Sternocostal Mobilization with the Hypervolt

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

1. 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.
2. 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.
3. 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
4. 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:

• Supine for sternocostal mobilization

Bony Areas: (Place a towel folded several times over the sternum and sternocostal joints)

• Sternum
• Sternocostal joints
• Sternoclavicular joint
• Lateral humeral condyles

Joints

• The sternocostal joints: The articulation between the sternal end of ribs 2-7 and the accompanying costal notch on the sternum. This sternal ends of the ribs can be felt as round bumps on the lateral aspects of the sternum (or the sternal end of the ribs), deep to the medial attachment of the sternal head of the pectoralis major.

Mobilization:

• Through a folded towel, apply pressure over the joint in an anterior-to-posterior direction. Hold over each joint for 10 - 30 seconds. Manual therapists can assess if arthrokinematics stiffness has reduced using manual passive accessory mobilizations.