Category Archives: Astym, the basics

Astym

Research on Astym: Summary of Astym Treatment’s Evidence Base

At its core, Astym treatment was developed from solid basic science research to stimulate regeneration at a cellular level.  Following that, there were a number of case studies published and then a randomized controlled clinical trial on patellar tendinopathy.  A large randomized controlled clinical trial on lateral epicondylosis was awarded a platform presentation at the American Society for Surgery of the Hand’s national meeting, and is now being submitted for publication(for more information on this study, click here: http://blog.astym.com/blog/astym/0/0/effective-treatment-for-tennis-elbow-presented-at-hand-surgeons-meeting).

Several other studies have also been completed and are being prepared for publication or submitted for publication. To see a full listing of research on Astym treatment, please visit the research page by clicking here: http://astym.com/professionals/research.asp

One of the main reasons for the effectiveness of Astym treatment is its sound evidence base.  Astym treatment was scientifically developed to target the true underlying cause of many soft tissue problems:  degeneration and inappropriate scarring/fibrosis that interferes movement and causes pain.  One of the factors that guided the scientific research and development of Astym treatment was medical science’s recent discovery that tendinopathy is degenerative (worn or broken down) in nature and only rarely has a component of inflammation (the body’s immune system actively responding to an injury or threat).  Generally, most treatments of tendinopathy focus on reducing inflammation, and those treatments have not been very successful.  In light of the recent evidence indicating that degeneration is the underlying cause of tendinopathy, Astym treatment was developed with a focus on stimulating the regeneration of healthy tissue, rather than on reducing inflammation, and that is one reason why Astym is so effective at resolving tendinopathies.

In addition to ongoing clinical and scientific research, the Astym program also emphasizes the collection of practical, clinically useful information.  Astym treatment has put major effort into developing a reliable national outcomes collection system and database, where clinicians from all across the country independently enter data to create a national bank of dependable outcomes data.  These outcomes (treatment results) show the percentage of people with each condition that resolve (get better).  Not only does this provide a good real-world evidence base for Astym treatment, it also allows patients and health care providers to know how many treatments it should take to resolve a certain condition, and what percentage of those cases should resolve.  For instance, for a patient with plantar fasciitis, you can predict that in 10 therapy visits, 91.8% of patients will be improved or much improved.  To see a full listing of diagnoses and outcomes, click here:  http://www.astym.com/upload/pdf/Astym%20Outcome%20Reports.pdf

Achilles Tendinosis in Elite Runners

Meet today’s guest blogger:

Stephanie Penny, PT, DPT

Stephanie practices at Lakeshore Sports Physical Therapy in Chicago, Illinois. She earned her Doctor of Physical Therapy degree from Central Michigan University in 2008. She has a special interest in sports medicine and vestibular rehabilitation, has completed coursework in manual therapy, and is a certified Astym® provider. Stephanie is an active member of the American Physical Therapy Association.

Elite runners alternate between intensive physical training and recovery to improve performance.  However, many runners fail to maintain a balance between intensity of training and appropriate recovery, resulting in a breakdown of tissue reparative mechanisms which eventually leads to overuse injuries.  Historically, these injuries have been referred to as “tendinitis” or “tendonitis”, words that point to inflammation as the cause of the problem.  Continue reading Achilles Tendinosis in Elite Runners

Rib pain: The buck can stop here.

Meet today’s guest blogger:

Gus Gutierrez, PT, OCS, FAAOMPT
Gus is an owner of and serves as clinical director of BRPT-Lake, a multi-clinic private practice that specializes in the treatment of orthopedic patients and sports-related injuries. He received his Orthopedic Certified Specialization distinction in 1994 and then again in 2004. He is certified as a Level 2 Manual Therapist and is Fellow of the American Academy of Orthopedic Manual Physical Therapists. He has over 23 years of clinical experience and working with athletes on all levels. Gus has been certified in Astym since 2001.  He is also certified in Kinesiology Taping and as an Active Release Technique practitioner for the upper extremity, lower extremity and spine.

Often times patients who develop rib pain with no known etiology (cause) are processed through the medical system undergoing countless medical diagnostic tests and consultations.  Physical therapy needs to be part of the assessment team to determine whether treatment for soft tissue and joint restrictions can be helpful.  Often time these patients respond very quickly to manual therapy techniques including joint manipulation, mobilizations and Astym for the intercostal soft tissues.

A patient with a 3 month history of mid costal (rib) pain was referred to me by an Orthopedist that believed Astym could be helpful and asked us to assess her.  Clinically she presented with all the signs and symptoms of costochondritis as he indicated.  After 6 treatments including Astym, rib mobilizations and thoracic manipulation she was 100% better.  She is instructed in postural exercises for home and given foam roller exercises.  This is an example of how physical therapy can be an important part of the consultation algorithm and Astym can be an effective adjunct to your manual joint mobilization techniques.

 

Tendonitis: Why Won’t It Go Away?

Because it’s probably tendinosis.  Often, chronic tendonitis (also spelled tendinitis), which lasts more than 6 weeks is really tendinosis (also spelled tendonosis).  The difference is that acute, short-term tendinitis is thought to be caused by inflammation, which is an active immune response of the body to a perceived threat.  The acute, inflammatory tendonitis can be treated and usually resolved within several weeks by icing the area 3 to 4 times daily for 20-30 minutes, resting, and taking over-the-counter or prescription strength anti-inflammatory medication, such as ibuprofen.

Chronic tendonitis is usually defined by the tendon pain lasting more than 6 weeks, and the condition is more accurately referred to as tendinosis.  Tendinosis is mainly caused by degeneration of the tendon.  In order to effectively treat and resolve tendinosis, you must stimulate regeneration of the affected tendon.  There are very few approaches that do this.  Astym treatment has been used successfully for years and is the most established treatment to stimulate regeneration of a tendon and other soft tissues.  To view the resolution rates (outcomes) of Astym on particular types of tendonitis/tendinosis, click here:  http://www.astym.com/Content/documents/ASTYM%20Outcome%20Report.pdf

What is Astym treatment?: Astym Definition, Part III

Scientific studies have shown an increase in fibroblast recruitment and fibroblast activation with Astym treatment, which reveal the body’s underlying physiological response to Astym.  These studies highlight the regenerative mechanism of Astym treatment and help us understand how Astym treatment results in the regeneration of soft tissues. There also appears to be a neurological component to the Astym treatment process as evidenced by immediate changes in pain perception (often pain is immediately reduced) and strength measures (strength often immediately increases) following treatment.

At its core, Astym treatment was developed from basic science research to stimulate a regenerative response at a cellular level.  Following that, there were a number of case studies published and then a randomized clinical trial on patellar tendinopathy.  A large randomized clinical trial on lateral epicondylosis was then awarded a platform presentation at the American Society for Surgery of the Hand’s national meeting.

In addition to ongoing clinical and scientific research, the Astym program also emphasizes the collection of practical information.  Astym treatment has put major effort into developing a reliable national outcomes collection system and database, where clinicians from all across the country independently enter data to create a national bank of dependable outcomes data.  These outcomes (treatment results) show the percentage of people with each condition that resolve (get better).  Not only does this provide a good real-world evidence base for Astym treatment, it also allows patients and health care providers to know how many treatments it should take to resolve a certain condition, and what percentage of those cases should resolve.  For instance, for a patient with plantar fasciitis, you can predict that in 10 therapy visits, 91.8% of patients will be improved or much improved.  To see a full listing of diagnoses and outcomes, click here:  http://www.astym.com/Content/documents/ASTYM%20Outcome%20Report.pdf

What is Astym treatment?: Astym Definition, Part II

Astym treatment is effective in resolving many soft tissue problems, including chronic tendinopathies, tendon pain, tendon injury, stiffness, restricted movement, limited function and other conditions associated with adhesions or scar tissue that can occur after trauma or surgical intervention. It is also quite effective on sprains, strains, and other acute and sub-acute soft tissue injuries.  Continue reading What is Astym treatment?: Astym Definition, Part II

What is Astym treatment?: Astym Definition, Part I

Astym treatment is a regenerative therapy provided by specially trained (and certified) physical and occupational therapists.  Instruments are applied topically (on top of the skin) to locate dysfunctional (unhealthy) soft tissue, and to transfer pressure and shear forces to the underlying soft tissue structures.  The protocols, the force, and direction of the treatment induce a healing/regenerative response in tendons, muscles, and other soft tissue structures.  Astym treatment stimulates tissue turnover, scar tissue resorption, and the regeneration of tendons, muscles and other soft tissue structures. Therapy is typically provided twice weekly for three to four weeks and is done in conjunction with eccentric loading, stretching, and functional exercises. Continue reading What is Astym treatment?: Astym Definition, Part I

Heel Pain: Most Common Cause is Plantar Fasciitis

The tough band of tissue that connects your heel bone to your toes is called the plantar fascia.  It supports the arch of your foot, and when it becomes irritated or degenerated, then you have what is called plantar fasciitis (other names include: plantar fasciosis, which indicates degeneration, and plantar fasciopathy, which includes both degeneration and the inflammation indicated by plantar fasciitis).  This condition affects up to 2 million Americans each year.

Runners or people who are on their feet for long periods of time often get plantar fasciitis.  Also, people who are middle-aged, overweight or pregnant are susceptible to getting plantar fasciitis.  One of the most common symptoms of plantar fasciitis is foot pain in the morning getting out of bed or foot pain after getting up following prolonged sitting.  Once the foot loosens up it usually gets better unless you spend a lot of time on your feet or go running.

How can you get better?

Drugs to reduce inflammation are commonly prescribed and should help if the cause of the pain from plantar fasciitis is inflammation.  However, most long term plantar fasciitis is likely caused by degeneration of your plantar fascia, and in that case, medication to reduce inflammation will be ineffective to resolve the condition, although it may give some temporary pain relief. Rest, splints, stretches and modified shoes are also commonly recommended. Again, these treatments may also be effective if the condition is caused by inflammation, however, they will not be effective if the plantar fasciitis is caused by degeneration.

Plantar fasciitis caused by degeneration will often recur when resting is over, splints are removed, stretching is stopped or different shoes are worn.   Modifiying your lifestyle can help in certain cases, but the downside is that you have to keep it up.  To me, that is an indication that you haven’t cured the underlying problem, but rather you are constantly treating the symptoms and you are learning to live with the inconvenience.

Although it is not fully understood, researchers and a growing number of health care professionals recognize that almost all cases of chronic plantar fasciitis are due to degeneration of the plantar fascia, and treatment should involve stimulating regeneration of the affected tissue.  This link will show you some of the scientific evidence – histologic findings – that confirm this view: http://www.ncbi.nlm.nih.gov/pubmed/12756315.  Right now, there are very few approaches that focus on regenerating healthy tissue.  However, a good treatment option that focuses on stimulating regeneration and has a high rate of success for plantar fasciitis is Astym treatment.   You can see what Astym treatment is like by clicking here:  http://astym.com/video

Internal Scar Tissue/Adhesions Limit Movement and Cause Pain

Over time, internal scar tissue or adhesions can build up in your joints, muscles, tendons, and soft tissues.  It can be caused by working your body too much, injury (such as sprains, strains and trauma), surgery, disease, or just by moving and not being in absolute perfect physical condition or having perfect “form” when you move.  Stiffness and many of the aches and pains that we have after reaching a “certain age” are due to the build up of internal scar tissue and adhesions.  Astym treatment is effective at reducing or eliminating internal scar tissue or adhesions.

Once the scar tissue and adhesions are reduced or removed, stiffness, and aches and pains often go away.  Astym’s resolution rates (outcomes) for scar tissue and adhesions related pain are impressive.  Click on this link to see how many people resolve their conditions after Astym treatment: http://www.astym.com/Content/documents/ASTYM%20Outcome%20Report.pdf.  These outcomes were submitted by independent clinicians from all across the country.