IASTM is a popular manual therapy technique.  This soft tissue technique helps when rehabilitating injuries and increasing the mobility of muscles, fascia, and tendons.  

The technique uses stainless steel instruments in various scraping and gliding techniques. It’s a bit like massage, except the specialized tools are used in place of a therapist’s hands.

Instrument Assisted Soft Tissue Mobilization is an advanced technique that uses special stainless steel tools shaped to contours of the body.

IASTM has been around for decades. It is similar to Gua sha, a method used in Chinese medicine. Gua sha uses stone, Jade, and wooden tools to scrape the skin.

It is also an advanced progression of the cross-friction techniques popularized in physical therapy by James Cyriax.  Applying high levels of pressure across tissues is easier using the tools than therapists’ fingers.

What does IASTM stand for?

IASTM stands for Instrument Assisted Soft Tissue Mobilization.  That’s a mouthful, so the abbreviation is commonly used. But you may also know it as something else.

It can be confusing because there are manufacturers of tools who also promote their brand technique. Practitioners use terms such as Graston Technique and Rock Blades.  These specific brand names or techniques are still all considered IASTM.

What is IASTM used for?

Like other forms of soft tissue work, IASTM is used for many different goals. Some of the common conditions IASTM is used for include;

The specific techniques used for these purposes vary. In fact, there are two competing theories of how IASTM works.

How does IASTM work?

There are two basic concepts of how IASTM works.  “Breaking down” fascial restrictions and scar tissue is one.  The other is based on influencing the nervous system.

IASTM to breakdown adhesions and scar tissue

The original idea was that instruments effectively break down fascial restrictions and scar tissue.  Concentrated pressure damages and irritates structures like muscles and tendons. 

Controlled microtrauma to soft tissues stimulates a local inflammatory response. Subsequently, this creates a natural healing response. In theory, that facilitates remodeling of the tissue structures.

Fascial release is a well-established concept, but research shows that it’s unlikely there is a change to the structure of fascia (Schleip, 2016). It is too strong for the pressure to deform it.

However, research does support the concept that IASTM can improve tendon healing (Imai, 2015, Davidson, 1997). Superficial tendons like the patellar, elbow, and Achilles tendons have responded positively to IASTM treatment.

Is IASTM Painful?

If the older approach is used; YES.

A drawback of this older IASTM technique is that its painful and damages tissues.  This treatment’s core concept is based on irritating and damaging tissue structures.

Ecchymosis (bruising) and Petechiae (small red dots on the skin) can form during aggressive IASTM treatment. It was previously thought this was evidence of fibrotic tissue breaking up. However, it’s actually capillary damage to the skin.

An Updated Theory for IASTM

A more current understanding is that IASTM influences the nervous system. It does that through neurophysiological and mechanical mechanisms.  

The connective tissue and fascia have lots of nerve endings.  The fascia contains 10 times the sensory nerve receptors compared to muscle.

IASTM and skin mechanoreceptors
Skin and fascia are abundant with sensory nerves that can be influenced by tension and pressure during IASTM

Ruffini endings and interstitial receptors are two types present in the skin. They are receptive to sustained pressure.

Light and moderate scraping stimulate these nerve endings. This alters input to the central nervous system.   

Consequently, this reduces the activation of specific motor units. The sustained pressure on these receptors causes a relaxation or inhibitory effect on muscle tone.

As a result, it allows the tissue to relax and for more movement to occur.

This technique does not require the aggressive pressure or irritation of the older techniques.  It allows trained practitioners to improve muscle tension and reduce pain. All, without causing damage or pain to clients.

To sum it up, there is ample evidence that IASTM can positively influence tissues.  However, the old concepts of scars and facial adhesions being broken down are limited at best. 

The technique aligns with modern knowledge of the nervous system and with pain theories. 

Is IASTM effective?

Research supports the idea that IASTM may help create physiological and neurological changes.

So it is fair to say that there is evidence it works, and there are science-based theories as to why.

IASTM feathering
Light IASTM feathering techniques are effective for reducing pain and increasing mobility

Using IASTM for Recovery

The concept of recovery is to help the body’s physiology and neurology return to a normal state after stress.  For active individuals and athletes, balancing stress and recovery is key to sustaining healthy function.

Using IASTM with modern techniques to influence the nervous system fits in this model.  It doesn’t add to pain and irritation of tissues.

Instrument-assisted soft tissue mobilization can help people restore their range of motion and reduce pain so they can do the things they love to do.