How does it work?
Instruments effectively break down fascial restrictions and scar tissue. The ergonomic design of these instruments provides the clinician with the ability to locate restrictions and allows the clinician to treat the affected area with the appropriate amount of pressure.
The introduction of controlled microtrauma to affected soft tissue structure causes the stimulation of local inflammatory response. Microtrauma initiates reabsorption of inappropriate fibrosis or excessive scar tissue and facilitates a cascade of healing activities resulting in remodeling of affected soft tissue structures. Adhesions within the soft tissue which may have developed as a result of surgery, immobilization, repeated strain or other mechanisms, are broken down allowing full functional restoration to occur.
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Conditions For Which IASTM is Usually Used
- Medial Epicondylitis, Lateral Epicondylitis
- Carpal Tunnel Syndrome
- Neck Pain
- Plantar Fascitis
- Rotator Cuff Tendinitis
- Patellar Tendinitis
- Tibialis Posterior Tendinitis
- Heel Pain /Achilles Tendinitis
- DeQuervain’s Syndrome
- 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
- Trigger Finger
- Hip Pain (Replacements)
- IT Band Syndrome
- Shin Splints
- Chronic Ankle Sprains
- Acute Ankle Sprains (Advanced Technique)
- Scars (Surgical, Traumatic)
Contraindications
- Open wound (unhealed suture site)
- Unhealed fracture
- Thrombophlebitis
- Uncontrolled hypertension
- Patient intolerance/hypersensitivity
- Hematoma
- Osteomyelitis
- Myositis ossificans
- Hemophilia
Precautions
- Anti-coagulant medications
- Cancer
- Varicose veins
- Burn scars
- Acute inflammatory conditions
- Kidney dysfunction
- Inflammatory condition secondary to infection
- Rheumatoid arthritis
- Pregnancy
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IASTM Physiology & Benefits
Physiological Mechanism
Studies have explored the cellular-level benefits of Instrument Assisted Soft Tissue Mobilization (IASTM). The microtrauma induced by IASTM initiates an inflammatory response in the affected tissues, leading to increased fibroblast proliferation, collagen synthesis, and the maturation and remodeling of the disorganized collagen fiber matrix. This process helps in breaking down scar tissues, adhesions, and fascial restrictions.
Fibroblasts play a crucial role in the extracellular matrix (ECM), which is vital for the repair, regeneration, and maintenance of soft tissue. They synthesize key components of the ECM, including collagen, elastin, and proteoglycans. As mechanotransducers, fibroblasts can detect biophysical strain—such as compression, torque, shear, and fluid flow—and generate a mechanochemical response.
Research by Gehlsen et al. investigated the effects of different IASTM pressures on rat Achilles tendons, finding that fibroblast production increases proportionally with the magnitude of IASTM pressure. Davidson et al. supported these findings, using electron microscopy to show that IASTM significantly increased fibroblast production in rat Achilles tendons.
IASTM also has neurophysiological effects by stimulating mechanosensitive neurons through skin deformation. These neurons include mechanoreceptors, responsible for two-point discrimination, and mechano-nociceptors, responsible for pain perception.
A study by Weiqing Ge found that IASTM altered the neural activity of large mechanoreceptor neurons, affecting two-point discrimination. Scott W. Cheatham et al. studied the effects of IASTM on delayed onset muscle soreness (DOMS) and observed a decrease in the area of two-point discrimination, suggesting improved local tactile sense through mechanoreceptor stimulation, and a decrease in the pain pressure threshold, indicating that light IASTM modulated nociceptor activity.
IASTM also influences the vascular response in injured soft tissue by increasing blood flow. Loghmani et al. demonstrated that IASTM increased tissue perfusion and the proportion of arteriole-sized blood vessels in the treated leg of rats.
Practical Application
IASTM should be integrated with motion and strengthening programs to enhance tissue remodeling. The procedure involves six steps:
- Examination
- Warm-up: 10-15 minutes of light jogging, elliptical machine, stationary bike, or an upper body ergometer
- IASTM: Applied at a 30-60 degree angle for 40-120 seconds
- Stretching: 3 repetitions of 30 seconds each
- Strengthening: High repetitions with low load exercises
- Cryotherapy: 10-20 minutes
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