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“Is bruising OK?” This is one of the most common questions I hear about instrument assisted soft tissue mobilization (IASTM). Here’s the best possible answer: Yes, it is OK. But let me explain why:

Bruising will not kill a human being (except possibly if you have hemophilia). Nor should bruising cause any kind of irreversible harm. Therefore, bruising is OK. But I also want to emphasize that bruising is not the goal of IASTM.

bruising IASTM treatment HawkGrips instrument assisted soft tissue mobilization

Although bruising can sometimes occur with instrument assisted soft tissue mobilization (IASTM), it is not the goal of treatment.

There’s nothing in modern literature that says bruising indicates a release of toxins or of any adhesion. Those are purely ideas from traditional Eastern medicine. When it comes to modern-day Western medicine, we’ve seen that bruising may actually inhibit the healing caused when we use IASTM.

“Does bruising happen after an IASTM treatment?” More often than you would think. If it does, let this be a guide that the treatment you conducted before the bruising occurred might have been a little too aggressive. Some people bruise easier than others, so patient education is key.

Patient Education

Inform your patients that bruising may occur following treatment with IASTM. Ask if they bruise easily or not. Some other questions that clinicians may consider asking include: “Are you currently on blood-thinners?” and “Do you have a higher pain-tolerance level than average?” If the patient’s pain-tolerance is high, they may not provide any sort of warning that the treatment is too aggressive, even if you are constantly adding more pressure to the point of bruising.

When bruising does occur, the patient may feel mildly sore. This bruising and soreness typically clears up after a day or two. If it doesn’t resolve or actually worsens, please contact a physician. For a more complete discussion on patient education, check out this previous HawkTalk Blog post.


Petechiae (pronounced peh-tee-kee-ah) refers to broken capillaries near the skin’s surface. The Wikipedia definition for petechia (singular) is a small (1-2 mm) red or purple spot on the skin, caused by a minor bleed (from broken capillary blood vessels). Usually referred to in the plural as petechiae, they may occur when excessive pressure is applied to tissue.

This is a normal occurrence (don’t be alarmed!) when friction forces are applied to the skin. It’s a sign that treatment should begin to wrap up since these broken capillaries could lead to bruising.

Trista Barish is the director of education at HawkGrips and can be reached at tbarish@hawkgrips.com.

IASTM: A Performance Enhancement Tool

The human skin is the the largest organ of the integumentary system. It is enriched with dense neurological tissue that permeates the entire body and provides a uniquely accessible means of influencing tone and function of underlying structures. Fascia and muscle generate and transfer kinetic energy in an environment by which functional movement relies on a combination of elastic recoil and eccentric control around a focal, multi-planar axis.

Taming ‘Tennis Elbow’ Through HawkGrips Therapy, Exercise, and Activity Modification

tennis elbow Dr. Jim Wagner American Occupational Therapy Association AOTA annual conference exposition HawkGrips therapy“Tennis elbow,” a diagnosis that strikes fear into the hearts of clinicians the world over! (OK… that may be a slight overstatement). Why is this condition so dreaded? Because when treating tennis elbow, everything works and nothing works. Tennis elbow is one of the most commonly diagnosed and discussed musculoskeletal conditions known to humankind. An article by Arnett et al. on the evaluation and treatment of lateral epicondylitis reported a 2-percent incidence in the general population, with a significantly higher rate among manual laborers.

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tension headaches upper trapezius muscle HawkGrips IASTM Trista Barish Mark Shires Baltimore OriolesAlthough I’m a certified athletic trainer, it’s rare that I seek any type of physical treatment for myself. There are many reasons, but mostly I just feel bad about asking fellow clinicians to treat me when I know they’ve already been treating patients all day. Recently though, something wonderful happened. I asked Mark Shires, MS, ATC, PES, to treat my left shoulder and neck because of tension headaches I’ve been experiencing and he said yes!


  BRIDGING THE GAP FROM REHAB TO PERFORMANCE By Sue Falsone   Review by Phil Page, PhD, PT, ATC, CSCS, FACSM First, a disclaimer: I’ve known Sue Falsone for almost 20 years and she is a great friend and colleague, and one of the smartest and hardest working people I...

Is Treatment with HawkGrips Painful?

quadriceps treatment HawkGrips IASTM Graston musculoskeletal condition therapyIs treatment with HawkGrips painful? The simple answer to this question is no. However, it may depend on your definition of the word “pain” versus “discomfort.” This treatment is certainly not based on the “no pain, no gain” adage. In fact, if a patient feels pain during treatment, they should inform the clinician that too much pressure is being applied. Then the clinician can modify treatment to ensure it is tolerable for the patient. Instrument assisted soft tissue mobilization (IASTM) employs smooth…

IASTM Emollient: The What, Why, and How

emollient HawkGrips IASTM Graston instrument assisted soft tissue mobilizationWe often hear questions at HawkGrips about the emollient that’s a necessary adjunct to instrument assisted soft tissue mobilization (IASTM). In this blog post, I’ll provide the answers to these common queries.

What Is It? HawkGrips original oil-based emollient is specifically manufactured to contain the least amount of allergens to reduce the possibility of adverse reactions among your patients.

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