Project Description


Trigger Point Shock Wave Therapy, also known as the Extracorporeal Shock Wave Therapy, or myofascial compression, is widely used in the treatment of acute and chronic pain in muscles, tendons, and joints. Shock wave therapy describes the use of acoustic waves to target tissue at varying depths to compress and manipulate tissue resulting in a focused and precise deep tissue massage. The results of the mechanical stimulus delivered can lead to increased circulation and pain relief – key components in the healing process.

The PiezoWave2, combines orthopedic applications of Extracorporeal Shock Wave Therapy (ESWT) with the applications of Trigger Point Shock Wave Therapy (TPST), which are highly efficient, non-surgical treatments for chronic pain in the musculoskeletal system

Trigger Point Shock Wave Therapy offers a significant expansion of the range of applications for myofascial pain syndrome. The extracorporeal, focused shock wave allows precise diagnosis and therapy of active and latent trigger points that are thickened, pain-sensitive points within a usually tense muscle.

Common Diagnoses Treated:

  • Tennis Elbow
  • Calcific tendonitis of the shoulder
  • Golfer’s elbow
  • Trigger point treatment
  • Arthritis
  • Greater trochanteric pain syndrome
  • Patellofemoral syndrome
  • Medial tibial stress syndrome
  • Plantar Tarsalgia
  • Achilles tendinopathy

How it Works:

The PiezoWave2 delivers mechanical energy in the form of sound waves to target tissue, including tenocytes in tendons, fibroblasts in ligaments and skin, osteocytes in bone, chondrocytes in articular cartilage, and endothelial cells in blood vessels, which are all highly responsive to mechanical energy. The PiezoWave2 then localizes trigger points, delivering highly focused acoustic pulses that penetrate precisely to the desired depth. Penetration depths of between 0.5mm and 3 cm are possible, depending on the therapy source. This facilitates cellular repair by increasing blood flow and reducing pain.


Active Release Technique® or ART® is a patented, state of the art soft tissue system/movement based massage technique that treats problems with muscles, tendons, ligaments, fascia and nerves. Headaches, back pain, carpal tunnel syndrome, shin splits, shoulder pain, sciatica, plantar fasciitis, knee problems, and tennis elbow are just a few of the many conditions that can be resolved quickly and permanently with Active Release Technique®.

These conditions all have one important thing in common: they are often a result of overused muscles. Throughout the years the world has spread that ART® is an extremely effective soft tissue management system and many individuals, groups, and business entities have come to rely on Active Release Technique® care.

Corporations such as electronics manufacturer Sanmina-SCI have seen a greater than 80% reduction of injuries in the past four years with 81% reduction in workers compensation costs using Active Release Technique® certified practitioners.


Cold Laser Therapy treatment helps to reduce inflammation, a primary cause for pain. When our tissues are injured, a lack of oxygen and other nutrients may slow the healing process. Toxins accumulate within the tissues, which further blocks the healing process. Thick bands of scar tissue can form across the muscles, inhibiting movement and restricting your body’s natural range of motion.

Cold laser therapy promotes circulation; this fresh blood flow is essential to flushing out toxins and reducing inflammation. This helps to minimize neck and back pain while helping the body heal faster.

While only recently cleared by the FDA for use in the United States, Cold Laser© has been used extensively throughout the world for more than twenty years. Also known as cold laser or phototherapy, Cold Laser© is backed by extensive research with over 500 published studies covering a wide range of conditions.

Cold Laser© has been proven effective in the treatment of a number of soft-tissue injuries, pain, and inflammatory conditions. Recently, this exciting technology was cleared by the FDA for the treatment of pain and stiffness associated with arthritis. This is particularly important and timely in light of recent published concerns regarding the safety of traditional arthritis medications. Treatments are fast and easy to apply. With treatment times generally less than 5 minutes, Cold Laser© is a perfect complement to traditional soft-tissue treatments. Preferably, treatments are administered 2-3 times per week for optimal results.


What is Fascia?
Fascia – is connective tissue which exists within and throughout our entire body. Fascial Tissue is regarded as an infused, mobile, three-dimensional, intertwined, continuous web of interconnecting Fascia Tissue which extends throughout the body forming the body’s Myofascial System. Which creates separation between and within organs and muscles, It also creates space through which delicate nerves, blood vessels and fluids pass.

Fascial manipulation or FM is a system of evaluating and treating myofascial dysfunction throughout the body.  The fascial system is a complex network of connective tissues that run the entire length of the body and connect all of its parts together.  It has been shown to play a vital role in the synergy of muscle contractions and joint motion.  Many problems from back pain to headaches can be caused from the fascia not working properly.


What is Instrument Assisted Soft Tissue Mobilization?
Instrument Assisted Soft Tissue Mobilization (IASTM) is a procedure that is rapidly growing in popularity due to its effectiveness and efficiency while remaining non-invasive. Are struggling with a chronic injury or want to bounce back from a recent injury?

IASTM is another option to resolve pain and tightness in the body. This approach to fascial work reduces friction which allows for precision, sensitivity and depth that cannot be accomplished with the hands, knuckles, elbows etc.  IASTM instruments make it easier to detect and treat fascial dysfunction. They magnify the abnormalities (scars, restrictions and adhesions) in the fascia and make it easier to locate the area to treat. Using a tool focuses the force through an area smaller than your finger with less friction which allows a more efficient treatment. The goal is to trigger an inflammatory healing response. This will stimulate the production of new collagen and proper, functional, pain-free healing.

Benefits of IASTM

  • Decreases overall time of treatment
  • Allows faster rehabilitation/recovery
  • Reduces need for anti-inflammatory medication
  • Resolves chronic conditions thought to be permanent
  • Clients can continue to engage in everyday activities

Instrument Assisted Soft Tissue Mobilization (IASTM) incorporates a patented form of instrument assisted soft tissue mobilization that enables clinicians to effectively detect and treat scar tissue and restrictions that effect normal function. The technique separates and breaks down collagen cross-links; splays and stretches connective tissue and muscle fibers.

IASTM Technique increases the rate and amount of blood flow to and from the area, and increases cellular activity in the region, including fibroblasts and mast cells.

Common Issues Treated

  • Cervical sprain/strain (neck pain)
  • Lumbar sprain/strain (back pain)
  • Carpal Tunnel Syndrome (wrist pain)
  • Plantar Fasciitis (foot pain)
  • Lateral Epicondylitis (tennis elbow)
  • Medial Epicondylitis (golfer’s elbow)
  • Rotator Cuff Tendinitis (shoulder pain)
  • Patellofemoral Disorders (knee pain)
  • Achilles Tendinitis (ankle pain)
  • Scar Tissue
  • Adhesions
  • Trigger Points
  • Shin Splints
  • Plantar Fasciitis

What is scar tissue?

Scar tissue is dense, fibrous tissue affects us all and is an underlying factor in many injuries. Scar tissue binds up and ties down tissues that need to move freely. As scar tissue builds up, muscles become shorter and weaker. Tension on tendons causes tendinosis. Nerves can become trapped. All these problems can cause reduced range of motion, loss of strength, and pain as well as tingling, numbness, and weakness.

Scar tissue forms two different ways. First, if a muscle, tendon, or ligament is torn or crushed, the body creates scar tissue to ‘glue’ the torn pieces together. This is a necessary part of the healing process.

The second, more common way for scar tissue to form is by soft tissue in the body not receiving enough oxygen (hypoxia). Hypoxia is more common than one may think. Poor posture, athletic pursuits, repeated use, and sustained pressure (as in sitting) all increase muscle tension and result in hypoxic conditions. When muscle tension is increased, blood supply to the area is reduced. A healthy blood flow is so important because blood carries oxygen to muscles. A reduced blood flow means less oxygen and that means hypoxia.

Hypoxia leads to free radical accumulation in muscles. Unfortunately free radicals attract cells that produce scar tissue. These cells begin lying down scar tissue and over time, scar tissue begins affecting surrounding muscles, tendons, ligaments, fascia, and nerves.


Kinesio Tape has the ability to re-educate the neuromuscular system, reduce pain and inflammation, optimize performance, prevent injury and promote good circulation and healing, and assist in returning the body to homeostasis.

Kinesio (TM) Taping® is 140% the elasticity of human skin. By skillfully applying the tape to specific structures with a particular amount of stretch on the tape different effects can be achieved. Some of these effects include: muscle inhibition, muscle facilitation, increased circulation, increased lymphatic drainage (to reduce swelling), pain relief, functional correction, and increased range of motion.

The effect that there is the most evidence to support is lymphatic drainage. Kinesio(TM) Taping® method can be used to encourage the reduction of swelling, edema, and bruising. There is also evidence to indicate that it can improve the proprioception in some joints possibly reducing the likelihood of an injury such as an ankle sprain. Beyond sporting applications Kinesio(TM) Taping® is used to treat discomfort associated with pregnancy, infant colic and digestive disorders, and TMJ disorders to name a few conditions.

Kinesio Tape® is used for anything from headaches to foot problems and everything in between. Examples include: muscular facilitation or inhibition in pediatric patients, carpal tunnel syndrome, lower back strain/pain (subluxations, herniated disc), knee conditions, shoulder conditions, hamstring, groin injury, rotator cuff injury, whiplash, tennis elbow, plantar fasciitis, patella tracking, pre and post surgical edema, ankle sprains, athletic preventative injury method, and as a support method.


How does Myofascial Stretching differ from traditional stretching?
Stretching, in general, can accomplish two things; calming down of excessive muscular activity/tone, lengthening of connective tissue/fascia.

Traditional stretching is two-dimensional (although our body, of course, is three-dimensional) and typically involves stretching a muscle over a joint and involves holding the stretch for a brief period of time (15-30 seconds). Traditional stretching addresses the muscle and the elastic tissue, but not the collagenous, firmer component of our connective tissue. Results are therefore partial and temporary. Lots of people have been diligent about regular stretching for years and still feel stiff and prone to injury!

Myofascial Stretching differs from conventional stretching in three primary ways:
-Time element: Myofascial Stretches are held continuously for at least 90-120 seconds. This is how long it takes for the fascia to begin to let go. Shorter stretches do not affect the collagenous aspect of the fascia (connective tissue) and therefore lead to only temporary, partial results.
-Active elongation: This would for example mean actively extending your arm away from the body and telescoping or reaching your arm as if you’re trying to make it longer, feeling how this lengthens the tissue in a three-dimensional way through your arm.
-Stretching and strengthening occur simultaneously During active elongation of the body, muscle groups opposing the tight fascia contract in a sustained manner. This prolonged isometric contraction of muscles against the resistance of the fascial barrier strengthens them, helping to maintain the elongated state of the tissue you’ve just released.

Oftentimes, pain or stiffness in the body leads to some degree of dissatisfaction with our current state and, without us really noticing it, us working against our bodies in order to correct what we find wrong with it. An example of this would be stretching with the (not always conscious) mindset of trying to force tissue to lengthen.


Heavy Rope Training
Whether you’re a beginner or seasoned athlete Heavy Rope Training offers a complete metabolic workout for every fitness level. Used primarily as a tool for fitness, with no stress on the joints, the simple movements of Heavy Rope Training offers an ideal workout for those with rehab needs.

Employed in our lab daily, the workouts quickly gained attention for their cardiovascular benefits, quickly elevating ones heart rate to near maximum levels in under a minute. Implemented as an “active rest,” Heavy Rope Training is the perfect addition to an existing workout or circuit. Due to the grip required to perform the exercise, Heavy Rope Training offers a tremendous grip strengthening workout, great for those with an ailment of the wrist including carpel tunnel syndrome and arthritis.

Heavy Rope Training was voted the best core and cardio workout for 2009 by Men’s Health Magazine©.

Russian Kettlebells Training
A kettlebell is a traditional Russian cast iron weight that looks like a cannonball with a handle, making it a versatile tool for well-rounded fitness. With their wide range of uses, kettlebells can be used to deliver extreme fitness and preserve balance, strength, and functionality. Kettlebells can be combined with other exercise modalities to increase functional movements that often involve full body effort. Utilizing full body effort reveals bodily mis-alignments, weaknesses, and compensations the body uses to ease pain and weaknesses.

Kettlebell training proceeds to correct physical limitations the body possesses and results in musculoskeletal pain relief. Fundamentally, kettlebells develop functional strength and full body coordination. The Russian kettlebell replaces other fitness hardware including barbells, dumbbells, belts for weighted pull-ups and dips, thick bars, lever bars, medicine balls, grip devices, and cardio equipment.

Sandbag Training
Sandbags have a very rich history, maybe more so than any other training implement. For hundreds of years (possibly thousands) sandbags has been an integral training tool for athletes. Why? They are an inexpensive tool that is incredibly versatile and can offer the benefits of unstable training with a challenging load.  This is a benefit that many of today’s unstable gadgets cannot provide. However, the benefits don’t stop there. Greater stabilizer, trunk, and grip strength can be developed with sandbags as well as sport-specific drills, mobility work, and a great conditioning tool.

In the famous book, Dinosaur Training, Brooks Kubik states, “You feel sore as you do because the bags (sandbags) worked your body in ways you could not approach with a barbell alone. You got into the muscle areas you normally don’t work. You worked the “heck” out of the stabilizers.” (Kubik, p. 115)

The non-cooperative nature of sandbags makes using every muscle possible to lift it crucial. More stable and predictable implements can cause the body to find a particular groove. Once this groove is established then one becomes more efficient at performing the lift and the body actually decreases the amount of muscles utilized. This becomes especially true of explosive sandbag lifts such as cleans, throws, snatches, and shouldering. The trunk muscles (including those of the low back and abdominal area) have to work harder to stabilize the body against the awkward load while moving very quickly. This is very unique to sandbag training.


What is Ultrasound Imaging of the Musculoskeletal System?
Ultrasound imaging is a noninvasive medical test that helps physicians diagnose and treat medical conditions.  Ultrasound is safe and painless, and produces pictures of the inside of the body using sound waves.

Ultrasound imaging, also called ultrasound scanning or sonography, involves the use of a small transducer (probe) and ultrasound gel placed directly on the skin. High-frequency sound waves are transmitted from the probe through the gel into the body. The transducer collects the sounds that bounce back and a computer then uses those sound waves to create an image.

Ultrasound examinations do not use ionizing radiation (as used in x-rays), thus there is NO RADIATION EXPOSURE to the patient. Because ultrasound images are captured in real-time, they can show the structure and movement of the body’s internal organs, as well as blood flowing through blood vessels.

You should wear comfortable, loose-fitting clothing for your ultrasound exam. You may need to remove all clothing and jewelry in the area to be examined.  You may be asked to wear a gown during the procedure.
Ultrasound scanners consist of a console containing a computer and electronics, a video display screen and a transducer that is used to do the scanning. The transducer is a small hand-held device that resembles a microphone, attached to the scanner by a cord. Some exams may use different transducers (with different capabilities) during a single exam.

The ultrasound image is immediately visible on a video display screen that looks like a computer or television monitor.  A small amount of gel is put on the skin to allow the sound waves to best travel from the transducer to the examined area within the body and then back again. Ultrasound is an excellent modality for some areas of the body while other areas, especially the lungs, are poorly suited for ultrasound.

Ultrasound imaging is based on the same principles involved in the sonar used by bats, ships and fishermen. When a sound wave strikes an object, it bounces back, or echoes. By measuring these echo waves, it is possible to determine how far away the object is as well as the object’s size, shape and consistency (whether the object is solid or filled with fluid).

In medicine, ultrasound is used to detect changes in appearance, size or contour of organs, tissues, and vessels or to detect abnormal masses, such as tumors.

In an ultrasound examination, a transducer both sends the sound waves and receives the echoing waves. When the transducer is pressed against the skin, it directs small pulses of inaudible, high-frequency sound waves into the body. As the sound waves bounce off internal organs, fluids and tissues, the sensitive microphone in the transducer records tiny changes in the sound’s pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. One or more frames of the moving pictures are typically captured as still images. Short video loops of the images may also be saved.

For certain ultrasound examinations of the musculoskeletal system, the patient may be seated on an examination table or a swivel chair. For other ultrasound exams, the patient is positioned lying face-up or face-down on an examination table. The radiologist or sonographer may ask you to move the extremity being examined or may move it for you to evaluate the anatomy and function of the joint, muscle, ligament or tendon.

Most ultrasound studies of infants and children are performed with the child lying on his or her back on the examination table, but other positions may be required.

After you are positioned on the examination table, the physician/sonographer will apply a warm water-based gel to the area of the body being studied.

There is usually no discomfort from pressure as the transducer is pressed against the area being examined. However, if scanning is performed over an area of tenderness, you may feel pressure or minor pain from the transducer.

Ultrasound examinations are painless and easily tolerated by most patients.

Musculoskeletal ultrasound examination is usually completed within 15 to 30 minutes but may occasionally take longer.

When the examination is complete, you may be asked to dress and wait while the ultrasound images are reviewed. After an ultrasound examination, you should be able to resume your normal activities immediately.

A physician specifically trained to supervise and interpret these examinations, will analyze the images and send a signed report to your primary care physician, or to the physician or other healthcare provider who requested the exam.

Ultrasound images are typically used to help diagnose: 

Tendon tears or tendinitis of the rotator cuff in the shoulder
Achilles tendon in the ankle and other tendons throughout the body
Muscle tears, masses or fluid collections
ligament sprains or tears
inflammation or fluid (effusions) within the bursae and joints
early changes of rheumatoid arthritis
nerve entrapments such as carpal tunnel syndrome
benign and malignant soft tissue tumors
ganglion cysts and hernias
foreign bodies in the soft tissues (such as splinters or glass)
dislocations of the hip in infants
fluid in a painful hip joint in children
neck muscle abnormalities in infants with torticollis (neck twisting)
soft tissue masses (lumps/bumps) in children