Graston Technique / IASTM in San Clemente, CA

The instruments are contoured pieces of stainless steel. As they glide, ridges and gritty spots vibrate into the doctor's hand, which makes a small adhesion easier to locate than with skin on skin alone. The tool does not decide the treatment. The exam does. A smooth, springy muscle may never see an instrument that day.

Graston technique is one branded set of those tools and a trained way of using them. Other instrument shapes exist. At FRI the choice is the edge that fits the body region, a broad convex face for a thigh, a smaller beak for a tendon near the ankle. The name on the steel matters less than the dose.

Emollient goes on the skin so the tool slides instead of grabbing. The first passes are often lighter, a scan. Later passes slow down on the gritty line and may be shorter. You will feel a distinct scrape, deeper than a massage lotion rub, and you can say when it crosses from useful to too much. The stroke stops at that line.

Tendon work is usually shorter than a broad fascial sweep. A plantar fascia stroke near the heel is brief and retested with a step or a toe raise. Plantar fasciitis that has been poked hard every visit without a loading plan tends to stay angry. The instrument is one input. The calf and foot strength work is the other.

Skin can turn red during the session. Some people develop a bruise, from a faint patch to a mark that looks like a scrape under the skin, and it fades over several days. That mark is small blood vessels responding to mechanical load. It is not a trophy, and it is not required for the tissue to change. Dr. Sani Kohen would rather under-bruise a first session and read the response.

If you bruise easily, take blood thinners, or have skin that tears, say so before the tool comes out. Pressure drops, or the instrument is skipped. A bruise that spreads, a wound, or pain that climbs for more than a couple of days is a reason to call. Honesty about marks belongs in the consent, not in a surprise the next morning.

Fingers sink and fatigue, and they blur a small lesion into the surrounding muscle. Steel keeps an edge on a tendon that is only a finger-width wide, which is useful around the elbow, the patellar tendon, and the Achilles. Hands still win when the goal is broad, sustained pressure or when the skin cannot tolerate a tool. The methods are chosen, not stacked by default.

After the stroke, the tendon needs load it can accept, often a slow heel drop or a similar drill from corrective exercise therapy. Rotator cuff injuries are a common place for this pairing: the instrument addresses thickened tissue, and the arm then works in a range that was guarded. Dr. Tara Kohen retests the motion before you leave so the exercise matches what the shoulder can actually do.

The area is exposed, lotion is applied, and the tool makes several passes while you give feedback. Scanning passes feel like a firm scrape. Treatment passes are slower. Visits often last 30 to 60 minutes depending on the plan, because the instrument work is only a slice of the hour. Testing and a loading drill take the rest.

Redness is common. A bruise is possible and should fade. You can usually walk and do light daily tasks the same day. Heavy loading of that tendon can wait until soreness settles. FRI is out of network. HSA and FSA cards work at the desk, and a superbill is printed if you want to submit one. A free 20-minute consultation can answer whether instruments belong in your case.

Board sports and trail hills make shoulder, neck, and knee complaints ordinary reasons to come north. McKenzie-based spine care is a fit when back or leg pain has a clear directional preference. Corrective exercise is how a Talega hill gets written into the plan instead of fought with a generic core sheet.

Families also come for problems that are not sports. Thyroid, sleep, and migraine questions are evaluated with the limits those conditions require. A migraine plan does not replace a neurologist. A thyroid plan does not replace the prescriber. Read the city overview at the San Clemente chiropractor page.

No referral is required. Bring shoes you hike or walk the trail in if the foot or knee is the issue. Prior MRIs are useful and not mandatory. If you have bowel or bladder changes, saddle numbness, or a rapidly weakening leg, do not drive past an emergency department to reach us.

The practice is out of network. San Clemente patients typically use HSA or FSA funds and a superbill. We will not guess your benefits. The doctors are Drs. Sani and Tara Kohen. Their biographies are on the about page, and the clinic layout is on the office page.

San Clemente has two terrains that matter clinically. The Pier Bowl, the beach trail, and the streets near the water are relatively level and sandy. Talega, Forster Ranch, and the newer hills are the opposite: repeated grades, youth sports, and a drive just to reach I-5. Surfing at Trestles and along the pier loads shoulders and low backs. Hill neighborhoods load knees on the way down and necks on the drive. We ask which part of town you live in because the home program has to match the grade outside.

A lot of San Clemente patients are trying to stay active while working north of here. The I-5 commute itself is a sitting test. If your low back or sciatica eases when you walk the beach trail and worsens in the car, that detail changes the exam. Tell us the direction of the commute and how long you sit, not only where it hurts.