1. Mechanical Assessment

A model that provides a means to identify accurately the direction of therapeutic motion required to reduce internal derangement. The model provides a possible explanation for the obstructions to movement that occur in acute patients and would also account for the centralization of pain described in the study of pain described in the study of Donelson et al. (1986)

This model explains the effectiveness of various procedures based on the assumption that flow, or displacement of fluid, nucleus or sequestrum can occur within the intact annulus of the intervertebral disc as a result of prolonged or repetitive loading. Sisplacement most commonly, but not exclusively, occurs with flexion loading, To treat such displacements we must apply well-defined compressive forces, in order to reverse the direction of flow or displacement. This model is supported substantially by Kramer (1981).

2. Mechanical Treatment

To achieve an alteration in the distribution or location of displacement, either static loading or repetitive motion can be effective. An exercise becomes a mobilisation when performed with a certain frequency and in such a way that a rhythmical passive stretch is created. In a similar manner the same exercise with the addition of overpressure can become a manipulation. The suggestion put forth is that mobilisation and manipulation are nothing more then extended exercises, and an exercise can become a mobilisation or manipulation. In this way patients can be taught to practise mobilisation and manipulation of their own spine.

3. Prophylaxis

McKenzie model ends with prevention. It has now been demonstrated that several different patient populations have been taught to manage and treat their own back problems using self-applied movement described here and elsewhere (Di Maggio and Mooney, 1987a, b; Donelson et al., 1986; Kopp et al., 1986; McKenzie et al., 1988; Nwuga and Nwuga, 1985; Ponte et all, 1984). If there is the slightest chance that a patient can be educated in any method that enables him to reduce his own pain and disability using his own understanding and resources, he should receive that education. Every patient is entitled to the information, and every therapist should be obliged to provide it.

What is ASTYM?

Treatments is conducted in conjunction with a rehabilitation regimen designed to restore patients to their pre-injury level of activity. This is accomplished through the implementation of a functional progression program designed to modify biomechanical flaws by addressing musculoskeletal strength and muscle imbalances throughout the entire kinetic chain. Flexibility, strengthening, and muscle re-education are employed to provide patients with optimal results with a minimal number of treatment sessions. The positive clinical results achieved thus far have led to additional research exploring patient responses to ASTYM as compared with traditional treatment techniques. Outcome data measuring both pain and function on clinical patients continue to be gathered.

What can the patient expect?

Patients receive a thorough evaluation followed by a five to ten minute ASTYM treatment for each affected area. Patients then progress through a stretching and strengthening regimen tailored to their individuals needs. A functional progressional program is initiated to optimally adapt patients' bodies to the specific demands of their work, athletic, or recreational activities. Patients are responsible for maintaining a home flexibility program. Patients may experience an increase in soreness, inflammation, and /or mild bruising for 24/48 hours following a treatment session. Such a reaction is typically followed by a decrease in pain with an increase in mobility and function.

Who can benefit from ASTYM?

Patients who are experiencing pain or loss of motion and function following surgery, injury, cumulative trauma disorders, and chronic irritation/tendinitis may benefit from ASTYM. Some of the clinical diagnoses which have responded well to ASTYM include: lateral epicondylitis, carpal tunnel syndrome, deQuervain's tenosynovitis, trigger finger, joint contractures, IT band syndrome, hip pain, patellar tendinitis, anterior knee pain, shin splints, chronic ankle sprains, plantar fasciitis, and Achilles tendinitis.

How does ASTYM work?

It is theorized that ASTYM owes its effectiveness to two processes; (1) the breakdown of fascial restrictions, and (2) the introduction of controlled microtrauma to affected soft tissue structures, causing the stimulation of a local inflammatory response. This initiates resorption of inappropriate fibrosis or excessive scar tissue and facilitates a cascade of healing activities resulting in remodeling and reparation of affected soft tissue structures. Adhesions within the soft tissue which may have developed as a result of surgery, immobilization, repeated strain or other mechanisms are broken down allowing full functional restoration to occur.

What benefits does ASTYM often provide?

ASTYM treatment frequently provides the following advantages:

• Allows the patient to remain on the job
• Reduces the need for splints and braces
• Reduces the need for surgical intervention
• Achieves success where other forms of traditional treatment have failed
• Contributes to overall reduction in health care costs
• Teaches the patient how to manage their injury and how to prevent future injuries.

X-RTS (pronounced "exerts") is an acronym for "Cross-Reference Testing System". "X-RTS" is a registered trademark referring to testing devices and methodology. This system is designed by a clinician to meet the needs of other clinicians who perform functional capacity evaluations. The devices and methodology are intended to objectively document patient compliance during the evaluation of functional abilities, including dynamic lifting, dynamic pushing and pulling, and bilateral carrying.

The X-RTS approach was inspired, in part, by Gordon Waddell's classic research on "non-physical signs in low back pain" patients. In his landmark findings, Waddell proposed the concept of "distraction-based testing" that is "non-surprising." The clinician using X-RTS establishes a baseline milk crate or wooden box which contains unmarked steel weights. Data from the baseline tests are subsequently cross-referenced on the X-RTS devices.

Dubuque Physical Therapy and Physical Therapy Solutions is now offering a 6 week sports enhancement program designed to improve an athletes performance in any sport.

Overview of Program

• Injury prevention
• Education of proper body mechanics
• Proper instruction in weight room lifting
• Instruction in appropriate warm-up, cool-down, and stretching
• Speed, strength, agility, stability, and sport-specific training
• Pre and Post-testing

Sports programs are designed and implemented by licensed physical therapists with backgrounds in orthopedics and sports medicine.

Schedule

Charges for Sport Performance Solutions Program

• Individual for 10 sessions = $450
• Groups of 4 (specific sport) for 12 sessions = $300 each person