Everyone has their go-to gadgets in their therapy clinic- the tools that we use most days, most frequently, and couldn't imagine life without. I will start off by saying that I am SO very grateful to have access to so many awesome tools & therapy "toys" in my clinic, large and small, expensive and cheap. Just like with most toddlers though, the "Go-To" items that I literally use every single day are some of the cheapest in my facility. I'm always a little suspicious of things that are truly "cheap" because this could mean that they are cheaply made, and thus require frequent replacement from wear & tear. This is not the case for these items. Yes, some of these things need to be replaced because I run out of the supply from using them on patients. Otherwise, the durability of these items are tried and true.
My case load is easily made up of 90% shoulder cases- from post-surgical to elite athletes. So this list comprises mostly items that I use for these clients- but several of them can be used for many other body parts and conditions. As 2019 is winding down, and the holiday season is firing up, I couldn't help but reflect on the months behind me: things I've learned, goals I've achieved, ways I've failed, and gadgets that staples in my clinic. In the spirit of shopping this week, here are my Top 10 Therapy Gagdets you need to hunt down for your clinic this Black Friday. You won't be disappointed!
Disclaimer: I have no financial conflicts or ties to any product listed below. All items are my true, unbiased recommendations!
1) Lacrosse/Mobility Balls
I use lacrosse/mobility balls for modulating neural muscle tone on most of my patients with shoulder pain. Not only are these great for reducing overall tone in a muscle (via rolling with the grain of muscle tissue for at least 60 seconds), but they are also great for pinning & stretching a stubborn "knot". I order these in serious bulk because I give them to patients as part of their homework- it's so easy and so effective! I keep these ready for clinic use as well, and they are super easy to clean between patients. You can also purchase them individually here, here, or in most Sporting Goods Stores for under $3. I even carry one of these suckers in my purse/travel bag.... my family & friends are notorious for needing one when we least expect it.
2) The Pronator
The Pronator design was originally intended for what you think: resisted pronation/supination. But I was first introduced to this product by Mike Reinold when he used it for a prone horizontal abduction exercise with a light weight on the end. The beauty of this device is that you can work scapular retractors AND the rotator cuff at the same time. This is one of the exercises that wears my patients out the fastest. We work on retraction without shrugging, and holding the "hammer" parallel to the ground for stabilization. When they get good with 1 hand, we move to a hammer in EACH hand and their chest over a ball, like this. I typically have patients hold this movement for 3-10 seconds, watching a clock for accuracy (because we all know when fatigue sets in, that "10 second hold" might as well have been counted by 5's). Super effective and easy to modify the resistance. A cheaper alternative is literally using a hammer- which most people have at home (minus my college kids, of course- they barely have forks).
3) Theraband CLX bands
Theraband listened to the needs of therapist around the country- we are CONSTANTLY tying knots (and ending up with only loops, whereas I feel like it should more resemble an elephant or puppy by the time I'm done) in resistance bands. The Therband CLX Bands solve this issue with loops designed in the bands. This cuts down on wasteful cutting of bands to serve a single purpose AND they are latex free. Thank you Kevin Wilk for showing us many dynamic exercises that would never be achieved with regular rolls of Theraband. This specific kind of band can be expensive to hand out regularly to patients, so I use these solely for the clinic and cut regular Theraband (with my elephant/puppy loops) for patients to use at home. I use nearly every color of this product- particularly the strongest (gold/silver) for MET's, and lighter resistances for exercises like these:
4) Perform Better Bands
Less cutting theraband, 100% easier to clean, better resistance for lower body exercises. I use these daily for many different things- I'm positive your imagination can run wild. These bands are pretty resilient, but also something I keep in clinic rather than issuing to patients due to cost. The yellow resistance is the lightest, and nearly equivalent to the green theraband on the roll. Yellow and green are usually the highest I need for upper extremities, whereas blue and black are often needed for lower extremity exercises. Because the yellow is used most frequently, it's often the one I have to replace the most (about every 3-4 months) depending on usage. You can find these gems here and here.
5) Light Kettle Bells
I use 5lb, 7.5lb and 10lb kettlebells a lot for shoulder exercise. The kettlebell provides a great source of rhythmic stabilization for rotator cuff exercises like this. The most mobile joint in the body requires initially light weight as we work to improve stability- progress the degree of elevation from supine at 90 degrees, incline at 120 degrees, to standing at 180 degrees. Kettle down and kettle up are great ways to progress as well. The question becomes, how efficient is your patient with drawing circles (not squares) and the alphabet? A quick Google search will help you find them here, here, and here.
6) Baseball/Softball Resistance Band
Because why not? Why not motivate your athletes by simply putting a ball back in their hand? I use these bands for my advanced throwing warm ups in baseball and softball players. I got the baseball resistance band from here and the softball resistance band here.
7) Edge Mobility Tool
I use instrument-assisted soft tissue mobilization a lot when METs and self mobilization aren't enough. My favorite tools are under lock & key (aka a lot of paperwork and $$$), so for the affordability, material and quality, the Edge Mobility Tool is my current preference. The metal in this tool provides better resonance and has multiple kinds of edges to use (beveled for deeper tissues, sharp for superficial tissues, large & small surface areas), and is on sale!
8) Small Weighted Medicine Balls
Rhythmic stabilization is a big part of my rehab plan for most shoulder & elbow conditions. Medicine balls are a great way to achieve this goal, especially when they fit in the palm of the hand & fingers are open. I cue patients to hold the ball at shoulder height while I provide perturbations or have them roll the ball in tiny circles on the wall. I also use these for ball flips of all kinds. Enter the Theraband Soft Weights. These vary in weight by kilogram- I use the 1kg, 1.5kg and 2kg weights the most. We've had these in my clinic for at least 5 years and have YET to replace them- very durable and super easy to clean too!
9) Kinesiotape
Most research articles cannot prove that kinesiotape is effective for treating anything. The problem with this research, like with most therapy-related evidence, is that kinesiotape should never be used to "fix" anything. I use kinesiotape a TON to help cue posture and positioning between treatment sessions. I find that patients have less tension between therapy sessions when I've used kinesiotape, meaning it requires less work to gain mobility at the next treatment session and I can focus more on strengthening/stabilization. There are of course patients that are allergic to adhesive, including kinesiotape, but I've found good success with using a thin layer of this to help a patient tolerate it for up to 24 hours longer.... call me crazy, but this nonsense works. All of it. Lord knows there are plenty of brands out there. I use this one and this one in clinic regularly, and have this one with pre-cut strips at home. I never use white- for some reason, I think the dye in the other versions gives better resistance and tension than the white tape. The theraband brand is awesome for their stretch technology also- aka a self check on how much tension you apply for various strips (which is quite handy if you need to teach a patient or their family how to apply it at home).
10) Soft Medicine Balls
When it's time to progress from basic strengthening into more plyometrics, medicine balls are a great way to achieve that. With all the baseball players I've seen, I have worn through some medicine balls so much they look like Bailey's (my yellow lab) squeaky toys when she decides to shred them of all stuffing. I went in search of a more durable medicine ball and came across these. This brand has held up the best through multiple teenage, high school and college players.... and let's be honest, that's a lot of aggression. There are hundreds of variations for utilizing "gadgets" like these, I recommend visiting Eric Cressey's website & social media pages for lots of ideas.
Happy Shopping!
コメント