The Rehabilitation Benefits of Suspension Training

Motion is Life. – Hippocrates

Motion is at the core of our development and remains an essential part of our well-being throughout life.

We often take the ability to move efficiently without pain for granted. When we move, we typically dismiss the subtle adjustments our body and mind make to support functional motion.

But when we lose the ability to move without pain, it is an awakening to just how miraculous the human machine really is. In movement, pain changes everything.

Movement patterns are affected by the subtle changes in behavior the body uses to compensate for the painful dysfunction. The nervous system innately goes into protective mode by adding stiffness and/or tightness to ensure sustained movement. Unfortunately, it does so at the cost of the normal biomechanical relationships between mobility and stability factors.

The art of human movement encompasses all angles, vectors, forces and directions. We can no longer use antiquated rehabilitation programs performed on linear-based equipment and expect the body to restore proper movement.

Human movement is a behavior, and it should be thought of in terms of behavioral patterns. To optimize patterning, we must integrate rehabilitation protocols using body-weight exercises aimed toward optimizing multi-joint movements in more challenging force vectors.

The majority of musculoskeletal pain syndromes, both acute and chronic, are the result of cumulative micro-trauma induced by repeated dysfunctional movements and positions. We can reduce the risk of injury by "teaching" the body to move more efficiently.

Suspension training principles comprised of more dynamic directional vectors, angles and forces is a highly effective strategy for accomplishing this goal.

What It Is

What is suspension training, and why care about directional vectors? Suspension training is characterized by one or more hands or feet supported by a single anchor point while the opposite end of the body is in contact with the ground. It uses your own body-weight as resistance and takes advantage of stability to load and unload exercises.

Directional Load Vectors

According to strength and conditioning specialist Bret Contreras, "Load vectors refer to the direction of force resistance relative to the human body. Since load vectors are relative to the body, one must consider both the position of the human and the direction of the resistance in order to determine the load vector."

The diagram to the right depicts ways of illustrating the six primary load vectors in strength training rehabilitation.

In the sagittal plane, there are three main types of load vectors: axial, anteroposterior, and a combination of axial and anteroposterior. In axial exercises, the direction of the resistance comes from top to bottom (or vice-versa) in reference to anatomical position. In anteroposterior exercises, the direction of the resistance comes from front to back (or vice versa) in reference to anatomical position. In axial/anteroposterior blend exercises, the direction of resistance is halfway between axial and anteroposterior at a 45 degree angle relative to the human body.

Body-weight axial exercises are usually performed when standing, while anteroposterior exercises are performed in the supine, quadruped or prone positions.

Most people perform solely single-vector body exercises and need to perform more multi-vector body exercises to maximize their recovery, athleticism and muscle activation. Suspension body-weight training can integrate all of these vectors to balance strength levels and prevent injuries.

Load vectors profoundly impact muscular activation during exercise. Muscles become stronger over time, enabling them to resist various loading patterns.

Suspension-training body-weight exercise is uniquely effective at enabling loading and unloading of movements to meet individual client needs. Remember, suspension training is distinguished from traditional exercises in that either the user's hands or feet are generally supported by a single anchor point, while the opposite end of the body is in contact with the ground. Therefore, the client is in total control of exercise ranges of motion, thus decreasing neuromuscular "guarding" mechanisms.

The versatility in manipulating load and stability is a functional training strategy that is critical in the treatment and prevention of musculoskeletal injuries and improving durability. One excellent example is the overhead squat with a suspension trainer.

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This exercise enables you to work the posterior chain by limiting flexion and controlling the upper torso. The two straps and handles attached to the central anchor point increase stability and prevent poor technique. (See image at right).

Single-leg movements on a suspension trainer, such as reverse lunges, are easier to perform and less intimidating for clients who are new to corrective exercise, since body-weight load on the leg can be altered easily by handle and strap positioning. (To see an example of this exercise, access the online version of this article at DCPracticeInsights.com. Search under "Nickelston" or visit the July 2011 issue.)

Functional Training

Rehabilitation programs should always include functional training principles. Functional training typically involves an integration of multi-planar total-body exercises with variable challenges to load, balance and stability. It is an exercise continuum involving balance and proprioception performed without machine assistance. This enables your clients to become more adept at accomplishing activities associated with daily living such as bending, twisting, turning and rotating.

It is common in rehabilitation to prescribe exercises that are focused solely on the injured or symptomatic area. This negates the principle of a full-body continuum of multi-joint, movement-based rehab. During activities of daily living, the body does not move in isolated patterns. It moves as an integrated unit, be it functional or dysfunctional. Either way, it moves!

Suspension training engages the entire body, and hence the core, with every exercise. This full-body engagement is partly under volitional control, while challenges to balance and stability rely on feedback-mediated adjustments and anticipatory control.

Depending upon the phase of rehabilitation and individual needs, exercises may be modified to place more emphasis on motor- control adaptations than tissue adaptations. To increase motor control, it is necessary to establish static and dynamic stabilization. During the performance of whole-body, multi-planar exercises, muscular and joint forces are distributed across the bod,y thus lessening the load of direct impact on volatile tissue.

Finding activities that enable a patient to confidently perform and progress on their exercise program is important to long-term success in a rehabilitation program. Given the opportunity, clients will usually perform an exercise with poor technique. Be steadfast in your observation and coaching of movement. Keep in mind that it takes time for the neuromuscular system to learn a new behavior.

Observe whole-body movement patterns via suspension training to see if you have corrected the underlying dysfunctional problem. It's an unforgiving system of checks and balances. When it comes to patient care, you should accept nothing less.

Unique Appeal

Suspension training has a unique crossover appeal from rehabilitation into fitness and performance. Clients can easily integrate this form of exercise into their current program or lifestyle. Suspension training equipment is cost-effective and portable, allowing for ease of use in the clinical setting and the home environment. Patients may purchase the inexpensive equipment directly from you, thus adding to practice revenue from product sales.

In addition, you will have a broader appeal to the athletic population and can even organize group exercise classes to expand your practice services. You can feel confident knowing that clients will continue their home-prescribed program because they enjoy the movements, and more importantly, they see and feel the results!

The Practice Benefits of Suspension Training

• Cost-effective
• Easy to implement
• High patient compliance
• Value-added product
• Effective word-of-mouth advertising
• Can be used in exercise and fitness group classes
• Space-saver rehabilitation equipment

References

1. Contreras, Bret. T NATION | Dispelling the Glute Myth." T NATION | The Intelligent and Relentless Pursuit of Muscle. Web. 09 Mar. 2011
2. Cook, Gray. Movement: Functional Movement Systems : Screening, Assessment, and Corrective Strategies. Santa Cruz, CA: On Target Publications, 2010. Print.
3. Sahrmann, Shirley. Movement System Impairment Syndromes of the Extremities, Cervical and Thoracic Spines. St. Louis, MO: Elsevier/Mosby, 2011. Print
4. Boyle, Michael. Functional Training for Sports. Champaign, IL: Human Kinetics, 2004. Print.
5. Bettendorf, Brian. TRX Suspension Training Bodyweight Exercises: Scientific Foundations and Practical Applications, 2010 Fitness Anywhere, Inc.,San Francisco, California
6. Cressey, E., West, C., Tiberio, D., Kraemer, W., & Maresh, C. (2007). The effects of ten weeks of lower-body unstable surface training on markers of athletic performance. Journal of Strength and Conditioning Research
7. McGill, S., Karpowicz, A., Fenwick, C., & Brown, S. (2009). Exercises for the torso performed in a standing posture: spine and hip motion and motor patterns and spine load. Journal of Strength and Conditioning Research