This past weekend I attended Rocktape's FMT Blades course at the Brooklyn Athletic Club here in NYC. Rocktape has been around for quite some time now and has been steadily increasing the number of continuing education courses they offer beyond just taping, including a "movability" course, a special populations course and even animal-focused therapy courses. I received virtually zero exposure to instrument-assisted soft tissue mobilization (IASTM) during my formal education, and had only come across it in the past as a portion of Dr. Erson Religoso's Eclectic Approach seminar. Having heard good things about Rocktape's series of continuing education courses, I was eager to dive in.
A main point regarding the mechanisms behind IASTM that was established early on was providing sensory input that would in turn help guide a desired motor output. Personally this was important for me as I believe the concepts behind manual therapy or soft tissue management systems should be as aligned with modern pain science as possible. In regards to mechanical versus neurological mechanisms, the former model appears to be receiving more scrutiny as far as the scientific literature is concerned. For example, clinically speaking I subscribe to the beliefs that there is poor inter-rater reliability behind the ability of clinicians to locate trigger points, that fascia cannot be physically deformed and changed without a tremendous amount of force and that soft-tissue adhesions can't be simply rubbed away. Therefore in order for me to responsibly incorporate IASTM into my practice, the primary reasoning behind its usage would be that it'd be influencing the nervous system to change neurological tone or to decrease the perception of threat which would then allow windows of opportunity for desired rehabilitative neuromuscular activities to then occur.
The didactic portion of the course delved into a bit of the science surrounding pain, fascia and the physiology of mechanoreceptors which helped set the stage for the different techniques we would learn and employ with our instruments. Having no instruments of my own heading into the course other than Kelly Starrett's Mobility Star product, I opted for the course price of $550.00 which included an FMT Blades kit containing two instruments (the Mallet and the Mullet), emollient and alcohol wipes. This kit's retail price on the Rocktape website is $299.00, and if you already have your own set of tools you are given the option of a $250.00 price for taking only just the course. For a single-day course to include these tools, a roll of Rocktape and an unexpected bonus of lifetime discounts to their products, the price of $550.00 is probably one of the most competitive prices as far as IASTM continuing education courses go. Another big bonus for me was that it was a convenient 15 minute drive from my house, which is always nice for weekend courses.
The Mallet is made of surgical-grade stainless steel, weighs one pound, has four treatment surfaces and is engineered to offer six different types of comfortable grips. It is the more robust of the two tools and feels both comfortable and durable in my hands. A problem I've encountered with other tools I've used in the past was that their awkward shape never quite allowed me to get a comfortable grip for applying treatment. So it was nice to not have my hand cramp while using the Mallet.
The Mullet is the lighter of the two instruments weighing in at 0.4 lbs and is constructed of thermo-plastic polyamide. While lacking the versatility of different grips, angles and greater surface-edge size of its Mallet counterpart, it is more lightweight and portable. Also has a nifty can opener that is built in--no joke.
At this point I'm going to digress a little bit from the review to discuss my brief experience with the Graston Technique at the course. A knowledgable gentleman also attending the course who is a private-practice chiropractor sat next to me throughout the day and was my partner for most of the breakout activities. After some initial group ice-breakers, he informed me that he had been using the Graston Technique for many years in his practice, and I allowed him to perform his techniques upon me so that I could get a feel for the difference between Graston and the FMT Blades method. I've never taken a Graston course and can only speak upon it based on what my partner told me, but the force applied to my skin was much harder. After only 2 minutes of scraping to my right latissimus dorsi, I received the following skin response:
While not painful, I was surprised at the vascular response my skin produced from such a short period of scraping and I don't doubt that the epicenter of erythema would've easily developed into darker shades of petechiae. While he was explaining his methods, based on his verbiage I was under the impression that my partner subscribed to more of the mechanical-based approach to IASTM along with the neurological-based approach. This theme appeared to be consistent throughout the day as we partnered up for additional activities. Upon noticing my skin reaction and not desiring to be any more bruised, I kindly asked him to refrain from such pressure to which he also kindly obliged. For the record, we became friends throughout the course and he was a great partner to have. He freely shared his knowledge and I was grateful to learn from his clinical expertise in using IASTM despite our differences in treatment approaches.
The course also included some educational content on their taping philosophies and included exercises involving the combination of "taping & scraping". Several volunteers from the class received movement assessments in front of the room, received taping and/or IASTM and were subsequently reassessed. Out of all the course content I was probably the most critical of these case studies. The assessments and movement screens were basically abridged portions of SFMA top-tier tests and a couple of their breakdowns. Now, I understand that for the purpose of the course's objectives, it is not practical to perform entire SFMA breakouts in order to reveal the underlying root cause of pain or dysfunction. The course instructor also responsibly admitted this throughout the day. But when fundamental concepts like mobility versus stability and regional interdependence are continually emphasized throughout the course, the case studies and class demonstrations should illustrate those principles correctly. The SFMA is not required to take this course, but when a class consists of fitness and healthcare professionals from different educational backgrounds and disciplines, sometimes making a general conclusion off a small fraction of a top tier test can be a slippery slope towards misapplication of course concepts. It also creates dissonance between the the fuzzy areas that overlap between scopes of practice of different professionals. This is one area that I think would benefit from some change. All in all, when using the SFMA correctly and finding the correct direction to apply one's interventions, Rocktape's FMT Blades approach can definitely be effective.
At the day's end I was pleased with the course and would recommend this to health care professionals especially if you've never had educational exposure to this topic before. Knowledge of the SFMA and other Gray Cook principles of movement would greatly help flesh out some concepts and give more meaning within a treatment framework. I see myself incorporating the content into my daily practice, so it always feels good to walk away from these courses with some practical takeaways. It's always important to take into account the scientific evidence surrounding a certain kind of technique or approach, but remember that nothing is going to be always 100% scientifically justfiable and there are other factors to consider (think Sackett's model of evidence-based medicine). However, do make sure that it fits within the system or treatment framework that YOU employ, and do your due diligence when justifying your reasoning behind it.