Daily Mobility Exercises by Dr. Kelly Starrett › Forums › General › TRS Mobilisation vs dynamic and PNF stretching with Isometrics for rehab of chro

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    • 02/21/2020 at 12:41 am #90865
      AvatarJamie Irving
      Participant

      Looking at many of these techniques they seem to combine massage (self) with dynamic, PNF stretching and Isometric exercises in end range. Most of the traditional research advises that these modalities are the most effective for rehabbing or restoring/increasing active and passive ROM for both acute and chronic issues. That said the volume and time requirements these traditional methods (not TRS) are much greater, e.g. isometrics holds for 45-60 secs x 5 sets, +1-5 mins PNF stretching + higher rep slow isolated eccentrics x 2-3 sets 3-4 days per week for 1 area (knee).

      QUESTION – Do i still have to continue with these ‘traditional’ and lengthy methods as well or can they simply be replaced with TRS mobilisations protocols?

      Also for chronic issues, i.e. compound fractures and recons that now have decades of compensatory measures/movement patterns, assuming consistent frequency and intensity of TRS protocols, how long before someone expect to persist before seeing a more permanent return to normal painfree ROM and movements? Obviously this is variable, however a range would be great.

      Thanks again.

    • 02/28/2020 at 12:32 pm #91078
      Michael AlzheimerMichael Alzheimer
      Moderator

      Hey Jamie!

      As you mentioned, the great thing about the TRS techniques are that they incorporate the principles of these “traditional” methods. Your mobility routine needs to be sustainable, so extensively long routines don’t tend to be effective. So no I wouldn’t necessarily recommend trying to throw all these protocols together. More is not always better, and in fact you could certainly over treat an area as well. We are big advocates of 10-20 min/day. We are looking to get a dose/response and then move on.

      In terms of chronic issues if you spent years in compensated positions you can expect it take a long time to get out of it. It depends on many factors and it can vary greatly but ideally you still want to be seeing changes from week to week and month to month and observing improvements in ROM and pain. If there’s no change then there’s no change and you need to adjust the strategy. However, it still can take quite a bit of time to restore ROM and be completely pain free. For chronic issues it’s often better to set 6 month or even year long goals rather than expecting complete resolution in just a few weeks.

      Cheers,
      Mike

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