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Vibration Therapy

Whole lotta shakin’ going on! An odd rehab option for muscular inhibition (as in some cases of frozen shoulder)

Paul Ingraham, updated

Vibration therapies of many kinds are regarded as “stimulatory,” often with the implication of beneficial effects on our biology. Many kinds of treatments and therapies are basically based on different types of vibration, like using ultrasound or infrared radiation to vibrate our cells at a wide range of frequencies and amplitudes, or electrical stimulation,1 or even frickin’ lasers.2 Most such methods are not especially promising and there are no clear examples of a vibrational therapy that really delivers the goods.

There’s also a whole class of more fanciful and exotic claims that overlap with “energy medicine,” most of them cluelessly referencing quantum physics.

But this article is about coarser, stronger vibration. Jiggling! Shaking! Nothing subtle about it.

There are a few familiar types of coarse vibrational therapies:

A good condition to vibrate: frozen shoulder

This therapeutic approach might be more useful for folks with frozen shoulder (AKA adhesive capsulitis) than many other conditions. If the freezing is functional — if the joint is stuck because it’s inhibited rather than a physical limitation3 — vibration might be quite a good way to disrupt the inhibition.

Even if a case of frozen shoulder is completely dominated by contracture, it’s still a condition that relies heavily on the use-it-or-lose-it principle, and there’s almost always some inhibition piled on top of the contracture. Vibration could help eliminate that, creating a window of opportunity for as much movement as the contracture can possibly allow — and every little bit counts.

There is no evidence that this is the case. This is just a hypothesis. But it’s a really promising one, I think. I’ll explore it a little more below.

Other conditions to vibrate … or not

Other conditions where movement dysfunction might be a significant factor, and a bit of why, and therefore might be helped by vibration:

Conditions less likely to be helped:

The effects of vibration

Not many people take vibration seriously as a therapy, which is probably wise. The science on it is thin and inconclusive (of course), though there have been a few scraps of encouraging evidence.45

Coarse vibrations might have some intriguing neurological effects. The best example I’m aware of: it appears that if you just add some vibration, even already flexible gymnasts can get a surprising boost in flexibility.678 Clearly that is a neurological effect on flexibility … and a very cool one.

But these are largely uncharted waters, and it’s clear that some popular uses are failing to pass fair scientific tests. For instance, the trendiest application of vibration therapy trying to boost strength training results, which probably doesn’t work, according to a 2014 review.9

Why does vibration feel so good?

Vibration is inherently relaxing for most people, assuming it isn’t applied too suddenly or intensely or in an uncomfortable location. I think there are a couple reasons for this:

  1. Proprioceptive confusion. Proprioception is the sense of position or movement, our under-appreciated “sixth” sense. If you move or shake the body at random, the cerebellum gets a deluge of nonsensical proprioceptive data, sensory information about movements that the brain did not plan. Assuming a safe and healthy emotional context, the nervous system, overwhelmed by the flood of stimuli, willingly “gives up” and stops resisting the movement — an unusual state.

  2. Sensory novelty. Fresh and unusual sensations are the bedrock of massage therapy: when we get a good massage, we experience many sensations that are unique to that context, and that is half the appeal. But vibration delivers especially strong and distinctive sensory novelty: it feels like nothing else, and it feels like the opposite of feeling stuck and stagnant. Like splashing cool water on your face when you’re hot, vibration feels like a natural antidote to the sensation of stiffness.

To a minor extent, these effects might explain why people like the subtler, finer vibration therapies like TENS — but the “confusion” and “novelty” are also subtler, and the relaxation effect are definitely less profound.

More about the relevance to frozen shoulder

The effect of vibration on stretching mentioned above is also quite relevant to frozen shoulder. Flexibility is probably mainly a matter of our “tolerance” of stretch rather than the actual physical looseness of our tissues. In other words, our brains detect excessive stretch and actively block us from going further than it thinks we should. Vibration probably interferes with that, essentially “confusing” the brain about what an acceptable level of stretch is. And if it can interfere there, it might be able to free up a badly inhibited shoulder.

Even if it’s just a temporary, minor effect, it would still be an extremely useful way to faciliate range of motion exercises. My advice is to integrate vibration into your rehab plan, using it as a way to improve the odds that you’ll be able to move further.

Please experiment: try range of motion exercises before vibrating, and then try again after vibrating. Is there an obvious difference?

How to vibrate

The Thumper is a sturdy example of a vibrating massage tool, a class of massage tools that deserves a little more attention. There are many gadgets like the Thumper, but I am fond of the Thumper brand: a well-designed device built here in Canada. I’ve had my Thumper for about 15 years now, and it works as well today as it did the day I brought it home. I used it routinely in my clinic for many years (a favourite part of the treatment for many clients), and mainly as a self-massage tool ever since, but it’s also a nice easy way for my wife to give me a quite a bit of massage for minimal effort.10

The “Thumper Maxi Pro” is the thumpingest of all vibrating massage tools. (Except for the one built for horses.)

A Thumper is not cheap, so there ought to be a good reason to get one. Fortunately, it offers a lot of value regardless of therapeutic effect, just as massage does generally, but probably even more so: for those who enjoy them, vibrating massagers can deliver a lot of pleasant stimulation super conveniently for a long time. It may cost up front, but over the long haul it’s quite economical.

This has been a short excerpt from my frozen shoulder book. If you want to know more, there’s a substantial free introduction, and a couple of other excerpts available:

About Paul Ingraham

Headshot of Paul Ingraham, short hair, neat beard, suit jacket.

I am a science writer, former massage therapist, and I was the assistant editor at ScienceBasedMedicine.org for several years. I have had my share of injuries and pain challenges as a runner and ultimate player. My wife and I live in downtown Vancouver, Canada. See my full bio and qualifications, or my blog, Writerly. You might run into me on Facebook or Twitter.

Related Reading

Here are a few other articles tangentially related to vibration therapy, but there are dozens more therapy and rehab options and concepts reviewed on PainScience.com.

What’s new in this article?

MarchAdded a couple citations; some editing and clarifications.

MarchPublication.

Notes

  1. There are two electrical stimulation therapies that produce vibration-like sensations:
    • transcutaneous electrical nerve stimulation (TENS) stimulates finer vibrations with electricity, basically “tingles” that feel somewhat vibratory
    • electrical muscle stimulation (EMS) is closely related to TENS, and uses slightly different settings to cause muscles to contract very rapidly
  2. Even light/laser therapy (photobiomodulation therapy) could be considered a kind of vibration therapy, just on extremely small scales — molecular at the largest — but now we’re reaching a bit. Still, many people have observed over the years that waves and oscillations are an extremely fundamental aspect of nature at all scales. This doesn’t translate into any clear clinical implications, and note that laser therapy is included in the treatment hall of shame here.
  3. Ingraham. The Role of “Spasm” in Frozen Shoulder: How to identify cases of functional frozen shoulder, dominated by muscular inhibition. PainScience.com. 1553 words.
  4. Germann D, El Bouse A, Shnier J, Abdelkader N, Kazemi M. Effects of local vibration therapy on various performance parameters: a narrative literature review. J Can Chiropr Assoc. 2018 Dec;62(3):170–181. PubMed #30662072.  PainSci #52722. 

    The Journal of the Canadian Chiropractic Association isn’t exactly The Lancet, but I agree with them that “Most studies found that LMV elicits beneficial changes in the mentioned outcome measures.“ And I also agree that the research is “heterogenous“ — way too many different varieties of vibration — and probably also too shabby to draw any conclusions from.

  5. Broadbent S, Rousseau JJ, Thorp RM, et al. Vibration therapy reduces plasma IL6 and muscle soreness after downhill running. Br J Sports Med. 2010 Apr. PubMed #18812416. 

    This is a test of vibration therapy on sore muscles in runners. 29 male creational runners were studied after running a 40-minute downhill run. Half were given “once-daily sessions of vibration-therapy on the upper and lower legs,” and the other received no treatment. Vibrated muscles were less sore and had fewer blood markers associated with soreness

    Conclusion: “Vibration therapy reduces muscle soreness and IL6. It may stimulate lymphocyte and neutrophil responses and may be a useful modality in treating muscle inflammation.”

  6. Issurin VB, Liebermann DG, Tenenbaum G. Effect of vibratory stimulation training on maximal force and flexibility. J Sports Sci. 1994 Dec;12(6):561–6. PubMed #7853452. 

    In this 1994 experiment, as described by Sands et al, gymnasts “used a vibrating ring suspended by a cable, in which the foot of the subject was placed while they stretched forward over the raised leg, targeting the hamstrings. The resulting increase in ROM was astonishing. These researchers demonstrated that vibration could enhance flexibility.” The results were replicated by Sands et al in 2006, and Kinser et al in 2008.

  7. Sands WA, McNeal JR, Stone MH, Russell EM, Jemni M. Flexibility enhancement with vibration: Acute and long-term. Med Sci Sports Exerc. 2006 Apr;38(4):720–5. PubMed #16679989. 

    This experiment replicated the results of an intriguing 1994 experiment by Issurin et al. Ten highly trained gymnasts did forward splits with or without vibration. They stretched to the point of discomfort for 4 minutes, alternating between each leg, 10 seconds of stretching at a time. Flexibility immediately after stretching with vibration was dramatically greater; the long-term results were less striking.

  8. Kinser AM, Ramsey MW, O’Bryant HS, et al. Vibration and stretching effects on flexibility and explosive strength in young gymnasts. Med Sci Sports Exerc. 2008 Jan;40(1):133–40. PubMed #18091012. 

    Replicates the findings of both Issurin and Sands — “simultaneous vibration and stretching may greatly increase flexibility, while not altering explosive strength.”

  9. Anwer S, Alghadir A, Zafar H, Al-Eisa E. Effect of whole body vibration training on quadriceps muscle strength in individuals with knee osteoarthritis: a systematic review and meta-analysis. Physiotherapy. 2016 Jun;102(2):145–51. PubMed #26619822. 
  10. Speaking of my wife, bless her charming idiosyncrasies: she thinks that “Thumper” sounds displeasingly violent for a massage tool, whereas most people seem to think of the Thumper of cute animated-character fame. (Still others imagine summoning enormous sand worms.)