Instrument Assisted Massage: A Therapists Review

I was first introduced to the wonders of Instrument Assisted Massage and IAM Tools by the fabulous Jenny Burrell late last year and was amazed by the level of soft tissue release achieved in such a short space of time.  This weekend I attended the Advanced Course in Instrument Assisted Massage Tools run by IAM Tools and have been absolutely amazed by the extent these tools can help in soft tissue

work having got myself into a bit of a tool rut reserving its use for necks, hip flexors and forearms.

If Instrument Assisted Massage is so effective what is stopping more therapists from integrating it into their treatment tool belt?  Here I intend to write a review of Instrument Assisted Massage from a once sceptic who is now fully converted to its benefits in the hope that it maybe helps you to give it a go!
The Concerns

I hear many Therapists ‘poo poo’ the use of tools as part of their hands on treatment.  ‘It cannot replace your hands.’  ‘ I wouldn’t be able to palpate the tissues as well as with my hand.’ ‘It looks aggressive.’ ‘It would be too painful.’ ‘I like to connect with my client with my hands.’ And on and on it goes.  Perhaps IAM is one of those things you have to try before you can believe what it can do.  I like to think of the tool as an amplifier.  Like a microphone it heightens your palpation.  As you work through a part of the body with your hands, we as therapists sense strain, tension, restrictions. Taking the tool and again ‘palpating’ the same tissue what you feel is an amplification of what you feel with your hands, you find the same lines of tension and restriction, but along with this you get a more granular, grainy depth to your palpation helping to pinpoint the exact area of tension and restriction in not only the muscles but the connective tissue.   The tool also ‘highlights’ quite visibly these restrictions with a visible glow that again reaffirms and helps to pinpoint what you have already felt through your hands.  The tool does not take you further from your client but can help you to connect at a different level in a different way.

The Method

Like any technique, it can only be as effective as the therapist using it.  As we all know releasing tension in tissue that does not need to be released will always limit or prohibit positive results for your clients.  The inspiring words of the lovely Lucy Allitt who was leading our course summed this up perfectly.  ‘The IAM Tool is just that a Tool, you need to have the method!’.  I could not have put this better myself.  You need to be able to assess your clients thoroughly, theorise what you believe to the issue and have a clear view of your treatment approach.  Once this is clear and you have the tool to hand – the world is your Oyster.  You can use it to stimulate, release and soften.

 The first thing that hit me was the speed.  Seeing someone double their range of hip extension in 30 seconds was certainly something to astound and what got me initially interested in working with tools.   The tools work quickly with a surprising light touch and can be used through clothes making them perfect for fine tuning and event/competition work.  They not only work quickly but they work effectively.   Like massage, tools can be used to realign fibres, breakdown adhesions and scar tissue but what I see as its greatest benefit is that it appears to have quite an impact on the neural network.

 It is believed that Fascia can send messages to and from the brain far quicker than nerves ‘nerve impulses travel between 150-175 miles per hour.  However, Fascia transmits messages at approximately 750 miles per hour —- the speed of sound in water!’ (Dr. Shierling).  Given that the tool works directly with the subcutaneous layer and Fascia is this the reason why you get such quick results and also why it has such an impact on proprioception and movement re-education?

An Integrative Approach

I am a big believer in integrating techniques.  No two clients are the same, and what works for one client will not necessarily work for the next.  To this end some clients simply melt at the touch of your hands but others refuse to let go.  Working with a tool is simply another approach, for some people they simply respond better to this form of treatment.  This is where creativity is key, mixing up your techniques, waking up the tissues and fibres and getting them to respond to stimulation.  The tool can be used to facilitate, support  or leverage techniques such as Soft Tissue Release, Trigger Points, Massage, Myofascial Release, Neuromuscular Techniques and Muscle Energy Techniques.

My favourite use is to integrate use of the tool into my CORE Bodywork or Soft Tissue Release.  I am a big believer in getting my clients to move and function while we release restrictions.  If the brain helps to release something, there is a better chance of it sticking then if we were to simply manually release these areas.  Getting my client off the bed, moving, stretching, working while releasing tension is made all the easier with the use of a tool and has helped me be more creative in coaxing function back into a clients body.

The Research

Although there isn’t buckets of research out there on the benefits of using instrument assisted massage what is out there is promising.  Lucy Allitt highlighted some of the work my Loghmani, MT et al at the Indiana University on Instrument Assisted Massage.  Loghmani seems to be pioneering research in this area with studies as recent as last year showing the impact of instrument assisted massage in ligament healing times.  The images of knee ligament healing with or without the use of instrument assisted massage are striking.   Where there is a lack of direct research on IAM there is a growing set of research on Fascia itself and on Fascia Release techniques.   See my article on Fascia here – http://www.pamofit.co.uk/2014/05/freeing-fascia-massage-connection.html.

Back in the 1800’s Dr Andrew Taylor Still claimed that Fascia was one of the most important tissues in the body, more recently in the 1900’s Ida Rolf was pioneering its importance in body alignment and health yet its only more recently that research is starting to prove this.    In particular Schleip, Findlay and the Fascia Research Group at ULM University are paving the way for  research in this area and are already showing how vital it is to human health and function.  I encourage any therapist out there who wants to make a real difference to their clients to start working more directly with Fascia and instrument assisted massage is one way of doing this.  Although Noah Karraschs CORE Bodywork techniques still remain my firm favourite!

 The Tool

There are lots of tools out there – IAM Tools, Graston, FAT Tools, K Tools ……………  a spoon! So how do you choose one?   For me the importance in the tool is one that works with me as the therapist not against me – something that is designed to allow me to adopt the best posture as with any technique.  The IAM Tool for me is perfect.  I work with the polycarbonate Dolphin as I like its warmth compared to the steel version.  The quality of its engineering is crystal clear when you see what you can achieve with this one tool, with every edge, turn and side designed to allow you to work at different depths, angles and with varying levels of feedback.

Secondly, the passion of the IAM Tools Team not only in the technique of IAM but in the quality of each tool itself is re-assuring.  High precision engineering meets passion.  Handcrafted and lovingly formed you know you are buying something that will work and last.   Doing the Advanced Course this weekend was also a great opportunity to try different tools and surfaces. The ‘Handlebar’ has now gone straight to the number one spot on my Christmas list!

References/Related Articles

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