Instrument-assisted soft tissue techniques include Astym therapy, which increased fibroblast activation and number, production of fibronectin, movement, and decreased pain in patients with fibrosis (129) and Graston technique which reduces pain and improves movement (130), and are performed by physical therapists who can be located on websites for these techniques
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Fendt SM, Bell EL, Keibler MA, Olenchock BA, Mayers JR, Wasylenko TM, Vokes NI, Guarente L, Vander Heiden MG, Stephanopoulos G (2013) Reductive glutamine metabolism is a function of the alpha-ketoglutarate to citrate ratio in cells
