1. Synergistic Healthcare Methodology (SHM) ! by Human Tecar! As part of treatment for ITB syndrome ! Marc Michnowski - 23 av Niel 75017 Paris - France - marcophysio@yahoo.fr

2. SHM combines the action of technologies Electromagnetic Stimulator of the Microcirculation, PhysioTT products with functional ingredients special manual techniques and rehabilitation programsTo assist physiotherapist and give their hands power to help tissues to: regain a new balance initially lost! create other balance if it permanently lost ! (rheumatology)! restore a balance before pathology occurring ! (prevention)! 3. Synergistic Healthcare Methodology! Use of this technique since 10 years in high level sports (football, tennis, motorsports, athletics.) has helped us to develop a method of treatment called SHM Athletes need fast recovery, precision and security from physiotherapy to treat and prevent imbalances SHM helps us to accelerate bio repairing processes, control pain without inhibiting inammation (often necessary) 4. Electromagnetic Stimulator of the Micro Circulation !Uses an electromagnetic signal 485 Mhz (intermediate frequency radio wave) produced by a generatorApplied directly to human tissues without space propagation by two different types of conducing electrodesMobilizes electrical charges into tissues and creates a deep high or low modication of the temperature For different therapeutical effects 5. Using RadioFrequency (RF) in medicine: a bit of history! Introduced in 1920: Bovie and Gusting for electro cauterization 1950: in neuro surgery to create localized lesions of the central nervous system 1960: in cardiac surgery to remove nodules 6. RF used to treat tumour masses!Leveen et al, 1976! creating hyperthermia in order to destroy central cells (which have less active metabolism and are less vascularized)Ley et al, 1992! show central necrosis and reduction of peripheral oedema of carcinomatous mass suggested possibility to use RF for other tissues 7. Using RF in tissues subject to inammatory reactions! with appropriate proportions of intensity and timenot to reach temperature who leads to cellular necrosis observed in tumour therapy ! 1953 Lehmann: ! 40-45 C have therapeutical effects in various pathological conditions NON-INVASIVE Therapeutic RadioFrequency 8. Physical Principles. Electromagnetic wave.!Product of an electrostatic eld and a magnetic eld produced by an alternating electrical current. Transportenergy and is not perceptible by sensesAll conductive structure subjected to electromagnetic waves will undergo an energy increase as an increase of the ion movements Temperatureincreases where the wave condenses 9. The HCR 1001 generator of ESTMC Technology ! Signal is transmitted to the human body by 2 different electrodesHigh impedance or capacitive (lympho dynamic or thermo dynamic)Low impedance or resistiveA metal conductor sheet closes the circuit 10. Electricity!Capacitor: elementary electrical componentconstituted of two conductive frames (electrodes) covered by an dielectric polarizable insulator Property: to store opposite electrical charges on their frames by electrostatic effect Capacitive effect 11. High Impedance (Capacitive) effect!Capacitor is made up of: one frame - a metal electrode with an insulating layer placed on tissue surfaceone other frame - the metal conductor sheet which closes the circuit with the human tissues as insulator 12. Charges tend to condense mainly around the insulated electrodeEnergy tends to increase gradually around it with subconsequent increase of the microcirculaton and temperature (if desidered)The energy depends on the voltage applied by the generator (Volts) and the size of the electrode. The movement changes the endothermic response. 13. High impedance electrodes Lympho or Thermo dynamic (Capacitive)! The electrodes are constituted by: Inside : different type of conductive metallic material, outside : biocompatible insulating material applied with a technique of overlap.The geometry : at or convex Two different models:Lymphodynamic : allows action to low intensity and causes small temperature variations lymphatic system Thermodynamic : allows action to high intensity and causes higher temperature variations other uidic components 14. Electrical Resistance!Property of a conductive material to slow down the passage of an electrical current Responsible for energy dissipation as heat Certain materials are offering more or less resistance Resistive effect 15. Low impedance electrode (Resistive):! Withinthe structures subjected to the radio frequency signal comprises a movement of ions Wherethe waves condense (bone, ligaments tendons) , energy increases and then microcirculation and temperature (if desired) 16. The RF signal produced by HCR 1001 is administered to the tissues through a manual therapyThe conductive electrolyte emulsion between electrodes and the skin reduces the skin resistancehydrates tissues and facilitates the electrode sliding facilitates a deep action 17. Technologys actions! Action on the tissues temperature either supercial or deep in a localized or larger areaHCR 1001 induces an important or a very small temperature variation depending on the delivered intensityObjectives:- to increase the vasodilatation- to increase the blood microcirculation - to increase the tissue metabolism- to cause biological reactions -=> to stimulate mechanisms of repair 18. In combination with a manual therapy and in rehabilitation programs! Increase extensibility of collagen tissue by the modication of viscosityReduce pain and release endorphinsReduce muscle spasms and contractures Help the reduction of edema and hemorrhagic collections 19. Practical application for ITB syndrome! 20. Main mechanism for runners : valgus / varus! 21. Valgus! Over contractions of the tensor fasciae latae and gluteus medius and maximus to control the medial collapse of the knee. 22. Varus! Over tractions on ITB with knee lateral shear stress during lateral foot ground attack ! 23. Associated parameters! Oblic pelvisDifferences in leg lengthPosterior muscular chain retractionRunning with back positionof the shoulders 24. Treatment Decrease muscle tone and increase passive structure elasticity around low back, hip, knee and foot joints to help: Manual harmonisation of joint mobility Prepare for stretchingIncrease muscular blood ow to prepare strengtheningIncrease temperature around ITB conict zoneDrain locally without temperature increase 25. Hip ! Using High Impedance Electrode Thermo dynamic with high intensity on gluteal muscles to reduce spasms 26. Using specic manual therapy to relax gluteal muscles 27. Using Low Impedance Electrode with high intensity " together or separated with manual therapy" to increase hip rotations 28. On Ilio Tibial Bandelet! using a Low Impedance Electrode with High Intensity to reduce tone associated with massage techniques 29. On knee, ankle and foot Joints" using Low Impedance Electrode with Medium Intensity " associated with manual Therapy to restore specic movements 30. in Inammatory area " using convex High Impedance Lymphodynamic Electrode" and Low Intensity to increase drainage and decrease edema 31. Conclusion ! ESTMC TMis a valuable tool to empower physiotherapists hands Indicatedfor many orthopedic and sport pathologies Manualtreatments depend on the specic training and experience of operator who stays the central actor of the therapeutical program 32. Merci!