Ask Mike Reinold Show

Using Vibration Devices in Physical Therapy

On this episode of the #AskMikeReinold show we talk about using vibration devices, such as guns, foam rollers, and mobility spheres, in the physical therapy setting. To view more episodes, subscribe, and ask your questions, go to mikereinold.com/askmikereinold.

#AskMikeReinold Episode 238: Using Vibration Devices in Physical Therapy

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Show Notes



Transcript

Student:
All right. So Michelle from Miami says, what are your thoughts on using vibration therapy as part of the treatment? Is it worth the investment in a clinic or do you find it unnecessary?

Mike Reinold:
Okay. All right. Well, let me see.

Lenny Macrina:
What? What was the question?

Mike Reinold:
You’re not in the clinic, wait a minute. Mine’s upstairs. I was looking for mine. I was just doing my hamstring last night. But yeah, in physical therapy, no, that’s terrible. You shouldn’t do that. We’re all doing it personally, but you should not do it in physical therapy. All right. So interesting. So good question, Michelle. I mean, vibration therapy is getting more and more popular every day it seems like, and it’s one of those things that I think there’s a lot of things out there now that the mainstream media even picks up on a little bit, so you start seeing articles. And who knows? Maybe this is just marketing and PR and stuff like that. But when you see all the pro athletes using it, companies like Hyperice, they have their vibration gun on the bench underneath every seat in the NBA. They’re doing that.

Mike Reinold:
I know they’re doing it in major league baseball too, where there’s going to be Hyperice, the hyper-volt massage guns are on the bench. Right? And trust me, the players are using them. They’re using them during time outs, they’re using them between innings, they’re pretty popular. So what I like about this question though, that I thought Michelle asked, and we’ve talked about this briefly in the past every now and then on the podcast. But I think it’d be good to kind of talk about our current update on this. Is this something we want to use as part of treatment and physical therapy? So before we get to that, I want to go to Diwesh, right? And I want to get Diwesh’s opinion.

Mike Reinold:
Because we use vibration therapy quite a bit at champion, so we’re a big fan of the Hypervolt and all their devices that they have because they have such great vibration technology built into more than just the gun, but also in some of the self myofascial release things like the roller and the ball and stuff like that. So we have a lot of options, but we use it quite a bit and we know that there’s science to support that people feel better and move better afterwards. So Diwesh, why don’t you start with this? How do we use vibration therapy in our fitness based setting, right? Because I think that’s going to help us answer our physical therapy question.

Diwesh Poudyal:
Yeah. So I think on the fitness side of things, we use it for two big reasons, right? So one is just general warmup and prep, getting the body ready before our athletes do some of their speed, agility, power stuff, and before their lifts. So that’s just more for general preparedness getting an athlete to feel better. And then the other half of that being post-workout for feeling better after lifting after they’re sprinting and jumping stuff. So one big picture is just feel better pre and post. And we’ll use a combination of the bigger foam rollers that vibrate to get whole body, and we’ll also use like the little hyper spheres to get a little bit more targeted, localized work to feel a little bit better.

Diwesh Poudyal:
The other end of it is going to be a little bit more for targeted mobility reasons. One that I’ve really started to love is using the hyper volt, the gun for ankle mobility restrictions. Right? So using a little bit more of the vibration on the soleus and then having athletes to ankle mobility drills, and then load that ankle into a squat or a lunge positions, and then having them go do sprint work and jumping stuff that requires that positive shin angle. Stuff like that has worked really well for us in terms of gaining mobility. And obviously you can apply the same concept where we’re talking about athletes that might be restricted overhead in their lats or, whatever it may be, but use them for a little bit more soft tissue, easy access to help with mobility gains. So I would say those are the two big reasons. Warm up and prep, just feeling better and then a little bit more dedicated mobility work in targeted areas.

Mike Reinold:
And that’s awesome. And this episode is not about the physiology of all this, but I think we can briefly say what we know about vibration therapy is that it helps neuromodulate tone. I mean, we’ve known about this for quite some time. So if you feel tight, you have some mobility restrictions and you do any sort of vibration, whether it be localized or even the platforms that were super popular 10 years are a little less popular now. But if you actually just went on there and did a toe touch on there for 30 seconds, you gained six inches off a toe touch, right? Immediately afterwards here. I think what a lot of people don’t realize is that a lot of our soft tissue restrictions, let’s say hamstrings in a field sport, like running athlete, right?

Mike Reinold:
Those hamstrings get so tight from the eccentric contraction stuff after their activities, a little bit of vibration helps with that. Now there’s some knock on that physiologically that perhaps now that muscle is not going to be very capable to accept strength, maybe even power transitions over time. But keep this in mind, the results are transient. We know that. They know that. Right? The results are transient, they help, but we are not permanently doing anything to the hamstring, we’re just trying to neuromodulate tone. But like Diwey just said fantastically, is we’ll do that to then allow us to get more out of what we want to do in their program. So it helps us achieve our goals. Okay? So that’s a little bit of how we use vibration therapy.

Mike Reinold:
So I think right there that’s been accepted, right? People feel like that’s an acceptable use vibration therapy is to work on that. Now let’s talk physical therapy and go to the physical therapist. I don’t know who wants to jump in first, maybe Dan, I don’t know if that was a scratch or a raised hand, but anyone can jump in first.

Dan Pope:
It was a scratch.

Mike Reinold:
You have a scratchy head. But don’t we have those same goals, right? So the question is, should vibration therapy be part of our physical therapy treatment and what we do for people? Who wants to start?

Lenny Macrina:
I mean, I can, I will, because I know some people would say this is poopoo, you’re creating reliance. People shouldn’t rely on this. They should do stuff on their own. Well, this is a great way for them to do stuff on their own if they have one. But also if it makes them feel better short term and it can get you to have them do something different this session, and they feel good about it, and they feel good about going into a session then I’m all for it. And then, like you said, the vibration and the neuromodulation of pain, the pain receptors, anything that’s in our skin and muscles that may help the person feel a little bit better to move better, which then they can work on training better and perform better, I’m going to take it.

Lenny Macrina:
So do I use the gun in PT practice? Not as much as I should. And this podcast is probably going to change things. So guys and girl down below, students make me and remind me. Be that person that comes in, save my hands. Right? And let’s do this more because I really think that it would benefit them. I honestly think that. And I think that it’s a good modality, a short term modality. I’m not going to again, create reliance, so I don’t want the social media world to get all huffy puffy at me. This is something that the person can do on their own. They could foam roll. There’s a bunch of things they can do, but it all helps them feel better. And that’s the key, right? That’s why they’re coming to see me.

Mike Reinold:
That was amazing. I liked that.

Lenny Macrina:
And I have one. So obviously I bought into the whole thing. I bought one.

Mike Reinold:
I’m not going to lie. So for those that, most people have listened to this, but Lenny’s got a hyper volt there. I’m surprised by your choice of tip applicator there, by the way. You have the little like… Yeah. I always go straight for the hardest one for some reason. You went for the soft one.

Lenny Macrina:
You bet. We changed it out. This was probably my wife using this, but it’s… Yeah. I was probably doing some work on the walls too or something. Who knows what I was doing with it?

Mike Reinold:
I love it. Well, I mean, Lenny just said it really great. I actually don’t use it probably as much as I probably should. Right? You know what I mean? If somebody has some tight hips or tight hamstrings, I think we should use it. I think I should use it more on those things. Anybody else want to jump in though? I know everybody’s got some good feedback on that. Dan, I’d love to hear how you think and how you’ve used it. I know you’ve tried it. What do you think?

Dan Pope:
Yeah. And I’m a little shell shocked from these just because one, an old model we were using at the clinic got a little too close to someone’s hair and it started chewing their hair up actively as the gun was turned on. And that was a bad experience, generally.

Lenny Macrina:
Different model, different company.

Dan Pope:
Yeah.

Mike Reinold:
Yeah. We could just do it through clothing. That’s the good thing of vibration therapy is you can do it through clothing.

Dan Pope:
Yeah. I do think it’s a tool that we can use to make ourselves more effective. Oftentimes someone’s coming to me and they have limited time and maybe they want me to go through specific movements. Right? And I’m working with a lot of movements that require a lot of mobility. Let’s say this. Now, if that athlete comes in a little bit earlier and utilizes some of these tools, they can get into better positions a little bit later when I have the time to work with them. Because I think the big thing is we’re trying to give our patients the most bang for their buck. So if you have a tool like a gun, then it can help patients mobilize and get that accomplished and it makes our treatment a little bit better with the limited time we have.

Mike Reinold:
Right. One neat thing that I’ve kind of found about the vibration therapy too, that the mainstream tends to like this, right? So Mike, good example with golfers, right? Your work, you do your assessment on them, they have some mobility restrictions. You want to give them some drills to do at home. Right? Golfers are one of those crowds, that I think loves getting these devices. Right? And I’ve gone to some golf pro shops, right, and they’re selling them in the pro shop now. That’s how popular they are. So Mike, have you had much experience or anything about incorporating it as even part of your home exercise program with some of your mobility drills with some of your clients.

Mike Scaduto:
Yeah, absolutely. And obviously we have these tools available to us in the gym and we have quite a different variety of tools that we have. So I’ll have people go experiment with the ones that they like. And I find that actually kind of funny, I’ll do a hands-on manual therapy treatment to try and achieve the goals that we’re working on, whether it’s gain mobility or decrease pain, and then I’ll have them go use a vibrating gun and they come back to me the following session, they go, I really loved the vibrating gun. I think it really helped me and they talk more about the vibrating and gun than they talk about my hands on treatment.

Mike Scaduto:
So I think it can be, maybe I’m just not that good of a manual therapist. But I think patients enjoy the experience, right? If it’s properly applied and it helps them achieve their goals, then I think it’s a very useful tool for them. And if they want to make the investment, it’s something that I encourage them to do with a little bit of guidance on the appropriate time to use it, what the appropriate dosage is, and to get the most effectiveness out of the tool.

Mike Reinold:
Nice. Awesome. Good, good. Awesome. All right. So I would end with this, I guess, for this kind of interesting point on the vibration therapy here is I think we’re all pro using it. I think you’re going to see actually some really good outcomes if you do use it too, by the way. But that being said, let’s keep this in mind, we’re talking about doing it for 30 seconds to somebody’s hamstring before we do some manual therapy, before we do a mobility drill, before they do dynamic stuff, before we stretch or whatever it may be. Right? If you are trying to do vibration therapy on somebody for eight minutes to get a billable unit out of it, then we have a lot of other things to talk about, right? That’s not the point of vibration therapy.

Mike Reinold:
So I think it’s just a small tool that we use. Going back to Michelle’s question. The second part was she said, is it worth the investment? Right? And I think it’s such a low cost investment that you can amortize over so many visits per day and stuff like that, that I would say it’s definitely worth the investment. And heck I don’t even know. I mean, we probably we’d probably have four or five now. We get a bunch of the foam rollers and the mobility spheres. So we have a lot. It’s one of those things that once you start using them, you start to use them more. And then we have a ton of patients and clients that have even then just wanted to purchase their own for them. So keep that in mind.

Mike Reinold:
So I think overwhelmingly, I think we’d say I think we’re very pro vibration therapy in physical therapy as a useful tool, if you do it right, you don’t over-utilize it, and you keep it a part of your bigger, comprehensive program. Right? I think that’s a great way to do it. So, awesome question, Michelle, thank you so much for submitting that. If you have another question like that, head to mikereinold.com, click on that podcast link, and you can fill out that form to submit your own question. We get tons every month, so keep them coming. Anything you guys want to talk about, we’re here for you. Head to iTunes, Spotify, rate/review, make sure you subscribe to us and we will see you on the next episode. Thank you so much.