Resistance bands have always been part of physiotherapy and recovery. One of the reasons for resistance bands’ popularity is their ability to isolate muscles and provide resistance through the whole arc of the movement, rather than relying on gravity. Although resistance bands are most well-known for rehabilitation, they are also useful to progressively load, stress and strain a specific group of muscles during exercise. These elastic bands provide a low-impact workout that can be adapted to target specific muscle groups. Using the right movement principles, and with some expert guidance, resistance bands can even mimic weightlifting exercises.

What is a resistance band?

Resistance bands are stretchable bands made of elastic material in a rainbow of colors. They are used for exercises where you need to control the level of resistance and load. Have you ever wondered why they come in different colors? The resistance bands used by health professionals are standardized, so each color has a specific weight to tension ratio. This allows us to control the effort and load during each phase of rehabilitation. It also means that a red resistance band has exactly the same resistance as another red band from the same system. Resistance ranges from very light to heavy, making the bands extremely useful for exercise progression.

Why do we use elastic resistance?

As experts in pain control and rehabilitation, physiotherapists have various tools to tailor exercises to your current abilities and phase of healing. While elastic resistance can’t, and shouldn’t, replace weight training, there are benefits that you won’t get from other forms of resistance. Let’s use a seated biceps curl to illustrate the difference between weights and resistance bands.

An unweighted biceps curl is simply moving your arm from a straight to a bent position. If you add a dumbbell, the bending becomes more effort due to the added weight. This effort stays more or less the same throughout the movement. Your Biceps is fighting gravity to overcome the force and bend your elbow. Straightening your elbow is easier though because gravity helps to lower the weight. In other words, resistance from weights depends on levers and gravity.

When you do a biceps curl with elastic resistance, the movement creates tension in the band. The tension, not gravity, is what provides resistance. This tension increases exponentially as you keep on pulling the band, so the exercise actually becomes more difficult throughout the movement. As soon as you start lowering your arm, this same tension becomes recoil, pulling you down. Now, instead of gravity making the movement easier, you have to use your biceps to control the sudden recoil. The elastic properties of the band allow for continuous load and a much smoother force transition.

Isometric contraction is when a muscle contracts but no movement takes place. After knee surgery you’d be very cautious when moving your thigh and knee, so we use resistance bands over your ankle to allow you to tighten the muscles, without moving the injured site. This allows us to keep the muscles strong and prevent joint stiffness.

Benefits of resistance bands
  • Gain muscle strength and tone
  • Resistance throughout the whole movement
  • Adds rotational resistance
  • Highly adjustable
  • Graded progression
  • Concentric and eccentric loading
  • Fast progression in amount of load applied
  • Easy adaption without need for extra equipment
  • Safe, stable, smooth movement arch

“Resistance bands are not only for the weak or injured.”

The technique:

Elastic resistance exercises are all about anchors and angles. The resistance band always needs a fixed point or anchor. This fixed point allows us to create tension in the band. Without tension, the band is about as useful as a colorful ribbon – pretty to look at, but not what you want to use to get stronger.

So does that mean you tie the elastic band to any convenient spot? No, because the angle of the tension determines which muscle group or movement you’re training. If the fixed point is under your foot and you pull the band with your hand, the tension loads your biceps muscle. However, if the fixed point is next to your hip, doing the same exercise will have a minimal effect on the biceps. The anchor point of your band should generally be in line with the movement you want to perform. Technically at a right angle.

We combine bands with weights for multidirectional loading. Or use two bands with different anchor points to train different planes of movement. If we want to improve stability, we’ll make your injured limb the fixed point. In this case we create tension in the band while the injured side resists movement, i.e. the muscles works to keep it from moving.

The sky is the limit when it comes to exercise techniques with resistance bands. This is why physiotherapists use it as part of their training program to strengthen specific dysfunction muscle groups or reinforce a weak movement pattern.

Different types of elastic resistance

Resistance bands are the most common form of elastic resistance you will find. These bands are broad and flat and come in different lengths. The best in the business is TheraBand. Have a look at the weight you’re able to apply through the band on their site.

Resistance tubing is exactly what the name says: an elastic tube. The different levels of resistance (colors) will be identical to resistance bands, but staring off with a much higher tension ratio.

Minibands are circular elastic bands. These are especially useful for bilateral exercises like squats when you want to resist the same movement on both sides.

Powerbands are basically the next level of resistance in the range of elastic bands. These bands provide much more resistance than the standard resistance bands. You will typically find powerbands in the weight-training part of the gym, where they’re used for high load leg exercises and even for assisted pull-ups.

One of the most commonly used brands of elastic resistance is the Theraband system. The table below illustrates how much resistance you can expect from the different bands in this specific system.

 Resistance at 100% elongationResistance at 200% elongation
Yellow (lightest)1.3 kg2.0 kg
Red (light)1.7 kg2.5 kg
Green (light-medium)2.1 kg3.0 kg
Blue (medium)2.6 kg3.9 kg
Black (heavy)3.3 kg4.6 kg
Silver (heaviest)4.6 kg6.9 kg
Gold (heaviest)6.5 kg9.5 kg

Muscular changes from resistance band exercises:

Resistance exercises, like those performed with elastic resistance bands, have a multitude of benefits. This includes increases in muscle size and strength.

Muscle hypertrophy

Bulking, muscle gain or build. The tissue in your body responds to stimuli, and muscle fibers are no different. Consistent, progressive load from resistance training leads to an increase in the cross-sectional area of the muscle. In other words, the muscle will get bigger.

Muscle strength

You may think that a big muscle should be strong and a small muscle is weak, but that isn’t always the case. Just look at long-distance runners. They usually have lean muscles and a slender build. Does that mean that they aren’t strong enough to run a marathon? No, their muscles can do exactly what they need to and keep going for as long as it takes. The muscle’ ability to withstand tension must not be confused with brute power.

The improvements in muscle strength we get from resistance band training are from increased activation of muscles, better communication in the neural system – specifically motor unit recruitment, that stimulate the muscle to contract – and less activation of the muscles doing the opposing movement. All of these combined speeds up recovery after an injury. Instead of treating each component individually, the benefits of elastic resistance band exercises has been proven over and over again.

Resistance band exercises and neural adaptation:

Every muscle in your body is innervated by nerves. These nerves carry messages to and from your brain and spinal cord. Without these messages, you wouldn’t be able to do any coordinated movements or activities. Every muscle would basically be doing its own thing, without any control or planning. The constant flow of information back to your brain also means that your muscles adapt to changes almost immediately. We use the umbrella term nervous or neural system to refer to all the different nerve cells in your body.

When we do exercises to retrain movements, we rely on our nervous system to “remember”. This principle is called neural adaptation. Every time you do an exercise or movement, it stimulates the nerves that power the muscle. Repetition reinforces the message to and from your brain. Over time, this neural adaptation means that your nerves and muscles replicate the movement with less effort and concentration from you.

Resistance band exercises use this mechanism to retrain movement patterns. The resistance is applied throughout the whole movement, so there’s a constant flow of messages to and from your brain. This enhances the neural adaptation we get from exercise.

Your focus required to get the movement right the first few times is quite challenging and requires maximum brain effort. The more you do it, the nerves fire in sequence to contract your muscles, and with a bit of practice you’ll be sipping a smoothy while you do your squats.

What should I feel when I’m doing resistance band exercises?

Each exercise you do should be targeted at a specific muscle or muscle group. When you are training with a resistance band, you should feel the tension in these muscles. This tension should feel challenging but manageable. If you can’t maintain proper form and technique throughout the movement, rather use a band with less resistance.

You should never experience any sharp or intense pain while exercising with resistance bands. No pain does not mean no gain. If you do experience pain with an exercise, stop the exercise and assess your form or technique.

A general rule for resistance training is that your exercises should feel challenging but not overwhelming.

How long before I feel the effects of resistance band exercises?

Your body needs time to adapt, so you won’t see the effects overnight. It takes about 4-12 weeks to see noticeable improvements in muscle strength from resistance training. How long it takes depends on various factors, including how often you train, the intensity and duration of exercise, and your previous fitness level. The golden rule is consistency; don’t give up if you don’t see instant results. Keep doing the work and give your body time to adapt.

The effects from resistance band exercises that you will see within a couple of days or weeks is the change in how you move. Even though your muscles need time to get bigger and stronger, your body will already start responding to the simple fact that you’re moving better and more often. Movement really is medicine and you will notice the difference in your symptoms even before you see a difference in the mirror.

Muscle strength gains are fast and instead of going out to buy more dumbbells, we adapt the amount of tension through the resistance band. Measure your maximum effort once a week and write it down. In some cases the goal is to strengthen the available range of motion. You’ll notice a faster improvement in range and effort needed, rather than resistance capacity.

Why do I need follow-up sessions if I already have a resistance band?

We are all creatures of habit. Therefore, we respond to repetition. The things you do often becomes easier and easier. This may sound like a good thing, so why do we need change?

Imagine only walking around your house every day for weeks. No other exercise at all, just one walk around your house. Initially, this walk might make you a bit tired and take some time. After a couple of days, your walk will become little to no effort and be over before you know it. If you always walk the same distance, though, this short walk will become your “normal” and everything else will seem like too much effort. Any exercise works on the same principle. In rehabilitation, we use the term progressive loading. To keep on improving, you need a gradual increase in the demand placed on your body.

When you do any form of resistance exercise, your muscles adapt by becoming stronger and more resilient. However, once your muscles adapt to a particular weight or resistance level, there’s no need to get stronger unless the stress is increased. This is why our recovery programs run over weeks with days in-between for you to continue the progress.

This is where your physiotherapist comes in. We reassess you during every stage of healing to adapt your rehabilitation program to meet your current abilities. Enough stress to keep adapting and healing, but not so much that you get reinjured. Finding the safe balance to ensure maximum gains. After all, if you’re doing it – you might as well be going all out.

What can I do at home to get the most benefit out of resistance band exercises?

  1. Consistency is key. Don’t skip a session when you don’t feel like exercising, it only delays your recovery.
  2. Stay focused during your exercises. Your brain and muscles take much longer to learn the correct movement patterns if you’re distracted.
  3. Don’t overdo it. It may seem like more is better, but if you push yourself too hard you actually reinjure healing structures. This is why you must stick to the repetition count instructed by your physiotherapist.
  4. Store your resistance band correctly. A wet, bunched-up resistance band won’t last long. Make sure to dry the band after every training session and, preferably, store it by hanging it over a bar or rail. Powder helps in humid cupboards.

Cost of resistance bands

If your physiotherapist prescribes exercises with a resistance band, you will not be charged an extra fee for the resistance band. However, the true value of resistance bands lies in using it for the right exercises at the right time. A tool is only useful if you know how to apply it, and that is where expert advice and exercise prescription comes in.

Medical Aid Codes 501 and 305

The use of resistance bands falls under medical aid codes 501 and/or 305. Medical aid code 501 is used for various aspects of rehabilitation and can include resistance band exercises. Another application of resistance bands in physiotherapy is re-education of movement which falls under medical aid code 305.

Resistance bands are only a tool, and will never solve your problem when used in isolation. The long-term value of physiotherapy treatment lies in learning what to do, what to avoid, which exercises will give you the most benefit, and when the time is right to change these exercises.

Does it make a difference to have an experienced physiotherapist prescribe exercises with a resistance band?

Nowadays you can find information about anything and everything on the Internet. But, watching a video on how to fix your car can’t make you a mechanic.

Physiotherapists are experts in human movement, anatomy, and physiology. We are not only trained to diagnose your injury, but we also know how to find the root cause of the problem. Having a diagnosis and cause is only the start, though. Every injury has different stages of healing, and each stage can handle different amounts of strain. Your physiotherapist knows how much to load the injured structure and monitor your progress. As you heal, the tissue tolerance increases, so your exercise program has to change. Overloading the structure leads to more damage, whereas underloading can keep you from regaining full strength and mobility.

An experienced physiotherapist can prescribe the right exercises at the right time, ensure proper form and technique, and help you get the best results from resistance training.

Important notes when using resistance bands:

  • Store resistance bands in a cool, dry place.

  • Check your resistance band for small tears before exercising.

  • Inspect your skin after using resistance bands and discontinue use if you have an allergic skin reaction.

  • Make sure to use a sturdy object when anchoring your resistance band for exercise.

Frequently asked questions about resistance bands:

Yes, resistance bands are very effective for muscle building when used correctly and in conjunction with a well-designed workout program.

Yes, but with proper use and storage, the bands are designed to withstand up to 200% elongation. Meaning 4 times its relaxed position length.

Yes, resistance bands generally last about one year.

No. See our section above for guidance while doing your resistance band exercises with an elastic band.

No. Resistance bands and traditional weights have different applications, depending on the goal of the exercise, and load required to train at optimal levels.

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