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  • Dori Nissenson

Tools Of The Trade


All materials in this e-newsletter are written and distributed by Dori Nissenson

My New Tool

As we all know, fascia is the hot topic right now in the world of health care and physical fitness. I have written a few newsletters about fascia, myofascial pain and how through manual therapy, I reduce pain that results from fascial and muscle restriction, returning you to maximal physical function.

To review…. manual therapy is a form of hands-on physical treatment that I use to diagnose and treat joint and soft tissue problems. It involves manipulation, mobilization, and massage.

Historically in the field of physical therapy and in my own practice, I have used my hands to evaluate and treat a body part for fascial or muscular restrictions. Recently, instrument-assisted soft tissue mobilization or IASTM, has become more popular in the physical therapy profession.

So, here is the big news...

I completed my IASTM certification in December of 2018 and I have been integrating the use of instruments in my treatment sessions since then.

I now am able to use steel blades to do fasciae release. Don’t worry they are not sharp blades;) they have beveled edges. I have two sizes ….The body part I’m working on dictates which blade I will use. The results have been amazing.

What Is IASTM???

IASTM is a form of manual therapy where the provider uses specially designed hand-held instruments made of steel or plastic instead of his or her hands to perform the soft tissue manipulation.

There are many companies that offer their own versions of the metal and/or plastic tools, but the goal of IASTM is the same across all vendors: to help free soft tissue and myofascial restrictions to improve the way you move!!!

Here's How It Works:

During an IASTM treatment, your physical therapist uses a metal or plastic tool to provide the manual therapy. This tool is gently or vigorously scraped and rubbed over your skin.

The rubbing of the instrument is used to locate and release tightness in fascial and then at a deeper layer…. in your muscular system.

When your PT uses an IASTM tool during your treatment, he or she will be searching for areas of fascial and muscle restriction. These areas will feel crumbly or craggy as the tool passes over them.

Once the restrictions are found, your PT will hone in on them using the IASTM tool to scrape at them. This scrapping causes microtrauma to the affected tissues, thus re-initiating your body’s natural inflammatory response.

This inflammatory response causes reabsorption of excess scar tissue and fibrosis that causes the restrictions in the first place. After an IASTM session, your therapist will have you perform active motions or stretches that will use the range of motion just gained by the IASTM. This will help keep scar tissue or fascial restrictions from reforming.

Why IASTM???

IASTM is a great adjunct to your physical therapy program because it:

1. Decreases overall time of treatment 2. Allows for faster recovery 3. Reduces the need for anti-inflammatory medication 4. Resolves chronic conditions thought to be permanent 5. Clients can continue or return to everyday activities

What Are The Benefits Of IASTM???

1. Improving range of motion: IASTM helps to decrease stiffness and increase your ability to move after an injury. 2. Decreasing pain: With soft tissue injuries, it is almost a given that you will be experiencing pain. IASTM helps to decrease pain because it triggers a healing response in the damaged tissue. 3. Breaking up scar tissue and removing adhesions: After injury, soft tissue can scar down. This scarring causes tissues to lose elasticity and form adhesions which are clumps of scar tissue. This scar tissue impairs blood flow to the injured area. IASTM helps to remove the scar tissue and breakdown any adhesions that have formed, re-establishing normal blood flow necessary for healing. 4. Healing: Once your scar tissue and adhesions are broken down, the injured tissues will start to receive blood and oxygen and other nutrients normally. This allows the tissues to heal and return to regular function. 5. Stimulating formation of collagen: After an injury, the collagen that your body forms is deformed and clumpy. IASTM stimulates your body to create new collagen that is aligned and not clumpy. This allows the damaged tissue to improve and heal well.

Common Issues Treated With IASTM:

1. Neck pain 2. Low back pain 3. Carpal Tunnel Syndrome or other types of wrist pain 4. Plantar Fasciitis 5. Tennis Elbow 6. Golfer’s Elbow 7. Rotator Cuff issues 8. Knee pain 9. Achilles Tendinitis or other types of ankle pain 10. Shin Splints 11. Scar tissue formation

Things To Consider:

If you have any of the above-listed conditions or you feel that your body is “just not moving right,” you should consult a physical therapist. Your PT may suspect muscle or fascial restriction to be the culprit and may use IASTM as part of his or her treatment plan.

IASTM should ONLY be mildly uncomfortable, NOT painful. While the area in focus may be red after treatment, you should NOT have any bruising after the session.

At Hands On At Home Physical Therapy, we use a manual therapy approach to treat pain and dysfunction that combines the use of our hands and IASTM followed by stretching and neuromuscular re-education of the affected area. The results are extraordinary.


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