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.
“IASTM is a Soft Tissue Mobilisation technique that enables the therapist to detect and treat myofascial restrictions to improve ROM and decrease pain”
The mechanisms for how IASTM works are largely being attributed to one thing. That the treatment causes some therapeutic movement to local lesions, encouraging an inflammatory process to initiate, pro-inflammatory substances brought in to the area, which will remove damaged cells and replace these with normal cells thereby improving healing.
As the technique has evolved and we learn more and more about the possible mechanisms of this approach. It becomes quite apparent that in clinical practice, the response from the technique occurs with in a small timeframe of 2-5 minutes depending on the size of the area. One mechanism that has the potential to cause alteration in tissue tension within such a timeframe, is the nervous system. The focus on purely a mechanical effect on breaking down soft tissue dysfunctions has encouraged a far too aggressive approach and causing unnecessary tissue trauma.
With a focus on stimulating the neurophysiological mechanisms less force is needed, without the trauma to the tissues. This doesn’t exclude the mechanical effects as these are important as well.