There are many established methods of treatment for both acute and chronic soft tissue injuries.  Examples of treatments methods (non inclusive) are massage, dry needling, active release technique, heat, ice, vibration, taping, exercise, including stretching, and other passive modalities like therapeutic ultrasound.  Instrument Assisted Soft Tissue manipulation (IASTM) is one of those methods. IASTM or tools assist in reducing adhesions and increase healing rates of targeted tissue (Aspegren, 2007, Bayliss, 2011, Burke, 2007; Davidson, 1997, Fowler, 2000, Hammer, 2005, Howitt, 2009, Laudner, 2014, Lee, 2014, Loghmani, 2009).

Specially designed tools are used to apply longitudinal pressure along the course of tissue.  The tools facilitate the clinician’s ability to detect altered tissue properties, as well as facilitate the patient’s awareness of altered sensations within the treated tissues.  Increased vibration within the tool is believed to be an indication of abnormal tissue properties.  Additionally, the tools are believed to provide a mechanical advantage that allows the clinician to achieve greater depth of mechanical force transmission than can be produced with hands.  Tools also reduce compressive stress on the clinician’s hands which can prolong the career of a manual therapist.

Gua Sha was the first instrument assisted technique dating back to ~220 BC (Nelson, 2013).  The original Gua Sha instruments were made from spoons, coins, jars, wood, bamboo, bone, or jade.  The goal of Gua Sha was to intentionally create petechiae and ecchymosis (sha) by scraping the soft tissue.  Raising sha is theorized to remove blood stagnation and to promote normal circulation and metabolic processes (Nelson, 2013).

In the mid-1990s, David Graston, a pioneer of IASTM, created a method and instruments for treating soft tissue injuries.  Since the development of Graston Technique®, nearly twenty five other instruments and similar or novel techniques have been developed based on the original Gua Sha philosophy.  The problem with many of these instruments and techniques is the need for numerous tools (up to 6) and expense (many greater than $3,000 for tools and education). 

As a response to the needs of clinicians to have access to an affordable and universal tool, RockTape developed the RockBlades.  The affordability and ease of one tool allows for clinics with numerous treatment rooms to afford a tool in each room.  In addition to the clinical tool made of stainless steel tool (Figure 1), a plastic tool (Figure 2) was developed that can be traveled with easily without fear of having the tool confiscated by airport security or lost with a great expense to replace. 

Figure 1. Stainless Steel Clinical Tool

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The stainless steel tool has numerous edges to contour around the body which prevents the need of multiple tools.  Some edges are sharp for scanning the tissue and treating superficial adhesions and some edges are dull for deeper tissue penetration. In Figure 1 the edges are numbered in a clockwise order and described below.

Edge 1: Dull – Treatment of Deeper Tissue in Large Area (ie. Superficial Muscle of Hamstring)

Edge 2: Dull – Treatment of Deeper Tissue in Smaller Regions (ie. Soleus under Gastrocnemius)

Edge 3: Dull – Treatment of Deeper Tissue in Medium Size Area (ie. Bicep)

Edge 4: Sharp – Scanning and treatment of smaller regions (ie. Carpals)

Edge 5: Sharp – Scanning Large regions (ie. Forearm)

Edge 6: Sharp – Scanning and Treatment of Small Regions and Bony Prominences (ie. Elbow)

Edge 7: Dull – Treatment around Fingers and Toes

Edge 8: Dull – Treatment around Small Regions and Bony Prominences (ie Malleolus’)

Edge 9: Handle – Can be gripped either way               

Figure 2. Plastic Tool                                                                                                

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Edge 1: Dull – Treatment of Deeper Tissue in Large Area (ie. Superficial Muscle of Hamstring)

Edge 2: Dull – Treatment of Deeper Tissue in Smaller Regions (ie. Soleus under Gastrocnemius)

Edge 3: Dull – Treatment of Deeper Tissue in Small Area (ie. Finger)

Edge 4: Sharp – Scanning and treatment of Larger regions (ie. Edges of Iliotibial Band)

Edge 5: Sharp – Scanning & Treatment Medium Size regions (ie. Patellar Tendon)

Edge 6: Sharp – Scanning & Treatment of Small Regions and Bony Prominences (ie. Elbow)

Edge 7: Dull – Treatment between Fingers and Toes

Edge 8: Dull – Treatment around Small Regions and Bony Prominences (ie Malleolus’)

Edge 9: Handle – Can be gripped either way

Edge 10: Bottle Opener for after a long day of treatment

 

Some examples of the tool edges being used in the clinic:

Figure 3.  Plastic Tool: Edge 4 – Anterior Aspect of Iliotibial Band

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Figure 4.  Plastic Tool: Edge 5 – Patellar Tendon

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Figure 5. Stainless Steel Tool: Edge 7 – Between toes (ie. Metatarsalgia)

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In addition to comprehensive and affordable tools, RockTape education provides training on how to use IASTM in a safe and effective manner.  The RockBlades course presents an alternate model for IASTM work – what we define as “Instrument Assisted Neuro Sensory Modulation” or IANSM.  This draws from current thinking of the way in which fascia behaves and the influence that manual therapy has on these tissues.  Our IANSM model does not rely on traditional, at times aggressive treatment strategies using instruments, and shows how similar, if not better results can be achieved with more gentle methods.

Learn More About RockBlades Here.

RocktapeBlades Kit Out of Box (1)

Attend a half day course and get RockBlades for $499.

About the author:

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Ed Le Cara, DC, PhD, MBA, ATC, CSCS has over 20 years of chiropractic, athletic training and strength and conditioning experience.  He is based out of Dallas, TX where he treats high intensity and endurance athletes. You can contact Ed by email (ed@kinetikchain.com) or follow him on Twitter/Instagram: @drlecara

References:

Aspegren D, Hyde T, Miller M. Conservative treatment of a female collegiate volleyball player with costochondritis. J Manipulative Physiol Ther. Vol 30. United States 2007:321-325.

Bayliss AJ, Klene FJ, Gundeck EL, Loghmani MT. Treatment of a patient with post-natal chronic calf pain utilizing instrument-assisted soft tissue mobilization: a case study. J Man Manip Ther. Vol 19. England 2011:127-134.

Burke J, Buchberger DJ, Carey-Loghmani MT, Dougherty PE, Greco DS, Dishman JD. A pilot study comparing   two manual therapy interventions for carpal tunnel syndrome. J Manipulative Physiol Ther. Vol 30. United States 2007:50-61.

Davidson CJ, Ganion LR, Gehlsen GM, Verhoestra B, Roepke JE, Sevier TL. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Med Sci Sports Exerc. 1997;29(3):313-319.

Fowler S, Wilson JK, Sevier TL. Innovative approach for the treatment of cumulative trauma disorders. Work. 2000;15(1):9-14.

Hammer WI, Pfefer MT. Treatment of a case of subacute lumbar compartment syndrome using the Graston technique. J Manipulative Physiol Ther.Vol 28. United States 2005:199-204.

Howitt S, Jung S, Hammonds N. Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report. J Can Chiropr Assoc.2009;53(1):23-31.

Laudner K, Compton BD, McLoda TA, Walters CM. Acute effects of instrument assisted soft tissue mobilization  for improving posterior shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther. 2014;9(1):1- 7.

Lee JJ, Kim do H, You SJ. Inhibitory effects of instrument-assisted neuromobilization on hyperactive gastrocnemius in a hemiparetic stroke patient.Biomed Mater Eng. Vol 24. Netherlands 2014:2389-2394.

Loghmani MT, Warden SJ. Instrument-assisted cross-fiber massage accelerates knee ligament healing. J Orthop Sports Phys Ther.2009;39(7):506-514.