"Hey Dr. E,
I am a recent DPT graduate (2013) and have recently completed your IASTM online course. I admit, when I was first introduced to IASTM as an intern, I was taught to create MILD petechiae to create acute inflammation to facilitate the healing response (acute inflammation, repair, and remodeling). I have since began using it lightly, for the neurophysiological benefits, and am getting great results. My question/scenario: currently treating a man who is 1 1/2 month post-op R shld subacromial decompression with a very tight pec minor. Regardless of how light I perform IASTM to pec minor, I continue to get petechiae, so of course I stop. I don't get this response when working other scapulohumeral patterns on him. Thoughts?
Drew"
Drew,
That's a good question and it happens often. In terms of the anterior chest area, it tends to be more tonic. Areas that have higher tone have higher resistance even to the lightest superficial stroking. Petechiae is common with repetitive stroking in high tone areas and is not a concern. Areas that are more prone to this are
That's a good question and it happens often. In terms of the anterior chest area, it tends to be more tonic. Areas that have higher tone have higher resistance even to the lightest superficial stroking. Petechiae is common with repetitive stroking in high tone areas and is not a concern. Areas that are more prone to this are
- anterior chest patterns
- upper traps
- masseter
- paraspinals
That's not an exhaustive list, and any area that has abnormally high resting tone will be resistant to change against pressure or stroking with or without an instrument. If I encounter tone that does not change within 5-10 seconds, I immediately switch strategies.
How to decrease abnormal tone during tissue work
- use PNF to reciprocally inhibit the agonist
- repeat the pressure or stroking during the inhibition
- light oscillations to the joint to decrease tone
If you use the 5-10 second rule for high tone areas, and then some agonist inhibition, you are much less likely to cause any petechaie. Below is a video where I demonstrate this on the masseter and upper trap on a recent The Eclectic Approach to UQ and LQ
Mike Reinold and I go over why you should barely cause any discoloration, if any and more on IASTM Technique! For a quick review on some IASTM Myths, read this older blog post.
Keeping it Eclectic...
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