Introduction
An interest in advanced medical technologies and regenerative medicine has focused my approach to managing patients as well as my own fitness and wellbeing. Working with Therabody and using Theragun over the past few years has been a real game changer. I use the percussive therapy system in my clinic as it offers a variety of innovative treatment solutions for my patients, enhances performance, recovery and sleep and is an ideal accessory to any home treatment plan. I wanted to share some of the experiences I have had personally, some of the background neurophysiological effects and research to support those who are thinking of using the devices.
Percussive Therapy
The device combines a specific amplitude, frequency, and torque to deliver long vertical strokes into the tissues. The device allows the clinician or user to administer percussions specific to their needs. By altering the frequency, amplitude, depth, or attachment one can completely change the focus of treatment.
How and why do I use Theragun?
The technology is so versatile I use daily in clinics with almost every patient. It has transformed the way I treat my athletes and patients. Whether working on performance parameters in the gym or desensitising tissues on the table it is my go-to piece of tech. Here are some examples of how I use Theragun.
Pre- manipulation
In preparation for a spinal manipulation I tend to use the device with a deeper slow movement pattern along the surrounding para-spinal musculature. This type of percussion stimulates the golgi tendon organs which send an inhibitory signal to the extra fusal muscle fibres lowering muscle tone. In addition, I can manipulate the frequency of percussion to deliver between 30-40hz. This sweet spot stimulates the skin receptors ‘ruffini endings’ which modulate any local pain that may be present. This simple and brief pre-treatment provides a great platform to enhance manipulations and their associated neurophysiological effects.
Pain Management
Patients generally see a clinician for issues that relate to pain. Managing patients’ pain is often a challenge and lowering this can be a revelation for them. Pain modulation as discussed above is of course considered, but in addition, another viable approach is via stimulation of the ruffini endings, the golgi tendon organs and muscle spindles. Using long slow and deep percussions one can decrease sympathetic nervous activity, lower local neural activity whilst causing vasodilation and increasing local perfusion.
Myofascial pain syndromes are relatively common, particularly around the upper back and I have found this approach is excellent for managing what is termed ‘energy crisis theory’. In addition, with the latest super soft attachments we can target delicate tissue areas around the tissue-nerve interface or tissues that have become hypersensitive to mechanical stimulus such as touch. This allows us to treat areas we may previously have left alone.
Stiff Joints or Range of Movement Restrictions
I have seen some fantastic results, and this is where the device really comes into its own. Fundamental to a clinician’s assessment is the ability to identify movement dysfunction, whether this is a simple straight leg raise, a knee to wall or an overhead squat. The Theragun is an excellent tool for improving range of movement immediately with little effort. We have discussed pain modulation which certainly could be a restrictor, so we already know the device could improve range of movement on this basis. We also have considered how the device can lower muscle tone allowing tissues to stretch further and improve range of movement.
Another area to consider is fascial tissue which is comprised mainly of an extracellular matrix and fluid ground substance (Hyaluronic acid). Stress and strain related to exercise is normal, however the tissues can be left with micro scarring which may restrict tissue mobility and function. Percussion targets the extracellular matrix and fluid ground substance causing heat and shear forces. This lowers the viscosity of the hyaluronic acid improving slide and glide of tissues over one another to restore normal tissue function.
Performance
Whilst working with athletes or just training myself I use Theragun for pre-activation. By adjusting the application of the percussion to a lighter faster sweep over the desired muscle we can increase blood flow and stimulate the muscle muscle spindles and pacinian corpuscles to increase muscle tone and proprioceptive feedback. This prepares the body for exercise by controlling movement and boosting force production. This may be a 10 second sweep over the gluteals before running on the treadmill or a 15 second sweep over the pectorals to re-active in between sets of bench press. It really is that simple.
Recovery
Recovery is a cornerstone of any rehabilitation or performance plan, using percussive therapy to lower muscle tone, improve circulation and lymphatic drainage along with stimulation of the parasympathetic nervous system all assist in resetting homeostasis. The nervous and endocrine systems are intrinsically linked acting together to co-ordinate all bodily functions, the influence is broad and helps to regulate all types of cells.
We can acknowledge Theragun has demonstrated value in improving sleep, lowering blood pressure, improving heart rate variability, lowering pain and muscle soreness. Therefore, using percussive therapy to stimulate this super system has great capacity for overall health and wellbeing.
Part of my work involves managing elite older athletes where it is crucial to keep them fit and healthy from season to season. This is an area I place great emphasis on, so we have invested heavily to incorporate recovery strategies into their daily routine. It is certainly what my family and I use daily to promote recovery and wellness.
Research
It is always difficult to quantify new innovative technology, as research usually lags and takes an awful long time to catch up. Therabody have committed to a variety of ongoing research studies that support all the discussed areas of neurophysiology. I have reviewed the literature, read extensively around the neurophysiological and endocrine responses related to how percussive therapy may influence these systems and have used my broad experience as a practicing clinician to make my own assumptions and for me it truly works.
Final Thoughts
Therabody have developed an innovative approach to performance, treatment, recovery and wellbeing that can be used by clinicians and the general public alike. They have committed to provide research and education for everyone to ensure the tech is optimally utilised. Clinician's and fitness professionals can make their own judgements by exploring the many uses with patients or clients. Individuals have a fantastic opportunity to use their own device in a variety of ways to enhance their physical and mental wellbeing.
Personally I love the 'Mini Theragun' – its a go anywhere device that I use religiously twice daily and every night before bed to aid sleep. Its small but powerful, quiet and is so easy to use for a full body treatment. If you want to know more about how I use Theragun feel free to DM me, I am always happy to chat all things Therabody.
References
Khan & Scott (2009): Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair. Br J Sports Med. 43:247–251
Powers & Howley (1994): Exercise Physiology. Theory & Applications for Fitness & Performance. Brown & Benchmark.
Tortora & Grabowski (2003): Principles of Anatomy & Physiology. Wiley
White & Frangos (2007): The shear stress of it all: the cell membrane and mechanochemical transduction. Phil. Trans. R. Soc. B 362, 1459–1467
Wilmore & Costill (1994): Physiology of Sport & Exercise. Human Kinetics.
Zhao et al (2015): Vascular nitric oxide: Beyond eNOS. Journal of Pharmacological Sciences 129. 83