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.


Why am I walking bent over like a 90 year old?

I remember almost 3 years ago now, I did the CrossFit benchmark WOD Grace (30 clean and Jerks for time), and crushed it… at least for me. The next day however Grace had the last laugh, I was walking like I was 90. Every time I got out of a chair, the bed, or car I was hunched over for 5 minutes. It was horrible. As a PT it is the worst getting hurt because you know you can fix yourself, but where do you start? Do you look at WebMD and ultimately conclude, it is either a spinal tumor or a disc herniation (neither of which are usually correct for this type of pain). Hopefully this is not your route since you’re reading this.

There are typically 2 reasons for this type of pain. First, is that the muscles got over worked and have shut down as a protective mechanism to let the body heal. This typically occurs with/after lifting objects from the floor. Second, is that the little joints in the back got jammed and now are inflamed. The second scenario is most common when arching back or lifting overhead which causes overarching through the low back jamming the little joints. This scenario is similar to jamming your finger, it hurts to start moving it but as you keep it moving it sucks less and less every day to keep it moving.

The good and bad about these 2 scenarios is that the treatment will be similar. When muscles tighten up they will compress the joints. When the joints have an inflammatory reaction the surrounding musculature will tightness up. For both we need to loosen up the muscles and the joints followed up by exercises to stabilize and get blood flow to the area. Here are my favorite 5 exercises that need to happen to get your back up and running.

Too much of a good thing can be a bad thing. start with 2-3 minutes.
Too much of a good thing can be a bad thing. start with 2-3 minutes.
This one is not comfortable but can give you great results especially if you have a desk job.
Less is more with this one. If you go too high or too fast you will bypass the small muscles you want to target.
Start small and work your way down based off comfort. If you go too hard it can overload the back muscles.

Consistency is key, there is a physiologic healing time with these types of injuries it will not get better in a day. Be patient and consistent with the exercises, trust the process it can take weeks.

Thanks for reading!


Add 15 Yards To Your Drive

In 2016, the National Health Statistics Reports (NHSR) after analyzing thousands of surveys showed that Golf has a higher risk of injury associated with it than Rugby. As shocking as this is, it makes sense. Most injuries associated with Golf are due to overuse, opposed to the trauma type injuries of Rugby. 18 holes a week over 52 weeks is 936 holes, assuming you are shooting 85 average per round that is almost 80,000 strokes in a year! That much repetitive stress without some sort of maintenance program is a recipe for disaster. The NHSR did also show that there are other risks of golf such as being run over by a cart, struck by a arrant ball and even some lightening strikes.

The easiest way to reduce your risk of injury is to move better, and be stronger within this range. If you can get through the proper sequencing of a swing stress is evenly placed on the body, decreasing your risk for injury. The best part about improving movement though is that with a more efficient swing the ball will go further! Less pain/risk or injury and more distance on your ball what could be better.

The most common area injured in golf is the low back. This is due to increased stress going through an area of the body that is meant to be stable through the golf swing. Most of our rotation on the back swing and follow through should come through the hips and upper back. Not our low back and shoulders. If this is happening, at through the swing you will continue to put excess stress on low back until it has had enough and starts to have pain. To fix this you need a couple easy exercises to test out your rotation and to fix it.

First things first we need to see if we are limited with hip rotation. If you have enough motion there are many other limitations that can lead to pain, or it could be a weakness/stability issue.

Hip Rotation Test

This test is a quick and easy way to assess hip and lumbar rotation to make sure that you have all the motion needed for a great swing.

Hip PA Mobilization

This hip mobilization can be done anywhere even on a golf cart seat.

Golf Rotational Strength

Rotational strength is a great way to follow up any type of soft tissue or joint mobilization work to get the muscles working in a new range.

If you have pain or discomfort with golf make sure you give us a call today before it gets worse.




Shoulder Mobility Before Stability Always

Have you ever seen a really strong guy that looks like he has a penguin walk because he cant move? A person can be really strong, lack motion and have lots of pain. Mobility must come first to fix a motion problem no matter how strong you are if you lack motion your chances of injury are much higher.

I recently I got to work with Steve who was a surfer who was having lower back pain. He would head out for dawn patrol most mornings then sit at a desk the rest of the day. He had been working on his back getting massages, rolling out, increasing his core and low back exercise to build strength with no success. After assessing his low back he looked great, he was moving well with full low back range, and his core wasn’t bad. Due to this I had him show me his paddle position. This started to show his limitations, he had minimal upper back motion causing increased need for motion in his low back. With upper back limitations we next took a look at his shoulder mobility, which turned out to be very limited. Because he was so limited with his shoulder and upper back mobility he needed to move more through his lower back to still be able to paddle out.

Steve had good core strength and had great shoulder endurance with good stability in the motion he had. Even though his strength and stability were good he had pain because of his poor mobility. To fix his problems we need to first address his mobility issues then gain stability in his new range. Mobility must come before stability. The following exercises are the ones that Steve got to improve his shoulder and upper back mobility that got rid of his back pain.

Band Overhead Mobility

Perform for 2-3 minutes moving the body to fine tune and find the stiffest part of the shoulder.

Band External Rotation

Perform for 2-3 minutes moving the arm up and down to fine tune and find the stiffest part of the shoulder.

Band Thoracic Opener

Perform for 2-3 minutes moving the body closer or further away from the heels to fine tune and find the stiffest part of the upper back.

Thoracic Opener On Peanut

Perform for 2-3 minutes the arms and hips to fine tune and find the stiffest part of the upper back.

After the mobility exercises are completed it should be followed up with some light stability exercises to get the muscles working in the new range.