video1414420547 — Transcript

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1. 0:00eration or shock wave.
2. 0:02Um because they're both they're both
3. 0:04mechanical stress but in different ways.
4. 0:07>> Okay. We can also um well we'd like to
5. 0:11we'd like to hear how you use both. We
6. 0:12also have like a fictional client as
7. 0:14part of our presentation. So we could
8. 0:16show you that and maybe you could be
9. 0:17like oh it's obvious it would be this or
10. 0:19this.
11. 0:20>> Yeah.
12. 0:21>> Um okay that
13. 0:26>> and you've been doing this stuff for a
14. 0:28really long time.
15. 0:30Yeah.
16. 0:30>> Like what was what motivated you to kind
17. 0:33of
18. 0:36mute myself to pursue this and and then
19. 0:39also like keep pursuing different
20. 0:40certifications?
21. 0:41>> Yeah. You know, from a from a young age,
22. 0:44I was very into movement. Um I was an
23. 0:46athlete. I was very into health. Um you
24. 0:50know, I saw firsthand what happens if
25. 0:52you don't take care of your health and
26. 0:54as you age, if you don't take care of
27. 0:56just general function, right? in
28. 0:59movement which is so important um
29. 1:02freedom as well. So I always wanted to
30. 1:05do something that I really loved and my
31. 1:07first job one of my first jobs was
32. 1:09working in a gym racking weights and was
33. 1:13around a whole bunch of personal
34. 1:14trainers and really loved how they were
35. 1:17working with people and I started
36. 1:20studying anatomy and physiology on my
37. 1:22own and I just I've loved it. Um, like I
38. 1:25would work out and be like, "Okay, I'm
39. 1:26now concentrate." Like, you know, I'd go
40. 1:27through all the muscle origin
41. 1:29insertions. This is when I was like 18
42. 1:30years old. Um,
43. 1:34and it just it grew from there. I worked
44. 1:37with a sports medicine company. I was
45. 1:39really fortunate right off the bat. Um,
46. 1:41where I got to work like side by side
47. 1:43with physical therapists, sports
48. 1:45medicine pros, like with a ton of
49. 1:46athletes. And then it moved more from,
50. 1:50you know, kinesiology
51. 1:52and assessment and really physical
52. 1:55therapy uh background to more me wanting
53. 1:59to help more with hands-on cuz we did
54. 2:01some stuff like you did some tissue work
55. 2:02and you did some, you know, pin and
56. 2:04stretch and all that fun stuff, but I
57. 2:06really loved how when I was able to get
58. 2:08my hands on somebody and feel and listen
59. 2:11with my hands and al also
60. 2:14I guess um I won't say manipulate the
61. 2:17tissue but guide it and show it
62. 2:19different possibilities how much it
63. 2:21helped people and then I loved coupling
64. 2:24the hands-on work with movement and the
65. 2:26two just worked beautifully together um
66. 2:28so that's how it's really much pretty
67. 2:31much evolved and then you know as you go
68. 2:32through stuff you want to learn you want
69. 2:35to help your clients or patients you
70. 2:37know you get different things coming
71. 2:39into you I just had a new situation
72. 2:40where I was like huh you know like I
73. 2:42need to learn more about that so I just
74. 2:44felt I just needed to continue my
75. 2:46education in many different modalities.
76. 2:48So, I was aware of what was out there so
77. 2:50that I could help as many people as
78. 2:53possible. And these this day and age,
79. 2:55it's really hard to keep up with
80. 2:56everything.
81. 2:58>> So,
82. 2:59>> we're we're trying to learn it all, too.
83. 3:00>> Yeah. Yeah.
84. 3:02>> Um what are some of like um the most
85. 3:04common injuries or most common um
86. 3:06diagnoses that you that you're working
87. 3:08on?
88. 3:09>> So, I'm a certified massage therapist
89. 3:11with state of California and I'm also a
90. 3:13certified Ralpher. I don't know if
91. 3:14you're familiar with that.
92. 3:16um also certified trainer. So I deal
93. 3:19with people that come into me with
94. 3:21chronic pain, chronic injuries. You
95. 3:24know, they've gone and seen a physical
96. 3:25therapist, they've gone and seen a
97. 3:27chiropractor, they've gone and seen and
98. 3:29for some reason this pain keeps
99. 3:31lingering. So common things that I'll
100. 3:33see chronic lower back pain, SI pain,
101. 3:36shoulder that could be coming from the
102. 3:38neck, um neck tension is really common.
103. 3:44Um, sometimes I'll get foot, ankle, um,
104. 3:47just chronic things that they can't seem
105. 3:49to figure out.
106. 3:51>> That's a typical client.
107. 3:53>> That's And what kind of like age range
108. 3:55like male, female?
109. 3:57>> You know, I'm really fortunate. I have a
110. 3:5950/50 clientele. I I I think it's great.
111. 4:02I think it's because I grew up with two
112. 4:03brothers, so I can relate to like both
113. 4:05sides. Like I think um where I think
114. 4:07some sometimes people have more female,
115. 4:10more male, but I'm pretty 50/50. And the
116. 4:12age range, it really v varies. I've
117. 4:15worked with some of my clients children,
118. 4:17you know, um I've worked with, you know,
119. 4:20UCLA gymnasts at a collegiate level and
120. 4:22then I even have like my older clients
121. 4:2470s, 80s. So, I have a really nice range
122. 4:28of clients to work with.
123. 4:30>> And are they mostly um like are they
124. 4:34mostly like athletes? Are they mostly
125. 4:36like office workers? Like what kind of
126. 4:38like in what's what is resulting in the
127. 4:40back pain? basically.
128. 4:43>> Yeah. You know, it's interesting because
129. 4:45pain these days as we know is very
130. 4:48multiffactorial, right? Um so I couldn't
131. 4:52tell you what definitely, you know,
132. 4:54every person's different. You know, the
133. 4:56way I look at somebody is what's causing
134. 4:58the pain in this one person might be
135. 5:00some other factors causing it in this
136. 5:03other. So I wouldn't be able to say
137. 5:04exactly. I do know that a large majority
138. 5:08of them um they are seated for long
139. 5:10periods of time. Um they good questions
140. 5:14I ask is about desk setup taking breaks
141. 5:17which they don't multiple screens that
142. 5:20definitely contribute to certain neck
143. 5:21tensions and postural patterns that
144. 5:23could possibly be what's causing it.
145. 5:25Right. Um and then I also deal with
146. 5:29athletes as well. Well, I since I worked
147. 5:31with the UCLA gymnasts, I get a lot of
148. 5:33the athletes that sometimes come to me
149. 5:35for things that they can't figure out.
150. 5:37And that's more like um um what is that
151. 5:41called? Cumulative stress, you know,
152. 5:43injuries, you know, um because when
153. 5:45>> the way I look at it is when you're an
154. 5:47athlete, the body really gets to express
155. 5:49itself. You know, the compensations that
156. 5:51would necessarily not mean anything when
157. 5:54you know, you're just walking your dog
158. 5:55or just regular lifestyle. really have
159. 5:57the ability to express themsel when
160. 5:58you're, you know, performing at that
161. 6:00level. And sometimes, as you know,
162. 6:01athletics require you to get into
163. 6:04positions that
164. 6:06just like the UCLA gymnasts like
165. 6:09watching them all, what are you guys
166. 6:11doing? Like,
167. 6:12>> and you know, we know that bones aren't
168. 6:14even fused, some of them, till like your
169. 6:15early 20s, and here they are like
170. 6:17twisting around and like doing all this
171. 6:18fun stuff. So, um, yeah, I think that
172. 6:21answers the question.
173. 6:22>> Yeah, absolutely. That's so cool that
174. 6:24you work for the gymnastics team. Um,
175. 6:26I'm just curious like
176. 6:29how would you explain um like how you
177. 6:33use shockwave versus how you use
178. 6:35vibration and if there are like
179. 6:38>> common conditions like like what what
180. 6:41would determine using shockwave versus
181. 6:43vibration because to us it we're not
182. 6:45we're we have we don't know anything so
183. 6:47we wouldn't know how to like choose.
184. 6:49>> Yeah, it's a really good question. And
185. 6:51so I use them both as part of an overall
186. 6:55program. Um I'm basically looking at the
187. 6:59whole body. Um when I do treat somebody
188. 7:01and shockwave I would use for somebody
189. 7:04that
190. 7:06is not having any response to any any
191. 7:09manual therapy. There's like some key
192. 7:10areas there. Um maybe like resistant
193. 7:14tissue, fibrous tissue. Um
194. 7:18you know because shockwave what it does
195. 7:20is the one we use is a real shock wave
196. 7:23and what it does is it creates sound
197. 7:26waves through water which help penetrate
198. 7:28the tissue which stimulate the body's
199. 7:30repair process. It creates micro trauma
200. 7:33and that I know there's different types
201. 7:35of shock wave that are out there. Um I
202. 7:38think in order to you know there's a
203. 7:39whole like argument out there what's
204. 7:41true shock wave but I think the true
205. 7:43shock wave is through the water. Um, so
206. 7:46this microinflammation process kind of
207. 7:48gets the body going to repair the tissue
208. 7:50again. So I'll use it with chronically
209. 7:53tight tissues. I'll use it with areas
210. 7:54that aren't responding to manual
211. 7:56therapy. I just used it um the other
212. 7:58day. I have somebody who's he's a
213. 8:00conductor and this guy is like 6'5, like
214. 8:03he's tall and you know he has to look
215. 8:06down all the time. So he always has like
216. 8:08chronic neck, tricep
217. 8:11and the shock wave just works really
218. 8:13well for him after some long hours of
219. 8:15work. It just gives him some relief um
220. 8:18in those particular areas. Um and I'll
221. 8:21use it as part of an overall program. So
222. 8:23somebody that maybe has depends on what
223. 8:26the lower what's causing the lower back
224. 8:28pain where I'm going to use the shock
225. 8:30wave also. Um so I use it as part of
226. 8:32like a overall session
227. 8:35>> and it it's more localized. Yeah.
228. 8:37>> Correct. Yes.
229. 8:38>> And what is the do you have the name of
230. 8:40the the product or system you use just
231. 8:42so we can look it up so you can get
232. 8:43>> it's called it's called Omniwave.
233. 8:46>> Okay.
234. 8:49And you're actually like, are you like
235. 8:52immersing his shoulder in water to use
236. 8:54it?
237. 8:55>> No. So, it's a
238. 8:57If you guys want, I can bring it in
239. 8:58here. You want me to bring it in to
240. 8:59show?
241. 8:59>> That'd be awesome.
242. 9:20Sounds like maybe a little bit like what
243. 9:22we did with ultrasound if it's like
244. 9:26through water. Yeah,
245. 9:28>> sounds.
246. 9:30>> So,
247. 9:33it's pretty nice size machine. Um
248. 9:35>> Oh, wow.
249. 9:37>> So, this is the handle and there's water
250. 9:40in here.
251. 9:41>> Oh, cool.
252. 9:43>> Um but you also use a coupling gel. We
253. 9:45also use a water-based gel that we put
254. 9:47on their skin to help it travel through
255. 9:48>> like like we would use for ultrasound.
256. 9:50>> Correct. You use it the same way. Same
257. 9:52way. And you know the way you set it.
258. 9:56Let me see if I can
259. 9:59see if it will turn on. Oh, I don't have
260. 10:01it plugged in. Hello. I'm like, "Oh my
261. 10:04god, it's not turning on. What's going
262. 10:05on?"
263. 10:07Keep on. Let me find it out lid
264. 10:13so you guys can hear it also because it
265. 10:14has a distinct sound to it.
266. 10:19>> And would you use it like for 20
267. 10:21minutes?
268. 10:22>> It's dependent. It's a short treatment.
269. 10:24Okay.
270. 10:25>> I'm going to have to turn my computer
271. 10:26around because there's an outlet only
272. 10:27over here. One second.
273. 10:32Okay.
274. 10:46You see actually this table moves up.
275. 10:48Give me one second.
276. 10:49>> Yeah. So you guys can see
277. 11:00it. Oh yeah. There we go.
278. 11:02>> Oh yeah.
279. 11:04So the water is in here
280. 11:07>> and then you adjust it based, you know,
281. 11:09power, frequency. It's based upon the
282. 11:11number of shocks
283. 11:12>> is determines the time.
284. 11:14>> So I'm going to start it so you can hear
285. 11:16it. Um,
286. 11:21and the power.
287. 11:26>> Can you hear the
288. 11:32>> I can hear a little bit there.
289. 11:34>> Yeah.
290. 11:35>> Yeah.
291. 11:36>> It's like a You hear like a click. It's
292. 11:37like a It's the number of shocks and
293. 11:40that determines um that determines the
294. 11:43amount of time. So, it's based on
295. 11:45>> a little click, right? Yeah. So, it's
296. 11:47based on the area that you're working.
297. 11:49Um, how many shocks, the power, the
298. 11:52frequency, if something's more
299. 11:53superficial or more or deeper.
300. 11:56>> So, like fewer shocks for super
301. 11:59superficial, more for deeper, or is it
302. 12:02the other way around?
303. 12:03>> Um,
304. 12:05more for deeper. And I think also the
305. 12:08way it travels and I'm still like
306. 12:13you would fill this if something's more
307. 12:15superficial. For example, I worked on a
308. 12:17client's um
309. 12:19>> toe.
310. 12:20>> Mhm.
311. 12:21>> This gets filled up a little bit more
312. 12:24the water. So it can hit like this the
313. 12:26more superficial
314. 12:28um and the lower it gets is for um
315. 12:31deeper.
316. 12:32>> Got it. And is there a difference in
317. 12:34frequency or shock with like a smaller
318. 12:37versus a larger area?
319. 12:39>> Yes, you would do less shocks for a
320. 12:41smaller area.
321. 12:42>> Got it.
322. 12:43>> Yeah.
323. 12:44The frequency I think, let me see. I
324. 12:47have my protocol down. I always just
325. 12:49follow. Um, so for example, a shoulder
326. 12:54would be 5 to 700 shocks. Um, but you're
327. 12:59not just hitting. You would hit the
328. 13:01front, the back, the side with that
329. 13:03combination of shocks for, let's just
330. 13:06see, the knee is four to 600, ankle 5 to
331. 13:09700,
332. 13:11and the power is anywhere from it's the
333. 13:16lowest is one, the highest is 12.
334. 13:19>> Um, so would power would be dependent,
335. 13:22you know, based on what the client also
336. 13:24can tolerate. And this is not as painful
337. 13:25as the other shock waves. Mhm.
338. 13:27>> Um and the frequency is anywhere from 2
339. 13:29to six, but it looks like it looks like
340. 13:32more superficial is less
341. 13:36frequency. Yeah, that's what it looks
342. 13:38like.
343. 13:39>> Okay.
344. 13:41And then in terms of like duration,
345. 13:45um, he's just going to kind of want us
346. 13:47to say like kind of like a range of when
347. 13:49you usually I know it depends on like
348. 13:52the muscle and the pain and everything's
349. 13:54like that, but do you have like a basic
350. 13:55range
351. 13:56>> for time?
352. 13:57>> Yeah,
353. 13:58>> it's really quick. I mean, it's under
354. 14:00five minutes. Yeah.
355. 14:01>> Oh, wow. Okay. That's
356. 14:02>> Yeah, it's really quick. Like you can go
357. 14:03through I've never really timed it, but
358. 14:05it's pretty like 500 shots. It's like
359. 14:07tick tick tick tick tick tick tick tick
360. 14:09tick tick tick. of 500 shocks I guess.
361. 14:12>> Yeah, it would be a couple of minutes.
362. 14:14>> That's interesting. And then in terms of
363. 14:16like um the protocol, if you're working
364. 14:19with someone like the conductor, do you
365. 14:21start with the shock wave and then go
366. 14:24into other modalities like massage or is
367. 14:27it is it kind of like something you
368. 14:28start with as
369. 14:29>> Yeah, I would start with it because
370. 14:30research also says that it can um
371. 14:32increase blood flow. It helps to
372. 14:34stimulate some cellular activity. Um it
373. 14:38can reduce some you know chronic
374. 14:40inflammation. Um so I always like to
375. 14:42start with it and then I would do my
376. 14:44whole treatment.
377. 14:46>> Um what else was I going to ask? Is it
378. 14:50is it painful at all or
379. 14:52>> So this one is not
380. 14:54>> okay.
381. 14:54>> But some of them are.
382. 14:56>> Okay.
383. 14:57>> Yeah. Yeah. So, if you guys research the
384. 14:59different types of there's radial,
385. 15:02there's um acoust uh
386. 15:06what's it called? Hydroelect electric is
387. 15:08this one.
388. 15:09>> Okay. Hydro Oh, that's so interesting.
389. 15:12Um,
390. 15:17and in terms of like um
391. 15:20like like creating like a like a
392. 15:23short-term or long-term treatment plan
393. 15:25um like do you do it like once a week, a
394. 15:28couple times a week to start? Like
395. 15:30what's sort of your protocol?
396. 15:31>> Yeah, it's re it's on average it's
397. 15:34suggested anywhere from four to six
398. 15:36sessions. I've noticed that that's the
399. 15:38general range. um approximately two
400. 15:40times a week. You want it 48 hours um in
401. 15:43between each treatment because it's
402. 15:45creating that microinflammation.
403. 15:50>> And in terms of the um the vibration
404. 15:54therapy, could we do you guys have any
405. 15:56other questions on um the shock wave? I
406. 15:58think I I think I asked everything. Oh,
407. 16:01um safety. Yes. So we don't put it
408. 16:06anywhere in front of the chest by the
409. 16:08lungs by the heart
410. 16:11um behind the clavicle in the front
411. 16:12here. We'll do upper trap but we won't
412. 16:14come in front here. Um staying away from
413. 16:17anybody that has any implants that
414. 16:19particular area pregnancy um
415. 16:26I think I'm covering all of them.
416. 16:30>> Yeah, those are the
417. 16:31>> Oh, sorry. Go ahead. I think those are
418. 16:32the main ones.
419. 16:34>> Is there anything with like I think it's
420. 16:36more with vibration, but I just want to
421. 16:38check. Anything with like epilepsy or
422. 16:40heart conditions or anything like that
423. 16:42that you need to be aware of?
424. 16:44>> That's a really good question. They
425. 16:46didn't mention anything about epilepsy
426. 16:47when we went through the whole training
427. 16:48with it.
428. 16:50>> Yeah,
429. 16:50>> we found it on research in chak
430. 16:53vibration, but I I was I wanted to make
431. 16:55sure that we're
432. 16:57>> Yeah,
433. 16:57>> but that's also full body vibration.
434. 17:00>> Yeah, it does. It's larger oscillations.
435. 17:02So, yeah.
436. 17:05>> Um,
437. 17:06>> that's what
438. 17:07>> Mhm.
439. 17:08>> nothing. I was going to ask you more
440. 17:09about your research that you found
441. 17:10because I love learning stuff.
442. 17:12>> Yeah. Yeah. I can I can send you the
443. 17:14whole PowerPoint that we came up with.
444. 17:15>> I would love to see it.
445. 17:16>> Yeah, I'll send it to you. Um,
446. 17:18>> what about when it comes to things like
447. 17:21um cancer spots or like you would just
448. 17:23avoid that all
449. 17:24>> stay away if the cancer just avoid that
450. 17:26spot. You can work the other area in the
451. 17:28body. Yeah. Okay.
452. 17:29>> Good question. That was another
453. 17:31precaution.
454. 17:35>> Did I ask all the questions? Did I miss
455. 17:38anything you guys?
456. 17:41>> I think you got it all.
457. 17:43>> I think that we do need to ask um not
458. 17:46about the vibration but or the or the
459. 17:48shock wave but um where do you work
460. 17:51from?
461. 17:54>> Oh, I have all that information.
462. 17:55>> You have all that. Okay. So, you have
463. 17:56like the setting.
464. 17:58>> Yeah. Yeah. I
465. 17:58>> Oh, okay.
466. 17:59>> Yeah. Got it.
467. 18:01>> I Yeah, I got that. Sorry. I should have
468. 18:03told you guys I sent it to Nata before
469. 18:05just to make sure I had everything
470. 18:06accurate.
471. 18:07>> Okay, perfect.
472. 18:08>> Wait, I have some I have some other
473. 18:09notes for you on precautions.
474. 18:10>> Yes.
475. 18:11>> Um I'm looking at my notes because I
476. 18:12took some about your questions. Um
477. 18:16>> avoid treating directly over nerves.
478. 18:18That makes sense. You have nerves
479. 18:19everywhere. Um lungs, growth plates, any
480. 18:23active infections, malignancy,
481. 18:27um or areas of impaired sensation.
482. 18:31use precaution around implanted
483. 18:32electronic devices or over recent
484. 18:35corticosteroid injection sites
485. 18:38>> that I got directly from them.
486. 18:46Um, and then could we see uh Oh, and
487. 18:50what would you in terms of choosing
488. 18:53shockwave over vibration like what kinds
489. 18:55of like conditions or diagnoses would
490. 18:57you choose shockwave for?
491. 18:58>> Yeah. So, but you know, since you've
492. 19:00done your research, vibration is just
493. 19:02very different than shock wave.
494. 19:04Depending on the goal, it's larger
495. 19:06oscillations and based on your
496. 19:08frequency, you can use it to kind of
497. 19:10like general circulation, blood flow, or
498. 19:13you can use it to uh relax the tissue.
499. 19:16So again, as part of an overall program,
500. 19:18I might use both in the same session,
501. 19:20but just different different results
502. 19:22because the vibration I use it to
503. 19:25improve somebody's like circulation to
504. 19:27warm up the tissue. Um maybe before
505. 19:30treatment. Um sometimes it's really good
506. 19:33for decreasing muscle guarding like the
507. 19:35lower frequencies. It's really calming
508. 19:36for the nervous system. Um especially if
509. 19:39it's overactive, you know, the lower
510. 19:41frequencies work really well. Um, and
511. 19:44then, you know, at higher frequencies,
512. 19:46it can be more stimulating, you know, to
513. 19:47increase blood flow. So, it depends on
514. 19:50what client I'm working with, which
515. 19:52modality I would use. Um, I tend to use
516. 19:55the vibration more, I think, frequently
517. 19:57than because we have the Hypervolt that
518. 20:00we use.
519. 20:00>> Hypervolt.
520. 20:01>> Yeah.
521. 20:02>> Kind of like the massage gun.
522. 20:03>> The massage gun. Yes.
523. 20:05>> Okay. Is this also kind of like having
524. 20:07massage plate like the
525. 20:09>> Yeah. Handle and the vibration plates.
526. 20:12Everybody's using those.
527. 20:14>> Yeah.
528. 20:16Does So that does the same thing with
529. 20:17like muscle guarding and circulation
530. 20:21>> and also help with like lymphatic
531. 20:23drainage.
532. 20:24>> Yes.
533. 20:35Um and let's see what is kind of like um
534. 20:41your your protocol for vibration like in
535. 20:44terms of like is it similar like twice a
536. 20:47week um like two to three minutes or is
537. 20:50it much different than the shock wave?
538. 20:53>> Yeah.
539. 20:55So I use it as a tool in my session with
540. 20:58shockwave. Clients will come in
541. 21:00specifically for it. Um
542. 21:04so they would come in. It's a good
543. 21:07question because this might help us
544. 21:09explain when when and why I would use
545. 21:11it. Shockwave, you know, the protocol is
546. 21:13you want to come in two times at least
547. 21:14two times a week for six sessions. So
548. 21:16there's a set protocol with it where
549. 21:17vibration I feel is a tool that I use
550. 21:20from within my session. And I typically
551. 21:23don't see people more than one time a
552. 21:25week. Um,
553. 21:28so it would be used if you're looking at
554. 21:29it that way less when I how I would use
555. 21:32vibration therapy is let's say somebody
556. 21:35came in and um I just noticed their
557. 21:40let's just say like their upper traps
558. 21:42are really like
559. 21:44overactive, tight, you know, they just
560. 21:46came back from a stressful I don't know
561. 21:49from their job or something like that. I
562. 21:50would use a lower frequency maybe just
563. 21:53to reduce like the muscle guarding, calm
564. 21:55the nervous system down and then maybe
565. 21:58I'll use like a higher frequency when I
566. 22:00want just local, you know, circulation
567. 22:02or to warm up the tissue. So, let's just
568. 22:03say I'm going to get them up. Not that
569. 22:05this is, you know, let's say I'm going
570. 22:06to get them up and after I've done some
571. 22:08manual therapy, I want them to do some
572. 22:10movement. I might do some quick
573. 22:11circulation, you know, higher frequency,
574. 22:14quicker break through the tissue to
575. 22:15prepare it more. Um, so that's how I
576. 22:18would use them differently. Okay, that
577. 22:20makes sense.
578. 22:22Um, in terms of like, uh, what what
579. 22:26types of outcomes or prognosis do you
580. 22:28usually expect with um, vibration?
581. 22:32>> Um, I think what I what I just said like
582. 22:35I was look for the response from within
583. 22:37the tissue. Um, the lower frequencies,
584. 22:41the calming ones, more of a relaxation.
585. 22:44I look for um you know we have the
586. 22:46mechano receptors from within the muscle
587. 22:48that I'm when I'm thinking in the back
588. 22:49of my head that I want to stim stimulate
589. 22:52or override
590. 22:53>> um to create you know the response in
591. 22:56the tissue that I'm looking for.
592. 22:58>> Um
593. 22:59>> so if I'm using the lower frequencies I
594. 23:01I basically want to feel the tissue kind
595. 23:03of like calm feel a little bit more
596. 23:05relaxed not as tense and tight. um for
597. 23:09the quicker ones, you know, that I'm
598. 23:11going quicker. You you know, you can
599. 23:13feel when there's more circulation or
600. 23:14blood flow, you know, through the
601. 23:16tissue,
602. 23:19>> but it doesn't have like um with like
603. 23:21the shock wave, it's like twice a week
604. 23:23for this many weeks like vibrations.
605. 23:25>> Not in my practice. Yeah. No, not in my
606. 23:27practice. Like I just use it as part of
607. 23:29a tool like from within my hands-on
608. 23:31treatment.
609. 23:32>> Got it.
610. 23:34Like I use shockwave to mainly specific
611. 23:38uh target specific areas of chronic
612. 23:40dysfunction that aren't responding well
613. 23:43to the manual techniques. And I use
614. 23:44vibration before or during a treatment
615. 23:47to improve circulation, reduce muscle
616. 23:50guarding or prepare for hands-on work.
617. 23:54>> So it's less prescribed and correct as
618. 23:57needed.
619. 23:58>> Correct.
620. 24:03Um, in terms of uh any like uh safety
621. 24:08issues with vibration
622. 24:11or like contradictions or precautions
623. 24:15um
624. 24:18epilepsy,
625. 24:24>> that could be totally wrong. Okay. No.
626. 24:28>> Um, let's see. When would I what would I
627. 24:31not use it on? I wouldn't I mean
628. 24:33>> pregnancy open wound.
629. 24:35>> Yeah. Things like that. Yeah.
630. 24:37>> Yeah. Yeah.
631. 24:40I guess they're pretty common sense, but
632. 24:42I've never thought I had to like say
633. 24:43them out loud because they're pretty
634. 24:45common.
635. 24:48>> But I think that with vibration, if
636. 24:51you're using the massage gun, you can
637. 24:53use it on other areas for pregnancy,
638. 24:55just not in like the the tummy or the
639. 24:58back area, like the lower back area,
640. 24:59right?
641. 25:00>> Yeah.
642. 25:00>> You're using like the vibration plate or
643. 25:02a vibration mat, you would just avoid it
644. 25:04completely, right?
645. 25:05>> I think so. Yeah.
646. 25:11here. Oh, is it okay if I share our
647. 25:13case?
648. 25:14>> Yeah, totally.
649. 25:14>> Okay, let me grab it.
650. 25:20This is going to be the most like OT
651. 25:23probably PT thing.
652. 25:27I'll drop it in the chat. I'll put it in
653. 25:29like a couple different sections just so
654. 25:31because it's long.
655. 25:36reading a couple other notes I made.
656. 25:38Okay, so vibration also
657. 25:41um
658. 25:45well I already went over this. It
659. 25:46doesn't stimulate tissue remodeling or
660. 25:48regenerative healing. I went over that
661. 25:50already. They're more neuromuscular and
662. 25:52circulatory which I said. Okay, I just
663. 25:54want to check my
664. 25:56There we go.
665. 26:10You guys know you need me to you don't
666. 26:12need me to demonstrate the Hypervolt,
667. 26:15right? You use the massage gun. Yeah,
668. 26:18>> it's kind of it's kind Oh, I do like How
669. 26:20long do you usually use it for?
670. 26:21>> Couple minutes.
671. 26:22>> Just a couple minutes.
672. 26:23>> Yeah, a couple minutes in the session.
673. 26:32So, um, our case, I put it in the chat
674. 26:34so you can see it. Um, shoot.
675. 26:38>> I got to upgrade my Zoom, but I don't
676. 26:40want to.
677. 26:42Um, we have 10 minutes, but if we get
678. 26:44kicked off, we can just hop back in, I
679. 26:46think. Okay.
680. 26:47>> Um, so we have Marisol is a 46-year-old
681. 26:49elementary school teacher
682. 26:52>> with uh chronic rightsided
683. 26:55dequorans.
684. 26:57What the heck is that?
685. 27:01>> It's like a It's like a hand thing.
686. 27:03>> The chronic soft tissue injury that
687. 27:06happens like right about here.
688. 27:08>> Is it like
689. 27:14>> It's like um
690. 27:15>> I don't think I've heard of that one
691. 27:16yet, but it's like a
692. 27:17>> or maybe we're talking about the same
693. 27:19thing, but I'm saying
694. 27:21>> I might be saying it wrong. It's a
695. 27:23tendon, inflammation of a tendon in this
696. 27:26area.
697. 27:30>> This is the one that's often called like
698. 27:33>> mother's thumb, right? Cuz you're it's
699. 27:35from doing this, right?
700. 27:37>> Like you pick up a baby.
701. 27:41>> Um, dupetrins contraure. That's what I'm
702. 27:43thinking of.
703. 27:45>> Oh, yeah. We could do that, too.
704. 27:50>> Yeah. So fracture would be kind of
705. 27:52different though whereas like a tendon
706. 27:55is um inflamed
707. 27:57>> from that here.
708. 28:00>> No,
709. 28:01>> that's what I thought. No, that's what I
710. 28:03thought this was was saying. I was like,
711. 28:04"Oh, is it duper trends?" But I'm not
712. 28:06familiar with dupins.
713. 28:08>> We can also change the condition.
714. 28:10>> No, not at all. It's fine.
715. 28:27Declare Q U E R I'm just looking it up
716. 28:31so I know
717. 28:36I know.
718. 28:38Oh, where' Deafany go?
719. 28:40>> I think we lost her.
720. 28:42>> Okay, so it's a painful conditioning
721. 28:44affecting the tendons on the thumb side
722. 28:45of your wrist. Okay. Repetitive
723. 28:48gripping, pinching, grasping.
724. 28:51Oh, this would be okay.
725. 28:54Got it.
726. 28:56Um, she So, she was independent in all
727. 28:58activities before this. She's a school
728. 29:00teacher.
729. 29:02Um,
730. 29:04she enjoys gardening and cooking at
731. 29:06home. Um, preparing meals. Um,
732. 29:11lives with her spouse and children,
733. 29:12enjoys gardening and cooking. Uh, she
734. 29:14reports pain at 6 out of 10 with thumb
735. 29:17abduction and seven out of 10 with
736. 29:19resisted thumb extension.
737. 29:21Um, repetitive handwriting, lifting
738. 29:23classroom materials, opening jars,
739. 29:25carrying grocery bags, and cooking tasks
740. 29:27require gripping or chopping all
741. 29:29increase her symptoms.
742. 29:31>> She's unable to tolerate handwriting for
743. 29:33more than 5 minutes and reports
744. 29:34frustration with her decreased ability
745. 29:36to participate in her work, home, and
746. 29:38leisure roles.
747. 29:40She would also like to be able to write
748. 29:42on a whiteboard and cook dinner without
749. 29:43pain.
750. 29:47>> One second.
751. 30:06>> Soon I'm just on the call, buddy.
752. 30:17So with this um case study, I guess
753. 30:20we're asking like how would we
754. 30:23>> how would we treat it with shockwave
755. 30:25therapy?
756. 30:26>> So with shockwave therapy, you would use
757. 30:28it directly on the thumb
758. 30:32>> kind of
759. 30:32>> Yeah, you would use it directly on the
760. 30:34thumb. Um
761. 30:36just
762. 30:37>> and because you're saying it's
763. 30:38superficial be less frequency
764. 30:40>> and it be just a couple of minutes at
765. 30:43most.
766. 30:43>> Yes, you do probably let's see probably
767. 30:46anywhere from about 400 shocks I would
768. 30:50probably use for that.
769. 30:52>> Okay.
770. 30:55And I'd say like power would be so let's
771. 30:57let's do the full thing. So power would
772. 30:59be anywhere from
773. 31:026 to 12 based on person's tolerance. So
774. 31:05you would start at a lower power and
775. 31:07then you can slowly increase it. The
776. 31:10frequency I would do start at a four,
777. 31:15keep it at a four and then it would be
778. 31:17about 400 shocks.
779. 31:18>> Okay.
780. 31:20>> Okay.
781. 31:20>> And you just go you would just
782. 31:23just like ultrasound. put the gel on
783. 31:25here and just go slowly and it'll go
784. 31:27tick tick tick tick tick tick tick and
785. 31:29you just go over the area. Yeah.
786. 31:32>> Okay, awesome.
787. 31:38Is there anything else that would you
788. 31:40would do with this client?
789. 31:42>> Well, I'm not a physical therapist,
790. 31:46but so I can give you what I would do.
791. 31:50Um, which is probably different than
792. 31:51what a physical therapist would do.
793. 31:54Yeah. Um, basically I would look at her
794. 31:57whole alignment. If something's going on
795. 31:59in the thumb, creating um, an overuse or
796. 32:02some inflammation there, I would be
797. 32:03basically looking at what's going on in
798. 32:06her upper body. She's gardening, she's
799. 32:08cooking, she's using her hands a lot.
800. 32:10Um, you know, we all know that if
801. 32:13there's lack of mobility in the
802. 32:14shoulder, thoracic spine, there's not a
803. 32:16good alignment between the neck. And I
804. 32:18mean, it can cause issues going all the
805. 32:19way down the hand. So, that's what I
806. 32:21would look at in addition to
807. 32:25giving her some symptom relief from
808. 32:26within the thumb to help heal that.
809. 32:29>> Um, and then
810. 32:32you could, if we wanted to talk about
811. 32:34vibration, I mean, what would you
812. 32:35typically what areas would you guys
813. 32:38address with this?
814. 32:40Would you any of the flexors or
815. 32:42extensors of the wrist and hand?
816. 32:45>> Yeah, we would. But I think also like
817. 32:47what you're talking about with
818. 32:48alignment, addressing overuse of it.
819. 32:50>> Yeah.
820. 32:51>> Talk about a lot about um proximal
821. 32:53stability for distal mobility.
822. 32:55>> Yeah.
823. 32:56>> Um so we would make sure that all
824. 32:58everything's working up here and then we
825. 32:59would look um here and try to treat the
826. 33:02pain and then try to look at her setup
827. 33:05um at work, look at her setup cooking
828. 33:08and
829. 33:08>> Yeah. pretty much you just said.
830. 33:11>> Yeah. Yeah. It's like it never really
831. 33:14where where the pain is, right? Mhm.
832. 33:16>> Sometimes it's like, yeah,
833. 33:18>> I get that a lot. Like when I was
834. 33:19working as an aid, I would be like, "Oh,
835. 33:22you have pain in your hands, but all of
836. 33:24that is up here." And they'd be like,
837. 33:25"No, I have pain here."
838. 33:27>> I know. I know. And sometimes it's on
839. 33:29the other side where the real issue is.
840. 33:31And they're like, "Oh, I never realized
841. 33:33it was on the other side."
842. 33:35>> Yeah.
843. 33:37>> Um I don't know. I guess with Hypervolt,
844. 33:39I'm trying to think like Hypervault like
845. 33:41um or the vibration therapy,
846. 33:44you know, it might be good like if she's
847. 33:46overusing there's I don't know there's
848. 33:48something going on
849. 33:51um tissue wise maybe in the forearm the
850. 33:54extensors cuz you said it's the
851. 33:56abductors. I don't know maybe some light
852. 33:59relaxation with the hypervolt like in
853. 34:01those in the forearm muscles and the
854. 34:02extensors um
855. 34:05>> like the shoulder area maybe. Yeah,
856. 34:07might be good. Yeah. Um for her.
857. 34:15>> Okay.
858. 34:16>> Yeah,
859. 34:16>> this is absolutely perfect. We got two
860. 34:18minutes left on my sad free Zoom.
861. 34:22>> I know. I just switched over on mine
862. 34:24>> like I felt silly always being like I'll
863. 34:26call you back. Right. I I know. I just
864. 34:30It's terrible. Do we Do you guys want to
865. 34:32hop get out of the link and hop on
866. 34:34again? Um, if we have more questions or
867. 34:37what do you guys think?
868. 34:38>> I'm feeling like we've got it. Unless
869. 34:39you have more that you wanted to share
870. 34:41with us
871. 34:43because I I feel like we we have a lot
872. 34:46to work. Oh, we did want to see like I
873. 34:49mean we did see it. So yeah,
874. 34:53this is
875. 34:55>> hugely hugely hugely helpful. We are
876. 34:58deeply deeply deeply grateful. Um, thank
877. 35:02you for taking the time to speak with
878. 35:03us. I know you are very busy running
879. 35:05three businesses. So, thank you so so so
880. 35:09much.
881. 35:10>> Yeah, you're welcome. I wish you guys
882. 35:12the best. I'm excited.
883. 35:14>> And we'll share that we'll share a
884. 35:15presentation with you in case
885. 35:16>> when are you guys graduating?
886. 35:18>> Two years.
887. 35:19>> Uh, April of 2028.
888. 35:21>> Okay. Make sure you reach out to me once
889. 35:23you graduated because I like referring
890. 35:25people to OT's, PTS, like Yeah. So,
891. 35:29>> oh yeah,
892. 35:30>> I'd love to talk to you about the
893. 35:31Ralphing and I love red light therapy
894. 35:34and so like things like that would be
895. 35:36amazing.
896. 35:37>> Yeah, absolutely. I mean, I just I love
897. 35:39working with other practitioners. So
898. 35:42excited for you all.
899. 35:44>> Thank you so much for meeting with us.
900. 35:46Thank you so much.
901. 35:46>> You're welcome. Okay, you guys have a
902. 35:48good weekend. Bye guys.
903. 35:49>> Bye.