Instrument Assisted Soft Tissue Mobilization

Origins – Traditional Chinese Medicine

Gua sha – “Scraping” “Spooning” “Coining”

Practitioners believe that gua sha releases unhealthy bodily matter from blood stasis within sore, tired, stiff or injured muscle areas to stimulate new oxygenated blood flow to the areas, thus promoting metabolic cell repair, regeneration, healing and recovery.

Strokes are performed along pathways or meridian lines of the body.

Graston technique

instruments to treat soft tissue injury

tool hygiene

ALWAYS clean between patients

Alcohol wipes/Disinfectant wipes or spray

Follow clinic protocol for cleaning

Never put tools back into the case unclean

Do not store tools in an excessively hot or cold environment

fasica

A sheet or band of fibrous connective tissue enveloping, separating, or binding together muscles, organs, and other soft structures of the body

IASTM creates

a localized inflammatory response

When to use IASTM?

Patient with limited mobility – from soft tissue restriction

Pain modulation

Potential Motor Control issues

Kinesthetic Feedback

When your hands hurt from all the other manual therapy you are doing…

What can you treat with IASTM?

Spastic diplegia – Cerebral Palsy (ASTYM)

Lateral Epicondylitis (ASTYM)

Achilles tendinitis

Posterior shoulder tightness

Mastectomy related scarring (ASTYM)

Total knee replacement with recalcitrant stiffness (ASTYM)

Plantar Fasciosis

contraindications

DVT

Open Wound

Infection

Skin Sensitivity

Blood thinners

Patient tolerance

Sensory deficits

CHF – with edema

Osteomyelitis

Sutures/staples in the area

Myositis Ossificans

Hematoma

Active cancer

Varicose Veins/superficial veins

varicose veins

spider veins

Myositis Ossificans

bone growth where it should not be

IASTM getting started

Palpate for aberrant tension (Hands on first)

Scan the suspected area with a tool to narrow down treatment field (EDGE tool- use sharp side to scan first)

static before dynamic

unloaded before loaded

IASTM Pearls

Long assessment on tissue quality

“Scrape” in multiple directions, Don’t always go the same way

“Restrictions” – Short quick tend to produce the best results

Neurological Tone – longer slower strokes tend to be more effective

For extremely tender/painful areas

• Slower strokes usually perform better. Less is more.

Go with what works for your patient

• If the patient responds well then keep going!

• If they do not, try something else. Maybe IASTM is not the best option for the patient.

desired response

Mild redness or irritation (Remember: create a localized inflammatory response)

undesired response

Petechia - pinpoint, round spots that appear on the skin as a result of bleeding. The bleeding causes the petechia to appear red, brown or purple.

Bruising or Purpura

If Petechia or bruising develops, stop treatment.

elbow

Stay away from bony landmarks: lateral epicondyle, olecranon, radial head, ulnar nerve

Hands on assessment first: hold tool at 30-45 degree angle and scan using sharp side (for EDGE tool)

In areas of restriction: use dull side and start gentle and progress pressure depending on patient feedback.

calf/foot/achilles

Bony landmarks:

Hands on first!

Scan, find restrictions, progress pressure and change stroke direction.

infraspinatus

Bony Landmarks:

Hands on first!

Scan, find restrictions, progress pressure.

High tone area – Slow strokes are better!