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  • Writer's pictureKevin Kapka, PT, DPT

What is "Instrument Assisted Soft Tissue Mobilization" (IASTM)?

Updated: Oct 10, 2023

Instrument assisted soft tissue mobilization is a form of treatment based on the principles of James Cyriax(1). This technique most commonly utilizes stainless steel tools with beveled edges that provide the therapist and patient an increased sense of vibration and awareness of pathologic tissues. IASTM was developed to improve range of motion, decrease soft tissue restrictions and improve pain levels.

Why do people and therapists choose to use IASTM? Is it right for me?

IASTM is theorized to stimulate connective tissue, and in turn, reduce the amount of scar tissue formation, adhesions, and fascial restrictions, and is indicated for many orthopedic issues. IASTM is far less demanding on the therapist and allows more directive force compared to traditional massage. Patients that have had any of the following may benefit from further consultation for IASTM:

· Tibialis Posterior Tendinitis

· Heel Pain /Achilles Tendinitis

· Post-Surgical and Traumatic Scars

· Myofascial Pain and Restrictions

· Musculoskeletal Imbalances

· Chronic Joint Swelling Associated with Sprains/Strains

· Ligament Sprains

· Muscle Strains

· Non-Acute Bursitis

· RSD (Reflex Sympathetic Dystrophy)

· Back Pain

· Hip Pain (Replacements)

· IT Band Syndrome

· Shin Splints

· Chronic Ankle Sprains

· Acute Ankle Sprains (Advanced Technique)

· Scars (Surgical, Traumatic)(2)

What is the physiology behind IASTM?

If you're not a fan of science, I suggest skipping this next section, but if you're curious as to how IASTM affects the tissues of the body, you're in luck...

To understand the IASTM process, one needs to understand the basics of musculotendinous tissue healing. After an injury, there is an activation and eventual proliferation of fibroblasts in the extracellular matrix (ECM). These fibroblasts produce fibronectin and begin to produce type III collagen in the ECM. As the remodeling phase occurs, these collagen fibers begin to align and mature into type I collagen(3). When the beveled edge of an IASTM tool compresses the tissue, it is thought to stimulate this connective tissue remodeling through resorption of excessive fibrosis, along with inducing repair and regeneration of collagen secondary to fibroblast recruitment. The literature as to the efficacy of this treatment is still controversial, however literature is growing and should provide more insight in the near future. Below are some visuals incase any of that went over your head.

layers between skin and muscles

Extracellular Matrix

If you are in the Mission Viejo area and think you, or someone you know, might benefit from some physical therapy with IASTM, please don’t hesitate to reach out!

1. Cheatham SW, Lee M, Cain M, Baker R. The efficacy of instrument assisted soft tissue mobilization: a systematic review. J Can Chiropr Assoc. 2016;60(3):200-211.

3. Hawkins W. Effects of instrument-assisted soft tissue mobilization on musculoskeletal properties—corrigendum. Medicine & Science in Sports & Exercise. 2020;52(2):524-524. doi:10.1249/mss.0000000000002230

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