‘’TMG100 has become the cornerstone of my therapeutic success’’

Tell us about the progress in rehabilitation sciences and physiotherapy that you have witnessed.

Stef Harley

The trend in rehab sciences and physiotherapy is to seek new ways to be more efficient and effective in treatments. More emphasis is being placed on injury prevention through screening and education.

You have identified a way to detect and prevent muscle injury and speed up recovery. Can you elaborate on this technique?

TMG100 tensiomyography is based on measuring the displacement of muscle during standardised muscle contraction. From this we obtain parameters that describe the muscle function for each individual muscle that we measure. We can then compare function between the left and right side of the body, or compare injured to non-injured side. This gives us an exact insight into muscle symmetry. Muscle symmetry is important in injury prevention, improving performance and speeding up recovery.

The technique has been proven, through scientific research, to show very high correlation with the invasive way of determining muscle fibre composition through biopsy and histological examination. The very basis of TMG100 tensiomyography is this ability to distinguish in a simple, fast, reliable and completely non-invasive way, the activation of fast motor units and slow motor units in muscle. This in turn gives various insights in muscle diagnostics and determining changes in muscle function throughout therapy or training.

The advantage of our TMG100 technology is that it is very simple to use, entirely non-invasive, does not require any effort on the patient’s behalf which is important when there’s an injury, is portable and can be used anywhere and is considerably less costly than other state-of-the-art diagnostic equipment.

When and where was this first launched?

Tensiomyography was first introduced in the late 90s as a method for measuring the dynamics of skeletal muscle by Prof Dr Vojko Valencic from the Faculty of Electrical Engineering of the University of Ljubljana (Slovenia, Europe). In the ensuing years, several researchers, mostly conducting their work in bio-mechanics, muscle physiology, applied anatomy and sports sciences, adopted the technology in their work and it is from there that various applications for TMG100 tensiomyography arose. The device was first commercially introduced in elite sports and sports sciences and in the last several years has found its way into mainstream medicine and rehabilitation.

Coming back to rehab science, how can one improve symmetry in the trained body and prevent injury or re-injury? How can the TMG100 help in this regard?

First of all, one must have a tool to accurately and consistently quantify muscle function asymmetry. It is important to know precisely which muscles are functioning asymmetrically and asynchronously within the muscle chain, before then defining in which aspects of muscle function these deviations exactly lie. TMG100 provides a simple, non-invasive and fast way to do this. Following that precise exercises or interventions can be suggested to improve symmetry in function. Furthermore, we can continuously assess progress throughout the exercise programme or therapeutic intervention, in order to adjust there where necessary.

How can athletes or sportsmen decrease injury risk?

To decrease injury risk one must understand where muscle asymmetry and weak functional symmetry is present. Where is the muscle chain broken? Once this has been defined, athletes must train these muscles in a very specific way in order to gain better symmetry. It is also essential to be able understand and objectify or quantify muscle recovery and fatigue, in order to know when an athlete can be expected to give 100 per cent again. Today’s strenuous competition schedules rarely allow athletes to fully recover from the strain of competition, let alone if there is an injury.

What is the best way to prevent re-injury after a rehab?

Too early return-to-competition is the largest contributor to re-injury. This is because in many cases only subjective measures are used to make the decision to return to competition. It is then inevitable that the various motivations of athlete, medical staff coaches, managers, agents, spectators etc., prevail and increase injury risk. Our TMG100 technology helps objectify and quantify, so that subjective measures can be set aside and a more informed decision can be made.

Re-injury also often occurs due to mistakes in the rehabilitation process; the wrong therapies are applied at the wrong time and rehabilitation exercises that help the athlete to return to practice are applied in the wrong phase of recovery and at the wrong dosage. Even incorrect exercise types are prescribed. By consistently monitoring muscle recovery with TMG100 this can be avoided.

The same also applies to non-sports rehabilitation. People tend to think that as soon as the pain has gone that everything is alright. But in fact the battle maybe only half won. The decrease or lack of pain does not mean that the faulty movement patterns and muscle contraction properties that drive these movements has been corrected. So the risk of re-injury remains.

How can one maximise therapeutic gain from rehab sessions? Do you have examples to share?

Maximum therapeutic gain is obtained when you can define exactly what is happening to the muscle in response to the intervention you are making. For example, I consistently use TMG100 during rehabilitation training to monitor for excessive local muscle fatigue. I’m a strong believer that local muscle fatigue in rehab training is detrimental to treatment success. When a muscle becomes overly fatigued, two things happen:

• people will adapt and compensate in that movement by activating other muscles thus motor learning of healthy movement is disturbed
• the fatigued muscle will destabilise the joint or muscle chain leading to acute pain. Acute pain leads to central pain inhibition which in itself changes muscle function by altering muscle tone and the level at which the muscle is activated. In essence, when someone has a muscle that becomes acutely fatigued and you continue to work that muscle, then there will not be any effect of the therapy, because the muscle and all systems connected to that muscle need to recover from the therapy itself. During therapy, I use TMG100 to look for signs of local muscle fatigue in specific muscles and simply stop that part of therapy when we have reached the acute muscle fatigue point. Usually, we would like for subjective signs of fatigue or the patient simply reports pain, in my opinion it is far too late at that point. I feel that the ability to monitor for local muscle fatigue with TMG100 has become the cornerstone of my therapeutic success.

Since you bring the TMG 100 to India, how are you planning to promote this technique in India?

We have already established that there is interest for TMG100 tensiomyography in elite sports in India, predominantly in cricket. Several private and more innovative clinics and rehabilitation professionals have also expressed a keen interest in using the technology to offer their patients and clients something more. In Fit and Spa Solutions from Bangalore, we have found an ideal partner who understands our needs and sees the potential for TMG100 tensiomyography on the Indian market. They offer a range of products that is complementary to our device and we are confident they will be able to offer a comprehensive package for any clinic or individual who wants to stay on the state-of-the-art side in sports training, research and rehabilitation. In the next several months we have planned a series of workshops around India and have already established contacts with key opinion leaders who are keen to work with TMG100.

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