Manual Therapy Using the 3TOOL®

I wanted to share about this little tool I’ve found helpful for me as a clinician treating patients, and also for me as a clinician treating myself. I am big on protecting my hands and elbows as I want/need them to work for a long time. I believe the better I take care of them the longer they will last for me. I use my elbow/forearm whenever I can for working on fascial densifications as it’s tougher and more of a workhorse than my delicate hands and fingers. But for some body parts the elbow is too much – like the neck. And when I am treating myself I simply can’t reach my elbow to my own back. I’m hypermobile, but there’s a limit!

3 TOOL for manual therapy
The 3TOOL®, a handy device that can help save your hands, costing $34.90. I use it on patients in the clinic as well as on myself. Accessed at

There are several ways to use the 3TOOL®. Some of the videos and photos demonstrate dragging or raking it over the tissue, while others depict leaving it still on one point and applying pressure – leaning or sitting on it, much like acupressure with a tennis ball. You do as you wish, but I don’t use either of these techniques. Instead, I apply enough pressure to reach the deep fascia and then exert a horizontal shear force. The intent with this is to restore slide to the deep fascia layers that have become densified and adhered to each other. I never move from my initial contact point on the skin – I’m glued to that spot. I may change the linear direction I’m moving, but I stay on the same point. I may also change the angle at which I’m approaching it, but it’s the same point. As a matter of fact, too much movement over the skin can actually break the epidermis down causing an abrasion. This glued-to-the-spot is also the technique I use when working with my knuckle or elbow on a fascial densification.

Steps to reaching/treating densified fascia
This image from the Fascial Manipulation® First Level course book depicts the strategy for treating a fascial densification. It involves applying vertical pressure from the skin down to the deep fascia, then maintaining this while adding a horizontal (tangential) shear or friction force. Used with permission from Dr. Antonio Stecco.

Prepping the tissue with a percussion or vibration tool can be very helpful in minimizing the manual work needed to resolve fascial densifications. Using these tools also hurts less than the manual component, although the tools are not as effective as manual techniques at fully resolving denifications. Prior to purchasing my 3TOOL® I would actually use the round head (I call it the Mickey Mouse nose) from my percussion gun like a tool. I would disconnect it from the unit, hold it in my hand by the upright connecting piece, and use it in the same manner as the 3TOOL®. While this is a workable option, I find it’s easier to grip the 3TOOL® with my hand. Plus the 3TOOL® has different edges on it suiting different body regions better, like between the fingers or toes.

Colleen using the 3TOOL and percussion gun
Here I am using the 3TOOL® on the fascia of my knee (specifically over the vastus medialis or Ir-GE in the Fascia Manipulation® model). I alternate between using my percussion gun and doing the manual work as percussion can help prep tissue so that manual work goes easier. Before I got my 3 TOOL® I would use the round head from my percussion gun (here attached to the gun) as a manual tool. Photo by Bill Whiteford.

So now for THE QUESTION: how do you know where to work with the 3TOOL®? This truly is the golden question, and one that is not answered easily. I discussed this topic in depth in my post on percussion tools and determining where to use them, and here it is again:

Since most of you reading this don’t know the methodology used in Fascial Manipulation®, then moving around where it hurts may be your best bet. Do whatever works for you. Here are some guidelines you can try:

  • Treat where you hurt. Simple, straightforward. If it helps great, if it doesn’t then it may be because the problem causing your pain is remote. In other words, where it hurts isn’t always where the problem is. Try checking tissues a little further out from where you hurt and see if it helps.
  • Listen to your body. If working a sites is extremely painful and/or makes your condition worse, then it’s likely not the best choice.
  • Treat where I direct you to treat. Of course, this only works if I am currently working with you. I like doing this for stubborn points that need additional care, or for those who want to accelerate progress between visits.
  • Not all pains and problems are appropriate for percussion and vibration. I never use percussion or vibration on the fascial points around the eyes (yes, there really are several). I typically don’t use percussion on the skull (but I have had one patient swear it helped), but I have used the vibration ball here. It depends on the person and the problem.

Many people are surprised to learn that anyone can purchase the textbooks that give the locations for all the points in the Fascial Manipulation® (FM) model. There are two basic textbooks for the first level (showing the centers of coordination) and the second level (showing the centers of fusion), and they give written and illustrated descriptions of every point. So the secret is out. However, before you rush out to buy your copy, remember that a tool is only as good as the operator. If it were as simple as that then there would be no need for courses taught by instructors like me and others all over the world, review sessions, conferences, books, videos, and the like to help us understand this method better. There are also a LOT of points that can be treated! The art and science of this method is determining which points are to be treated so as to accomplish an optimal and sustainable therapeutic outcome. Only clinicians can take these courses, and these textbooks are included in the registration cost. Clinicians can learn more about course availability on the Fascial Manipulation Association website as well as the Structure and Function website.

Fascial Manipulation® first and second level textbooks
The Fascial Manipulation® first and second level textbooks are available for purchase by anyone. The second level book even comes with an app for the phone which shows all the points. Accessed at

Lastly I’ll mention the hypodermis, which is the tissue above the deep fascia. If the problem is in the hypodermis then the 3TOOL® or percussion may not be the best option to begin with, and could actually aggravate things. Just because something is tender doesn’t necessarily mean it is the deep fascia that is at fault. For more guidance on this please see my past post on cupping, which explains much more in depth on the hypodermis.

As always, I hope this is helpful for those of you wishing to self-treat. Please be reasonable and get appropriate help when things are not improving or worsening.

Wishing you health and joy,


Published by Colleen Murphy Whiteford

I am a physiotherapist, graduate of Saint Louis University Class of 1984. I married my best friend and business partner, Bill, who is also a physiotherapist, in 1988. We have worked together all these years - an example of God's grace! Together we started Appalachian Physical Therapy which continues to thrive. I am a big believer in the power of touch, the manual therapies, and treating holistically. There are many alternatives to medications, surgeries, and testing, but people are often uninformed. My perspective emphasizes the role of the connective tissues including the fascia. Lack of attention to this structure is the source of many physical ailments - our bodies are truly fearfully and wonderfully made (Psalm 139)! I am passionate about helping people of all ages and diagnoses maximize their health, and empowering them to understand their role in management and prevention of problems.

Leave a Reply

%d bloggers like this: