IASTM

Instrument assisted soft

tissue mobilization
(Level - 1)
 Content

Introduction of Soft tissue Injury

Introduction of Soft tissue Mobilization

Introduction of IASTM

Physiological Effect of IASTM

Indication and Contraindication of IASTM

Different techniques of IASTM

Application of IASTM
 Introduction of soft tissue

What is soft tissue?

What is soft tissue

injury?

Healing of soft tissue

injury.
 Introduction of soft tissue
It involves

1. Tendons

2. Ligaments

3. Fascia

4. Muscles

5. Nerve & Blood Vessels

 What is Soft Tissue Injury?

Its is trauma to the muscles, ligaments, tendons & skin in

the body.

Mechanism of Injury:

1. Acute Trauma because of external force

2. Over use injury during the activity ( Common in Sports

activity )
 Stages of Soft tissue Healing

1. Inflammatory Response (Up to 72 hrs)

2. R e p a i r & R e g e n e r a t i o n ( 4 8 h r s t o 6
weeks)

3. Remodeling Stage (3 weeks to 12 weeks)

 Inflammatory Phase
Unto 72 hours
Inflammatory response : 5 signs of Inflammation
Accumulation of Oedema to tissue repair
Blood clot & seal the area
Myofilament reaction & Peripheral Muscles fibers contraction
in first 2 hours
Accumulation of oedema and low O2 results in cell death in
first 24 hours
It will lead to further accumulation of oedema
 Regenration and Repair
48hours to 6 weeks

Structure rebuilt and regenerate

Fibroblast start synthesize scar tissue

Type III collagen production (its is immature in its fibers

organization)

Collagen cross linkages begins

Starting of wound contracture and shortening of the

margins of the injuries area.
 Remodeling Phase

3 weeks to 12 months

cross linking and shortening of the collagen fibers

lead to formation of tight and strong scar.

Its also look like remodeling of collagen

So it will increase functional capabilities of

muscles, tendon and other tissues.
 Important Note

Regeneration of the injured muscles does not

fully restore muscle tissue to its prior levels

As “Fibrous Scar Tissue Slows muscle

healing “
 “Scar Tissue”
“Adhesion”
“Fibrosis”
Above words are different but concept is same

Its is dense fibrous tissue

 Reality of Scar Tissue

When a muscle is torn we will think its will body

will repair that tear with new muscles

In Reality….. its not happen

The tear or rupture repaired with scar tissue

Untreated scar cause of re-injury

Introduction of Scar Tissue

Its made from a very tough, inflexible fibrous

material.

This fibrous material binds itself to the damaged

soft tissue fibers in efforts to draw the damaged
fibers back together

Which results in bulky mass of fibrous scar tissue

completely surrounding the injury site.
Feature of Scar Tissue

Its is never strong

So it will lead formation weak spot which could

be easily get further damage

Its also tendency to contract and deform the

surrounding tissues.

So it will create shortening of soft tissue which

results in loss of flexibility
 How muscle perform in full
power

When muscle can go in fully stretched position

then only go for maximum contraction

“So shortening effect and weakening of soft

tissue means that a full stretch and optimum
contraction is not possible because of scar tissue”
How the adherent scar affects
the other tissue

Scar tissue need to move freely

If can not move freely then shorter and weaker

muscle will give load on tendon and convert in
tendinitis

Never become trapped

This all problems cause reduced in range of motion,

loss of strength and pain as well as tingling,
numbness
Comment effects of scar tissue

1. Decrease in Muscle length

Scar tissue does not have the same flexibility and
elasticity as health muscle

So doesn’t lengthen like normal muscle

Its will limit ROM and alters joint motion

Delayed Lengthening speed

A muscle with scar tissue sometime get full

length but time needed for to achieve.

Since group of muscles need to work on same

time together for precise contraction

When some scare tissue in one group it will not

allow speedy contraction as compare to other
normal muscle soft tissue so again chance of tear
 Decrease strength

Scar tissue acts like glue binding up muscles

Bound muscles have less functional muscle

available to work

Scar tissue didn’t allow for fully stretch so muscle

can not perform maximum contraction

It will lead decrease in strength

 Pain

Nociceptors ( Free Nerve Ending ) is found in

scar tissue

So scar it self become painful

Pain also felt in involve tendon because of

attachment
 Nerve Entrapment

Nerve are supposed to slide through and around

muscle….. not stick to them

If the nerve happens to lie next to scar tissue it

become trapped

So when you move it will crate tension in nerve

Nerve symptoms like weakness, numbness, tingling,

burning, aching kind of sensation will come.
Unfortunately the body doesn’t have a natural
mechanism to remove scar tissue

So need to remove with Soft tissue release

techniques
 Introduction of
IASTM

History

What is IASTM?

Features of IASTM
Tools

Different Tools of
IASTM
 History of IASTM
Instrument Assisted Soft Tissue Mobilization (IASTM)
is a relatively new form of treatment, however
similar treatments have been used for centuries with
origins as far back as Hippocrates, the most well-
known is Gua Sha which originated in China
centuries ago.

Gua : “To Scrape or Scratch”

Sha: “Loosely Translated”

 Gua Sha
Traditional Chinese Medicine Tool
 What is IASTM ?

“IASTM is a Soft Tissue Mobilisation

technique that enables the therapist to

detect and treat myofascial restrictions to

improve ROM and decrease pain”

 Features of IASTM
TOOLS

Material

Edges

Surface ( Concave & Convex )

Point Surface ( Knob Surface)

 Material

Stainless Steel

Medical Grade

Advantage of SS tools:

Cleaning, Durability, Gliding, Result &

Response
 Edges

Bevelled Edge: Single & Double

Full Bullnose

Edges need for Smooth Application

of techniques
 Surface
Convex & Concave

Convex Surface: To
Simulate more Specific
area.

Concave Surface: To
Scanning and To Cover
Wide area.
 Point Surface

Use: Small area, Trigger point, Pointed Pain

 Different Tools of
IASTM
Scanner

Dolphin

Handle Bar

Fibroblaster

Jack ( M2 Blade )
Scanner/ Boomerang
Double Bevelled Edges - Scanning - cross fiber friction
 Multicurve Tool
Balance Curve - comfortable - shoulder - knees - arms - small muscles
 Twin glider
Comfortable for Tendinitis - scanning - strokes
 Myo Bar
Over size - larges muscles - lower limb - Traps
 Myo Blaster
Patient comfort - Therapist Feedback - Surface can be altered by angle
Physiological Effects of
IASTM

Cellular level effets

Soft Tissue Repair

Neurophysiological effects

Biomechanical Effects
Cellular level effects

Increased fibroblast proliferation

Reduction in scare tissue

Increased vascularity
 Soft tissue repair

Controlled microtrauma

Trigger inflammatory response

Reabsorption of scar tissue

 Neurophysiological
effect

Stimulation of mechanoreceptors

Changes in soft tissue tone

Biomechanical Effects

Stimulate healing

Strengthen new collagen

Break down scar tissue

Remove blood and waste

 Indication

Limited Joint Mobility ( fibrosis, Chronic

Inflammation, Degeneration)

Pain during Activity

Muscle Activation

Muscles Spasm
 Contraindication

Infection

Open wound

Cancer

Non united fracture

Vascular conditions

Muscle Pathology
Different Techniques of
IASTM

Scanning Scooping

Rotational
Sweeping
Move
Fanning Nudging
Strumming Framing
 Scanning

Its also called as Diagnostic Scanning.

Light pressure and applied in slow manner in long

strokes.

Need to scan in all direction.

First use Concave Surface then Convex Surface

Obstruction or vibration will during free movement of

scanning.
 Sweeping

Its short longitudinal strokes in parallel to

muscles fibers

Use any instruments to do sweeping

Use : Fascial Restriction, Adhesion

 Fanning

Spin around

One end need to be stabilize

Stabilize end works as fulcrum

Another moving in circular manner

Use : Swelling and Mobilise myofascial

Structures
 Strumming
Movement like guitar strings

Use flat concave edge

Give oscillation with edge

Use: mobilise tendon

 J - stroking

J strokes

Use convex surface

Making up J shape stroke

Facial Expression of Patient

Use: Muscle Tightness, Chronic Adhesion

 Scooping

Take scoop on upward direction

Use : scar & Chronic adhesion

 Rotational Move

Place instrument of Pain Point ( Trigger Point )

Rotate Clockwise & anti-clockwise direction

Use: Trigger Point, Local Pain, Scar Mobilization

 Nudging

Push

Push the scar or tendon

Use: Scar Mobilisation

 Application of IASTM

Evaluation
Recovery Time

Methods of Griping Common Factors for

Instruments IASTM
Selection of Emollient
Adverse effects of
Warm Up IASTM
Treatment Duration
Treatment Aspects
 Evaluation

Concave & Convex surface

All Direction

3 to 4 inch per 1 second

Check for Obstruction or Vibration

Methods of Gripping
of IASTM

Pencil grip

Single Hand Hold

Double Hand Hold

Selection of Emollient

Emollient is necessary to keep

moisturizing and avoid friction

Smooth and effective application

Mineral oil + wax , Coconut Oil

liquid Paraffin USP

 Warm up

After evaluation treatment part should be

warmed

To warms up the treatment : Exercise,

Ultrasound, Heat Therapy methods

Best of exercise with mild to moderate

intensity and mild pain
Treatment duration

15 mints for warm up

10 to 15 minutes for treatment

2 to 4 session per week

Each stroke applies approximately 40 to

50 times.
 Recovery time

Positive Changes will seen in 4 to 6

sessions

Sometime depends on conditions and

associated conditions
Common factors for
IASTM
Evaluation

Period of Treatment

Rate of force application

Direction of force

Patient Position
 Adverse effects

Over gripping

Over emollient

Non Specific treatment choice

Bruising

Pain & Discomfort

Treatment Aspects

Regional Treatment

Joint Treatment

Nerve Conditions

Tendinitis

Scar
Regional Treatment

Cervical Region

Thoracic Region

Lumbar Region

Arm Region

Forearm and Arm Region

 Joint Treatment

Shoulder Joint

Elbow Joint

Wrist Joint

Knee Joint

Ankle Joint
 Nerve Conditions

Carpal Tunnel Syndrome

Cubbital Tunnel Syndrome

Piriformis Syndrome

Sciatica

Sural Nerve & Tibial Nerve

Thank you