IASTM | What is it?

Achilles Tendinopathy

There's a new buzzword going around the manual therapist's newsfeed around the world now. IASTM, also know as Instrument Assisted Soft Tissue Manipulation/ Mobilzation. This additional modality is picking speed like wild fire across the globe for its efficacy and the plethora of clinical cases that practitioners can apply it into. Iastm is a very safe, non invasive, portable and the duration of soft tissue works last no more than 90secs on areas that needs to be treated. Let’s dwelve deeper into why practitioners everywhere are picking this up!

What is this therapy tool? 
The IASTM tools that are used widely by practitioners nowadays are mostly made up of Surgical Steel. The therapist will then use this tool to glide across the skin to feel for any peculiar feel of the soft tissues, this leads the therapist to proceed and see what might be the underlying soft tissue that may have a big impact on the current patient. This particular gliding on the skin using the tools helps to feel far deeper and more constant by giving the therapist feedback from vibrations that is given back via resonation of the tools upon gliding across the tissues. One can as well use the tool for both Diagnosis and Prognosis purposes, which again is a very quick and simple indicative of looking at how fast the body is flushing waste product out of the affected area. Through Myofascial Induction, the practitioner uses a specific technique to induce change in the connective tissue. The best part is, only two people can feel if there is any restrictions or soft tissue build up, the therapist and the patient. ​

Who can use this tools?
It's mostly preferred by providers that offer treatments to musculoskeletal dysfunctions as IASTM is usually complimented or accompanied with other types therapy which may include corrective exercises, joint mobilizations or just about whatever your current practice background is. Though anyone with a keen interest can still pick it up to learn self management. 
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Why so many different tool?
Most IASTM tools are made with a vast difference of shapes and sizes due to ergonomics for the practitioner's handling, contours to fit different parts of the body, angles to help exert more force for deeper soft tissue work  and of course the patients comfort. There isn't a one tool fits all unfortunately as there will be parts of another tool which will help you work more efficiently around certain body part area.

Why should I use the tools, not my hands?
If you already are doing manual therapy then you would know that sometimes you can't go deep enough, tired hands, fatigued fingers and can spend quite a bit of time with patients applying techniques that applies the same concept with IASTM just a lot more shorter with time. Using the tools will help in terms of providing the therapist better leverage to apply deeper force, save hands from fatigue and get better feedback from the soft tissue. While IASTM is NOT supposed to replace your hands, it helps practitioners feel more and get deeper feedback from resonation via the tools, allowing your hands to do what they do best. The resonation from the tools are somewhat how bats uses echolocation to locate food/ navigate their way around, we use the the tool to navigate and feel for soft tissue irregularities etc.
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How to start
You can start with a very simple technique called scanning. Here you will be able to feel some tissue irregularities both superficial and deep tissues. This is done at the very beginning of most IASTM induced work thereafter you apply specific trchinqies based in your desired outcome or goals.

Here's how you can use this technique and start your journey:

1. Simply apply a small amount of emmollient onto the area of interest(you can use baby oil or just about anything you have as cream but not too much), the traps would be great as a great number of us would have tight, tender points or trigger points due to the nature of the musculature and our daily habits of not strecthing and getting soft tissue work on them. They work constantly throughout the day!
2. Apply  light pressure and stroke from the distal part to proximal a few time making sure to count the strokes being about three to four before moving into lower part of the traps.
3. Now you want to do the same application of pressure but the opposite direction, distal to proximal.
4. Make sure you feel if there are any differences between going upwards or going downwards. Here are as well some of the things that you can take note of when doing  IASTM.

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• Is there more "sandy feeling" when you come closer to the supraspinatus tendon? If there is, then most probably you want to work towards that area. 
• Is there more soft tissue build up when you are closing in to the suboccipital? If there is, then that is the area of interest for treatment.
• Does the muscle fibres feel constant when you are following it? If it is constant, then you have great traps(which I highly doubt given my experience).
• Is there any bumps along the fibres? If so, then that has tightened up and soft tissue build up has taken place. That will be the area of interest.
• Is there general redness around it? Then most probably, you want to stop before it starts bruising.
• Is it a blotchy kind of redness? If it is, then you are applying the strokes in an uneven manner(most common mistake)
• How long does it take for them to recover from that redness(5,10,30min, 48hours etc)?. The faster the better!

So there you are, you just did your first feel of IASTM work effectively! Well done, you can apply the scanning technique in most areas where there are no open wounds, DVT and diabetics.
While there are many questions from hereon, we exlore in much greater details and learn what are the exact mechanisms during our IASTM Clinic. 

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Contraindications
While there aren't many contraindications with IASTM, you still have some limitations with it. People with diabetes and renal failure patients are mostly cautioned with IASTM as they bruise easily. 

• Flaky skin
• Acute wounds
• Renal failure patients 
• myofibralgia 
• Subscapularis 
• Psoas 

What can IASTM typically help with?
IASTM has been used in clinical settings which includes but not limited to:

• Kinetic chain dysfunctions 
• Carpal tunnel 
• TMJ 
• ACL injuries
• Tendonopathy 
• Frozen shoulders
• Performance 
• Plantar fascia
• Myofascial Restriction
• Decreased ROM
• PFPS 
• Post Operative Scars
• ITB Pain
• Muscle Facilitation
• Muscle Cramps
• Carpal Tunnel 
• Tennis Elbow
• Golfers Elbow

General Consensus 
Iastm is leveraged upon the ancient Chinese method of "scraping" or collectively referred to as Gua Sha and the idea of causing micro trauma to soft tissues(e.g criss friction)to allow the body's self healing mechanism to kick in and help with treating the dysfunctions. Studies have shown to have an increased fibroblast production and from a neurological standpoint practitioners can help with reducing nociceptive pain via an analgesic level, treat scar tissue in both post surgery and traumatic events, and increasing ROM with specific treatment strokes. While a full spectrum of research is still needed on various IASTM applications, we can be sure that this tool will be here to stay and still evolve both theoretical and technical. 


Price
Prices starts anywhere from a mere ten dollars(USD) and it can fetch a whopping four thousand dollars for the tools! While you don’t have to go out and put a hole in your pocket, you can start with something much cheaper and economical, such as the Gua Sha. They are normally made from Buffalo Horns and come in a plethora of shapes and sizes. They go as cheap as 10 dollars((USD). At Integrated Training Institute, their surgical steel tools start from SGD100(fishtail) with free delivery around the world.

Author

Jab is the main facilitator for IASTM CLINIC. He shares and discusses more during the workshop through a unique process of thought.