In this topic we're going to do vibration or percussive release techniques with my "MUSCLE MASSAGE GUN". I'm going to have my friend Melissa come out, she's going to help me demonstrate. Now if I'm doing gastrocnemius and soleus release as I am in this today's topic, we're going to assume that I already did an assessment, Melissa was complaining about some plantar fasciitis. So we did our overhead squat assessment, she had excessive forward lean, and then I wanted some way to be able to assess improvement so I did a little goniometry, and she actually has a restriction in dorsiflexion. These are great reasons to use a little bit of vibration release. Now the vibration release techniques do work a little different than like let's say foam rolling or our static manual release techniques. Rather than going for deep trigger points and staying in one place we're going to use a slightly different protocol here. Now, Melissa's body position, since I'm working on her calf I have her laying face down and I actually have her ankles off the end of the table, and the reason I like having the ankles off the end of the table like this is because I can now control dorsiflexion with my thigh which will control how much tension is in this tissue, which is kind of a nice benefit to have as I'm going through this technique. To start off with I'm going to use the flat round piece that comes with my hyperbole, and I find that it works very well for the lower extremity and a little counterintuitive I'm actually going to start on the higher frequency setting. So this is number three and the reason being is I'm also going to start very superficial. So when I'm doing these techniques initially I'm just using the weight of the "MASSAGE GUN" itself, I don't need to push any deeper, I'm just going to let the frequency do all the work.
Now you'll also notice that rather than staying in one place like I would with a foam roll or finding like a trigger point and doing my static manual release techniques in one spot, I'm also going to glide through the entirety of the tissue for the muscle that I'm working on. Now I am going to pay attention to areas that I think are a little bit more dense or maybe have a little bit higher tone, but overall I'm just going to slowly work my way through her entire calf complex. I kind of got a mowing the lawn pattern here going right now. Now as I'm going through and I'm taking note a little counter-intuitively, the reason I'm taking note is we then might go back with a smaller piece something with less surface area so we increase the pressure a little bit. I'm going to decrease the frequency and I'm going to be able to dig into the tissue a little deeper for those more stubborn or denser areas, and that's definitely a dense area right here for Melissa. Alright so steps 1 are just superficially going over the tissue on the higher frequency settings, but monitoring some parts where you think maybe they could use another pass or maybe a little deeper work with a lower intensity, and in this case point to your tool you might be thinking to yourself it doesn't matter whether skin or clothes because we glide over the tissue. I actually find that thin clothing is actually better, so Melissa's yoga pants here are absolutely perfect, because there's some moisture in your skin you sometimes get a little caught up on the skin, whereas you can glide really nicely over like basketball shorts or yoga pants or even like these these prana pants that I'm wearing here, which are kind of like that those gym pants that look a little bit more like slacks. Alright so next step I'm going to go to this smaller piece which I think hyperbole calls the bullet here, and as I mentioned a little counter- intuitively I'm going to stay on the low setting. Now the high settings you'll notice that you will be able to try this out yourselves, the high setting if you even tried to dig in deeper into the tissue the machine's going to kick you right back out because that frequency is so high. Or if you really press in you're just going to cause a lot of pain and obviously a lot of pain is not going to help us get releases. So I notice Melissa was a little bit more tender or a little bit more dense in here, so I'm going to apply a little bit more pressure. Notice I'm not like digging in, I'm not using all my muscles to like get through and like penetrate bone, I'm just digging a little further into the tissue until I get a little density, and then again I'm not necessarily going to stay in one spot but I'm going to very slowly crawl through the tissue as I feel it release. Now for my manual therapists the "MASSAGE GUN" is light enough that you can use one hand, and use this other hand to monitor tissue density. So for example I felt like okay here I have an increase in tissue density maybe I can even feel some hypertonic fascicles, or some fascicles that are very guitar string like. I can use my thumb to figure out where they are and then put the tool over them and work through them, and then of course go back and monitor them again with my thumb. Not necessarily essential to make this effective okay, so for those of you who are not manual therapists or license manual therapists "MUSCLE MASSAGE GUN'' is still a very effective tool, but I'm just going to work through the tissue here, and a little smaller piece. Now of course after I was finished with this I could reassess to see if this technique was effective for what Melissa has going on with her movement impairment, and then go on with my other techniques. So just because I did this technique doesn't mean that I can't, again we talked about maybe foam rolling first, maybe doing some lengthening techniques, those of you who do other like dynamic release or pin and stretch techniques, you could absolutely follow up with this. What probably is happening with these vibration or percussive techniques, is we're working a little bit more towards these pacinian corpuscles and these Ruffini endings and they're stimulated by vibration, and from what we can tell, somehow neuromuscularly some of those endings will help stimulate that inhibitory response very similar to the way we expect like the Golgi tendon organ to act with autogenic inhibition. Stay tuned for the close-up recap. All right I wanted you to see a little bit of what this looks like as it passes through the tissue. So as I mentioned I'm going to go ahead and start on the higher setting, alright so we'll start on setting number two, and I'm just going to slowly work my way from the bottom of her calf. Alright now that's to say we hit her Achillies tendon, that might not feel very good. I'm just going to slowly work my way through your entire calf complex just kind of one row at a time here. Notice a little extra tissue density, so maybe I slow down right here a little bit. Take note for using that other tool alright we'll go ahead and assume I just went through the entire calf complex, I'm going to go ahead and turn this off real quick just by pressing that button a couple more times. I'm going to pop out the the flat piece, go to more of the bulleted piece. We noticed Melissa's tissue density was a little higher right here, So now I'm going to go ahead and just put this on one, and so it's a little lower frequency so I can get deeper into the tissue. Alright so if this is totally superficial I'm just going to dig in maybe an extra quarter to half inch, and then really slowly work my way through the tissue as I feel it let go underneath the Hyperbole. Of course my manual therapists, you could come in here and go okay I feel a little bit more density in here I can put this right behind. A "MASSAGE GUN" really easy to control with one hand and I can kind of work my way through the tissue slowly but surely go back through a monitor and see if those fascicles have let go. Now you guys have it vibration release using the hyper volt for the gastrocnemius and soleus complex.
Now you'll also notice that rather than staying in one place like I would with a foam roll or finding like a trigger point and doing my static manual release techniques in one spot, I'm also going to glide through the entirety of the tissue for the muscle that I'm working on. Now I am going to pay attention to areas that I think are a little bit more dense or maybe have a little bit higher tone, but overall I'm just going to slowly work my way through her entire calf complex. I kind of got a mowing the lawn pattern here going right now. Now as I'm going through and I'm taking note a little counter-intuitively, the reason I'm taking note is we then might go back with a smaller piece something with less surface area so we increase the pressure a little bit. I'm going to decrease the frequency and I'm going to be able to dig into the tissue a little deeper for those more stubborn or denser areas, and that's definitely a dense area right here for Melissa. Alright so steps 1 are just superficially going over the tissue on the higher frequency settings, but monitoring some parts where you think maybe they could use another pass or maybe a little deeper work with a lower intensity, and in this case point to your tool you might be thinking to yourself it doesn't matter whether skin or clothes because we glide over the tissue. I actually find that thin clothing is actually better, so Melissa's yoga pants here are absolutely perfect, because there's some moisture in your skin you sometimes get a little caught up on the skin, whereas you can glide really nicely over like basketball shorts or yoga pants or even like these these prana pants that I'm wearing here, which are kind of like that those gym pants that look a little bit more like slacks. Alright so next step I'm going to go to this smaller piece which I think hyperbole calls the bullet here, and as I mentioned a little counter- intuitively I'm going to stay on the low setting. Now the high settings you'll notice that you will be able to try this out yourselves, the high setting if you even tried to dig in deeper into the tissue the machine's going to kick you right back out because that frequency is so high. Or if you really press in you're just going to cause a lot of pain and obviously a lot of pain is not going to help us get releases. So I notice Melissa was a little bit more tender or a little bit more dense in here, so I'm going to apply a little bit more pressure. Notice I'm not like digging in, I'm not using all my muscles to like get through and like penetrate bone, I'm just digging a little further into the tissue until I get a little density, and then again I'm not necessarily going to stay in one spot but I'm going to very slowly crawl through the tissue as I feel it release. Now for my manual therapists the "MASSAGE GUN" is light enough that you can use one hand, and use this other hand to monitor tissue density. So for example I felt like okay here I have an increase in tissue density maybe I can even feel some hypertonic fascicles, or some fascicles that are very guitar string like. I can use my thumb to figure out where they are and then put the tool over them and work through them, and then of course go back and monitor them again with my thumb. Not necessarily essential to make this effective okay, so for those of you who are not manual therapists or license manual therapists "MUSCLE MASSAGE GUN'' is still a very effective tool, but I'm just going to work through the tissue here, and a little smaller piece. Now of course after I was finished with this I could reassess to see if this technique was effective for what Melissa has going on with her movement impairment, and then go on with my other techniques. So just because I did this technique doesn't mean that I can't, again we talked about maybe foam rolling first, maybe doing some lengthening techniques, those of you who do other like dynamic release or pin and stretch techniques, you could absolutely follow up with this. What probably is happening with these vibration or percussive techniques, is we're working a little bit more towards these pacinian corpuscles and these Ruffini endings and they're stimulated by vibration, and from what we can tell, somehow neuromuscularly some of those endings will help stimulate that inhibitory response very similar to the way we expect like the Golgi tendon organ to act with autogenic inhibition. Stay tuned for the close-up recap. All right I wanted you to see a little bit of what this looks like as it passes through the tissue. So as I mentioned I'm going to go ahead and start on the higher setting, alright so we'll start on setting number two, and I'm just going to slowly work my way from the bottom of her calf. Alright now that's to say we hit her Achillies tendon, that might not feel very good. I'm just going to slowly work my way through your entire calf complex just kind of one row at a time here. Notice a little extra tissue density, so maybe I slow down right here a little bit. Take note for using that other tool alright we'll go ahead and assume I just went through the entire calf complex, I'm going to go ahead and turn this off real quick just by pressing that button a couple more times. I'm going to pop out the the flat piece, go to more of the bulleted piece. We noticed Melissa's tissue density was a little higher right here, So now I'm going to go ahead and just put this on one, and so it's a little lower frequency so I can get deeper into the tissue. Alright so if this is totally superficial I'm just going to dig in maybe an extra quarter to half inch, and then really slowly work my way through the tissue as I feel it let go underneath the Hyperbole. Of course my manual therapists, you could come in here and go okay I feel a little bit more density in here I can put this right behind. A "MASSAGE GUN" really easy to control with one hand and I can kind of work my way through the tissue slowly but surely go back through a monitor and see if those fascicles have let go. Now you guys have it vibration release using the hyper volt for the gastrocnemius and soleus complex.
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