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

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

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

4. 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

5. Enhance mobility of the fascia
Increase ROM
Patient feels better

6. 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

7. 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

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

10. 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

11. Typical Treatment Session
Warm Up
Scan Area
Find Restrictions
Treat
Exercises

12. 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):
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):
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):
Hammer, W “The effect of mechanical load on degenerated soft tissue”. Journal of Bodywork and Movement Therapies 12. (2008):
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):

13. Questions??