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Instrument-Assisted Soft Tissue Mobilization - Types of Tools, Benefits, Indications, and Contraindications

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IASTM is a beneficial technique using specialized tools to address soft tissue issues and promote healing in physical therapy.

Medically reviewed by

Mohammed Wajid

Published At January 23, 2024
Reviewed AtJanuary 23, 2024

Introduction:

Instrument-assisted soft tissue mobilization (IASTM) is a technique commonly utilized in physical therapy. It resembles a standard massage, but instead of a physical therapist's hands, specialized instruments are employed. These instruments enable a more direct treatment of the soft tissues involved in movement, which encompass muscles, fascia (the connective tissue surrounding and separating muscles), ligaments (tissues connecting bones to other bones), and tendons (tissues connecting muscles to bones).

IASTM involves two types of treatments: broad and targeted. Broad treatments are used for large muscle groups, like an injured back, while targeted treatments focus on specific injured areas. By employing different tools, angles, and pressures, therapists can concentrate on treating a particular layer of soft tissue during the therapy session.

How Does Instrument-Assisted Soft Tissue Mobilization Work?

IASTM utilizes specially designed, medical-grade stainless steel tools to address scar tissue and enhance the function of injured areas in the body. Scar tissue can impact the performance of muscles and tendons by breaking it down. Therapists facilitate increased flexibility, improved movement, and reduced pain.

During the treatment, therapists apply the rounded stainless steel tools to inflamed or scarred soft tissue, stimulating the body's natural healing processes. The unique shape of these tools enables therapists to treat areas that are difficult to access with their hands alone, enhancing the precision and sensitivity of the treatment. These frictionless tools glide comfortably against the skin during the therapy session.

IASTM is even useful for diagnosing soft tissue problems. The size and shape of the tools allow therapists to feel areas they could not reach previously, enabling them to identify areas of tightness or pain with greater accuracy.

What Are the Benefits of Instrument-Assisted Soft Tissue Mobilization (IASTM)?

IASTM offers several benefits, including reduced pain, increased range of movement, enhanced tissue elasticity, and improved recovery. One significant benefit of IASTM is pain reduction. This technique achieves pain reduction through various mechanisms. By increasing blood circulation, IASTM helps dilate vessels under the skin, allowing more blood flow to the area. The increased circulation also raises the tissue temperature, which can alleviate pain. Additionally, IASTM breaks down restrictive tissues like scar tissue and adhesions, thus restoring movement and decreasing pain. Moreover, IASTM disrupts pain signals to the brain by sending alternative signals, preventing pain signals from being received.

IASTM also enhances the range of movement. This is achieved by breaking down scar tissue and adhesions that form when collagen fibers lay in a disorganized manner across muscles following soft tissue injuries. IASTM applies force to soft tissues, breaking them down and realigning collagen fibers, thereby increasing the range of movement.

The technique further improves recovery by increasing blood circulation and breaking down scar tissue. The enhanced blood circulation facilitates cellular exchange and the delivery of nutrients and oxygen to the affected area, aiding in cell repair and healing. IASTM's ability to break up scar tissue and realign fibers contributes to a faster recovery of the soft tissues.

  • Active cancer.

  • Bone fracture.

  • Diabetic neuropathy, a type of nerve damage associated with diabetes.

Peripheral artery disease (PAD) is a circulatory condition that reduces blood flow to the arms or legs.

What Conditions Can Instrument-Assisted Soft Tissue Mobilization (IASTM) Help?

IASTM can aid in alleviating pain or discomfort linked to various conditions like the following:

  • Medial epicondylitis (inflammation of the inner elbow tendons).

  • Lateral epicondylitis (inflammation of the outer elbow tendons (tennis elbow).

  • Neck pain).

  • Plantar fasciitis (inflammation of the tissue on the bottom of the foot, causing heel pain).

  • Rotator cuff tendinitis (inflammation of tendons in the shoulder, leading to pain and limited movement).

  • Patellar tendinitis (inflammation of the tendon connecting the kneecap to the shinbone).

  • Tibialis Posterior Tendonitis (inflammation of the tendon behind the inner ankle).

  • Heel pain / Achilles tendinitis.

  • DeQuervain's syndrome (inflammation of tendons at the base of the thumb.)

  • Post-surgical and traumatic scars.

  • Myofascial pain and restrictions (pain in the muscles and surrounding connective tissues.)

  • Musculoskeletal imbalances.

  • Chronic joint swelling associated with sprains/strains.

  • Ligament sprains.

  • Muscle strains.

  • Non-acute bursitis (inflammation of fluid-filled sacs cushioning joints).

  • RSD (Reflex Sympathetic Dystrophy) (chronic pain condition affecting the sympathetic nervous system).

What Are the Contraindications of Instrument-Assisted Soft Tissue Mobilization (IASTM)?

  • Open wound (unhealed suture site).

  • Unhealed fracture.

  • Uncontrolled hypertension.

  • Patient intolerance/hypersensitivity.

  • Hematoma (a localized collection of blood outside the blood vessels, often due to injury or trauma).

  • Osteomyelitis (inflammation of the bone, usually caused by a bacterial infection).

  • Myositis ossificans (formation of bone tissue inside a muscle, usually as a result of trauma).

  • Hemophilia ( a genetic disorder that impairs the body's ability to form clots, leading to excessive bleeding and bruising).

  • Thrombophlebitis (inflammation of a vein, often with blood clot formation, causing pain and swelling).

What Are the Physiological Impacts of Instrument-Assisted Soft Tissue Mobilization (IASTM)?

During an IASTM session, various physiological effects occur, including increased cellular exchange, heightened vascular response, and the breakdown and realignment of collagen fibers.

IASTM leads to increased cellular exchange, which involves the transportation of cells into and out of tissues. The friction of IASTM against soft tissues enhances blood flow and cellular movement. This process is essential for removing waste products and toxins from the tissues while replacing them with oxygenated cells. The influx of oxygenated cells also boosts nutrient supply to the tissues, aiding in tissue repair and recovery.

Furthermore, IASTM triggers a heightened vascular response in the treated area. Vascular response is the body's reaction to tissue injury. IASTM can cause inflammation, which is the body's natural response to cell damage. This inflammation leads to vasodilation, widening of the capillaries, and an influx of oxygenated blood to promote healing. The nutrients and minerals carried by oxygenated blood are crucial for cell repair and growth.

One of the significant benefits of IASTM is its effectiveness in addressing scar tissue and adhesions in soft tissues. After an injury, the body attempts to repair the damaged area by forming scar tissue. However, scar tissue can cause issues due to its uneven and disorganized layering over the tissues. It does not align correctly with the direction of the previous tissues, leading to movement restrictions and pain. IASTM can break down these restrictive scar tissues and realign the collagen fibers to match the direction of the normal tissue. This realignment is crucial for restoring movement and reducing discomfort.

What Are the Types of Tools to Perform Instrument-Assisted Soft Tissue Mobilization?

IASTM can be performed using a variety of tools, each with its unique characteristics:

  • Buffalo Horn: Originally used by Chinese Gua Sha practitioners but also suitable for IASTM. However, it may not resonate as effectively. These tools are relatively inexpensive to acquire.

  • Jade Tools: Heavier and more slippery compared to buffalo horn tools. They require careful handling as they can break easily if dropped.

  • Plastic Tools: A newer addition to the market, offering various designs suitable for manual therapy work. They are commonly used for training before transitioning to more advanced tools.

  • Stainless Steel Tools: Considered the best tools for IASTM and a must-have for physiotherapists. When the steel tools run on the soft tissues, they produce excellent resonance. They come in different sizes depending on the company producing them, catering to various parts of the body.

Conclusion:

In conclusion, instrument-assisted soft tissue mobilization (IASTM) offers several beneficial physiological effects, including increased cellular exchange, heightened vascular response, and the realignment of collagen fibers. It provides various advantages, such as reduced pain, improved range of movement, increased tissue elasticity, and enhanced recovery. With its effectiveness in addressing scar tissue, adhesions, and promoting healing, IASTM is a valuable technique in physical therapy for individuals seeking relief and improved function.

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Mohammed Wajid
Mohammed Wajid

Physiotherapy

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soft tissue mobilizationpatient-specific instrumentation
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