Instrument Assisted Soft Tissue Manipulation Meredith Petschauer, PhD, ATC, LAT University of North Carolina Chapel Hill

What is IASTM? Utilization of instruments to achieve similar effects as soft tissue mobilization or massage with your hands

Potential Affects of IASTM Role of Fascia Principle of Tensegrity Healing of Soft Tissue

Role of Fascia Fascia is the most prevalent type of connective tissue Superficial Fascia separates skin from muscle Deep Fascia houses blood vessels and nerves Following injury and surgery mobility decreases http://true.massage-research.com/2013/06/fascia-and-reflexology.html

Enhance mobility of the fascia Increase ROM Patient feels better

Tensegrity Changes in tension of one tissue are balanced by change in tension of another tissue. Direct or indirect connections created by the collagen fibers in tissues. Allows for a transfer of tension long distances. IASTM can relieve some of these tensions and restore balance

Soft tissue healing Healing is related to fibroblast proliferation and collagen repair More fibroblast proliferation with more pressure placed on the tissue Davis’s Law Loading the tissue so it can respond IASTM may stimulate remodeling In Graston specifically, ligaments treated were stiffer, stronger, and had improved fiber alignment

What about the real world? Easier on the practitioner Evaluation tool Potential deeper penetration More specific treatment area More time efficient than soft tissue

Indications/Contraindications Not designed to treat everything Anywhere you would use massage Tendinopathy, Myofascial Pain, Ligament Healing, Scars, Edema Reduction Contraindications Anywhere you would not use massage Open wounds, Infections, Hematomas, Thrombophlebitis, Injection Sites, Certain Medications

Typical Treatment Session Warm Up Scan Area Find Restrictions Treat Exercises

References Loghmani, M. Terry, and Stuart J. Warden. "Instrument assisted cross-fiber massage accelerates knee ligament healing." journal of orthopaedic & sports physical therapy 39.7 (2009): 506-514. Gehlsen G, Ganion L, Helfst R. "Fibroblast responses to variation in soft tissue mobilization pressure." Medicine and science in sports and exercise 31.4 (1999): 531-535. Cheatham, S, Lee, M, Cain, M, Baker, R “ The efficacy of instruments assisted soft tissue mobilization: a systematic review”. Journal of Canadian Chiropractic Association 60.3 (2016):200-211 Hammer, W “The effect of mechanical load on degenerated soft tissue”. Journal of Bodywork and Movement Therapies 12. (2008): 246-256 Kassolik, K, Jaskolska, A, Kisiel-Sajewicz, K, Marusiak, J, Kawczynski, A, Jaskolski, A. “ Tensegrity principle in massage demonstrated by electro- and machanomyography”. Journal of Bodywork and Movement Therapies. 13 (2009):164-170

Questions??