Hello everyone my name is Dr. Jacobs, I’m a doctor of physical therapy and I’m also
the inventor of advanced soft tissue release, (ASTR specialty).
I am a cancer survivor and I used to suffer from chronic migraines, headaches, pain and
fatigue before I invented ASTR specialty.
Alright Chris tell me what’s going on with your elbow.
The problem is the tendonitis in my inner elbow.
I have pain when I use it for say curls or any kind of motion pulling up, stuff like
that.
How long has this been going on?
A little over a year and a half.
A year and a half?
Okay, can you tell me what kind of treatments you had before coming here.
I’ve done chiropractic.
I’ve done physical therapy.
I’ve had numerous cortisone shots.
How many cortisone shots?
About 5.
5?
Okay.
So how much pain do you feel there from 0-10?
About 6.
6.
What motion aggravates it?
Curls?
Curls or any kind of pulling.
Pushing up.
But curls mostly.
So let’s do the motion that aggravates it and tell me how much pain you have with that.
So right now it’s maybe about a 4.
Right when I pull right about here is when I feel it.
Where do you feel it?
In the inner elbow.
Inner elbow, okay.
So I’m actually going to take the range of motion for that limitation and then we’ll
do the treatment.
That’s not the best position for the range of motion.
Okay, I’ll come closer.
We’ll get the side view of the range of motion.
Bend your elbow.
Oh bend it.
So that’s when you feel it?
About right there.
About there.
Okay so this is about 120.
120 here.
Stretch your elbow.
How much pain do you feel there?
It’s tight.
So that’s minus 10.
Minus 10 and 120.
It’s localized there or is it going down?
No it’s right there.
So you’ve tried everything under the earth now.
120 flexion, extension minus 10.
Okay, let’s roll this up.
You feel pain here?
Where is the spot?
Right in here?
Over here.
Yeah, you feel that scar tissue?
That’s what it is?
Yeah that’s scar tissue.
You have more here too.
And you have it here.
Do you feel that bump?
Yeah, that’s tight.
That’s the scar tissue.
That’s scar tissue?
It should not have this like rock there.
I feel it there yeah.
And you have it here.
You have it all over.
So do you remember how you hurt your elbow?
I believe from doing curls.
A lot of overtraining?
Overtraining.
So it’s going to feel cold okay?
So that’s been going on for a year now, yeah?
Yeah.
Is that too much?
And did you have any other injuries?
What other medical history do you have?
Neck surgeries for neck fusion.
What levels?
C6 and C7.
You feel this bump here?
That’s the scar tissue.
Yeah, I have it all over.
Do you do a lot of typing?
No.
Yeah I really feel it there.
You feel it here?
Painful?
Make sure it’s not painful.
It’s nothing terrible.
So for it to heal you really need to break the scar tissue?
Yeah, the thing is you don’t want to feel pain when I’m breaking it.
There’s a fine line between breaking the scar tissue and creating scar tissue.
When you have trauma you’re starting the cycle again.
You have inflammation and proliferation.
I don’t want you to feel pain because that’s opposite of what we’re trying to do.
That’s where I disagree with the philosophy “No pain, no gain.”
If you feel pain, God gave us that pain as a signal, similar to a check engine light
for your car.
So when you get that signal you have 2 options.
One, you either cover the signal and you keep driving.
Or 2, fix it and the signal will disappear by itself.
Right.
So we don’t want to cause the pain.
We want to investigate why you have the pain, allieve it, and correct it.
Look here.
See this?
Yeah, See it.
That’s all scar tissue.
Remember this bump here that prevented you from moving?
You feel it now?
It’s starting to break up.
Yeah it’s moving.
Before it was stuck here.
It was not moving.
It’s going in just one straight line.
Before I was just stuck here.
Now I can go further.
That’s all the scar tissue.
See the line here?
I’m going to get here.
Is that too much here?
I had pain in the middle of the forearm and I was just treated in the one area it was
hurting.
Well when you understand the body, you know there’s referred pain and you know there’s
a fascia system.
There’s no beginning or end of it so for the treatment, you cannot just focus on here
because it’s compensating for something else.
So part of this could be causing this you think?
Yeah.
You see the scar tissue?
You have 2 muscles, in the front and in the back.
When one contracts, the other one should relax.
So if you don’t have movement in both of them it can affect the contraction and relaxation.
You have to have those muscles work synergistically.
So I’m going to dig in.
You can come this way.
That’s hurting right there.
Sorry.
Feel that here?
Yeah.
You can hear it actually.
You can hear the scar tissue.
Feel that?
Here.
Do you hear that?
Say yes.
All of these muscles are connected to your elbow.
I think you had a lot of repetitive strain injuries.
A lot of scar tissue.
Accidents of trauma usually cause it.
So I want you to turn out.
Make sure it’s not painful.
It’s not painful.
Okay.
Make sure you breathe okay?
We want you to breathe here okay.
Okay.
Lift it up.
Why do you think I got it more on the right than the left?
Probably because of repetitive motion.
Using this muscle more?
Yeah.
Right there.
Too much?
No.
I feel the scar tissue.
Do you feel it?
No.
The correct answer is yes.
Starting to loosen now but you feel all that?
Painful?
No.
Let’s try it again.
It feels better.
0-10?
I don’t really know.
I don’t feel pain.
Feels even looser.
Yeah, that’s when the scar tissue breaks down so the knot releases.
Your pain is because your muscle cannot fully contract because the scar tissue is in the
way.
Extend it again.
Let’s do the range of motion.
Remember the numbers?
120 and minus 10.
Will that work on the leg as well?
Yeah.
For example you had the fusion in your neck so as part of your body’s healing, you have
to have scar tissue or it’s going to be an open wound.
Straighten your elbow.
That’s 0.
That’s 10.
Bend.
That was 120, now can you see it?
It’s 132.
You see that?
Any pain or discomfort.
No it works great.
I like it.
It’s better than getting a cortisone shot.
It’s only temporary, I’m looking for a permanent solution.
Yeah, we have to work on the scar tissue.
Especially when you have golfer’s elbow because that’s usually when you have a lot
of scar tissue that restricts the range of motion.
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