeding disorders and hemophilic arthritis.Phys Ther. 2010 Apr;90(4):509-26.

Visit the Thera-Band Academy Hemophilia Resource Center here

Physical therapy researchers in Norway compared 2 types of ACL rehabilitation in 74 post operative patients. In the study, published in the American Journal of Sports Medicine, patients were randomly assigned to a traditional exercise program or a neuromuscular exercise program. The neuromuscular program (described in a separate study) included balance exercises on foam pads, wobble boards, and mini-trampolines. Download their rehabilitation protocol here. Plyometric and agility exercises were also included. Each group was tested for their strength, pain, function, and quality of life.

At a 2-year follow-up, the neuromuscular exercise group significantly increased in function and pain compared to the strengthening group, while the strengthening group only improved in hamstring strength. The authors suggested that both balance and strength exercises be included in ACL rehabilitation program. Thera-Band® Stability Trainers and balance boards are ideal for use in a neuromuscular rehabilitation program.

Reference: Risberg MA, Holm I. The long-term effect of 2 postoperative rehabilitation programs after anterior cruciate ligament reconstruction: a randomized controlled clinical trial with 2 years of follow-up. Am J Sports Med. 2009 37(10):1958-66.

Visit the Thera-Band Academy ACL Tear Resource Center here

Researchers in Norway wanted to compare 2 types of exercise programs on patients with whiplash. 25 patients were randomly assigned to a strength and endurance group or a “motor control” exercise group during 6 weeks of physical therapy. The motor control group performed 10 repetitions of deep neck flexor activation against an inflatable blood pressure cuff. The strengthening group used elastic bands to strengthen their neck muscles and dumbbells to strengthen the upper body. Each exercise was performed for 1 set of 15 to 20 repetitions; each session included a 5 minute warm-up and cool down period.

Both groups significantly improved their disability levels approximately 60%; there was no significant difference between the groups. About half of the patients in each group obtained clinically important improvements at 6 weeks and 1 year after the exercise program. Some subjects did not maintain improvements at 1 year, suggesting exercises must be continued.

Whlie the findings are encouraging, the study was limited by a lack of control group and small sample size. Thera-Band elastic resistance can be used to improve pain and disability in chronic neck pain patients.

Reference: Ask T et al. 2009. The effect of two exercise regimes; motor control versus endurance/strength training for patients with whiplash-associated disorders: a randomized controlled pilot study. Clin Rehabil: 23(9):812-23.

Visit the Thera-Band Academy Neck/Whiplash resource center here

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 rotation, and prone external rotation. The researchers noted that all exercises produced similar high levels of supraspinatus activity, while the full and empty can exercises also had higher levels of deltoid activity.

External Rotation with Thera-Band

Prone External Rotation with Soft Weight

The researchers concluded that shoulder external rotation at 0° of abduction with an elastic band and prone external rotation were preferable exercises for the supraspinatus. While the full- and empty-can exercises are traditionally favored to isolate the supraspinatus, the authors noted that elastic external rotation and prone external rotation did not activate the deltoid at high levels compared to the full- and empty-can exercises. In addition, the exercises also exhibited high levels of infraspinatus activation.

In summary, clinicians should consider using Thera-Band® exercise bands for resisted external rotation and isotonic prone shoulder external rotation exercises because they preferentially activate the supraspinatus and infraspinatus without activating the deltoid, which may be more beneficial for patients with impingement.

Reference: Boettcher CE, Ginn KA, Cathers I. Which is the optimal exercise to strengthen supraspinatus? Med Sci Sports Exerc. 2009;41(11):1979-83.

Visit the Thera-Band Shoulder Impingement Resource Center Here