Recently, instrument-assisted soft-tissue mobilization (IASTM) has been on the rise among health care practitioners. In fact, the Graston Technique, one of the most recognized of IASTM modalities, is used by more than 16,000 clinicians worldwide including me.
I often tell my patients “I have a lot of tools in my tools belt to help get the body working right again.” I could tell from early in my schooling that having treatment options would set me apart from my peers. So I took it on myself to study IASTM when I was still going through my schooling to become a chiropractor. It was relatively new back then but I should say that having a way to address problems of the fascia as well as the joints set me apart from my fellow student physicians. Finishing the Graston Technique course while still a student gave me the confidence to use IASTM in the student clinic. The results that I got with the patients I was seeing in the student clinic made me the “go to” guy among my peers to fix stubborn problems, and that persists even today. I still receive referrals from my peers because I saw the value of IASTM and learned the Graston Technique.
Even though chiropractors and physical therapists have always used their hands to increase blood flow and break up fibrotic or scar tissue present in an injury, it can be difficult with only the hands and fingers to detect restrictions in deeper tissue levels. Or, for that matter, treat the full range of these restrictions. Because of this, several companies have now developed handheld tools to perform instrument-assisted soft-tissue mobilization.
What is the Graston Technique and how does it work?
Graston is the leading technique when it comes to IASTM. Over time and testing, a set of six stainless steel instruments of various shapes and sizes have been developed to address lesions and injuries of the soft tissue. Though many different materials have been used to make the instruments—wood, ceramics, plastics, stone— stainless steel appears to be the best.
“Stainless steel instruments have the highest resonation and make it easier to feel both local and broad areas of tissue restriction…” says noted area expert Dr. Warren Hammer.
IASTM has two main objectives:
- Loosen and break free dysfunctional densities in tissue, such as scar tissue or fibrosis
- Start the first-stage healing in the body over again to get it right this time
During a soft tissue injury the body sends blood, specifically the healing substances found in white blood cells, to the area of the lesion and lays down new collagen to begin repairing the injury this is quite simply “scar tissue.”
IASTM is similar to a very mild new injury in the area of the lesion with the purpose of starting this process over again and helps the body to heal itself, to functionally get it right this time.” Scar tissue is the bodies “tire patch” at the site of an injury. The “patch” does its job in helping the area to heal, however, it is much less flexible than normal tissue. In the long run, scar tissue often causes restriction of motion or muscle tension, which leads to pain. It is then that it’s necessary for a clinician or health care provider to restart the curative process.
Is the treatment painful?
It’s should be noted that what gives Graston or any IASTM tools the ability to reinitiate first-stage healing is that it is essentially reinjuring the body, but to a much lesser degree and in a specific way. So while it may cause some discomfort during the procedure and some bruising afterward, there is great therapeutic benefit to the procedure. While adhesions or fibrotic tissue is often called “scar tissue” it is more accurately described as dysfunctional tissue. This dysfunctional tissue can restrict normal movement in the body which then leads to a myriad of problems. Some recent findings indicate increased temperature and friction normalize the hyaluronic acid, allowing freedom of the gliding between the fascial layers to return.
What does the Graston Technique help with?
The lesions and injuries that best respond best to treatment or any IASTM include acute and chronic spinal and extremity problems such as:
- Medial Epicondylitis, Lateral Epicondylitis (Tennis Elbow. Golfers Elbow)
- 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)
It should be noted that patients who get the best results from IASTM are those who are more physically active. Correct targeted stretching and exercise of the involved tissues is a crucial component to respond well to this particular type of treatment.