I’m sure you remember falling off your bike as a kid. Maybe it was a little accident on the monkey bars or on the ball field? Or perhaps a bump on the head, a bruised knee, a sprained ankle or a sore shoulder from a childhood full of horsing and playing around? Maybe your pulled your back or twisted your neck playing in high school or city league football or soccer? Whichever it was, you went home, mom or dad put on a cold compress and the next day or the day after you’re up and running around again like nothing ever happened.
Ahhh… but something did happen. Your little bump, bruise, strain or sprain started a little process. Yes it’s your body’s natural healing process which starts with an inflammatory response to the injury, no matter how large or small. It’s how we ignore the process that presents the problem. Mom or dad puts an ice pack (if you were lucky) or a heating pad on it (if you weren’t so lucky) for a couple days and then off to the races you go. It doesn’t really matter if you go to a doctor or therapist for treatment of your injury, it will heal on its own regardless. But that doesn’t mean it will heal properly or optimally. That’s where we (the doctors, trainers & therapists) come in.
So, you have a contusion (deep muscle bruise) or strained a muscle that now needs some repair. The healing process starts by removing the damaged tissues, then it starts bring in the new materials to start rebuilding. Inflammation happens, hopefully it subsides on its own, but often it doesn’t. So you put on some ice, take some over the counter pain killers or an anti-inflammatory and you feel fine again. But you’re only “feeling” fine you’re not really any better-just numb. You can ignore the pain, the slight change in function and get on with your little life….and the healing process ensues. Eventually, the damaged tissue heals with a haphazard array of scar tissue and you’re all patched up. So where’s the problem?
Scar tissue isn’t as good as the original tissue. Just look at any old cut on your arms or hand, or that spot where you skinned your knees as a kid and you can easily see it. Scar tissue has a haphazard matrix of fibers whereas the original tissues matrix is very organized. It’s organized based on the specific function of the tissue for both strength and resiliency. Have you ever seen a car that had bad body work done on it? It’s kind of like that. Most scar tissues (adhesions) are simply a bad “patch job”. If you’re lucky enough to realize what’s going on in the beginning, applying ice compresses, doing light stretching and light resistance exercise (eccentric deceleration exercises are best for this) can help scar tissue heal optimally. If you just brushed it off, took a few over the counter pain killers and ignored it, (like most of us); as you get to your mid 30s or 40s all of a sudden you start getting these aches and pain out of nowhere. Then you are forced to deal with it. That once childhood bump, bruise or strain has comes back to haunt You.
The problem lies in the transition area between the scar tissue and “normal” tissue. It’s a zone of weakness that is prone to re-injury. It’s a haphazard array of disorganized tissue adjacent to very
organized “normal” flexible tissue that had prior to that old injury. At the junction of where the scar tissue and normal tissue meet is a zone of weakness. This is the area that is most prone to re-injury. So, how do you get rid of it? Just take a look the the picture to the left. “D” shows then on treated and “E” shows the IASTM treated injury. See how much better, well organized the scar tissue is in the IASTM treated injury?)
In the past, we never realized that scar tissue and adhesions from old injuries was such a big deal. These conditions were attributed to “old age” (or what I call a cop-out diagnosis), or it’s attributed to arthritis. The approach was typically physical therapy, ice or heat compresses and some over the counter medicine such as Tylenol, Advil, Aleve or aspirin. While these treatments will help with some of the pain you’re in, they never really addressed the primary problem-faulty scar tissue causing biomechanical dysfunction. Now, through a lot of trial and error and some published research, reducing scar tissue and adhesions from old injuries seems to be solving many of the problems people have been told they simply have to “live with”.
Once scar tissues have formed they are pretty darn durable. Overall, this is usually as good thing. But many scars attach to more than just the originally injured area, rather they adhere to all of the surrounding tissue. Other muscles, ligaments, joint capsules, tendons, vessels, facial tissue planes and other connective tissue can be bound together in what I call a physiological static cling, and therein lies the problem.
Muscles, ligaments, connective tissue, fascia etc., are all layered on top of one another and they slide & glide on top of each other to perform various functions. When one tissue gets injured, the “stuff” that becomes a scar to heal the area solidified while attaching to a bunch of different tissues in the area bonding them together. But they weren’t made to work together like that, they should work independently. This causes restriction and pain and sometimes it could take years for it to develop as the scars become more mature as the years pass. (Think about taking a band-aid off of a cut while the little white pad sticks to the scab, the hair and the surrounding skin – OUCH!!!)
You can’t massage them away, some more aggressive stretching works in some cases but is mostly temporary. Typical therapies just never really did the trick. However, over the past 20 years new technology has emerged that directly addresses scar tissues and adhesions at their source. With high density stainless steel soft tissue mobilization tools, doctors and athletic trainers are using Instrument Assisted Soft Tissue Mobilization techniques to reduce and remove these adhesions. Don’t worry, it’s a superficial technique, no cutting is involved. Rather the physician, therapist or trainer will gently work the scar tissue with an IASTM instrument to free up the normal tissue allowing it to work more freely. The gross fiber techniques have also been shown to help improve the organization of the healing scar tissue to form a near normal or more normal health bond between the formerly torn muscles/tendons/ligament, etc.
Some of the commercial techniques being taught are Graston Technique®, FAKTR, AYSTM, SYSTM and Gua Sha which teach their practitioners proficiency in performing IASTM treatment. Through these methods, physicians and therapists have been able to detect both superficial and deep scars and adhesions, reduce and remove them and in combination with proper IASTM treatment protocols, finally get rid of this nemesis that plagues us as we get older.
Personally, I’ve been performing Graston Technique® since 2002, have been trained in FAKTR and use IASTM on a multitude of patients every day. I has made a significant breakthrough and success with old chronic pain from sports injuries, car accident injuries, work injuries as well as the various strains and sprains you encounter every day. It’s one of these most useful “tools” I’ve learned as a physician. (pictured above, I’m working on an athlete who strained several tendons in his foot while playing basketball in a tournament 6 weeks ago. He came to me, having been to several other physicians and therapists, walking in a walking boot, with crutches unable to bear his weight on his foot. Yesterday he was in the gym on an elliptical trainer for 30 minutes).
I have great successes with rotator cuff problems, post surgical knees, chronic hip pain after hip replacement surgery, low back pain, TMJ disorders, neck pain, pain from deep contusions, ankle sprains and plantar fascitis just to name a few.
Instrument Assisted Soft Tissue Mobilization has been wildly successful to the point where most ATCs (Athletic Trainers) for the NBA, NFL, MLB have become certified and use the technique to treat their pro athletes. In 2011 I was at the Pan American Games in Guadalajara Mexico where I used IASTM to successfully treat the Pan American and future Olympic athletes. And, I wasn’t the only one. At this high level of athletic competition, all the physicians, trainers and therapists use this stuff. In 2006 I was in Cartegena Colombia treating world class athletes along with some colleagues at the 2006 Central American & All Caribean Games; and after only a few days, those of us certified in Graston Technique® (This was before FAKTR) were getting a huge following among the athletes, their team physicians & trainers. Those physicians who weren’t certified, all inquired about signing up for the certification programs. That’s how powerful this stuff is. Trust me, physicians are a skeptical bunch.
So, if your joints are starting to ache and you feel like you too are suffering from “old age”, maybe it’s time try a new approach. If you are an athlete and you feel things aren’t just right, maybe not like they use to be, then seek out a physician, therapist or trainer that is trained and experienced in Instrument Assisted Soft Tissue Mobilization and maybe you will be able to get rid of those aches and pains that have come back to haunt you.
Healthfully yours,
Dr. Todd M. Narson
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. His is a diplomate of the American Chiropractic Board of Sports Physicians. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.
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