IASTM stands for Instument Aided Soft Tissue Manipulation, and may also be called ASTYM or Graston. Both ASTYM and Graston are specific types of IASTM, much like Xerox is a type of copier. IASTM is used extensively in the outpatient orthopedic setting due to the results generated with the technique. The tools do not replace the hands of a PT, but only add another option in a therapist's manual therapy tool bag.

The purpose behind IASTM is multi-factorial. The techniques are designed to produce a healing response from the body to the affected area. This is accomplished through breakdown of the capillary beds inducing nutrition to the tissues of the injured area. A secondary effect occurs at the site of scar tissue formation. Scar tissue is the body's way of healing injured tissue. However, scar tissue is not as pliable, or contractile as normal tissue. Under a microscope, scar tissue appears as a plate of cooked spaghetti, where as normal tissue appears as a box of uncooked spaghetti. With the pressure of the tools, mechanical changes at the cellular level can and do occur in order to normalize scar tissue as much as possible. The greatest effects from IASTM are experienced when the clinician is aware of the fascial connections up and down stream from the affected area, and can treat an entire limb, as opposed to spot treating. For example, when treating an elbow problem it is expected that the clinician treat up into the shoulder and down into the wrist and hand every visit. Important to note is that in order to achieve maximum results with IASTM, a comprehensive exercise program is necessary to stress the affected tissues and remodel the underlying tissues and create new movement patterns.

IASTM is indicated for many different diagnosis treated with Physical Therapy on a daily basis. Originally designed to treat tendonitis, tendonosis, and tendonopathy, IASTM also provides relief and increased functional outcomes in other instances. We have used IASTM on strains and sprains, arthritic joints, chronically painful tissues, post operative areas with proper scar and incision healing, myofascial dysfunction just to name a few. Side effects of the treatment may include mild bruising along the lines of treatment, and delayed onset muscle soreness. Often times, the patients describe a general warming feeling, or even some tingling in the treated areas for up to 24 hours.

Joe Fiore/Director – Ivy Rehab Decatur, IL