Complete Evaluations

At ProActive Physical Therapy, and its associated clinics, an evaluation is unique to each client, and its contents are dependent upon each client's goals and problems. This makes every evaluation unique. However, the one thing that every evaluation we perform has in common is that they are analytical, accurate, and comprehensive.

Here are a few of the things that we look at during our evaluations.


We will take a medical history; discuss the nature of the client's problems, including the area, intensity, and quality of symptoms and/or impaired function; determine what aggravates or decreases the symptoms or problem; inquire what are the client's typical postures, positions, and activities. We will also ask what treatment the client has had in the past and with what degree of success, and we will discuss the results of any special tests, including MRI's, CT scans, x-rays, etc.

Objective Examination

Objective Examinations typically include analysis of the following:

  1. Posture
  2. Skeletal Alignment
  3. Joint Mobility
  4. Movement Analysis
  5. Strength
  6. Flexibility
  7. Neurodynamics (all things associated with your nerves)
  8. Tissue Palpation
  9. Reflex and Sensation Testing
  10. Special Tests - unique to each client

The findings from an evaluation typically present themselves in an pattern from which we are able to identify the root cause you're your problem. Based on the results of the evaluation, we will develop a treatment program. Click the headings below for more information.


What is ultrasound?
Ultrasound is a machine that produces high frequency sound waves that are transmitted into the body via a sound head or probe. The sound waves travel deep into the body generating a gentle soothing heat.

How is the treatment administered?
The probe of the ultrasound machine generates a high frequency sound wave. The physical therapist applies a gel to the skin which helps the sounds waves be transmitted into the body more efficiently. Using gentle circular motion with the probe the therapist then moves the sounds head over the area to be treated. The treatment lasts anywhere from 5 to 10 minutes depending upon the size of the area to be treated. Ultrasound can also be use to push an anti-inflammatory medication through the skin. When ultrasound is used to push an anti-inflammatory medication through the skin it is called phonophoresis.

Does the treatment hurt?
No. Much of the time the patient will feel and nice soothing warmth or slight tingling. Sometime the patient doesn't feel anything at all.

How does the patient benefit from ultrasound?
As the sound head moves over the surface of the skin, the sound waves penetrate the body, creating heat. The heat in turn creates vasodilatation. Vasodilatation is an enlarging of the blood vessels which serve to bring a lot of nutrient rich, oxygen rich blood to the injured area to speed up the healing process.

Massage/Soft Tissue Mobilization

What is the difference between massage and soft tissue mobilization?
Soft tissue mobilization includes a number of various specialized techniques and are more skilled in nature that traditional massage techniques.

How does it work?
As therapists use their hands or specialized tool to rub, knead and stock the muscles, blood flow to the area is improved. Increased blood flow to the area brings nutrients and oxygen to the area to speed of the healing process. The increased blood flow also served to eliminate waste products, such as lactic acid, that may accumulate in muscles from spasms causing pain.

Hot and Cold Therapies

Hot therapies include hot and moist compresses, dry or moist heating pads, hot tub/pool and commercially available chemical/gel packs.

Heat therapy creates vasodilatation of the blood vessels. Vasodilatation is an enlarging of the blood vessels resulting in increased blood flow which delivers more oxygen and nutrients to speed up healing and remove waste products. The warmth also relieves pain, relaxes tense muscles, and decreases muscle spasm, and increases range of motion.

Cold therapies produce vasoconstriction, the opposite of vasodilatation. Vasoconstriction is a narrowing of the blood vessels which slows circulation reducing muscle spasm, pain, and inflammation.

Cold therapy includes commercially available cold packs, ice cubes, and forms of hydrotherapy. Cold therapies should never be applied directly to the skin. A barrier such as a thin towel or pillow case is placed between the cold and the skin to prevent skin and nerve damage. The duration of the hold therapy is usually less than 15 minutes.

Aquatic Therapy

Aquatic therapy is simply water therapy. Water virtually eliminates gravity to enable movement that may not be possible on dry land. Depending on the depth of the water, weight bearing can be virtually eliminated enabling the patients to perform exercises in a gravity free environment. Gentle water exercises use the water's resistance to build muscle strength and flexibility. Warmer water induces vasodilatation. Vasodilatation is an enlarging of the blood vessels resulting in increased blood flow which delivers more oxygen and nutrients to speed up healing and remove waste products. The warmth of the water also relieves pain, relaxes tense muscles, and decreases muscle spasm, and increases range of motion.

TENS (Transcutaneous Electrical Nerve Stimulation)

TENS sends a painless electrical current through the skin to specific nerves. The current serves to block the pain that a patient feels, while only feeling the gentle buzzing of the electrical current. The electrical current is much different than the current that comes out of your wall. This current can be described as a gentle buzz or massaging feeling. The treatment stimulates the body's production of endorphins and natural pain killers.

How is the treatment applied?
You therapist will place electrode patches to the skin the area they wish to treat. The mild current runs from a stimulator, through wires, into the patches that are places on the patient's skin. The level of stimulation completely adjustable to the patient's feeling of comfort.


What is ASTYM?
The ASTYM System is the form of augmented soft tissue mobilization (ASTM) that allows the clinician to stimulate the body's own capacity for healing in patients with soft tissue degeneration or fibrosis and chronic inflammation. This leading edge, non-invasive treatment is performed with ergonomically designed instruments that initiate the healing process necessary for tissue remodeling.

How does ASTYM work?
The ASTYM System's effectiveness is theorized to be due to the following:

  • Adhesions and inappropriate fibrosis within soft tissue can result from trauma, surgery, immobilization or repetitive strain. The ASTYM System stimulates the breakdown of this dysfunctional tissue and allows functional restoration to occur.
  • Soft tissue adhesions and resulting restrictions are identified and broken down.
  • Controlled microtrauma initiates a local inflammatory response that leads to the resorption of inappropriate fibrosis or excessive scar tissue.
  • In chronic tendonopathies, doses of controlled microtrauma stimulate regeneration of the affected tendons.
  • Existing collagen is remodeled and new collagen is influenced by a program of specific functional activities and stretching.

What can the patient expect?
The ASTYM System program begins with a thorough evaluation. The clinician then administers a 10 to 15 minute treatment addressing the entire kinetic chain. A regimen of specific strengthening and stretching exercises is prescribed, customized to the patient's work, athletic or recreational activities. Patients experience a decrease in pain and rapid improvement in function which results in high patient compliance and satisfaction.

Who can benefit from ASTYM?
Patients who are experiencing pain or loss of motion and function following surgery, injury, cumulative trauma disorders, and chronic irritation/tendinitis may benefit from ASTYM. Some of the clinical diagnoses which have responded well include:

  • Lateral Epicondylitis
  • Carpal Tunnel Syndrome
  • Dequervain's Tenosynovitis
  • Trigger Finger
  • Joint Contractures
  • IT Band Syndrome
  • Patellar Tendinitis
  • Anterior Knee Pain
  • Shin Splints
  • Chronic Ankle Sprains
  • Plantar Fasciitis
  • Achilles Tenditinitis
  • Other Forms of Tendinitis & Tendinopathies

** Physician referral may be required for treatment

What benefits does ASTYM provide?
Multiple studies demonstrate the effectiveness of the System in restoring mobility and hastening recovery in patients with cumulative trauma disorders and other soft tissue dysfunctions. In a vast majority of cases it offers these distinct advantages:

  • Restoration to pre-injury level of activity
  • Enjoyment of maximal results with a minimal number of treatments through an emphasis on re-establishing function
  • Maintenance of normal activity in conjunction with the treatment
  • Decreased need for splints, braces or job site modifications
  • Decreased need for surgical intervention

More information about ASTYM.