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The Fibroblaster IASTM Tool

[box type=”note” icon=”none”]UPDATE: There is a new article that discusses my current recommendations for the best IASTM tool.  This newer article contains my updated recommendation for several tool options and information on how to learn how to use IASTM.[/box]

 

Over the past several months there has been much discussion about instrument assisted soft tissue mobilization (IASTM) techniques and IASTM tools on this website.  I was pleasantly surprised at the amount of people using IASTM.  For those that know me, you know that I am constantly striving to improve and find the best product to use for IASTM.  I have tried almost all of the products on the market and have shared my past thoughts on IASTM tools in a previous post and discussion.

There was a lot of discussion regarding my previous post on the Graston Technique and during the discussion, I was lucky enough to receive a post from Jacob Fey.  Jacob is a physical therapy student at the University of Buffalo and has started to make a pretty good IASTM tool called the Fibroblaster.  Before we talk about the tool, I asked Jacob to write me a brief background into the development of the Fibroblaster, below is Jacob’s story.

 

 

How and Why the Fibroblaster Started

IASTM ToolDuring undergrad I first heard of IASTM, from a friend and former classmate that was attending chiropractic college; he talked about Gua Sha, Graston and SASTM.  He went into their use and cost (how he was going to try to even pay for it).  He sparked my curiosity and I started to look into IASTM, particularly the major marketers (Graston, SASTM, and ASTYM) and how it was theorized to work.  Also, during my extremities orthopedic class in DPT, an adjunct clinical professor showed us a tool that he had been using.  This was my first hands on exposure to an instrument.  He also talked about some of the IASTM tools on the market.  Most of us were interested in the tools but not the price.  I joked to a couple of classmates that day in class that I could make them less expensively and they said they would buy one if I could pull it off.

I started talking with the Machine Shop staff in the Engineering Department at the University at Buffalo.  Since I was a student I had access to the university’s facilities to do the project at a substantial savings.  I learned to use CAD software to save money by doing the designing and prototyping myself.  Once I had the design, I also figured out the whole machining process and related costs.  It was pitched to my current and former classmates getting enough interest to move forward.  About 75% of the class pre-ordered to fund the project and the first run of Fibroblasters was made in late Fall ’09 (entire project was not-for-profit).

Over the following year, there was enough interest to pursue another run of Fibroblasters with an updated design. This time the entire project was done off campus with a local company to assist with manufacturing (Made in the USA).  After I collected the pre-orders and borrowed some startup money, I completed the necessary paperwork to form Fibroblaster LLC.  Tools were completed and Fibroblaster sales began Nov. 1st, 2010.

As with all good stories, I have to give a shout out for my mom.  She went online to be the first to purchase a Fibroblaster from the website, at retail price no less.  She proudly displays it next to the clay knickknacks that were made in elementary school.  For the financially strapped graduate student, there is a student discount for those willing to supply me with their advisor’s name, email, contact number, school name and grad date.  Once status is verified, they receive a discount via email.  Since the start sales have been steady and there has been lot of positive feedback from those who have purchased.  The goal of Fibroblaster is to make a quality soft tissue mobilization instrument without the high price tag that is associated with other stainless steel IASTM tools on the market.

 

My Thoughts on the Fibroblaster IASTM Tool

[box type=”note” icon=”none”]UPDATE: There is a new article that discusses my current recommendations for the best IASTM tool.  This newer article contains my updated recommendation for several tool options and information on how to learn how to use IASTM.[/box]

I thought that was a good story to share and that the product was worthy to promote to my readers (I have no financial interest). I have been using the tool for a couple of weeks now and must say that it is definitely worth looking into.  The design and materials, being stainless steel, are of top quality.

The tool has a great weight to it and resonates well, again thanks to the stainless steel.  The holes in the tool make it real easy to grip, especially when things get a little slippery.  And the sides have good concave and convex edges to them.  It has a single beveled edge but I found that you could using it in either direction to get a slightly different feel that was adequate.  I’m also trying to talk Jacob into working on a second Fibroblaster IASTM tool for more intricate areas of the body like the hand, forearm, foot, and ankle.

Fibroblaster Fibroblaster

I would still advocate that if you are interested in IASTM but worried about cost, that you start with simple Gua Sha tools made of horn, jade, or even bian stone.  I would rather see more people using IASTM with less expensive tools if cost is prohibitive to some.  But if you are ready to make the jump to a more expensive IASTM tool, stainless steel is definitely the way to go.

I have tried almost all of the tools on the market and the Fibroblaster ranks pretty high among them, I would recommend you try it first.  The Fibroblaster is relatively affordable for a stainless steel tool at $125, especially with the huge student discount that Jacob is offering at $75, and you have to respect Jacob’s approach and background story.  Kudos to him for trying to bring a quality IASTM tool to the market without excessive pricing!

For more info visit Fibroblaster.com

 

Do You Have Interest in Learning More About IASTM?

My new online educational program will teach you everything you need to know to start using IASTM today!  IASTM does not have to be complicated to learn or expensive to start using.  Learn everything about IASTM including the history, efficacy, tool options, different stroke patterns, basic techniques, advanced techniques, and how to integrate IASTM into your current manual therapy skills and treatment programs!

Learn more about how to perform IASTM today!

 

Graston Technique: A Case Study and Other Thoughts on Instrument Assisted Soft Tissue Mobilization Techniques

[box type=”note” icon=”none”]UPDATE: There is a new article that discusses my current recommendations for the best IASTM tool.  This newer article contains my updated recommendation for several Graston alternatives and information on my online educational programming teaching you how to use IASTM.[/box]

Today’s guest post is quick overview of the Graston technique and it’s application within a case study by Eric Schoenberg, MSPT, CSCS.  I thought Eric did a great job with the post and have will share some of my thoughts on instrument assisted soft tissue techniques, such as Graston technique, at the end of this article.

Graston Technique

graston techniqueRegardless of treatment philosophy, it is difficult to dispute the importance of soft tissue work to help treat pathology, correct muscle imbalance, decrease recovery time, and restore proper muscle recruitment and firing patterns.

While there are many available soft tissue options, in my practice, I have found Graston techniques to be particularly useful in both treatment and evaluation.  Many people don’t realize that the Graston technique can also be a valuable diagnostic tool to quickly “scan” or evaluate a patient’s soft tissue quality and determine its contribution to a patient’s current symptoms or injury risk factor.

The Graston technoique concept is grounded in the works of English orthopedist James Cyriax and the concept of cross fiber treatment. The treatment edge of the Graston instruments allows for improved precision in the treatment of fascial restriction and fibrotic/scar tissue.

I wanted to share my experience and techniques with the Graston technique and will use a case study to illustrate the benefits and specificity of the Graston Technique.

The patient is an 18 year old male who is a 3-sport athlete (football, basketball, baseball) presenting with 9 month history of anterior knee pain consistent with patellar tendinosis. The patient presents with the following objective findings at evaluation:

  • Point tenderness at inferior pole of patella
  • Pain at end-range supine and prone knee flexion
  • Pain with resisted concentric and eccentric knee extension (Kendall MMT position)
  • Decreased hip mobility B
  • Decreased ankle DF ROM B
  • Decreased lumbopelvic/hip and single leg stability
  • Decreased gluteal/core strength B

The patient is participating in pre-season football conditioning with emphasis on sagittal plane squat/split squat/lunge activities, sprinting (including hills), and plyometrics (sagittal plane). He is using foam roller daily on own to improve tissue quality. His symptoms are gradually worsening with increased training intensity.

After evaluating the patient, I decided to include Graston technique treatment focused on the quadriceps, ITB, adductors, hamstring, gastroc/soleus, and tibialis anterior muscle groups.  Here are a couple of examples:

Graston Technique – Seated Quadciceps

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Graston Technique – Seated Patellar Tendon

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One specific application of Graston technique is the ability to effectively treat the injured area in positions of provocation. This patient experiences symptom reproduction in the split squat/forward lunge position:

Graston Technique – 1/2 Kneel Position

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Graston Technique – Dynamic With Squat:

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Treatment Outcomes

The patient was seen for 3 treatments with full resolution of symptoms. Treatments consisted of the following:

  1. 1. Tissue quality: Graston technique, daily lower body foam roller program
  2. 2. Mobility: hip and ankle mobility exercises, active warm-up corrective exercises
  3. 3. Multiplanar strength: frontal and transverse plane strength (emphasized single leg activity, band walks, lateral lunges, lumbopelvic stability- chops/lifts)
  4. 4. Activity Modification: patient educated in proper jump/land technique, limited sagittal plane repetitions, proper muscle firing patterns

Clinical Observations From Using the Graston Technique:

1. The specificity of the treatment edge and the ability to provide uniform pressure is what sets the technique apart from other manual approaches.

2. The instruments truly enhance the clinician’s ability to detect and treat fascial restrictions and adhesions (particularly effective in positions of provocation).

3. Incorporating stretching and strengthening (tendon-loading) exercises with the instrument assisted soft tissue mobilization is the key to promoting re-alignment of the fibers and helping to fully remodel the injured tissue.

4. Coupling Graston in the clinical setting with self myofascial release (SMR) products, such as foam rollers and other similar equipment at home or in an athletic setting (pre/post activity) is an ideal way to achieve maximum success.

Lastly, at least for me, the most exciting part of using Graston Technique in the clinical setting is feeling better suited to treat the more difficult diagnoses (plantar fasciitis, chronic tendonosis, etc) with the expectation of good clinical outcomes.

 

My goal in writing this article is to present a simple case to allow the reader to appreciate the functionality and ease of use of the Graston Technique. In addition, it is important to note that Graston (along with any soft tissue treatment) should be used in conjunction with skIASTMilled movement evaluation and prescription of corrective exercise to allow for the most effective clinical outcomes.

Eric Schoenberg, MSPT, CSCS is co-owner of Momentum Physical Therapy with offices in Milford, MA and Wellesley, MA.  The owners of Momentum PT are experts in the human movement system. Their mission is to bridge the gap between traditional medicine and fitness with emphasis on patient education and injury prevention.  Visit eric’s blog at www.momentumptblog.blogspot.com.

 

Mike’s Thoughts

[box type=”note” icon=”none”]UPDATE: There is a new article that discusses my current recommendations for the best IASTM tool.  This newer article contains my updated recommendation for several Graston alternatives and information on my online educational programming teaching you how to use IASTM.[/box]

Eric, great article and examples of use of the Graston technique.  I’m sure the patient got better from your very well thought out treatment plan and all of the techniques and exercises you performed in combination with Graston technique.

It is important to note that while this article is specifically about the Graston technique, it also applies to instrumented assisted soft tissue mobilization (IASTM) techniques in general.  Late last year I polled my readers and 20% of you said you used IASTM, including Graston technique, SASTM, and ASTYM.  We could also group in the traditional Gua Sha to this mix as well.

I have used these techniques and do incorporate IASTM in my practice, I have also taken the basic Graston class (though have not taken SASTM and ASYTM classes and have not used their tools).  Here are my thoughts:

  • IASTM is a valuable component of my treatments, but just a component.  Just like everything else, it has its value and it has areas where I would choose another technique.
  • There are a lot of misconceptions here and the internet makes this worse – a huge black and blue down the leg is not what you are trying to achieve using IASTM.  I consider this a sign that you’ve done too much.  This is a misconception.
  • The actual Graston Technique tools and courses are really good.  If you have the budget to go all out for these, great, they will be great to work with. Visit their website for more info, I would be surprised if you were not satisfied with the course and their tools.  They have put a lot of thought and effort into their technique and tools.
  • I do not use the Graston instruments.  I think many more people should learn IASTM techniques.  If you really like the technique and want to learn more or get the better Graston tools, great.  But cost should not be a reason that you don’t learn how to use IASTM.
  • In regard to tools, I go traditional Gua Sha from China.  I have tried other tools, like the Starr Tool, they are good, but more expensive.
  • In regard to Gua Sha tools, you can Google them, there are many shapes and materials for anywhere from $2 to $10.  Horn is a good starting point, but in the grand scheme I would grade them as stone > jade > horn.  Just my opinion.  I have a bunch of horns as they come in a variety of versatile shapes, and a few jades and stones.  So far Bian or Energy stones have felt best for me, but these are closer to $20-$40.  Still cheap in contrast to some of the other instruments.  If you are not sure, start with the horn.

 

What do you think?  What has been your clinical experience with Graston technique, instruments, and other instrument assisted soft tissue mobilization techniques?