A 22 year old student who has never played tennis but works out regularly and uses his laptop computer extensively at the university presented to our office with moderate pain in the right elbow at the right epicondylar region. The pain started a month ago and patient did not seek any help until the pain made him unable to use his laptop computer.
He visited an orthopedist who diagnosed Lateral Epicondylitis of the right elbow and administered a cortisone shot. Patient’s pain subsided for about a week and started again.
Patient whose father used to be a previous patient of our organization recommended him to see us. Indeed patient came with direct access to receive evaluation and treatment from us.
When we asked the patient what treatment if the orthopedist recommended to him Physical Therapy the patient answered that the physician was convinced that the shot will be all that he needs.
TREATMENT: Upon a thorough evaluation we found that the patient had no significant involvement of the wrist extensor musculature, however patient exhibited increased MyoFascial Trigger Point activity in the Right Brachioradialis and Right Supinator muscles. Prolonged and repetitive use of a keyboard frequently produces an overuse type of syndrome to the above mentioned muscles.
Both of these muscles are well known as producing a referred pain pattern in the epicondylar region.
This patient was treated successfully with 8 short Manual Therapy session and has been pain free for the past several weeks.
The entire treatment took place in the two muscles mentioned above along with stretching, strengthening and a home exercise program.
This is the power of properly applied Manual Physical Therapy!
A 43 year old taxi cab driver presented with severe low back pain to the point that he was unable to sit or stand for more than a few minutes at a time. The pain started two months ago after he drove his car continuously for 14 hours. He visited his primary care doctor who referred him for an MRI of the lumbar spine, since the pain radiated to the front of his thigh. MRI was negative and the primary care doctor sent him for physical therapy to a different office. The patient received PT for about 4-5 weeks with no change of his pain. He states: “I would notice some improvement for an hour or two but the moment I would step into the car, the pain would come back”.
His cousin happens to be a patient at Hands-On and he referred him to us for an evaluation and treatment.
When we asked the patient what treatment he received at the other PT office he stated: “They gave me some heat, electricity and massage in my back. Then I had to do bike and some exercises for my belly”
TREATMENT: Upon a thorough evaluation we found that the patient had a MyoFascial Trigger Point syndrome of his Iliopsoas muscle. The Iliopsoas muscle is located in the front of the lumbar spine and attaches to the lumber vertebrae and to the femur. Interestingly enough this muscle when is injured by repetitive motion, such as overuse while driving a car and moving the leg from the gas pedal to the break pedal can refer pain to the lower back.
This patient was treated succesfuly with 6 short Manual Therapy session and has been pain free for the past several weeks. We never touched or treated his lower back. The entire treatment took place in the front hip area at the Iliopsoas muscle.
This is the power of properly applied Manual Physical Therapy!
