Instrument assisted soft tissue mobilization (IASTM) is a very effective and powerful treatment modality that addresses a variety of soft tissue dysfunction. It is utilized on a daily basis in my hand/upper extremity clinic with much success. Addressing soft tissue restriction is imperative to excellent clinical outcomes, as demonstrated by the following case study on elbow dislocation.
The patient is a 44-year-old right-handed male who presented six weeks and four days post-left posterior elbow dislocation, with multiple musculoskeletal injuries. The clinical examination identified: c/o mechanical pain along proximal radio-ulnar joint (PRUJ) 6/10 at end range of motion (EROM) elbow flexion/extension, tenderness at coracoid process of scapula, and constant median nerve paresthesias, negative valgus/varus stress test, – radiocapitellar dysfunction, + Tinel’s sign at TRL.
His range-of-motion (ROM) values (Figure 1) were: elbow flexion 110 degrees – 40 degrees extension (capsular end feel), forearm supination/pronation 85/75 with soft end feel (passive range of motion greater than active range).
Tissue Assessment & Treatment
The soft tissue assessment included scanning the shoulder, upper arm, and forearm. Significant superficial gritty soft tissue restrictions noted in biceps, muscle belly and musculotendinous junction. Adaptive shortening from six weeks and four days in a sling. Soft tissue restrictions noted after scanning at bicipital aponeurosis and decreased activation of triceps.
The treatment plan included moist heat, IASTM utilizing HawkGrips (Figure 2) and proprioceptive/therapeutic exercise. There was significant soft tissue reaction and release at the antecubital fossa/brachioradialis proximally. The patient was seen twice a week for six weeks along with completion of a home exercise program (HEP).
The following measures were taken at discharge: no report of pain, paresthesia in left upper extremity, 140 degrees active elbow flexion – 10 degrees active elbow extension with no limitation in forearm rotation (Figure 3). The patient’s goals were met and he successfully returned to all occupations.
Every patient we treat has unique and individual concerns. To be effective clinicians in our healthcare system today, we must be efficient. Multiple treatment modalities were utilized in the care of this individual. Addressing the soft tissue passive and dynamic stabilizers in this case made all the difference. IASTM with HawkGrips instruments helped this individual regain function following elbow dislocation in a much more effective and efficient manner.
Dr. Jim Wagner is an occupational therapist and certified hand therapist who has specialized in treating upper-extremity and sports-related injuries for 24 years. He is currently team leader at the hand/upper-extremity center of The Guthrie Clinic in Sayre, PA, as well as an adjunct professor in the occupational therapy programs at both Keuka College in Keuka Park, NY, and Ithaca College in Ithaca, NY.
How U.S. Paralympic Team Physical Therapist Dr. Dawn Gulick Helped Implement HawkGrips into the Widener University Curriculum [Interview]
Dr. Dawn Gulick, PhD, PT, ATC, CSCS, is a professor of physical therapy at Widener University in Chester, PA. She began her clinical career as an athletic trainer, before earning her master’s degree in physical therapy more than 30 years ago. Dr. Gulick has been a Widener faculty member for about 22 years and HawkGrips instructor for the past three years. In this Q & A article, she discusses her educational roles, extensive background with the U.S. Olympic and Paralympic teams, and how HawkGrips treatment has been implemented into the curriculum at Widener.
Why Orlando City Soccer Club Massage Therapist Desmond Diaz Treats so Many Pro Athletes with HawkGrips [Interview]
Desmond Diaz, LMT, OMT, is the team massage therapist for Orlando City Soccer Club, which competes in the premier American professional league, Major League Soccer (MLS). In this role, Diaz also provides massage therapy for the team’s minor league club (Orlando City B), and sister team (Orlando Pride) that’s a member of the National Women’s Soccer League (NWSL). In addition, Diaz has represented the United States as a martial arts assistant coach and competitor, earning several medals in international tournaments. For this Q & A article, he discusses his role with Orlando City, how implementing HawkGrips…
Why Physical Therapist Dr. Keith Cronin Advocates Combining IASTM and Biomechanical Taping [Interview]
Dr. Keith J. Cronin, DPT, OCS, CSCS, has been a physical therapist for nine years and owns a niche distribution and education company in Denver called Sports and Healthcare Solutions, LLC. He works with innovative clinicians and companies from around the world to offer effective rehabilitative products and strategies that maximize patient outcomes. In 2018, Dr. Cronin will launch Biomechanikits, a distribution platform that combines quality education, great products and competitive pricing. He first became aware of HawkGrips about four years ago and soon implemented them into patient treatments.
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“Tennis elbow,” a diagnosis that strikes fear into the hearts of clinicians the world over! (OK… that may be a slight overstatement). Why is this condition so dreaded? Because when treating tennis elbow, everything works and nothing works. Tennis elbow is one of the most commonly diagnosed and discussed musculoskeletal conditions known to humankind. An article by Arnett et al. on the evaluation and treatment of lateral epicondylitis reported a 2-percent incidence in the general population, with a significantly higher rate among manual laborers.
Although I’m a certified athletic trainer, it’s rare that I seek any type of physical treatment for myself. There are many reasons, but mostly I just feel bad about asking fellow clinicians to treat me when I know they’ve already been treating patients all day. Recently though, something wonderful happened. I asked Mark Shires, MS, ATC, PES, to treat my left shoulder and neck because of tension headaches I’ve been experiencing and he said yes!