The Flexionater can generate loads from zero to several hundred foot-pounds of torque to accommodate the specific mechanical characteristics of...
Clinical research explains that improving your motion requires the balancing of multiple biomechanical factors. A fundamental biomechanics’ principle was studied in the 1990’s, now known as the Total End Range Time (TERT) method. TERT informs how ERMI devices can effectively stretch and treat scar tissue. In landmark research, a study of shoulders advanced our understanding of shoulder motion loss, and established a benchmark for effective treatments of motion loss. [Learn More]
In that study, loss of shoulder motion was reported as one of the most common reasons patients seek medical attention. Often loss of shoulder motion is diagnosed as so-called “Frozen Shoulder” by clinicians not specifically trained in treating shoulder conditions when the actual condition is Selective Hypomobility (SH). SH is a condition in which a portion of the capsule becomes abnormally tight resulting in abnormal pressures on the humeral head and reduced functional motion in the shoulder. Treatment of Selective Hypomobility calls for aggressive stretching of the shoulder to regain lost motion.
Soft Tissue Mechanics Revealed:
At the microscopic level, collagen fibers in a stiff joint contract and adhere to one another forming scar tissue leading to motion loss. Initially, this scar tissue is somewhat compliant, but over time it gets stiffer and stiffer, and becomes much harder to stretch out. Therefore, the earlier a patient is identified as having motion-loss and is started on an aggressive stretching program, the more likely they are to regain the lost motion.
Total End Range Time (TERT)
The TERT method of treating patients with stiff joints strives for permanent elongation or stretching of the scar tissue that causes motion restrictions. The formula for TERT is as follows:
- Intensity: The maximum a patient can tolerate based on pain threshold.
- Duration: 60 minutes of end range stretch per day is optimum (e.g.; 20 minutes; 3 times per day).
- Frequency: The 60 minute stretching protocol should be done every day.
TERT RESEARCH SUMMARY
Focused Exercise Aids Shoulder Hypermobility.
Source: Davies, and Ellenbecker, Biomechanics, November 1999.
APPLICATION OF TERT RESEARCH:
Based on the clinical research, ERMI balanced 3 key components to improve motion:
- The intensity or force of the stretch (Intensity)
- How long you hold the stretch (Duration)
- How many times per day you stretch (Frequency)
- Intensity – the stretch should be close to, but not above, your pain threshold. It should be uncomfortable, but shouldn’t be painful. This is called “overpressure stretching”, and has been demonstrated to be very effective.
- Duration – you need to stretch at a high intensity for a total of 60 minutes per day, but doesn’t have to be done all at once – you can be break up your stretching into smaller periods of time.
- Frequency – studies have shown that you need to stretch more than once per day in order to keep the motion gains you make during therapy.
When these components are balanced appropriately, the scar tissue is treated effectively. Permanent elongation of the tissue results from the appropriate balance of intensity, duration, and frequency.