Instrument-assisted soft tissue mobilization, or IASTM for short, is a technique that has been becoming more mainstream recently, especially with the Olympics shedding a spotlight on other specialized manual techniques such as “cupping”. The terms IASTM, Graston, and Hawk Grips are synonymous, as Graston and Hawk Grips are simply particular brands of IASTM tools. IASTM encompasses using any specialized instrument(s) that can help a clinician to identify and treat soft tissue restrictions manually. These instruments come in various shapes and sizes, and are typically constructed with rubber, plastic, stone, or surgical grade stainless steel. These instruments are used by various healthcare providers, such as physical therapists, who utilize manual therapy as one of their treatment techniques, to help mobilize tissue and optimize movement patterns. All of these tools serve the same purpose in assisting the clinician in locating and treating areas of soft tissue restriction and dysfunction. These tools assist in addressing “tight” areas that have limited motion, poor scar mobility, or tissues that are painful with movement. Any licensed physical therapist who has completed some specialized training in IASTM is qualified to utilize IASTM as part of their physical therapy treatment sessions.
As part of the normal healing process, new tissue is formed following an injury, however this tissue can be laid down in a disorganized fashion and form adhesions. These adhesions can prevent the muscles or other tissues from moving properly, which can limit function and cause pain. IASTM is very effective in assisting the clinician to both identify and then break up these adhesions, so tissue can then be remodeled appropriately through specific stretches and strengthening exercises. These exercises following this form of manual therapy allow for the tissue to become re-organized in a direction that promotes better movement patterns and therefore helps the person to be able to move in a more pain-free manner. Some examples of soft tissue pathologies that respond quite well to IASTM treatment include various forms of tendonitis, tendonosis, and post-surgical scarring, although IASTM works well with almost any soft tissue restriction.
A typical treatment session involving IASTM begins with a gentle warm-up of the involved tissues, which can range from various dynamic stretches to activity-specific aerobic exercise to applying heat to the area to be treated. IASTM treatment is then performed by the physical therapist, adjusting the pressure and the angle of the instruments based on patient comfort and respective restrictions. Following IASTM, specific stretching and strengthening exercises prescribed by the physical therapist are performed in order to facilitate proper tissue reorganization in the injured region and promote improved joint biomechanics.
A huge misconception regarding IASTM is that these tools and techniques are “painful” and must cause bruising in order to be effective. In fact, these treatments should NOT cause pain (most patients love IASTM!), and bruising should never be the goal of an IASTM treatment. Temporary redness to the skin can be expected and is desired, as this indicates increased blood flow (faster healing!) to the area. Patients should let their therapist know of any pain during the treatment so the clinician can adjust the pressure, the angle, or the tool to maximize patient comfort.
IASTM is a very effective adjunct physical therapy treatment, although it is not a “magic wand” or cure-all for all pain and injuries, and does not take the place of therapeutic exercise to improve your biomechanical set-up (your mobility and strength). It also does not take the place of neuromuscular re-education and movement retraining, another mainstay of your physical therapy plan of care; however, it is a means to give you a foundation to achieve these new movement patterns and can assist in speeding up your recovery. As soon as appropriate, your therapist will progress away from using IASTM to address soft tissue dysfunction and focus on transitioning you towards a more functional strengthening and stretching program, with the ultimate goal being discharge from therapy and independence in maintaining the new healthy you.
IASTM is not appropriate for everyone, as everyone does not present with a soft tissue restriction, and therefore would not have a need for the use of IASTM in their treatment program. IASTM is also not appropriate over areas with open or healing wounds, infections, or unhealed fractures. Caution should be exercised when considering IASTM for persons with conditions such as rheumatoid arthritis or fibromyalgia. Your therapist will ask you questions, but be ready to share your full medical history with your therapist prior to beginning any of these techniques.
Here at DPT Sport we use Hawk Grips as our IASTM instruments of choice. All of our physical therapists have been specially trained in their use with patients, and would be happy to answer any questions you may have whether IASTM is right for you. If you would like information from our clinic regarding our use of IASTM as part of our customized physical therapy treatment plans, or if you need to be evaluated for an injury or are in pain, please call us at (630) 230-9565 or email us at firstname.lastname@example.org. DPT Sport is the premier physical therapy and wellness clinic in the Burr Ridge/Hinsdale area, offering one-on-one evidence-based physical therapy and post-surgical rehabilitation as well as a multitude of customized wellness and injury prevention programs.