Posts tagged strength training
Does Treatment Of Trigger Points Improve Outcomes For Patients With Rotator Cuff Injury?

Rotator cuff injuries span the spectrum from acute strains to chronic tendon pain (tendinopathy) and rotator cuff tears. Physical Therapy remains the gold standard, first line treatment for all rotator cuff injuries due to its’ cost and clinical effectiveness treating these disorders. A Physical Therapy first strategy has been reinforced by recent research demonstrating equivalent outcomes between surgery and Physical Therapy for patients with rotator cuff tears. Strength training exercises remain the most important intervention for patients due to their ability to reduce pain, heal injured tissues, and restore lost function. A recent study examined the effectiveness of adding trigger point treatments to an established Physical Therapy exercise program.

Akbaba and colleagues randomized patients with rotator cuff tears to one of two groups (J Back Musculoskelet Rehabil. 2019). Both groups received the same Physical Therapy strengthening program completed twice a week for 6 weeks, but one group also received manual soft tissue treatment of their shoulder’s trigger points. Authors assessed each patient’s pain, range of motion, function, and mental health outcomes initially and upon completion of the 6 weeks. Both groups improved pain, range of motion, function, and mental health but the addition of trigger point treatments did not improve clinical outcomes in patients with rotator cuff tears. This study highlights exercise remains the most important treatment in patients with rotator cuff injury and soft tissue interventions add little to the overall recovery of patients.

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Resistance Training Improves Older Adults' Quality Of Life

Inactive adults can expect up to a 5% loss of muscle mass each decade after age 30. This loss of muscle tissue, sarcopenia, occurs in part due to lack of exercise and is a major cause of disability and lost independence among aging adults. To combat this weakness experts recommend each American adult should participate in weekly Resistance Training sessions. According to our National Physical Activity Guidelines, the recommended amount of strength training involves exercising major muscle groups at least 2 times a week. Previous research has shown this frequency of strength training exercise can increase strength, muscle mass, and bone density among older adults.

A recent review of the available evidence was conducted by researchers investigating the relationship between strength training and quality of life in older adults (Hart et al. Health Promotion Perspective. 2019). Authors reviewed 16 research articles and found resistance training had a significant effect on both mental and physical health variables. They reported significant improvements in both health related quality of life and bodily pain among the trained participants compared to their sedentary peers. Specifically, resistance training was found to positively effect emotional and social functions within overall quality of life scores.

This article adds to the existing literature on the mental and emotional benefits of exercise. Contact the experts at MEND to learn which exercises are most appropriate for you.

Optimizing Glut Activation During The Crab Walk

Strengthening the muscles of the hip, gluts, is a key component of rehabilitation for patients with low back pain, hip pain, and knee pain. These muscles help to optimize movement in the lower quarter improving joint mechanics and force distribution during life and recreational activities. In our Facebook posts, we have shown videos on optimizing the firing in the muscles on the back and side of the hips. These videos detail beginning, intermediate, and advanced exercises for each muscle group. One commonly utilized exercise is the crab walk which incorporates a lateral side stepping movement against a resistance band. A new research article highlights how placement of the band can optimize recruitment of the glut muscles.

Lewis and colleagues analyzed the activation of the glut muscles during a crab walk exercise using different elastic band positions (J Athletic Training. 2019). 22 healthy adults were asked to side step with the elastic band around the knees, ankles, and feet. During each 3 of the conditions, researchers analyzed EMG activity from the hip muscles including the TFL, gluteus medius, and gluteius maximus. As expected, increased glut work was found when the band was moved from the knees to the ankles lengthening the lever. Interestingly, placing the band around the feet increased the glut work without increasing the contribution from the TFL (often a muscle we try to utilize less during exercise). Thus, placing the band around the feet may be an optimal position to recruit the hip with less contributing from compensatory muscles.

The Importance Of Neck Strengthening In Patients With Neck Pain

Neck pain is a common source of musculoskeletal pain with up to 70% of Americans experiencing neck pain at some point in their lives. In the early or acute phases of pain, hands on treatment including spinal manipulation and joint mobilization have been shown to reduce pain and disability due to neck symptoms. If left untreated, neck pain begins to create muscles imbalances including weakness and tightness of the upper quarter muscles. Specifically, research has shown poor performance of the deep neck muscles along the front of the spine. The deep neck flexors provide strength and stability to the skull on the spine as well as the spinal vertebrae. Normally these muscles have a feed forward response where they fire before bigger movements of the neck, but in patients with neck pain these muscles fire late or may not fire perpetuating muscle imbalances and movement impairments at the neck. A new systematic review highlights the importance of the deep neck flexors for patients with neck pain.


Blomgren and colleagues examined the available evidence behind the utilization of deep neck flexor strengthening in patients with neck pain (BMC Musculoskeletal Disorders. 2018). Authors included 12 randomized controlled trials in their final analysis to determine the impact of these exercises on aspects of muscle performance including strength, endurance, coordination, and function. They reported strong evidence was found for the effectiveness of these exercises on coordination, but smaller effects were found for deep cervical strengthening on strength or endurance measurements. In addition, deep cervical flexor strengthening exercises were found to improve neck and head posture.

In our physical therapy practice in Boulder we commonly start with these exercises before rapidly progressing patients toward a higher level strength training program. In our practice experience, higher level strength training of the neck and shoulders is the most effective way to restore function and prevent recurrence in patients with neck pain.

To learn more on how to develop your neck strength contact the experts at MEND

Resistance Band Improves Glut Recruitment During Squat

The squat, and its’ many variations, remains one of the best all around exercises for strength and power development. Its’ utilization of the majority of lower quarter muscle groups also makes it a foundational exercise for patients in our Boulder Physical Therapy practice. The complexity of the complete movement pattern can be a challenge for novice strength training participants and often we utilize modifications in the early training stages to optimize a patient’s mechanics. We have found a looped band around the knees is a great feedback tool to cue a patient into keeping their knees apart. A recent research trial examined the impact of this looped band during a barbell squat.

Foley and colleagues in the International Journal of Sports Physical Therapy analyzed both healthy trained and untrained participants during a barbell squat (2017). Researchers examined muscle activity and knee mechanics during both a body weight and 3 repetition maximum squat to failure. Each of the squats was examined both with and without a resistance band around their knees. Authors reported increased muscle activation of the quadricep and hip musculature during the squat with the band. Surprisingly, the looped band had a minimal impact on knee mechanics among this healthy population.

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Protein Supplementation and Resistance Training Improves Lean Muscle Mass and HDL levels In Older Females

Strength training is one of the most effective ways to slow the loss of muscle mass with aging (sarcopenia). Sarcopenia will occur in all aging adults, but key differences are found between active and inactive adults. As expected, inactive adults show faster declines in muscle mass, strength, and function compared to their active peers. Previous research on strength training indicates it is never to late to begin a safely implemented resistance training program. Even novice participants in their 70s and 80s can benefit from the effects of strength training. A new research paper highlights the benefits of resistance training and protein supplementation for female older adults.

Fernandes and colleagues studied the impact of resistance training and protein supplementation on cardiac, metabolic, and tissue composition in older adult females (Experimental Gerontology. 2018). 32 older adult females were randomized to receive either 35 grams of whey protein or 35 grams of placebo. Each group performed resistance training exercises 3 days a week for 12 weeks. Authors collected body composition (DEXA scan), blood samples, and body circumference measurements at the start and conclusion of the training period. They reported greater improvements in lean soft tissue and total cholesterol/HDL profile among the protein and resistance group compared to the placebo protein group. Both groups improved waist circumference measurements and other measurements of cholesterol, triglycerides, and C reactive protein but no differences were found between groups. This study highlights the importance of incorporating resistance training into your exercise routine. Participants are advised to speak with their primary care physician before beginning any supplementation program.