Hands OFF!


How instrument-assisted soft tissue mobilization can benefit rehab professionals

Over the years, rehabilitation professionals have worked tirelessly to break the stigma or connection between their craft and pain. But there seem to be two unbreakable truths:

  • Manual therapy can be highly beneficial to individuals who are recovering from injuries or those with chronic conditions
  • Sometimes, it hurts

Enter the world of instrument-assisted soft tissue mobilization (IASTM), a process in which a qualified clinician uses a set of hand-held instruments to break down the scar tissue and fascial restrictions in soft tissues (muscles, ligaments, tendons, fascia, and nerves).

Rick Daigle, PT, DPT, STMT, CF-L1, has almost 15 years’ experience in sports medicine and private practice as a physical therapist. Dr. Daigle also holds multiple certifications in IASTM and has been teaching continuing education courses on this topic and others for the past seven years. This spring in Tampa, FL, he’ll be offering his first massage therapy-related IASTM course.

“IASTM is another form of manual therapy,” Dr. Daigle explained, “and there are a number of schools of thought as to what it can or cannot do.”

IASTM is not intended to replace the clinician or therapist; rather, it aids them and gives them yet another means of introducing what Dr. Daigle calls “novel sensory input” into the skin.

“You feel different things with the stainless-steel tools than you do from the therapist’s hands,” he explained. “It’s not a matter of one being better than another, they’re just different. They allow more feedback.”

From a therapist’s perspective, these tools can also save some wear and tear on the hands, as the tools lessen the manual workload on the practitioner. “My whole philosophy on manual therapy goes back to the nervous system, and the skin as an extension of the brain. It’s a case of ‘less is more,” Dr. Daigle explained. “If we go too hard, too aggressive, we increase threats to the system, which diffuses the entire purpose of calming the nervous system and allowing patients to complete their movement drills more effectively.”

Dr. Daigle cautions against following some of the conventional wisdom associated with IASTM. “If you research, you’ll see claims that IASTM breaks down scar tissue, and that couldn’t be further from the truth,” he explained. “There’s no real, solid evidence that shows anything we do directly breaks down scar tissue. Technically, a lot of the effects are secondary. I primarily use tool work to calm the system down, get people doing things quicker, more effectively.”

Dr. Daigle’s background in sports medicine gives him a certain level of expertise when it comes to treatment that can extend an athlete’s career, and IASTM works similarly—but for therapists. Picture a seasoned PT, who’s provided decades’ worth of manual therapy to countless patients—work that takes a toll on the muscles, joints, and nerves in that practitioner’s own hands. IASTM may improve, or prolong, that therapist’s ability to practice. “Their own discomfort is keeping them from doing as much manual therapy as they once did,” he explained, “and these tools ease the process. You’re not working as hard.”

It’s not, however, a replacement for manual therapy. If you’re inexperienced in the area, IASTM will not suddenly create a new expert. More accurately, IASTM serves as an adjunct to an existing set of skills in the area.

IASTM and Massage
This spring won’t be Dr. Daigle’s initial foray into teaching massage therapists. Much like PTs, massage therapists are interested in discovering new ways to help their patients through the use of tools. But now, he plans to target this population of practitioners specifically.

“I have found that [massage therapists] in general may be a little more tentative to use these tools,” Dr. Daigle observed, “and I think there’s an opportunity to add this to their repertoire. It’s also a useful marketing tool to get people in the door.”

The principle-based approach emphasizes the philosophy behind IASTM rather than the utilization of any one piece of equipment. “It’s a piece of stainless steel,” Dr. Daigle simplified. “It’s not the tool that matters—different shapes, different uses, and each person will have a specific response.”

Where many instructors are teaching specific techniques based on one particular tool, Daigle’s course focuses on the principles of IASTM.

“If someone already has tools, great,” he said. “In my course, therapists will get five, six, seven different options for practice—if they like those, great.

“If they don’t like them, there are probably another 75 or so options out in the market that they can go find to utilize these skills.”

The principle-based approach is what makes Dr. Daigle’s course unique and effective. Both the experience IASTM practitioner and the novice can benefit, because the approach is so scientific. “We go through the science—what works, what doesn’t work, the research that proves this can contribute to neurological feedback, and the research that shows there are no direct mechanical effects. You won’t be pigeonholed into using a specific tool—I’ll lay out the ideas, and you can use the principles in the way you see fit.”

Finally, Dr. Daigle reinforced his “less is more” philosophy. “From a manual therapy standpoint, we’re not trying to ‘grip and rip’ or get in there and dig as hard as we can, bruising patients,” he said. “We want to give good feedback, decrease threats to the nervous system. That sums up our philosophy.”

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