Electromagnetic Stimulator of the Microcirculation  "ESTMC™ Tecnology by Human Tecar "

WHTcare Switzerland " Applications in Sports Medicine "

© Marc Michnowski - 23 av Niel 75017 Paris - France - marcophysio@yahoo.fr

Electromagnetic Stimulator of the Micro Circulation "

§  Uses an electromagnetic signal 485 Mhz (intermediate frequency radio wave) produced by a generator

§  Applied directly to human tissues without space propagation by two differents types of conducing electrodes

§  Mobilizes electrical charges into tissues and creates a deep high or low modification of the temperature and conseguently an increase of the microcirculation

§  For different therapeutical effects

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

RF used to treat tumour masses"

Leveen et al, 1976" creating hyperthermia in order to destroy

central cells (wich have less active metabolism and are less vascularized)

Ley et al, 1992" show central necrosis and reduction of

peripheral edema of carcinomatous mass suggested possibility to use RF for other tissues

Using RF in tissues subject to inflammatory reactions"

§  with appropriate proportions of intensity and time

§  to not reach temperature who leads to cellular necrosis observed in tumour therapy

§  1953 Lehmann: "40-45 °C have therapeutic effects in various pathological conditions ➜ NON-INVASIVE Therapeutic RadioFrequency

"

Other uses: dermatology and aesthetic"

§  Heat the deep dermis and subcutaneous tissue

§  Treat the sagging skin of face and body

§  Reduce local fat and cellulitis

§  Acne

§  Product of an electrostatic field and a magnetic field produced by an alternating electrical current.

§  Transport energy and is not perceptible by senses

§  All conductive structure subjected to electromagnetic wave will undergo an energy increase as an increase of the ion movements

§  Temperature increases where the wave condenses

Physical Principles. Electromagnetic wave."

§  Signal is trasmitted to the human body by 2 different electrodes

§  High impedance or capacitive (lympho dynamic or thermo dynamic)

§  Low impedance or resistive

§  A metal conductor sheet closes the circuit

The HCR 1001 generator of ESTMC™ Technology "

Electricity"

Capacitor: elementary electrical component constituted of two conductive frames (electrodes) separated by a dielectric polarizable insulator Property: to store opposite electrical charges on their frames by electrostatic effect Capacitive effect

High Impedance (Capacitive) effect"

Capacitor is made up of:

§  one frame - a metal electrode with an insulating layer placed on tissue surface

§  one other frame - the metal conductor sheet which closes the circuit with the human tissues as insulator

§  Charges tend to condense mainly around the insulated electrode

§  Energy tend to increase gradually around it with subconsequence increase 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.

§  The electrodes are constituted by:

§  inside different type of conductive metallic material, outside biocompatible insulating material applied with a technique of overlap.

§  The geometry : flat 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 fluidic components

High impedance electrodes Lympho or Thermo dynamic (Capacitive)"

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

•  Within the structures subjected to the radio frequency signal comprises a movement of ions

•  Where the waves condense (bones, ligaments, tendons …) energy increase, temperature and microcirculation too (if desired)

Low impedance electrode (Resistive):"

§  The RF signal produced by HCR 1001 is administered to the tissues through a manual therapy

§  The conductive electrolyte emulsion between electrodes and the skin reduces the skin resistance

§  hydrates tissues and facilitates electrode sliding

§  Facilitates a deep action

Technology’s actions"

Action on the tissue’s temperature either superficial or deep on a localized or larger area. HCR 1001 induces an important or very small temperature variation depending on the delivered intensity

Objectives: -  to increase the vasodilatation - to increase the blood microcirculation -  to increase the tissue metabolism -  to cause biological reactions - =>to stimulate mechanisms of repair

In combination with a manual therapy and in rehabilitation programs"

§  Increase extensibility of collagen tissue by the modification of viscosity

§  Reduce pain and release endorphins

§  Reduce muscle spasms and contractures

§  Help the reduction of edema and hemorrhagic collections

Studies"

Healing"

§  “Good orthopeadic health” is a state of balance of our systems

§  Under various aggression effects (intrinsec or extrinsec) trauma, over uses, sport training, ageing, fatigue, stress…

§  Balance changes ➞system

adaptations to new balance until a decompensation ➞ pathology ➞

inflammation ➞ healing process ➞ same or new system balance

Natural Healing Cascade "

Physiological response to aggression,

Necessary to lead to tissue reconstruction and healing

2 phases"

§  Vascular : vasodilatation and vascular permeability increase release of molecules, activation of proteines, secretion of chemical mediators

§  Cellular : local vasodilatation to increase blood flow to: # ## evacuate dead cells and toxins

bring necessary elements for reconstruction

§  Clinic : vasodilatation ➞ redness and heat aqueous fluid from blood plasma

by osmosis to tissues ➞ edema edema ➞ nerves compression ➞pain

# # "

Inflammation = usefull for healing

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 inflammation often necessary

SHM combines the action of : technologies products with functional ingredients special manual techniques Rehabilitation programs To assist therapist’s 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)"

Practical applications"

Trauma "

•  London 2012 , women pault vault qualification

•  Athlete felt acute pain on heel during impulse

•  Clinical exam :

pain on manual pressure of posterior and lateral heel area

pain on plantar fascias stretching / contraction

walking difficulties

Athlete wants to try to compete the olympic final 36 hours later

US (3h) : fat lesion with sub cutaneous edema "no visible strain on plantar fascias"

Treatment with ESTMC"

•  Low Impedance electrode application with high intensity on calf and popliteal area to :!

-  Create important temperature variation up the heel !

-  Stimulate blood flow increase, relax calf muscles and help drainage!

•  High Impedance electrode application with really low intensity on heel area to : !

Analgesie and drain edema!

Others : Ice applications / compressive bandage!

30 minutes treatment 3 times a day!

US after 36 hours : edema resorbtion"

conclusion"

•  Clinical exam :

Pressure pain was less

No pain during stretching / contraction / walking

Running 60 % result :

Treatment with SHM help for analgesic and edema resorbtion

No enough time for healing

Acute pathology : Achille’s tenosynovitis"""

Acute occuring during running or jumping

Pain and oedema

US ➞ oedema in sheath / fibre thickening or strains

Fonctionnal disability: fast walking / stairs / foot impulse

Clinical examination"

•  Tendon palpation to evaluate where is the most painfull area ( lateral, medial side, depth or superficial …) and oedema tonicity

•  Calf palpation to research muscle spasm : soleus +++

•  Evaluate the ankle, subtalar and foot join motions

•  Evaluate the stretch range before onset of pain

Preparation"

Mild application of lymphoarticular oil on popliteal area, on achilles tendon and on ankle and foot joins

application of thermoactivante oil on the calf muscles

➞ lymphatic stimulation and reduce resistances

application of dermopurifiante solution to cleansing the skin

Treatment

Objectives:" Reduce pain and oedema

1/ Thermodynamic High Impedance Electrode"

High intensity, cranially, on calf muscles and poplitéal area :

➞ Creating signifiant temperature difference between 2 areas

➞ Improving lymphatic drainage

➞ Increasing blood circulation in muscles to relief tensions and relax

➞ Application associated with massage and slow and soft stretching if possible

2/ Low Impedance Electrode "

Low intensity on tendon, paratenon, ankle, foot joints :

➞ Inducing a small increase in temperature

➞ Associated with massage (Cyriax) stretching or eccentric techniques

➞ Manual therapy for joint loss of mobility

3/ Convex Lymphodynamic High Impedance Electrode"

Low intensity"

➞ inducing a minimal temperature variation to activate lymphatic drainage

➞ mild massage to reduce space between tendon and sheath

Chronic pathologie: knee arthrosis"

Clinical examination"

§  Cartilage and meniscus degeneration of patellofemoral and/or tibiofemoral joint(s)

§  Beside inflammatory phase where pain can be severe if sub chondral achievement

§  Fibrosis synovial / flexum / ligament stifness

§  Thigh muscular stiffening

§  Muscle atrophy / loss of strengh and elasticity

Treatment "

Thermodynamic High Impedance"Electrode""High intensity on the thigh muscles for increasing blood flow to ➞ Reduce spasms ➞ Prepare to strecthing and

strenghtening

Low Impedance Electrode "

Low to medium intensity on the knee and caudally to:"➞ concentrate action on joint elements for flexibility ➞ prepare manual therapy treatment

§  Patellar movements §  Specific minor mouvements ➞ Followed by rehabilitation exercises

Conclusion "

•  ESTMC TM is a valuable tool to empower physiotherapist’s hands

•  Indicated for many orthopedics and sports pathology

•  Manual treatments depend on the specific training and experience of operator who stay the central actor of the therapeutic program

Merci"