Instrument Assisted Soft Tissuesues Mobilization (IASTM)

Instrument assisted soft tissues mobilization (IASTM)

• If you have an injury or illness you may benefit from physical therapy to help you move better and feel better. your physical therapists will assess your conditions and use various treatment and techniques as part of your rehabilitative programe. One of such treatment is massage and myofascial  release of tissues. There are various type of massage that physiotherapist often use and one of such type is known as instrument assisted soft tissue mobilization.
• Instrument assisted soft tissue mobilization is a new range of tools which enables clinician to efficiently locate and treat individuals diagnosed with soft tissues dysfunction.
• IASTM is a modern evolution from traditional Chinese medicine called Gua-sha but it was not used to treat musculoskeletal conditions but it was traditionally applied along meridians to move the bad-chi(negative internal energy) out through the skin.
• There are ergonomically shaped metal or plastic stools helps to mobilize muscle, fascia and tendon to reduce pain and improve movements.
• IASTM is popular due to its effectiveness and efficiency while the remaining non-invasive.

How does IASTM work?

Instrument effectively breakdown facial restrictions and scar tissues. this microtrauma is a the cause of simulation of local inflammatory response. Microtrauma initiate reabsorption of inappropriate fibrosis or excessive scar tissues and facilitate a cascade of healing activities resulting in remodeling of affected soft tissue structures. Adhesions within the soft tissues which may have developed as a result of surgery, immobilization, repeated strain or other mechanics are broken down allowing full functional restoration to occur.

Benefits of IASTM

1. Cellular level:  

•  Researchers say that instrument assisted soft tissues mobilization increase fibroblast proliferation, reduction in scar tissues, increase vascular response and remodeling of unorganised collagen fibres.
• Gehlsen al investigated the effects of IASTM pressure on rat Achilles tendon. They conclude that fibroblast production is directly proportional to the magnitude of IASTM pressure used by clinicians.
• Davidson at all supported Gehlsen at al. by concluding that IASTM significantly increase fibroblasts production in rat Achilles tendon by using electron microscope to analyse tissues. Davidson at al found morphologic changes in rough endoplasmic reticulum indicating microtrauma to damage tissues resulting in an acute fibroblast response.

2. Clinicals benefits: 

• Studies showed clinical benefits showing improvement in range of motion, strength and pain perception after IASTM treatment.
• Melham El Al. Found that IASTM significantly improve range of motion in college football player following 7 weeks of IASTM and physical therapy.
• Melham El al. found that scar  tissues surrounding the lateral malleolus was reduced and remodeled structurally following IASTM application.
• Wilson at al. found improvement in pain reduction and impairment scale at 6 to 12 weeks following IASTM application for patellar tendonitis.

3.  Benefits to the therapist:

• IASTM provides clinicians with a mechanical advantage, thus preventing over use of the hands
• Snodgrass SJ surveyed physical therapist and found that 91% of physical therapist using some short of massage had to modify their treatment techniques because of thumb pain.

Why IASTM?

1. During standard massage techniques physiotherapist uses his or her hands direct skin to skin contact to provide the treatment and during IASTM treatment, physical therapists use metal or plastic tools to provide the same tissues massage and mobilization. this tool is gently rubbed over skin and rubbing is used to locate and release tightness in the facial system.
2. IASTM is not aggressive and does not cause excessive tissue damage and  bruising.
3. IASTM can use in conjunction with your existing manual therapies.
4. IASTM is based on simple principles that any clinician can implement.

Indication:

1. Limited motion
2. Pain during motions
3. Motor control issues
4. Muscle recruitment issues.

Contraindications:

1. Compromise tissues integrity(open wound, infection, tumor)
2. Active implants (pacemakers, internal defibrillators, pump line)
3. Deep vein thrombosis
4. Cervical carotid sinus.

Evidence of efficacy of instrument assisted soft tissue mobilization:

1. Once meta-analysis compared the use of hands on myofascial release to the use of instrument myofacial release likes IASTM, for chronic low back pain. The result of the analysis found little difference in the two techniques of reducing pain the IASTM techniques did provide greater improvement in diability when compared to hand on myofacial techniques.
2. A systematic review in the journal physical therapy reviews, look at 7 studies and compare IASTM to other techniques for musculoskeletal pain and dysfunction. The author concludes that IASTM may have a positive effect on blood flow and tissue extensibility while reducing tissue viscosity and reducing the activity of pain receptor in tissues.
3. A study examine the use of IASTM, sham(fake) ultrasound and spinal manipulation. 143 patient were randomized into 3 groups: IASTM, sham ultrasound and spinal manipulation. outcome measures is includes pain level and disability. the researcher found no significant difference in pain for disability with any treatment for thoracic pain. so IASTM is no more or less effective than spinal manipulation or fake ultrasound for thoracic pain.