Suspension Training: Is There Any Benefit?

Suspension Training and Muscle Activity

Suspension training is hotter than sunburn in fitness and rehabilitation right now.  TRX, the “Jungle Gym” and other similar models are hanging from the rafters at gyms and rehab facilities all over the fruited plain.  The benefits of suspension training largely center around resistance coming from bodyweight, versatility, and the space as well as cost saving benefit of having them.  Bodyweight training is far safer for most untrained individuals and you can do a total body workout with the bands.  Furthermore, they avoid the cost of having to buy tons of weight equipment.  Plus, the bands are relatively affordable.  All good things to be sure!  There have been several studies that have looked at muscle activity while doing suspension training – so what does the research say?  Does suspension training really do anything different than “traditional” training methods?  As always, the physical therapists at SSOR look to the research to guide our practice.   We try not to “geek out” too much, but it’s important to know what legit studies find rather than what some fitness magazine says they “think” is happening.

Suspension Training vs. Traditional Methods

Atkins et al in the Journal of Strength and Conditioning Research performed two studies, one in 2014 and one in 2015.  Each study looked at suspension training versus stable surfaces doing abdominal exercises.  In both studies, researchers found that suspension training with the plank exercise resulted in greater rectus abdominus activity than the “traditional” stable surface plank, but not with the erector spinae or the external oblique.
Another study by Byrne et al in 2014, also in the Journal of Strength and Conditioning Research looked at TRX Training with the feet suspended, arms suspended, both suspended, and the “traditional” plank on stable surfaces.  Researchers found that rectus abdominus activity was highest with the arms suspended, abdominal activity was higher in all suspended conditions compared to stable, and serratus anterior activity was highest with feet suspended and in the “traditional” plank position.
Catalayud et al in Phys Sports Med in 2014 looked at chest, shoulder, and abdominal muscle activity with suspension push-ups versus traditional push-ups.   Like Atkins et al, abdominal activity was higher in the suspension condition,  but interestingly, pectoralis major, deltoid, and serratus anterior activity was higher in the stable push up condition.
Snarr & Esco in the Journal of Strength and Conditioning Research (2014) looked at suspension planks, stable surface planks, and Swiss ball planks.  In this study, they found that erector spinae activity was much higher in suspension than other conditions.  Additionally, they found that all surface muscle activity was higher in both the suspension and Swiss ball activity overall compared to the stable conditions.  The study authors suggested that because of their findings, caution should be used in using suspension training in those with lumbar spine pathology.  In another study by Snarr & Esco (2013), they looked at traditional versus suspension push-ups.   In the suspension condition, greater muscle activity of the pectoralis major, deltoid, and triceps was elicited compared to stable push-ups.
Finally, Stuart McGill, arguably one of the top spine researchers, led a study in the Journal of Strength and Conditioning Research (2014) to look at spinal loads during suspension push-ups versus stable push-ups.  Interestingly, greater shear forces in the spine were higher with stable push-ups, but compressive forces in the spine were higher in suspension conditions.  McGill and colleagues concluded that individuals with a resilient low back that need a greater challenge are good candidates for suspension training, but caution should be used in those with low back pathology.

The Bottom Line: Suspension Training

Based on the current evidence, it appears suspension training is a good choice for increasing muscle activity, but caution should be used in people with low back pathology.  For a person in rehabilitation for any condition, we always encourage exercises be performed on stable surfaces with good form prior to challenging conditions like suspension training is used.  Additionally, we caution those with shoulder pathology to be mindful of how “deep” they go when doing push-ups.  We suggest a good target is to lower yourself as low as you can provided you can still see your elbows.  When you go all the way down (elbows at their highest above your trunk), your shoulder is in a very vulnerable position.  Proceed with caution!!
It would be a privilege to serve you and partner with you in your care should the need arise.  Rest assured, the physical therapists at SSOR understand appropriate exercise progression to make sure you’re safe, but we also know when and how to “turn it up” so you get the challenge you want!

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