By Matthew Hajzl, DC
As a stand-alone technique, IASTM has been taught in the States for nearly 20 years as a very basic modality for the treatment of tendonitis and sports injuries. But, is there a place for IASTM to complement Fascial Manipulation and other advanced and diversified techniques?
Rather than developing improved trainings over the years based on new developments in the understanding of trigger points, fascia, and neurology, the big IASTM companies tried to sell the idea that somehow they invented an entirely new and comprehensive manual therapy.
It turns out, scraping a painful area with an edge tool is not a new idea, and certainly is not a “comprehensive” technique. This simplified approach is unimaginative in light of all the amazing advancements in the manual therapy professions, and it has turned many skilled practitioners away from the idea of utilizing IASTM tools.
One such manual therapy technique that I have integrated with the use of IASTMtools is Fascial Manipulation (FM). FM is a both functional assssment method and manual treatment modality brought to the world by the Stecco family and their clinic in Padova, Italy.
Fascial Manipulation is a both functional assessment method and manual treatment modality brought to the world by the Stecco family and their clinic in Padova, Italy.
FM is used to treat myofascial syndromes, sports injuries, and selected visceral conditions. If you haven’t investigated FM training, I enthusiastically recommend it.But, if you can accept the idea that (even though fingers, knuckles, thumbs, and elbows are the primary “tools” of the manual therapist) certain approaches in manual technique might be complemented by the use of a hand tool(s) then there is a whole new world waiting for you.
The entity that a FM practitioner is trained to look for is fascial densification (actually gelling of hyloronic acid between fascial layers) within specific anatomically mapped points. These points correspond to very specific movement vectors of the various extremity joints and spinal regions.
The points are linked together in ten kinetic chains/lines- two on each side of the traditional planes (frontal, sagittal, horizontal) and two on each side of the FM diagonal planes. Within this conceptual framework pain syndromes or movement disorders can be described while fascial dysfunction is traced out on one or more planes and even spirals.
Long story short, when you’ve mapped out your points you are ready to perform your manual therapy. In FM this consists of knuckle, forearm, or elbow contact to the skin without emollient so that the skin pulls on the fascia deep and far from the contact. With moderate to deep pressure the contact is reciprocated in several vectors around the given point until the patient and practitioner feel the fluidity come back to the tissues and pain and/or referrals subside.
And, here is where I’d like to explain some tremendous benefits for both the patient and the practitioner of using the IASTM K-Tools. Some are obvious, like having the mechanical advantage of a fulcrum(s) in the way that you hold and apply the tool will ease strain on the practitioner’s hands. For the smaller FM points, using the HART- Tool is ideal when grasped in the pen hold. Unlike using your knuckle, you can perform this stroke all day in your clinic without fatigue.
For a larger point like LA-LU (lateral lumbi) having two hands on the K-Bar (using the flat of the bar rather than the edge) gives you a break from leaning on your elbow. When treating centers of fusion in Carpus or Talus the K-Edge wraps around the anatomy and gives you a really nice “hold” on the tissue for moving the fascia. And, too, because the Edge is balanced on the fulcrum of your index or middle finger you can get much more control with your treatment stroke vs. holding your knuckle on the point.
Here are some clinical advantages you may not have considered. There is limit (even if you are very experienced) to what you can palpate with your finger or thumb. Until you have probed the smaller end of the K-HART Tool or the hook of the K-Detail there is an entire range of smaller and very important densifications or other myofascial phenomenon you might be missing.
Until you have probed the smaller end of the K-HART Tool or the hook of the K-Detail there is an entire range of smaller and very important densifications or other myofascial phenomenon you might be missing.
Another key benefit is that you end up performing shorter strokes with a tool because you take the “slack” from your skin out of the equation. This adds up to much less effort for the practitioner. Finally, here’s something that practitioners of IASTM have known for a long time- that deep pressure exerted with the uniform geometry of a tool during palpating or treatment is actually more comfortable to the patient than probing with your thumb. Could it be that the patient perceives a more predictable set of afferent stimulus?
FM is a relatively new treatment approach and I hope those of you reading that are familiar with it consider IASTM tools to complement your practice. Also, those of you who have advanced training in other manual therapies may be able to imagine ways that a certain tool geometry could improve a tissue stroke or make your life a little easier.
For more information on Fascial Manipulation® please visit their website here.
For more information on the K Tools and the specially designed Hyaluronic Acid Release Tool the K-HART, visit their stores here.