SMPT SINDO MANUAL PHYSICAL THERAPY
Specializing in manual therapy of the spine and extremities  

SERVICES OFFERED:
Guiding Principles:
As a practitioner of manual physical therapy, I continue look out for the path that has been laid down before me by the great practitioners of manual therapy. Whatever I learned from them serves as my guiding principles as I practice manual physical therapy.

Click on My Philosophy to learn more about it.

SMPT offers MANUAL THERAPY principles of evaluation and treatment based from (however not limited to):

ACTIVE RELEASE TECHNIQUE ®
ASTYM SYSTEM
DON TIGNY APPROACH
INTEGRATIVE MANUAL THERAPY SOLUTIONS
INSTITUTE OF PHYSICAL ARTS
MAITLAND APPROACH
MCKENZIE METHOD
MULLIGAN APPROACH
PARTRIDGE METHOD
UNIVERSITY OF ST AGUSTINE

NON-TRADITIONAL MANUAL PHYSICAL THERAPY APPROACH:

PRIMAL REFLEX RELEASE TECHNIQUE

THERAPEUTIC MODALITIES AND EQUIPMENT

ALPHA STIM 100
ASTYM SYSTEM
DEEP MUSCLE STIMULATOR
ELECTRO THERAPEUTIC POINT STIMULATION
GRASTON TECHNIQUE
KINESIOTAPING
ML830® COLD LASER
SPINAL DECOMPRESSION

ORTHOPEDIC MANUAL PHYSICAL THERAPY

Active Release Technique ® ( P. Michael Leahy, DC, CCSP ). www.activerelease.com

ART is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splints, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with ART. These conditions all have one important thing in common: they are often a result of overused muscles.

How do overuse conditions occur?

Over-used muscles (and other soft tissues) change in three important ways:
· acute conditions (pulls, tears, collisions, etc),
· accumulation of small tears (micro-trauma)
· not getting enough oxygen (hypoxia).

Each of these factors can cause your body to produce tough, dense scar tissue in the affected area. This scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker, tension on tendons causes tendonitis, and nerves can become trapped. This can cause reduced range of motion, loss of strength, and pain. If a nerve is trapped you may also feel tingling, numbness, and weakness.

What is an ART treatment like?

Every ART session is actually a combination of examination and treatment. The ART provider uses his or her hands to evaluate the texture, tightness and movement of muscles, fascia, tendons, ligaments and nerves. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.

These treatment protocols - over 500 specific moves - are unique to ART. They allow providers to identify and correct the specific problems that are affecting each individual patient. ART is not a cookie-cutter approach.

What is the history of Active Release Techniques?

ART has been developed, refined, and patented by P. Michael Leahy, DC, CCSP. Dr. Leahy noticed that his patients' symptoms seemed to be related to changes in their soft tissue that could be felt by hand. By observing how muscles, fascia, tendons, ligaments and nerves responded to different types of work, Dr. Leahy was able to consistently resolve over 90% of his patients' problems. He now teaches and certifies health care providers all over the world to use ART.

If you want to locate a ART practitioner, please check this website: http://www.activerelease.com/providersearch.asp

ASTYM treatment is a revolutionary process that heals soft tissue problems
www.astym.com
ASTYM (A-stim) treatment is a rehabilitation program that stimulates the regenerative healing process of the body. This approach is a non-invasive therapy that works fast and consistently. The ASTYM system rejuvenates muscles, tendons and ligaments. It gets rid of scar tissue problems from old injuries in a fashion previously unimaginable.  ASTYM system has the scientific background, data and experience that prove it.
Diagnosis that respond well to the ASTYM system:

●Post surgical scarring	● Rotator cuff tendinopathy	● Patellar tendinosis
●Post-traumatic scarring	● Plantar fascitiopathy	● Medial epicondylitis or golfer’s elbow
●IT band syndrome	● Chronic ankle sprains	● Lateral epicondylitis / Tennis elbow
●Hamstring strain	● Achilles tendinosis	● Hip pain / trochanteric bursitis
● Carpal tunnel syndrome	● Shin splints	●Sacroiliac Joint Pain / Low back pain
● Anterior Knee pain	● DeQuervains tenosynovitis	●Most chronic tendinopathies.

• ASTYM treatment is fast - a typical course of treatment lasts only four to six weeks.
• You get to stay active - during ASTYM therapy you are actually encouraged to continue normal activities. You can still go to work and stay in your sport or favorite activity without having to take time off from your life while you heal.
• It's non-invasive - no needles, no knives, no drugs. Period.
• It really fixes the problem- the ASTYM system doesn't just treat the symptoms or hide a problem with a temporary solution. Instead, the system stimulates the body to heal properly and completely.
• Certified providers – only certified ASTYM therapists offer this therapy.  These certified clinicians undergo intensive training and they will give you the results you expect from ASTYM treatment.  Click here to locate a certified ASTYM provider.
• ASTYM treatment was developed by experienced medical professionals through years of detailed research.

DON TIGNY METHOD ( RICHARD DONTIGNY PT): http://thelowback.com.

Got LOW BACK PAIN? It may surprise you to know that most LOW BACK PAIN have its origin from Sacroiliac Joint (SIJ) Dysfunction. “In 1992 at the First World Congress on the Sacroiliac Joint, Dr. Joseph Shaw of the Topeka Bank and Neck Pain Clinic reported that in a series of 1000 consecutive patients he examined for low back pain (LBP) and Sacroiliac Joint Dysfunction, he found that 98% had an Sacroiliac Joint (SIJ) Dysfunction. When he addressed that problem his surgical incidence for herniated disks dropped to 0.2%. In 1982 the American Academy of Orthopaedic Surgeons met in Toronto specifically to address LBP. They established criteria for testing and for the interpretation of those tests. They assumed that the SIJ was so strong as to be immune to injury through minor trauma and paid scant attention to it. They also reported that 'in spite of thorough examination they could establish a firm diagnosis less than 15% of the time. What they did not seem to realize is that when you use their recommended tests and interpret those test in the recommended manner that you will be compelled to miss the diagnosis over 85% of the time! It's not that they are not an intelligent group, but they just have not considered all of the evidence. Boorstin once commented that "The chief obstacle to discovery is the illusion of knowledge." People are reluctant to learn what they think they already know. This is willful ignorance. Instruction is of scant value. You must instill some doubt to stimulate investigation“.

“Richard DonTigny has researched pelvic dynamics since 1965. He has published many articles and presented nationally and internationally. He has been on the advisory board of the World Congress of Low Back Pain and the Pelvis from 1992-2002 and is on the board of associate editors of the Journal of Manual and Manipulative Therapy. His detailed critical analysis of the pelvis has led to a simplified method of treatment whereby with a skilled precise manual procedure three out of four patients with low back pain can be free of pain within ten minutes“. And guess where is the emphasis of his treatment for the so-called LOW BACK PAIN is? Yes it is indeed at the dysfunctional sacroiliac joint as illustrated below.

INTEGRATIVE MANUAL THERAPY SOLUTIONS ( JEFRREY ELLIS, MS, PT, MTC FFCFMT). www.imtsglobal.com

"IMTS specializes in the area of Orthopedic Manual Physical Therapy with a foundation of Osteopathic methodology and intervention. IMTS approach is based upon an integrative "Corrective versus Palliative" philosophy and management approach to somatic dysfunction. IMTS utilizes integrative and systematic approach in differentiating and correcting somatic dysfunction of the spine, costal cage, pelvic girdle extremities, lumbar spine, pelvic girdle and coccyx.. IMTS primarily integrates Muscle Energy Technique (MET) with Soft Tissue Mobilization (STM), Neuro-Muscular Re-Education and Prescriptive Home Exercises, while combining, harmonizing the principles of Osteopathic methodology with those of Orthopaedic Manual Physical Therapy. Jeffrey Ellis, founder of IMTS, had extensive studies in osteopathic approach to manual therapy. He completed over 2700 hours of post graduate studies in the area of orthopedic and osteopathic manual therapy".

Institute of Physical Arts (Greg Johnson PT, FFCFMT). www.instituteofphysicalart.com.

“Emphasis is on functional Manual Therapy that integrates PNF, soft tissue and joint mobilization, muscle energy, Functional Orthopedics™, Functional Mobilization™, neuromuscular reeducation, and Back Education and Training. The material bridges the needs of the orthopedic, neurological, and sports patient populations, and is immediately applicable in any clinical setting. The emphasis of functional mobilization is the facilitation of optimal structure and function through the identification and appropriate treatment of neuromuscular, skeletal, and myofascial dysfunctions. Treatment of pain is most successful when the focus is on function. Researchers often perform analysis on the general population to discover the average in performance or skill.  For the physical therapists, our goal is the enhancement of optimal or efficient function rather than attempt to achieve the average or normal

Maitland-Australian Physiotherapy (Geoffrey Maitland MBE, AUA,FCSP,TACP,SASP Mappsc).

http://www.ozpt.com.
The Maitland Approach is a World-Renowned, highly effective, gentle approach to the management of neuromuskuloskeletal conditions. The approach was pioneered in the 1950s by legendary Australian Physiotherapist Geoffrey Maitland, and has continued to evolve over the years with groundbreaking concepts such as Combined Movements, Neurodynamics, Stabilization. Geoffrey Maitland states that “Assessment is the keystone of effective, informative treatment, without which treatment successes and treatment failures lose all value of learning experience. Like the keystone, assessment is at the summit of treatment, locking the whole together”.

The Mckenzie Institute USA ( Robin Mckenzie  PT, CNZM, OBE, FCSP (HON), FNZSP (HON) Dip. MDT.

www.mckenziemdt.org.
“The McKenzie  Method is not merely extension exercises. In its truest sense, McKenzie  is a comprehensive approach to the spine based on sound principles and fundamentals that when understood and followed accordingly are very successful. In fact, most remarkable, but least appreciated, is the McKenzie assessment process.  Also known as Mechanical Diagnosis and Therapy, the McKenzie Method is a philosophy of active patient involvement and education for back, neck and extremity problems. The key distinction is its initial assessment component—a safe and reliable means to accurately reach a diagnosis and only then make the appropriate treatment plan. Rarely are expensive tests required, Certified MDT clinicians have a valid indicator to know right away whether—and how—the method will work for each patient” “ The Mckenzie assessment process has been found to be superior to MRI in distinguishing painful from non-painful discs. A non-invasive, low tech, relatively inexpensive clinical assessment using repeated end-range lumbar tests movements can provide considerable more relevant information than non-invasive imaging studies” ( Donelson et al 1997).

The Mulligan Concept ( Brian Mulligan FNZSP (Hon), Diploma M.T. ) www.bmulligan.com.

“Mobilizations with Movement”: a new approach. It is stating the obvious that many different manual therapy concepts and procedures are taught, and all have a place in the treatment of patients. However, all the techniques in the Mulligan Concept, when indicated, are expected to bring about an immediate improvement in the patient's condition. This is important in manual therapy, as endless perseverance with no lasting benefit to the patient cannot be justified. This new approach has been found to be able to restore functional movements in joints (often in one treatment session), even after many years of restriction, which questions the text books that speak of adaptive shortening. Spectacular results are often obtained using mobilizations with movement (MWMS)”.

PARTRIDGE METHOD (Dora Partridge PT): http://www.partridgeseminars.com

When your shoulder pain really bothers you- this is something just for you!!!

SMPT is proud to introduce a unique non-traditional physical therapy method of shoulder dysfunction management that requires a high level of expertise and yet when applied is pain free and very effective.

“The shoulder is a complicated and fascinating joint often described as “Mysterious” in the literature. Shoulder symptoms can puzzle and fool even the most experienced practitioners. When surgeries and traditional treatment options fail patients are often told “there is nothing more to offer them”. As a result many shoulder patients are left with limitation of motion, persistent pain, and less than optimal outcomes. The Partridge Method is a unique manual therapy approach & systematic treatment philosophy that is effective for even the most difficult shoulder cases ( from frozen shoulders, unrepairable RTC tears, SLAP lesions, MDIs, and multiple surgeries).Therapists trained with partridges method can be remarkably effective with many difficult shoulder cases that have not responded to surgery, drugs, injections and traditional therapy approaches. When pain and limitation of motion persist there are 5 key restrictions that are frequently the cause. The shoulder responds rapidly when we release these restrictions & restore the stability. Results are often amazing & the techniques are painfree & gentle. This systematic method of manual therapy techniques using 5 key positions to release the 5 types of shoulder restrictions in order to effectively restore range of motion often in just 1-3 visits”.

University of St Augustine for Health Sciences (Stanley Paris PT., PhD., FAPTA). www.usa.edu.

The advance manual physical therapy concepts that I learned from the University of St Augustine for health Sciences reflects highly of the aspiration and dreams of its founder, Dr. Stanley Paris. “Since his immigration to the United States from New Zealand in 1966, he has been actively involved in research, clinical practice and teaching in the area generally known as orthopaedic and manual physical therapy. His doctoral work was in functional anatomy of the spine with emphasis on neuroanatomy of the lumbar spine. For his work in founding and developing the Orthopaedic Section of the American Physical Therapy Association, the Section has named after him the annual Paris Founders Award for Distinguished Service. He was also the founding chairman of the International Federation of Orthopaedic Manipulative Therapy. In 2002 he was made a Catherine Worthingham Fellow of the American Physical Therapy Association. In 2006 he received the highest honor in physical therapy in delivering the 37th Mary McMillan Lecture”.
Stanley Paris states that “Dysfunction is the cause of the pain. Pain follows dysfunction. It cannot precede it. Pain does not warn of anything; it states that something is wrong. If pain starts as a disease, then it is a medical/surgical case. If pain starts as a dysfunction, then it is a physical therapy case”. Our therapy is to be directed at the dysfunction and not the pain. However in acute painful states, we may seek to relieve pain in order to lessen the effect on the dysfunction, but the dysfunction remains to be our main focus”.

Understanding the limits of Manual Physical Therapy: It is the nature of all concepts of therapeutic intervention, regardless of how great they are, that certain limitation to its application are a conceivable and reasonable expectation. It is also quite true in the application of manual physical therapy. In this regard, SMPT has endeavored to incorporate in its practice certain therapeutic modalities, equipment, and evolving physical therapy concepts that may facilitate in the fruitful resolution of a patient’s condition.

NON-TRADITIONAL MANUAL PHYSICAL THERAPY APPROACH:

Superspine: Primal Reflex Release Therapy™:  (John Iams  MPT). www.theprrt.com

SMPT is proud to introduce PRRT – Primal Reflex Release Therapy. With PRRT, muscle pain and tenderness could disappear with the use of a simple maneuver that influences the patient’s reflex holding pattern. This reflex holding pattern is responsible for maintaining patient’s pain sensation. It takes is only a few seconds or minutes to perform and is a painless maneuver. When PRRT is indicated, no other techniques have come close to how fast it can relieve pain, regardless of how long you have had pain! It can work on pain anywhere in your body too! “PRRT™ blends seamlessly with traditional treatment techniques and modalities. While PRRT™ isn’t every patient’s answer; it has been clinically proven to frequently reduce pain by 50% or more, even on the first visit. Many chronic pain patients notice drastic reductions in pain only after a few short treatments. If PRRT™ hasn’t made changes within just a couple sessions; it’s not likely to be helpful for that patient”. I believe that this is the most effective and efficient tool that a manual therapist can use in eradicating pain, and thus facilitate faster healing and recovery of function. Daniel is the only advanced PRRT practitioner in Brooklyn, NY as well as in adjacent areas of Manhattan, Queens, and Bronx. (If you want to locate a PRRT practitioner, please check this website: http://www.prrtpatient.com/locate/

Here is how PRRT works:

Humans are gifted at birth with many primal reflexes that help us to survive. Most of these reflexes disappear after a few months. The startle and withdrawal reflex are a couple of the reflexes that remain. The startle reflex is very common in patients who have experienced some form of trauma, like a car accident. We all know someone who startles easily. The withdrawal reflex occurs when you accidentally step on something sharp. Without thinking about it, you will "reflexively" pick up that foot and transfer your weight to the other side. This is a "normal" protective reflex! These two reflexes work in concert with the autonomic nervous system (ANS). The ANS automatically controls certain bodily functions, like breathing, blinking, salivation, digestion etc.

Immediately after an injury, there is a withdrawal that occurs, possibly with a facial grimace and a groan, as we reflexively grab and/or rub the painful area. In many people who are injured, muscles stay in a state of reflex muscle spasm, possibly for years. So now the startle and/or withdrawal reflex become abnormal. When these abnormal reflex muscle spasms are examined by the physical therapist, patients may withdraw away from the pressure, grimace, groan or grab, just like they did when they were injured. When this happens, we say that the patient is an "upregulated" state.

When a patient comes to our office in pain, we examine him or her from head to toe in an attempt to find areas that are upregulated. The examination only takes a couple of minutes, but it is extremely revealing and may be the most thorough physical therapy examination you have ever experienced. These upregulated areas are obvious, because the patient will withdraw away from the therapist's palpation (touch). It is important to know that an upregulated area has the potential to cause pain in multiple locations throughout the body.

The physical therapist will then treat the painful area in a way that is similar to a doctor testing your knee jerk with a reflex hammer. This type of treatment can be done anywhere on the body and significant pain relief can be experienced in a few treatments as opposed to weeks and months. In more sensitive areas of the body, light tapping is used instead of the reflex hammer. Overall, the PRRT™ evaluation and treatment is gentle, non-invasive and it can be extremely effective.

Another wonderful feature of PRRT™ is that when it fails, it fails fast. This means we will know within the first couple of visits whether or not PRRT™ will work for you. Then you are not wasting a lot of time, energy and money over weeks and months waiting to see if you will get pain relief. If PRRT™ does not work for you, we then proceed with conventional physical therapy treatments.
Remember, with this technique, we expect changes fast. Quite a few patients have experienced immediate relief.

Therapeutic Modalities / Equipment

Aside from the usual PT modalities such as ultrasound, iontophoresis, etc…, SMPT offers you:

“Freedom from Pain... of the Body and Mind. Absolutely nothing relieves pain, anxiety, depression, and/or insomnia like the Alpha-Stim 100.The Alpha-Stim 100 uses microcurrent electrical therapy (MET) for those suffering from acute, chronic or postoperative pain. The Alpha-Stim 100 works with the body on a large variety of ailments, including difficult-to-treat problems. Alpha-Stim 100 microcurrent technology produces residual and cumulative results, far superior to previous traditional milliampere transcutaneous electrical nerve stimulation (TENS) devices”. Alpha-Stim® produces residual and cumulative results, which means your relief will last and let you resume your normal activities”.

• Alpha Stim 100: www.alpha-stim.com.

• DEEP MUSCLE  STIMULATOR: http://d-m-s.com

Much of muscle pain stems from various conditions, strain, lactic acid build up, scar tissue, etc… The DMS uses percussion, mechanical vibrations that reach deep into the muscle tissue to stimulate proprioceptive functions. No other device on the market matches the effectiveness of the DMS.

The DMS provides deep muscle tissue with kinetic forms of percussion and concussion vibration, which in turn facilitates the patient or athlete with the benefits of:

The DMS also concentrates on general or local muscle spasms. It increases muscle metabolism and increases the lactic acid cycle to relieve pain. Deep, rapid, short-duration percussion is the key to the elimination of pain. The DMS can be used in effective management of acute and chronic pain, not exclusive to, but including: migraine headaches, sciatica, TMJ, carpal tunnel syndrome, tendonitis, bursitis, edema, myofacial pain and frozen joints.

The Deep Muscle Stimulator is known to increase the circulation of blood and flow of lymph. The direct mechanical effect of rhythmical pressure and movement used in DMS can dramatically increase the rate of blood flow. The stimulation of nerve receptors causes the blood vessels to dilate, which also facilitates blood flow.

DMS can help loosen contracted, shortened muscles and can stimulate weak, flaccid muscles. This muscle “balancing” can help posture and promote more efficient movement. DMS is also being used for Integrated Manual Therapy and Musculoskeletal Dysfunction.

It is possible to do more exercise and training, which in the long run strengthens muscle and improves conditioning. DMS also provides a gentle stretching action to both the muscles and connective tissues that surround and support the muscles and many other parts of the body, which helps keep these tissues elastic.

DMS also aids recovery from soft tissue injuries such as sprains and strains. This is possible because the growth and repair of tissue are accelerated by efficient circulation in the injured areas and appropriate stimulation of the healing tissues.

ETPS™ Neuromechanical Therapy (Bruce Hocking, D.Ac.) http://www.acumedmedical.ca

Consistent with the SMPT ‘s philosophy to provide you the most effective treatment approach that can be used in conjunction with SMPT ‘s wide array of manual therapy system of evaluation and treatment, SMPT is proud to have Electro-Therapeutic Point Stimulation or ETPS™ as an integral part of its clinical services offered.

“The theoretical underpinnings of Electro-Therapeutic Point Stimulation or ETPS™ therapy are based on sound medicine, firmly grounded in the concepts of acupuncture, modern neurology, microcurrent stimulation and myofascial release (muscular relaxation) techniques. ETPS™’s unique contribution to pain relief comes from the synthesis of these different approaches, combining the therapeutic ‘pearls’ of these different therapies into easy-to-use protocols. ETPS™ has been a remarkable success in the fight against chronic pain. The results are so impressive using this approach, that complete or substantial relief from pain may often occur in the first or second treatment. Most patients require 2-10 treatments for permanent results, with some chronic patients requiring ongoing treatments in the home setting. ETPS™ can be individualized to any patient's needs and applied non-invasively in almost any setting, indoor or out, usually within 5-15 minutes. ETPS™ stimulation is significantly more effective than any other therapies offered on the marketplace, decreasing recovery time by over 80%”. ETPS is applied non-invasively with concentrated direct current (DC) stimulation, often producing positive therapeutic result in minutes! Traditional TENS application are not effective for ETPS therapy as they are too cumbersome in application and may treat only one system at a time. ETPS can be used to quickly treat multiple systems at one setting, thereby creating an opportunity to investigate different therapeutic systems to determine which is/are contributing to the patients pain condition. ETPS has been proven to be effective with back and neck pain, whiplash, TMJ, fibromyalgia, neuropathies, migraines, headaches, sports injuries, carpal tunnel, failed backs, post-operative radiculopathy, plantar fascitis, frozen shoulder syndromes, shoulder pain, knee pain, tennis elbow, and most other neuromuscular pain syndromes”.

ETPS PAIN THERAPY PROTOCOLS

THE SEVEN ETPS THERAPEUTIC PILLARS

1. Deregulating the Autonomic Nervous System (ANS).  Heightened autonomic nervous system perpetuates chronic pain cycle. Recognizing this condition as a major perpetuating factor of pain, deregulating the autonomic nervous system is therefore a very important step for relieving chronic pain. Specific parasympathetic acupuncture points, which have an effect on the body’s nervous system, are treated with ETPS to reduce sensitivity and to calm the patient’s autonomic nervous system.

2. Structurally realign body mechanics – Sacral / Gait Balancing:  Shortened piriformis/psoas muscles will misalign the sacrum leading to structural misalignment and  asymmetric movements. Asymmetric gait will lead to mechanical and structural imbalance throughout the body, degenerative changes in the spine and joint articulation, and disruptionof energy flow.  With ETPS - Sacral balancing will substantially reduce ANS stress, structurally realign the body, and reduce energy blockage.

3. Locate/Treat Nerve Root Entrapment:  Impingement of the nerves ( proximal ) and the reduction in the flow of motor impulses throughout the nerve pathways causes weakness to its corresponding organs and tissues (distal). Sub-clinical Radiculopathy is a condition in which the proximal aspect of the condition (nerve impingement is not yet quite evident or recognizable clinically.  However the distal manifestation or symptoms of weakness and pain are already experienced by the patient. Segmental / Dermatomes:  In many cases patients complains of pain in the arms or legs (distal) following a dermatomal pattern. This pain pattern is caused by a nerve entrapment (proximal). ETPS protocols recognizes that nerve root radiculopathy controls extremity pain. With ETPS, injuries are traced back to the nerve root/s (proximal) where paraspinal tissue changes are identified. ETPS stimulation is applied to paraspinal muscles at the level of the entrapped nerve in order to relax the muscles responsible for the radiculopathy, and thus relieving the patient of pain (distal)

4. Releasing Intersecting Scars: Scar tissue, especially after surgery or trauma, surrounds the nerves, meridian,   lymphatic, fascia, and circulatory systems.  This can lead to chronic pain cycle and limited joint range of motion. ETPS stimulation is applied around scars (called neural therapy) in order to re-polarize the scar. Releasing or repolarizing the scar will lead to increased blood circulation, increased energy flow, released of tight fascia, and improved range of motion. Emotions and energy blockages are often “locked” into scars and this technique can often provide enormous relief to patients

5. Myofascial Release: ETPS is applied to muscles above and below distal joint injuries, relaxing tight local muscles/myofascia and thus significantly increasing range of motion and overall joint strength. This will also facilitate healing to the injured area and decrease of pain symptoms.

6. Limbic System: Treating the emotional (limbic) system is often ignored by many therapists. Emotions are often the key to unblocking energy and healing of patients. Applying ETPS stimulation to key acupuncture points relating to fear, anxiety, anger, worry, grief can often “unlock” old gates and provide enormous relief to a patient suffering from chronic pain.

7. Balancing Energy using Traditional Acupuncture Energetic:  balancing the meridian systems by applying ETPS to key distal acupuncture points allows energy to flow freely once the above physical and emotional blockages are cleared up.

With each step, ETPS stimulation is applied to acupuncture and trigger points, which helps isolate specific tissues/organs involved. Using the process of elimination, the therapist can isolate “root” causes of pain, providing a more efficient therapy with much stronger or better treatment outcomes.

GRASTON TECHNIQUE

SMPT is proud to introduce Graston Technique Instrument-Assisted Soft Tissue Mobilization® (GISTM), a great evaluation and treatment tool that can be utilized in managing even the so called “very difficult soft tissue dysfunction”. Though the clinician’s hands may be considered as the manual therapist’s best tool in identifying and treating soft tissue dysfunction, it is only fair to say that it has certain pertinent limitation, and that this limitation may be crucial in attaining a more efficient and effective approach in managing soft tissue dysfunction. With GISTM, this minute but critical gap is filled, thus offering the clinician an advantage that he would otherwise not have. Soft tissue dysfunction--which includes scar tissue adhesions and restrictions--results in pain, weakness and functional limitation for the patient. In many cases, chronic pain is a result of soft tissue dysfunction (scar tissue/soft tissue adhesion) which remained despite receiving treatment. Irritation of this scar tissue/soft tissue adhesion will facilitate cyclical inflammatory cascade. Thus patient complains of never ending complaints of pain. Fortunately, with Graston technique®, this chronic pain cycle is interrupted by releasing the soft tissue adhesions. Graston technique® allows the soft tissue to heal in optimal alignment. SMPT combines Graston Technique® with other advanced manual therapy techniques in order to attain the most optimal effect of tissue changes desired.

Graston Technique Instrument-assisted Soft Tissue Mobilization® is an advanced form of soft tissue mobilization that is used to detect and release scar tissue, adhesions and fascial restrictions. It allows the clinician to detect and treat soft tissue dysfunctions in a precise and specific manner. GISTM uses patented stainless steel instruments that are designed to adapt to the various tissue/shapes/curves of the body. GISTM combines instrument-assisted soft tissue mobilization with a targeted exercise program to address soft tissue dysfunction: THE GRASTON TECHNIQUE® = GISTM + EXERCISE.

Frequently Asked Questions:

What is the Graston Technique®?
A. The Graston Technique® incorporates a patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively detect and treat scar tissue and restrictions that affect normal function.

The Technique:
• Separates and breaks down collagen cross-links, and splays and stretches connective tissue and muscle fibers
• Increases skin temperature Facilitates reflex changes in the chronic muscle holding pattern
• Alters spinal reflux activity (facilitated segment)
• Increases the rate and amount of blood flow to and from the area
• Increases cellular activity in the region, including fibroblasts and mast cells
• Increases histamine response secondary to mast cell activity

Why is scar tissue a problem?
A. Scar tissue limits range of motion, and in many instances causes pain, which prevents the patient from functioning as he or she did before the injury.

How is scar tissue different from other tissue?
A. When viewed under a microscope, normal tissue can take a couple of different fashions: dense, regular elongated fibers running in the same direction, such as tendons and ligaments; or dense, irregular and loose with fibers running in multiple directions. In either instance, when tissue is damaged it will heal in a haphazard pattern--or scarring--that results in a restricted range of motion and, very often, pain.

How are the instruments used?
A. The Graston Technique® instruments are used to enhance the clinician's ability to detect adhesions, scar tissue or restrictions in the affected areas. Skilled clinicians use the stainless steel instruments to comb over and "catch" on fibrotic tissue, which immediately identifies the areas of restriction. Once the tissue has been identified, the instruments are used to break up the scar tissue so it can be absorbed by the body.

Is the treatment painful?
A. It is common to experience minor discomfort during the procedure and some bruising afterwards. This is a normal response and part of the healing process.

Is Graston Technique® used alone?
A. No. Whether the injury is work or non-work related, the Graston Technique® Protocol is the same. Our protocol includes a brief warm-up exercise, Graston Technique® treatment, followed by stretching, strengthening and ice.

What is the frequency of treatment?
A. Patients usually receive two treatments per week over 4-5 weeks. Most patients have a positive response by the 3rd to 4th treatment.

Is Graston Technique® something new?
A. The concept of cross fiber massage is not new. Graston Technique® is grounded in the works of English orthopedist James Cyriax. The use of our specially designed instruments and protocol is new.

What kind of results does Graston Technique® produce?
A. Historically, the Graston Technique® has resolved 87% or more of all conditions treated. It is equally effective on restoring function to acute and chronic injuries, and as well as pre and post surgical patients.

Can anyone obtain the instruments?
A. Only clinicians who have been trained and accredited in the Graston Technique® Basic course are qualified to obtain the Graston Technique® instruments and apply the technique to treat patients. The course is offered either on-site or at trainings offered throughout the year at a variety of locations.

I am aware of the success of Graston Technique® for treating soft tissue injuries. How do I find a clinician in my area that can provide the Graston Technique®?
A. To locate a provider, Please check this link: http://www.grastontechnique.com/Locate_a_Provider.html

What are the clinical applications of the patented GT instruments?
A. The Graston Technique® (GT) Instruments, while enhancing the clinician's ability to detect fascial adhesions and restrictions, have been clinically proven to achieve quicker and better outcomes in treating both acute and chronic conditions, including among others the following:

Cervical Sprain/ Strain ( neck pain ), Carpal tunnel Syndrome ( Back Pain ), Plantar Fascitis ( foot pain), Lateral Epicondylits ( tennis elbow ), Medial Epicondylitis (golfer’s elbow ), Rotator Cuff Tendinitis, Patello-femoral Disorders ( Knee Pain ), Achilles Tendinitis ( ankle pain ), Fibromyalgia, Trigger Finger, Shin Splints, Compartment Syndromes, DeQuervain's Syndrome , Post-Surgical and Traumatic Scars, Myofascial Pain and Restrictions, Chronic and Acute Sprains/Strains, Etc…

Can you give us an idea of some institutions who is using Graston Technique® currently?
A. Graston Technique® has become standard protocol in universities and hospital-based outpatient facilities, industrial on-site treatment settings such as Indiana University and the University of Michigan. The technique is also being used at industrial settings and by NBA, NHL and Major League Baseball trainers

• KinesioTaping : www.kinesiotaping.com.

“The Kinesio Taping  Method has taken the Rehabilitation and Sports Medicine world by storm. Kinesio Taping has become the gold standard for therapeutic rehabilitative taping. Kinesio-Taping is used by therapists and doctors who have completed specialist training as Kinesio-Taping therapists. A basic prerequisite to practice this complex method of therapy is medical knowledge of anatomy, muscle formation and ligament and nerve paths. In contrast to classic taping methods, Kinesio-Taping does not restrict the patient’s mobility. In most cases, classic taping methods are applied around joints and structures in order to immobilise them or to protect them from overloading. This restriction in movement is connected with known problems of stiffening and a reduction in muscle mass. Kinesio-Taping offers an effective treatment and prevention concept while still maintaining full mobility!”

 

 

 

 

 

 

• Microlight ML 830 ® cold laser: www.microlightcorp.com

“ML830® cold Laser is a non-thermal laser capable of penetrating   deep into tissue. Once delivered, the light energy promotes the process of photobio-stimulation. In human tissue the resulting photo-chemical reaction produces an increase in the cellular metabolism rate that expedites cell repair and the stimulation of the immune, lymphatic and vascular systems. The net result, observed in clinical trials to date, is the apparent reduction in pain, inflammation, edema and an overall reduction in healing time”.

                    

 

 

 

 

 

                   

• Spinal Decompression: Lumbar Traction

Other sources of therapeutic taping techniques:

1. Advance physical Therapy  Institute: www.aptei.com
2. Mulligan taping: www.bmulligan.com
3. Mcconnell  Taping: http://mcconnell-institute.com

Cervical Traction

•  Carpal Decompression:
     Carpal Traction            
                                                                                                                                                                                     

 

 

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