IASTM Home Study

Lessons

Foreword and Welcome Introduction

Foreword from Dr. Nik Vizniak Congratulations on making the best investment of your life. Professional Health Systems was started in 2002, by Dr. Nikita Vizniak with the mission of creating high value, evidence based resources for students, therapists and doctors that improve patient outcomes by achieving clinical excellence. Frustrated with the cost and lack of [...]

Learning Objectives

At the end of this course, you will be able to: Interpret and list two sources on the foundation and origin of Instrument Assisted Soft Tissue Mobilization (IASTM) and the latest research as it applies clinically. Apply the fanning stroke with a patient who has active or latent trigger points in their upper trapezius muscle. [...]

Chapter 1a: Foundation and Origin of IASTM

Background Soft tissue manipulation (STM) is a type of manual therapy administered by hands alone or with a rigid device. Instrument assisted soft tissue mobilization (IASTM) is a type of STM that uses rigid devices to deliver directed, targeted forces to specific tissue (Loghmani 2016). The history of IASTM has been traced back to ancient […]

Chapter 1b: Foundation and Origin of IASTM

Graston Technique In 1987, David Graston suffered a knee injury, leaving him in need of reconstructive surgery. The physical therapist that treated him used cross friction massage on his scar. David saw the benefits and started to treat himself. When traditional rehabilitation failed to help with his post-surgical scar tissue, he developed the first prototypes [...]

Chapter 1c: Foundation and Origin of IASTM

IASTM: Humans Research Multiple case reports have demonstrated positive IASTM treatment outcomes for numerous diagnoses, including post-natal chronic calf pain (Bayliss et al 2011), ankle pain/fibrosis, knee arthrofibrosis and quadriceps insufficiency after a patellar tendon repair (Melham TJ 1998), plantar fasciitis (Daniels 2012), trigger thumb (Howitt 2006), tendinopathies (Papa 2012 & Miners 2011) epicondylopathy (Slaven [...]

Chapter 2a: Research and Effectiveness of IASTM

Research Simplified Background Research is complicated. However, in order to understand this next section, we need to explain and clarify a few points when it comes to research. When reading a journal article, it is imperative that the reader understands the type of study (design) performed, the supporting evidence behind it, and the grade of […]

Chapter 2b: Research and Effectiveness of IASTM

Different Types of Research Studies Meta-Analysis: A systematic review that uses quantitative methods to summarize the results. Combines the results of several studies that address a set of related research hypotheses. Systematic Review: Authors have systematically searched for, appraised, and summarized studies all of the medical literature on a specific topic with predetermined criteria. Most [...]

Chapter 2c: Research and Effectiveness of IASTM

IASTM Effectiveness: Research Evidenced based research is limited with respect to high quality articles (Meta Analysis, Systematic Reviews and Randomized Controlled Trials) on IASTM. Discussed below first are the different types of high-level research on cervical, shoulder, trunk/lumbar, hip/knee, elbow and foot pain. Next, various clinical studies and case reports are listed that have been [...]

Chapter 2d: Research and Effectiveness of IASTM

Knee Research A RCT study by (Markovic 2015) wanted to compare the effects of one session (2 minutes) of the IASTM Fascial Abrasion Technique (FAT™) to one session of foam rolling (2 minutes) on hip and knee ROM in soccer players. Results: the group that received the IASTM gained twice as large increases in range [...]

Chapter 2e: Research and Effectiveness of IASTM

Lateral Epicondylitis Research In a randomized controlled trial (RCT) by (Sevier and Stegnick 2015), they wanted to investigate and compare the efficacy of ASTYM treatment to an evidenced based eccentric exercise program for patients with lateral epicondylagia. Subjects with lateral epicondylagia were randomly assigned to 4 weeks of ASTYM or eccentric exercise treatment. Results: The [...]

Chapter 3a: Principles and Benefits of IASTM Related to Soft Tissue Dysfunction

Principles of IASTM The purpose and usefulness of IASTM is two-fold. First to target affected tissue deeper than your hands can and to literally save your hands. IASTM is a simple and practical technique because the surface of the instrument minimizes the force used by the practitioner, but maximizes the force delivered to the tissues. […]

Chapter 3b: Principles and Benefits of IASTM Related to Soft Tissue Dysfunction

Clinical Benefits Research shows that the one of the best ways to repair tendons is by stimulating fibroblast creation. Fibroblasts are the cells that help create new collagen fibers to repair tissues. IASTM has been shown to increase the stiffness in tendons after injury and promote faster healing times. By creating micro-trauma to a tendon [...]

Chapter 4a: Mechanical and Neurophysiologic Responses to IASTM

Tissue Dysfunction: Scar Tissue and Adhesions Injury, trauma or surgery, all affect the connective tissue within the body. Where it has been show in research, that after an injury and surgery, the body starts to heal itself from the inside out. Scar tissue is a natural occurrence from the inflammatory response that is seen after […]

Chapter 4b: Mechanical and Neurophysiologic Responses to IASTM

Mechanical Effects of IASTM Mechanotransduction is the physiologic process where cells both sense and respond to mechanical loads. Biomechanically, IASTM decreases the resistance of the involved tissue(s), providing a direct improvement in the range of motion (ROM) of the areas being treated (Ostojic et al 2014). When a rigid instrument (IASTM) is used, the device [...]

Chapter 4c: Mechanical and Neurophysiologic Responses to IASTM

Neurophysiologic Responses of IASTM In terms of explaining the neurophysiological effects of soft tissue mobilization, mobilization stimulates the same tissues as spinal manipulation (Simmon 2010). Except, the number of receptors around a joint is far outweighed by those in the surrounding fascia (such as epimysium and deep fascia) so that absolute joint motion may not [...]

Chapter 5a: Type of Tools

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Gua Sha Tools Tools for Gua Sha include the Chinese soupspoon, an edge-worn coin, buffalo horn, a cow rib, honed jade, or a simple metal cap with a smooth round lip as seen in the Figure 1 listed below. IASTM Tools Since the early 1990s and the development of Graston Technique, nearly twenty-five other instruments [...]

Chapter 5b: Type of Tools

Tool Order Selection There are a few IASTM continuing education courses available for allied health professionals offering both online, home study and/or live seminar IASTM training. Of the continuing education providers that either offer online, live seminar or both format, I have not found one provider that explains the ‘standardized approach’ when choosing your first [...]

Chapter 6a: Type of Strokes and Techniques

Basic Concepts When choosing an instrument think about what you are trying to do, as there are a few considerations that should be made: 1. Size of the treatment area will determine which tool to use. Meaning, the larger the instrument, the broader the muscle regions covered as seen in hamstring, iliotibial band, quadriceps and […]

Chapter 6b: Type of Strokes and Techniques

Types of Strokes and Techniques There is limited information on the types of strokes pertaining to IASTM other than the popular graston technique. Nielsen et al (2007) wanted to study the microcirculatory effects of Gua Sha on the skin and sub cutis in humans to elucidate physiological mechanisms responsible for the clinically observed pain-relieving effect [...]

Chapter 6c: Type of Strokes and Techniques

Size and Shape of Tool There are a number of instruments available. A larger instrument is ideal for treating cover larger surface areas, such as the quadriceps, hamstring or latissimus dorsi muscles. Whereas a smaller instrument, is ideal for targeting smaller areas, targeted tissues with a focused treatment. The convexity of the instrument will effect [...]

Chapter 6d: Type of Strokes and Techniques

Strokes and Techniques (cont'd) Fanning Stroke Fanning stroke is an ideal stroke for crossing over muscle fibers in multiple directions. Technique: There are two different approaches you can use, a one handed approach or a two handed approach. Despite which the clinician uses, the strokes are performed in an arc of motion, as seen in [...]

Chapter 6e: Type of Strokes and Techniques

Strokes and Techniques (cont'd) Framing Stroke Framing stroke is performed around bony contours. This technique involves short to medium straight or circular strokes. It is like cleaning of gristle. Technique: IASTM tool is applied multidirectional around bony prominence in a ‘fanning’ direction as seen in the figure nine below. Clinical Application: excellent technique for clinical conditions [...]

Chapter 6f: Strokes and Techniques

Recommended Dosage Pre IASTM Treatment Prior to treatment, a general warm-up is recommended for the target region. The stationary bike, elliptical trainer for the lower body and UBE for the upper body are ideal. After identifying from your objective initial examination, begin with utilizing a larger instrument to scan the soft tissue for irregularities and [...]

Chapter 7a: Indications, Precautions and Contraindications

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Fundamentals of IASTM It is important to review the fundamentals of IASTM, which includes indications, precautions and contraindications before applying with patients. Understanding each of these will yield greater, safe results for your patients and clients. Purpose of Treatment The clinician should always keep in mind the intention and treatment goal while using IASTM. As [...]

Chapter 8a: The Foundation of Fascia and Fascial Slings

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What is Fascia? Fascia is a seamless web of connective tissue found throughout your body. It wraps around every muscle, bone, organ, nerve and blood vessel and holds the body together. Fascia is a component of the connective tissue system (Myers TW 2009). Connective tissue (CT) is one of four major classess of tissue. The [...]

Chapter 8b: The Foundation of Fascia and Fascial Slings

Foundation of Fascia Fascia is a tough connective tissue that spreads throughout the entire body encasing muscles, bones, nerves, blood vessels and various organs of the body. Fascia can be categorized into three divisions: fascia superficialis, fascia profunda, and deepest fascia. Layers of Fascia 1. Fascia superficiais (superficial fascial layer) A layer of loose connective [...]

Chapter 8c: The Foundation of Fascia and Fascial Slings

Injury and Fascia With acute inflammation, fascia tightens and loses its pliability. Maintaining poor posture over a long period of time will prevent full excursion of the fascia, and shorten fascia. When this happens, stretch of the fascia to what was previously a pain free range may cause pain to be felt at distant sensitive [...]

Chapter 8d: The Foundation of Fascia and Fascial Slings

Fascial (Muscle) Slings and Lines Background It has been suggested through various texts, the locomotor (musculoskeletal) system and myofascial tissues act as one unit, functioning as a whole. That within our body, there are “muscle slings” that are described as the co-operation of muscle groups that exert coordinated movements. A muscular group must have a [...]

Chapter 8e: The Foundation of Fascia and Fascial Slings

Tom Myers: Six Distinct Lines Figure 4. Superficial Front Line; permission granted from Anatomy Trains by Tom Myers, page 97, copyright Elsevier 2009 Figure 5. Superficial back line; permission granted from Anatomy Trains by Tom Myers, page 73, copyright Elsevier 2009 Figure 6. Lateral line; permission granted from Anatomy Trains by Tom Myers, page 115, copyright [...]

Chapter 9a: Trigger Points

What are Trigger Points? Simons, Travel and Simons defined a trigger point (TrP) as a hyperirritable spot in skeletal muscle that is associated with a hypersensitive palpable nodule in a taut band. The spot is tender and gives rise to characteristic referred pain, motor dysfunction and autonomic phenomena. Thus each TrP contains a sensory component, […]

Chapter 9b: Trigger Points

Clinical Presentation and Symptoms The prevalence of trigger points per the research, states that TrpS are found greater in women than men and the frequency of locations are head/neck (scalenes, levator scapula and upper trapezius muscles), shoulders, extremities, and low back (quadratus lumborum), in that order (Gulick D 2016). The pain is described as "deep [...]

Chapter 9c: Trigger Points

Why Trigger Points Form: Evidenced Based Research (cont'd) The altering of a person’s sitting or standing posture, affects the muscle contraction, tissue length and muscle balance between the neck flexors and extensors of the body. In other words, if someone sits with a forward head posture and rounded shoulders several hours a day, every day, [...]

Chapter 9d: Trigger Points

Why Trigger Points Form: Evidenced Based Research (cont'd) Vladamir Janda defined muscles into two primary categories, postural and phasic. Tonic and Phasic Muscle Systems Janda identified two groups of muscles based on their phylogenetic development (Janda 1987). Functionally, muscles can be classified as “tonic” or “phasic”. The tonic system consists of the “flexors,” and is [...]

Chapter 9e: Trigger Points

Why Trigger Points Form: Evidenced Based Research (cont'd) Trauma and Surgery Injury to the body can be either direct or indirect trauma. Trauma directly affects contractile fibers including both actin(thin) and myosin(thick) filaments. With trauma, swelling may be present or not, however, there is a recruitment of large, myelinated A-delta fibers (nocioceptors) initially. Biochemically, direct [...]

Chapter 9f: Trigger Points

Evidenced-Based Research: Treating Trigger Points As stated previously, trigger points can be formed in muscles as a result of direct or indirect stimuli. Travell and Simons first identified the importance of myofascial pain and its localization in what they termed trigger points, providing the first classification of diagnostic criteria for TrPs. They also provided detailed [...]

Chapter 9g: Trigger Points

Evidenced-Based Research: Treating Trigger Points (cont'd) In a systematic review by Howard, V (2009), wanted to review the most commonly used treatment procedures in chiropractic for MPS and MTrPs. Evidence supports laser therapy (strong) or A rating. While there is moderately strong evidence (B rating) for nonmanipulation, manual therapy and ischemic pressure to support the [...]

Chapter 9h: Trigger Points

Evidenced-Based Research: Treating Trigger Points (cont'd) Therefore, a convincing conclusion was not made, requiring a further need for future studies to make recommendation in this area. There is some evidence of the effects of acupuncture for chronic low back pain. Conclusion: the data suggest that acupuncture and dry needling may be useful adjuncts to other [...]

Chapter 9i: Trigger Points

Evidenced-Based Research: Treating Trigger Points (cont'd) Ankle Research Leitch, S, et al (2012) conducted a systematic review and meta-analysis of the evidence for physical therapies for achilles tendonopathy (AT) management. Although the evidence base for physical therapies for AT continues to evolve, there remains a lack of evidence for their efficacy from high-quality studies. Eccentric [...]

Chapter 10a: Clinical Patterns of Common Orthopedic Movement Dysfunctions

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Clinical Reasoning Clinical Reasoning is the process by which a therapist interacts with a patient, collecting information, generating and testing hypotheses, and determining optimal diagnosis and treatment based on the information obtained. It is defined as “an inferential process used by practitioners to collect and evaluate data and to make judgments about the diagnosis and [...]

Chapter 11a: IASTM Techniques for Upper Body

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Neck Conditions 1. Cervical Spondylosis History of Condition: Patient will complain of having a history of neck pain that recently worsens over time. A traumatic event potentially occurred previously, but patient doesn’t remember. Cervical spondylosis typically effects 50-60 year old men and women with a gradual onset. The levels most affected by cervical disc disease [...]

Chapter 11b: IASTM Techniques for Upper Body

Neck Conditions (cont'd) 2. Cervical Disc Herniation (HNP) History of Condition: Cervical disc herniation is less common than lumbar disc herniation. The lower incidence is because the cervical discs are anatomically smaller than the lumbar discs, and undergo less stress from weight bearing than the lumbar disks (Starkey & Johnson 2006). Typically associated with an [...]

Chapter 11c: IASTM Techniques for Upper Body

Neck Conditions 2. Cervical disc herniation (HNP) (cont'd) Evidenced-Based Practice: To date, optimal strategies for the management of patients with cervical radiculopathy remains elusive. Preliminary evidence suggests that a comprehensive treatment program consisting of manual therapy, exercise, and cervical traction may result in positive outcomes for patients with cervical radiculopathy. Langevin, P. et al (2015) [...]

Chapter 11d: IASTM Techniques for Upper Body

Neck Conditions 3. Cervical Facet Syndrome History of Condition: Patient will complain of having a history of neck pain that recently worsens over time. Condition can also occur as a result of sudden action or can result from falling asleep on couch or position that compromises facets. According to the research, More than 50% of [...]

Chapter 11e: IASTM Techniques for Upper Body

Neck Conditions 4. Cervical Radiculopathy History of Condition: Cervical radiculopathy is a common condition, affecting both sexes after middle age or those individuals who are older, with a history of degenerative changes. Irritation of cervical nerve root occurs as a result of mechanical derangement in or about the intervertebral foramen. Other causes include a ruptured [...]

Chapter 11f: IASTM Techniques for Upper Body

Neck Conditions 5. Whiplash History of Condition/Mechanism of Injury: Whiplash is an acceleration-deceleration mechanism of energy transfer to the neck often as a result from a motor vehicle collision or other traumas to the neck. During a whiplash injury, there is a sudden hyper flexion or excessive hyperextension affecting the soft tissues. Based on documented [...]

Chapter 11g: IASTM Techniques for Upper Body

Whiplash (cont'd) Medical Management: In the acute phase, soft collars are recommended. However, Prolonged rest periods or use of a collar weakens tissues and studies have shown that immobilizing the neck for long periods of time can decrease muscle strength and impair recovery. Patients will also receive NSAIDS to assist with inflammation and pain. Patients [...]

Chapter 11h: IASTM Techniques for Upper Body

Neck Conditions 6. Concussions History of Condition: Concussions occur as the result of a rapid acceleration-deceleration force that is applied to the moving brain, that imparts shearing or torsional forces to neural tissue. This is followed by metabolic and mechanical changes. Pathophysiology: Concussion creates a cascade of changes inside the brain. Metabolic changes occur resulting [...]

Chapter 11i: IASTM Techniques for Upper Body

Neck Conditions Thoracic Outlet Syndrome (TOS) History of Condition: Occurs with insidious onset typically without specific trauma. Sustained postures that compromise the neck with side bending (SB), create compressive force on the brachial plexus. Overtraining the pectorals, anterior deltoid, biceps (creates compression on the anterior muscles and soft tissue), can compromise the neurovascular plexus. TOS [...]

Chapter 11j: IASTM Techniques for Upper Body

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Common Dysfunctions of the Shoulder Shoulder injuries can occur as a result of trauma, overuse or gradual onset overtime. The next section will review the most common shoulder injuries providing insight to understanding these pathologies and how to train respective clients. 1. Shoulder Impingement Syndrome History of Condition: Is a condition affecting the shoulder with [...]

Chapter 11k: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) b. Secondary (Structural) Impingement (cont'd) Area of Symptoms: Characterized by pain as a result of painful shoulder abduction from approximately 60-120 degrees of shoulder abduction. Associated Symptoms: Generalized ache within the scapula and upper trapezius. Behavior of Symptoms: 24 hr. pattern: a.m. patient describes pain that is achy and [...]

Chapter 11l: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 2. Rotator Cuff Tear (RTC) Tear History of Condition: Rotator cuff injuries can occur as a result of trauma, overuse or gradual onset overtime. Rotator cuff tears are one of the most common causes of shoulder pain. With the growing population, the prevalence of rotator cuff injury, correlates with [...]

Chapter 11m: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 3. Bankart Lesions History of Condition: Bankart lesions typically occur as a result of a traumatic event, affecting typically younger patients. Pathophysiology: Result from the detachment of glenohumeral ligament (GH) from the glenoid cavity causing disruption of the inferior glenohumeral ligament. This disruption greatly reduces the anterior stability of [...]

Chapter 11n: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 4. Superior Labral Anterior Posterior (SLAP) Injury History of Condition: The superior glenoid labrum is a common site of injury in overhead throwing athletes, because of the relation of the long head of the biceps tendon on the glenoid rim. Andrews was the first physician to describe labral injuries [...]

Chapter 11o: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 5. Hills Sachs Lesion History of Condition: Results from forceful impaction of the humeral head against the anteroinferior glenoid rim when the shoulder is dislocated anteriorly. Mechanism of Injury: It occurs when a force displaces the humeral head outside the concavity of the glenoid. Once the humeral head is [...]

Chapter 11p: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 6. Glenohumeral Instability History of Condition: Anterior shoulder instability has been reported to occur in 2% to 8% of the population, most often as a resulting from trauma to the affected extremity (Crumet, R et al 2010). Pathophysiology: Injury to the glenoid cavity, and supportive tissue and structures, creates [...]

Chapter 11q: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 7. Multi-directional instability (MDI) History of Condition: The condition of MDI is one of an unstable shoulder joint typically caused by trauma or repetitive trauma. Pathophysiology: Injury to the glenoid cavity, and supportive tissue and structures, creates increased laxity within the joint and among the supportive ligaments (superior, middle [...]

Chapter 11r: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 8. Glenohumeral Separations/Dislocations a. Anterior Dislocation (most common dislocation) History of Condition/Mechanism of Injury: results from an upper extremity or arm that is in a combined abducted and externally rotated position forcing the humeral head forward (anterior). This causes a possible tear of the inferior glenohumeral ligament (IGH). Stability [...]

Chapter 11s: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 9. Acromioclavicular Sprains (AC joint) History of Condition: The mechanism of injury occurs as a result of direct trauma or fall onto the shoulder with arm adducted (across body). The patient will typically remember a specific isolated event relating to his/her pain. Pathophysiology: Sprains are defined generally as direct [...]

Chapter 11t: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 10. Bursitis (sub deltoid or sub acromial) History of Condition: Bursitis affects the medial deltoid (sub acromial), which can be caused by a repeated minor trauma such as overuse of the shoulder joint and muscles or a single more significant trauma such as a fall. In overuse type injuries, [...]

Chapter 11u: IASTM Techniques for Upper Body

Common Dysfunctions of the Shoulder (cont'd) 11. Adhesive Capsulitis (frozen shoulder) History of Condition: There are several factors that contribute to the development of adhesive capsulitis which includes; 1) prolonged use of sling. This places humerus in an internally rotated (IR) position, which shortens the pectorals and anterior shoulder musculature. 2) patient may not move [...]

Chapter 12a: IASTM Techniques for Lower Body

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Lumbar Conditions Spinal injuries, particularly the lower lumbar(back) regions are becomingly increasing prevalent, where the research indicates that 60% of Americans will have an injury to their lumbar spine in their lifetime. In this next section, common spinal dysfunctions will be extensively reviewed. 1. Lumbar Spondylosis History of Condition: Patient will complain of having a [...]

Chapter 12b: IASTM Techniques for Lower Body

Lumbar Conditions 2. Lumbar Spondylolysis History of Condition: The exact cause of spondylolysis is unknown, however, theories have evolved implicating both congenital and developmental causes (McNeeley 2003). The ‘congenital theory’ states that there is a genetically predisposed weakness in the pars interarticularis (Motley et al. 1998), and evidence for the theory is found in the [...]

Chapter 12c: IASTM Techniques for Lower Body

Lumbar Conditions 3. Spondylolisthesis History of cCndition: Degenerative spondylolisthesis is a condition where there is a slip of one vertebral body over the one below. Compared to congenital spondylolisthesis, in which sometimes is due to malformed facets with intact pars interarticularis the whole upper vertebra, can slip forward and cause spinal stenosis with potential impingement [...]

Chapter 12d: IASTM Techniques for Lower Body

Lumbar Conditions 4. Spinal Stenosis History of Condition: The patient will have a history of degenerative changes in spine. The majority of cases of lumbar spinal stenosis occur secondary to degenerative changes. Stenosis is insidious and commonly heralded by a long history of central low back pain (Smith, H.S. 2009). Pathophysiology: A narrowing within the [...]

Chapter 12e: IASTM Techniques for Lower Body

Lumbar Conditions 5. Herniated Disc - Four Types: Protrusion/Prolapse/Extrusion/Sequestration History of Condition: Lumbar disc injuries are a result of typical specific episode or event that a person recalls or due to a degenerative process of the lumbar spine. Traumatic events involved usually a combined bending and twisting motion. Pathophysiology: Trauma or injury stimulates nocioceptors (pain [...]

Chapter 12f: IASTM Techniques for Lower Body

Lumbar Conditions 6. Facet/Joint Dysfunction (Inadequate gliding of facet) History of Condition: Patient may be involved in an event where the lumbar spine is placed in a combined side bent, rotated and extension position, compromising the facet joint, causing the segment to become stuck (i.e. falling asleep on the couch). Pathophysiology: Facet joints, also known [...]

Chapter 12g: IASTM Techniques for Lower Body

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Elbow Conditions 1. Lateral epicondylitis History of Condition: An overuse condition of the extensor-supinator forearm group of muscles at the elbow, leading to micro tears and progressive degeneration. Caused by overuse repetitive gripping or manual tasks that involve pronation +/- extension of wrist, plus change in loading. Area of Symptoms: pain along lateral elbow/lateral epicondyle, [...]

Chapter 12h: IASTM Techniques for Lower Body

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Hip Conditions 1. Gluteal Tendonopathy History of Condition: Lateral hip pain is a debilitating condition characterized by pain located at or around the greater trochanter, which is the site of the integration of three bursae, the hip abductor-lateral thigh muscles and the iliotibial tract. Gluteal tendonopathy (GT) is thought to be the primary cause of [...]

Chapter 12i: IASTM Techniques for Lower Body

Hip Conditions 2. Iliotibial Band Syndrome History of Condition/Mechanism of Injury: liotibial band syndrome (ITBS) is an overuse injury associated with pain on the lateral aspect of the knee. Patients have no history of trauma and describe an insidious onset of lateral knee pain during a run. The pain typically appears a few kilometers into [...]

Chapter 12j: IASTM Techniques for Lower Body

Hip Conditions 3. Hip Osteoarthritis History of Condition: Hip osteoarthritis is the most common form of arthritic disorders and is one of the most common reasons for visiting a health care provider (Sutlive 2008). Hip OA is predicted to affect people age >60 years of age with an increase of 20-30% by 2030 (Wrist 2009). [...]

Chapter 12k: IASTM Techniques for Lower Body

Hip Conditions 4. Total Hip Replacement History of Condition: Osteoarthritis is the most common form of arthritis and one of the leading causes of pain and disability worldwide. The lifetime prevalence of symptomatic hip osteoarthritis is estimated at 25.3%, while that of knee osteoarthritis is even higher at 44.7%. (D van der windt 2013). Joint [...]

Chapter 12l: IASTM Techniques for Lower Body

Hip Conditions 5. Femoral Acetabular Impingement (FAI) History of Condition: Femoroacetabular impingement (FAI) is an abnormal articulation and abutment of the femoral head against the acetabulum, is suggested to contribute to acetabular labral tear (ALT) and chondrolabral injuries. FAI is a musculoskeletal condition that affects young population who engage in sports such as hockey, tennis, [...]

Chapter 12m: IASTM Techniques for Lower Body

Hip Conditions 6. Hip Labral Lesions History of Condition: Athletes, who are involved in repeated hip flexion positions that involve twisting and turning in weight bearing sports such as soccer, handball, hockey, and ice hockey are prone for labral injuries. Labral hip lesions are more common in women (Leibold et al 2008). Usually patients do [...]

Chapter 12n: IASTM Techniques for Lower Body

Knee Conditions 1. Patellofemoral Syndrome (PFS) History of Condition: Is a condition where the patella does not translate biomechanically in the trochlear groove between the femoral condyles. Here the patella is positioned in either a tilt, glide or rotation accompanied by diffuse, achiness in the front of the knee. PFS is a common disorder of [...]

Chapter 12o: IASTM Techniques for Lower Body

Knee Conditions 2. Chrondomalacia Patella Pathophysiology/Sign and Symptoms: Chrondomalacia is a softening of the articular cartilage on the underside of the kneecap. This results in irritation and knee pain. Anatomically, the undersurface of the kneecap, or patella, is covered with a layer of smooth cartilage. The role of cartilage is to provide a gliding of [...]

Chapter 12p: IASTM Techniques for Lower Body

Knee Conditions 3. Knee Osteoarthritis (OA) History of Condition: Is a condition with insidious onset, or over time where there is a degenerative, “wear-and-tear" type of arthritis that occurs most often in people 50 years of age and older, but may occur in younger individuals. Osteoarthritis (OA) is the most common form of arthritis and [...]

Chapter 12q: IASTM Techniques for Lower Body

Knee Conditions 4. Total Knee Replacement History of Condition: The most common indication for a total knee arthoplasty is disabling arthritic pain that failed from conservative treatment (i.e. NSAIDS, physical therapy, cortisone injections, synvisc). In elderly, typically over 65 years of age. Pathophysiology (same as Knee Osteoarthritis): O.A. is characterized by a progressive loss of articular [...]

Chapter 12r: IASTM Techniques for Lower Body

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Ankle Conditions 1. Ankle Sprains Pathophysiology/Mechanism of Injury: Are typically as a result of direct trauma where 85-90% of all ankle sprains are lateral (inversion) ankle sprains. With lateral sprains, the foot is plantar flexed and inverted at the time of injury injuring the anterior talofibular ligament initially, with the calcaneofibular ligament and posterior talofibular [...]

Chapter 12s: IASTM Techniques for Lower Body

Ankle Conditions 3. Achilles Tendonitis Mechanism of Injury/Pathophysiology: The achilles tendon is among the most prone to overuse injury, with tendon problems accounting for up to 18% of injuries in runners and 4% of patients presenting to sports medicine clinics (Magnussen et al 2009). When someone complains of pain in his or her achilles, this [...]

Chapter 12t: IASTM Techniques for Lower Body

Ankle Conditions 3. Achilles tendonitis (cont'd) Evidenced-Based Physical Therapy Treatments for tendinopathies are wide ranging, and include but are not limited to orthotics, physiotherapy, orthotics, laser treatment, eccentric training, shock wave therapy, platelet rich plasma injections, and surgery. This wide range of treatments reflects the limited consensus among clinicians on how this pathology is best [...]

Chapter 12u: IASTM Techniques for Lower Body

Ankle Conditions 4. Plantar Fasciitis Pathophysiology: Caused by mechanical loading of the plantar fascia, causing an irritation and inflammation of the plantar fascia as a result of over/excessive pronation. Figure 21. Plantar fascitis; copyright permission granted by Dreamstime Figure 22. Decreased longitudinal arch (fallen arch); copyright permission granted by Dreamstime Risk Factors: Excessive pronation, decreased [...]

Chapter 12v: IASTM Techniques for Lower Body

Ankle Conditions 5. Tarsal Tunnel Syndrome Pathophysiology: Is compression or entrapment of the posterior tibial nerve within the tarsal tunnel as a result of over/excessive pronation resulting in tendonitis of the long flexor and posterior tibial tendon. Risk Factors: Hereditary, excessive weight, improper/poor shoes, excessive pronation of foot. Sign and Symptoms: Pain, numbness and parasthesias [...]

Chapter 12w: IASTM Techniques for Lower Body

Ankle Conditions 7. Anterior Compartmental Syndrome (ACS) Pathophysiology: Is increased pressure within the anterior tibialis/myofascial compartment as a result of increased pressure. This occurs when the increase in the intra-compartmental pressure is sufficient to retard blood flow to the tissues within the compartment, leading to pain and neurological deficits. Risk Factors: Direct trauma, fracture, and overuse. [...]

Upper Body: Treatment and Assessment Strokes

Treatment Strokes for the Neck Sweeping stroke to the cervical paravertebral muscles at the base of the occipital condyle. Sweeping stroke to the left upper trap using the EDGE tool. J stroke to left upper trapezius muscle. Strumming to the superior aspect of left medial scapula border. Application: whiplash patients when tissue and cognitively appropriate. [...]

Upper Body: Treatment and Assessment Strokes

Treatment Strokes for the Neck and Shoulder Fanning stroke to the left pectoral muscles. Fanning stroke to left anterior deltoid and to left short head of bicep. Fanning stroke with scapular release to left medial scapula with the patient in side lying position. The IASTM tool is placed medial to the scapular border with the [...]

Upper Body: Treatment and Assessment Strokes

Treatment Strokes for Shoulder Girdle Sweeping stroke over the posterior deltoid (concave on convex). Brushing stroke to left supraspinatus. Application: Whiplash patients, suprinatus tendonitis vs. tendonopathy. Sweeping stroke using handlebar tool along medial scapular border applied medial to lateral. Application: frozen shoulder (adhesive capsulitis). Sweeping stroke to superior and medial aspect of left shoulder.

Lower Body: Treatment and Assessment Strokes

Treatment Strokes for the Lower Back Brushing stroke to paraspinals and left quadratus lumborum muscle. J stroke to distal aspect of erector spinae and superior aspect of sacrum. Alternative sweeping stroke holding handlebar tool stationary while patient actively side bends trunk to left. Application: tight quadratus lumborum secondary to trauma. Sweeping stroke where patient is [...]

Lower Body: Treatment and Assessment Strokes

Treatment Strokes for the Thigh and Leg Scanning/sweeping stroke using EDGE tool to proximal aspect of right quadricep muscle. Application: for TKR patients to address adaptive shortening tissue protecting surgical site. Strumming to distal quadriceps and vastus lateralis muscles. Sweeping stroke using handlebars to right ITB, vastus lateralis and outer quadriceps muscles in left side [...]

Lower Body: Treatment and Assessment Strokes

Treatment Strokes for the Calf and Foot Sweeping stroke to right upper calf muscle from proximal to distal. Strumming and framing strokes to the gastrocnemius muscle. Application: patients suffering TKR as calves adaptive shorten to protect, plantar fasciitis as well as ankle sprain patients. Sweeping stroke to gastrocnemius muscle. Fanning stroke to gastrocnemius muscle. “Tenderizing” [...]

IASTM Home Study Summary

Summary Injuries to the musculoskeletal system commonly occur as a direct result of trauma, repetitive overuse, poor posture, muscle imbalances and more commonly surgery. The type of any injury someone sustains is directly related to the mechanism of injury (MOI), force applied to the body and magnitude involved. This directly results in developing pain, guarding [...]

IASTM Home Study Course Evaluation

Your Feedback is important to us.Thank you for taking a few moments to complete this course evaluation. Select the online course are you reviewing:*Arteries and VeinsCervical Instability Master ClassClinic Forms How-ToCommon InjuriesDocumentation Refresher for RMTsEnd Feels of the BodyIntro to IASTMIASTM Home StudyMassage DrapingMuscle TestingNerve PathwaysPain Management Through Diet and NutraceuticalsPresentations & ProductivityproSTM Kit - [...]

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