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 

_________________________________________________________________________________

 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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It's Alive - IT'S ALIVE: Fascia, More Than Just A Cover Surrounding Your Muscles

By Miami Beach Chiropractic Sports Physician, Dr. Todd Narson

Most of us grew up in our sports injury profession, albeit sports chiropractic, physical therapy, orthopedics, athletic training or the like thinking that fascia was simply a covering that surrounded various structures in the body. Kind of an envelope that surrounded the stuff inside and kept is separate from it's neighbors and allowing for the sliding and gliding of the individual parts.

However original research by Stecco et.al., Histological Characteristics Of The Deep Fascia Of The Upper Limb show that what we once thought of as a kind of a sock or wallpaper type tissue covering on the inside is more like that of a proprioceptive information superhighway interwoven into the fascial weave. This proprioceptive information superhighway relays information throughout the musculo-skeletal system allowing the coordination of movement throughout a kinetic chain.


Imagine having an injury such as a contusion, muscle or tendon strain or having surgery that interrupts or cuts through the fascial planes and no real consideration is given to the condition of it's state of healing. No longer can we think it's just incidental connective tissue keeping things compartmentalized. We must now think about fascia as an integral part of our neuro-musculo-skeletal system as it gives afferent information into the system that that helps to provide for our movement, balance and coordination.

This information now places more importance on treatment modalities like Instrument Assisted Soft Tissue Mobilization (Graston Technique(r), AYSTM, SASTM, FAKTR) as well as manual hands on mobilization systems like ART(r), Fascial Manipulation (Stecco & Hammer) & NIMMO.

For surgeons, you need to think more about the post surgical rehabilitative process to account not only the proper healing of the target structures of your surgery, but the supportive systems of muscle, tendon, joint capsules AND fascial planes.

Fascia my friends is alive and well...AND loaded with proprioceptive organs: Ruffini and Pacini corpuscles and woven around the muscle fibers, muscle spindles reside in the fascia surrounding them.

If you want to learn more, go to www.pubmed.gov and in the search screen type only two words: stecco facia. They (brother and sister) have written over 40 articles on this very subject.

Quite interesting and enlightening information indeed. A big thank you to Warren Hammer, DC, DABCO for his lecture on the subject at the ACBSP Sports Science Symposium, Boston MA, April 2011.

'nuff said

Dr. T

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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The ICE File - From SportsInjuryTV.com - Weekend Warrior Show

From: Sports Injury TV - The Weekend Warrior Show

So recently I started a "SportsInjuryTV.com" video blog on Your Tube but for some reason You Tube s taking way too long to put up the video. So I embedded it here on my trusty old Natural Sports Medicine Blog.... Enjoy - Todd



The I.C.E. file

Something each and everyone of us should have in our cell phones, and even more important for athletes, people who exercise regularly and people with potentially serious health conditions. About 3 weeks ago another cyclist died on the Rickenbacker causeway on Key Biscayne. Although this time is wasn’t from a car hitting the cyclist, this older gentleman had a heart attack and fell off his bike. Those riding with him administered CPR but couldn’t save his life. I was wondering about all of the triathletes, cyclists, runners and others training in the gym by themselves and what would happen to them in case of an emergency.

So, I know I sound pretty serious about this but it something I think is important. “ICE” is an acronym and stands for In Case of Emergency. If you should ever have a health problem and are unable to communicate, this is where the paramedics, police, fireman, emergency room doctor or good samaritan will find your vital information.

So I want you to take out your cell phone (yes…right now) and:

1. Open a new contact file named ICE
2. In your ‘ICE’ file I want you to put the following info:
3. Your full name & year of birth
4. Your home and work phone numbers
5. Your home and work address
6. Phone numbers of your spouse/significant other (who you want contacted in case of an emergency)
7. Parents & in-laws phone numbers
8. Name/phone # of your family doctor
9. Any allergies you may have
10. Any medications you take
11. Any conditions you have
12. Your blood type if you know it.
13. The name of your health insurance as well as your policy and group numbers
14. Press Save

The purpose of this is to give emergency personnel vital information about yourself in case you are unconscious or are unresponsive. Vital information like allergies, medications, health conditions, phone numbers of your relatives and health insurance information may make a critical difference in a life saving situation. So put as much or as little information as you feel necessary. I know some people are worried about identity theft. Personally, I’m more concerned with making sure I’m okay in a life threatening situation. So, put as much information you feel is necessary about yourself and those you want contacted in case of an emergency.

More and more paramedics and EMTs are looking for this info in emergency situations. As I always say, prepare for the worst and hope for the best. Make sure you are prepared ‘just in case’. Sometimes in these situations, the slightest piece of information or just saving a few extra minutes could make the difference between life and death.

'nuff said

Dr. T


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.

Olympic Chiropractic - Don't You Deserve The Same Care as TEAM USA??

Miami Beach Chiropractor Dr. Todd Narson writes;

Chiropractic care has been extremely successful in helping 'Joe Public' regain their health since it's official founding in 1896. So well in fact, it's withstood the decades of negative attacks from orthodox medicine(which has since improved), slander in the media(which still goes on) and more. Chiropractic has been so successful that in spite of all the negative publicity, the athletes themselves demanded chiropractic be there at the Olympic Training Center and at the Olympic Games.

Why? Simply because joints that don't move - hurt, and people with joints that hurt, don't win.

Since Dr. Phillip Santiago's successes as the first sports chiropractor to officially be credentialed and admitted to the 1980 USA Olympic Medical Team for the Barcelona Olympics, there have been sports chiropractors at the Olympic Training centers and treating team USA ever since.

When you choose a chiropractic physician for your aches, pains and injuries don't you deserve a chiropractor who is qualified to deliver the same level of care that Team USA gets?

In order for a chiropractic physician's application to merely be accepted by the credentialing committee, you must have a minimum post graduate CCSP qualification. CCSP means Certified Chiropractic Sports Physician. It's an intense 130 hour post graduate program followed by a National Board examination. The CCSP credentials carry a lot of weight and bring with them excellent knowledge for any team or athlete needing a physician with a great understanding of the evaluation and management of sports injuries.

In order to maintain a CCSP, you must get an additional 12 continuing education hours per year in sports medicine related subjects and maintain an active CPR card

The only thing that trumps the CCSP, is the DACBSP. DACBSP stands for Diplomate of the American Chiropractic Board of Sports Physicians. In Florida, in order to say you "Specialize" in sports injuries / sports medicine, you must have a Diplomate. The DACBSP program starts with a CCSP certification and adds an additional 200 classroom hours, you must publish in a peer reviewed scientific journal, spent a minimum of 200 "on-field" hours with teams/athletes, pass a 2nd National Board written examination and pass an intense practical "hands-on" examination consisting of management of a spine injured athlete, evaluation and management of a head trauma athletes, radiology, athletic taping, evaluation & management of an upper extremity & lower extremity injury.

Once passed, you are considered a sports injury specialist. In order to maintain the diplomate, you must get an additional 24 hours of sports medicine education per year and maintain an active CPR card.

All this is above and beyond what is required to maintain your regular Doctor of Chiropractic degree.

As taken from the official web site of the American Chiropractic Board of Sports Physicians (http://www.acbsp.com/) Here are the chiropractors in Miami that have CCSP or DACBSP qualifications:

William Atherton, DC, CCSP, DACBR
(305) 895-6408
dacbr@hotmail.com
North Miami, FL
(William is a Chiropractic Radiologist and doesn't see patients, however he reads X-rays as his specialty; He's a diplomate of the American Chirorpactic Board of Radiology)

Joseph Gambardella, DC, CCSP
(305) 598-8788
drjosephdc@aol.com
Miami, FL

Carlo Guadagno, DC, CCSP
(305) 386-9559
wkchiro@fdn.com
Miami (West Kendall), FL

And of course.....ME

Todd Narson DC, DACBSP
(305) 672-2225
miamibeachdoc@yahoo.com

Remember, your every day aches and pains, your injuries at work and injuries from fender benders and car accidents are all traumas. CCSP and DACBSP chiropractors are trained in the assessment and treatment of sports injuries. Which are simply traumas that happened while playing sports. If you think you deserve the same level of care as our US Olympic Team Athletes, then give one of the doctors above a call.

'nuff said

Dr. T
http://www.drnarson.com/
http://www.naturalsportsmedicine.com/




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.