IASTM – Instrument Assisted Soft Tissue Manipulation for Fascial Related Pain & Disorders
Instrument Assisted Soft Tissue Mobilization - IASTM
IASTM is an advanced form of myofascial mobilization. IASTM is primarily used to detect and release scar tissue, adhesion and fascial restrictions. This technique enables a clinician to locate adhesion and restrictions in the soft tissue through the vibrations or undulations of the IASTM instruments. IASTM instruments have been intentionally designed using medical grade steel that is specifically designed to contour to muscle shapes and sizes, but to also respond to tissue acting as a secondary diagnostic tool for the administering practitioner. Once areas of fascial restriction have been identified, clinicians may then utilize the IASTM instruments to restore optimal musculoskeletal function.
IASTM is a therapeutic modality that addresses soft tissue fibrosis by decreasing chronic inflammation. IASTM technique was procured by instituting methods similarly used in Traditional Chinese Medicine; specifically, Gua Sha. Gua Sha uses a scraping technique on the skin to create red, bruised marks commonly seen with IASTM treatment. With Gua Sha, there is a practice of using scraping technique commonly in “yang areas” of the body, including the back, neck, shoulders, buttock, and limbs. In Traditional Chinese Medicine, it is believed that Gua Sha helps with symptoms and prevention of the common cold, flu, respiratory conditions, and acute & chronic pain syndromes. By bringing heat to specific areas of the body, Gua Sha helps with releasing the excess through to the exterior to bring toxins to the surface of the body for expulsion (2).
IASTM is a manual therapy similar in its mechanism of action to that of Gua Sha however there has been more research done to support the proposed benefits of IASTM vs. Gua Sha in the medical community. IASTM is categorized as a Myofascial Release Therapy (MFR Therapy) in western medicine. MFR Therapy is the facilitation of neural, mechanical and psychophysiological adaptive potential as interfaced with the myofascial system. The therapy is based on theories postulated by John Barnes, which propose that morphological changes occur in both connective tissue (fascia) and the neuromuscular system (2).
Fascia is a specialized system of the body that materializes almost identically to a knit sweater. Fascia is very densely woven, covering and interpenetrating every muscle, bone, nerve, artery and vein, as well as, all internal organs including the heart, lungs, brain and spinal cord. The most interesting aspect of the fascial system is that it is not just a system of separate coverings. It is one continuous structure that exists from head to toe without interruption. Trauma, inflammatory responses, and/or surgical procedures create Myofascial restrictions that can produce tensile pressures of approximately 2,000 pounds per square inch on pain sensitive structures that do not show up in many of the standard tests (x-rays, myelograms, CAT scans, electromyography, etc.) Many people suffering with pain and lack of range of motion may be experiencing fascially related problems. Many of these people go undiagnosed or are diagnosed with incorrect illnesses that cover a broad scope (e.g. fibromyalgia).
Fascia is extremely important in means of support and function for the human body. Fascia surrounds and attaches to all structures. In a normal healthy state, fascia is relaxed and wavy in its configuration having the ability to stretch and move without restriction. When one experiences physical trauma, emotional trauma, scarring, or inflammation fascia can lose its elasticity. When this happens fascia then becomes tight, restricted, and a source of tension to the rest of the body. Trauma, habitual poor posture and repetitive stress injuries has a cumulative effect on the fascial system of the human body.
The role of IASTM technique as a Myofascial Release Therapy is to break up the adhesions formed in and around the muscles to bring inflammation to the area to initiate a healing response. It is widely accepted that the inflammation brought to the area via IASTM will create a healing process that will not only heal the new micro-traumas caused by this technique; but is believed to heal the original damaged tissue that caused the adhesion to form in the first place. IASTM treatment has the best therapeutic outcome when coupled with patient self-care prescriptions that include but are limited to: tissue lengthening protocols (e.g. proprioceptive neuromuscular facilitation (PNF), static stretching, yoga) tissue strengthening protocols, and tissue stabilizing protocols (1).
When patient adherence to patient self-care prescriptions are high, positive therapeutic outcomes seem to be reasonably achieved. There also seems to be a higher percentage of patient success with therapeutic outcomes in the athletic community (3). This may be a direct correlation with a necessity to perform physically in a competitive environment. In reviewing the referenced studies, even single applications of the IASTM treatment method can reduce muscular pain and increase joint range of motion (ROM). The results of these studies demonstrate that IASTM can be an effective method for improving fascial related disorders.
References
1. McMurray, Janet. (2015). A Comparison and Review of Indirect Myofascial Release Therapy, Instrument Assisted Soft Tissue Mobilization, And Active Release Techniques to Inform Clinical Decision Making, International Journal of Athletic Therapy and Training, 2015; Volume: 20 Issue: 5 Pages: 29-34
2. Baker, Russell. (2013). Instrument-Assisted Soft Tissue Mobilization Treatment for Tissue Extensibility Dysfunction, International Journal of Athletic Therapy and Training, 2013; Volume: 18 Issue: 5 Pages: 16-21
3. Laudner, Kevin. (2014). Acute Effects of IASTM for Improving Posterior Shoulder Range of Motion in Collegiate Baseball, International Journal of Sports Physical Therapy, 2014; Volume: 9 Issue: 1 Pages: 1-7
