Above The Bar

Treatment regimen restores Marine’s grip strength with promotion on the line.

As he learned of the four coordinated terrorist attacks that shattered the morning of September 11, 2001, and altered the course of history, a fire grew in the belly of Joshua McCallister that still burns today.

Photo by Jordan Pysz.

Joshua McCallister

“I was in middle school when 9/11 happened, and I decided right then that there was no way I wasn’t at least going to put in four years of service to my country,” Joshua says. “After that, it was really just a matter of which branch I would serve in.

“I eventually joined the Marines because they have the longest boot camp, the one that I knew was going to challenge me the most physically, and because I really wanted to go to Iraq and Afghanistan and see what it was really like there.”

Joshua got his wish. He spent two years serving on the front lines in Iraq, Afghanistan, Syria and Kuwait. Now in his 14th year of service, Joshua has settled into a job as a recruiter, but at 32, he still has advancement on his mind.

“Our goal is to provide the best care possible for our patients, and this is living proof that we’re doing just that.” – Paul Ernandes, PT, PhD.

A staff sergeant, Joshua recently began focusing his efforts on earning a promotion to gunnery sergeant. He was well on his way to fulfilling the requirements when an elbow injury crept up and slowed his pursuit.

“One of the things they evaluate whenever someone is seeking a promotion is their physical fitness, and as part of that test you need to do a certain number of pullups,” Joshua explains. “In my age group, 23 is the number you go for.

“That’s considered perfect. And they have to be perfect pullups, too. You have to have your chin full over the bar, you have to lock out your elbows on the way down and there can be no kicking or swinging. You have to do it with straight muscle, perfect.

“So I was doing 200 pullups every other day to get ready for that, and at some point along the way, I really aggravated my right elbow. It almost felt as if it was dislocated or something. It was painful, but more than anything it just didn’t feel right.

“And driving really aggravated it. After a long drive especially, my elbow would really hurt. I tried just resting it for a while and that helped. I actually thought for a week or two that everything was all right, but then the pain came back.”

Loss of Hand Strength

Joshua wound up fighting through his discomfort for almost a year, but when it started to rob him of “grip strength” in his right hand this past spring, he knew the time had come to seek medical help.

“I would normally go to MacDill (Air Force Base in Tampa) for any kind of medical treatment, but they were busy treating COVID-19 cases, so they referred me to another place,” Joshua says. “That’s how I wound up at Regional Rehab.”

Joshua first visited Regional Rehab in early May, when he was examined by Paul Ernandes, PT, PhD. Paul quickly confirmed Joshua’s loss of hand strength through a test that showed Joshua had just 40 pounds of strength in his right hand, which had been his stronger hand.

“That was 60 pounds of strength less than he had in his left hand, so there was definitely a problem there,” Paul says. “But Joshua reported no triggering event or trauma that might have caused the problem, nor could I really find anything wrong myself.

“There was no injury to the elbow that I could find that might have caused the problem, but Joshua was clearly experiencing a great deal of discomfort. And keep in mind, this is an active Marine. He’s not going to say he’s in pain if he’s not in pain.

“So there was obviously something going on, and based on the fact that he was mostly experiencing this pain whenever he did his pullups or pushups told me that he was likely suffering from inflammation.”

Laser and Oscillation

To eliminate the inflammation, Paul made use of two of the most advanced tools available to physical therapists, the Class IV deep tissue therapeutic laser and the HIVAMAT® 200 deep oscillation therapy device.

Photo by Jordan Pysz.

Regional Rehab helped keep Joshua on track for a promotion to gunnery sergeant

The laser uses specific wavelengths of red and near-infrared light to stimulate the body’s natural ability to heal cells. It works by releasing nitric oxide, which removes congestion and swelling, promotes rapid healing and reduces discomfort while increasing blood circulation.

The HIVAMAT 200 creates gentle impulses that relax muscles and penetrate all tissue layers to remove inflammatory byproducts from the cells that cause pain but are not part of the cells’ natural makeup.

“The Class IV laser, in particular, is an impressive and versatile tool,” says Charles C. Donley, PT, the owner and director of Regional Rehab. “We use it for burn and wound patients as well as for all the different musculoskeletal issues we typically treat such as acute, chronic and postoperative pain.”

The Class IV laser and HIVAMAT 200 are part of a protocol that typically includes stretching and balance exercises as well as manual therapy. In Joshua’s case, the treatment also included a modality called phonophoresis.

“Phonophoresis is an ultrasound therapy that uses an anti-inflammatory medicated cream called ketoprofen to reduce the inflammation,” explains Glenn Guterman, PTA, of Regional Rehab. “Together, those modalities all worked very well for Joshua.

“By the time we discharged him, he was doing full weight, on a pulldown exercise machine, and he was doing his pullups with no pain, which made him feel confident that he could pass the Marine Corps fitness test.”

Joshua’s confidence was rebuilt across a six-week period in which he received 14 treatments combing the three modalities. The results not only alleviated Joshua’s pain and discomfort, but also greatly strengthened his chances of earning the promotion.

“It took a few weeks for me to notice any changes, but in the end it all worked out right,” Joshua says. “There’s no arguing with the results. My right hand is stronger than my left, the way it was before.”Photo by Jordan Pysz.

Joshua says that because of the coronavirus outbreak, he won’t know until late this year whether he earned the promotion. He’s confident he’ll get it, though, and says that some of the credit has to go to the folks at Regional Rehab.

“It’s a great place, and the people who work there are great,” he says. “I’d go back just to hang out with them. In fact, I have a knee issue that I’ve been fighting, and I’ll probably go back to see if they can help with that. That’s how much I believe in them.”


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    • Regional Rehab

      Regional Rehab's ultimate goal is to enrich people’s lives by helping to enhance their physical and mental well being, creating an atmosphere of quality care and optimum healing with a loving touch.... Read More

    • Paul Ernandes, PT, PhD

      Paul Ernandes, PT, PhD, joined the Regional Rehab team in April 2018. His arrival comes after he spent nearly a year serving as the director of physical therapy at Vitality Physicians and Rehab. Paul previously worked for ten years as the dire... Read More

    • Charles C. Donley, PT

      Charles C. Donley, PT, is director of Regional Rehab. He earned his Bachelor of Science degree in Physical Therapy, graduating cum laude, from the University of Pittsburgh, PA. He is a member of the American Physical Therapy Association and Fl... Read More