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Welcome to The Dr. JJ Thomas Podcast! Here I'll be talking all things physical therapy, raw and unplugged, giving you the unfiltered insights you've been searching for in your cash-based physical therapy business. If you're caught in the grind of the traditional model, swamped with paperwork, or feeling like you're not reaching your full potential as a physical therapist, this podcast was created just for you.
This is really meant to just be a device to enhance the overall clinicians, expertise and knowledge. So, so many times I think, you know, seeing it as a patient and then also now, you know, leading other clinicians, oftentimes a lot of modalities are kind of you have to use it this way. You know, I wanna treat a shoulder. This is the protocol.
Dr JJ Thomas:Boom. Boom. Boom. Yeah.
Kevin Sheehan:You know, you're doing that across the board.
Dr JJ Thomas:Welcome to
Kevin Sheehan:the doctor JJ Thomas podcast.
Dr JJ Thomas:Hey, everybody. Welcome to the doctor JJ Thomas podcast. I'm JJ Thomas. Today, we have Kevin with us. We had Kevin on the last episode, but, but Kevin is our superstar, win back rep.
Dr JJ Thomas:So we have the win back machine here. Kevin, thanks for coming. Thank you for having me. It's Kevin Schiam.
Kevin Sheehan:Yes.
Dr JJ Thomas:Okay. That's
Kevin Sheehan:alright. Kevin win back.
Dr JJ Thomas:I know. I told you guys in the last episode. He's in my phone as Kevin win back, and I knew it was a good Irish last name, but I I couldn't remember right away. Anyway, Kevin is our win back rep, and that does not I'm sure you have a different role, like, title through win back. Couple.
Dr JJ Thomas:Yeah. Yeah. Because he's everywhere. I'm like, Kevin is like, where's Waldo? Like, I'm like, Kevin.
Dr JJ Thomas:He's like, I'm in, you know, another country or whatever. So, do you wanna talk about your title at win back?
Kevin Sheehan:Yeah. So, yeah. I've been I was actually employee number 1 here in the US. So my boss, Matthew, reached out to, my other therapist, actually. So I was introduced to all the technology first as a patient, years ago after Winbach got their approval here in the states.
Kevin Sheehan:Was treated at Johns Hopkins for a couple of surgeries and, you know, when I went in there this was something I had never seen before and I was kinda curious and picked my therapist brain there and he said, yes, new piece of technology out of France that that we're the first place here in the US to have it. I was actually one of the first patients I think think, too, in the US to be treated with it.
Dr JJ Thomas:Can I give them a little more background on you? Kevin played Devon Lacrosse at University of Delaware, total stud athlete and good and the brains behind it. So, like, that I just have to give them a little background that, you know, when I've worked I've worked with a lot of reps in different companies, in different machines, and devices, and whatever, and Kevin is so knowledgeable, like, you know, not like a typical rep. I mean, I think, yeah, between experiential learning through your own PT, and then as you said, being day 1 with the company, I think you just you've learned so much, and and you teach me so much still. Like, he was just showing me other things that I'm like, this is gonna be fun.
Dr JJ Thomas:So anyway Yeah.
Kevin Sheehan:No. Thank you. So, yeah, I I really was curious because this was one of the things I I ended up there about 2 years into my rehab journey and a year after my my major surgery and wasn't getting a lot of results with other things, and I started to feel a lot better with this. And, obviously, right, it's a combination of being in the hands of skilled clinician, which
Dr JJ Thomas:is
Kevin Sheehan:at Winbach something we really take pride in is working with those clinicians. And, yeah, I just started to feel better. And I I really kinda dove into this. And all the free time that I had, I've started to research what it was and, you know, flash forward a couple years, my boss went to open a US office and started with the company. So, yeah, few different roles, but so I cover the the East Coast, worked with, you know, clinicians like JJ from Maine all the way down to Maryland.
Kevin Sheehan:And then I'm also the national director of
Dr JJ Thomas:our sports segment. So I work with all of our
Kevin Sheehan:professional collegiate teams who are using the equipment. So for me, right, that's kind of in my wheelhouse being in an athletic training room and talking athletic trainers. So, it it really is neat. No day is the same with this job, and it's really cool because, we'll talk about it in a little bit, but Winvac has really done a great job of making the device fit into your clinical expertise and not the other way around. So, you know, every time I meet with the clinician, the the conversation is always different.
Kevin Sheehan:How they're using it is always different. But, yeah.
Dr JJ Thomas:Yeah. And that's I will say that now, like, right off the bat, my experience with Winback, one of the reasons so, okay, so I should give my experience of how I got introduced to Winback. Yeah. So I tore my ACL a little over 2 years ago now, now, and my friend Doug Adams, who owns RunDNA, and, Omega Project PT, and he's an amazing clinician also, when I tore my ACL, Eric was my only PT working here at the time, I didn't have rest of the team yet, and, and Eric was out of town, and I was a week before surgery, and I was like, I'm I'm I wanna make sure I have the best range of motion going into surgery. Mhmm.
Dr JJ Thomas:So I called Doug, and I'm like, Doug, can I come down to your place in Delaware and get a little bit of treatment, try to get my range as good as possible before surgery? He said, absolutely. So I show up, and he puts this thing on me, and I felt so much better. I had 2 sessions it only took 2 sessions with Doug where I was like, I need to buy one of these for myself and my my clinic, and then next thing you know Yep. That was how I met you and Matthew.
Dr JJ Thomas:But but since then, even more than that, like, besides the fact that you guys have such a strong education piece, so they have Winbeck Academy for clinicians, which has protocols on there and education and training. As I said, their reps are very knowledgeable, but in addition, they're constantly upgrading. Like it seems like every time I talk to you almost, they're working on another update for another, and it's and they're good pieces. Like the minute I might think, oh, we benefit from such and such addition, they they have it, it's almost done, it's in the works. So so it's just a company that obviously cares about quality and cares about, giving the best care to their patients.
Dr JJ Thomas:So, that's been really, really good from my end.
Kevin Sheehan:Yeah. I mean, so when when I started with the company, you know, early on, you're kinda learning the ins and outs. And for us, we're we're a global company based out of France. We have, you know, headquarters all throughout the world and the one here in the United States is up in New York. And right on kinda learning the company culture and and the first thing that really stuck out is this is really meant to just be a device to enhance the overall clinicians, expertise and knowledge.
Kevin Sheehan:So, so many times I think, you know, seeing it as a patient and then also now, you know, leading other clinicians, oftentimes a lot of modalities are kind of you have to use it this way. You know, I wanna treat a shoulder. This is the protocol. Do boom, boom, boom.
Dr JJ Thomas:Yeah.
Kevin Sheehan:You know, you're doing that across the board. With WinVac, they they really took, kinda opposite approach where the the first thing in mind was the clinician and then the the technology kind of followed suit. So, Chris, who created the the device years ago, over in France, really was asking a lot of clinical users who are using other tech art devices what were some things that they wish they could do. And, you know, some of the big ones that came up were, you know, combining this with manual therapy, combining it with functional movement and rehabilitation, and also just, you know, looking for ways to take what they're already doing with their patients
Dr JJ Thomas:Yeah.
Kevin Sheehan:And supplement this into it. So, that's kind of the the big thing with us is we always say, right, WinVac is really just we're trying to add another tool in your tool belt for for clinical, treatments. We're not trying to tell you how to treat people.
Dr JJ Thomas:Right.
Kevin Sheehan:And we're not trying to change what you do. Right? Because there's, only one of you here. Right? And and people are coming here to see you not for a machine.
Dr JJ Thomas:Yeah.
Kevin Sheehan:But,
Dr JJ Thomas:but that is how I would describe it. More like an enhancement. Like I've described it to other clinicians, kind of like the Mario mushroom thing. It's like it kind of powers you up. So like he said, we just did an evaluation on Kevin.
Dr JJ Thomas:We picked some areas that I thought were important to treat, I did some wind back work, and, you know, 5 to 7 minutes of a little wind back work with the massage that I was already doing, and his movement was almost completely clean even without any needling. So it is, it really does enhance, it's cool.
Kevin Sheehan:Yeah. So it's I I think too one of the unique things when I started the company, it's, you know, one of the things was, like, with the name Winback, I'm not
Dr JJ Thomas:Oh, yeah.
Kevin Sheehan:Not really sure where where that comes from. It's not a French Yeah. French name. Yeah. And it's funny.
Kevin Sheehan:So Chris, who started the company, was actually coming to the US for something and was reading, I think it was the New York Times, one of those newspapers. And, head, article on the sports page was about, championship runner who had lost, you know, his champion status, due to an injury and came back and won back.
Dr JJ Thomas:Are you kidding me?
Kevin Sheehan:Won back, you know, his championship, title, if you will. So he was like, oh, it's a great name. Win back. And so the the whole premise around the company, right, is that we, you know, everybody, every patient that comes in here is trying to get back to some portion of their life, whether it's, you know, athletes returning to sport,
Dr JJ Thomas:whether it's,
Kevin Sheehan:you know, people living pain free so they can play with their kids or whatever it may be.
Dr JJ Thomas:Or their dog.
Kevin Sheehan:Right. Or their dog. So, for for the company, that's where we kinda took that and and really embraced that name because we wanna help, you know, people win back their lives, their well-being
Dr JJ Thomas:That is awesome. Get back what they want. I can't believe that's the first time I'm hearing that story. But it's funny because I've had patients say to me, like, we'll use the win back on you. And and they've heard win back and like, when they hadn't been exposed to it yet and thought that I was saying it was probably after needling.
Dr JJ Thomas:Like, I'm gonna win you back. Yeah. Like, I'm gonna win them back. So I'll be happy to tell them that is maybe the second meaning. That's cool.
Dr JJ Thomas:What about let's talk about tech therapy a little bit.
Kevin Sheehan:Yeah. So tech art therapy, it's funny because it's a pretty new modality here in the United States, but it's actually been around for over a 100 years. So the concept of using, you know, radio frequency to stimulate healing in the body has been around since the late 1800s. And, you know, as most things in Europe, they kinda started to play with different frequency ranges. And, you know, into the the mid nineties and late nineties, they kinda formed that a range of 1.3 megahertz to around 200 or 300 kilohertz depending on who you ask.
Kevin Sheehan:Right, is gonna increase the permeability of the cell. So we're able to really flush toxins out, get nutrients back into the cell, and kinda restore the body's cellular ability to heal itself. And as you know, right, that's kind of the building blocks in the foundation of healing. So, for us, we we kinda took that idea and really wanted to, again, make a device that covered that whole frequency range. Uh-huh.
Kevin Sheehan:But 2, also allowed you to facilitate that process right at the dermis and epidermis all the way down into bones, tendons, and joints. Because whether it's, you know, we're managing scar tissue from a knee replacement 10 years ago or we're looking at someone who's about to have, you know, total knee replacement, and we wanna try to get them the best that they can going into it.
Dr JJ Thomas:Or just had it.
Kevin Sheehan:Or just had it.
Dr JJ Thomas:Because Yeah.
Kevin Sheehan:Yeah. So really the the cool thing with this is I tell everyone it's not a sales pitch, but 9 out of 10 people are candidates for this because of the wide range of conditions you
Dr JJ Thomas:see. And that's what I was just gonna say. Like, Winbach really did, I think what they did was they took that foundational knowledge between of of tech of electrical current Yep. And what it can do at high frequencies for the body on the cellular level, and then like you said, they had the clinicians in mind, it's very obvious through the, basically through the features that it has is what I want to say, because it can be used, you can change not just the type of frequency, but also the material that we use, and we're going to show you this through a demo with Shannon in a little bit, you guys. The material that you're conducting the frequency with will change the depth, Right?
Dr JJ Thomas:But they've also made the intensity changeable so that we can use it and have a low, like, a low thermal effect for those that are post operative, and we still want the cellular changes, but we don't want to overheat or overstress the tissue from a metabolic standpoint. Or we can if we have old scar tissue or old chronic condition where we really wanna heat the tissue and get more blood flow and get more neovascularization, then we can do that too. So Exactly. Yeah.
Kevin Sheehan:That's the the big thing with us too when designing the device and kind of educating everyone on it is, right? I mean, there's never gonna be something that does everything perfectly. But when you're looking at other modalities, especially, you know, clinicians who might be looking to bring in their first piece of technology, for us we wanted something again that's gonna touch a lot of your bases and and 2, provide a really comfortable patient experience. And I'm sure you can speak to this.
Dr JJ Thomas:Yeah.
Kevin Sheehan:This is, you know, your shock waves and other things they do great great outcomes and get great results for your patients, but they can be uncomfortable at times or I say they hurt so good, you know, because you're eliciting a different response in the body. With this, you know, our kind of tag on is better, faster, gentler because it really is that comfortable, gentle patient experience.
Dr JJ Thomas:Yeah. It really is. Should we show them?
Kevin Sheehan:Absolutely.
Dr JJ Thomas:Alright. Shannon, you wanna come over? Alright. So, Kevin, why don't you come around with me? We're gonna actually put Shannon on the table.
Dr JJ Thomas:Perfect. And then we're not gonna do a movement testing right now. I'm literally just gonna show them the features. Yes. It is like a cooking class.
Dr JJ Thomas:Come on over, Shannon. You're gonna lie on your back, and I'm gonna do everything from this side. That's okay. Right? You can see.
Dr JJ Thomas:Alright. So because it's electrical current, you guys, we we need a ground of of some sort. And, so for clinicians that are already using Windback, this may help you. I know when I was first starting to use Windback, a lot of times I was calling Kevin like just with some of the basic principles, and essentially the handpiece current is going to go to the ground for the most part. So that's something to remember.
Dr JJ Thomas:It's going to take the most direct path that it can. So that's something to remember when you're deciding what tissue you want to treat. For instance, if I want to treat, let's say I want to treat, Shannon had a quad strain that I want to really work on, then that's gonna change what, all kinds of different things. We're gonna it's gonna change. The head that I use might change.
Dr JJ Thomas:The intensity that I use might change. Where I put the ground plate might change. Let me just get a towel to support
Kevin Sheehan:What are you treating?
Dr JJ Thomas:Or So I'm gonna literally show, like, all different things, probably on the quad, but I might go down to here as well. Just I was thinking mostly light because it's easier to It's easier to see and then Yeah.
Kevin Sheehan:Everything in response.
Dr JJ Thomas:I could, at some point, flip her if it's easier so I can be on that side, but then I have to move all that.
Kevin Sheehan:Yeah. Yeah. Yeah.
Dr JJ Thomas:Okay. So relax, yeah. So, we good? So I just took a towel just to make sure the ground plate's in good contact because, as I said, like, the the electrical current's gonna transfer from the head to the ground contact plate, and if the contact plate has less surface area than the head, then that may confuse where the current's going, essentially, right? So if I wanna treat like a quad strain on Shannon, I'm gonna definitely choose the the the head with the cover on it because the head with the cover on it is gonna sort of it's called the capacitive head, but because it has a cover on it, essentially it resists some of the electrical current going through, which makes it hit more of a surface area than if I do the metal head, which looks like this.
Kevin Sheehan:Yeah. So yeah. Absolutely. So the devices we're using, like I said, kind of a frequency of our spectrum of frequency. So we're using, 1 megahertz setting, 503100.
Kevin Sheehan:With the capacitive, we're gonna be using a a 500 or 300 kilohertz frequency range. But what's nice is there is, you know, a ceramic coating to that applicator. So it's gonna keep the the metabolic action relatively superficial. So about 2 to 5 centimeters to affect changes in tissue with more water content. So again, with like JJ said, if we're coming back to muscle streams, this is really where we wanna keep it relatively local to that muscle.
Dr JJ Thomas:Okay. Yeah. So if we so if we wanna work on a, on superficial and like soft tissue that's going to have more water content, then the covered head is going to be the way to go. We have 2 units here because I said they're the best company on earth. I'm sorry I'm not being salesy, but we have the back 4, which is has 2 handpiece options plus the ground plate.
Dr JJ Thomas:The back 3 has the 1. So when I'm using the back 3, I don't always have the option to do both, but I can also use the metal head here, which is gonna get me the deeper tissues, targeting more, like, more resistive tissues like bone, maybe scarred down areas, maybe a scarred down, like, or entrapped nerve area. So if if this is a chronic injury for sure, then we can hit all the all the areas at once with the ground plate underneath. Yep.
Kevin Sheehan:Yeah? And so the coming to that point, so TEC R therapy is an acronym. It stands for the transfer of energy capacitive, which is the blackhead, and resistive, which is the silverhead. You know, our company had a little fun with this tagline, but most devices out there are really tech or with an o because you're only using capacitive OR resistive. So with the BAT4, you know, we're kind of the 1st TechR device out there because by having the 2 channels, and as JJ is showing, you can really use the capacitive and the resistive at the same time.
Kevin Sheehan:So the clinical benefit is, right, we're able to target both pathologies, superficial and deep, simultaneously. So especially if we're trying to maximize our time, it allows us to, you know, take what would maybe a 10 minute treatment, and now I can condense it down to 5, and it frees me up to now do some other things. Right?
Dr JJ Thomas:So Exactly. Exactly. And we'll talk about this later, but, like, you and I were talking about some of the mobile options. I wanna show that in a little bit. But for this scenario, what I was hoping to do is kinda paint a picture for clinicians out there who wanna know, like, scenarios where they may use the wind back or ones who already have the wind back, ways they can utilize it.
Dr JJ Thomas:So because I know that was one of the learning curves I had in the beginning. Mhmm. So for instance, let's say if Shannon was an acute injury, like an acute pull, we may not wanna get a whole ton of heat in that for like, I'm talking a dent within the 1st 3 days of injury of a of a of a not even a pull, more of a tear, then we wouldn't necessarily want to get a high thermal effect. We really just wanna flush out the inflammation, support the cellular healing, and and reproduction of that muscle tissue. So in that case, we would keep this, the CET and the RET down to a pretty low, like, 10 or 20%.
Dr JJ Thomas:The reason I wanted to highlight this in particular is because, you know, in case you hadn't noticed, I'm kind of like a for the most part, I'm a recovering all or nothing kinda girl. Mhmm. And I think when I first had Winback, I had a hard time recognizing the value of the low percentages.
Kevin Sheehan:Yeah.
Dr JJ Thomas:It took me a long time to be like, okay. It's not that more is always better. It's that it's really like we wanna match the right scenario to the to to the right scenario.
Kevin Sheehan:Yep. Right? Exactly. And so we see this a lot, especially in the the sportsmen side of the things that we work with. Right?
Kevin Sheehan:You're seeing those inflamed ankle sprains, things like
Dr JJ Thomas:that. Yes.
Kevin Sheehan:Where we wanna let the body handle that inflammatory process and not draw more fluid to the area, which of course, right, the heat with this device is is all endogenous. So, right, if you're getting an increased heating sensation, that means we're pulling more cellular metabolic activity and oftentimes more blood flow to that tissue.
Dr JJ Thomas:Mhmm.
Kevin Sheehan:So to help with those early on stages and really decreasing the inflammation, is really great. And it also comes back to, especially when we're thinking about more resistant tissue, if it was an ankle sprain, for instance, right? I could work locally and I'd put that grounding plate all the way on Shannon's back because now I'm sending fluid all the way out of the leg since it's traveling from the foot to the back. So you can see really, really early on, those decreases in inflammation, which is right gonna allow you to get into your ranges of motion and some strengthening a lot faster. So that's why We can do that.
Kevin Sheehan:Yeah. When we see, you know, typically a 2 times faster recovery rate for most musculoskeletal conditions, that's why is because, you know, we're able to jump, start, and get on top of things right away.
Dr JJ Thomas:So, like, on that note, if we talk about an ankle sprain Mhmm. And we're talking about swelling Yeah. There's also, like, the lymphatic piece to this Yeah. Which is so cool. And that's mostly the BOCK 4 has that.
Dr JJ Thomas:Right? I don't think the 3 has that. And so there's actually a drain protocol on on the BOCK 4 that we use, not just for things like ankle sprains and post op knee stuff, but even, like, a lot of, pelvic floor issues, women postpartum, women really chronic postpartum even, who still just have that, like, difficulty getting that kind of lymphatic flow going. Right. Absolutely.
Dr JJ Thomas:That's been one of our favorite features of that's been one of our favorite features of the bach 4.
Kevin Sheehan:Yeah. No. It's great. I mean, it's kind of funny. Every time I feel like Jay just said earlier, when you start to see new people, the the company is always kind of forward thinking and just conditions and ways to improve some of those outcomes.
Kevin Sheehan:So when this first came out, the drainage function wasn't on there.
Dr JJ Thomas:And then,
Kevin Sheehan:right, they started to really think about ways to play on the lymphatic system and, you know, decrease that inflammation. So, they came out with those protocols and yeah.
Dr JJ Thomas:Yeah. Yeah. It's been awesome. So, so good. So so that's the that's, like, the low 10%.
Dr JJ Thomas:If we had a chronic if we had a chronic condition and we really wanted to keep that tissue, let's say let's say a different scenario is somebody who had, you know, a knee injury and or maybe a arthritic knee, and they had an injury or even a knee replacement, like like, 8 years ago, and they just never got their range of motion back, and now it's manifesting into back pain Mhmm. Or hip pain, or they're getting other injuries because pain, or they're getting other injuries because this knee is just really restricting them, then I might crank that baby up to, like, 40 or 50, depending on the person. Remember, every person's gonna every person, depending on their adipose tissue and muscle tissue and whatever, is gonna tolerate the percentages differently, so you do still have to get feedback from them, but closer to a 40 to 50, maybe even higher if they can tolerate a percentage.
Kevin Sheehan:Absolutely.
Dr JJ Thomas:Right? And I will say, I think actually we should pause and, let's show it in sitting so we can do some, like, movement with it, because I think this is kinda cool. So just sit off the edge, yeah. Yeah, so the other option you can do, like Kevin said, like, you can still be your creative self as a therapist and combine goals, I would say, to make your treatment most effective. So we can also, we have the ground plate under Shannon's thigh, and so Shannon was that scenario where she's got old, old chronic stuff, we have this cranked up to like 40 or 50, and we have the capacitive and the resistive, so we're gonna get some more superficial tissue, but we're also gonna get the deeper tissue.
Dr JJ Thomas:And then if we can decide to have the joint open here and work at the joint a little bit, but we can also, if we wanna say focus on the quad more, I can have her do some knee extension with this. So now we get motion, and now that does also change the resistance of the tissue. Right? Yeah. So it will change the way, from what I understand, Kevin, tell me if I'm right or not, but when you now increase muscle activation under the heads of the of the handpieces, you're gonna get a little bit of change in resistance.
Dr JJ Thomas:So we could so, essentially, the muscle tissue is a little denser at this point. Right? So Correct. We can prioritize a little bit more muscle work here. Yeah.
Kevin Sheehan:And the nice thing too is, yeah, come kind of coming back to that. So TEC are they're already drawn towards resistance in the body. So if you have really healthy tissue, it's going to conduct pretty efficiently.
Dr JJ Thomas:Mhmm. So
Kevin Sheehan:your thermal sensations aren't going to be as high because everything's is able to move to and from through that tissue pretty easily. When you increase the resistance, whether it be, right, scar tissue, damaged tissue, or in this case right now we're kind of mechanically creating it with that muscle contraction, we're able to also now isolate and target the current more specifically into the parts of the muscle we're activating. And so we'll get to it in a little bit too, but around that concept, right, some of the innovation with the company was for the people that have a hard time activating or even loading, we also built in that that muscle stim feature to
Dr JJ Thomas:be able to stimulate
Kevin Sheehan:too. Yeah. Yeah.
Dr JJ Thomas:I was just I was actually just heading there so you're reading my mind. Yeah. So there's so one of the added things that they've had since I've been using it, I think, is the addition of now essentially electrical stimulation. Well, essentially, you're pulsing the 305100 hertz Correct. In a way that the that the nerve fibers will will stimulate muscle contraction as well.
Dr JJ Thomas:Right?
Kevin Sheehan:Yes.
Dr JJ Thomas:So it's it's basically interrupting the pulse. Yep. So that it targets the muscle fibers. Yes?
Kevin Sheehan:Yes. We have, yeah, 2 settings. The high tens is gonna take that radio frequency and it's just gonna pulsate it to mimic the effects of a tens unit on the nerve. So, you know, for those people that are really into the science, if we're looking at the waveform it's not going to look like that of a TENS unit. It's still going to be the Teq R wave which is a sinosumal radio wave.
Kevin Sheehan:However, we're just sending it in bursts, independently.
Dr JJ Thomas:Try to relax.
Kevin Sheehan:To be able to kind of play on nerve pain. The other thing we have is the EMS, which is also on its own signal. So the cool thing is, is right, we can run that and the RET at the same time.
Dr JJ Thomas:Mhmm.
Kevin Sheehan:So as I'm contracting the muscle, I'm also healing it with that deep heating sensation. But, that is just gonna be a 1500 or a 4000 hertz electrical signal. So it's just gonna be there to really pump and recruit the muscle.
Dr JJ Thomas:Mhmm. But you have what do you have it on right
Kevin Sheehan:now? 10%.
Dr JJ Thomas:So that can we I like so he has it on the radial. So there's so this is the other thing. There's more options. But wait, there's more. So he has it on the radial option.
Dr JJ Thomas:So radial, I don't I think it just essentially, the way I view radial is it's a little bit more superficial. It's gonna be a little bit it doesn't quite penetrate quite as deep, and so if I really want that muscle to contract and I like the focal one, and then let's let let's let it contract a little. Let's give her a little bit more with that. So I could continue to do this with it too, honestly, but I just really wanna see that muscle. There it is.
Dr JJ Thomas:So you can start to see her quad contract now, and then, Shannon, let's do some so again, now we have post op whatever, post op, you know, total knee, post op ACL, post op meniscectomy. Let's have you, extend your knee with this. Great. And then come down. So we're getting mobility with it.
Dr JJ Thomas:We're getting muscle activation with it with lots of one of my things keep going up and down. One of my things with with other therapists is, like, one of my I have these, like, principles. Right? And, essentially, one of them is, like, everything we do is input, output. Whether I'm needling you, whether I'm saying hello when you walk in the door, whether I have Tehcar on you, everything's input, output, and so the tech hour machine is allowing me to have so many different inputs to the nervous system.
Kevin Sheehan:Absolutely.
Dr JJ Thomas:Yeah. Yeah. So hopefully you guys can see that. Go ahead and just relax again one more time, Sean. That looks so good.
Dr JJ Thomas:Yep, baby. So, yeah, so we just love this. Alright. Good. Let's see what else.
Dr JJ Thomas:So we have adhesive electrodes on Shanann now so that it gives us us all a little independence, but it also allows her to move better, not being not being, like, having to work around me as my hands are all over. So, Shannon, so we can turn the unit on. Do we have it on? Yep. Yeah.
Dr JJ Thomas:So we can put it in whatever setting we want. Like, again, like we talked about, whatever our goals are. If we want if we strictly want more cellular change, then we're gonna keep it at a lower level. If we want if we want more of a thermal effect, we're gonna put it at a higher intensity. We have the RET going here.
Dr JJ Thomas:Do we have stim on it? No. No.
Kevin Sheehan:Turn it on.
Dr JJ Thomas:Yeah. Let's turn some of the stim on. We'll do the so we have the high EMS along with it. It, and we have it at a 20% right now, which we can play with. So Shannon, go ahead and let's do some knee extension just with that.
Dr JJ Thomas:So again, we're just enhancing, as Kevin said in the beginning of the episode, we're just enhancing the work that we're doing now through, through a mobile electrode. Mhmm. We can also, if she has enough room, move this to, like, squats. As Kevin said, we could even do it all the way up the chain to the back, like if swelling is an issue. Shannon, let's lie back.
Dr JJ Thomas:So just put your legs up here, and then, yep, scoot all the way back. I'm gonna actually elevate your legs. So we could combine things like concepts that you're already doing in physical therapy. Right? If this is a post op knee, we wanna get a little elevation and we wanna get some ankle pumping.
Dr JJ Thomas:We could do this just like this or we could do it even with some straight leg raises. Go ahead and lift. Right? So now we're getting lots of goals at once. We're getting we're getting blood flow.
Dr JJ Thomas:We're getting lymphatic flow. We're getting drainage. We're getting muscle activation. What else are we getting? Yeah.
Dr JJ Thomas:Everything. And
Kevin Sheehan:then for those of you who have, like, recovery rooms or things like that where you're using compression therapy, you can also use this and those compression boots at the same time. That's true. Put this, you know, low intensity. Again, grounding plate in a central spot to move fluid out of the legs.
Dr JJ Thomas:Yeah.
Kevin Sheehan:But then you're also gonna get the benefits of the compression moving fluid out as well. So especially, you know, marathon runners, things like that.
Dr JJ Thomas:It's a
Kevin Sheehan:really great way to kind of supplement their their workout plans.
Dr JJ Thomas:I'm glad you said that because I love I love the recovery boots. I they're another thing that I purchased when I had my ACL done. When I bought the tech car, one of the reasons it made sense to me is because it is electrical current, and our everything in our body basically responds to electrical current. Like our nervous our nervous system responds to electrical current. Our cells depolarize because of electrical and electrical depolarization.
Dr JJ Thomas:So to me, we're basically speaking the body's language. Mhmm. And so, yes, the boots are great because you get an actual mechanical compressive component that flushes fluid, but when you add the electrical current with that, it's like
Kevin Sheehan:Yeah. That's, like, one of my favorite things when I go in places, people say, how would I explain this to my patient? And I say, right, we're doing something that the body is gonna do with it's with time. Right? The younger you are, you sprain your ankle, a doctor says, hey, in a week Yeah.
Kevin Sheehan:You'll be okay. You sprain your ankle when you're 50, takes a little bit longer, they put you in a boot, and then you do it when you're 70, you might be looking at surgery depending the condition. It's just because your body can't heal itself as quickly. So this is really more or less kind of using, like you said, speaking the body's language, using a current that the body recognizes to help stimulate a healing response in any tissue.
Dr JJ Thomas:And that's the thing. You're kinder than I am because I I guess maybe because no, it's true, but I because I see patients all the time who their body didn't, like for whatever reason, they they weren't able to heal their body. And so it does, it's more than that to me because it does access tissues that we weren't able to access otherwise.
Kevin Sheehan:Yeah. Yeah. Absolutely. I mean, again, that's kinda when we created this too and and the idea between a lot of different accessories and reasons why we're showing you different setups is, right, there's only so much that your protocols can do to affect changes in the body, but this is affecting the cellular matrix in
Dr JJ Thomas:addition to
Kevin Sheehan:all those things. So the goal is for this to know, again, combine it with what you're already doing. Speaking of, I was listening before before we did this. I was
Dr JJ Thomas:listening to one of the things on the academy, on Winbeck Academy online. Once you when you buy a unit, you have access to all this great educational material, and I was listening to one of the thing one of the, lectures on, like, fascia, and I I started thinking of people who do a lot of fascia work, like structural integration. So even if, like, if you're a massage therapist listening to this who does, especially if you're trained in, like, anatomy trains or foundations training or, or your structural integration or your, Ida Rolfe trained, all of these people, if you're trying to access fascia, you can have the settings to prioritize accessing the fascia, and then you can do mobile units and you can stretch them with it as well. Yeah. Yeah.
Dr JJ Thomas:And that's been a a
Kevin Sheehan:big one for us and it it's funny you say that because my old therapist who also does some educational things for us is, you know, he says in his talk about TECARS, you know, hyaluronic acid is kind of that foundation and you
Dr JJ Thomas:wanna increase hyaluron in
Kevin Sheehan:the body and Yeah. That fascia when it gets sticky, it's such a hard thing to manage
Dr JJ Thomas:Mhmm.
Kevin Sheehan:You know, with your hands and there's a lot of great techniques out there. But this is gonna help increase the viscosity of it. So you, again, can now start to get fascia to move easier than you add in the manual component to it and you see a lot of changes right away
Dr JJ Thomas:in time in session. Alright. So let's move to some deeper stuff, which is like the needling stuff, which is, something that some of you may not have seen much of. Alright, guys. So we are on with, we wanna show you some other ways we can use different tools, Like, again, this win back is meant to just enhance what you're already doing as a physical therapist.
Dr JJ Thomas:So for those of you that already use, tools, instrument assisted tools, like this one, you can have the ground plate, you know, remote from the area that you wanna work on. Remember, it's always gonna be a direct line, so the the most direct line from where the input is to the output, to the ground plate, essentially. And then I have the bracelet on. So remember, when the bracelet conducts the electricity essentially through my body and then to the metal object that I'm using, so now you can now that the unit has turned on, we have it on a low, like, a 30%, so a little bit more than than the like, we're gonna get a little bit of thermal work here, kind of a subacute phase. And then we can just use a regular instrument assisted tool like this, to transfer the energy through the bracelet to the yeah.
Dr JJ Thomas:And so, again, just makes my life a lot easier.
Kevin Sheehan:Yeah. The the benefit here too is, right, when we're I like to kinda think things like when you were setting inputs and outputs. Another thing is, you know, congestive therapies and decongestives. So, right, with with a tool you're applying pressure, so it's more of a congestive, right, because we want to elicit the body to start healing the
Dr JJ Thomas:tissue in
Kevin Sheehan:that area with the kind of micro trauma from the iastem. With the wind back, we're now kind of getting a decongestive in a way at the same time because it's just trying to do those cellular changes without any response, you know, negative response on the body. So, with this in particular, you know, some of those those hamstrings, quads, areas that are really, really dense and kinda like a rumble strip as you're going through it, the petechiae can can look a little rough the next day. With this, because we're at 30% getting some microcirculation with it at the same time. It'll also help it be a more comfortable treatment for the patient and help with some of those effects afterwards as well.
Dr JJ Thomas:Yeah. I mean, I would just had a course this last weekend, and we were talking about not just the not just the mechanical effects we're having on people, but remember, every input that we give is changing their somatosensory cortex in their brain. So if we have the opportunity to enhance a mechanical effect through something like an instrument assisted tool by adding electricity to it, we're giving even more signals of input to this metasensory cortex to help heal that tissue, because ultimately the brain controls everything. So this is a great option if you don't happen to have the, adapter to do so bracelet and this, if you have a BAC 3, essentially, right? Yeah.
Dr JJ Thomas:We're showing both. Yeah. And then you can also, so like I said, they're always up in their game, so once they saw a therapist combining that, they actually developed a tool where it can go directly through so I don't have to wear the bracelet in this case. The electricity will conduct through their own, tools that they that they created for us, and we can go now, same kind of thing.
Kevin Sheehan:Yeah. We're kinda always having a clinician in mind with everything we're creating. So for this, right, let's say, especially female clinicians, right, pregnancy is a contraindication. So wearing the bracelets means, you know, you're a part of the system, so you wouldn't be able to do that if you're pregnant. However, with this, you're not a part of the active circuit.
Kevin Sheehan:So, again, I can still do my scraping, the exact same treatment I was just doing. It's just now, you know, freeing me up from from that standpoint as a clinician.
Dr JJ Thomas:Yeah. And, I mean, it's just awesome. Thank you. So so that's sort of the instrument assisted. Now those of you that are already using instrument assisted, you know this is again kind of like the difference between, kind of like the difference between capacitator and resistive.
Dr JJ Thomas:The instrument assisted tools are gonna give us a little bit more of a superficial effect on tissues, which has a lot of benefits. Like, we need we need the entire depths of of this beautiful quad to be mobile and and and I wanna say pliable. And so this is a great method for the more superficial tissues. We'll often combine something like this with something like needling where we can now access deeper tissues. Alright.
Dr JJ Thomas:So, we're gonna find some areas. I have the ground always put the ground plate in first when you're getting ready to needle so they don't, like, put the needles in and make them move too much. So I'm gonna find some taut areas of tissue that Shannon can Shannon has an old ACL. How long was when was the ACL surgery you had? First was 2014 and then 2018.
Dr JJ Thomas:I Samey. Yeah. So when I was I don't know if you guys saw when I was doing work with the, with the instrument, you could see some restrictions right here on this lateral quad. So I'm gonna tease those out and target them with the needles. Gotta get my my J.
Dr JJ Thomas:Lo readers on. And, if you are a needling therapist, you wanna use a little bit of a longer needle here so that you're not burying it to the handle, in something in like, Shannon's got great quads. She was a soccer player, and, you wanna just make sure that you're allowing some of the needle to not be buried to the handle here. So I may need one longer than this, we'll say. So I'm gonna set up my so, yeah, you see that band right there, a nice taut top band?
Dr JJ Thomas:I need to go around here. There's another one right there. Compress, spread, tap, and then I'm gonna go essentially right there. I'm on femur there, but wow. That's good.
Dr JJ Thomas:Now I'm gonna let the tissue gather around. I'm gonna set a couple up because I wanna show those of you that use needling with the wind back right now. I wanna show you some different options. There's a couple different things you can do. So we'll set a couple up and there's another so right here.
Dr JJ Thomas:I just wanna make sure it's in sort of an active trigger point, there's one right there. So now we're good. So we'll just do those 2 just for the purposes of showing you what we do here, and then, yeah, we're gonna take the, we're gonna do an ret setting with the handpiece first. Put a little I usually do a little lotion on there. Thank you.
Dr JJ Thomas:Good. And then, we'll go to I'm gonna actually so it's on 30%. I'm gonna put this around I'm gonna rub this around I think I need a little bit more, actually. You you thought I was gonna go directly on. I'm gonna do that next.
Dr JJ Thomas:So a little bit more cream, and and then we're gonna actually go around the tissue here. So just the resistive head, the metal head, and I'm starting just with the RET. We can actually even add the EMS stim on this as well, and if you think about that, this is we input a metal object in here, so, once we add the stim, we can sort of indirectly, you wanna do it for me now? Great. So we have the high EMS, it's on the focal, Focal's my favorite.
Dr JJ Thomas:It's on the focal setting, and I think I just messed up my hair. It's on the focal setting, and so it's only at 20%. We could probably go a little higher. Great. And then so it's essentially conducting now through her muscle tissue and targeting the needles a little bit.
Dr JJ Thomas:Now through her muscle tissue and targeting the needles a little bit. Now if I want, I'm not if I touch the handle here, I'm, you know, I'm not touching any part of the needle that's going in her, so I can touch that without a glove, and I can actually change this needle a little bit and then get a little bit change in in where the current because these needles, especially these eye dry needles, they have a great surgical coating on the round outside of them, so the stem will actually accumulate on the very tip. So if you're trying to target a different depth of tissue of the muscle, you may have to pull that out a little bit. Let's turn that stem up just one more percent, so now 40%. Yeah.
Dr JJ Thomas:And then just see if we can get any muscle. There it is. And so we're getting it through the head, but also a little bit of added effect to those needles that are in there. So I really like that. I'm gonna pause it and show you another option.
Dr JJ Thomas:So now we're gonna show you how to, target the needles using the bracelet. So this one, we're not gonna go anywhere near the 30%. We're gonna go much lower because essentially, I'm gonna use the bracelet to conduct the electrical current through my hand, and then I'm gonna touch the needle. Again, yeah, so we'll go to, like, 10% at first. This is RET 10% essentially.
Dr JJ Thomas:So I everyone that has heard me talk about finding a good continuing education company for dry needling knows how I am about gloves. And so the way you do this, if you noticed, is I wear the gloves, I put the needles in, I set them up, then I take the gloves off. When I touch this needle, I need the gloves off so that I can conduct the electricity because the the, the gloves will be a barrier, but I just have to make sure that I'm not touching any part of the needle that will go inside her, and then that's still, a safe and clean technique. So we'll go ahead and turn it on now, and essentially the way to do this is, you wanna approach them with more surface area from your hand at first, and then you're gonna at from there, touch the needle to conduct the electricity from your body to theirs. So we'll start with this one.
Dr JJ Thomas:So I'm gonna put the side of my hand here, and then I'm gonna touch the handle only. And then from there, I can even manipulate the tissue a little bit while I'm in there. You know, I essentially could touch outside of that if I needed more, more control over it, but really, if I'm not I'm not really heavily pistoning the needle I'm gonna put my glasses back on so I can see it better. I'm not heavily pistoning the needle, so I can just do that approach where I just touch whole hand and then put my hand on the needle now I'm conducting, and I can change where that current is going from there. Okay?
Dr JJ Thomas:So if you didn't do that, then potentially it would be really an abrupt change for them on the needle. If I just touch this needle, then all that current, even though it's only 10%, would go right into that needle and it might be a little intense. So that's why we teach this technique where whole hand, touch, and then manipulate if you want. The other option, I showed you the head option. Oh, we can I should go back to the head because I wanna show them the let's pause this?
Dr JJ Thomas:So we can also do the, the current through the head touching the needle. Again, this I said I used, with someone recently and she's a runner who has a lot of kind of chronic long term overuse injury type things, and we used it on her legs and thank you. And it it was excellent at kind of sort of I said it was almost like an AED kind of shocking, directly shocking the muscle in a in a way that helped it recruit better, it like snapped it out of it. So again, when we do this one, I'm gonna put high EMS focal, but I'm gonna go way down to 10%, and then I can hit play, and then I can directly touch the needle with this if I want. And so that's 10%.
Dr JJ Thomas:Isn't that crazy? So if so therapists clinically yeah. Clinically, if you're thinking about how I would use this, this is for the patient that you just can't seem to wake up their their muscles. And so, like, when we teach needling, oftentimes we'll say when somebody has a hard time recruiting muscle, we'll say one of the ways you can help the muscle relearn how to fire is by mixing it up on them. And so all these different types of input using the electric, the electrical current is gonna, again, wake up the somatosensory cortex in different ways.
Dr JJ Thomas:So for instance, when we teach dry needling with stim, if somebody's not, if their muscle is having a hard time recruiting and firing, we will often, as instructors, coach them to say, okay. Play with the frequency. Try it at 3 hertz. Try it at 15 hertz. Try it at 20 hertz.
Dr JJ Thomas:And then go back and vary it so that the brain doesn't sort of adapt to it. And it's the same thing with this. Like, you can do all these different inputs to actually give more sources of stimulation to the nervous system so that it wakes up. And this is one of my favorites. You do you just have to go I mean, 10% is really all you need for this one because it's metal to metal, direct.
Dr JJ Thomas:And and as I said before, if I wanna get a different part of the tissue, I may have to pull these out a little bit because it's essentially going to the very tip of that needle, and then I can touch it and get a different layer, and that one doesn't have much there. That one's pretty good. That one I knew was gonna need it because when I was massaging her, you guys probably saw that with the instrument assisted tool. It was pretty limited. So guys, thanks for joining us.
Dr JJ Thomas:I'm gonna take these needles out. For you clinicians that are needling with the wind back, we'll put our gloves back on to get this needle out so that we can compress the area that we needled right afterwards using clean needle technique. And then basically, again, I showed you a lot of the features that I like with the wind back and that I've seen really useful with our patients. There are actually more features even than this. So if you have any questions, reach out to me.
Dr JJ Thomas:I will I'll connect you to Kevin as well, and, yeah, just let me know. And hopefully, you'll if you if you're local and you wanna come try it out, I'm happy to show you how it works. And if you're not local, just we'll get in touch. I agree. Yeah.
Dr JJ Thomas:Alright. Hope you enjoyed it. Let me know if you have any questions, and we'll talk soon.