As is often the case, I began this post having no idea all it would entail. Researching any topic I end up going down all kinds of interesting rabbit holes. For instance, I had no idea percussion and vibration devices went back so far in history – some records mention evidence of Cleopatra having used a form of vibration with bees in a dried gourd (no, I don’t know her purpose or chosen site of said bees). Motives for using these historical devices varied extensively: beauty treatments, pain, “hysteria,” and, of course, sexual stimulation. As is often the case, popular “historical” perspectives can circulate for years only to be later shown to have no basis. So gleaning the truth can be challenging. Suffice it to say that the application of percussive and vibratory forces to the human body is not new.
My internet search of the history of the vibration device yields all kinds of information, some of it kind of kinky (be careful where you go!). As far as I have seen and generally speaking, vibration devices precede percussive. Perhaps this is due to the fact that the piston, an essential component in percussive devices, was not invented until long after Cleopatra and her bees. In specifically researching the history of percussion, the name Josef Leopold Auenbrugger surfaces recurrently as being the father of the concept. He “tapped” into it by wrapping on wine kegs to discern how full they were, and went on to apply his methods to identifying fluid in the lungs. His work went unheralded and plagierized by others for many years, prompting this brutally honest comment from him which still holds true today.
I have not been unconscious of the dangers I must encounter, since it has always been the fate of those who have illustrated or improved the arts and sciences by their discovery, to be beset by envy, malice, hatred, detraction, and calumny.
Auenbrugger 1807
People frequently blur the difference between the forces of percussion and vibration, so it can be difficult to know from a picture which action a device truly imparts even though it’s labeled as a percussor or vibrator. Adding to the confusion is that they may both be labeled as “massage tools.” Perhaps a few definitions will help to clarify:
- Percussion: bypassing the musical instrument definition, in this case we are talking about the striking of one solid object with or against another with some degree of force.
- Vibration: an oscillation of the parts of a fluid or an elastic solid whose equilibrium has been disturbed, or of an electromagnetic wave.
As you might perceive, there is potential for some overlap in these definitions, perhaps owing to the smudging of precision in use of terminology. Both percussion and vibration forces require the input of energy to operate (be it muscle, battery, or electricity). Yet the resultant output differs greatly. The key difference may boil down to the words striking versus oscillation in the above definitions. Percussion involves the movement of a pistoning head, while vibration does not. This pistoning action causes a fluctuation in the force imparted to the tissue, whereas there is far less fluctuation involved with vibration. Percussion typically involves a very targeted spot, while vibration can be more global and impact a larger area.
There are multiple tissues impacted by percussive and vibratory forces: skin, superficial and deep fascia, fat, lymphatics, nerves, muscles, blood vessels, bones, and organs. The power of the force imparted may certainly play a role in the tissue influenced. For instance, a gentle vibration force is more likely to impact the more superficial structures (skin, fat, superficial fascia, vessels, superficial nerves) than the deeper structures (muscle, deep fascia, organs). Reaching these deeper tissues may understandably require a bit more power from the chosen device, as well as a strategy for which device to choose. If my empirical evidence is worth anything (please tell me it is), I will say that when I want to impact the more superficial hypodermis I tend to migrate toward the oscillatory effects of vibration. When my target is the deep fascia, I look to the percussion tools more. Having said that, it’s worth pointing out that you can’t get to the deep structures without impacting the more superficial, so they always need to be considered. In other words, perhaps there’s an order to all this that necessitates consideration of the outermost tissue layers in treatment before blasting past them to get to the deep stuff. In cases where the superficial tissues harbor significant dysfunction it may be good to consider cupping.
The mechanisms for the impact of percussion and vibration on the tissues are thought to be multi-modal:
- Thermal – the transfer of kinetic energy from the percussive/vibratory device to the tissues layers creates friction, stimulating a tissue temperature rise. This is evidenced by a palpable warmth in the area targeted, as well as reddening of the tissue which signals increased circulation/vasodilation. It’s kind of like clapping or rubbing your hands for an extended period.
- Biochemical – the low level trauma introduced by percussion/vibration stimulates a localized inflammatory process. This ushers in the release of a host of biochemicals including histamine (causing temporary localized itching), and hyaluronan (also known as hyaluronic acid) which promotes tissue lubrication.
- Biomechanical – the percussive/vibratory action begins to break up the dysfunctional bonds adhering tissue layers, nerves, and other structures (like adipose cells) together, promoting lubrication and slide.
- Neurological – percussion stimulates proprioceptors (nerves that detect motion) which can override nociceptors (nerves that transmit signals to the brain that may provoke pain). Percussion/vibration can also serve to free up nociceptors trapped in adherent tissue layers as mentioned in #3 above.
As mentioned earlier, there are many reasons for using percussion and vibration. Within the realm of rehabilitation, evidence shows benefits such as muscle relaxation/facilitation, wound and fracture healing, improved circulation, nervous system inhibition/facilitation, pain control, and improved flexibility. The effects vary according to the power of the device used, frequently measured in hertz (Hz), as well as amplitude and torque. Studies show varying effects on parameters such as blood flow according to the power of the device, as well as the length of time applied. While there is wide variability in protocols, there seems to be some agreement that 30-50 Hz applied for five or more minutes generates positive therapeutic effects. In other words, that little AA battery-operated buzzing child’s toy is not going to give you the same effect as a more powerful unit.
In future posts I’ll explore more on using percussion/vibration, choosing an appropriate device for your needs, knowing where to work, and the basics of using percussion and vibration as part of a self-management strategy.
Wishing you health and joy!
Colleen