Vibration therapy: stabilizing knee function in rehabilitation

Although I’ve used vibration therapy for stabilizing knee function in rehabilitation for over 10 years, it’s always refreshing to see some new research that substantiates some of the results we’ve achieved. This article is not only written for health professionals. If you have any knee pain or undergoing rehabilitation, you’ll get a great insight into how vibration therapy can benefit you. We’ll look at a great new research study and how vibration therapy can benefit the end user and the health professional.

Vibration therapy and neuromuscular control of the knee

Knee rehabilitation generally follows specific guidelines in the treatment process. Whether you are a physical therapist, chiropractor or strength and conditioning coach, having proper control of the knee stabilizing muscles is critical for increasing the effectiveness of an exercise program. When one thinks of vibration therapy, we tend to focus more on strength and flexibility gains. There isn’t much talk about neuromuscular control. This is one area of rehab that health professionals should begin seeing a huge advantage of integrating vibration into the process.

Let’s take a typical knee patient. They may have arthritis and limited range of motion, or they may be coming off knee surgery. Strength and flexibility are critical to recovery and are usually the main drivers of rehab. However, what if you could find something that could decrease the time to stabilize the knee joint? You can progress a patient through functional training or proprioceptive exercises with better neuromuscular control. The better control you have, the more effective that rehabilitation exercise becomes.

A study was recently done, and to be published in the Journal of Sports Science. The study looked at whether vibration exercises could improve neuromuscular control after single-legged drops. The significant finding was that the time to stabilize the lower-limb was lower in the vibration group. The group performed the vibration exercise for 1 minute, 6 times at 30 Hz and 4 mm. The study was done on a vertical vibration machine.

Practical implications of vibration therapy research study

The practical implications are significant. Our main focus with vibration therapy for knee pain has been to increase muscle activation of inhibited muscles. For the knee, this basically refers to the vastus medialis (inner thigh muscle) and the gluteus medius. We have been getting great response with using vibration exercise for strengthening and flexibility, but it’s the activation of inhibited muscles that showed the greatest benefit. Most health professionals know the frustration in trying to get these muscles to fire. The better they can fire with movement, the better neuromuscular control over the knee joint. Vibration exercise is one of the few treatment modalities that has been able to consistently affect these muscles.

The best situations that we’ve seen this to work is in those with arthritis and those that have undergone surgery. We’ve also used these principles in functional training and sports performance. If vibration therapy can truly decrease the time that it takes to stabilize the knee joint, then it becomes an important tool. However, everyone should also realize that the technology is one aspect of a complete rehabilitation program. It doesn’t have to be a stand alone tool, although I’ve been able to get much faster results using only vibration therapy. Do you have someone that is doing knee lunges or squats but has difficulty with proprioception and balance? Try 1 minute of vibration exercise, preferably in a squat position. Rest for 1 minute and attempt the squat or lunge again. You’ll begin to notice subtle improvements in balance and muscle firing.

In summary, vibration therapy research is beginning to show why vibration exercise has been an effective part of a knee rehabilitation program. It allows for increased neuromuscular control, in addition to activation of inhibited muscles. Using vibration therapy to stabilize knee function in rehabilitation makes it one of the most effective tools any health professional or patient can use in return to optimal function.

About the Author Dr. Jasper Sidhu

Dr. Jasper Sidhu has been using vibration platforms for over 10 years in rehabilitation, sports, fitness and weight loss settings. In addition to hands on treatment of patients and clients in these settings, he has lectured at various universities and medical association meetings on the application of vibration training.  

Leave a Comment:

Doreen Coles says January 8, 2013

I have sprained the med collateral ligament in my right knee 7 weeks ago. I took an impact to the outside of my knee when a large dog pounded into me when playing.
Though there is less pain, I still am having a lot of tightness in the knee joint when walking, or standing from sitting (which can be very painful). What suggestions do you have to treat this. I have at home a Gravity HQ (Vibration method is Pivotal).

    Dr. Jasper Sidhu says January 12, 2013

    Hi Doreen, here are a few things to consider that should help:

    1. Make sure you have been screened out by your therapist or doctor to ensure there are no other areas affected, like a meniscal or anterior cruciate ligament. This may require further intervention, conservative or surgical.

    2. The goal is to strengthen the thigh muscles while the medial collateral ligament heals. Gentle stresses are okay to help heal the ligament.

    3. If you are cleared to ‘strength train’ your thigh muscles, and there are no contraindications to suggest otherwise, begin by increasing the flexibility of the muscles around the ligament first. Do calf, hamstring and thigh stretches. You can do this lying down with the lower legs on top of the platform.

    4. The next step is to begin strengthening the calves and thighs. Start with the calves first. Then progress to squats. I always suggest someone to begin with the feet close on the machine. You’ll get a good sense of how that feels. If it feels good and there is no increase in pain, you can gradually separate your feet over the next few sessions. This increases the intensity of the vibrations on the thigh muscles.

    5. The key to remember is not to continue if you feel more pain. The key is to provide just enough ‘vibration exercise’ to continue strengthening the knee and helping the ligament heal with some gentle positive stresses placed on it.

    Hope that helps. It’s not a substitute for medical advice and you should always consult your primary physician or therapist prior to starting any exercise program.

Barb says August 27, 2015

My son just had ACL surgery for a complete tear. He received donor tissue, as well. His pain threshold is low and 2 days after surgery, he’s waking up with little pain. By the end of the day, he’s at about an 8 on the pain scale. Which note, frequency(ies) should I use and where? I have a full set of tuning forks, plus a medium ohm fork. If you could help me with his pain and his ligament’s healing, I’d very much appreciate it.
Thank you.

    Dr. Jasper Sidhu says August 28, 2015

    hi Barb

    At this early stage of the game, its all about proper rest and then movement based on what his therapist and surgeon are recommending. I don’t usually like to deviate from this. ACL protocols in the first 6 weeks are very strict with respect to what you can and cannot do. Once he’s able to weight bear and regain range of motion, you may want to discuss alternative options with the therapist or surgeon. I’ve had meniscal surgery before and I also followed a strict rehabilitation program until i was out of pain, with full range and able to weight bear. Hope that helps.

pat schmidt says April 9, 2016

I have had a double bi-lateral partial knee replacements on the inside of both knees five weeks ago. Have seen conflicting reports on using vibration therapy on knee or hip replacements. Can you give me some more insight on this issue?

    Dr. Jasper Sidhu says April 18, 2016

    hi Pat

    You’re seeing conflicting reports because the benefits are not just dependent on the type of knee surgery, your surgeon’s specific exercise progression recommendations, and the type of machine itself. In a nutshell, here’s what you need to know:
    1. If you are performing other exercises under the supervision of a therapist or your doctor, continue doing those for now.
    2. For vibration, I usually recommend someone use it as a complement to other exercises that they’re doing. If you’re looking to buy a machine specifically for your surgery, I suggest sticking with your current exercise program instead. If you already have a vibration machine, I usually recommend someone begin using a vibration machine around 8 to 10 weeks after surgery. This number usually changes. A couple years ago, i would do it after 6 weeks (a research study also pointed to 6 weeks as acceptable). However, I like to make sure someone is fully engaged in regular exercises for at least 8 weeks. That’s just my comfort level nowadays based on my experience.
    3. For knee or hip replacements, vibration exercise is going to be beneficial. But you still need to talk to your surgeon or therapist so you are all on the same page when it comes to what exactly you want to get out of it and whether it’s something that’s going to enhance what you are currently doing.

    I hope that answers the question. As you can see, there are benefits, but starting with vibration exercise for your condition is dependent on several other factors so that you can get the best outcome. Let me know if you have any other questions.

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