This treatment is for scar tissue between the 3rd and 4th metacarpals following a fall over a year ago.

The fall resulted in an unusual injury; a dislocation of the 4th carpo-metacarpal joint which was relocated manually the same day.

The hand was not immobilised in plaster or a brace but still developed fibrous tissue between the 3rd and 4th metacarpals.

Here is a picture immediately following the injury:

The patient has had extensive deep tissue massage and release in both physiotherapy and massage therapy but with little effect. The gutter between the 3rd and 4th metacarpals is raised with fibrous tissue which prevents the patient from making a full fist and limits power grip strength.

The patient has also had extensive ultrasound and laser therapy to no avail.

The first video is radial shockwave:
15mm head
60mj
2000 shocks
10hz
Using an Enraf Nonius 811
This is actually the second treatment, the first treatment was not filmed.

We are now at the third treatment. The gutter is clearing with less scar tissue and a visible gap between the bones.

The patient can now make a fist and his grip is improved.

There remains two main spots that are still problematic: at the top near the dislocated joint and at the bottom near the metacarpal phalangeal joint.

The patient reports being over 50% improved after the first 2 sessions.

To try a new machine for feedback from real patients the third treatment is given with a different machine:

Gymna Shockmaster 300
15mm convex head
1.0 bar
2000 shocks
10hz

Onto the 4th treatment.

The patient now has much less swelling between the 3rd and 4th metacarpals.

There is just a calcified lump on one of the tendinous insertions. The ‘lump’ is on one of the finger tendons (interossei) and there is still a painful spot up near the carpo-metacaral joint.

Much less limit on grip. Full clenching of the fist is now possible. This is the fourth session of shockwave.

Gymna Shockmaster 300
15mm convex head
1.0 bar
2000 shocks
10hz

5th treatment.

The swelling/scaring between the 3rd and 4th metacarpals has almost fully resolved.

The calcified lump has almost resolved but there is still a painful spot up near the carpo-metacaral joint.

Grip is now normal.

This is the fifth session of shockwave.

Gymna Shockmaster 300
15mm convex head
1.0 bar
2000 shocks
10hz