Percussion & Vibration (part II)

This post is part of a series on Percussion and Vibration, and is best understood by reading the earlier post on the subject.

My dear husband, Bill, asked me if I was including the vintage vibrating belt machines in this series and I realized I hadn’t! Too funny because for years I have talked about them and wondered why they aren’t around anymore. Bill says it’s because they didn’t work. Maybe they didn’t work the way people expected them to as as a magic fat buster that melted pounds away effortlessly. Dream on. But in light of all that’s known about percussion and vibration I have to wonder if these machines have potential when used in conjunction with other measures. I have a future post planned on exploring adipose and metabolic problems, and I foresee it including vibration as well as cupping.

As I write this in 2021, percussion and vibration devices are all over the internet especially in the last few years. The first percussion device I recall being on the market years ago was the Theragun® which is the brainchild of chiropractor Dr. Jason Wersland. He was involved in a motorcycle collision which left him in disabling pain. He repurposed some power tools he had and redirected their percussive force to his painful sites with good results. (I love these kinds of stories – good coming from something bad!) He was certainly an early innovator in the introduction of percussion devices in the treatment of soft tissue pain, and has created an impressive line of products.

I was shamefully tardy to embrace the use of percussion and vibration in the clinic, even though several colleagues touted the benefits to me. Finally conceding to give it a try, I borrowed a Hypervolt® from one of them, which is another brand of percussion device that is a little less aggressive than the Theragun®. I remember holding it over the bony sacrum of a patient, and it started bouncing all over like a runaway jackhammer which startled me and turned me off to it for another year. (I should have been using a different head on the Hypervolt® for that bony site but I didn’t know better.) Eventually I gave it another chance, and I now own three of them! I also have a vibrating roller and vibrating sphere, both from Hyperice. I use these devices every day in the clinic on nearly every patient at least for some part of treatment.

Typically these devices are demonstrated by people moving the percussion gun around like they are sanding or painting, or rolling the body part being treated over the roller or sphere. To each his own, but that’s not how I use them. I apply the chosen device to the fascial densification points I determine to be in need of treatment in the Fascial Manipulation method. The device serves to prep the tissue in a relatively pain free manner – the relatively is in comparison to my elbow or knuckle. Percussion and vibration hurt the patient much less than my elbow, and also save me from having to do so much manual work: a win-win for both of us. Sometimes I’ll also use vibration after treatment to mitigate soreness.

The use of percussion versus vibration, as well as which percussion head to use, is determined by the anatomy and the patient. The percussion guns are very versatile and can be used on most body parts. If it’s a bony place (like that sacrum!) I may use the soft squishy head (many percussion devices do not have this head). If it’s a fleshy place like a hip I often use the ball head (looks like Mickey Mouse’s nose). I like using the vibrating roller for prepping fascial densifications in the abdomen or back of the leg before applying a manual shear force to them. The small sphere is very gentle, and I’ll use it on a head, neck, ribs, or other sensitive areas. It’s also nice for older adults or young children who can’t tolerate or are concerned about the more aggressive percussion/vibration devices.

While percussion and vibration are incredibly helpful, research supports that percussive and vibratory forces do not fully resolve fascial densifications. The manual component is still needed for maximal therapeutic benefit. This is perhaps due to the fact that neither percussive nor vibratory forces can impart the essential vertical shear component integral in the manual element with the elbow and knuckle. While more intense and uncomfortable, the manual element is also more effective. No machine currently existing can replicate this shear force and still leave the skin intact – yes, we like our patients leaving with their skin on. Guess I’ll always have a job.

In summary, there are multiple advantages to using these devices:

1. They reduce pain for the patient related to manual compression and shearing over fascial densifications. I think they can also help mitigate pain by serving as a distraction at one point while I work on another site.
2. They reduce the manual component I have to perform which helps me a lot!!!!
3. They allow me to work multiple fascial points simultaneously, which can help tremendously with time management.
4. They can facilitate a patient actively participating in a treatment session, such as when they hold the device. I find this strategy works especially well with children and teens to remove anxiety and apprehension associated with treatment.
5. They pave the way for self-management, independence, and implementing a home maintenance program.

In the next post I’ll explore how to put all this to work for you as part of a self-management strategy.

Wishing you health and joy!

Colleen