Hand Therapy and Soft Tissue Treatment

In the past, depending on the patient’s injury, diagnosis, and symptoms, I have used transverse friction massage, myofascial release, trigger point release, lymphedema massage and scar massage to deal with restrictions, fibrosis, or pain in the soft tissues.  Five years ago, my patient load was about 90% cumulative trauma injuries.  My frustration with my inability to adequately and consistently help these patients, many of them work comp patients, lead me to the Astym technique and training.  Eureka!  First of all, the theory behind the technique makes so much sense. Second, treating the whole arm with these patients? Hello!  Third, the square footage treated in a short time is very efficient, just what our current health care industry demands.  Fourth, Occupational Therapists are all about function, and with Astym, activity is encouraged during treatment!  And last, but not least, the Astym tools are ergonomic.

Astym has been a valuable addition to my toolbox.  I still use all the other soft tissue treatment  techniques, frequently more than one technique on the same patient in the same therapy session.  I always use my hands at some point to address soft tissue dysfunction.  My fingertips can tell me more about the injury than any other evaluative tool.

A couple years ago a co-therapist was treating a woman for tennis elbow who was originally from China.  She and her husband had moved to the US about 10 years previously.  Her husband attended every therapy session with her.  He was very interested in the Astym tools and admitted that he had been treating his wife’s arm with a kitchen spoon before she went to the doctor and started therapy.  He said this is a very common practice in China to use tools to work on soft tissue pain.  In ancient times, tools were made from animal bones and horns.  There’s something reassuring about the fact that successful treatment of injuries dates back to the more holistic approach honored by Eastern medicine!

In fact, in the very beginning of the research that led to the development of Astym treatment, the researchers looked into many old-style manual therapies and reviewed their effectiveness and limitations.  This investigation led to new theories that are now the foundation of Astym.  There are key differences that separate Astym from soft tissue mobilization. To read more about these differences, click here.


Meet Today’s Guest Blogger:

Maureen Scanlan, OTR/L, CHT

Maureen Scanlan, OTR/L, CHT works at St. Croix Orthopaedics in Stillwater Minnesota as the lead hand therapist.  She has 33 years of experience as a therapist, 20 of those specializing in hand therapy.  Her work experience includes Mental Health/Chemical Dependency, Cardiac Rehab, Industrial rehab, Ergonomics, and Hand Therapy.  Maureen has a BA from the College of St. Catherine in St. Paul, MN.  She has been a Certified Hand Therapist since 2003.

Twenty years as a hand therapist has convinced me that nearly every patient with an upper extremity injury or surgery will benefit from one or more types of soft tissue treatment  at some point during the course of their therapy.

Astym and Soft Tissue Mobilization are Very Different

Soft tissue mobilization (STM) is a very broad term. It can include all types of manipulating or “mobilizing” soft tissue in an effort to decrease pain and improve movement. Recently, tools have been added to soft tissue mobilization which is called IASTM or Instrument Assisted Soft Tissue Mobilization (Graston, St3 Fuzion, etc. are brands of IASTM). The goal of instrumented STMs, or IASTM, is clear and simple: to mechanically break apart adhesions.

Continue reading Astym and Soft Tissue Mobilization are Very Different

Astym Resolves Chronic Plantar Fasciitis in Runner

Astym treatment routinely resolves chronic plantar fasciitis and heel pain.   Here an experienced physical therapist talks about how a 50 year old runner who had suffered with chronic plantar fasciitis for over eight years finally got relief with Astym treatment.  The runner had tried other treatments for his plantar fasciitis without any success.  Finally, he received Astym treatment in physical therapy, and Astym relieved his heel pain.

Astym is a highly effective treatment for plantar fasciitis because it was scientifically developed to actually regenerate soft tissues on a cellular level.   It works fast (total treatments are usually completed in 6 weeks or less) and consistently. Here are some useful links:

Statistics on how many patients improve or completely resolve their plantar fasciitis/fasciopathy and other conditions with Astym
What Astym treatment is like
How to find an Astym provider

Astym Resolves Chronic Plantar Fasciitis in Runner


Astym Resolves Chronic Achilles Tendinitis in Runner

Astym treatment routinely resolves chronic Achilles tendinitis/tendonitis and Achilles tendon pain.   Here an experienced physical therapist talks about how a runner who had suffered with chronic Achilles tendinitis for over 6 years finally got cured with Astym treatment.  Continue reading Astym Resolves Chronic Achilles Tendinitis in Runner

Problem Scar Tissue After Mastectomy/Radiation: Astym Treatment Removes Scar Tissue and Restores Movement

Many women experience scarring, adhesions and/or contractures which restrict movement after they receive surgery/radiation for breast cancer. Often, women suffer needlessly with this restricted movement because they are unaware that there is treatment available to eliminate scar tissue and restore normal movement.

A clinical research study just published in Rehabilitation Oncology, the official journal of the oncology section of the American Physical Therapy Association, documents how Astym treatment can effectively restore movement by removing scar tissue in women who had undergone either a single or bilateral mastectomy.

The study focuses on the thickened scar tissue and hypersensitive soft tissue adhesions that develop following mastectomy and other treatment for breast cancer. These difficulties are often left untreated, leaving many women to suffer with tight scar tissue, poor flexibility, swelling, decreased range of motion, and pain.

Astym treatment stimulates the resorption of restrictive scar tissue, adhesions, and contractures, and also stimulates the regeneration of healthy tissue in affected areas. After Astym treatment, women reported that their pain decreased, hyper-sensitivity to clothing lessened and their function improved. At the outset of the study, the majority of women were unable to wear a bra due to hyper-sensitivity, however after Astym treatment, 100% of the women reported that they could wear a bra.

The study was designed to evaluate the effectiveness of Astym on range of motion and perception of functional ability in women who underwent surgery and other treatment for breast cancer.  Results of the study show that Astym is effective in returning women to their prior functional status following surgery.

The entire Rehabilitation Oncology article on this research study is available here.

Back Pain Part II: Pitfalls and Opportunities

Meet today’s guest blogger:

Dave Rubsam, PT, OCS, Astym certified

Dave Rubsam, PT, OCS

Dave has been a physical therapist for over 20 years, having graduated from the University of Iowa in 1989 with his masters in physical therapy. He practices at Marion Physical Therapy in the Marion, Iowa area, and has worked in outpatient settings most of his career. Dave has been board certified as an orthopedic specialist since 2001, and has been certified in the Astym system since 2003, which he uses extensively in his practice. 

            In our last discussion, we talked of the structural causes or origins of back pain, and spoke of how we may need professional guidance to help us sort out what type of back pain we are having. Now, I’d like to talk about some pitfalls of how we cause back pain to happen, and tie these errors to the sources of pain we now understand.

            Back pain can be the result of a traumatic one-time injury like a car accident, a bad fall, or a sports collision. Just like a sprain or a broken bone, these injuries have significant forces involved, and it is no surprise the back can be affected if it is the part of the body impacted by those forces. If so, any of the 5 structures (disc, nerve, joint, ligament, or muscle) we spoke of can be damaged, creating pain. However, trauma is not the most common cause of low back pain (LBP).

            The most common cause of LBP is repetitive stress. This stress can take many forms, including poor posture, sustained positions (especially in poor posture), poor lifting technique or improper body mechanics, poor strength or flexibility (or both), and inadequate fitness. Other factors involved are the amount or frequency of lifting, type of job or recreation, smoking, and nutrition.

            Poor posture takes the spine out of its natural position and creates excessive bending of the spine, creating abnormal tension on one side and abnormal compression on the other. Eventually some part of the spine or its supportive musculature will begin to break down in response, creating pain in the back, and sometimes elsewhere as well. Sustained positions, even if in good posture, can create excessive strain on our muscles and joints. Virtually all of our tissues thrive on movement, to relieve tension, to promote circulation, and to create joint fluid movement; all helping to bring nutrition to our tissues and take waste products away.

            How we move and how we lift can be a major cause of back pain. Lifting improperly puts too much stress on our spine, rather than in the joints and muscles of our arms and legs that were designed to carry the burden of lifting. Even bending over at the waist rather than bending our knees and hips creates a large amount of stress on our low back—made even worse if we add reaching, twisting, or lifting to that bend. If we have a job that includes heavy lifting, prolonged sitting, awkward body positions, or lots of repetition, we are set up to have higher risk of injury.

Back Pain: Why so common?

Meet today’s guest blogger:

Dave Rubsam, physical therapist certified in Astym treatment

Dave Rubsam, PT, OCS

Dave has been a physical therapist for over 20 years, having graduated from the University of Iowa in 1989 with his masters in physical therapy. He practices at Marion Physical Therapy in the Marion, Iowa area, and has worked in outpatient settings most of his career. Dave has been board certified as an orthopedic specialist since 2001, and has been certified in the Astym system since 2003, which he uses extensively in his practice.

The statistics in the United States say that 8 out of 10 of us will suffer enough back pain at some point to have to change our plans and likely seek medical attention. But why is back pain so common? Let’s explore some reasons why, and we can each think of which of these (in any combination) might apply to us personally.

First, where does back pain come from? I like to tell my clients that it can originate from at least 5 different structures anatomically. The most feared is the disc, commonly diagnosed as a “disc bulge” or a “slipped disc” or a “herniated disc,” among others. The disc itself may create pain if injured, or it may create pain by pushing on or irritating a nerve running next to the disc. Next is nerve pain, most frequently called “sciatica” if affecting the large sciatic nerve running to the lower extremity, or nerve pain can affect any of the smaller nerves in the back itself, the abdomen or pelvis or groin areas. Nerve involvement may also create numbness, tingling, burning, or other abnormal sensations in the areas affected. Third, back pain may come from the facet joints, which are the small joints joining each vertebra in the spine to the ones above and below. Like any joint, these can be sprained or have arthritis affect them, creating pain in the middle of the low back, or just to either side. Fourth, the ligaments that link the vertebrae together may be sprained, just like an ankle sprain. And lastly, the muscles that surround the spine and pelvis and hip joints can be injured, creating spasm or tension in the low back, and possibly affecting any of the prior four structures, creating pressure and pain from them as well.

While not an exhaustive description of back pain, the discussion above should highlight the complexity of back pain, and should lead us to realize that “back pain” is not generic, and should not be treated generically—not every episode of back pain is the same, so treating back pain shouldn’t be the same every time. If you are experiencing back pain, look to the experts to help you obtain a plan of care that fits your situation. Your doctor can help with the medical management of your symptoms, and your physical therapist can help with the appropriate treatment and exercises to get you back to your regular activities as soon as reasonably possible. Treatments may include medications, modalities (the term for treatments such as heat, cold, ultrasound, electrical stimulation), and hands-on interventions like spinal mobilizations or manipulations, Astym treatment or other soft tissue work, exercises specific for your type of back pain, and help with proper lifting techniques and injury prevention ideas to keep your pain from returning.

What’s Your Astym Story?

Share your Astym story with us and our readers.Astym treatment has improved lives across the country. We would like to hear your story about what Astym did for you. Whether Astym helped you win a race or the big game, dance at your daughter’s wedding, or simply got you back to doing the things you love, we want to hear about it.

Here are some ideas of things you may wish to include in your story:

  1. What problem did you suffer from? How did this problem limit you – what things were you not able to do?
  2. How long did you suffer before you found Astym? Did you try other treatments that failed before you found Astym?
  3. How soon after receiving Astym treatments did your condition start to resolve? What things could you do again after receiving Astym treatment that you could not do before?
  4. How has your life improved now that you are well again?
  5. How has Astym met or exceeded your expectations?

*Such as patient, long-time runner, professional athlete, recreational athlete, tennis player, etc.


I give my full permission for all information I have submitted here to be disclosed and released on the internet or other publication.

Jumper’s Knee Treatment

Meet today’s guest blogger:

Noel Tenoso

Noel Tenoso, PT, DPT, OCS practices in the Portland, Oregon area and owns 2 clinics, Advance Sports & Spine Therapy. He has certifications in manual therapy and Mechanical Diagnostic Therapy with the McKenzie Institute. Both clinics have met the criteria of being certified McKenzie Clinics. He has been certified with Astym since 2005.

Pain in the front of the knee is very common in many types of sports that are associated with quick stops, starts, changes in directions, and jumping. “Jumper’s knee” or patellar tendinitis/tendinopathy is a condition that usually persists for more than 4-6 weeks after symptoms appear. Pain is generally intermittent and associated with activity.


Clinicians practicing Astym will find a nodule of tissue (scar tissue) just below the kneecap that correlates with the patient’s symptoms. This scar tissue may represent the dysfunctional healing of the tendon that can be addressed effectively with Astym treatment and exercises.


Clinically, a physical therapist can assist with management of jumper’s knee by stimulating the lower extremity with Astym treatment to assist with resorption of the dysfunctional tissue, and to stimulate production of new collagen tissue. In conjunction with treatment, the patient needs to participate by doing stretching exercises and increasing activity that will help guide the healing of this new tissue. Another important aspect of rehabilitation is making sure future recurrence is prevented by addressing the poor biomechanics that may have put too much pressure on the knees. A physical therapist can help to evaluate and educate the patient on how to reduce the stress to the knees through incorporation of the hips and proper trunk posture with quick stop/starts, changes of direction, and jumping.


Stretches that address improving flexibility of the muscles of the hips, quadriceps, hamstrings, and calf muscles in conjunction with Astym are helpful. Also “eccentric” exercises1 have been shown to help by doing lengthening exercises of the quadriceps with resistance to discomfort while squatting on a decline board.


1Jonsson P, Alfredson H. Superior results with eccentric compared to concentric quadriceps training in patients with jumper’s knee: a prospective randomized study. BJSM, 2005; 39: 847-850

Restore – Revitalize – Recover