Hey everybody! Today's post was written by my good friend Yuya Mukaihara. He was telling me about some success he was having using some Rocktape samples that I had given him so I asked him to write up one of the cases for my blog. So without further adou here it is:
I am one of Adam's classmates at Illinois State University and I work at a local HS. I am a Certified Athletic Trainer with CSCS, and NSCA-CT credentials. I have Graston Technique and Technica Gavilan IASTM certifications. I have also taken some PRI courses--Myokinematic Restoration, Postural Respiration, CCM, and I just finished Impingement & Instability this weekend. I use manual therapy, PRI, and corrective exercises in my practice but this case was an acute episode of left torticollis. So, I mostly used manual therapy to manage this case.
On Monday, a basketball player came into the ATR 10 minutes before his practice started, c/o of left neck pain and tightness that resulted in his inability to look left. It was a day before his playoff game and he was needed in practice because he was one of better players on the team.
- Active left cervical rotation was limited and was about 15deg with pain. Full right rotation.
- Active left side bending was also limited and was about 10 deg with pain. Full side bending.
- Palpable tightness over left cervical extensors, upper trap and levetor scapula compared to right. He c/o pain with palpation of these muscles.
He had to go to the practice so I only had 10 minutes to treat him. I began with Muscle Energy Technique(MET) reciprocal inhibition on left rotation and side bending. I didn't target specific muscle but general motions. I had him to rotate to the right from neutral and side bend to right from neutral to gain motions on the left side. There was not much improvement but he had to go to the practice.
15mins later, the player came back to me because he could not play due to pain. So, now I had a little bit more time to treat the athlete. I had him lay supine and checked his passive ROM. Passive left cervical rotation and sidebending caused pain as did active.
I used strain-counterstrain on his left upper trap and levator scapulae because I suspected muscle spindle hyperactivity. After resetting the mechanoreceptors, he had increased left cervical rotation and side bending.
After finding the most tender spot I started counting time, I slowly increased left rotation and stayed there for about 20-30sec and then increased a little further and repeated. At the same time, I added some sidebending a little by little to increase as well.
After this technique, his active left rotation was about 80% and sidebending was about 30% of his right rotation and sidebending. (active left cervical rotation about 75deg and 25deg sidebend).
Then, I performed a 1st rib MET on the left to inhibit his left scalenes and to increase left sidebending.
Fortunately, I had a sample of Rocktape from Adam, so I put the player’s neck into flexion, right rotation and right sidebending to place his left neck muscles on stretch then applied two strips of Rocktape.
One from the occiput to about T3 level and the other strip from the mastoid process to scapular spine. My intension to use Rocktape was to inhibit the hyperactive or hypertonic muscles. I had some personal experience of inhibiting hypertonic muscle with Rocktape previously.
After those interventions during 15 mins of treatment, he was still limited to left sidebending with pain, but was able to complete the practice with team. He ended up keeping the Rocktape on for the next four days.
Tuesday, the day of the playoff game, he returned with full left cervical rotation without pain and improvement on left sidebending, which 80% of right side and with minor pain. On that day, I used MET for left 1st rib, upper trap, and levator scapulae. He played the game without any complaints and we won the game.
Wednesday, he had no limitation on both left rotation and sidebending without pain. On that day, I used MET for 1st rib only. No deficit with RROM for flexion, extension, both rotation, and both sidebending. He completed a practice without any complaint.
Thursday, full return to play without treatment. He completed a practice without any complaints.
In conclusion, Rocktape was a lifesaver for this athlete, his team, and me. Without the tape, I think he would continued to suffer from his tight and painful neck which could have affected the dynamics of our entire team.
I think the tape maintained immediate effects of the strain-couterstrain technique and even moreso enhanced inhibition of those hypertonic muscles that caused pain. I was happy that he responded so quickly and positively to the intervention thus allowing him to return to play very quickly