The Opposable Thumb

Idaho physical therapist has invented a versatile manual rehabilitation tool

By Brian W. Ferrie

They say necessity is the mother of invention. In the case of Kevin Sgroi, PT, inventor of the "Opposable Thumb," that necessity took the form of chronic thumb pain. An effort to relieve this pain led to the invention of a hand-held, two-headed piece of molded plastic, designed to assist with myofascial release, trigger-point release, deep and superficial stretching, as well as general massage.

Sgroi founded Joshua Tree Physical Therapy in Hayden, ID, four years ago. He uses the Opposable Thumb there with his patient population, which generally presents with orthopedic and neurological conditions while ranging in age from teenagers through people in their 90s. Sgroi discussed the inspiration for and evolution of his invention with ADVANCE last month.

ADVANCE: When did you invent the Opposable Thumb and what was the process from inspiration to its status today?

Sgroi: In its current form, I invented it about two years ago. Being a hands-on therapist, I would use my fingers and thumbs a lot. I've been a PT for 12 years and it got to a point about 10 years ago where, after treating 12 to 14 patients a day, my thumbs started hurting really bad. It was causing me pain to even pick up certain objects. So one day I was at my parents' house and my sister was having a problem with her neck. She asked me to treat it for her but I had just gotten off work and my thumbs were killing me.

I really couldn't push on her trigger points and acupressure points the way I needed to relieve the pain and get those muscles loosened up. But I asked my father if he had anything around the house that was semi-rounded like a thumb. It turns out he had carved a handle for a keyhole file that he kept in the garage. So he pulled off the handle, which had a semi-rounded surface, and I started using it. That worked so well with my sister that I started trying it with my patients. I kept that handle in my pocket at the office and continued to use it in treatment for about eight years.

Then a couple of years ago, I finally got the idea to buy some clay that I could fire and mold in the oven. I shaped it to create a tool with one large round end and a smaller round end like a hook on the other side. The original handle my father gave me had only one rounded end — it looked like the larger end of the current tool. I just expanded on that, basically to cover a lot of areas for acupressure, trigger point release, deep and superficial stretching, along with myofascial release. There are all different ways you can use the tool, such as the broad end for treating a larger area, like myofascial release. Or you can try the smaller end for deep stretches. I also use it to release fisette joints, which works very well.

ADVANCE: After buying the clay, did you try other prototypes before coming up with the current model?

Sgroi: Yes, we started with some different shapes. There's actually a box that my office manager made up for the different tools as the invention evolved. But now we have a final production model.

ADVANCE: Have you taken steps to get a patent on it?

Sgroi: Yes, we filed all the patent paperwork about a year ago. But they wanted some of the drawings re-done, so we re-sent the paperwork about four months ago. Now, the invention is considered "patent-pending" while we wait for final approval. I'm not sure when that will happen.

ADVANCE: When you went through the patent process, did you hire an attorney?

Sgroi: No, my office manager supervised that. I actually started a second company with her for the tool once it takes off. It's called Joshua Tree Enterprises.

ADVANCE: On what percentage of your patients do you use the tool?

Sgroi: Pretty much 100 percent. I treat everybody with it.

ADVANCE: Do you ever use your own thumbs anymore or has the tool completely replaced that?

Sgroi: I basically use my thumbs now only for palpation skills. In other words, I find the trigger points with my fingers and thumbs. What I've tried with patients is pushing with my thumb as hard as I would push with the tool, and they say the thumb causes a lot more pain. The base of the tool is quite a bit wider, so it doesn't have that real poignant trigger point right on top of a sore muscle. It spreads out the sensation a little bit.

ADVANCE: Did you ever seek treatment for your initial thumb pain and is there any lingering pain?

Sgroi: I never sought treatment because the pain went away after I started using the tool.

ADVANCE: What kind of feedback have you gotten from patients about the tool?

Sgroi: Basically if you boil it down, they realize it releases the muscle a lot quicker than other things. For example, let's say a patient has pain in the musculature of the mid-thoracic or low-back area. There are massage therapists who work in my clinic and our standard protocol would be to have a massage therapist go in first to loosen the patient up. After that massage, the patients do feel quite a bit looser. But they would say even though the area feels better than when they came in, it still isn't quite right. So then I'll find the pressure point and hold onto it with the tool. The beauty of the tool is I can hold that pressure point as long as I want. Sometimes I'll hold up to five minutes. Then after holding it, I use the other end of the tool to stretch it.

The Opposable Thumb comes packaged as two separate hand tools along with two wide rubber bands. I can put those rubber bands over the top and use it as a fulcrum, then I'll stretch that muscle after I hold it. The patient will get off the table and say, "Wow." So I get a lot of positive feedback. Because you're using pressure points over sore muscles, of course it hurts to some degree. But after two or three minutes, the muscle releases. I can get a lot quicker release with the tool than I can with my thumb. Even if I was using my thumb, I wouldn't be able to hold for five minutes because of fatigue.

ADVANCE: So becoming an inventor happened pretty spontaneously for you. You weren't trying to invent something Ð you just became inspired by circumstances at your parents' house one night. So looking back from now to then, how do you feel about the success of your invention?

Sgroi: I'm ecstatic with it. It makes my job a lot easier. And it makes treatments a lot more efficient. Whereas in the past I would spend probably 20 minutes trying to get a muscle to let go with my hands and thumbs, I can do it with the tool in probably between five and 10 minutes. The amount of pressure you can apply is great, but you also have to know how to use it. If you're an experienced PT, you know you don't just dive into somebody's muscle with all the strength you have. You ease into it and as it releases, you can put more pressure there.

But with the tool you can hold it longer and get a real heavy-duty stretch. Another potential area for use is the peri-spinals, a series of muscles next to the spinal column. If I want to get just one set of them, I can use the smaller end of the tool. But if I want to treat a wider branch, I put the handle part there and stretch it across. It's also really good in the neck area for stretches you just can't get with your hands.

ADVANCE: What are your future plans for the Opposable Thumb?

Sgroi: I'm going to try to market it. I'd like to put it into not only the physical therapy arena, but also massage therapy. Some of my patients have actually bought the tool because they wanted to use it at home. A lot of them apply it to their neck. Basically it could be used in any application of holistic health, PT, massage and athletic training.

ADVANCE: At what point did you come up with the name "Opposable Thumb?"

Sgroi: Right about the time I started working with the clay. Having a name was one of the prerequisites for getting a patent. People thought it was funny and I liked it, so I stuck with it.

ADVANCE: Are there any other thoughts you would like to add about the invention?

Sgroi: Just that you can use it in so many aspects, from myofascial release to trigger point release, acupressure points and general stretching. I could give an all-day seminar on its potential applications. When I use it, and I've been working with this model for more than two years now, I come up with a different application at least once or twice a week. I can apply it to so many trouble points on a person's body, using different configurations to create different stretches. You can treat with the large end and small end simultaneously, pinning a muscle and stretching with the other side. The possibilities are limited only by your imagination and ingenuity.

Brian W. Ferrie is managing editor at ADVANCE and can be reached at bferrie@merion.com