Instrument Assisted Soft Tissue Mobilization (IASTM)

Instrument assisted soft tissue mobilization, also known as IASTM, uses a manual therapy technique performed by a skilled physical therapist that uses a hand held, specially shaped tool to address muscular and fascial restrictions.  The tool may be in the form of medical grade stainless steel, plastic, horn, or wood.  Your physical therapist might choose this tool to address restricted fascia that limits muscular mobility or to address trigger points in a more widespread region of the body. It is generally a more aggressive type of soft tissue mobilization and is chosen carefully depending on the patient.  In our practice, IASTM is a great tool for people who want to return to running, weight training, skiing, hiking, or other forms of active movement as this tool allows your therapist to address multiple musculoskeletal regions in a shorter period of time compared to manual therapy with the use of their hands.

IASTM stands for instrument assisted soft tissue mobilization, and is a type of skilled manual therapy used in physical therapy practice. We typically use IASTM in the manual therapy portion of the physical therapy session in order to address soft tissue restrictions, including muscle, fascia, and fibrotic tissue.  Fibrotic tissue is an excess build up of fibrotic connective tissue that results from injury or repetitive injury.  Fascia is a connective tissue that wraps regions of muscles to group them. Networks of fascia can become restricted as a result of scar tissue or movement limitations which can result in muscles being restricted. IASTM is a tool which helps your therapist address restrictions of the fascial network, fibrotic tissue as a result of injury, and trigger points or “knots” in the muscles. Once your therapist has used an IASTM device to release your muscles or fascia to restore optimal movement of the soft tissue, they will use active exercises to complement and strengthen that region of the body.

What Is IASTM?

IASTM works by addressing the myofascial system. The myofascial system is a term used to describe a network of connective tissue that surrounds muscles, nerves, blood vessels, and organs.  A handheld tool (most commonly stainless steel) is typically used to glide over the skin with pressure applied by the therapist to release restrictions under the skin. This results in increased blood flow and circulation to the area, inciting a local inflammatory response. There is a “microtrauma” that is caused to the skin and soft tissue which leads to a series of healing events that takes place. These healing events can include appropriate breakdown of scar tissue, and IASTM helps speed these events along through the use of tactile feedback. At a cellular level, the IASTM tool helps to reorganize collagen to initiate remodeling, reorganization, and processing of scar tissue so that the muscles and tissues can function more optimally. At Summus Rehabilitation, we use this for painful restrictions or adhesions from surgical scars, addressing fascial restrictions that cause burning or stretching sensations, and to address muscle restrictions.

How Instrument Assisted Soft Tissue Mobilization Works

Benefits of IASTM in Physical Therapy

IASTM can help speed up the muscle recovery process by increasing local circulation and inciting a controlled inflammatory response. It promotes tissue healing and speeds up the recovery process in order for your muscles to quickly learn new active exercises and skills to restore optimal movement patterns. IASTM does the following: 

  • Increases blood flow

  • Improves tissue healing timelines

  • Helps break down scar tissue

  • Decreases pain caused by fascial restrictions and trigger points

  • Improves range of motion

  • Helps muscles contract and release optimally to improve participation in active exercise

  • Reduces painful movement

  • Restores optimal movement patterns

Conditions Commonly Treated With IASTM

  • Plantar fasciitis

  • Achilles tendinopathy

  • Patellar tendinopathy (jumper’s knee)

  • Tennis elbow / golfer’s elbow (medial and lateral epicondylitis)

  • Hamstring tendinopathy

Tendon & tendon-related issues

  • Limited range of motion

  • Joint stiffness due to soft-tissue restriction

  • Postural dysfunction

  • Movement compensations affecting gait

Joint-related & movement dysfunctions

  • Muscle strains (acute or chronic)

  • Myofascial pain syndrome

  • Trigger points

  • Muscle tightness or adhesions

  • Pelvic pain

Muscle & myofascial conditions

  • Scar tissue management

  • Post-operative stiffness (e.g., knee, shoulder)

  • Soft-tissue restrictions after immobilization

Post-surgical & post-injury rehab

  • IT band syndrome

  • Shin splints (medial tibial stress syndrome)

  • Piriformis syndrome

  • Forearm overuse injuries

Overuse & repetitive stress injuries

  • Non-specific neck pain

  • Thoracic stiffness

  • low back pain (muscular/fascial, not disc herniation)

Spine-related soft tissue issues

IASTM vs Other Manual Therapy Techniques

IASTM is a form of manual physical therapy, which uses hands on treatment to address pain, calm the nervous system, and progress tissue healing.  Based on the findings of the physical assessment, we will determine which form of manual therapy treatment is best for your body in any given session. Using IASTM allows us to address soft tissue in a different manner than using a hands only technique, for example it can allow us to address deeper soft tissue restrictions and can more effectively “break up” faulty connective tissue or fibrotic tissue patterns around the muscle.  There may be instances where we use IASTM and cupping or other specific trigger point work in the same session to address the muscle and restrictions differently. After any manual therapy treatment, we will pair the treatment with complementary exercises to achieve optimal muscle function, length, and movement.

Instrument Assisted Soft Tissue Mobilization at Summus

At Summus Rehabilitation, here in Denver, CO, our priority is to use evidence based practice to provide you with clinical excellence and compassionate care. At your initial visit, we will start by discussing your goals and concerns, performing a thorough physical assessment, and creating a plan of care for you to get you back to activities you love. If your physical assessment findings include muscle tightness, fascial restrictions, or pain from scar tissue, IASTM may be a great intervention for you. IASTM uses a handheld tool to induce a localized inflammatory response. During treatment, you should expect to feel a tender or stretching sensation as the therapist performs the technique. You can expect to see some redness of the skin as the treatment progresses. After the technique, you may experience some soreness, but this sensation should dissipate in 24-48 hours. We will then pair the technique with active exercises to capitalize on the gains in tissue length and mobility.

At the initial session, your therapist will ask you questions about your medical history which helps your therapist to determine which treatment interventions are safe for you and which ones to avoid. IASTM is typically safe, however, there are some situations where this intervention may be unsafe. Here is a list of some conditions where IASTM is not the intervention of choice. 

  • Unhealed fractures

  • Open wounds

  • High blood pressure that has not been treated

  • Infections

  • Increased pain or sensitivity to prior IASTM treatments

 Is IASTM Safe? Precautions and Considerations

Here at Summus Rehabilitation, we treat the whole body and specialize in treatment of complex lumbopelvic dysfunction including pelvic pain, low back pain, SI joint dysfunction, and hip dysfunction. We are experts in movement and use skilled manual therapy to address pain and optimize movement to help you return to activities that you love without pain. Our culture and priority is to provide individualized care for you to assess your unique movement patterns and your goals. Our values include patient care, evidence based practice, and one on one time with our patients. Manual therapy at Summus Rehabilitation can look like hands-on treatment for soft tissue mobilization, fascial release, IASTM, or joint mobilizations. Whether you are seeking our guidance for pelvic health, pregnancy, postpartum, gait analysis, pain, or rehabilitation post surgery, our priority is to address your unique concerns and develop a treatment plan tailored to your needs.

Why Choose Summus Rehabilitation for IASTM?

How Cupping Fits into Your Rehabilitation Plan

Cupping therapy performed by a skilled physical therapist is a manual therapy intervention. Rather than a standalone treatment, it is used as a tool within a physical therapy session to promote blood flow, decrease tissue restrictions, and improve recovery timelines. Once these benefits are delivered and your tissues are moving optimally, your therapist will then introduce active exercise to improve functional movement patterns and create long term change. 

Cupping therapy has similar benefits to massage therapy. Both are modalities used within a physical therapy session, and both deliver increased blood flow, and improve tissue restrictions. However, massage therapy delivers more gradual results that some consider to be more relaxing for the nervous system while cupping therapy delivers a strong pulling sensation that can feel more intense. Cupping, unlike massage therapy, leaves marks on the skin due to the negative pressure it creates. You and your therapist will decide together which form of manual therapy is right for your individualized concerns and goals in physical therapy.

Cupping vs Massage and Other Techniques

Frequently Asked Questions About IASTM

Instrument assisted soft tissue massage. A handheld tool (typically stainless steel or plastic) is used to glide over the skin with pressure applied by the therapist to release restrictions in the soft tissue.

What does IASTM stand for?

Our therapists are trained to prioritize communication and perform manual therapy that passively mobilizes tissues and centers nervous system relaxation. Our goal is to find what is known as the “therapeutic range of pain”, which is pain that does not exceed what you consider to be a 3/10 at most. IASTM should feel good, and feel like a release.

Is IASTM painful?

At your initial visit, your physical therapist will listen to your concerns, your goals, and perform an examination tailored to your symptoms. Using evidence-based research, the specific findings from your assessment, and your goals, we will share a plan for you to help you understand how long your plan of care will last, and how long it may take to see results achieve your goals. Most often, results occur within one or just a few visits of seeing one the therapists at Summus Rehabilitation.

How long does it take to see results?

IASTM is performed by a skilled physical therapist. We use a skilled assessment that includes special tests to understand drivers of your pain, palpation of muscle groups and other involved structures, and functional movement testing to get a clear picture of how you move on a daily basis. From there, we will decide where on the body to perform this intervention and for what reason and we will communicate this with you for your consent, understanding, and empowerment.

Is IASTM massage or physical therapy?