Key Practical Points from Effects on Local Vibration
- Pre-exercise local vibration reduces functional signs and chemical markers of delayed onset muscle soreness (DOMS) and may improve performance in subsequent frequent workouts.
- Local vibration is effective for reducing acute muscle pain (and can be added to a home program via the devices like the Hypervolt by Hyperice® or similar devices).
- Local vibration alone may be sufficient to increase strength in deconditioned muscles/individuals.
- Current research implies that adding vibration to self-administered release techniques (SMR) (e.g. foam rolling) enhances benefits for DOMS, pain pressure sensitivity, and increasing proprioception. Further research is needed to refine protocols and determine whether adding vibration to SMR enhances benefits for increasing range of motion and improving power performance when used as a warm-up.
Protocol for Using Percussion Massage Device
- Start with a higher setting and superficially (with gentle pressure) trace the entire surface of the muscle.
- Setting 3 is likely appropriate for the lower body.
- Take a mental note of dense or sensitive points. Manual therapists may use the opposite hand to palpate for taut bands and nodules (trigger points).
- Stay away from areas where the bone is superficial. Using percussion massage devices over bone may be uncomfortable, painful, and/or cause bruising. Placing a finger or thumb over bony protuberances will prevent accidental contact.
- Using a piece with a smaller surface area and lower setting (setting 1), return to the dense/sensitive points using deeper compression.
- It may be helpful to add tension or slack by shortening or lengthening the target tissue
- The Brookbush Institute recommends 30 seconds to 2 minutes per muscle group, and 5 minutes as an upper limit even in the case of multiple trigger points.
Best Body Position:
- Lying in prone
- Child's pose also works well if the patient/client can comfortably maintain the position.
Bony Areas: (Block with a thumb or finger when approaching these areas)
- Spinous process
- Posterior iliac spine
- Sacrum
Muscles:
- The erector spinae and multifidus are superficial muscles on either side of the spine. Ask your patient/client to adjust their clothing to reveal the lumbar region of their back. (With a little practice this technique may be performed through clothing.) Identify the "valley" created at the spinous processes of the lumbar spine. The valley is created by the layers of fascia and skin being tightly bound together to the tips of the spinous process. The "hills" or "columns" of tissue are created by the mass of the multifidus and erector spinae filling the fascial sheaths on either side of the spinous process like long, tube-shaped balloons.
- Common Trigger Points: Because the erector spinae and multifidus are segmentally innervated, trigger points may occur in any fascicle along their length. A very common multifidus trigger point occurs adjacent to the L4/L5 segment, just medial the PSIS. Common erector spinae trigger points seem to develop adjacent to the mid-lumbar spine and thoracolumbar junction, perhaps where these fascicles originate on the thoracolumbar fascia.
