ASTR Manual

Manual
Table of Contents
GTO Page Fascia Page
License Agreement 2 Background 50
Biography 7 Fascia Scale 51
ASTR Discovery 8 Advanced Fascia Release 51
Body mechanics & posture effects 8 Advanced Fascia Release with Instruments 52
Pain cycle 9 Contraindications 53
Advanced Soft Tissue Release® - definition 10 123 Release Approach 53
Golgi Tendon Organs (GTO’s) 10 Deep Fascia Release 53
Spasm scale 11 Nasalis Fascia Release 54
Muscle Spasm Screening: (Whole Body) 11 Procerus Fascia Release 55
Fingers Maneuver 12 Zygomaticus Fascia Release 56
Advanced Trigger Point ReleaseTM 12 Nasal - Frontal Fascia Release 57
Treatment Positions & Maneuvers 13 Galea Aponeurotica Fascia Release 58
Treatment Positions & Maneuvers 34 Occipital Fascia Release 59
References 48 Neck Fascia Release 60
Clavicle Fascia Release 61
SCM Fascia Release 62
Fingers Fascia Release 63
Chest Fascia Release 64
Visceral Fascia Release I 65
Visceral Fascia Release II 66
Intraoral Fascia Release 67

Table of Contents
Muscle Page
Head & Neck Masseter 14
Lateral Ptyergoid - Masseter 15
Temporalis I 16
Temporalis II 17
Occipitalis 18
Trapezius - Levator Scapulae 19
Trapezius - Splenius Capitis 20
Trapezius 21
Scalenes 22
Sternocleidomastoid (SCM) 23
Longus Colli 24
Medial Ptyergoid 25
Stylohyoid 26
Core & UE Pectoralis 27
Rhomboid - Lower Trapezius 28
Infraspinatus - Teres Minor 29
Subscapilaris 30
Serratus Anterior 31
Biceps - Brachialis - Triceps 32
Wrist Flexor 33
Wrist Extensor 34
Diaphragm 35
Para-Spinal 36
Quadratus lumborum 37
LE Iliopsoas 38
Hip Flexors 39
Hip Adductors 40
Quadriceps 41
Vastus lateralis - ITBand 42
Hamstrings 43
Piriformis 44
Gastrocnemius 45
Pernous 46
Tibialis Anterior - Back 47

Copyright © 2018 by ASTR Institute
All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any
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“Attention: Permissions Coordinator,” at the address below.
ASTR Institute
26895 Aliso Creek Rd. Suite B270
Aliso Viejo, CA 92656
Tel: (888) 210-2787
support@ASTRinstitute.com
www.ASTRinstitute.com
Disclaimer
We do not allow recording of this class at all. Any and all information provided in this class is purely from the
standpoint of the developer and inventor and is considered general information. By participating in this class or
online class, your voice, image, or likeness may be videotaped, audiotaped, photographed and/or recorded by us.
You are giving us permission to use your photo and audio voice or likeness and you also give us permission to edit
and distribute them along with the class recording without condition. You are giving us all of the rights that pertain
to these photos, audio and images, including copyright and moral rights, you or your family, heirs and assigns may
have to all of these things.
Doctors, healthcare providers and patients have the responsibility to properly evaluate any and all information
distributed by ASTR to determine if in fact the information is applicable and appropriate. Neither the authors,
instructors, nor ASTR Institute assume any liability for any injury and/or damage done to people or property as a
result of information or suggestions found in ASTR courses, reading materials and websites.
Copyright © 2018 ASTR. All Rights Reserved.

ASTR License Agreement
THIS LICENSE AGREEMENT (“Agreement”) is made and entered into as of the date of taking the online course by and between [Advanced Soft
Tissue Release Institute (ASTR)] (“Licensor”), and the registered individual (“Therapist”).
R E C I T AL S
A. Licensor is the sole and exclusive owner of and has the right to license to Therapist the patent forth on Schedule 1 (the “Licensed Patent”) and the
trademark set forth on Schedule 1 (the “Licensed Trademark”). The Licensed Patent includes (a) the patent listed in Schedule 1, all patents issuing
from the patent applications listed in Schedule 1 and all continuations, continuations-in-part, divisions, extensions, substitutions, reissues, re-
examinations and renewals of any of the foregoing, and (b) any patents in the Territory issuing from any applications filed after the Effective Date and
that claim priority from any of the patents or patent applications identified in subsection (a) or from which any of the patents or patent applications
identified in subsection (a) claim priority.
B. Therapist wishes to enroll in training classes with Licensor to learn to perform the Advanced Soft Tissue Release speciality (the “Service”), and
Licensor is willing to teach Therapist to perform the Service on the terms and conditions set out in this Agreement.
C. Therapist wishes to use the Licensed Patent and the Licensed Trademark to perform the Service, and Licensor is willing to grant to Therapist a non-
exclusive license to the Licensed Patent and the Licensed Trademark on the terms and conditions set out in this Agreement.
A G R EE M E N T
NOW, THEREFORE, in consideration of the mutual covenants, terms and conditions set forth herein, and for other good and valuable consideration,
the receipt and sufficiency of which are hereby acknowledged, the parties hereto agree as follows:
1. License Grant.
(a) Scope of Grant. Subject to the terms and conditions of this Agreement, Licensor hereby grants to Therapist during the Term a non-exclusive right
and license to use the Licensed Patent and Licensed Trademark to perform the Service.
(b) Requirement to Complete ASTR Course and Pass the all Exams. THERAPIST SHALL NOT ADVERTISE OR CLAIM PERFORMING THE SERVICE
UNTIL THERAPIST HAS COMPLETED ASTR COURSE ON THE SERVICE WITH LICENSOR AND PASS THE LICENSING EXAM AND MEET ALL THE
LICENSING REQUIREMENTS. Upon completion by Therapist of the training course on the Service with Licensor, pass the licensing exam, meet all the
licensing requirements that listed in ASTR website and pay the licensing fees. Licensor will list Therapist on Licensor’s website as a licensed
practitioner of the Service and receive certificate of completion.
(c) Renewal Requirement. The license expires TWO YEARS after the date the license was issued. Therapist shall either watch renewal education
videos OR attend the renewal conference in order to renew their license.
(d) Lost or stolen instruments. Therapist shall report lost or stolen instruments to ASTR institute. Therapist shall pay new instrument replacement.
(e) Expired License Requirement. At the date of the License expiration, therapist shall no longer be permitted to use trademarks, patents,
instruments and copyright materials. Therapists claiming to be a licensed provider are prohibited when license has not been renewed.
(f) No Sublicensing. Therapist shall not have the right to grant sublicenses of any of its rights under the Licensed Patent or the Licensed Trademark.
FOR THE AVOIDANCE OF DOUBT, THERAPIST SHALL NOT TEACH THE SERVICE TO ANY OTHER PERSON.
(g) Limited Grant. Except for the rights and licenses granted by Licensor under this Section 2, this Agreement does not grant to Therapist or any
other individual, corporation, partnership, joint venture, limited liability company, governmental authority, unincorporated organization, trust,
association or other entity (“Person”) any right, title or interest. Without limitation of the foregoing, nothing in this Agreement shall be construed as
granting by implication, estoppel, or otherwise, any right, title or interest in, to or under any Licensor patents other than the Licensed Patent
regardless of whether
such other patents are dominant or subordinate to the Licensed Patent. All rights, titles and interests not specifically, and expressly granted by
Licensor hereunder are hereby reserved.
(h) Use of Licensed Trademark. Therapist shall use the Licensed Trademark only in the form approved in writing by Licensor and with no departures
in appearance or treatment. Therapist agrees to inform Licensor of the details of the use of the Licensed Trademark, including graphics, position, size,
color, script and the like, and Licensor reserves the right to inspect and to approve the use of the Licensed Trademark. Therapist agrees that all use of
the Licensed Trademark by Therapist under this Agreement inures to the benefit of Licensor. Therapist agrees that at the termination or expiration of
this Agreement, Therapist will be deemed to have assigned, transferred and conveyed to Licensor any rights, equities, good will, titles or other rights
in and to the Licensed Trademark which may have been obtained by Therapist or which may have vested in Therapist in pursuance of endeavors
covered hereby, and that Therapist will execute any instrument requested by Licensor to accomplish or confirm the foregoing. Any such assignment,
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transfer or conveyance shall be without other consideration than the mutual covenants and considerations of this Agreement. Therapist shall comply
with any laws with regard to the use of the Licensed Trademark.
2. Confidentiality.
(a) Definition. “Confidential Information” means any information that is treated as confidential by Licensor, including trade secrets, technology,
information pertaining to business operations and strategies, and information pertaining to customers, pricing and marketing, in each case to the
extent it is: (a) if in tangible form, marked as confidential; or (b) otherwise, identified at the time of disclosure as confidential and confirmed in writing
as such within ten (10) days after disclosure. Confidential Information of Licensor does not include information that Therapist can demonstrate by
documentation: (w) was already known to Therapist without restriction on use or disclosure prior to receipt of such information directly or indirectly
from or on behalf of Licensor; (x) was or is independently developed by Therapist without reference to or use of any of Licensor’s Confidential
Information; (y) was or becomes generally known by the public other than by breach of this Agreement by, or other wrongful act of, Therapist; or (z)
was received by Therapist from a Third Party who was not, at the time, under any obligation to Licensor or any other Person to maintain the
confidentiality of such information
(b) Confidentiality Obligations. Therapist acknowledges that in connection with this Agreement Therapist will gain access to Confidential Information
of Licensor. As a condition to being furnished with Confidential Information, Therapist agrees to (i) not use the Confidential Information other than as
strictly necessary to perform its obligations under this Agreement; and (ii) maintain the Confidential Information in strict confidence and, subject to
Section 3(c), not disclose the Confidential Information without Licensor’s prior written consent.
(c) Exceptions. If Therapist becomes legally compelled to disclose any Confidential Information, Therapist shall (i) provide prompt written notice to
Licensor so that Licensor may seek a protective order or other appropriate remedy or waive its rights under this Section 3; and (ii) disclose only the
portion of Confidential Information that it is legally required to furnish.
3. Disclaimers.
(a) LICENSOR EXPRESSLY DISCLAIMS ALL WARRANTIES REGARDING THE SERVICE WHETHER STATUTORY, EXPRESSED OR IMPLIED, A
WARRANTY OF MERCHANTABILITY, A WARRANTY OF FITNESS FOR A PARTICULAR PURPOSE, OR A WARRANTY ARISING FROM COURSE OF
DEALING OR USAGE OF TRADE. LICENSOR SHALL NOT BE RESPONSIBLE FOR THE OUTCOME OF THERAPIST’S PERFORMANCE OF THE
SERVICE AND SHALL HAVE NO LIABILITY TO THERAPIST OR ANY OTHER PERSON IN CONNECTION THEREWITH. THERAPIST SHALL BE
RESPONSIBLE FOR APPLYING CLINICAL JUDGMENT IN CONNECTION WITH PERFORMANCE OF THE SERVICE.
(b) NOTHING CONTAINED IN THIS AGREEMENT SHALL BE CONSTRUED AS AN AGREEMENT TO BRING OR PROSECUTE ACTIONS OR SUITS
AGAINST THIRD PARTIES OR CONFERRING ANY RIGHT TO BRING OR PROSECUTE ACTIONS OR SUITS AGAINST THIRD PARTIES; OR
CONFERRING ANY RIGHT TO USE IN ADVERTISING, PUBLICITY, OR OTHERWISE, ANY TRADEMARKS, SERVICE MARKS, TRADE NAME OR NAME
OF LICENSOR, OR ANY CONTRACTION, ABBREVIATION OR SIMULATION THEREOF, EXCEPT AS SPECIFICALLY PERMITTED IN THIS
AGREEMENT.
4. Exclusion of Consequential and Other Damages. TO THE FULLEST EXTENT PERMITTED BY LAW, LICENSOR SHALL NOT BE LIABLE TO
THERAPIST FOR ANY INJURY TO OR LOSS OF GOODWILL, REPUTATION, BUSINESS PRODUCTION, REVENUES, PROFITS, ANTICIPATED PROFITS,
CONTRACTS OR OPPORTUNITIES (IRRESPECTIVE OF HOW THESE ARE CLASSIFIED AS DAMAGES), OR FOR ANY CONSEQUENTIAL,
INCIDENTAL, INDIRECT, EXEMPLARY, SPECIAL, PUNITIVE OR ENHANCED DAMAGES WHETHER ARISING OUT OF BREACH OF CONTRACT, TORT
(INCLUDING NEGLIGENCE) OR OTHERWISE (INCLUDING THE ENTRY INTO, PERFORMANCE OR BREACH OF THIS AGREEMENT), REGARDLESS
OF WHETHER SUCH DAMAGE WAS FORESEEABLE AND WHETHER OR NOT LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH
DAMAGES.
5. Release.
(a) In consideration of participating in the Training Program, Therapist, on behalf of himself or herself, Therapist’s spouse, heirs, and assigns, (a) agrees
to assume full responsibility for any risk, injuries or damages, known or unknown, which Therapist might incur as a result of participating in the
Training Program; and (b) knowingly, voluntarily and expressly forever release, waive, indemnify and hold harmless, discharge and covenant not to sue
Licensor (including its officers, employees, trainers and agents) from any and all liability, losses, injuries, claims, demands, actions, causes of actions
and expenses, including without limitation, reasonable attorney’s fees and costs, or damages of any kind, including injury or death, related to, arising
from, or in any way connected with my participation in the Training Program, including those allegedly attributed to the negligent acts or omissions of
Licensor (including its officers, employees, trainers and agents).
(b) Therapist certifies that he or she has read Section 1542 of the California Civil Code, set out below:
A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the
release, which if known by him must have materially affected his settlement with debtor.
Therapist hereby waives the protections of Section 1542 of the California Civil Code. 6. Indemnification.
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(a) Third Party Claims. Therapist shall indemnify, defend and hold harmless Licensor and its officers, directors, employees, agents, successors and
assigns (each, an “Indemnitee”) against all “losses, damages, liabilities, deficiencies, claims, actions, judgments, settlements, interest, awards,
penalties, fines, costs or expenses of whatever kind, including reasonable attorneys’ fees and the cost of enforcing any right to indemnification
hereunder and the cost of pursuing any insurance providers (“Losses”) arising out of or resulting from any third party claim, suit, action or proceeding
related to or arising out of or resulting from Therapist’s breach of any representation, warranty, covenant or obligation under this Agreement or
Therapist’s use of the Licensed Patent or the Licensed Trademark (each an “Action”).
(b) Infringement Claims. Licensor shall indemnify, defend and hold harmless each of the Indemnitees against all Losses arising out of, resulting from
or relating to any Action involving a claim that any manufacture, use, sale, offer for sale or importation of any Licensed Product in the Territory, or the
exercise of any rights or privileges by Therapist granted to it under this Agreement, infringes any patent or other intellectual property right of any
third party.
7. Term and Termination. 

(a) Term. This Agreement shall commence as of the Effective Date and shall continue until terminated in
accordance with Section 7(b). (b) Termination.
(i) Either party may terminate this Agreement at any time without cause, and without incurring any additional obligation, liability or penalty, by
providing at least thirty (30) days’ prior written notice to the other party.
(ii) Either party may terminate this Agreement on written notice to the other party if the other party materially breaches this Agreement and such
breach (A) is incapable of cure; or (B) being capable of cure, remains uncured thirty (30) days after the breaching party] receives written notice thereof.
(iii) Either party may terminate this Agreement by written notice to the other party if the other party: (A) becomes insolvent or admits inability to pay
its debts generally as they become due; (B) becomes subject, voluntarily or involuntarily, to any proceeding under any domestic or foreign bankruptcy
or insolvency law, which is not fully stayed within sixty (60) Business Days or is not dismissed or vacated within sixty (60) days after filing; (C) makes a
general assignment for the benefit of creditors; or (D) has a receiver, trustee, custodian or similar agent appointed by order of any court of competent
jurisdiction to take charge of or sell any material portion of its property or business.
(c) Effect of Termination. On any termination of this Agreement Therapist shall (a) return to Licensor all documents and tangible materials (and any
copies) containing, reflecting, incorporating or based on the Confidential Information; (b) permanently erase the Confidential Information from its
computer systems; (c) cease performing the Service and using the Licensed Patent and the Licensed Trademark; and (d) certify in writing to Licensor
that it has complied with the requirements of this Section 8(c).
(d) Survival. The rights and obligations of the parties set forth in this Section 13(d) and Section 1 (Definitions), Section 4 (Confidentiality), Section 7
(Indemnification), Section 8(c) (Effect of Termination), and Section 10 (Miscellaneous), and any right, obligation or required performance of the parties
in this Agreement which, by its express terms or nature and context is intended to survive termination or expiration of this Agreement, will survive any
such termination or expiration.
8. Certain Agreements.
(a) Purchase of Tools. Therapist purchase all products created by Licensor related to performing the Service and using the Licensed Patent and the
Licensed Trademark (the “Products”) only from Licensor. Therapist shall not attempt to replicate the Products or have any other Person attempt to
replicate the Products.
(b) Third-Party Infringement. If Therapist becomes aware of alleged infringement of the Licensed Patent of the Licensed Trademark, Therapist shall
promptly provide written notice to Licensor of the alleged infringement.
9. Miscellaneous.
(a) Further Assurances. Each party shall, upon the reasonable request, and at the sole cost and expense, of the other party, promptly execute such
documents and perform such acts as may be necessary to give full effect to the terms of this Agreement.
(b) Relationship of the Parties. The relationship between the parties is that of independent contractors. Nothing contained in this Agreement shall
be construed as creating any agency, partnership, joint venture or other form of joint enterprise, employment or fiduciary relationship between the
parties, and neither party shall have authority to contract for or bind the other party in any manner whatsoever.
(c) Notices. All notices, requests, consents, claims, demands, waivers and other communications hereunder shall be in writing and shall be deemed to
have been given in accordance with this Section 9(c) to the addresses of the parties set forth on the signature page hereto. Notices sent in
accordance with this Section 9(c) shall be deemed effectively given: (a) when received, if delivered by hand (with written confirmation of receipt); (b)
when received, if sent by a nationally recognized overnight courier (receipt requested); (c) on the date sent by facsimile or e-mail (in each case, with
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confirmation of transmission), if sent during normal business hours of the recipient, and on the next business day if sent after normal business hours of
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the recipient; or (d) on the third (3 ) day after the date mailed, by certified or registered mail, return receipt requested, postage prepaid.
(d) Interpretation. This Agreement shall be construed without regard to any presumption or rule requiring construction or interpretation against the
party drafting an instrument or causing any instrument to be drafted. Any Schedules referred to herein shall be construed with, and as an integral part
of, this Agreement to the same extent as if they were set forth verbatim herein.  
(e) Headings. The headings in this Agreement are for reference only and shall not affect the interpretation of this Agreement.
(f) Entire Agreement. This Agreement, together with all Schedules and any other documents incorporated herein by reference, constitutes the sole
and entire agreement of the parties to this Agreement with respect to the subject matter contained herein, and supersedes all prior and
contemporaneous understandings and agreements, both written and oral, with respect to such subject matter.
(g) Assignment. Therapist shall not assign or otherwise transfer any of its rights, or delegate or otherwise transfer any of its obligations or
performance, under this Agreement, in each case whether voluntarily, involuntarily, by operation of law or otherwise, without Licensor’s prior written
consent. Any purported assignment, delegation or transfer in violation of this Section 9(g) is void. This Agreement is binding upon and inures to the
benefit of the parties hereto and their respective permitted successors and assigns.
(h) No Third-Party Beneficiaries. This Agreement is for the sole benefit of the parties hereto and their respective successors and permitted assigns
and nothing herein, express or implied, is intended to or shall confer upon any other Person any legal or equitable right, benefit or remedy of any
nature whatsoever, under or by reason of this Agreement.
(i) Amendment; Modification; Waiver. ASTR Institute reserves the right, in its sole discretion, to change the terms under which
www.advancedsofttissuerelease.com is offered. The most current version of the terms will supersede all previous versions. ASTR Institute encourages
you to periodically review the terms to stay informed of our updates.
(j) Severability. If any term or provision of this Agreement is invalid, illegal or unenforceable in any jurisdiction, such invalidity, illegality or
unenforceability shall not affect any other term or provision of this Agreement or invalidate or render unenforceable such term or provision in any
other jurisdiction. Upon a determination that any term or other provision is invalid, illegal or unenforceable, the parties hereto shall negotiate in good
faith to modify this Agreement so as to effect the original intent of the parties as closely as possible in a mutually acceptable manner in order that the
transactions contemplated hereby be consummated as originally contemplated to the greatest extent possible.
(k) Governing Law; Submission to Jurisdiction. This Agreement and all related documents, and all matters arising out of or relating to this
Agreement, are governed by, and construed in accordance with, the laws of the State of California, United States of America, without regard to the
conflict of laws provisions thereof to the extent such principles or rules would require or permit the application of the laws of any jurisdiction other
than those of the State of California. The parties hereby consent to personal jurisdiction of the courts of the State of California with respect to any
legal action to enforce the terms and conditions of this Agreement or otherwise arising under or with respect to this Agreement, and agree that the
Superior Court of California, County of Orange, or, if applicable, federal District Court sitting in the County of Orange, State of California, shall be the
sole and exclusive venue, and the State of California shall be the sole forum, for the bringing of such action.
(l) Equitable Relief. Each party acknowledges that a breach by the other party of Section 9 may cause the non-breaching party irreparable harm, for
which an award of damages would not be adequate compensation and agrees that, in the event of such a breach or threatened breach, the non-
breaching party will be entitled to seek equitable relief, including in the form of a restraining order, orders for preliminary or permanent injunction,
specific performance and any other relief that may be available from any court, and the parties hereby waive any requirement for the securing or
posting of any bond or the showing of actual monetary damages in connection with such relief. These remedies shall not be deemed to be exclusive
but shall be in addition to all other remedies available under this Agreement at law or in equity, subject to any express exclusions or limitations in this
Agreement to the contrary.
(m) Attorneys’ Fees. In the event that any action, suit, or other legal or administrative proceeding is instituted or commenced by either party hereto
against the other party arising out of or related to this Agreement, the prevailing party shall be entitled to recover its reasonable attorneys’ fees and
court costs from the non-prevailing party.
(n) Counterparts. This Agreement may be executed in counterparts, each of which shall be deemed an original, but all of which together shall be
deemed to be one and the same agreement. A signed copy of this Agreement delivered by facsimile, e-mail or other means of electronic
transmission (to which a signed PDF copy is attached) shall be deemed to have the same legal effect as delivery of an original signed copy of this
Agreement.
IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed as of the date of the first ASTR class.
LICENSOR: [ADVANCED SOFT TISSUE RELEASE INSTITUTE] Dr. Joseph Jacobs, sole proprietor
Address: ASTR Institute : 26895 Aliso Creek Rd. Suite B270, Aliso Viejo, CA 92656
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Address: ASTR Institute : 26895 Aliso Creek Rd. Suite B270, Aliso Viejo, CA 92656
I HAVE READ AND UNDERSTANDS THE ABOVE WAIVER AND LICENSE AGREEMENT AND FULLY UNDERSTANDS ITS CONTENTS. THROUGH
TAKING ASTR CLASS I AGEE WITH ADVANCED SOFT TISSUE RELEASE LICENSING AGREEMENT.
ASTR License Agreement Schedule 1 Licensed Intellectual Property: Licensed Patents: Myofascial Release Method , Scar Tissue Instrument I, Scar
® ®
Tissue Instrument II, Scar Tissue Instrument III. Licensed Trademark: ASTR , Advanced Soft Tissue Release , Advanced Soft Tissue Release
® tm
Specialist , ASTRs . Licensed Copyrights: patient education materials, home exercises materials, ASTR forms.
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ASTR | Advanced Soft Tissue Release
Joseph Jacobs, DPT, ASTRs

Doctor of Physical Therapy
Advanced Soft Tissue Release Specialist (Inventor)
Doctor Joseph Jacobs is the creator of the Advanced Soft Tissue Release®
(ASTR) specialty. He holds a doctorate of physical therapy degree from
Dominican College in New York and a bachelor's degree concentrated in
hotel & restaurant management from Fairleigh Dickinson University in New
Jersey.
Dr. Jacobs began researching and developing his new specialty to treat patients' pain more effectively than methods
he had learned in school. From 2011 to 2016 he continued to develop the maneuvers, instruments, and
methodologies that ASTR is composed of, and he continues to refine the elements of ASTR through ongoing
research. Advanced Soft Tissue Release (ASTR) has been registered by the US Patent and Trademark Office.
Techniques and instruments Doctor Jacobs has invented include:

• Advanced Soft Tissue Release (Patent Pending)
• Tension Release TechniqueTM
• ASTR® Instruments I, II, III, IV, V, and VI (Patented)
• Fascia ScaleTM
• Fibrosis (Scar) ScaleTM
• Trigger Point ScaleTM
• Muscle Spasm ScaleTM
• Mind Body ReleaseTM
Dr. Jacobs' life ambition is to continuously develop and research new instruments, theories, and methodologies that
revolutionize the medical industry in order to more quickly and effectively alleviate pain. Dr. Jacobs spends on
average 2 hours daily researching and developing new solutions. Current clients already believe that his techniques
give immediate, long-lasting relief, so he is well on his way!
Dr. Jacobs strongly believes in ongoing education and has read a lot of books and taken classes in the
following subjects:
• Functional Medicine
• Nutrition
• Myofascial Release
• Strain-Counterstrain
• Muscle Energy Technique (MET)
• Soft Tissue Mobilization
• Joint Mobilization (including Mulligan concept)
• Trigger Point Release
• Primal Reflex Release Technique (PRRT)
• Proprioceptive Neuromuscular Facilitation (PNF)
• Connective Tissue Mobilization
• Craniosacral Release
• Visceral Mobilization
• Bowen Therapy
• Rolfing
• Massage
• Cognitive Behavioral Therapy
• Emotional Freedom Technique
• Talk Therapy
• And much more
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ASTR Discovery:
Watch Dr.Jacobs’ TEDx Talks at https://advancedsofttissuerelease.com/
Body Mechanics & Posture
Poor body mechanics and posture have finally hit a nerve in the backbone of today’s society. With an ever increasing
dependence on computers, a sedentary work environment, and a surge in the use of games and electronics, we can
no longer deny that these lifestyle habits are affecting people in a big way. As in the case of Mr. Smith, a retired,
computer programmer, his daily routine of sitting at his desk, hunched forward, for eight hours a day took a toll on
his neck and back. His muscles were constantly being overworked, which caused strain and micro-tears of the soft
tissue and degeneration of the neck joint. This activated his bodies’ pain cycle.
Pain Cycle
The human body can experience injuries in a variety of ways. Accidents, falls, poor body mechanics, poor posture,
and age related degeneration name just a few of these causes. When one of these takes place, the body’s central
nervous system, which consists of the brain and spinal cord, receives a pain message, detected by pain, nerve
receptors called nociceptors. The nervous system attempts to protect the injured location by sending a signal to the
surrounding muscle to guard itself and sustain a static position to avoid shear force. The goal of this mechanism is
to prevent excessive movement in the injured location to avoid further damage. The surrounding muscle is forced to
work hard to protect the injured area, which increases muscle tension and causes micro-tears in the soft tissue, which
causes a contracture. A contracture is the shortening of the soft tissue such as: muscle, tendon, ligament, and fascia.
Long term contracture causes adhesions, scar tissue, and loss of the joint’s range of motion. This phenomena causes
pain, which sends a signal to the nervous system and increases muscle activity to guard and protect the injured site.
Constant activity of the muscle causes more pain, which continues the pain cycle. In order to break the pain cycle,
an external intervention must be introduced to stimulate the golgi tendon organs, in order to decrease muscle
tension.
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The human body can experience soft tissue injuries in a variety of ways. Accidents, falls, poor body mechanics, poor
posture, and age related degeneration name just a few of these causes. It is very common for the body to develop
at least three to four of the following dysfunctions after experiencing soft tissue injuries: excessive scar tissue, soft
tissue adhesions, tender points, trigger points and myofascial restriction. ASTR is a unique manual technique that
addresses the previous mentioned dysfunctions.
There are several manual therapy techniques currently being used to treat soft tissue dysfunction such as: trigger
point release (trigger pressure release), strain/counterstrain (positional release technique), and myofascial release.
Trigger point release is a manual technique that is used to relieve hypersensitive palpable nodules in the muscle.
The guideline to treating trigger points include a treatment time of 15-20 seconds per trigger point. It is
recommended that this process be repeated 3 to 6 times per day for several days and sometimes for weeks.
Individuals complain that this approach is painful and time consuming. Strain/counterstrain (positional release
technique) is a manual therapy technique that is used to evaluate and treat tender points in the soft tissue. The
treatment recommendation is to position the client in a relaxed position. The clinician holds each treatment position
for 90 seconds for each tender point. For example, if an individual has 6 tender points in different areas of the body,
they would need at least 10-15 minutes of therapy to treat the points. Myofascial release is a manual therapy
technique that is used to evaluate and treat myofascial connective tissue restriction. Treatment recommendation is
for the clinician to slowly stretch the elastic part of the fascia until reaching the point of restriction and then hold the
position until the restriction releases. John Barnes’ recommendation is 3-5 minutes to release one fascia restriction
direction. Barnes states that “the key to myofascial release is sustained pressure over time”. If an individual’s entire
back fascia is restricted, it would take approximately 25 to 40 minutes, along with several sessions, in order to treat
the entire back.
As previously mentioned, it is very common for the body to develop at least three to four of the following
dysfunctions after experiencing soft tissue injuries: excessive scar tissue, soft tissue adhesions, tender points, trigger
points and myofascial restriction. If an individual has three to four types of dysfunctions, it would take approximately
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20-30 minutes per session for at least 4 to 6 sessions for that individual to be treated with a traditional manual
therapy approach such as trigger point release, strain/counterstrain, and myofascial release.
Currently, healthcare costs have skyrocketed, which has created additional financial burdens for injured individuals.
There is an urgent need for non-invasive, manual, medicine techniques that can treat these types of dysfunctions
simultaneously in a short period of time, while decreasing healthcare costs. There is also a need for manual
techniques that will relieve clients pain and help them to return to normal function activities in a short period of time.
That would increase individual productivity and decrease the financial burden due to the lengthy period of
rehabilitation experienced with traditional manual therapy.
Advanced Soft Tissue Release® (ASTR)
Advanced Soft Tissue Release (ASTR) is changing the way that patients experience Long-term pain relief. This
specialty addresses acute and chronic pain through the use of unique patient assessments, tactically drafted
treatment protocols, strategically designed patented instruments, and over 125 unique maneuvers. ASTR addresses
aliments at their source to reduce pain, increase range of motion, and help improve people's quality of life.
Golgi Tendon Organs (GTO’s):
ASTR addresses many systems in the body; one of them being the Golgi Tendon Organs (GTO’s). Every muscle has
many sensory receptors called the Golgi Tendon Organs (GTO’s). The GTO’s are located near the muscle tendon
junction. The GTO’s function is to decrease muscle tension and promote muscle relaxation. In addition to GTO’s,
each muscle has neurons called alpha motornerurons which stimulate muscle activity and increase muscle tension.
When the muscle becomes tense, the GTO’s fire to prevent the alpha motoneurons from stimulating the muscle,
which in turn decreases muscle tension and promotes relaxation. The two work to balance muscle activity. Another
way to look at this is to imagine that the muscle has two switches. One switch (alpha motorneurons) turns the muscle
on and the other switch (GTO’s) turns the muscle off. For example, if a person sits hunched over his/her computer
every day for hours, the alpha motorneuron switch is continually on and their nervous system adapts to their
improper posture, which continually stimulates the alpha motorneurons and causes soft tissue pain, muscle strain,
excessive scar tissue, increased muscle tension, trigger points, fascia restriction, and limited range of motion. One of
the approaches of ASTR stimulates the GTO in order to decrease muscle tension, soft tissue pain, and trigger
points.
10
TM
Spasm Scale : (0 to 4 scale)
• Normal 0/4: No increase in muscle tone when palpated. Relaxed muscle. Normal end range feel. A relaxed
muscle will be soft, pliable, and very easy to manipulate.
• Slight spasm 1/4: Slight increase in muscle tone. Slight resistance at end range. Slight firmness when
palpating the muscle belly.
• Moderate spasm 2/4: Moderate increase in muscle tone. Moderate resistance at end range of motion.
Increased muscle tone/ hard feeling when palpating the muscle belly. Patient experiences slight to
moderate muscle tenderness/pain with palpation.
• Severe spasm 3/4: Marked severe hardness when palpating the muscle. Severe muscle tenderness with
palpation (jumping effect, intolerance to firm palpation). When palpated, the muscle will feel hard and the
muscle fibers will feel like a tight band.
• Rigid 4/4: Rigid muscle tone. Decreased joint range of motion. Noticeable marked hard, tight band of
muscle fibers. Unable to manipulate the muscle with palpation. The muscle will feel very rigid and stagnant.
Usually it presents with peripheral or central nervous system dysfunction (stroke, cerebral palsy, etc).
Muscle Spasm Screening: (Whole Body)
Upper Body:
• Temporalis
• Masseter
• SCM/ Scalenes
• Levator Scapulae
• Splenus capitis
• Occipitals
• Trapezius
• Rhomboid
Lower Body (bilateral)
• Peroneus
• Calf
• Hamstrings
• ITB
• Iliopsoas
• Para-spinal
11
• Quadratus lumborum
• Diaphragm
Fingers Maneuver:
Fingers VibrationTM:
Place your fingers on the muscle belly, trigger point or muscle tendon junction, then apply light pressure over the
treated area, then perform radial/ ulnar direction movement of your elbow.
Fingers ThrustTM :
Place your fingers on the muscle belly, trigger point or muscle tendon junction, then apply light pressure over the
treated area then perform quick very gentle thrust.
Fingers GlidingTM:
Place your fingers on the muscle tendon junction and perform medial/ lateral glide
Advanced Trigger Point ReleaseTM:
• Muscle in relaxed shortening position (glide with firm pressure until you feel the release) usually 5 to
15 seconds.
• Use reciprocal inhibition + distal / proximal tendon gliding. Isometric contraction of the antagonist
muscle for 5 seconds. Very light resistance and perform the gliding.
• Use reciprocal inhibition + distal / proximal tendon vibration. Isometric contraction of the antagonist
muscle for 5 seconds. Very light resistance and perform the tendon vibration or trigger point
vibration.
• In a lot of cases, vibration is more effective than gliding
• With one hand, stretch the soft tissue. With the other hand, apply firm pressure with fingers and
perform finger vibration. Perform this maneuver around the trigger point.
• Muscle in neutral position. Apply deep, firm pressure on distal tendon for 3 seconds and then move
the tendon firmer medial to lateral. Use passive range of motion while tapping on the trigger points.
• Find the trigger point and maintain finger or hands on the area. Patient should contract the muscle
that has the trigger points and push the clinician’s hands with the same muscle. Hold 5 seconds x2.
• Use passive range of motion to get muscle into a relaxed position. Vibrate the joint and tap on the
trigger point.
12
Treatment Positions & Maneuvers
13
Masseter Release:
• Origin: zygomatic arch

• Insertion: lateral surface of angle and ramps of mandible
• Assessment: masseter muscle spasm and/or trigger points

• Patient’s Position: supine
• Clinician’s hand position: Stretch the soft tissue toward the zygomatic arch with one hand
and firmly apply pressure with the other hand, using your fingers to vibrate the area. Next,
with one hand, stretch the soft tissue toward the angle of the mandible, while applying firm
pressure with fingers from the other hand and vibrating area. Perform this vibration around
the trigger point.
• Repetition: 5 seconds x 2
14
Lateral Pterygoid - Masseter Release:
• Origin: greater wing of sphenoid bone/ lateral surface of lateral pterygoid plate
• Insertion: Condyle of mandible and temporomandibluar joint
• Assessment: lateral pterygoid muscle spasm and/or trigger points

• Clinician’s hand position: use gloves. Ask patient to open their mouth. Use your index to
apply pressure to the lateral pterygoid inside the mouth (closer to the attachment that is
close to the ear). Patient should close their mouth while the clinician is applying firm
vibration to the lateral pterygoid.
• Repetition: Hold index position and perform slight finger vibration for 20 seconds to 1
minute until you feel the release.
15
Temporalis Release I:
• Origin: temporal lines, temporal fossa and fascia

• Insertion: tip and medial surface of coronoid process of the mandible
• Assessment: temporalis muscle spasm and/or trigger points

• Clinician’s hand position: firm pressure; perform slow palm glide from superior to inferior;
cover all temporalis muscle fiber
• Repetition: x 2
16
Temporalis Release II:
• Origin: temporal lines, temporal fossa and fascia

• Insertion: tip and medial surface of coronoid process of the mandible
• Assessment: temporalis muscle spasm and/or trigger points

• Clinician’s hand position: resist opposite neck side bending and vibrate the entire
temporalis
• Repetition: x 2
17
Occipitalis Release:
• Origin: The lateral portion of the superior nuchal line of the occipital bone
• Insertion: Galea aponeurotica
• Assessment: occipitalis muscle spasm and/or trigger points

• Patient’s Position: supine; tuck chin while head is off the table
• Clinician’s hand position: perform finger vibration over bilateral occipitalis
18
Trapezius Release:
• Origin: medial nuchal line & protuberance of occipital bone, ligaments niche & spinous
process of C7-T12
• Insertion: lateral clavicle, acromion and spine of scapula
• Assessment: mid/upper traps muscle spasm and/or trigger points

• Patient’s Position: supine bilateral shoulder shrug
• Clinician’s hand position: glide and stretch traps fascia toward the head and shoulders. Or
vibrate bil mid traps with your thumb.
Levator Scapulae Release:
• Origin: transverse processes of the C1-C4

• Insertion: medial border of scapula between spine and superior angle
• Assessment: levator scapulae muscle spasm and/or trigger points

• Patient’s Position: supine, neck in neutral position, shoulder shrug
• Clinician’s hand position: vibrate c2-c3 transverse process and the medial superior angle of
the scapula
19
Trapezius - Splenius Capitis Release:
• Trapezius
• Origin: medial nuchal line & protuberance of occipital bone, ligaments niche &
spinous process of C7-T12
• Splenius Capitis
• Origin: inferior half of ligament niche (C3-C6) and spinous processes of C7-T3
• Insertion: superior nuchal line of occipital bone and mastoid process of temporal
bone
• Assessment: trapezius/splenius capitis muscle spasm and/or trigger points

• Patient’s Position: supine, chin tuck, head of the table
• Clinician’s hand position: vibrate or glide your fingers over bilateral splenius capitis from
superior to inferior
20
Trapezius Release:
• Origin: medial nuchal line & protuberance of occipital bone, ligaments niche & spinous
process of C7-T12
• Assessment: trapezius muscle spasm and/or trigger points

• Patient’s Position: supine, shoulder flexion 90, elbow flexed, hand across chest
• Clinician’s hand position: resist shoulder extension while vibrating the trigger point area. or
simultaneous vibration/ thrust to trapezius distal attachment.
21
Scalenes Release:
• Assessment: scalenes muscle spasm and/or trigger points

• Clinician’s hand position: resist neck side bend and perform finger vibration over the
transverse process of C3-C7
22
Sternocleidomastoid (SCM) I Release:
• Origin: upper part of the anterior surface of the manubrium - superior surface of the medial
one third of the clavicle
• Insertion: lateral surface of the mastoid process
• Assessment: SCM muscle spasm and/or trigger points

• Patient’s Position: supine, tuck chin
• Clinician’s hand position: finger thrust the SCM fibers from proximal to distal. Can be
performed on bilateral SCM at the same time
Sternocleidomastoid (SCM) II Release:
• Assessment: SCM muscle spasm and/or trigger points

• Patient’s Position: supine, tuck chin and rotate to one side while head is off the table
• Clinician’s hand position: glide SCM from superior to inferior on the rotated side
23
Longus Colli Release:
• Origin: Anterior body of T1-3, anterior tubercles of transverse processes of C3-7.

• Insertion: Anterior arch of atlas (C1) and bodies of C2-4
• Assessment: Longus colli muscle spasm and/or trigger points

• Patient’s Position: supine, tuck chin, push head posterior toward the table
• Clinician’s hand position: vibrate the longus colli close to clavicle end
24
Medial Pterygoid Release:
• Origin: superficial head: tuberosity of maxilla. Deep head: medial surface of lateral
pterygoid plate and palatine bone.
• Insertion: medial surface of ramps and angle of mandible.
• Assessment: medial pterygoid muscle spasm and/or trigger points

• Patient’s Position: supine, tuck chin
• Clinician’s hand position: vibrate or gentle thrust the medial pterygoid posterior to the
angle of the mandible
• Repetition: 5 seconds x2
25
Stylohyoid Release:
• Origin: base of styloid process

• Insertion: base of greater cornu of hyoid bone
• Assessment: stylohyoid hypertonicity and/or trigger points

• Patient’s Position: supine,
• Clinician’s hand position: very light resistance to the opposite side of the mandible while
vibrating the stylohyoid close to the styloid process
26
Pectoralis Release:
• Origin:
• Clavicular head: medial half of the clavicle.
• Sternal head: sternum, upper costal cartilages (1-6) and the aponeurosis of the
external oblique
• Insertion: Lateral lip of bicipital groove of humerus and anterior lip of deltoid tuberosity
• Assessment: pectoralis muscle spasm and/or trigger points

• Patient’s Position: supine, push scapula toward the table
• Clinician’s hand position: vibrate the pectoralis close to the distal part of the clavicle
27
Rhomboid - Lower Trapezius Release:
• Rhomboid major Origin: spinous process of T2-T5 vertebrae

• Rhomboid major Insertion: medial border of scapula inferior to spine
• Rhomboid minor Origin: spinous process of C7-T1 vertebrae

• Rhomboid minor Insertion: medial border of scapula superior to spine
• Assessment: rhomboid/ lower trapezius muscle spasm and/or trigger points

• Patient’s Position: supine, shrug shoulders
• Clinician’s hand position: glide and stretch mid-back fascia toward the head. Pull the skin
superior.
28
Infraspinatus - Teres Minor Release:
• Infraspinatus Origin: infraspinous fossa of the scapula

• Infraspinatus Insertion: middle part of the greater tubercle of the humerus
• Teres Minor Origin: middle part of the lateral border of the scapula
• Teres Minor Insertion: inferior aspect of greater tubercle of humerus
• Assessment: infraspinatus/ teres minor muscle spasm and/or trigger points

• Patient’s Position: supine, shoulder flexion 90 degrees , elbow flexed and hand across chest.
• Clinician’s hand position: resist shoulder flexion for 5 seconds while vibrating the
infraspinatus/ teres minor
• Repetition: x2
29
Subscapilaris Release:
• Subscapilaris Origin: sub scapular fossa of the scapula
• Subscapilaris Insertion: lesser tubercle of humerus
• Assessment: subscapilaris muscle spasm and/or trigger points

• Patient’s Position: supine shoulder scaption, elbow 90 degrees.
• Clinician’s hand position: resist external rotation while vibrating the trigger point area
30
Serratus Anterior Release:
• Serratus Anterior Origin: anterior surfaces of the first 8 or 9 ribs

• Serratus Anterior Insertion: anterior surface of medial border of scapula
• Assessment: serratus anterior muscle spasm/ trigger points

• Patient’s Position: side lying, involve side on the top, retract scapula.
• Clinician’s hand position: vibrate the serratus anterior muscle fibers medial border of the
scapula
• Repetition: 5 x 2
31
Biceps - Brachialis Release:

• Biceps Origin: long head: supraglenoid tubercle of the scapula
Short head: coracoid process of the scapula
• Biceps Insertion: radial tuberosity, bicipital aponeurosis
• Brachialis Origin: anterior distal half of humerus

• Brachialis Insertion: coronoid process and tuberosity of ulna
• Assessment: Biceps/ Brachialis muscle spasm and/or trigger points

• Patient’s Position: supine, shoulder scaption, elbow 90 degrees.
• Clinician’s hand position: firm pressure with medial / lateral vibrating over the distal biceps
tendon. Or you can resist elbow extension while performing medial/ lateral vibration over
the distal biceps tendon
Triceps Release
• Assessment: Biceps/ Brachialis muscle spasm and/or trigger points

• Patient’s Position: supine, shoulder scaption, elbow 90 degrees.
• Clinician’s hand position: firm pressure with medial / lateral vibrating over the distal triceps
tendon. Or you can resist elbow flex while performing medial/ lateral vibration over the
distal biceps tendon
32
Wrist Flexor Release :
• Assessment: wrist flexor muscle spasm and/or trigger points

• Patient’s Position: supine; elbow relax on table
• Clinician’s hand position: vibrate wrist flexor proximal tendons. Or medial/ lateral glide over
the wrist flexor tendon
33
Wrist Extensor Release:
• Assessment: wrist extensor muscle spasm and/or trigger points

• Patient’s Position: supine; elbow relax on table.
• Clinician’s hand position: vibrate wrist extensor proximal tendons. Or medial/ lateral glide
over the wrist extensor tendon
34
Diaphragm Release:
• Assessment: diaphragm muscle spasm

• Clinician’s hand position: vibrate or thrust the lower ribs
• Repetition: x 3
35
Para-Spinal Release:
• Assessment: para-spinal muscle spasm and/or trigger points

• Patient’s Position: supine; neck and upper chest slightly flexed, arms across the chest
• Clinician’s hand position: thrust bilateral para-spinal. or thrust bilateral lower ribs from the side
• Repetition: x 2
36
Quadratus lumborum Release:
• Origin: medial half of posterior iliac crest and iliolumbar ligament

• Insertion: transverse processes of L1-L4) and medial half of 12th rib
• Assessment: quadratus lumborum muscle spasm and/or trigger points

• Clinician’s hand position: resist trunk side bend hands superior the greater trochanter and
vibrate/ thrust the quadrates lumborum
37
Iliopsoas Release:
• Psoas Major Origin: bodies and bases of transverse process of L1-L5

• Psoas Major Insertion: lesser trochanter of femur
• Iliacus Origin: iliac fossa

• Iliacus Insertion: lesser trochanter of femur
• Assessment: Iliopsoas muscle spasm and/or trigger points

• Clinician’s hand position: vibrate/ thrust your fingers medial to the ASIS
38
Hip Flexors Release:
• Assessment: hip flexors muscle spasm, groin pain, uneven symphysis and/or trigger points
• Patient’s Position: supine, push gluteus toward the table
• Clinician’s hand position: vibrate/ finger thrust hip flexors inferior to the ASIS
39
Hip Adductors Release:

• Assessment: hip adductors muscle spasm, groin pain, uneven symphysis and/or trigger
points
• Patient’s Position: Supine, isometric contract hip adductors
• Clinician’s hand position: resist with thrust bilateral hip adductors proximal to the knees
quickly
• Repetition: x 2
40
Quadriceps Release:
• Assessment: Quadriceps and/or trigger points

• Patient’s Position: supine, knee extended, push heel toward the table
• Clinician’s hand position: vibration/ thrust or glide and distal quadriceps tendon (superior
to the patella)
41
Vastus lateralis - ITBand Release:
• Assessment: ITBand muscle spasm and/or trigger points

• Patient’s Position: supine knee extended
• Clinician’s hand position: hip internal rotation (toes in) while performing transverse glide for
distal part of the band
42
Hamstrings Release:
• Assessment: hamstrings muscle spasm and/ or trigger point

• Patient’s Position: supine, push heel down toward the table
• Clinician’s hand position: vibrate hamstring distal insertion and or the trigger point area
43
Piriformis Release:
• Assessment: piriformis muscle spasm and/or trigger points
• Clinician’s hand position: resist lateral side of the pelvis and vibrate the piriformis fibers and
or the trigger point area
44
Gastrocnemius Release:
• Assessment: gastrocnemius muscle spasm and/or trigger points

• Patient’s Position: supine, knee 90 flexion
• Clinician’s hand position: resist ankle dorsiflexion while vibrate the gastrocnemius muscle
and or the trigger point area
• Repetition: 5 x 2
45
Pernous Release I:
• Assessment: pernous muscle spasm and/or trigger points

• Patient’s Position: supine, knee extended, foot inverted
• Clinician’s hand position: vibrate superior or superior and inferior muscle tendon junction
Pernous Release II:
• Assessment: pernous muscle spasm and/or trigger points

• Patient’s Position: supine, knee extended
• Clinician’s hand position: resist ankle eversion; perform distal tendon (lateral ankle)
transverse glide
46
Tibialis Anterior Release:
• Origin: upper half of lateral shaft of tibia and interosseous membrane

• Insertion: Inferomedial aspect of medial cuneiform and base of 1st metatarsal
• Assessment: tibialis anterior muscle spasm and/or trigger points

• Patient’s Position: supine, foot isometric plantaflexed
• Clinician’s hand position: simultaneous, firm pressure for 3 seconds over distal or proximal
muscle tendon junction or tendon; follow with transverse glide
• Repetition: x 2
Independent Back Release:
• Assessment: back muscle spasm and/or trigger points

• Patient’s Position: supine; pull head superiorly & pull bilateral hips toward the feet
47
References
1. “Advanced Soft Tissue Release” inventor: Jacobs, Joseph. patent pending application number 13/317,234, filling date
10/13/2011.
2. “Physical Rehabilitation. 5th edition;” O’Sullivan S & Schmitz T. F.A. Davis, Jaypee. 2007.
3. “National Physical Therapy Examination: Review & Study Guide;” O’Sullivan S & Siegelman R. TherapyEd 2010.
4. “Therapeutic Exercise: Foundations and Techniques. 5th edition;” Kisner C & Colby L . F.A. Davis 2007.
5. “Pathology. Implication for the Physical Therapy. 2nd edition;” Goodman, Fuller & Boissonnault. Saunders An Imprint of
Elsevier 2003.
6. “Positional Release Therapy. Assessment & Treatment of Musculoskeletal Dysfunction;” D’Ambrogio K & Roth G. Mosby an
affiliated of Elsevier 1997.
7. “Myofascial Release. The Search for Excellence. A Comprehensive Evaluatory and Treatment Approach;” Barnes J. 1990.
8. “Travell & Simons’ Myofascial Pain and Dystunction The Trigger Point Manual” Travell J, Simons D., Simons L. 1999.
9. “Principles of Manual Medicine. 3rd edition;” Greenman P. Lippincott Williams & Wilkins 2003.
10. “Neuroscience Online:” An Electronic Textbook for the Neurosciences, Department of Neurobiology. James Knierim, Ph.D.,
Department of Neuroscience, The Johns Hopkins University. neuroscience.uth.tmc.edu/s3/chapter01.html
11. “Pharmacology in Rehabilitation: Notes;” Deluca D. Dominican College 2009.
12. “Advance Clinical Seminar; Powerpoint & Notes;” Michella K. Dominican College 2009.
13. “Neuroscience. 2nd edition.” Purves D, Augustine GJ, Fitzpatrick D, et al., editors. Sunderland (MA): Sinauer
Associates;; 2001. Bookshelf ID: NBK10986. www.nc bi.nlm.nih.gov/books/N BK 10986/
14. “Muscle spindles and Golgi tendon organs in bovine calf extraocular muscle studied by means of double-fluorescent
labeling, electron microscopy, and three-dimensional reconstruction.” Blumer R, Konakci KZ, Brugger PC, Blumer MJ,
Moser D, Schoefer C, Lukas JR, Streicher J. Department of Anatomy, University of Vienna, Austria. Exp Eye Res.
2003 Oct; 77(4):447-62.PMID: 12957144 [PubMed - indexed for MEDLINE]
15. The Goigi Tendon Organ: A Review and Update (neuromuscular receptors; proprioceptors; sensory receptors) josephine C.
Moore. The American Journal of Occupational Therapy. April 1984, volume 38, number 4
16. http://thewellnessdigest.com/scalenes-anatomy-origins-insertions-actions-innervations/
17. https://www.getbodysmart.com/ap/muscularsystem/shouldermuscles/posteriormuscles/trapezius/tutorial.html
18. http://thewellnessdigest.com/occipitalis-anatomy-origin-insertion-action-innervation/
19. http://www.lumen.luc.edu/lumen/meded/grossanatomy/dissector/mml/lncl.htm
20. http://www.lumen.luc.edu/lumen/meded/grossanatomy/dissector/mml/pcmj.htm
21. http://www.lumen.luc.edu/lumen/meded/grossanatomy/dissector/mml/styh.htm
22. http://www.lumen.luc.edu/lumen/meded/grossanatomy/dissector/mml/tiba.htm
48
®
Fascia
49
Background:
Fascia is a very strong connective tissue that wraps the entire body, including muscles and organs. Fascia is like a
spiderman suit that wraps the entire body from head to toe. Fascia can lose its elasticity and may become restricted
as a result of accidents, traumas, surgeries, scar tissue, stress, poor posture and poor body mechanics. When Fascia
loses its elasticity, it can cause excessive pressure on the muscles, blood vessels, nerves, bones and organs.
Excessive pressure can cause pain and may decrease joint range of motion. From clinical findings, fascia symptoms
can mimic nerve symptoms. Patient’s may complain of vague roundish pain/ numbness/ tingling/ soreness/ tightness
that doesn’t correlate with normal nerve distribution. Some patients say it feels like a band that surrounds the body
part. Clinicians should note that fascia restriction in the body can cause pain and /or decrease active range of
motion (AROM) in different areas of the body due to the compensatory effect of fascia tightness (the spiderman suit
example demonstrates this concept). Unfortunately, fascia restriction does not show up in any of the current,
standard tests such as: CAT scan, x-ray, electromyography, myelograms, PET scan, etc. I have developed the fascia
scaleTM to help clinicians have an objective scale to assess fascia/ myofascial restriction.
The human body can experience soft tissue injuries in a variety of ways. Accidents, falls, poor body mechanics, poor
posture, and age related degeneration name just a few of these causes. It is very common for the body to develop
myofascial restriction with most injuries.
Traditional approach
Myofascial release is a manual therapy technique that is used to evaluate and treat myofascial connective tissue
restriction. Treatment recommendation is for the clinician to slowly stretch the elastic part of the fascia until reaching
the point of restriction and then hold the position until the restriction releases. There are four possible directions for
each treatment area that may need to be released. Directions are transverse, longitudinal, left diagonal and right
diagonal. John Barnes’ recommendation is 3-5 minutes to release one fascia restriction direction. Barnes states that
“the key to myofascial release is sustained pressure over time”. If an individual’s entire back fascia is restricted, it
would take approximately 25 to 40 minutes, along with several sessions, in order to treat the entire back.
Currently, healthcare costs have skyrocketed, which has created additional financial burdens for injured individuals.
There is an urgent need for non-invasive, manual, medicine specialty that can treat myofasical restriction in a short
period of time, while decreasing healthcare costs. There is also a need for manual technique that will relieve clients
pain and help them to return to normal function activities in a short period of time. That would increase individual
productivity and decrease the financial burden due to the lengthy period of rehabilitation experienced with
traditional manual therapy.
50
Fascia Scale TM/ Myofascial ScaleTM: (0 to 4 scale)
Use palm, fingers or fascia instruments and glide the restricted fascia in 4 directions (top to bottom, side to
side, L diagonal to diagonal, R diagonal to diagonal) to decide which direction is restricted. This scale is not
applicable to certain parts of the head, hands, feet and ears. Clinicians should rate fascia tightness based
on the direction which shows the most restriction.
• 0/4 Normal glide: No fascia restriction. Fascia glides 1 cm or more.
• 1/4 Slight Restriction: Slight increase in fascia restriction. Slight resistance at end range of fascia
glide. From 3/4 cm and less than 1 cm.
• 2/4 Moderate Restriction: Moderate increase in fascia restriction. Resistance at mid range of fascia.
From 1/2 cm and less than 3/4 cm.
• 3/4 Severe Restriction: Severe fascia restriction. From 1/4 cm and less than 1/2 cm.
• 4/4 Rigid restriction: No fascia movement. Typically with surgical or hard scar tissue adhesions.
Unable to glide the fascia or less than 1/4 cm.
Advanced Fascia ReleaseTM:
The clinician should use either their palm, fingers using gloves and apply firm gliding pressure on the soft
tissue. ASTR should not be painful to the individual receiving the treatment. If the individual experiences pain while
receiving the treatment, the clinician should change the maneuver or the pressure of the hand to keep the individual
comfortable at all times. The individual should be positioned in a very comfortable position; usually supine, side
lying, or prone. Glide the fascia until you stretch the restricted area. You do this by taking the slack and stretching
the restricted area to the maximum point. Hold for 3-5 seconds and do the below maneuvers. For best results,
clinician should glide each direction 2 to 4 times. ASTR has several manual maneuvers to treat a variety of soft tissue
dysfunctions. The following maneuvers could be used together for optimal results:
1. Four way glide: Apply firm gliding pressure with both hands opposite to each other in the following directions:
up/down, side to side, right and left diagonal, left and right diagonal.
2. Four way one hand glide: Apply firm gliding pressure with palm or fingers in the following directions: up/down,
side to side, right and left diagonal, left and right diagonal.
3. Three way glide: Hold the soft tissue firmly with one palm or fingers. With the opposite hand, apply firm gliding
pressure with palm or fingers in the following directions: inferior, inferior left and inferior right.
4. Circle glide: Apply firm gliding pressure with palm or fingers in circular patterns clockwise and counter-clockwise.
5. Semi-circle glide: Apply firm gliding pressure with palm or fingers in semi-circular pattern clockwise and counter-
clockwise.
51
6. Interlocking glide: With both hands side-by-side, apply firm pressure to the treatment area. Apply pressure while
stretching the area using the palms of both hands. Glide with a twist like semi-circle in opposite directions;
superior or inferior to the other hand. This maneuver can be performed in a four way glide direction.
7. Interlocking with thrust glide: Both hands side-by-side firmly on the treatment area. Apply pressure with stretch
using the palms of both hands. Glide with thrust twist like semi-circle toward opposite superior or inferior to the
other hand. This maneuver can be performed in a four way glide direction.
8. One direction glide: Apply firm gliding pressure with bilateral palm or fingers in either transverse or longitudinal
direction in relation to the muscle fibers. Variation one: Both hands going opposite to each other. Variation two:
both hands going toward the same direction to treat more muscle fibers at the same time.
9. Glide with rolling: Apply firm gliding pressure with both palms. Roll the skin opposite to each other or place
both hands side by side
10. One hand glide: Apply firm gliding pressure with palm or fingers over the treatment area. Use the four way glide
direction.
11. Zig zag glide: Use either palm or fingers of one hand and go in zig zag direction; either transverse or
longitudinal to the muscle fibers.
12. Circle with stretch: Stretch the restricted fascia and perform a circle motion with the same hand (used with
myofascial release).
13. Half circle with stretch (fan motion): Stretch the restricted fascia and perform a half circle motion with the same
hand (used with myofascial release).
14. Fast Fascial Release: Glide fascia in all directions while patient is contracting the muscle associated with the
fascia area.
Advanced Fascia ReleaseTM or Advanced Myofasical ReleaseTM using A1 & A2 TM:
Fascia InstrumentsTM : A1 big head fascia instrument & A2 small head fascia instrument
A1& A2 are instruments that was developed by Dr. Jacobs to help clinicians release the fascia restriction faster and
to decrease the stress on the clinician’s hands. When you use the A1 & A2, use the black rubber side of the
instrument on the patient’s skin and apply non-painful firm deep pressure downward. Then perform one or more of
the following maneuvers:
• Stretch the adhesion area ; hold for 3-5 seconds then perform semi-circles
• Stretch the adhesion area; hold for 3-5 seconds then perform circles
• Stretch the adhesion area; hold for 3-5 seconds then perform longitudinal glide
• Stretch the adhesion area; hold for 3-5 seconds then perform transverse glide
• Stretch the adhesion area; hold for 3-5 seconds then perform diagonal glide
• Use both A1 & A2 simultaneously next to each other on the sides of the lesion and apply alternating downward
pressure (cover all areas)
52
• Use both A1 & A2 simultaneously next to each other on the lesion line and apply alternating downward pressure.
Cover all areas.
• Use both A1 & A2 simultaneously next to each other on the lesion line and apply alternating transverse pressure/
glide. Cover all areas.
• Use both A1 & A2 simultaneously next to each other on the lesion line and apply alternating longitudinal
pressure/ glide. Cover all areas.
Contraindications: Do not use the Fascia release in the following situations
• The wound is open and is not totally healed
• It is painful for the patient to apply pressure on the scar tissue
• There is a cut on the skin
• There is infection or cancer cells
• Patient is not tolerating the firm pressure of the fascia instrument
123 Release Approach:
• Hands: stretch the restricted fascia area with your fingers or palm then hold for 3 seconds then perform either
circle or gliding motion.
• Instruments: stretch the restricted fascia area with A1 or A2 then hold that position for 3 seconds then perform
either big circle or wide glide motion with the instrument.
Deep Fascia Release:
1. Fingers release: Use your fingers to grab on the muscle fiber apply deep pressure to reach the deep restricted
fascia sheets. When you feel the restrictions maintain the stretch and perform 123 release approach.
2. Modified pinch grip: be gentle, with one finger to stabilize and perform the stretch and release with the other
fingers using 123 release approach
3. Power grip release: be gentle, stabilize with your thumb and stretch the restricted fascia layers with your fingers
then perform 123 release approach.
53
Nasalis Fascia Release:
• Assessment: nasal surgery, trauma, headache and or fascia restriction

• Clinician’s hand position (be gentle): apply very light resistance to the lateral side of the
nose for 3 seconds. Ask patient to relax, then perform gentle fascia circle glide. Perform the
same maneuver on the opposed side of the nose.
54
Procerus Fascia Release:
• Assessment: nasal surgery, trauma, headache, allergy and or fascia restriction

• Clinician’s hand position (be gentle): stretch the procerus fascia into the superior direction,
hold for 3 seconds then perform circle or side to side glide.
55
Zygomaticus Fascia Release:
• Assessment: nasal surgery, trauma, headache, allergy, neuropathy and or fascia restriction
• Clinician’s hand position (be gentle): stretch the zygomaticus fascia into the lateral direction,
hold for 3 seconds then perform circle or side to side glide.
56
Nasal - Frontal Fascia Release:
• Assessment: nasal surgery, trauma, headache, allergy and or fascia restriction

• Clinician’s hand position (be gentle): simultaneously stretch the nasal fascia toward the
inferior direction and stretch the frontal fascia into the superior direction, hold for 3 seconds
then perform circle or side to side glide with both hands.
57
Galea Aponeurotica Fascia Release:
• Assessment: surgery, trauma, headache, jaw pain and or fascia restriction

• Clinician’s hand position (be gentle): stabilize the head with one hand and use A1 or A2 to
release the galea aponeurotica fascia. (use 123 release approach)
58
Occipital Fascia Release:

• Assessment: surgery, trauma, headache, jaw pain, neuropathy and or fascia restriction
• Patient’s Position: supine, head resting on the clinician hands
• Clinician’s hand position (be gentle): use 123 release approach with your fingers
59
Neck Fascia Release:

• Clinician’s hand position (be gentle): use 123 release approach with your fingers
60
Clavicle Fascia Release:

• Assessment: surgery, trauma, headache, neuropathy and or fascia restriction
• Patient’s Position: supine, head is resting on the clinician palm in flexed position
• Clinician’s hand position (be gentle): thumb is in the posterior aspect of the clavicle (use
123 release approach with your thumb) you can not see the thumb in the picture, it is
underneath the clavicle
61
SCM Fascia Release:

• Patient’s Position: supine, you can rotate the neck to reach the SCM muscle
• Clinician’s hand position (be gentle): use 123 release approach with your fingers to do
deep release
62
Fingers Fascia Release I:

• Assessment: surgery, trauma, neuropathy and or fascia restriction
• Patient’s Position: sitting, resting hand on a pillow
• Clinician’s hand position: move both of your thumbs in the same direction to detect the
restriction then perform 123 release approach with both of your thumbs going toward the
same direction of the restriction
Fingers Fascia Release II:

• Assessment: surgery, trauma, neuropathy and or fascia restriction
• Patient’s Position: sitting, resting hand on a pillow
• Clinician’s hand position: move both of your thumbs in the opposite directions to detect
the restriction then perform 123 release approach with both of your thumbs moving away
from each other
63
Chest Fascia Release:

• Assessment: surgery, trauma, breathing problem, poor forward posture, neuropathy and or
fascia restriction
• Clinician’s hand position (be gentle): use 123 release approach with your palm. Be very
gentle around the ribs, sternum and xiphoid process.
64
Visceral Fascia Release I:

• Assessment: surgery, trauma, GI problem, neuropathy and or fascia restriction
• Clinician’s hand position (be gentle): use 123 release approach and deep release with your
fingers. Be very gentle around the ribs, sternum and xiphoid process.
65
Visceral Fascia Release II:

• Clinician’s hand position (be gentle): use 123 release approach and deep release with
modified pinch or power grip with your fingers.
66
Intraoral Fascia Release:

• Assessment: surgery, trauma, jaw pain, and or fascia restriction
• Clinician’s hand position (be gentle): index finger inside the mouth to release the fascia,
thumb outside the mouth for stabilization/ gripping. Use 123 release approach with pinch
grip with your finger.
67

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Manual

GTO Page Fascia Page

License Agreement 2 Background 50

Biography 7 Fascia Scale 51

ASTR Discovery 8 Advanced Fascia Release 51

Pain cycle 9 Contraindications 53

Advanced Soft Tissue Release® - definition 10 123 Release Approach 53

Golgi Tendon Organs (GTO’s) 10 Deep Fascia Release 53

Spasm scale 11 Nasalis Fascia Release 54

Muscle Spasm Screening: (Whole Body) 11 Procerus Fascia Release 55

Fingers Maneuver 12 Zygomaticus Fascia Release 56

Advanced Trigger Point ReleaseTM 12 Nasal - Frontal Fascia Release 57

Treatment Positions & Maneuvers 13 Galea Aponeurotica Fascia Release 58

Treatment Positions & Maneuvers 34 Occipital Fascia Release 59

References 48 Neck Fascia Release 60

Clavicle Fascia Release 61

SCM Fascia Release 62

Fingers Fascia Release 63

Chest Fascia Release 64

Visceral Fascia Release I 65

Visceral Fascia Release II 66

Intraoral Fascia Release 67

Head & Neck Masseter 14

Lateral Ptyergoid - Masseter 15

Trapezius - Levator Scapulae 19

Trapezius - Splenius Capitis 20

Core & UE Pectoralis 27

Rhomboid - Lower Trapezius 28

Infraspinatus - Teres Minor 29

Biceps - Brachialis - Triceps 32

Vastus lateralis - ITBand 42

Tibialis Anterior - Back 47

26895 Aliso Creek Rd. Suite B270

Aliso Viejo, CA 92656

Tel: (888) 210-2787

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7. Term and Termination.

accordance with Section 7(b). (b) Termination.

Joseph Jacobs, DPT, ASTRs

Techniques and instruments Doctor Jacobs has invented include:

Copyright © 2017 ASTR. All Rights Reserved.

Watch Dr.Jacobs’ TEDx Talks at https://advancedsofttissuerelease.com/

Body Mechanics & Posture

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addresses the previous mentioned dysfunctions.

the entire back.

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rehabilitation experienced with traditional manual therapy.

Advanced Soft Tissue Release® (ASTR)

Golgi Tendon Organs (GTO’s):

Copyright © 2017 ASTR. All Rights Reserved.

Muscle Spasm Screening: (Whole Body)

Lower Body (bilateral)

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treated area then perform quick very gentle thrust.

Advanced Trigger Point ReleaseTM:

• In a lot of cases, vibration is more effective than gliding

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Treatment Positions & Maneuvers

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• Origin: zygomatic arch

• Assessment: masseter muscle spasm and/or trigger points

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Lateral Pterygoid - Masseter Release:

7. Term and Termination. 