Cole Brown SPT, Touro University Nevada
Instrumented assisted soft tissue mobilization techniques originate from the ancient Chinese technique of Gua Sha. Gua Sha is a natural, alternative therapy involved with scraping your skin with a tool to improve blood circulation and address the circulating energy life-force within our bodies called chi. Rubbing the skin’s surface was thought to help break up stagnant energy and blood that was responsible for inflammation and promote healing. Modern day IASTM was initiated by David Graston, a machinist, who developed metal tools to perform deep friction massages to help his chronic knee problems.
What is the difference between IASTM and regular STM? A proposed definition of IASTM is “Instrument assisted soft-tissue mobilization is a skilled intervention that includes the
use of specialized tools to manipulate the skin, myofascial, muscle, and tendons by various direct compressive stroke techniques” (Cheatham et al., 2019). Essentially, IASTM targets muscle, superficial and deep fascia that is prevalent throughout our whole body. Fascia is a network of dense connective tissue that connects muscles to muscles, surrounds blood vessels and nerves, muscles to tendons, organs to organs, etc. It has numerous functions which include but not limited to the following:
· Support and protective various structures of the body
· High concentration of sensory receptors
· Metabolic and thermoregulation
· High density of elastin fibers for extensibility
· Reduce friction of muscular force and gliding of structures
· Able to store and release kinetic energy
With the use of IASTM, practitioners can access deeper tissue and create physiological changes that are more difficult to attain than traditional STM. Recently, IASTM research is becoming more and more available to practitioners to support evidence-based practice. IASTM has been shown to promote breakdown of scar tissue and release of adhesions (Baker, 2013), increase short-term joint range of motion (Laudner, 2014), improve pain (Gulick, 2018), increase fibroblast production (Davidson, 1997), increase tissue perfusion (Loghmani and Warden, 2013), and neuromuscular facilitation. Conditions that IASTM is used for include but not limited to following:
· Muscles strains/ligament sprains
· Musculoskeletal imbalances/trigger points/ myofascial pain and restrictions
· Medial/lateral epicondylitis, carpal tunnel, plantar fasciitis, rotator cuff tendinitis
· Contractures, bunions, trigger finger
· Low Back/Hip/Neck Pain
· IT Band syndrome/shin splints
· Carpal tunnel syndrome/pronator teres syndrome
· Post-surgical scars
Our physical therapists are trained to have the best practice guidelines with IASTM and when it is appropriate to use IASTM to treat our patients. I personally have found tremendous benefits from IASTM in my own performance and of my patients. The efficiency and effectiveness of IASTM augments the healing process and allows me to focus on other aspects of the treatment to deliver high quality health care for my patients.
References:
Baker RT, Nasypany A, Seegmiller JG, et al. Instrument-assisted soft tissue mobilization treatment for tissue extensibility dysfunction. Int J Athl Ther Training. 2013;18(5):16–21.
Cheatham, Scott W, et al. “INSTRUMENT ASSISTED SOFT-TISSUE MOBILIZATION: A COMMENTARY ON CLINICAL PRACTICE GUIDELINES FOR REHABILITATION PROFESSIONALS.” International Journal of Sports Physical Therapy, Sports Physical Therapy Section, July 2019, www.ncbi.nlm.nih.gov/pubmed/31440416.
CJ Ganion LR Gehlsen GM Verhoestra B Roepke JE Sevier TL. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Med Sci Sports Exerc. 1997;29(3):313-319.
Gulick DT. Instrument-assisted soft tissue mobilization increases myofascial trigger point pain
threshold. J Bodyw Mov Ther. 2018;22(2):341-345.
Laudner K Compton BD McLoda TA Walters CM. Acute effects of instrument assisted soft
tissue mobilization for improving posterior shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther. 2014;9(1):1-7.
Loghmani MT Warden SJ. Instrument-assisted cross fiber massage increases tissue perfusion and
alters microvascular morphology in the vicinity of healing knee ligaments. BMC Complement Altern Medi. 2013;13:240.
McCormack JR Underwood FB Slaven EJ Cappaert TA. Eccentric exercise versus eccentric
exercise and soft tissue treatment (astym) in the management of insertional achilles tendinopathy. Sports Health. 2016;8(3):230-237.