What We’re Doing in Physical Therapy: Instrument-Assisted Soft Tissue Mobilization (IASTM)

Soft-tissue injuries sometimes happen gradually, such as overuse issues in athletes or people who do repetitive physical work. Other times soft-tissue injuries can occur from a single event such as falling, colliding or twisting in the wrong direction.  In general, soft tissue degeneration happens when those tissues experience progressive or sudden trauma and aren’t allowed to properly heal.

Whether it’s overuse, tendonitis, bursitis, a sprain or strain or a myofascial problem, these types of injuries to muscles, tendons and ligaments are extremely common and can really limit your function. The body responds immediately to soft-tissue trauma by dispersing white blood cells to the wounded area to stimulate the healing process with new collagen. Scar tissue can build up deep inside the body along those muscles, ligaments, joints and tendons as the body works to heal itself, often resulting in painful and restrictive movement.

That’s where Instrument-Assisted Soft Tissue Mobilization, or IASTM, comes in. 

As physical therapists we use our hands during manual treatment to help break up some of that scar tissue in the injured areas and as a way to feel restrictions, adhesions and nodules. Breaking down that scar tissue helps to increase blood flow and restore a normal state to the tissues. IASTM is a form of manual therapy in which we use small instruments as extensions of our hands. These simple tools can act as a stethoscope, amplifying the soft tissue restrictions so we can feel more and get a better understanding of the problem.

Here are some important things to know about IASTM:

• Scar tissue is less supple than normal tissue and can cause restricted motion and pain. IASTM helps to break down that abnormal scar tissue and get the body back to healing normally.
• IASTM restarts the healing process for the injured tissues by bringing blood flow and fibroblasts to the area.
• Instruments help the physical therapist feel soft tissue restrictions in the problem area that may be more subtle when using their hands.
• The tools we use in IASTM help save our hands by not compressing our joints.
• Some of the more common IASTM treatments include Astym®, which helps regenerate soft healthy tissue, or Graston® technique, which scrapes the skin with an instrument to locate and smooth out adhesions and fibrotic tissue – but there are many other types of IASTM as well.

So how do you know if IASTM is right for you? When you come for your appointment, we examine the musculoskeletal system as a whole, checking strength, range of motion, how the joints move and we palpate for soft tissue restrictions. Then we decide if the instruments will facilitate our treatment and improve your outcome. Like any other treatment, IASTM is another tool in our box. It helps get tissue in a better state, but we have to continue stretching, strengthening and providing neuromuscular reeducation in order to restore the normal state of tissue and help you return to your higher level of function.

Demian Gutierrez, PT, sees patients at OrthoCarolina Matthews and is the head physical therapist at Hendrick Motorsports, where he spends several days a week triaging and treating over 40 pit crew members. He uses IASTM frequently as a treatment method both in the clinic and with his motorsports (NASCAR) athletes and is a 14-year employee of OrthoCarolina.

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