Isometric Exercise: A Powerful Tool for Rehabilitation

For individuals going through post surgery, injury rehabilitation, illness and/or chronic condition management, can physical therapy isometric exercises help?

Isometric Exercise

Isometric exercises are used in physical therapy to help build muscle endurance, improve range of motion, relieve pain, and reduce blood pressure more effectively than other types of exercise. Because they don’t involve joint movement, they are a solid starting point for rehabilitation and are suitable for individuals with a limited range of motion. They can be performed by pushing against an immovable object, like a wall, or by having a therapist provide resistance. Examples of isometric exercises include:

• Planks
• Glute bridges
• Adductor isometrics

A physical therapist/PT may have a patient perform isometric exercises after injury or illness. During an isometric contraction, the muscle does not change in length, and there is no motion around the joint surrounding the muscle/s. (Rhyu H. S. et al., 2015)

When To Use

Isometric muscular contractions can be used at any time during physical rehabilitation and strengthening or a home exercise program and are regularly used with the following (Rhyu H. S. et al., 2015)

• Post-surgery
• When muscles cannot contract forcefully enough to move the joint it surrounds.
• To help increase neuromuscular input to a specific muscle/s.
• When injury or condition frailty makes other forms of exercise dangerous and not beneficial.

A healthcare provider or physical therapist should be consulted first if isometrics are used in a rehabilitation program.

Benefits

The benefits of using isometric exercise after injury or surgery may include the following:

• No special equipment is necessary to perform isometric exercises.
• The ability to safely contract a muscle while protecting a surgical incision or scar tissue.
• The muscles can be strengthened in a specific range of motion around a joint. (NikolaidouO. et al., 2017)

A physical therapist can help determine whether isometric exercise benefits the specific condition.

Effectiveness

Isometric exercise is very effective after injury or surgery. However, when a muscle is contracted isometrically, it gains strength in a very small area and with a short range of motion. For example, an isometric shoulder external rotation performed with the arm at the side will only strengthen the rotator cuff muscles in the specific position that the arm is in. (NikolaidouO. et al., 2017).

• Strength gains are specific to the joint’s position during the exercise.
• Individuals who want to strengthen their gluteal muscles in their hip using isometrics would have to contract their glute muscles in one specific position for several reps.
• Once several reps of the exercise in one position have been performed, the individual moves their hip joint into a new position and repeats the gluteal contractions in the new position.
• This makes the exercise time-consuming, but it is perfect for injury rehabilitation, preventing and avoiding worsening or further injuries.

How to Perform

To perform isometric exercises, all that is needed is something stable to push against. (Rhyu H. S. et al., 2015) For example, to strengthen the shoulder muscles:

• Stand next to a wall and try to lift an arm out to the side.
• Allow the hand to press against the wall so no motion occurs at the shoulder joint.
• Once pressed against the wall, hold the contraction for 5 to 6 seconds and slowly release it.
• Perform 6 to 10 repetitions of the exercise.
• This could be one set of completed isometric exercises for the shoulder muscles.

Elastic resistance bands or tubing can also be used to perform isometric exercises. Hold the tubing in a specific position and then move the body away from the anchor point instead of moving the joint. The muscles will contract against the increased resistance of the elastic tubing, and no motion will occur at the joint. A physical therapist can show and train on how to perform isometric exercises with the bands.

Neuromuscular Stimulation

Isometric exercise can strengthen muscles and help improve the neuromuscular recruitment of the muscles being trained. This enhances muscle contraction and expedites gains in muscle recruitment while protecting the joint. Isometric exercise can also be used during physical therapy using neuromuscular electrical stimulation (NMES). (Fouré A. et al., 2014) For example, a PT may use NMES to improve muscular function for individuals who have difficulty contracting their quadriceps after knee surgery and may be instructed to perform isometric quad-setting exercises during the session.

Injury Medical Chiropractic and Functional Medicine Clinic

A physical therapist can use isometric exercises to help individuals injured or have had surgery and are experiencing difficulty with normal functional mobility by improving their strength during recovery. The exercises can safely enhance the function and stability of the muscles and return individuals to the previous level of activity and function. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

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Personal Injury Rehabilitation

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References

Rhyu, H. S., Park, H. K., Park, J. S., & Park, H. S. (2015). The effects of isometric exercise types on pain and muscle activity in patients with low back pain. Journal of Exercise Rehabilitation, 11(4), 211–214. https://doi.org/10.12965/jer.150224

Nikolaidou, O., Migkou, S., & Karampalis, C. (2017). Rehabilitation after Rotator Cuff Repair. The Open Orthopaedics Journal, 11, 154–162. https://doi.org/10.2174/1874325001711010154

Fouré, A., Nosaka, K., Wegrzyk, J., Duhamel, G., Le Troter, A., Boudinet, H., Mattei, J. P., Vilmen, C., Jubeau, M., Bendahan, D., & Gondin, J. (2014). Time course of central and peripheral alterations after isometric neuromuscular electrical stimulation-induced muscle damage. PloS one, 9(9), e107298. https://doi.org/10.1371/journal.pone.0107298