Connective Issues – Tools of the Trade – Instrument Assistance

Firstly, I would like to say how proud and honoured I am to be included alongside the previous recipients of the David Simon award. It has been reward enough to be able to pass on to whoever is listening (reading) the latest in theoretical research and clinical applications. My workmates say you could kill somebody with the trophy; it’s quite beautiful, and sits prominently on display in my clinic.

Last time I brought to your attention two papers both published in October 2021. One was Massage Helps Injured Muscles Heal Faster And Stronger’. The other was Pressing Intervention Promotes The Skeletal Muscle Repair Of Traumatic Myofascial Trigger Points In Rats’.

The very next month Jan Dommerholt sent me an article entitled ‘Is Instrumental Compression Equally Effective And Comfortable For Physiotherapists And Physiotherapy Students than Manual Compression? A Comparative Cross-Sectional Study’ The authors come from Zaragoza, Spain and are noted for the invention of a compression device called a 3TOOL. The link to the paper is

I first came across the 3TOOL when I was teaching in Dubai in 2015. My sponsor gave one to me and when I got back to the USA I went online to buy more. There weren’t any on Amazon! I may have been the first to use it in this country. Now you can buy this blue coloured lump of plastic for $35, and the many knockoffs too, but he cheaper knockoffs are not as good. Here is the link to the 3TOOL;

The tool has three contact points; one is pointy, one is flat and the other is two-pronged. I mostly use the pointy one. It’s like a sophisticated Thumbby. There is potential bias in the study as two of the authors invented the 3TOOL. Thirty people volunteered their upper trapezius to have manual pressure applied and measured using a dynamometer. The 3TOOL application was compared to manual finger application. Tolerable pain was determined as 6-7/10 on a pain scale. Three determinants to consider were; the site of the most sensitized location, the uniformity of compression, and lastly the duration of pressure (60-90 seconds).

Although not described as such the application of pressure seems similar to what David Simons would describe as the ‘barrier release’ method. The instrument assisted group could control the pressure better than the finger group. The subjects reported less discomfort overall with the 3TOOL. The researchers also expressed less discomfort when applying the techniques. Although the subjects were young and healthy they all seemed to have latent trigger points. It’s not made clear whether these were deactivated completely.

What other instrument assisted tools do you have? I will assume you all have a Body Buffer and many will also have massage guns. I’m very pleased with my Kraftgun.

 I also use:

  • A Neuromuscular Therapy T-bar with a beveled latex head which is great for narrow spaces like intercostals, interossei, supraspinous ligaments, multifidi, and getting at infraspinatus under the spine of the scapula. This and other pressure tools can be found at
  • A ceramic Chinese soup spoon. I love to use this scraping device over ligaments and flat tendons and dense fascia, especially the IT Band. Go to Chinatown for this inexpensive Gua sha tool.
  • The Hedgehog is a spiky hand-held roller that I use for almost instant circulatory response, You can get all things spiky, like spiky belts and mats from Soma System. These distraction devises incorporate the ‘gate control’ theory, sending afferent messages via light touch receptors. The owner, Roman Torgovitski PhD, a local to Boston, also has an excellent TEDx talk on his website
  • Vacuum cups. For all my middle-aged THJRs and TKJRs scar tissue, and my lady who had the mitral valve replacement that resulted in a tennis ball sized clot in her pleura that needed multiple intercostal incisions to remove it. Her ribs didn’t move until I mobilized the scar tissue using various techniques, including vacuum cups.

Let me know about any must-use tools in your toolbox that I haven’t mentioned. By the way, has anyone noticed that Jan Dommerholt and crew no longer write their regular myofascial trigger point research paper overview in JBMT. It was the first thing I read when my copy arrived. The journal has gotten too big and something had to go. Boo!   🙂

Cheerio for now,