Journal of Orthopaedic & Sports Physical Therapy

l999;29(7)Al3-420

Resistance Properties of Thera-Band@Tubing

During Shoulder Abduction Exercise
Christopher1. Hughes, P7; PhDl
Kenneth Hurd, DP7; MS, ATC2
Allan )ones, DPP
Stephen Sprigle, P h D
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I
Study Design: Single-group, repeated measures. mprovement in muscle
Objectives: To investigate the relationship between tubing length and tubing tension for 6 strength is often a desired
colors of Thera-Band tubing (each color representing a different level of resistance) and to outcome of patient rehabil-
estimate the resistive shoulder toque provided during shoulder abduction exercise. itation. To this end, thera-
Background: Thera-Band tubing is popular for providing resistance in rehabilitation pists have a variety of train-
Copyright © 1999 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.

strengthening programs. Unfortunately, it is difficult to compare use of elastic tubing with ing modes available. Isotonic, i s
other resistance training methods because no published data exist on how much resistance kinetic, and isometric exercise
is being provided during exercise. represent the major classifications
+
Methods and Measures: Nine male and 6 female subjects (age, 25.9 3.6 years; height, of strengthening exer~ise.~.'J~ Iso-
173 z 10 cm) performed shoulder abduction, using 6 colors of tubing. A strain gauge tonic exercise requires that a seg-
attached at the fixed end of the tubing directly measured the tension generated during ment move a constant weight
stretch. For each color of tubing, each subject momentarily held a position at 30°, 60°, 90°, through a range of motion. Isoki-
120°, and 150" of abduction. Shoulder joint abduction, limb segment position, and tubing netic exercise is performed where-
length were analyzed by means of the Peak Motion Measurement System. Simple linear by joint motion occurs at a preset '

regression equations predicted tubing tension from percent change in tubing length at the speed or under a controlled veloc-
Journal of Orthopaedic & Sports Physical Therapy®

joint angle positions. A 2-way (5 X 6) repeated-measuresANOVA determined the mean ity. During isokinetic exercise, var-
differences in tubing tension across tubing colors at the shoulder abduction positions. ied resistance is encountered P
Results: Strong linear relationships were found for each tubing tension when referenced throughout the joint range of mo-
according to changes in tubing length. Significant differences in tension were found for the tion. Isometric exercise uses a s u b
various colon of tubing. The resistive torque curves for each color tubing were similar to maximal or maximal muscle effort
isotonic exercise. with no joint motion occurring.
Conclusiom: Thera-Band tubing provides linear resistance during shoulder abduction, but The choice of exercise appears to
the resistive torque provided by the tubing mimics isotonic exercise. ) Orthop Sports Phys influence the amount and rate of
Ther l999;29:4 13620. strength gain and the adaptations
that occur in skeletal m u ~ c l e . ~ J ~ . ~ ~
Key Words: elastic tubing exercise, strength
However, regardless of the choice
of exercise, the resistance must be
progressive for the most rapid
strength gains to occur." The
training method usually depends
on the patient's type of injury,
stage of recovery, and ability."
Graduate School of Physical Therapy, Slippery Rock Universify Slippery Rock, Pd. Resistance training using elastic
Staff physical therapist, Youngstown Orthopedic and Sports Therapy, Canfield, Ohio. tubing seems to fall into a distinct
Benson Rehabilitation Services, Benson, Ariz. category. Unlike traditional resis-
Director, Center for Rehabilitation Technology, Helen Hayes Hospital, West Haverstraw, NY.
Send correspondence to Christopher Hughes, Professor, Graduate School of Physical Therapy, Slip tance exercise methods, use of
pry Rock Universify Slippery Rock, PA 16057. E-mail: cjh@nauticom.net elastic tubing relies on the tensile
 properties of latex or other elastic polymers as a
form of resistance. The level of resistance varies ac-
cording to rate and elongation of stretch of the ma-
terial. The resistance properties of tubing are often
compared to the dynamics of a spring, whereby the
change in length (applied force), type of material
(modulus of elasticity), and cross-sectional area dic-
tate the magnitude of resistance and the amount of
potential energy stored.lRSince the resistance is not
constant, elastic exercise is not formally considered
isotonic exercise. In addition, the rate of stretch may
be nonuniform, and this prohibits elastic tubing ex-
ercise from being categorized as a form of isokinetic
exercise. Despite this categorical dilemma, elastic
tubing exercise is commonly used for therapeutic ex-
ercise because of its low cost, simplicity, portability,
versatility, and nonreliance on gravity for resistance.
Elastic tubing exercise seems especially popular for
shoulder rehabilitati~n.~."I~J~~~;~~ Specific protocols
and methods have been described that advocate ex-
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clusive use of elastic bands in strengthening the rota-
tor cuff muscles.1S21
Almost all studies investigating elastic tubing have
focused on the strength increases that one can ex-
pect when using this form of training.1J5J7.2R Past
studies have shown elastic tubing exercise to be a
Copyright © 1999 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
suitable method for increasing strength in the elder-
ly, young healthy adults, and athletes. Skelton et alZ2
reported significant increases in posttest isometric
strength of the elbow flexors and knee extensors in
elderly women who underwent a 12-week training
program using isotonic or elastic tubing for resis-
tance training. They reported 27% gains in maxi-
mum strength over the period of the study. A recent
study by Jette and colleaguesYalso showed strength
Journal of Orthopaedic & Sports Physical Therapy®
gains in communitydwelling adults, aged 60-94
years, who participated in a &month home exercise
program that exclusively used elastic bands for resis-
tance. Mikesky et all5 showed substantial strength in-
creases in older adults who used elastic tubing over a
12-week period. Additional studies by Brill et a l h n d
Topp et a1'4:25 also provide data supporting resistance
training benefits and carryover to function from ex-
ercise with elastic bands.
Younger subjects using tubing exercise have also
shown strength increases. Anderson et all reported
an increase of approximately 10% for the shoulder
internal rotators after 6 weeks of training. Ward et
al2%ompared free weights and Thera-Band elastic
tubing and found that both methods were equally ef-
fective in increasing external rotation strength of the
shoulder muscles after 4 weeks of training. 0'Brien17
also found strength benefits for college-aged women
who performed posterior rotator cuff exercises for 6
weeks. Furthermore, Page et all9 reported gains
when tubing was used in a "functional" or diagonal
shoulder motion to strengthen collegiate pitchers.
The researchers stated that "Many use elastic tubing
exercise as a strengthening device; however, most do
not know the extent or actual value of its resis-
tance."19(~352)
Despite documented improvements in strength
from this type of training, few studies have detailed
the actual resistance provided by elastic bands or t u b
ing.I0 Most investigators have used a repetition limit
to decide when to progress to a higher level of resis
tance. Only the studies by 0'Brien17 and Mikesky et
all5 cite a formal method or mechanical procedure
for determining band tension as a function of elon-
gation prior to starting a training program. Because
no data exist on how much resistance is being pro-
vided, it is difficult to compare elastic tubing exercise
with other conventional methods of training. This
makes it difficult to standardize subject effort and to
compare the training effects with other forms of ex-
ercise.
We believe a void exists in the literature. There a p
pears to be a lack of data quantifying not only the
resistance provided across the various colors (resis-
tance levels) of tubing, but also a lack of data detail-
ing the actual resistance provided during perfor-
mance of an exercise. This information seems essen-
tial in determining the intensity of this type of train-
ing compared with other forms of resistance
exercise. Such data would assist clinicians in stan-
dardizing exercise and progression of exercise to a p
propriate levels of intensity in accordance with the
overload principle of resistance training.2.J.23.24Fur-
thermore, the information would assist the clinician
in helping patients progress to other forms of resis-
tance exercise (ie, dumbbells or machines). This in-
formation could also be used to calculate the torque
provided throughout the exercise range of motion.
In a comprehensive review of skeletal muscle me-
chanics, Lieber and Bodine-Fowler" state that
strength must also be expressed in relation to torque
to understand the true strength requirements and ef-
fect of the exercise on the musculoskeletal system.
They further state that resistance training must in-
clude variables that relate to magnitude of force, mo-
ment arm, and angle between the moving segment
and the direction in which the resistance is acting.
Thus, not only will a particular joint movement pos-
sess a torque versus joint angle curve, otherwise
known as a strength - curve, but resistance exercise
can also generate a resistive torque curve as a func-
tion of joint position.
To rectify the lack of information concerning the
resistive properties of tubing, the objectives for our
study were to (1) determine the resistance character-
istics of 6 progressive levels of Thera-Band tubing
during shoulder abduction, and (2) estimate the re-
sistive shoulder torque provided by Thera-Band tub-
ing during shoulder abduction exercise.
J Orthop Sports Phys Ther.Volume 29. Number 7 .July 1999

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Copyright © 1999 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
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I Utah) was used to record tension in the tubing dur-
\ I
Camera #2
FIGURE 1. Diagram of camera set-up.
METHODS
Journal of Orthopaedic & Sports Physical Therapy®
Subjects
Nine men and 6 women aged 22-34 years partici-
pated in the study. All volunteers were required to
read and sign a university-approved consent form.
The criteria for inclusion in the study required s u b
jects to be able to (1) independently perform at least
150" of active shoulder abduction using their right
upper extremity, and (2) complete at least one repe-
tition of right shoulder abduction with a 151b d u m b
bell. This weight was selected to approximate the re-
sistance provided by the most difficult level (Silver)
of elastic tubing. Subjects were excluded if they re-
ported a previous or current shoulder pathology or
surgery that noticeably affected normal glenohumer-
al rhythm of the right shoulder. Of 20 volunteers, 15
met the inclusion criteria for this study.
Instrumentation
A diagram of the set-up is shown in Figure 1. A
commercially available strain gauge (model ITC V2.0;
J Orthop Sports Phys Ther .Volume 29. Number 7 .July 1999
Strain Gauge Calibration Data:
Applied Force vs Measured Force
r = .9@
SEE = 2.63
0 50 100 150 200 250
Actual Force (N)
FIGURE 2. Strain gauge calibration data: applied versus measured force.
Innovative Research and Development Inc, Murray,
ing the shoulder abduction exercise. The instrument
displays a force value to the nearest 2.2 N (0.5 lb)
when a strain is induced on the load cell. We tested
the device for repeatability by recording the tension
load induced by Thera-Band elongation. Repeatabil-
ity was within 2.2 N across 3 trials at each of 5 strain
levels ranging from 20% to loo%, at 20% intervals.
Strain is a normalized measure of extension and
equals the change in length divided by the original
length of the band, which was tested at a resting
length of 116.8 cm (46 in). Tests comparing the a p P---T*.r
plied force to the measured force displayed by the
gauge were also done. Known loads were hung on
the unit, and the force was recorded. The data dem-
onstrated acceptable linearity, with an error range of
7% at 45 lb to 20% at 44.5 N (10 lb). The increase
in error at higher loads was attributed to the sensitiv-
ity of the digital display recording to the nearest 0.5
lb. Figure 2 shows the applied versus measured force
curve for the gauge for loads of 3.1-198.9 N (0.7 to
44.7 lb).
The strain gauge tensiometer was anchored to an
elevated wooden platform, which was constructed by
the investigators. The platform was used to limit ex-
traneous motion of the gauge, minimize glare on the
liquid crystal display panel of the gauge, and stan-
dardize foot position for the subject (Figure 1). Each
of the 6 Thera-Band tubing colors was independently
attached to the tensiometer during testing. The oth-
er end of the tubing was attached to a revolving plas-
tic handle that was held by the subject.
 Two 60-Hz AG 450 Panasonic video cameras were
used to record subject performance. One camera was
used to enlarge the digital readings on the strain-
gauge liquid crystal display and display them on a
video monitor. The second camera was placed per-
pendicular to the frontal plane of the subject 15 feet
away and adjusted to capture the total area of move-
ment of the subject. The video monitor attached to
the first camera was placed in the field of view of a
second camera, to enlarge the digital values output
from the gauge and to allow the force values to coin-
cide with the video frames of the second camera.
Each subject wore reflective markers that attached to
standard positions on the right upper extremity, pel-
vis, and right lower extremity to assist in highlighting
the limb segment and to improve accuracy during
the digitization process. The Peak Performance M e
tion Measurement System was used to process the
data. The 2D data-acquisition module was used to
create a spatial model and calculate the joint posi-
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tion and angle data. All marker points were digitized
manually by the same investigator, to minimize error
in the digitization process.
Test Procedures
Copyright © 1999 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
All subjects meeting the inclusion criteria were re-
quired to read and sign a university-approved in-
formed consent form. Subjects were first required to
take part in a !%minutewarm-up consisting of active
shoulder exercises. This included pendulum and
wand exercises as well as general active stretching of
the right shoulder joint.
Subjects were dressed in shorts and a tank top, to
expose bony landmarks. Each subject's sex, height,
Journal of Orthopaedic & Sports Physical Therapy®
weight, and selected anthropomemc measures were
recorded. Anthropometric measurements included
arm length, distance from the floor to the center of
the glenohumeral joint (approximately 2 cm inferior
to the acromioclavicularjoint), and distance from
the subject's third metacarpophalangeal to the base
of the wooden platform.
During the final phase of the pretest session, bony
landmarks on the subject's right side were then locat-
ed for placement of the reflective markers. The actu-
al landmarks included (1) the estimated axis of the
glenohumeral joint 2 cm inferior to the distal end of
the acromion, (2) the medial epicondyle of the hu-
merus, (3) the anterior midpoint of the radiocarpal
joint of the wrist, (4) the anterior-superior iliac
spine, (5) the tibia1 tubercle, and (6) the anterior
talocrural joint line. The upperextremity and trunk
markers were used to calculate the shoulder abduc-
tion angle. The glenohumeral joint marker formed
the apex and the medial epicondyle of the humerus,
and anterior-superior iliac spine markers represented
the proximal and distal segment endpoints (Fig-
ure 3).
416
FIGURE 3. Variables used in determining shoulder torque.
The test session began with the subject standing in
anatomical position on the platform. Using the right
hand, the subject pronated the wrist and gripped the
handle attached to the "free" end of the tubing.
The "anchored" end was attached to the strain
gauge device at a height that was level with the base
of the platform. The "resting" or original band
length was cut according to the distance measured
from the subject's third metacarpophalangealjoint to
the attachment point of the gauge.
Tubing colors were randomized prior to testing.
For each of the 6 tubing colors, 5 repetitions of
shoulder abduction (0-150') were performed with
the subject momentarily holding arm positions at an-
gles of 30°, 60°, 90°, 120°, and 150".Joint angles were
approximated by use of angles created with lines of
tape on a cardboard backdrop. The backdrop was
used only to assist with correlation of a group of
frames close to the intended joint range, to minimize
the time required during the digitization process.
Each subject completed a total of 30 repetitions for
all band colors. Subjects were instructed to slowly
control the stretch of the band, to decrease the ef-
fect of acceleration, by momentarily holding at the
specific joint angle positions under investigation.
Randomization of each color served to control for
the effects of fatigue, and a rest period of 2 minutes
was provided after each tubing color was used.
The processed data fkom the digitization process
generated the following data: (1) segment length
from the glenohumeral joint center to the third me-
tacarpophalangealjoint, (2) tubing length at each of
the 5 joint positions, (3) shoulder joint angle at the
5 joint positions, and (4) the angle created by the
long axis of the tubing and the longitudinal axis of
the right upper extremity. This angle was termed the
J Onhop Sports Phys Ther .Volume 29 Number 7-July 1999
 TABLE 1. Regression equations for each color of Thera-Band tubing.
Band
color r Z Regression equation* SEE)
Yellow .86 .74 Y' = .03 (x) + 3.07 1.07 -Yellow
Red .97 .94 Y' = .12 (x) + 6.07 1.54 + Red

Green .99 .98 Y' = .18 (x) + 8.42 1.67 * Green

Blue .98 .96 Y' = .20 (x) + 9.92 1.97 * Blue
Black .99 .98 Y' = .23 (x) + 10.38 1.94 * Black
Silver .99 .98 Y' = .35 (x) + 13.19 2.29
* Silver
Y', predicted tubing tension (N);x, percent change in tubing length.
t SEE, standard error of the estimate.

% Band Length Change

band-twnn angle. Force values were also obtained
0% = Startlng Length
from the strain gauge at the intended joint positions
during digitization. We calculated torque values for FIGURE 5. Tubing tension in relation to percent length change of tubing
each band color by using the information and equa- for each band color. Standard deviations (SDs) are shown in Table 4.
tion shown in Figure 3. To allow comparison of the
resistive torque curves with traditional isotonic exer- RESULTS
cise, we used the same values to compute resistive
torque values across the same joint angles as would The results of the linear regression analysis are
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be used if the subjects attempted the movement with shown in Table 1. Figure 4 shows the tension length
a 22.25 N load (5 lb) and a 44.5 N load (10 lb). curve for the averaged vials of each tubing color
across the 5 joint positions. Tension values for all
Statistical Analysis tubing colors ranged from a minimum of 3.3 N for
the yellow band at the 30" range to a maximum of
Simple linear regression was used to predict tubing 70.1 N for the silver tubing at the 150" range. Stan-
Copyright © 1999 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.

tension from percent of tubing length for each color dard deviations for tension values ranged from a
of tubing. A 2-way (angle X color) repeated mea- minimum of 0.89 N for the yellow tubing to a maxi-
sures ANOVA was performed to determine whether mum of 3.0 N for the silver tubing. Tension changes
mean differences in tubing tension occurred among expressed as a function of percent tubing length are
tubing colors at SO0, 60°, 90°, 120°, and 150" of shoul- shown in Figure 5. Tubing length changes expressed
der abduction. If significance was found, then Tukey in relation to the original or "resting" length ranged
post hoc testing was done to specify significant pair- from a minimum of 18% stretch from resting length
wise differences among the factors. A between-sub at the low angle of abduction to 159% at the ex-
jects comparison was also done to determine wheth- treme range of shoulder motion. Resistive torque val-
Journal of Orthopaedic & Sports Physical Therapy®

er tension that developed in the tubing was indepen- ues were minimal at the extreme ranges but all
dent of subjects. Statistical significance for all tests torque values were maximal at 90" of shoulder ab-
was defined as P < .05. duction (Figure 6). This position coincided with a
band-tearm angle of approximately 60" across the

-Yellow
-Yellow +Red
+Red * Green
* Green +Blue
+Blue *Black
* Black *Silver
*Silver +5 #
+lo#

20 40 60 80 100 120 140 160

Shoulder Angle (degrees) Joint Angle (degrees)

FIGURE 4. Tubing tension versus joint angle for each tubing color. FIGURE 6. Resistive torque curves for each color of tubing. Standard de-
Standard deviations (SDs) are shown in Table 3. viations (SDs) are shown in Table 5.

J Onhop Sports Phys Ther-Volume 29. Number 7 .July 1999

 TABLE 2. Two-factor ANOVA (tubing color X angle) for tension developed during shoulder abduction using Thera-Band elastic tubing.
Source
Angle 43806.47 4 10951.62 4136.47 .OOO*

Error
Tubing Color
Error
Angle X Color
Error
Significant at P < .05.

tubing trials. Standard deviation values for data
shown in Figures 4-6 can be found in corresponding
Tables 3-5. The analysis of variance can be found in
Table 2. Significant main effects and a significant in-
teraction were found for the test conditions. No sig-
nificant difference was found for the between-sub
jects comparison (I;,.,, = 4.17, P = .O6). Tukey's post
hoc analysis showed significant mean tension differ-
ences at each angle for all colon, except comparison
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subjects were only instructed to slowly control the
stretch of the band and then decrease the effect of
acceleration by momentarily holding at the specific
joint angle positions under investigation.
Probably the most informative data from the study
are shown by the torque angle curves in Figure 6.
Despite a progressive increase in tension response by
the band, the angle of the band to the arm plays a
significant role in the resistive torque applied to the

of blue and black tube tension at 30' (Figure 4).
DISCUSSION
The results of this study shed light on the resistive
properties provided by elastic tubing during exercise.
Copyright © 1999 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
shoulder. This observation needs to be studied close-
ly. When one compares the torque data from tubing
with isotonic loads of 5 and 10 lb included in Figure
6, it becomes clear that the resistive patterns are
strikingly similar. The blue tubing appears to most
closely resemble the 51b load, whereas the silver t u b

The strong linear relationship between tubing ten-
sion and tubing excursion (percent length change)
seems logical given the material properties of the
band. However, it is interesting to note that the
grade of resistance levels across tubing colors is not
standard.
Figure 4 shows fairly similar resistance for green,
blue, and black tubing but fairly discrepant slopes
for yellow, red, and silver. The mechanical strains are
Journal of Orthopaedic & Sports Physical Therapy®
ing resembles very closely the 10-lb load. The data
indicate that, when patients use the silver tubing,
they closely approximate the torque required when
using a 10-lb weight, whereas the blue tubing repli-
cates the 51b load. Thus, if a therapist would like a
patient to progress from tubing to isotonic exercise,
a load greater than 10 lb may be needed to stimulate
an overload response by the patient's muscle. These
results should be verified in future studies.

unique, are a function of the thickness of material Kisner and Colby1I imply that a primary disadvan-
used for each color tubing, and may also have been tage of elastic resistance exercisers is related to the
influenced by the stretch rate during the trials. Our linear resistance provided. This form of resistance

TABLE 3. Mean (SD) tension (in newtons) for each joint angle and tubing
color. TABLE 4. Mean (SD) tubing tension (in newtons) for percentage length
change of tubing, for each band color.
Tension at mean
shoulder angle Mean tension for percentage length change
Band Band
color 300 60" 900 1200 1500 color 19 58 104 140 160
Yellow 3.3 5.5 6.7 7.1 8.6 Yellow 3.3 5.5 6.7 7.1 8.6
(1.1 (1.1) (0.0) (0.9) (1.1) (1.1) (1.1 (0.0) (0.9) (1.1)
Red 7.1 13.5 18.3 22.2 24.9 Red 7.1 13.5 18.3 22.2 24.9
(1.5) (1.6) (1.7) (1.5) (1.5) (1.5) (1.6) (1.7) (1.5) (1.5)
Green 10.4 19.9 26.7 33.4 36.9 Green 10.4 19.9 26.7 33.4 36.9
(1.8) (2.0) (1.71 (1.9) (1.4) (1.8) (2.0) (1.7) (1.9) (1.4)
Blue 12.2 22.2 30.0 37.5 41.8 Blue 12.2 22.2 30.0 37.5 41.8
(0.38) (1.5) (1.4) (1.7) (2.5) (0.38) (1.5) (1.4) (1.7) (2.5)
Black 12.5 24.8 33.8 41.4 46.3 Black 12.5 24.8 33.8 41.4 46.3
(2.O) (1.7) (1.5) (1.8) (2.4) (2.0) (1.7) (1.5) (1.8) (2.4)
Silver 17.5 34.1 49.4 60.9 70.1 Silver 17.5 34.1 49.4 60.9 70.1
(3.O) (2.1) (2.7) (2.0) (2.4) (3.0) (2.1) (2.7) (2.0) (2.4)

J Orthop Sporu Phys Ther *Volume 29 Number 7 *July 1999

 TABLE 5. Mean (SD) torque measurements (in newton-meters) for each low tubing. Another limitation is the lack of control
color of Thera-Band tubing. for limb speed. Even though subjects were told to
Mean toque at shoulder angle perform slow, controlled movements, it is possible
Band
color 300 60" 90" 120" 1500 that the subjects accelerated the limb, placing an ad-
ditional inertial strain on the gauge and inflating the
Yellow 2.2 4.6 4.7 3.7 1.6
recorded values. However, our finding of statistically
(0.9) (0.3) (0.3) (0.6) (.6)
nonsignificant differences between subjects indicates
Red 4.9 9.6 12.9 10.5 6.8
(1.2) (1.2)
that constant tubing tension can be maintained if ex-
(0.9) (1.3) (1.4)
ercise movements are performed slowly. In addition,
Green 6.3 16.3 17.3 13.3 9.4
(1.8) (2.O) (2.2)
the angle measures were approximated from the vid-
(1.2) (1.7)
eotape and digitizing process. Our indirect assess-
Blue 7.3 16.0 18.9 16.1 8.4
(1.1 (1.4) (1.8) (2.3) (2.5)
ment of the range of motion was limited by our abili-
ty to coincide the video frame number for joint an-
Black 7.9 18 20.3 17.9 12.8
(2.6) (2.8)
gle measurement with the strain gauge value d i s
(1.4) (1.7) (1.8)
played in the frame field. In some analyses this value
Silver 11.2 22.4 27.5 25.5 15.9
(2.8) (3.3)
was equal across a number of frames, and when cou-
(2.4) (2.6) (3.1)
pled with the 0.51b resolution of the gauge, this may
5 Ib 8.13 13.2 19.2 13.35 8.75
(1.1) (1.1) (1.3)
have skewed our joint angle positions and inevitably
(0.8) (1.O)
influenced the force values. This is why some of our
10 lb 16.1 26.1 30.0 26.4 17.3
angle values approximated the intended joint posi-
(1.6) (2.0) (2.3) (2.3) (2.6)
tions under investigation. In addition. we did not use
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a comprehensive model for calculating the resistive

makes it difficult for the patient to finish the end of
range, because the muscles are weaker at the point
where the resistance is greatest.ls If one considers re-
sistance to joint rotation, then the resistive torque
data from our study are in disagreement with this ob-
Copyright © 1999 Journal of Orthopaedic & Sports Physical Therapy®. All rights reserved.
torque at the shoulder. To calculate the torque
curves for the isotonic loads, we used the average an-
thropometric segment lengths obtained from our
sample and did not include individual estimated
limb weights. Furthermore, our not performing elec-

servation. The torque seems to follow an ascending-
descending pattern, with the greatest torque occur-
ring near 90" of abduction. The 90" of shoulder ab-
duction includes all interactions among the musculo-
skeletal system: muscle length, joint position, varying
resistance, and joint angle, as well as the line of resis
tance. These factors play a major role in defining an
exercise pattern and the amount of effort required
and therefore must be evaluated for each prescribed
Journal of Orthopaedic & Sports Physical Therapy®
tromyographic analysis limits our discussion to load-
ing at the glenohumeral joint and prevents fruitful
discussion regarding the role of individual shoulder
muscles in performing resistance exercise with elastic
tubing. However, a recent study by Hintermeister et
al" indicated that electromyographic levels in select
shoulder muscles were of adequate intensity when
elastic cords were used as resistance.
Despite these limitations, we feel that the results

exercise.'"rne of these factors appear to influence
the linear resistance provided by the tubing. Even
though the resistance increases as joint angle increas-
es, the band-to-arm angle and shoulder abduction
angle offset the linearity and vary the torque in a
manner that represents one of the most commonly
seen strength curves for the majority of muscle
groups in the body.'2
In a review of literature, Kulig et all2 showed that
the strength curve of shoulder abduction was a de-
scending pattern, with greatest abduction strength
occurring early in the range of motion. This is where
the resistance created by arm length has the least im-
pact on resistive torque at the shoulder, and muscle
mechanics may be more favorable, consequently al-
lowing for increased force.
We acknowledge several limitations in the study.
The first is our use of a commercial strain gauge.
The gauge was able to record only to the nearest 0.5
pounds across all tubing colors. This influenced the
accuracy with which we could record some of the
smaller tension values, especially in tests of the yel-
shed light on the effects of elastic exercise on ten-
sion development. We recommend further investiga-
tions to determine strain values with accelerated ex-
ercise movements, especially with eccentric training
loads and different joint movements, and also investi-
gations using electromyographic analysis to deter-
mine load sharing among muscles that act as prime
movers.
CONCLUSION
Our results support the linear response of Thera-
Band tubing in providing resistance during shoulder
exercise. However, the resistive torque pattern pro-
vided by various levels of elastic tubing appears to be
similar to that provided by traditional isotonic exer-
cise for shoulder abduction. The minimum and max-
imum resistance for each tubing color were identi-
fied and can be extrapolated to other exercises that
result in similar length changes. Additional research
on the biomechanics of elastic band training needs
to be performed to more completely delineate the

J Orthop Sports Phys Ther -Volume 29. Number 7 .July 1999 419
 advantages and disadvantages o f using elastic bands
as a method o f resistance exercise for patients in-
volved in a rehabilitation program.
ACKNOWLEDGMENTS
T h e authors thank the Hygenic Corporation, Ak-
ron, Ohio, f o r supplying the Thera-Band.
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J Orthop Sports Phys Ther .Volume 29. Number 7 .July 1999