Graston Technique®, ASTYM, FAKTR, SASTM, Gua Sha - A Brief Explanation & Commentary

The (now patented) Narson Body Mechanic N6

Graston Technique®, ASTYM, FAKTR, SASTM, Gua Sha are all forms of IASTM (Instrument Assisted Soft Tissue Mobilization). The purpose of which is to break down scar tissue and adhesions that are causing multi-layered soft tissue restriction and adversely affecting the dynamic function of the underlying muscles, tendons, fascia & fascial planes, ligaments, etc. These restrictive scars and adhesions can be from old injuries, surgeries, repetitive strain (like carpal tunnel), mis-use or improper use of your body when working, playing, doing sports or just from the day-to-day activities of your normal life. They happen from car accident, sitting in front of a computer too much for too long or from childhood bumps and bruises that were never really attended too properly. 

 There are some minor difference between the techniques I mentioned above however ultimately, all are very effective for the right conditions. However effectiveness doesn't depend so much on the original coursework or specific technique, but the experience of the practitioner and the accuracy of their diagnosis coupled with proper application of the technique. 

 One thing I want to "get off my chest" is that Graston Technique® & ASTYM aren't new techniques. Your doctor or therapist may have just learned it and is all excited about it, but these techniques have been around for over 20 years with the original research being done at Ball State University. Gua Sha actually dates back to the 5th &; 7th centuries (roughly 700-BC to 500-AD). FAKTR & SASTM have been around since the mid to late 2000 respectively

IASTM techniques are not simply the use of instruments to loosen or remove adhesions and provoke an acute inflammatory response, but it’s the follow up treatment, stretching, therapies, resistance, rehab & anti-inflammatory nutrition that completes the techniques and is equally as important. Otherwise, you're simply doing Gua-Sha/Instrument Massage and without the proper follow-up, you can expect the symptoms and condition to return. Sometimes, they’ll return with a vengeance. This is why you want a fully trained (and experienced) practitioner performing this on you or your athletes.

Having become certified in Graston Technique® M1 & M2 in 2002 and several years ago, trained in FAKTR-PM (now known simply as FAKTR), 11 years of the last 20 years using IASTM full time in my practice, weekend excursions as a member of the sports medicine team at local sporting events, a 10 day rotation at the 2006 Central American & All Caribbean Games and 10 days at the 2011 Pan American Games, all gives me a unique experience and perspective in the practical application of IASTM. You’ll find many others with varied but similar experience. 

Some of the most important factors for providing good IASTM are: 

1. A good physical exam 

2. Sports specific examination of their injury 

3. Creativity -Thinking outside the box (and sometimes outside the walls of your clinic) 

As a result of my experience with Graston Technique®, FAKTR and IASTM in general, I developed my own instrument design known as the Narson Body Mechanic N6. The design is patented in Canada and I’m very proud to announce that it has been awarded a US Patent as well (just received the certificate today!!). The reason I designed this instrument was out of my constant need to be more efficient with IASTM. The design affords me the ability to carry all of the most useful IASTM instruments with me in one convenient tool. No longer do I have to carry a kit of tools with me. No longer do I have to clean multiple instruments between patients. I have everything in one hand at all times. The design includes a non-slip gripping surface which reduces tool slippage and reduces practitioner finger & hand fatigue which, the longer you do IASTM with real highly polished stainless steel instruments, you’ll come to appreciate. The other thing most of us in the USA can appreciate is that it’s the only useful “multi-tool” for IASTM that is made from 100% U.S. steel and made 100% by hand right here in the U.S.A., although I have seen some copycats popping up here and there.

When it comes to giving effective IASTM, the most important thing to remember is after a good base education, it’s the wealth of experience along with the doctor’s (or therapist) ability to be creative. From my experience, it's thinking outside the box that matters most, coupled with a good nutrition plan, rehab and anti-inflammatory therapies and the results will astound. It’s very possible with IASTM to take long time chronic injuries-treat them with IASTM and have the athlete back out playing the same day or the next day. 

This year I have helped a multitude triathletes get back into their training to complete in the full Ironman triathlon. Others are back training to complete 26.2 distance marathons and half marathons and some people are back into their workout routine because of the proper application of IASTM. Often you’ll find me at the pool, the track, with a cyclist on an indoor trainer or running on the sidewalk with a patient working with them while they do their sport. For me, putting a person in the exact environment that produces their symptoms is the only way to resolve the problem. Just like anything else in life, experience matters and creative matters. Even with IASTM.

'nuff said 

 Dr. T 

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 Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

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Is it a Misconception To Think The Pros Get The Best In Sports Medicine???

by Miami Beach Chiropractic Sports Physician, Dr. Todd M. Narson

2008 AVP - "South Beach" Miami Beach, FL

I came across an article this morning about The Minnesota Vikings and their athletic training staff.  It's a nice article - building up their athletic training staff with all their accolades and experience. But something both bothered me and pleased me at the same time; It was this paragraph:

 

"The entire athletic training staff are Performance Enhancement Specialists through the National Academy of Sports Medicine. During the 2010 off-season, the Vikings staff was trained in Graston technique, a patented form of instrument assisted soft tissue mobilization that works to effectively break down scar tissue and fascial    restrictions"

Realistically, there's nothing wrong with that paragraph. It's absolutely 100% accurate. They took the courses, did the training and yes, Graston Technique(r) does all those things (and more)... It makes me happy to hear about people advancing their education and skill-set, especially when it comes to improving the health of other people. 

So what's my problem???

Well, what bothered me is here we have a group of medical professionals that have been behind the curve for quite a while, especially for being at the ultimate level in sports competition - The Pro's.

Working on a chronic post surgical knee using FAKTR technique (2006)

I've been certified in IASTM (Instrument Assisted Soft Tissue Mobilization) and specifically Graston Technique since 2002...both M1 & M2 certification levels as well as the more advanced IASTM concepts of FAKTR.  Most of the public sits back, watches the games and when their player suddenly gets hurt they rest assured that their getting the best of the latest and greatest technology out there when it comes to sports medicine.  Now it seems that may or may not be true.

Why am I being so harsh on them?

Graston Technique Represented a quantum leap in the technology of treating pain related soft tissue  injuries - a paradigm shift in the way we treat soft tissue injuries.  But this paradigm shift started back in 1994, not 2010.  I first found out about Graston Technique(r) when at a continuing education convention in 2001 and was walking around some of the vendor booths during a break with my friend and sports medicine mentor Dr. Tom Hyde.  This was the first time we encountered it.  Within a year I was sitting in a Graston Technique(r) course. Tom had taken the first course he could find and was already certified and preparing to teach it.  But if you know Tom, well, that's Tom.  He's a walking talking functional sports medicine encyclopedia. If there anything effective and worth while, he dives in head first..learns everything there is to know and ends up teaching the rest of us.

Same thing, just a close up (still 2006)

It took some time to become proficient in the technique and after mastering it, it eventually it became one of my main tools when treating various pain syndromes - especially long term chronic ones.  Conditions like chronic hamstrings strains, I.T. band syndrome & plantar fasciitis in runners and triathletes, rotator cuff injuries in swimmers and "throwing" athletes, bicipital tenosynovitis (what most people call bicipital tendonitis), Post surgical adhesion pain as well as other pesky aches and pains that don't seem to respond to typical physiotherapy, stretching, exercise, pain/anti-inflammatory meds or chiropractic care.  With Graston Technique as a base and FAKTR I was helping conditions that were extremely difficult to treat that took months and months of treatment previously. Now in as little as a few treatment sessions or only a few weeks. 

So why am I explaining this to you? Why does this "press release" erk me so much?  Because I use to think just because they work with the Pro's they were automatically the best. However it turns out you can often find (at least) the same quality physicians, trainers and therapists as the professionals use, right in your neighborhood.  And... you don't have to be a pro athlete to be treated like one.  It's taken over a decade for the Vikings to adopt this wildly successful technique, but I bet there's an advanced IASTM provider right in your neighborhood who is more experienced and more proficient.  

Team Jamaica's Orthopedic Surgeon Assisting Me With IASTM

Want to find a great chiropractic sports medicine physician right in your neighborhood?  Click here to begin your search 

'nuff said

Dr. T

Below are some great resources to find physicians and therapist with advanced degrees and certifications in sports medicine and/or advanced soft tissue treatment techniques like Graston Technique and FAKTR:

1. American Chiropractic Board of Sports Physicians(r) 

2. ACA Sports Council

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

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Graston Technique(r), FAKTR & Narson Body Mechanic

I've been certified in Graston Technique(r) since 2002/2003. It's a phenomenal method at treating chronic sports injuries and some acute injuries as well. The technique uses 6 stainless steel instruments (pictured to the right) that are used to treat scar tissue and adhesions that prevent the function of normal tissue dynamics typically seen after an improperly healed injury.

Since becoming certified and practicing this technique on thousands of patients over the years I began to notice that I would get the best results when I treated patients in a position of provocation. In other words, when a patient said, "it hurts when I do this" I would treat the condition with my Graston Technique(r) instruments while they were in the position where they complained provoked their pain. My rate of success increased even more.

I began having people hold dumbbell weights, pull on resistance bands or exercise tubing or simply go through the motions of their sport while I administered the treatment. I would follow this more active/function version of Graston Technique(r) with stretching, ice and electric stimulation and pulsed ultrasound. The results were outstanding. You should also know that Graston Technique(r) isn't just treating patients with their instruments. It also involved evaluation of the patient and the administration of treatment afterward (stretching, therapies and home instructions for patient self care).

In 2006 I was picked to travel with a team of sports chiropractors to treat athletes at the 20th Central American & All Caribbean Sport Games. It's basically a mini-Olympics where the winners of these events go on to the Pan American Games and then onto the Olympics.

In most circumstances, all I had was my reflex hammer, some athletic tape & and ACE bandage, my adjusting table and my set of Graston instruments. If I was lucky, there was some ice and plastic bags. I used both the standard Graston Technique(r) and also the more functional version I was slowly discovering. Being in an environment where you often didn't have electricity and certainly didn't have all the comforts of a modern chiropractic sports injury office, you had to so the best with what you had. I found that I was able to use these more functional treating techniques were extremely effective, more so than when treating statically. I helped quite a few athletes get back into their event pain free. I continued to use my modified methods when I finally returned home.

It wasn't too long after that I learned one of my sports medicine mentors, Dr. Tom Hyde along with one of my original Graston Technique (r) instructors, Dr. Greg Doerr had been developing a lot of this "functional" Instrument Soft Tissue Mobilization stuff. I believe they had been doing it for about 4 years at the point when I first caught onto it but had already taken it a lot further. Both being instructors & friends, they they continued to collaborate and add more and more to it. Dr. Hyde and Dr. Doerr continue to develop and add to this functional instrument based soft tissue technique and began teaching and adding to it. I took their class which was called FAKTR-PM (Functional And Kinetic Treatment with Rehab Provocation and Motion (...now shortened to just FAKTR). It was outstanding. The physicians, trainers and therapist that were in the classes were certainly the cream of the crop. I think people knew that they were on to something big.

The technique really developed and advanced, now getting the input of the many of the leading physicians, trainers and therapists from around the world. This FAKTR thing had developed into a very advanced Instrument Assisted Soft Tissue Mobilization method. It continues to evolve to this day and I'm sure will be better tomorrow than it was yesterday.

I think the Graston Technique(r) is an excellent base of knowledge and represents the foundation for this work. If you want to get into this kind of treatment, Graston Technique(r) is definitely the place to start. It represents the foundation of instrument based soft tissue treatment. In my opinion, you can't get very far without a good foundation. However, as you get more experienced with your technique, FAKTR is where you go from there. FAKTR is an ever evolving technique that incorporates current trends and research. I've seen where one seminar to the next will be different based on information that was published in a recent research journal. It's ever evolving for the right reasons.

What has made performing FAKTR so much easier was the N6 Narson Body Mechanic that I developed. I found that when treating a patient, I changed instruments at least twice, sometimes more. Now, I currently use only 1 stainless steel instrument that has the functionality of my 5 main GT instruments as well as other Gua Sha instruments on the market. It's like a Swiss Army Knife of Soft Tissue instruments. I've added a gripping surface to reduce finger and hand fatigue and now I only need to carry 1 instrument from patient to patient. I only clean 1 instrument and it's much easier to transport when traveling. That's probably considered a shameless plug, but it kind of like talking about baseball without mentioning the glove, ball or bat.

So combine your FAKTR Functional and Kinetic Treatment with Rehab Provocation and Motion with your Narson Body Mechanic N6 and you have a winning combination to treat athletes, difficult chronic sports injuries and more.

For more information on the techniques and instruments discussed above, please click on the following links:

FAKTR www.faktr.com
Narson Body Mechanic N6: www.NarsonBodyMechanic.com
Graston Technique: www.GrastonTechnique.com

Graston Technique(r), FAKTR and Narson Body Mechanic are separate and distinct companies. None of these companies endorses the other. The Narson Body Mechanic instrument should not be confused with Graston Technique(r) instruments. The Narson Body Mechanic is for use with Instrument Assisted Soft Tissue Mobilization while only Graston Technique(r) tools are for use with Graston Technique(r). Graston Technique(r) is owned by Therapy Care Resources, Inc.

Healthfully yours

DocT



Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.