TERT

TERT stands for:

Total End Range Time

What is TERT used for?

treat hypomobility of the shoulder complex

passive exercise

- cold and stretch in appropriate position to target tissue (2nd TERT) - no "bad" pain **clinical reality: many times start stretching for 10 mins because of patient intolerance.

manual therapy interventions

- mobilizations - strain-counter-strain - myotherapy - mobs with movement - etc. **whatever seems to work best in your hands

purpose of TERT steps 1 and 2

- prepare tissues by warming them up - all tissues have more elasticity when they are warmer - inside and outside warmups

first 2 steps of TERT

1. active exercise of involved area ~10 mins active metabolic warm-up to heat the tissue structures to increase elasticity 2. passive exercise - heat and stretch in appropriate position to target tissue **1st TERT - 3 sets x 20 minutes = 60 minutes/day **no "bad" pain **clinical reality - many times start stretching for 10 mins because of pt tolerance

What comes after active and passive exercises?

1. manual therapy interventions 2. exercises to gain dynamic stability of newly gained PROM 3. other: TAS, TLS, TBS 4. passive exercise (second TERT) 5. third TERT-HEP

purpose of passive exercise in 2nd TERT

get tissue that has been heated, stretched, mobilized, and exercised to remain in the elongated state

third TERT-HEP

using positional stretching, splints, casts, CPMs, etc. to complement the stretching time in the clinic to total 60 mins per day - ex. if 20 mins of stretching performed in clinic, then 40 mins in 3rd TERT of HEP

significance of dynamic stability exercises

KEY to maintaining PROM