Instrument Assisted Soft Tissue Mobilization (IASTM)

By Regina Durbin, PT

Chronic musculoskeletal conditions (“-itis”), or not so chronic, but slow to heal musculoskeletal conditions are the targets for IASTM (instrument assisted soft tissue mobilization).  This treatment technique, which has a growing popularity with physical therapists, has sound medical evidence backing its use as a treatment for the source of the pain, and not the symptoms of pain. Conditions that are frequently treated with IASTM include epicondylitis (tennis and golfer’s elbow), plantar fasciitis, patellar tendinitis  (jumper’s knee) and hamstring strains.  In addition, pain that persists post operatively in total joint replacement patients can be improved and/or relieved with IASTM.

When the body is injured the immune system works quickly to close the wound. The resulting tissue is scar. The scar tissue is irregular in nature and has very poor functional strength and flexibility.  The result of the scar restricts the tissue both in and around the wound, leading to pain and alteration of function.

IASTM uses tools to create a mild inflammatory response in the tissue which brings circulation into the tissue in order to remodel the scarred area into functional tissue.  This combined with appropriate stretches and corrective strengthening, restores the injured tissue to a functional, pain freestate.

While the treatment is frequently very uncomfortable during the actual process, most patients feel some sense of improvement almost immediately. Literature says seven to ten treatments is standard care, though frequently, less can be very helpful. Mild bruising is a frequent, not unexpected consequence of the treatment, which actually means that the patient’s body is having the appropriate immune response to the treatment.

Providers use a variety of forms of IASTM (SASTM, ASTYM, Graston and Gua Sha), but all are based on the same physiological response, often leading to complete resolutions of conditions that have been an aggravation for the patient for many years. Seeing a physical therapist, who is familiar with these techniques, even if previous physical therapy had been tried, can often lead to significant resolution of the chronic conditions.

Regina Durbin, PT, has over 25 years of experience as a physical therapist. She has a strong manual therapy background, with interests in orthopedics, at all levels, but especially in shoulder, spine and feet. She has over 20 years experience with orthotic fabrication. She has been the primary physical therapist with the Louisville Ballet Company since 2005. She has extensive experience in job analysis and industrial medicine for the injured worker. For more information visit us at



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