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Locations : Laurel Springs, Haddonfield, Mt Laurel, Somers Point, and Washington Township, NJ

All Posts in Category: Instrument Assisted Soft Tissue Mobilization

Calling all Philadelphia and South Jersey manual therapists! We are hosting SMART Tools with The Training Room!

Dr. Mark Kemenosh and Associates with the help of our good friends at The Training Room Physical Therapy group of South Jersey are proud to announce we are hosting the SMART Tools Level 1 IASTM certification at our shared facility in Washington Township aka Sewell, NJ.  We are putting the word out to everyone in manual medicine who would like to come out to feel welcome!  We plan to have DPT’s (Doctors of Physical Therapy), DC’s (Doctors of Chiropractic),  ATC’s (Athletic Trainers), and possibly more attending this event!  The course is a full two days and will be held on July 29th and 30th, a little down the road in the middle of summer!

SMART TOOLS – LEVEL 1 CERTIFICATION – SEWELL, NJ

Date: Sat July 29 – Sun July 30, 2017

Time: 8am – 5pm (each day)

Venue: The Training Room of Washington Township (Inside Velocity Sports Performance)

309 Fries Mill Rd
Sewell, NJ 08080

This course lays the foundation for how to properly use the SMART Tools most effectively with respect to movement. The tools were made specifically for these technique protocols to produce superior patient outcomes compared to other IASTM technique. This is an evidence-based technique that stresses early loading exercises and kinesiology tape after SMART Tools treatment.

The goal of therapy is to provide an optimal environment for the healing, by either modifying physiologic responses to injury (e.g., inflammation, muscle spasms, pain) or enhancing components of the normal musculoskeletal function (e.g., increase range of motion, increased muscular strength). No single therapeutic approach in isolation will completely resolve an impairment of musculoskeletal function. Smart Tool Plus® represents an approach to soft tissue manipulation that uses five different stainless steel instruments to release scar tissue, adhesions, and fascial restrictions. SMART Tools are designed to be used in conjunction with a thorough medical evaluation, movement based examination and other modalities to help patients overcome injuries.

Therapeutic stretches and exercises (preferably eccentric exercises) are necessary to promote tissue lengthening and collagen fiber realignment, which help to prevent the released tissue from becoming restricted again.

The primary objective of the Level 1 Certification course is to develop an understanding of the STP and how to apply it into the full spectrum of the musculoskeletal treatment approaches. By the end of the training, students will be able to:

Demonstrate a working knowledge of the STP Instruments, STP treatments and potential effects and benefits.
Identify and discuss the indications, contraindications (relative and absolute) of IASTM.
Review and develop a better understanding of soft tissue injury, healing and potential reactivity to instrument-assisted soft tissue mobilization (therapeutic and adverse).
Develop skill and competence in the STP application of the IASTM to the major regions of the spine and extremities.

Treatment effects of IASTM

  • Breakup abnormal densities in tissue
  • Stimulate nervous system
  • Reinitiate first-stage healing in the body via proliferation
  • SMART Tools IASTM techniques aim to treat the following Tissue Extensibility Dysfunctions

(TEDS):

  • Scarring & Fibrosis
  • Facial Tension & Densification
  • Neural Tension
  • Muscle Shortening
  • Neurologic Restriction
  • Trigger Points

This isn’t Gua Sha, nor is this another general IASTM course. This is a movement-based IASTM course unlike anything currently offered. Our training course addresses the neurological component, as well as the physiological component of the IASTM and corrective exercises in ways other courses do not.

This course is designed for clinicians that either have never used tools or have been using tools for years. Each will come away with new, innovative material.

So if you want faster patient outcomes, quicker recovery time, improved clinician ergonomics to save your hands, and last but not least, no patient bruising, then register for a course today and add a powerful technique to your toolbox… no pun intended.

Need more info?  Ready to register?

LINK:  http://www.smarttoolsplus.com/product/level-1-sewell-nj

 

 

Need more info?  Ready to register?

LINK:  http://www.smarttoolsplus.com/product/level-1-sewell-nj

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SMART Tools – ITBand Treatment (Short Version)

So a lot of our patients have issues with pain, tenderness and tightness in and around the Iliotibial Band, often times referred to as the ITBand.  While in most cases there are various reasons why our patients present with pain in this particular tissue, treating it has been done various ways in the past, some with great success and some with no success.  Here at the office we do our best to treat each patient individually using a mixture of treatment methods best on several things like the presentation of the patients issue, where it is located on the ITBand (near the hip, in the middle of the femur, or at the lateral border of the knee) and the mechanism of injury or in some cases the mechanism of aggravation (take that runners, cyclists, and crossfitters, I have a new way of explaining to you guys and gals who like to say to me “but I never actually hurt it”).

In all conditions, the first thing most patients do is GOOGLE IT to see what comes up.  In most cases of googling things that sound like ITBand Syndrome, here is an excerpt of the results.

Iliotibial band syndrome occurs when the connective tissue (ligament) extending from the pelvic bone to the shinbone becomes so tight that it rubs against the thighbone. Distance runners and cyclists are especially susceptible to it.

The main symptom is pain between the hip and knees that worsens with activity.

Treatments such as physical therapy and sometimes corticosteroid injections may help. In rare cases, surgery may be needed.

In my opinion, the only thing Google got right in the treatment section is that physcial therapy almost always helps because a good physical therapist will help you strength the posterior gluteal regions, lateral hips, hip rotators and the pressure on the ITBand will decrease in almost all cases.  Every so often we find an ITBand that needs a corticosteroid injection but those are fairly rare as well.  We are not the biggest fans of ITBand release surgical procedures unless something other than running 5k’s is the causation to the problem, but again, every tool has it’s purpose and when properly used/applied it makes sense.  So getting past all of that, lets take a look at what we are working with here.

If you are familiar with our office, then you are familiar with the fact that we treat the Tensor Fasica Lata muscle on almost every runner and cyclist who comes to our office.  We also commonly treat gluteus medius, and sometimes gluteus maximus as well because the Iliotibialband itself is a fairly dense/tough piece of tissue that runs from the lateral border of the ilium down to the lateral border just below the knee and attaches to tibia, hence it’s name, the ITBand (Iliotibialband).

What a lot of patients don’t realize that now we are using SMART Tools as well for some “harder to deal with” cases of ITBand syndrome and this video from Smart Tools shows one very effective technique for mobilize the borders of the ITBand with motion.  As seen in the video below, this is just another way that we are ever expanding our use of manual medicine here at the office and not just relying on Chiropractic Manipulation, Active Release Technique, RockTape, Corrective Exercises, or SMART Tools IASTM (Instrument Assisted Soft Tissue Manipulation) to keep you, our patient, going and doing what you love!

Please note that if you ever need help from us about something giving you issues, please shoot us an email and will do our absolute best to get back to you in 24 hours or less!

Contact Us Page:  http://drmarkkemenoshandassociates.com/contact/

Need to see more pics of the Tensor Fascia Lata, Iliotibial Band, and Gluteus Medius you can trust, here is a cartoon version in a runner that is somewhat accurate.

Lastly, here are a few shots from our meeting at the Haddonfield Running Co a few weeks back where we talked running, problems like ITBand Pain, ITBand Tenderness, ITBand Tightness, and ITBand Syndrome.  In these pictures I the Active Release Techniques movements for treating the Tensor Fascia Lata and ITB!

 Contact Us Page:  http://drmarkkemenoshandassociates.com/contact/

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Shin Splints are never fun, but at least ART can get you better quickly!

Dr. Kemenosh, Dr. Gross, Dr. Evans, and Dr. Legath treat a lot of runners in the South Jersey area for Shin Splints using Active Release Technique.  ART attacks shin splints differently than most other therapies and often yields better results.  The one thing Dr. Mark has built is a reputation with the local cross country teams on the best treatment possible for most foot, knee and leg aches and pains.

Before we get down to what we do for shin splints, we should discuss what shin splints actually are.  Most commonly, runners, dancers, and military recruits are diagnosed with shin splints, however, anyone can get them.  Medically speaking, medial tibial stress syndrome is the term used more commonly to determine shin splints, but anyone who has been a running club knows shin splints are bit more than just medial tibial pains, as they can also bite you on the posterior side of the tibia in some cases.  Patients often find that when they go untreated, pain can often then extend in the knee, ankle, or foot.  This is most commonly from your brain automatically trying to change your gait (running) pattern to stop pain in the shins.  So, overall, if you have shin splints, you may notice tenderness, soreness, or pain along the inner part of your lower leg.  You may also notice mild swelling in the leg, usually below the knee, but above the ankle.

So that you are aware, MOST cases of shin splints can be treated on your own!  Yes, we said, you can treat shin splints yourself, up to a certain point.  Some very helpful methods of home treatment including resting, ice, topical pain relief creams.  Some runners also intentionally seek out softer trails and find this helps to some degree, running on a mulch trail versus a concrete sidewalk can often make a small difference.  Another part of shin splints we find commonly are the shoes!  Worn out shoes or the wrong type of running shoes can often cause your shin splint and leg pain issues.  We will recommend our favorite shoe people at the end of this article.  Pain while running and exercising to a small degree can be considered normal in patients with shin splints, however if the pain levels rise to a point of being uncomfortable, unavoidable, or lingering longer than the run, you may need to seek medical help.

When is a good time to think about seeing Dr. Kemenosh and Associates about your shin splints or leg pains?

If rest, ice, and basic over the counter pain relievers are not helping your pains, it’s time to seek a medical professional.  If you have read along to this point, then you are probably rubbing your shins and thinking about what to do next.  Shin splints are most commonly caused by a repetitive stress of the muscles which anchor onto the shin bone (tibia).  The Active Release Technique employed by the doctors here at our office was specifically designed for treating repetitive stress injuries.  First, during your examination we will zero in on the structures which are truly injured and being over stressed.  Once these structures are identified, we will select ART Lower Extremity Protocols which will most commonly attack some of the following structures.  Tibialis Anterior is usually the key player in shin splints.  Tibialis Anterior is a very strong muscle that stabilizes and controls movement of the ankle and foot.  Often, runners who are just getting started for the season or are ramping up their mileage will overload the Tibialis Anterior muscle which can start to overload the periosteal attachment of the muscle onto the Tibia (shin bone).  Healing of attachments like these are often fairly slow and is an area that commonly is referred to as “less resilient” by most medical professionals.  Runners often try to run again, and the “less resilient” area refuses to lengthen properly during the running motion, as it is still in a state of healing and fibrosis of the structures further shortens the tissue.  The results of this cycle is increased pain with running, and all of it is related to overuse with proper attention to treatment.  If it helps, the muscle should work like a rubber band to help absorb force during running, but instead acts like a tight rope which has no give.

We also do not simply blame the Tibialis Anterior muscle, we also commonly find fibrotic spots of tissue in the Extensor Hallucis Longus and Extensor Digitorum Longus.  Outside of these three main structures, we also commonly treat the Gastrocnemius and Soleus muscles of the posterior compartment which are the muscles that make up your calves.

The muscle that is not commonly treated by other medical professionals when working on shin splints is the Tibialis Posterior.  The “Tib Post” as we like to call it around the office is often the muscle that patients don’t like us to treat while they are experiencing running/exercising related shin pain issues.  So why do we work on the Tib Post muscle, it is a very strong and deepest central muscle in the calf.  Because it is rarely truly treated on patients with shin splints, you are simply buffing the exterior of the car without cleaning out the exterior.  With proper treatment of this muscle, as well as the muscles listed above, we seek to break down fibrotic tissue using specific, strong contacts with active motion and this again allows your muscle to function as a rubber band, lengthening and shortening normally, and less like a rope.

Please note that in some cases, imaging can be necessary to rule out the possibility of a stress fracture and stress reactions.  In treating some cases of shin splints, we also watch out for a possible issue related to extensive degradation of the structures known as compartment syndrome, which while rare, is something we always keep on the possible differential diagnosis.

So, if you are having shin pain, shin splints aka Medial Tibial Stress Syndrome with activity and would like to give the team at Dr Mark Kemenosh and Associates to examine and treat you, please call us today!  856-228-3100

If you are not located in the Philadelphia or South Jersey area and need a certified ART provider, please look at http://www.activerelease.com/providerSearch.asp

Follow Dr. Kemenosh and Dr. Gross on Facebook at http://www.facebook.com/DrMarkKemenoshandAssociates

If you are feeling that your shoes are a serious problem, do not just trust a big box running shoe store to get you fitted properly if you are running in pain.  The two stores that we work extensively with are:

Dave at the Haddonfield Running Co. on Facebook at https://www.facebook.com/pages/Running-Co-of-Haddonfield-Moorestown-Mullica-Hill/113718775305658?ref=ts&fref=ts

-OR-

Moe at The Sneaker Shop of Ocean City on Facebook at https://www.facebook.com/thesneakershop.ocnj?fref=ts

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Plantar Fasciitis and Shin Splints – Why doesn’t Active Release and Instrument Assisted Soft Tissue Manipulation pop up on Google sooner?

Listening to Dr. Kemenosh, Dr. Gross, and a patient converse today, a very good point was brought up that for the sake of patient care, it’s sad that Active Release and IASTM (Instrument Assisted Soft Tissue Manipulation i.e. Graston, FAKTR) doesn’t come up sooner when sufferers are surfing Google looking for help.  Right now if you go to Google and search for “plantar fasciitis treatment” the results are somewhat abstract and trying to sell you items like the socks that pull up on your toes while you sleep, devices that stretch out or roll out the middle of your foot, as well as other devices.  These are probably great, however in a chronic case of plantar fasciitis, you need more.

We have found that the results are slightly better for “shin splints treatment”, but again, a good hands on treatment like Active Release and using an instrument on the areas like Graston/FAKTR/SMART Tools don’t come up.  In both of these cases, you have to treat the other areas around the actual pain, usually the calf muscles in these cases.  We also then use corrective exercises and other items like RockTape to help strengthen the areas, remove inflammation, and give you a long term fix with the ultimate goal of greatly improving and removing your pain.

Regardless, if you are fighting an uphill battle with Plantar related pain or shin splints, give us a call and we will gladly set you up with an examination and if we feel we can get you back on your feet with less or with out pain, we will treat you!  856-228-3100

 

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Our new SMART Tools Plus Kit is here! Better than a new phone book!

A few months back we ordered our new SMART Tools Plus Kit for the main office and they came in last week, just in time for the Cross Country Sectionals and States races that we are highly involved with here in South Jersey.  SMART Tools are medical grade 304 stainless steel instrument assisted soft tissue manipulation tools.  The tools are fully double beveled, so the skin contact is great in almost all situations.  These tools come very highly recommended by Chiropractors, DPT’s, Athletic Trainers, and just about anyone who is serious about Instrument Assisted Soft Tissue Manipulation and Manual Therapies.  Here at the office, we find that most of our sports related soft tissue injuries are best treated with a combination of Active Release Technique, and if need be, localized, targeted, Instrument Assisted Soft Tissue Manipulation.

From the SMART Tools Website:

“I have used a number of different soft-tissue manipulation instruments in both the clinical and academic setting and I must say that I am most impressed with SMART Tools. They are incredibly well crafted. The ease at which they glide over tissue to decrease scar tissue and adhesions is unparalleled. What I really like about these instruments is their double beveled treatment edge which is more functional for the practitioner and more comfortable for the patient. I would recommend these instruments to any manual therapist looking to add instrument-assisted soft tissue manipulation to their practice.”

Kevin J. Curtin, D.C.
Assistant Professor
National University of Health Sciences
Lombard, IL

smart-tools-1-iastm-kemenosh-evans-gross smart-tools-2-iastm-evans-kemenosh-gross

The contour edges on these tools are better than most others on the market and will allow us the ability to better treat more of the conditions we see on a regular basis.  Some of the issues we regularly treat with tools are plantar fasciitis that is truly localized and “stuck” in the bottom of the foot, lateral epicondylitis which is also known as tennis elbow, medial tibial stress syndrome which is a really cool and fancy name for shin splints on the inside of your shins, Achilles tendinitis, carpal tunnel syndrome, as well as many more soft tissue injuries, aches, pain!

If you have questions about what we do and how we treat, give us a call at 856-228.3100!  We have locations in Laurel Springs (aka Clementon/Blackwood), Haddonfield, Somers Point, and Washington Township aka Sewell), New Jersey!

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Instrument-Assisted Soft Tissue Mobilization – Another way to heel up better and recover faster!

So if you have been watching our Blogs and Facebook page lately you might have noticed that we picked up new IASTM (Instrument-Assisted Soft Tissue Mobilization) from Smart Tools.  IASTM has been around for about 20 – 30 years now and adopted many different techniques dating back to Gua Sha, which was Chinese medicines version of IASTM technique which dates back thousands of years and has been traditionally done with jade tools.  We realize that often time’s people have questions about IASTM and this blog posts goal is to answer some general questions.

What is Instrument-Assisted Soft Tissue Manipulation (also called Mobilization)?

IASTM is a form of mobilization applied to an area of dysfunction focusing on the interaction between soft tissue, connective tissue, and muscle.  In most modern medical uses, the tools are made of 304 grade surgical stainless steel.  Areas of dysfunction may contain scar tissue, fibrotic tissue, or fascial adhesions which all feel differently when the tool is applied to the area using an emollient as a lubricant.

What can ISATM treat?

IASTM has shown good results and an effective treatment for several types of soft tissue injuries.  Specific to runners, IASTM can effectively treat:  ITB (iliotibial band) syndrome, tibialis tendinosis (shin splints), compartment syndromes, ankle sprains, nerve entrapments, tennis elbow, golfers elbow, Achilles tendinosis, plantar fasciitis, patellar tendinosis, as well as many types of muscular strains from all types of different sports and occupations.

Why should I try IASTM treatments on my area of pain? 

Often times we have to start slow and soft with IASTM manipulation to see how resilient your injury will be to bruising.  Often times it is not necessary to severely bruise the tissues by doing IASTM, but causing the tissue to turn red from the use of the tools is common.  In most cases, after applying treatment using the tools, patients realize increases in range of motion (increased flexibility) and often times a decrease in pain.  Levels of pain decrease often times are dependent on the severity of the injury, but with follow up treatments in a reasonable amount of time, fibrotic tissues and scar tissues often break down over time, leaving patients with long term decreases in pain and much improved ranges of motion.

Can Active Release Technique and IASTM be used together? 

Yes and no.  We often do mix the techniques, but usually not on the exact same areas.  IASTM allows to quickly address very acute, specific areas of dysfunction.  IASTM also causes some low levels of inflammation of the treated structures and depending on the level of force applied to the area, the thickness or thinness of the tissue, and the nature of some areas being very tender, we sometimes do apply both techniques or may use our discretion to whether one or the other is best.

What should I do if I am interested in possibly having IASTM or Active Release technique at your office? 

Feel free to call our office at 856.228.3100 to make an appointment with our doctors of Chiropractic who all use Active Release Technique and Instrument Assisted Soft Tissue Mobilization to help our patient’s heel and recover as quickly as possible from musculo-skeletal injuries!

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