It’s been a while since i’ve posted any of my patented “Rick Rant’s” so I think it is only fitting that I take on one of my biggest pet peeves of manual therapy. Harder is not necessarily better.
Let me start with a little background before I get into the juicy stuff. I’m just as guilty as the next person for going to get a massage and saying “yeah, dig as hard as you can”. Just think about the last time you got a massage and had the therapist go to town… Were you able to relax through it? Did it feel good while it was happening? The answer is most likely no. When we are in pain, that’s our nervous system perceiving a threat which in turn is going to potentially make us guarded, fight the treatment and ultimately put the nervous system on more notice.
Manual therapy is meant to help people move and help them feel better. If we are digging, pushing, scraping so hard that we heighten the nervous response, we are just going to spin our wheels and waste our time. Less is more.
Now with that background out of the way, let’s get into the real reason for this post… Recently I’ve been seeing more and more people post pictures on social networks of post IASTM treatments which show massive bruising and discoloration kind of like this!
I’m sorry, but if you think this is correct you need to take a step back and re-evaluate your treatment philosophy. There is absolutely no evidence that shows harder force is better, in fact what we know about the nervous system is that it responded much better to lighter force. Roughly 80% of sensory fibers are interstitial receptors which respond best to light touch and pressure. When you scrape too hard, you run the risk of causing chemical irritation.
IASTM works from two foundations- Assisting with the healing process by improving localized circulation and generating a good healing response. Secondly, IASTM works by decreasing threat to the nervous system to help with improving mobility.
The goal is to generate a nice amount of redness, but not bruising. Bruising could happen, but that should not be the goal! If your patient looks like the above picture, you’re doing it wrong.
I’ll post more soon with research/etc but this post was just made to make y’all think a little and prime the engines for more detail later!