What is Myofascial Decompression and Instrument Assisted Soft Tissue Mobilization?

Myofascial Decompression (MFD) is the western medicine version of cupping. It focuses on providing a lifting force on tissue that with everyday life gets compressed. Cupping is a passive set it and leave it technique. MFD involves movements of the tissue to normalize body mechanics and tissue movement. Instrument Assisted Soft Tissue Mobilization (IASTM) commonly referred to as scrapping, HawkGrips or Graston uses surgical grade stainless steel tools to break up fascial adhesions and scar tissue that build up within the tissue from stress on the body through working out. Hawkgrips is the current industry standard and are the tools that we use. Click here for more information on HawkGrips.


What is the diffrence between MFD and Cupping?

“MFD is based on assessing and correcting movement inefficiencies. Backgrounds in biomechanics, kinesiology, and functional anatomy are essential to identify and treat ROM restrictions and muscular imbalance.  Interventions include neuromuscular re-education, AAROM, and PNF, making the patient an active participant in their treatment.  Traditional cupping does not include active movement, and often is targeting energetic imbalances from a traditional Chinese medicine perspective.  MFD is a novel approach to musculoskeletal treatment, utilizing negative pressure tools and western medicine based movement paradigms and algorithms.  These applications are very effective for orthopedics, sports medicine, contractures, post-op recovery, overcoming dominance strategies, postural syndromes, hand therapy, neuro re-education, and scar mobilization.” – cuptherapy.com


Why should I see a PT?

As a Physical Therapist, I pride myself in having multiple techniques including soft tissue work, joint manipulation, kinesiology taping and using Instrument Assisted Soft Tissue Mobilization (IASTM) tools and Myofascial Decompression Cupping to treat the various issues I see. I focus on normalizing movements, through hands on techniques as well as give you the power and knowledge to continue the healing once you have completed your sessions.


What do I need for my first appointment?

Each appointment is tailored to the individual. A typical initial session will consist of the first 10-15 minutes of discussing current and past conditions and your goals. The next 30-45 minutes will be spent with hands on one-on-one treatment to normalize body mechanics and decrease pain. The remainder of the visit will be spent going through specific movements to improve and maintain those movements.

Please wear workout clothing with the ability to reach the skin of the area to be treated for all treatment sessions.


Do I need a referral to be seen at Surf and Shore PT?

You do NOT need a referral from a Physician to be seen at Surf and Shore PT.

A referral from a Physician may be needed to in order to get reimbursed if you plan to submit them to your insurance company. Please contact your insurance provider for specific details on their out of network policies and reimbursement rates. Click here for referral form.


What does Out-of-Network mean?

Surf and Shore PT is an Out-of-Network clinic due to our treatment philosophy. We believe in providing the highest standard of care which involves one-on-one treatments with a Doctor of Physical Therapy and no oversight and treatment limitations by insurance companies that are throwing darts at a board to decide number of treatment sessions you need. Number of visits are not based on Physical Therapist or Physician recommendations unless they are directly paid by the insurance companies. Many insurance Physical Therapy clinics are seeing 3 or more patients an hour per PT in order to make a profit due to the limited reimbursement and high insurance co-payments. Click here for more info.


Can I submit for reimbursement from my insurance company for my out-of-pocket expenses?

This answer depends upon the type of insurance you have but with some insurances, Yes. We are currently out-of-network with HMSA PPO, UHA, HMAA, and TriCare. Please inform us if you plan to seek reimbursement. So we can better assist and provide a form that contains specific information in order to get reimbursed. It is best to contact your insurance company prior to starting to ensure that no pre-authorizations needed before starting.


Do you only treat CrossFit Athletes and Surfers?

No. We welcome all active individuals at Surf and Shore PT! Although we pride our selves in specializing in treating CrossFit Athletes, Triathletes and Surfers, and getting them back to what they love as quick as possible. We treat anyone from Professional athletes to competitive Hula dances to weekend warriors. We also treat anything from headaches, low back pain to ankle sprains and everything in between.


How much does a visit cost?

We pride ourselves in trying to keep our prices as reasonable as possible and well below industry standard for a cash based practice.

Our fee for a one-hour treatment is $150. A thirty-minute treatment session is $80. The full session is spent with a highly qualified Doctor of Physical Therapy.

Ask about our multi-session packages that are available to reduce the per visit cost of each session.

You may be able to get a percentage of this payment reimbursed through your insurance company. Please see our “Can I submit for reimbursement from my insurance company for my out of pocket expenses?” above.

For more information on why you should choose an out of pocket payment option please look at these links. Click here for more info.


Can I use my Flex Spending Account/Health Savings Account at Surf and Shore PT?

Yes, you are able to use your FSA account at Surf and Shore PT, ask about our special FSA package rates. Please let us know if any written documentation is needed to help with FSA use.


How Can I Fix My Posture? Part II

I always think of the guards at Buckingham palace in the UK when I think of perfect posture. They stand in one place without moving for hours, how crazy is that. Try sitting in one position without moving for 10 minutes. These guys do it day by day rain or shine. Imaging the self-discipline and muscle stamina it takes to continue to hold this posture.


In part II it is all about having the strength and stability to sustain our good posture. This stability will allow us to maintain our good posture when we are in an optimal position. Having the best mobility in the world is great but if you are only able to hold that perfect position for 5 minutes during a 8 hour work day, you will still have poor posture. The main postural stabilizers are the upper back muscles, deep neck flexors, front core muscles like the rectus abdominus, transverse abdominus and obliques, and glute muscles.


Crossover Symmetry Row

The goal with any of the Crossover Symmetry exercises is to keep your shoulder blades down, focusing on pinching the bottom points of the shoulder blades together.


Crossover Symmetry Reverse Fly

This exercises is just like the one above just with a longer lever arm with the arms being strait, make sure to keep your shoulder blades down, focusing on pinching the bottom points of the shoulder blades together.

Deep Neck Flexor Activation

Our deep neck flexors get lengthened as our posture gets worse, these little muscles in the front of the neck allow us to tuck our chin and keep our head stacked over our torso.


Hollow Rock Prep

This progression can be tailored to any level. The important part of this is to breath while you are using your core muscles to flatten your back.



Our hip muscles support the pelvis which is the foundation for our posture, the bridge is a great way to get glut max active and stronger.

Band Side steps-

Our world is often lived in the sagittal plane (forwards and backwards), this exercises adds strength and stability in the frontal plane (side to side). This will help prevent rotational and side shifting with poor posture.


The last variable is your work set up. This is where most people start and can’t seem to figure out why they still have poor posture. Set up is a component to optimize posture but just having a great desk set up, standing desk, or any other sweet new gimmick is out this month will not allow you to be in or sustain that position for a full work day without proper mobility and stability.


The number of postural exercises are infinite. Figure out what your biggest limitation is and work on it, then find a new limitation, we should never strive to settle for less pain if we can fix the problem. Get a list of 3-4 exercises that help you the most and keep adding exercises and taking them away as you improve your posture.

Call us today if you think you could benefit from improving your posture and get a postural assessment. 808-599-0177

How can I fix my posture? Part I

Have you ever seen an elderly person walking down the street and they look like Quasimoto form the Hunchback of Notre Dame? I’m not sure about you but even as I’m typing this my mind is hyper focused on mu posture because I don’t want to look like that when I’m in my 80’s, 90’s or even my 100’s. Most of the time this type of posture is acquired over years of poor posture and positioning. Yes there are some genetic, structural and disease pathologies that can cause this posture to like what Quasimoto had. The ultimate goal is to not let our seated, desk bound lives to take control of how we look, feel, and move. We should be able to have and keep good posture without having to think, or set reminders to “sit up straight”.


Having good posture comes from many different variables. First, we need to have the mobility to get into a good posture. If we lack this, the rest does not matter. Mobility will always come first to set ourselves up for success. This means we need to loosen up our upper back, neck, chest, hip flexors, and lower back muscles. Below are some of my favorite mobility exercises to fix your posture.


Thoracic opener, on Peanut-

This one is great to start off with to help increase thoracic extension to improve our mid back position.

Peanut neck mobility-

The neck is a key part to posture, for where the head goes the body follows. So if our head goes forward our body will follow.

Pec Smash-

Getting the pec muscles in the front to loosen up can be a helpful to allow up to open up our chests to get into a better postural position.

Band hip opener-

The hips are our foundation with sitting, if they are not in a good position the rest of the body will fold into poor posture.

Low Back Mobilization-

The little joints in our back can limit our ability to move appropriately. If you can get joints to move better you will move better.

Low Back Rollout-

Low back stress through the muscle are often caused through poor posture. If you can loosen them up and increase their usability posture will improve.


MOBILITY BEFORE ANYTHING. Get moving better first then you can focus on getting stronger and increasing postural awareness. Try to work through different areas of the body to see if you can fix your problems. If you have neck pain look and make sure your low back is moving and is not the source.


Look out for Part II next week where we will go through how strength will help improve posture after you are moving normally.

How to beat elbow pain

Elbow pain can be debilitating! After all it’s not like you can just go on for a week or even a day without using it. Elbow pain is often linked to the amount of gripping you do throughout the day or heavy loads through grip. I had a monster of a patient 6’2” 250 a year or so ago that is a world class Ju-Jitsu competitor, CrossFit enthusiast and big wave surfer amongst other things. He initially had some elbow pain from heavy kettle bell swings. It got a little better so he went surfing then as he was duck diving his board got taken and he had another strain trying to hold onto his board. After his elbow pain relented a bit he thought it would be a good idea to do a bunch of pullups and go to Ju-Jitsu, there they did tons of grappling and practicing throws which involved gripping the other persons Gi. After that he was un able to hold the remote, or even pull the sheets over him in bed without excruciating pain. Once he came it and I explained to him that it was gripping that he was doing he realized that even though he tried to vary all the sports he loved, they all required use of grip that was aggravating his elbow. He is now fully healed, but it took 4 months to get him back to his prior level due to how irritated his elbow was.


Elbow pain can be frustrating and challenging. It often is seen as either “tennis elbow” (lateral epicondylitis) or “golfers elbow” (medial epicondylitis). These injuries are based on direction of force and total grip. Although the injury can occur with a movement, it can be made worse with grip activities, like carrying a bag, opening heavy doors, holding a dog leash (if your dog’s a puller like mine is). All these day to day activities that usually are no problem lead to little injuries and increased stress through the injured elbow.


Here are some quick easy exercises to help get you back on the right track with your elbow pain.




Normal motion is important for the health not just of the elbow, but of the entire upper extremity. Try out these mobility exercises to get back the motion that you need. Grip strength will come after you get the motion normal and the tissue to loosen up. Try these 4 exercises to fix your elbow pain.


Band elbow mobility-

When the elbow is fully strait it is in its most stable position. If we lack full motion it can lead to increased stress through the supporting structures of the elbow, causing pain. Use the below band technique to help get the elbow strait.


Elbow lateral glide-

Working joints against there normal joint movement is a great way to loosen up the elbow especially if you have pushed in the other directions and need a little more to get back full range.



If you have elbow pain try out some RockTape to help take the edge off. This is a great way to help relive pain and improve functioning.


VooDoo Band-

The VooDoo band is one of my favorites, it is the quickest and easiest way to loosen up the muscles that surround the elbow. Make sure it is tight, due to this tightness the total on time should be 1-2 min.


If you have been struggling with elbow pain and need help contact us today for a free 15- minute phone consultation. CLICK HERE.