Sports Medicine - Introduction to TRX Suspension Training For Rehab Professionals ׀ by Dino Laurenzi, L-ATC, MA, MBA, TRX Trainer & Kevin Conto, MPT, ATC, COMT, TRX Trainer


Dino Laurenzi, L-ATC, MA, MBA, TRX Trainer, graduated from the University of North Carolina with a degree in Sports Medicine and Athletic Training. He has worked with clients ranging from professional to fitness athletes. Dino has developed various sports medicine and athletic performance training programs to assist his clients to achieve better performance and improved fitness. Dino is currently the Director of Rehabilitation at United Hospital System.


Kevin Conto, MPT, ATC, COMT, TRX Trainer, received his athletic training degree from the University of Wisconsin- Madison and obtained his Master of Physical Therapy degree from Concordia University. He has his certification in manual therapy from Maitland-Australian Physiotherapy Seminars and is currently a physical therapist at United Hospital System. Kevin works with a variety of patient populations and also specializes in industrial rehabilitation and orthotic fabrication. 

Overview of TRX Suspension Training

In the rehabilitation and performance training settings there are a variety of tools available to assist with achieving desired objectives for a patient or client. One such functional tool, the TRX Suspension Trainer™, has become quite popular not only in the training setting but now in the rehab setting as well. The TRX Suspension Trainer leverages gravity and the user’s bodyweight to enable hundreds of exercises. It is designed to utilize suspension training bodyweight exercise to develop strength, balance, flexibility and core stability simultaneously.

The TRX Suspension Trainer was invented by Randy Hetrick, a former US Navy SEAL, to allow him and his SEAL teammates to maintain fitness while deployed far from a conventional gym. Suspension Training bodyweight exercise allows the individual to perform strength, stability, and flexibility exercises supported in a suspended position using body weight for resistance.

In Suspension Training, the individual places their hands or feet into the Suspension Trainer that is connected by a single anchor point while the opposite end of the body is in contact with the ground. “All Core-All the Time” is the principle concept of the TRX. This is based on the assertion that training on the TRX will engage and increase core muscle activity. In addition, exercising on the TRX utilizes gravity and body movement to generate neuromuscular responses to changes in body position. Other benefits of Suspension Training include core muscle activation during closed chain therapeutic exercises and can be completed in multiple planes and angles. Studies have been conducted using adjunctive modalities such as the Swiss ball and unstable conditions to study core muscle recruitment (1, 2, 3, 4), but a review of the literature does not provide peer reviewed studies to validate core activation specific to Suspension Training. Further study is warranted to provide evidence for the effectiveness of the TRX and to gain a better understanding for the effective use of the TRX Suspension Training device in the physical therapy and performance training setting.


How to Use the TRX Suspension Trainer for Resistance  and Flexibility Training

The TRX can be used safely indoors or outdoors on a non-slip surface approximately 8’ x 6’ wide. Anchor points may include weight racks and machines, chin-up and overhead bars, doors, railings and tree branches; anything that can support bodyweight. 

Anchoring the TRX Suspension Trainer
The anchor point should be 7’ to 9’ high and strong enough to support the weight of the patient with the Black Equalizer Loop approximately 6’ off the ground. When the TRX is fully extended, the foot cradles should be approximately 3” off the ground.

Adjusting Exercise Intensity
Exercises can be designed to include changes in resistance, stability or both. This is very important when executing therapeutic exercises with the rehab client.

3 Principles of Suspension Training to adjust difficulty on the TRX Suspension Trainer
1. Vector Resistance Principle – Resistance based on change in body angle.



2. Pendulum Principle – Resistance based on position relative to the anchor point.



3. Stability Principle – Change in the size and position and body’s base of support. The wider the base, the more stability, the easier the exercise.



Six exercise positions relative to the TRX Suspension Trainer
1. Standing facing the anchor point
2. Standing facing away from the anchor point
3. Standing sideways to the anchor point
4. Prone
5. Supine
6. Laying Sideways




Although there may be a variety of tools available to the physical therapist, athletic trainer or personal trainer, the TRX Suspension System is the most versatile tool available which utilizes Suspension Training to assist with achieving strength, balance, flexibility, mobility and injury prevention needs. It is durable as well and can be used safely for clients of all ages with proper training. Workshops are available for the TRX Suspension Trainer and advised prior to implementing in the rehab or performance setting. Additional information can be found at or by contacting Dino at or Kevin at






Below are handouts of instructional exercises involving the TRX for core training, upper body training, lower body training and flexibility/mobility training which can be printed and utilized for exercise instruction.

TRX Strength Exercises - Core Handout


TRX Strength Exericses - Upper Body Handout



TRX Strength Exercises - Lower Body Handout


TRX Flexibility & Mobility Handout



Last revised: June 18, 2010
by Dino Laurenzi, L-ATC, MA, MBA, TRX Trainer & Kevin Conto, MPT, ATC, COMT, TRX Trainer


1. Behm DG, Anderson K, Curnew RS: Muscle force and activation under stable and unstable conditions. J Strength Cond Res 2002, 16 (3): 416-22.
2. Cosio-Lima LM, Reynolds KL, Winter C, Paolone V, Jones MT. Effects of physioball and conventional floor exercises on early phase adaptations in back and abdominal core stability and balance in women. J Strength Cond Res. 17:721-725, 2003.
3. Marshall, P.W.M., and B.A. Murphy. Core stability exercises on and off a swiss ball. Arch. Phys. Med. Rehabil. 86:242-249. 2005.
4. Moreside JM, Vera-Garcia FJ, and McGill SM. Trunk muscle activation patterns, lumbar compressive forces and spine stability when using the body blade. Phys Ther. 87: 153-163, 2007.

Terms & Conditions

Please review our terms and conditions carefully before utilization of the Site. The information on this Site is for informational purposes only and should in no way replace a conventional visit to an actual live physical therapist or other healthcare professional. It is recommended that you seek professional and medical advise from your physical therapist or physician prior to any form of self treatment.

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