November 19, 2017

Whole Body Vibration Therapy: Benign Joint Hypermobility Syndrome (BJHS)

painAs a Physical Therapist, I often encounter individuals who suffer from more complex and often painful conditions.  These individuals, whether it is their joints (Rheumatoid Arthritis), their tendons or bursae (Connective Tissue Rheumatism), their muscles (Regional Myofascial Pain Syndrome) or their whole entire body (Fibromyalgia), struggle day in and day out with nowhere to turn.

Since I have utilized Vibration Therapy to treat these patients, one thing has been clear; the ability they have to push their bodies physically while reducing their pain is unlike any other intervention. Vibration Therapy as well as Vibration Training, when done correctly and safely, is a highly beneficial exercise program with little to no negative musculoskeletal stress.

Due to the unique complexities of the issues mentioned above, they are deserving of their own articles. My goal with this article however, is to raise awareness to another condition that in itself is a problem and can benefit from Vibration Therapy. A condition that has an increasing amount of connectivity to each of the above mentioned conditions…..

Benign Joint Hypermobility Syndrome (BJHS)”

Definition:

This medical diagnosis, inaccurately termed “benign” usually takes anywhere from 2 – 5 years to be identified and properly diagnosed. It is defined as “the occurrence of musculoskeletal pain in and around hypermobile joints (otherwise referred to as joints with “loose” or “lax” ligaments) in the absence of systemic rheumatological disease”. The latter portion, I believe, is inaccurate as a general rule however, and time will likely prove this point.  So how exactly does BJHS become problematic and how does Vibration Therapy help?  It all starts and ends with communication.

Lost In Translation:

By nature, the function of ligaments is to provide stability to our joints. This stability allows the primary movers of our joints, the muscles, to carry out their functions efficiently. Surrounding all muscles and ligaments, and connecting everything together, is fascia. Within the ligaments, muscles, and fascial tissue are “reporting stations” (aka joint receptors) whose vital function is to relay the information relating to these specific tissues to our brain. This communication system is called Proprioception. This crucial information traveling to the brain determines the nature of the information going away from the brain. It is a two way street of dependency and includes not only messages to and from the connective tissue, but to and from other vital body functions. This information also dictates the release of nutrients and neuropeptides. Neuropeptides control our mood, energy levels, pain and pleasure reception, body weight, and ability to solve problems; they also form memories and regulate our immune system.

When these systems, as a result of hypermobility and the resulting movement dysfunction, become inefficient, the information systems become altered. This leaves us, with a reversal of roles (tight muscles and fascia around loose joints), and both an alteration in the transmission of the nutrients and neuropeptides as well as detrimental changes in circulation and oxygen supply. For the muscles fortunate enough to maintain their normal function, they inevitably compensate, become overworked, and develop internal dysfunction (Ever heard of a trigger point”? That is internal dysfunction of a muscle).  Finally, to complete the downward spiral, with all of the above considered, the end result is unavoidable stress to the joints and their internal structure.

Re-establishing Communication and Function via Vibration:

To effectively treat BJHS you must selectively harness the mechanical energy of the platform to create proper restorative changes to “the system”. This can be accomplished in several ways:

  • Increasing Local Circulation – Utilizing the muscle spindle (a reporting station) and the stretch reflexes it creates, we can rapidly restore local blood flow. In BJHS, this is crucial for restoring oxygen supply to the muscles so that trigger point (aka “knots’) reduction can occur. With reduced internal muscle tension, the muscle’s efficiency is restored, and there is improved permeability of the tissue to nutrients and fluids, including water. Water, a vital component of fascia further allows for improved connective tissue mobility. With better circulation and improved tissue mobility, tissue healing occurs more rapidly and restricted areas where nerves perforate the connective tissue are released. This all contributes to the mechanism by which we experience pain relief.
  • Improving Muscular Stability – Through excessive stimulation of the muscle spindle, we can increase the tone (resting tension level) of the muscle. Normally known for aesthetic benefits only, in BJHS, this assists in creating muscular stability for a joint that is unsupported by its ligaments. Being that excessive mobility is where this syndrome originates, this benefit gets to the “root” of the problem and is the most crucial component of restoring normal function and eliminating pain.
  • Improving Muscle FlexibilityFor those muscles that have become shortened in an attempt to stabilize the joints, we can now utilize selective stretching positions on the platform to normalize their length. In this case, we utilize vibration and the overwhelming sensory feedback that it provides to “hush” the muscle spindle so that a rapid increase in length of the muscle is achieved. This must be done slowly and carefully to avoid harming the tissue.
  • Improving Lymphatic Mobility – Although this is not specific to BJHS, the rapid amount of muscle contractions created by the vibration platform assists lymphatic system mobility. By stimulating the millions of one-way valves in this system, Vibration Therapy further improves the diffusion and movement of fluid between the cells. Better fluid movement means better cell health and improved tissue repair rate.
  • Restoring Normal Communication – Finally, through stimulation of the proprioceptive system and its reporting stations that have been discussed in length already, we are able to improve body communication; this includes the speed, accuracy, and appropriateness of the information that is transferred between the body and the Central Nervous System. This restoration process, deserving of its own 100 page article, is the final step in maximizing the therapeutic applications of Vibration Therapy for BJHS.

Written by Gabriel Ettenson, MSPT

Gabriel is a Physical Therapist in NY, NY

You may contact him at equilibriumpt.com

Comments

  1. Glad to see we are back up and running! New look a bit boring, but happy to see the blog is available again. Hope we can maintain the legitamacy of the this site.

  2. I have used vibe plates over the past two yesrs with a sixth month interruption after moving. I am back at it this week and find that after daily 10 min sessions I am feeling tired and achy. Is this normal at the start. I think the answer is yes – I tend to be an “over-doer” and I like to keep active but I feel like resting instead. Any advice?

    • Is the ezfitmachine (vibration) good to help you lose weight?

      • Hi Pat,

        As we have said in the past, machines like the ezfit (and the hundreds of poorly manufactured platforms like it) are extremely low quality and can not provide any additional benefit other than improved circulation, balance training, and massage.

        For bone density and weight loss, you will need a much better platform. With the ezfit, you will likely receive no additional benefit than doing the same exercises without a platform.

        Sorry to dissapoint you. We have provided a list of platforms on this site (article titled “purchasing a platform – part II”) that we support. The medium to high acceleration platform is what you need. Otherwise, you’d be better off spending your money on a gym membership or perhaps a qualified trainer to put together a good program (including nutrition) for you.

  3. I have RA and used the Power Plate machine daily for 3 months and loved it. We always end with 15 min of “massage” and my knee swelled up the size of a basketball. Still dealing with the pain and swelling a month later. Any experience with RA and worsening?

  4. Hi there, I have had hip resurfacing done nearly two years now. I wondered if vibration training is good for me? Will it undo the ball joints from my surgery?

  5. Hi Jackie,

    Assuming the surgery was done correctly, there is very little risk of damaging the surgical site. In fact, training on a pivotal unit is a very effective way of stimulating the hip and pelvic musculature with minimal risk. Probably a good idea to clear it with the surgeon to be on the safe side though.

    Be sure you are using a legit platform as well.

    This article (linked below) on a study done on total hips should help ease your fears and your MD’s

    http://amplitudevibration.com/scientific_studies/detail/acsm_2009_whole-body_vibration_improves_function_after_hip_replacement_surg/

  6. Thank you Gabriel, I will 😉

  7. Never used a vibration machine before. Where does one start? Not too overly concerned about price, but
    want a quality machine that has a sufficient number of hertz to be effective.

    Thanks,

    Rhonda
    Canada

    • Hi Rhonda,

      Where in Canada do you live? Depending on the location, it might be possible to direct you to a studio for a demonstration. As far as purchasing equipment, there are a handful of options and the best choice would be dependent upon what your goals are (i.e fitness vs rehab vs osteoporosis etc.) and what your current level of fitness is.

      Give us a little more info and the next steps will be easy.

  8. vspritchard says:

    Hi Gabriel:
    I live in Vancouver BC and have been working out on a powerplate (the only WBV gym or equipment I could find) for the last year and would like to purchase my own equipment. Please could you guide me through the quagmire of crap to something decent that will do the job.

  9. Hello VS,

    As mentioned in previous posts, there are several options for home use and they can range from 3-4K all the way up to 10K. There is also the distinction between lineal and pivotal to consider when purchasing.

    If you could give a little info about:

    1) Your goals of training and how you are using the PP presently?
    2) How you feel with the powerplate (to get a baseline)?
    3) Your price range ?
    4) Your age, medical history etc.?

    Just a bit more information should help guide you to the proper machine.

    Look fwd to your feedback

  10. Carol Anne Cherry says:

    Thank you for this informative article. I live with Ehlers Danlos Syndrome a connective tissue disorder that shares some similarities with BJHS. After reading this article I can see that there would be some significant benefits from WBV for me. Certainly circulation, proprioreception, trigger point release and pain management would be some of the things I am interested in but I also am intrigued by some of the excercise type impacts I have read about on your site. Sadly I do not have many thousands of dollars to purchase one of the better models but I am wondering what would be your recommendation for a unit under $1500 that would offer some benefit to me.

    Thank you,
    Carol Anne

  11. Hello Carol Anne,

    Thank you for taking the time to post. For THE MAJORITY of the goals you mentioned (circulation, proprioception, trigger pts, and pain), you can purchase a platform for under $1500. If I had to recommend one in particular, I would recommend the Noblerex K1. For true strength training effects on top of these benefits, you would have to go a bit higher in the price range. If you can find the additional $$, go with the Hypervibe (approx. $2500). That is the best verified platform you can get for your money.

  12. Carol Anne Cherry says:

    Have you any experience with the VibraSlim machine. It sells for about $1699 here in Canada and has many good reviews posted.

    Thanks,
    Carol Anne

  13. I cannot comment based on experience, but there has been quite a bit of negative feedback on the Vibraslim. Reviews are not always reliable on company websites. Contact Dan and Deb at Revibe. I think they have direct experience with the Vibraslim and can comment more accurately.

    Dan and Deb,

    Can you comment?

  14. PS:

    The Vibraslim is another machine that does not perform as specified and will only be good for circulation, balance and pain relief. Not necessarily for muscle/bone effects.

  15. Carol Ann,

    Like Gabriel says… be cautions as to where the reviews are coming from, for example there’s a website from a self proclaimed “Vibration Professor” evaluating machines for the good of the consumer. With a closer look you will see that there is no such individual… his image can be seen in other totally unrelated marketing campaigns. The site is controlled by another company cleverly tiring to market their own machine.

    I will also share that I have a VibrSlim Europlate, T-Zone VT-8, 12 and 15 sitting alongside a HyperVibe… there is no comparison of any to the ladder choice…… period.

  16. dan pelletier says:

    Hi Carol,

    We have had the opportunity to give both machines a go, actually we have our hypervibe in a studio in calgary right between there home and commercial model.

    As far as I am aware they have not released any independent tests on the platform and experience has shown there is a reason they don’t. Both machines did not perform by physical test (demo) anywhere near the galileo or the hypervibe. Best I can say and take this for what it is without verification they operate under 15hz.

    As always, a personal demo is always appropriate for a consumer when in doubt but if you have not tried a galileo or hypervibe your ability to associate by feel will be impaired.

    Be wary of reviews as they are what they are, you have no idea whether they are real, biased or unbiased.

    Gabriel has covered off there capabilities very well.

    Dan

  17. Will possibly purchase a quality machine for both wife and myself.
    Romy (wife) has severe COPD (emphysema) and muscle wastage is becoming apparent. Will vibration trainig help in this instance please?

    I have intermittent claudication which can be very painful after walking say a 1/4 mile. Once again, will V.T. help please?

    Regards

    Rick (U.K.)

  18. Hi Rick,

    For both you an your wife, Vibration Training can certainly be beneficial.

    For your wife, it will serve as a safe and effective means to strengthen her muscles without placing strain on her cardiopulmonary system. She will have to build her progrm gradually and progress as tolerated of course. This is exactly the type of person for which this training method holds great promise (among many other types of course).

    For you, given that clauducation has a strong circulatory component to it, the vibration will serve to enhance blood flow to the legs while also promoting strength and flexibility.

    Don’t forget to be sure the platform you purchase is verified and/or has shown to be beneficial through research. This is a messy industry with everyone trying to sell you something. Only several manufacturers have “proven” themselves to be legit.

    Please let me know if you have any further questions.

  19. Hi Gabriel

    Thanks for your speedy reply and most helpful comments.

    The machine I am considering is the JTX Pro10 which is available from JTX at £800.00.

    In the right direction or do you have better (same price) in mind?

    Once again, my thanks.

    Regards

    Rick

  20. Hi Rick,

    This machine is not verified or researched, so on this forum, we cannot recommend it. Putting that aside, I can guarantee it is nothing more than a large massager. Machines like this are a dime a dozen and the reason this industry has struggled to thrive. The benefits of the JTX Pro10 would be limited to massage and circulation (claudication treatment would be ok) for as long as the machine operates properly. The bottom line in this industry is that “you get what you pay for”.

    Unfortunately, there is nothing reliable in your price range. The minimum you would have to spend for a platform capable of delivering the benefits we discussed in the previous post would be $2700. I am sorry to inform you of this.

    Let me know if I can help in any other way.

    • Hi Gabriel

      Your comments much appreciated.
      I’ve now gone from a state of mild confusion to one of utter paranoia!
      I’ve read through a few of the other related forums which advise me that ANYTHING I purchase will be complete and utter crap.
      Romy has an appointment tomorrow with her COPD specialist and we will discuss our findings to date. The possibility exists of ‘try before one buys’ but I don’t consider this to be the way forward, a bit like purchasing a mattress in a bedding shop, finding it ‘brilliant’ and not taking into account that it will be a long term investment and finding the damned thing is too hard/too soft/too lumpy etc etc. after but a few weeks.
      I really do appreciate your help in this matter Gabriel and I will post again in due course after a period of contemplation.
      NB: I must advise that my limit is around £1,000 sterling and if I can’t find anything around this mark then Romy and I will apply to the local council for employment using a road drill or similar in an effort to gain vibration experience as it were!!

  21. No need to be paranoid Rick. This is the reality of Vibration Training and at the end of the day, the best built platforms deliver the best results. The building of them however is not cheap and that is why they often cost so much. There are a couple exceptions to this, but for the most part as I said, “you get what you pay for”.

    What most people fail to realize is that vibration is not about shaking. Its about reversing the process of walking or jumping whereby the ground (platform) hits you. With this in mind, we require solid engineering to deliver the appropriate forces. Forces strong enough to build muscle. If the platform is weak, the force is weak and the body has no need to respond.

    Some manufacturers offer 30-60 day trial periods so this might be worth pursuing. Although they may be expensive, if you see the benefits for you and your wife, you will easily break even against the medical costs that you will avoid.

    As far as the price range you gave, you will struggle to find anything that is legitimate. On the other hand, the benefits of a cheap platform can include balance training, circulation, muscle relaxation, and lymph movement. Those do improve health and may be worth considering despite the limitations. Also, if you perform exercise on the platform, you are going to improve muscle function just from the mere fact that you are doing exercise. You just won’t necesarily get the added benefit of the platform.

    By the way, the harmful effects of Vibration are from industrial exposure so might want to pursue another profession besides road drill operator ;-).

  22. joan sinclair says:

    what if any impact does the wbv have on thyroid (thyroiditis) function?
    thanks,
    joan

  23. I have fibromyalgia. I would like to know the best vibration machine for me. I am looking to lose weight improve muscle and control pain.

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