Management of Those Pesky Chronic Painful Tendon Problems; A Look at one of the Newer Approaches
Jackins SE: University of Washington Medical Center , Seattle , WA , USA

Background and Purpose

Some of my most challenging patients are those with chronic tendon-related conditions, such as tennis elbow and shoulder tendonitis. In my experience, there is no one single treatment that manages these conditions well and I always have my radar up for new modalities or treatment techniques to assist in managing these conditions. I recently became aware of a soft tissue technique that uses “tools.” As I looked into this, even taking a course, I found that there are actually a number of sets of “tools” or “instruments” made by several companies, reflecting the philosophy and methods of those in each company.

Case Description

This case presentation is of 2 cases, in which these “tools” were utilized – one with chronic shoulder pain and the other with tennis elbow/lateral epicondylitis. It includes the information I learned about these tools – history (some of which appears to go way back), applications, and available research.


Each of the patients had had multiple types of therapy in the past – from other therapists in the community, as well as from myself. In both of these cases, the addition of the use of these tools appeared to make a significant, and positive, difference. Measures taken were particularly related to pain, using a pain scale for current level of pain and level of worst pain in past 24 hours. Changes were also recorded for range of motion, activity type, and activity level at several points in the process.


We are all interested in getting our patients better faster. There are many products in, or on the edge of, the physical and occupational therapy marketplace. Some of these include lasers, other types of rays, types of ointments, heating modalities, new types of ultrasound, new types of iontophoresis, taping types and techniques. These tools are another technique that may be helpful to add as an option.