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.


Have you checked your hips lately?

Have you ever taken your car in to get an alignment, if you haven’t recently I would recommend it. This can significantly improve the life of your tire by decreasing wear and tear on your tire and car. Where am I going with this and how does this relate to my back? Our hips control the alignment of out body while moving, if one is tight and not moving optimally it can affect our body mainly our back, so check your hips to fix your back. Our body is an efficient machine but like any machine it needs regular maintenance and care to perform at its best.


Tightness in the hips can cause up to rotate at the bottom of a squat, or other movements with your feet on the ground. This hip tightness then causes us to use abnormal movement patterns, that can not only lead to increased stress on the low back but also the knees and ankles. Here is an easy way to check and see if you have any hip limitations.

Hip rotation check:

Now that you have check to see what direction you are limited with, we can go through some exercises to fix it. With this type of hip limitation consistency is key to getting results. We are going to focus on hip internal rotation (when seated foot goes out) which I see most often. These are great exercises for external rotation (when seated foot goes in) limitations as well.


Band PA-

Place the band high on the back of the hip just below the glutes and move back as tolerated. Tight leg should be back, hips should push forward with an active core to take stress off of low back. This should be held for 1-2 minutes.


Band IR-

Place the band high on the inside of the groin and move out as tolerated. band leg should be up and close to the band anchor point. While kneeling push the knee in tell a stretch is felt, let the band pull and try to relax the hip. This should be held for 1-2 minutes.


Hip flexor AR-

Place KB just inside the bone on the front of the hip, with the knee bent. Then straighten out the leg 6-10 times and with the knee bent let the knee drop to the side 6-10 times.


Now that we have gotten things mobile we need to get the muscle working to keep the changes that we have made.


Band Side Steps-

Place band around the ankle (if that is to hard move it up), turn toes slightly in. Start feet about hip width and step out to around shoulder width.



Start with both legs on the ground and focus on activating glutes with minimal hamstring activation. As you progress and can perform double leg exercises with minimal hamstring activation start preforming this exercise with one leg. Perform 2-3 sets of 8-12 reps or until hamstring become more active or glutes fatigue.



Squat warm up routine. Check out the video to find out more.

If you still have issues give us a call and we can help you out.

Surfing with Low Back Pain?

Does it take you more than 10 minutes to get rid of stiffness after you get out of bed when you’re getting ready for dawn patrol? When you’re paddling out do you feel slow for the first few waves? Does your back limit other areas of your life; playing with your kids or grandchildren, driving, or working?

Surfing is a great outlet to get away for a couple hours and recharge. This is harder to do when it is difficult to paddle and catch waves. When what used to be fun and almost meditative turns into a struggle and become physically draining it is time to address the problem that is causing your back pain. While the 3 exercises that follow may not completely fix your problems, they are a great start to getting to the root of the problem to get you back out to the waves.


Back pain is a billion dollar business in the US. What does this mean? It means that it is hard to treat and difficult to determine the cause. When self-treating your back if it is not getting better or gets worse change tactics. Muscle strains need to be treated differently than a disc herniation and other back problems.


Here are 3 quick and easy tips to get rid of back pain with surfing.


Hip flexor AR/stretch: By releasing your hip flexor you will be able to get your body into a better paddling and getting up position and place less pressure on the low back. Your hip flexor (psoas) goes from the front of the hip and attaches to the front side of the low back. If this muscle tightens up it will place increased pressure on focal points on the spine causing back pain when put on stretch.

Back extensions/prone press ups: This exercise with increase the overall range of motion at the spine and is a great stretch to get into a better position when hopping up to catch a wave. Make sure you relax at the top to get a good stretch and keep the hips on the ground.

Supermans/active extension exercise: Activating and strengthening the muscles in the back are a great way to allow the muscle to take the force and allow for less stress through the joints and discs in the spine. Make sure you are at the appropriate level, the goal is to fire the small muscles in the low back around the spine. If glutes or other areas of the body are taking over you are at too hard of a level.

4 Exercises To Relieve Neck Pain

Do you remember having such a stiff neck and needed to turn your whole body to look somewhere or answer someone? If so we have the solution you need! There are many different areas of the neck that can limit rotation and many different causes for neck pain. The easiest to modify this posture, and sleep position, but other factors such as prolonged positioning, quick movements or trauma can also cause the neck to be stiff and painful.

Cervical (neck) pain is a common issue with surfing, golf, CrossFit, and daily life. Often times it presents as stiffness in the morning or difficulty with turning your head while driving or talking to coworkers in the office. If left untreated, this stiffness limits ones activities in daily life and becomes painful as time goes by. Below are the top 4 ways to loosen up the neck and maintain it to continue to be pain free and without limitations.

The main limitations with neck motion are either the joints in the neck or that muscles that are around the neck. Read on to figure out what these different structures feel like and what exercises will work best for them. It is rare to have muscle tightness without joint stiffness, and vise versa, but it is important to figure out what is the root structure.


1. Band Rotations-

The band rotations are most helpful if you are looking one direction and have a pinching/hard stop feeling on the same side. You can also have this same sensation with looking up.  This sensation is the joints that allow our neck to move aren’t moving very well and limiting our motion.


Place band or towel at the level of the neck that you feel is tightest, with one hand holding the band on your chest. Rotate the hand and the neck together in the same direction while pulling the band away from the body. Repeat 8-10 times or until neck loosens. Can be performed throughout the day.


2. Theracane to Upper Trapezius-

The Theracane is most helpful if you are looking one direction and have a pulling/muscle stretch on the opposite side. You can also have this same sensation with bringing your ear to the shoulder.  This sensation is the muscles on the top of the shoulder are tightening up and limiting motion.



Place knob end of the theracane into the focal trigger point. Move the head away from the side that pressure is being given for an active release. Perform 4-5 times on each spot.


3. Band Distraction/Traction-  

The band distraction is most effective with relieving pain and giving a general stretch and unloading the joints. The effects of this alone may feel good temporarily but need to be combined with 1 or 2 other exercises to be effective.



Place band at the base of the skull. Do it either lying on your back or seated. Pull the band at an angle up and away from the face (ideal angle is as far up as possible without it slipping of the base of the skull). Perform 2-3 times with 30 sec to 2 min holds.


4. Self Massage with a Peanut-

The peanut is most effective if you are looking one direction and have a pulling/muscle stretch on the opposite side. You can also have this same sensation with looking down.  This sensation is the muscles in the back of the neck that are tight and limiting motion.



Place the peanut (Mobility WOD gemini or 2 lacrosse/tennis balls taped together) on a 1-2” surface at the level that is stiffest and move the neck slightly up and down or side-to-side to loosen it up. If more pressure is needed lift up the hips. Perform for 3-5 minutes moving to different levels on the neck.

Don’t let neck pain determine what you do and your activities. Take 10-15 minutes out of your day to help yourself. These simple and effective exercises can be used to get the neck moving and improve daily life.

If you have tried all of these and still need some help give us a call.

Thanks for reading