Management of chronic ankle pain using joint mobilization and ASTYM® treatment: a case report

Abstract

Treatment of ankle sprains predominately focuses on the acute management of this condition; less emphasis is placed on the treatment of ankle sprains in the chronic phase of recovery. Manual therapy, in the form of joint mobilization and manipulation, has been shown to be effective in the management of this condition, but the combination of joint mobilization and manipulation in tandem with ASTYMH treatment has not been explored. The purpose of this case report is to chronicle the management of a patient with chronic ankle pain who was treated with manual therapy including manipulation and ASTYM treatment. As a result of a fall down stairs 6 months previously, the patient sustained a severe ankle sprain. The soft tissue damage was accompanied by bony disruptions which warranted the patient spending 3 weeks in a walking boot. At the initial evaluation, the patient reported difficulty with descending stairs reciprocally and not being able to run more than 4 minutes on the treadmill before the pain escalated to the level that she had to stop running. After five sessions of therapy consisting of joint mobilization, manipulation and ASTYM, the patient was able to descend stairs and run 40 minutes without pain.

The management of bilateral high hamstring tendinopathy with ASTYM®treatment and eccentric exercise: a case report

“…19 The treatment includes specific protocols and instruments used to stimulate affected soft tissues to heal and regenerate at a cellular level. 20 ASTYM has been shown to cause increased fibroblast recruitment and activation in rat tendons which should theoretically promote proper healing, but this has not been thoroughly studied in humans. [21][22][23] ASTYM treatment is thought to activate a regenerative response in soft tissues via induction of leakage from dysfunctional capillaries which leads to fibroblast activation, macrophage mediated phagocytosis, and a local release of growth factors.…”

“…[21][22][23] ASTYM treatment is thought to activate a regenerative response in soft tissues via induction of leakage from dysfunctional capillaries which leads to fibroblast activation, macrophage mediated phagocytosis, and a local release of growth factors. [20][21][22][23][24] While eccentric exercise and ASTYM should theoretically be useful in the management of HHT, the research supporting both of these interventions is lacking and there are no studies that have reported the effects of a combined treatment approach. Therefore, the purpose of this report was to present the management and outcomes of a patient with bilateral HHT who was treated with eccentric exercise and ASTYM.…”

Astym Therapy Improves Function and Range of Motion Following Mastectomy

“…12,13 Astym therapy has been shown to increase movement and decrease pain in patients with inappropriate fibrosis and in patients with other soft tissue dysfunctions. 6,[9][10][11] Davies and Brockopp, 14 in a previous pilot study, demonstrated that Astym therapy increased active range of motion (AROM) of shoulder flexion and abduction, and improved Disabilities of the Arm, Shoulder, and Hand Outcome Measure (DASH) scores in patients with scar tissue around their mastectomy incision, drain site, and axilla. 14 The same study also reported that 56% of women were unable to wear a bra before Astym treatment, suggesting hypersensitivity of scars and clothing restrictions that affect BCSs.…”

“…7,8 It has also been found to reduce pain and increase function in people with soft tissue dysfunction. 6,[9][10][11] The aim of Astym treatment is to engage the regenerative mechanisms of the body in order to resorb scar tissue, stimulate tissue turnover, and regenerate soft tissues. 6 Handheld instrumentation is applied topically to locate underlying dysfunctional soft tissue and then transfer particular pressures and shear forces to the dysfunctional tissue through specific protocols and patterns developed from scientific and clinical study.…”

A Novel, Nonoperative Treatment Demonstrates Success for Stiff Total Knee Arthroplasty after Failure of Conventional Therapy

“…11 Clinical studies support the effectiveness of Astym therapy in the treatment of various soft tissue dysfunctions. [11][12][13][14][15] However, no publications have specifically addressed Astym therapy's role in knee stiffness following TKA. Thus, we aimed to evaluate (1) ROM and (2) subjective functional improvements in post-TKA patients who suffered from stiffness recalcitrant to other nonoperative modalities, who underwent Astym therapy after failure of conventional therapy.…”