What is IASTM?

Instrument-Assisted Soft Tissue Mobilization is a form of Manual Therapy (check out our blog on MT – here) is defined in a systematic review published on PubMed as “a popular treatment for myofascial restriction. IASTM uses specifically designed instruments to provide a mobilizing effect to scar tissue and myofascial adhesions.

IASTM stems from the theory of Friction Massage first introduced in the early 1900s by James Cyriax – known as the Father of Orthopedic Medicine. The efficacy of the friction massage treatment is proven to mitigate the adverse effects of the lack of movement during the healing process. Lack of movement during connective tissue repair can lead to unhealthy scar formation, increased pain when it is again moved and thus, scar stretching. This tissue repair process is when the scar is healing and forming which involves specialized cells, called fibroblasts, to produce a fibrous connective tissue made up of collagen.

Lack of or no movement during the healing process can throw off the connection and balance of the collagen-rich tissue and can increase the number and thickness of collagen fibers. Other negative effects are an increase in the intermolecular cross-links and a decrease in the water content of the extracellular matrix. All of which lead to increased scar formation. 1

What is the Graston Technique?

There are a number of manufacturers of IASTM tools – The Graston Technique is arguably the most commonly-known. Certification is required to administer this technique. Graston differs from other IASTM techniques because of their sequential treatment protocol. The seven-part protocol includes: exam, warm-up, treatment (30-60 seconds/treatment), post-treatment stretching and strengthening, ice.
The Graston instruments are either concave or convex in shape. The practitioner uses the concave shape to apply pressure over a large area, promoting comfort during treatment. The convex shape is used to apply pressure over a small area which causes greater discomfort, but allows the practitioner to focus on a defined specific area of tissue.

What are the benefits?

The benefits of using IASTM as part of a plan of care are:

  • Release of fascial restrictions 2
  • Breakdown of collagen cross-linkages 2
  • Increased blood flow 2
  • Increase in regenerative cellular activity 2
  • Improved range of motion 3
  • Reduction in tissue viscosity 4
  • Interruption of pain receptors 4
  • Improved flexibility of underlying tissue 4

what to expect

“Although discomfort and bruising may be experienced, patients who have realized a decrease in symptoms have returned repeatedly for additional IASTM sessions.” 5

Discomfort and bruising can become apparent during or after the treatment. Bruising results from localized trauma, which may be associated with the separation of adhesions from healthy tissue.

Your Treatment at Apple

Instrument-Assisted Soft Tissue Mobilization is a part of the majority of treatment plans for our therapists. We also have a number of therapists certified in The Graston Technique. You can find a location that’s right for you at our Locations page.


1. Chamberlain D. (1982). Cyriax’s Friction Massage: A Review. https://www.jospt.org/doi/abs/10.2519/jospt.1982.4.1.16

2. Stow, R. (2011). Instrument-Assisted Soft Tissue Mobilization, International Journal of Athletic Therapy and Training, 16(3), 5-8.  https://journals.humankinetics.com/view/journals/ijatt/16/3/article-p5.xml

3. Ikeda, N., Otsuka, S., Kawanishi, Y., & Kawakami, Y. (2019). Effects of Instrument-assisted Soft Tissue Mobilization on Musculoskeletal Properties. Medicine and science in sports and exercise, 51(10), 2166–2172. https://doi.org/10.1249/MSS.0000000000002035

4. Lambert, M., Hitchcock, R., Lavallee, K., Hayford, E., Morazzini, R., Wallace, A., Conroy, D., & Cleland, J. (2017). The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review, Physical Therapy Reviews, 22:1-2, 76-85. https://doi.org/10.1080/10833196.2017.1304184