IASTM and how I use it

Hello Everybody!

Today I am going to focus on Instrument Assisted Soft Tissue Mobilization (IASTM). Full disclosure, I am M1 Graston Technique certified.

I frequently use instrument assisted soft tissue mobilization in my treatments. There are three treatment goals I use IASTM for; 1) increase localized blood flow to the target tissue, 2) increase neural proprioception of a joint or muscle, and 3) decrease myofascial adhesions/malaligned fibrous tissue. Working a lot with baseball athletes leaves my practice prone to “routine treatments”. These are treatments I end up doing just about every day usually with pitchers as part of their process to get ready for sport activity. This often means I will perform Graston Technique on the same target tissue for one guy multiple days in a row. I started to notice that from one day to the next or even one week to the next I could not detect a difference in tissue quality on the athlete. Every time I performed IASTM on the same athlete in the same area, I noticed no change in the occurrence of “rice crispies” (my term for the bumps felt in the tissue supposedly representing myofascial adhesions). The athletes report feeling “good” after treatment every time despite the lack of physical tissue change. I started looking for research on Graston or any IASTM to see what has been recorded. That’s when I found some interesting studies.

I went way back to find some of the original research on IASTM, which involved studies performed on rats. Most of the results from these studies did actually show a physical change in the target tissue after treatment. I took a closer look at the studies though. In one study I noted, unconscious rats were used as subjects for the treatment. Typically in these studies, the rats suffered the equivalent of an MCL sprain, then normal, human-sized tools were used on the rats. The physical change in the target tissue they noted was only produced after using a human sized tool with supraphysiological pressure (a human pressing on a rat produces pressure not possible by a human pressing on another human) on an unconscious rat...Let that sink in for a second. This made me question my original 3 treatment goals using IASTM. 1) Increase localized blood flow to the target tissue, 2) increase neural proprioception of a joint or muscle, and 3) decrease myofascial adhesions/malaligned fibrous tissue. I still use Graston Technique almost every day in my treatments, but only for those first two goals. I don’t find that IASTM is truly effective at achieving the third goal. I will note that there have been more studies performed in recent years to show benefits of IASTM, but it is my understanding that the level of evidence for most of those studies is not well founded nor is the exact biomechanical causation of their results explained.

As it turns out, those first two treatment goals I use for IASTM also fall under my principle; “I can never affect your body as much as you can”. The IASTM acts as a simple nudge given to the patient to draw attention to a specific tissue within their body, but then their body causes the desired reaction. So let’s hear your thoughts on IASTM. Have you noted physical tissue change with consistent treatment? Do you have similar or different treatment goals when using IASTM?

More next time,

Mark D.

@MarkDomATC