Human Performance and Rehabilitation Centers, Inc.

ASTYM and Tennis Elbow

Astym therapy is a very specialized type of treatment therapists use to address soft tissue dysfunction in their patients. This treatment was developed by a group of multi-disciplinary medical specialists that wanted to use an external, non-invasive treatment to address issues their patients were experiencing, specifically with muscles, tendons, nerves, and other soft tissues. This group of specialists developed specific protocols that use the body’s own response to stimulate the growth of new, healthy tissue and facilitate the resorption of inappropriate scar tissue and fibrosis, which can play a leading role in pain in certain areas of the body.

Tennis Elbow, or lateral epicondylitis, is inflammation of the tendons that originate at the outside of the elbow. When a patient is diagnosed with lateral epicondylitis it is typically because of overuse or a specific injury that has damaged the soft tissue. These muscles are used often as they are the muscles that allow for extension of the wrist. Over time, development of “microtears” in these tendons cause the body to lay down scar tissue, which is made of collagen fibers. When the body lays down those collagen fibers, they are laid down in an unorganized manner…think cooked pot of spaghetti noodles. Astym treatment stimulates the body’s own healing mechanisms to realign the scar tissue (uncooked box of spaghetti noodles) and resorb inappropriate tissue, helping reduce pain while increasing motion and functional ability.

Using Astym specific instruments, the entire arm is treated with a very specific series of strokes that follow the direction of muscle, ligament, and tendon. During the treatment, which usually lasts about 20 minutes, you may feel smooth areas and you will feel more gritty areas. The gritty areas are the areas of dysfunction and as treatment progresses, those gritty areas will be less noticeable, indicating healing.

In conjunction with Astym treatment, stretches are essential to the healing process. The stretches provided by your therapist will tell the new fibers to line up properly (uncooked box of spaghetti noodles, again). And when your pain has been significantly reduced or alleviated, a strengthening program will be started to help the pain from returning once you get back to your daily routine.

A typical course of treatment utilizing Astym therapy lasts 4-6 weeks and can only be offered by certified Astym therapists. Many patients opt for this treatment instead of surgery and/or injections. Talk to your physician to see if you would be a candidate for Astym therapy.


Learn more about Katherine Branch, OTR-L. Learn more about ASTYM.

5 Ways to Use Bubbles to Promote Motor Development

Whether you’re blowing them, popping them, seeing who can blow the most, or simply watching them blow away with the wind, bubbles are a fan favorite for outside playtime with kiddos of all ages. Not only are bubbles fun, but they can also be great motivation for exercises to promote motor skill development in children. Do you have bubbles waiting outside to be played with? Go outside and grab them – let’s exercise and play!

Sitting Balance

Using bubbles is a great way to have a child sit still and practice their sitting balance. You can have them sit on the grass or challenge their balance more by having them sit on a pillow, bosu ball, or any surface that is wobbly, but safe. Challenge your child’s balance reactions by having them reach up, down, forward, and backward to pop the bubbles.

All Fours

Positioning your child on all-fours (quadruped) is an excellent exercise for strengthening their core, shoulder stability, back, and hips. Think of it as a mini plank for your kiddo! Use cues such as pretending to be a dog or cat and tell them they have to pop the bubbles with one hand at a time. If your child is a little older, challenge them mentally with you calling out right hand or left hand to pop the bubbles with.


Having kids stomp on bubbles is a great challenge for working their balance on one foot. You can blow the bubbles low to the ground and have them stomp multiple bubbles, or you can catch the bubble on the wand, hold it low, and have them slowly raise one foot to stomp the bubble.

Tip Toes

Many kids have trouble raising on to their tip toes and keeping their balance while doing it. Sometimes, if you place something (like bubbles!) just out of reach for your child will cue them to raise to their tip-toes. Make it a challenge and see how many they can pop while on their tip-toes before coming back down on their heels!


Jumping is a great task for your child to practice! Jumping helps strengthen all of your child’s lower body, and is also a developmental motor skill that physical therapy helps children achieve. You can cue your child to “bend your knees, and jump up high!”. Challenge them to pop at least 10 bubbles while jumping.

Meet the author of this post, Shelbi Moxley, PT! Shelbi is a licensed Physical Therapist at Pediatric Rehab at Easter Seals in Columbus, GA. She has been employed with HPRC since March 2020. Shelbi received her Doctorate of Physical Therapy from the University of St. Augustine in 2019, as well as her Bachelor of Exercise Science in 2015 from Columbus State University. Her primary practice interests include pediatrics and neuro rehabilitation. Shelbi is a member of the American Physical Therapy Association (APTA). She resides in Columbus, GA where her hobbies include exercise and enjoying all the live music Columbus has to offer.

Shin Splints: How to treat and prevent this common runner’s condition

Running is a popular pastime in the South, where the weather makes it possible to pursue the activity year round. But runners often face shin splints, the more familiar term for medial tibial stress syndrome, a common overuse injury. It refers to the pain experienced along, or on either side of, the shin bone (tibia). It can also be felt on the back of the leg between the bone and calf muscle. The pain is due to inflammation of the connective tissues that attach the muscles to your tibia. Several factors can trigger this inflammation, including improper body mechanics, a change in your routine of exercise regimen, lack of support in your footwear or weak or tight musculature.

The good news is that shin splints can improve with the right steps, especially when the condition is caught early. If the pain persists, it can also be addressed with a variety of therapeutic techniques under the direction of a physical therapist, including targeted exercises and “directed” dry needling. As shin splints improve, it’s important to also integrate consistent stretching/strengthening exercises and other prevention strategies into your routine in order to keep them from returning. Shin splints that get progressively worse can lead to other injuries.

What triggers shin splints?

Several factors can cause shin splints. Some of the most common include:

Improper body mechanics

Body mechanics, or the way your body moves as you walk or run, are an important factor in preventing or causing injury. Often, tightness in the hip flexors or weakness in the glutes can cause one side of the body to be off balance as you strike the ground, execute forward motion and then brake. Exercises that stretch and strengthen the hips, quads, calves and glutes can help to bring the body into better balance and prevent stress to the muscles around the tibia.

Change in routine

Most runners have a regular workout routine, but when you make a sudden change to your regimen, particularly when you haven’t stretched and strengthened key muscles, you open yourself up to inflammation. A change in routine could mean an abrupt increase in mileage or in speed. It’s better to make gradual changes, even when you’re in great shape. Another change that could trigger inflammation is a sudden change in terrain. For example, if you’re used to running on turf, dirt or a synthetic rubber track, and you start to primarily run on concrete, you could experience inflammation.

Running on an uneven surface

One of the causes for tightness on one side of the body is running on an uneven surface, especially if you run in the same direction each time you exercise. While most surfaces we might run on are, by nature, uneven, you can avoid tightness in your hips and quads by running your regular course in reverse on alternating days of the week.

How to treat shin splints

Rest and ice

The first step in treating shin splint pain is rest and ice, and if needed, an over-the-counter anti-inflammatory pain reliever like ibuprofen. While heat may feel good, it doesn’t actually do anything to reduce the inflammation.

Assess your footwear

Make sure you’re running in a supportive shoe that provides plenty of cushion and shock absorption, and that addresses any other foot issues you may have, like pronating. When you’re not wearing running shoes, be sure to wear shoes that provide good support, and aren’t too flat, or too high.

Stretch and strengthen

Stretching and strengthening your calves, quads, hips and glutes will go a long way in improving shin splints and ensuring they don’t return. Good exercises to do regularly are calf raises, toe taps, squats, hip abduction strengthening (side lying, or standing, with a resistance band) and glute bridges.

Remember, shin splints are treatable with the right steps. It’s important to catch them early to make sure they don’t turn into something worse.

Sachiko Garner, PT, is a licensed Physical Therapist. Employed with HPRC since 2005, she received her MSPT degree in 2004 at The University of Alabama at Birmingham and her BS degree in Exercise Science/Athletic Training at Columbus State University in 2001. She is credentialed as a Clinical Instructor and certified in the treatment of myofascial pain and dysfunction with dry needling and ASTYM. Her specialties and interests include shoulder rehabilitation, post-breast cancer rehabilitation including lymphedema and running biomechanics. She is a member of the American Physical Therapy Association (APTA) and Orthopedic Section of the APTA.



HPRC Announces Partnership with Confluent Health

Legacy private practice group, HPRC, announces partnership with Louisville-based Confluent Health

Human Performance and Rehabilitation Centers, Inc. (HPRC) is proud to announce plans to partner with Confluent Health, a Louisville, Kentucky-based private equity holding company focused on creating a healthcare system that combines best-in-class clinical care in the rehabilitation industry with proven management services.  The partnership is expected to be effective in 4th quarter 2020, and will maintain HPRC’s brand, management/leadership and namesake while allowing them access to Confluent Health’s shared management services, including accounting and finance, talent acquisition, marketing, and staff development opportunities.

HPRC was founded in Columbus, Georgia in 1955 by George M. McCluskey Jr, PT.  What began as one-man practice has grown into a business with locations across Georgia, Alabama, and South Carolina.   McCluskey founded HPRC with one idea in mind:  to rebuild the body’s functional capability and to improve life, one patient at a time.  “Our culture and values are the only things that haven’t changed since my father founded our company 60+ years ago.  Our task is to grow our business while understanding the realities of the present and the challenges of the future, and yet remain faithful to our heritage,” said Brian McCluskey, Ph.D., Chairman/CEO of HPRC.  “Change is the only constant we know,” he added.  “We believe that partnering with Confluent Health is our best chance to continue to grow and remain a viable and relevant healthcare company in the future.”

“We are enthusiastic to venture in this partnership with Confluent Health; this will enable us to continue to invest in our communities by improving patient’s lives, and increase professional growth opportunities for our staff,” stated Patrick Graham, PT, MBA, HPRC’s President/COO and son-in-law of founder George McCluskey.

Confluent Health has a simple strategy – to partner with legacy practices in the therapy industry, align their clinical focus with Confluent’s business resources and proven systems, and grow business.  “We offer our warmest welcome to Brian and Patrick and the team at HPRC.  They have a rich history of best-in-class clinical care and uphold a steadfast commitment to their patients, which are exactly the practices we love to join in partnership,” said Confluent Health CEO, Dr. Larry Benz DPT, OCS, MBA, MAPP.

To learn more about Confluent Health, visits


About Confluent Health:

Confluent Health is a Louisville, Kentucky-based private equity holding company focused on creating a healthcare system that recognizes physical and occupational therapy providers as the Best First Choice for preventing and managing musculoskeletal and movement disorders. Confluent Health offers the following management services: evidence-based practice, patient loyalty, regulatory assurance, marketing and branding, clinic operations, hiring and retention, strategy, accounting and finance, and customer service to Baton Rouge Physical Therapy – Lake, BreakThrough Physical Therapy, Capitol Physical Therapy, El Paso Physical Therapy Specialists, the Evidence In Motion family of companies, Fit For Work, Orthopedic & Sports Physical Therapy, Pappas Physical Therapy, Physical Therapy Central, ProActive Physical Therapy Specialists, ProRehab Physical Therapy, Redbud Physical Therapy, RET Physical Therapy Group, Rehab Therapy Works, Lake Center for Rehab, SporTherapy, and Texas Physical Therapy Specialists, and Tallahassee Orthopedic & Sports Physical Therapy.  Together, these companies share a common ownership team and are committed to developing a learning, purpose, and coaching culture.

About Human Performance and Rehabilitation Centers, INC.

Established in 1955, HPRC was founded with one idea in mind: to rebuild and enhance the body’s functional capability – to improve life, one patient at a time. Sixty-five years later, HPRC offers a broad service line including physical therapy, occupational therapy, speech therapy, orthotics, prosthetics, and electrodiagnostic testing to pediatric, adult, and geriatric populations in 9 locations across Georgia, Alabama, and South Carolina.