At the base of the Wasatch Mountains, about 13 miles south of Salt Lake City, is scenic Sandy, UT. On my way to the Neuroworx facility there to teach a HawkGrips instructional course, those majestic mountains formed the backdrop to one the most picturesque landscapes I’ve ever seen. Soon after arriving, I learned that Neuroworx, a community-based outpatient physical therapy clinic specializing in neurological conditions, was every bit as impressive as the peaks surrounding it.
Knowing that many of the participants treated a mostly neurological client base, I tried to devise methods of adapting our Level I: IASTM Fundamentals course to meet their needs. This course provides basic background information on IASTM (instrument assisted soft tissue mobilization) and teaches proper techniques for utilizing the different HawkGrips instruments, but the subject matter tends to focus on orthopedics. So I was challenged to find ways of teaching instrument fundamentals that related to both orthopedic (for the other participants including athletic trainers, physical therapists, and chiropractors) and neurological clients.
After taking a tour of the exceptional Neuroworx complex, I was treated to an enthusiastic group of attendees who were eager to learn. I also discovered that the main reason the clinic wanted to host a course was to learn more about the effects of IASTM on neurological clients. It turned out that a physical therapy student on his clinical rotation there had experience with IASTM.
This student had informed the staff of a journal article by JJ Lee and coauthors that demonstrated the effectiveness of IASTM for decreasing hypertonicity in the gastrocnemius while facilitating activity of the tibialis anterior. It so happens that one of the therapists at Neuroworx has a T3 spinal-cord injury and the student previously performed IASTM techniques on him. The staff was amazed by the results! (More on that later in this article).
As we progressed through the lab portion of the course, it became evident how special this group was. Everyone quickly took to the techniques and began relating them to current and former clients. Discussion involved the utilization of HawkGrips for orthopedic diagnoses that neurological clients face, such as shoulder tendonitis from using assistive devices and wheelchairs, and overuse of uninvolved extremities.
We related the treatment to neurological diagnoses as well. For instance, could IASTM be used for a client with arthrogryposis (congenital joint contractures)? What positions can be utilized for a client with low tone? Could IASTM be taught to family members to help patients progress after physical therapy? What techniques work well with baseball pitchers? (Remember, some of the attendees were interested in orthopedics too).
Ultimate Neurological Case Study
Thanks to a lot of brainstorming, we came up with some great ideas and people couldn’t wait to start using the instruments at work the next week. But first, we conducted the ultimate case study. As I mentioned earlier, one of the course participants had a spinal-cord injury. So I was challenged to perform techniques on his lower extremities to recreate the study by JJ Lee. I had been informed that after the physical therapy student previously treated him with IASTM, this course participant demonstrated improved gait for approximately 4 hours.
So the day of the course, we shot before and after videos of his gait (see Instagram post below). Technically, the pre-treatment video occurred after I had already provided some therapy to the patient’s upper leg. This may have slightly improved his typical gait, but deficits were still noticeable. As the video demonstrates, he had decreased dorsiflexion and poor ability to heel-strike bilaterally, mostly due to the hypertonicity of his gastrocnemius, and he compensated with circumduction. The patient also had clonus with normal dorsiflexion.
After I performed IASTM techniques on his gastroc-soleus complex, Achilles tendon (in both open- and closed-chain positions), and tibialis anterior, we shot the post-treatment video. He demonstrated a noticeable increase in bilateral dorsiflexion, enabling better transition from heel-strike to flat foot due to improved gastroc tone and decreased circumduction. Following this successful intervention, the class discussed other options to maintain his results, such as taping and daily treatments.
Overall, the Neuroworx course featured an awesome group of enthusiastic, intelligent and fun participants. It was challenging to relate IASTM techniques to the neurological population, but I think we did a great job with this integration. I enjoyed being part of their shared excitement about the new possibilities HawkGrips could provide to their clients. There was even talk about conducting research on IASTM treatment for the neurological population. Looking back on it, the only unfortunate aspect of the trip was that I didn’t have enough time to ski on those spectacular local slopes.
A great before-and-after video of just how effective HawkGrips treatment can be! Just a couple of weeks ago we held a course at the impressive @neuroworx facility ???. One of the attendees had a T3 spinal-cord injury, so instructor Kraig Bano performed HawkGrips Therapy on his lower extremities – and you can see the difference after just one session! This was an exciting course for several reasons, not least of which was this great story. For the rest of the details, check out Kraig’s article, coming soon at hawkgrips.com! ?? . . . . . . . . #hawkgrips #iastm #education #certified #teaching #learn #healing #walking #wellness #health #fitness #neuropathy #neuroworx #neuro #nonprofit #paralysis #physicaltherapy #occupationaltherapy #utah #sandy @kraigbano
Kraig Bano is director of hand therapy for the Philadelphia region at ATI Physical Therapy, as well as a HawkGrips course instructor.
“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!
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