Tuesday, March 7, 2017

Self Instrument Assisted Soft Tissue Mobilization (IASTM)

By: Joel Luedke

We post every Monday some great mobility exercises (usually compliments of Kelly Starrett) where you use a foam roller, med ball, lacrosse ball, band or some other apparatus to help increase the pliability of your tissues and increase range of motion (ROM) at your joints.  These tools are great but sometimes you need to get after the tissues a little more.  If you've gone to an athletic trainer, chiropractor, physical therapist, or massage therapist they may have used some sort of instrument to help mobilize the tissue.  That is what we are going to talk about and how you can utilize it yourself to get your tissues moving.

First, a little background.  The general origin story (at least the one I know) started back in eastern medicine with the type of treatment call gua sha or 'sand scarping'.  The initial instrument they used to treat the soft tissue was a traditional soup ladle. Practitioners would use the bigger bowl end of the ladle to hit the bigger areas of tissue restriction and then work down to the smaller handle in order to hit more specific areas and also to work the smaller areas of the body.  Since then things have evolved.

While that is a great story it doesn't explain what instrument assisted soft tissue mobilization (IASTM) actually does for you.  The goal of the treatment is two-fold (probably more but we will cover the main ones here).  The first is the mechanical changes you are looking to create by utilizing a tool across the skin and soft tissue.  Here you are trying to physically break up restrictions and adhesions that can form by general healing from working out and also when recovering from injury.  This is the 'grittiness' you will feel with the scan and broad strokes below. Also what you are trying to accomplish is from the physiological side.  That comes from creating micro-trauma.  The goal of this is to create enough injury that it helps force the healing of the area but not create to much injury that it can't heal.  This is a fine line of the treatment.

After the history lesson and general background lets talk about how you can utilize this technique to take care of your own soft tissues.

Step 1: Scanning
These strokes are the lightest that you will use.  You're using this to figure out what areas you might want to focus on throughout the soft tissue/tendon areas.  This should be light and not be over a 1-2/10 on the pain scale.  This is highly effective to target your treatment and also might just feel good if you're a little sore and tight.

Step 2: Broad Strokes
This is where we are trying to get the bigger areas of adhesions and restrictions that occur in the muscles belly.  Not often will we use these for smaller areas and tendons.  There are differing opinions on which direction you should focus these strokes.  Either working towards the heart and back to the main part of your body or work away from the main part of the body.  These broad stokes can be utilized with potential swelling in the area and should for the most part be worked back to the body.

Step 3: Specific Strokes
These are specialized strokes to help work through more specific areas of restriction and adhesion. Use these after your broad strokes so you know where to focus your more detailed work.  These strokes can be as simple as quick strokes over the areas of restriction to reduce the tightness.  You can also work perpendicular across the tight area to also free up the tissue.  One of the last types of strokes you can add in is the J-Stroke (LINK: Massage J-Stroke-Use tool instead) which will allow you to work around and through the adhesions and free up the tissue.

Step 4: Post Treatment
As with any soft tissue work such as massage or foam rolling you should rehydrate as much as you can and get your body filled back up with water.  You will also want to do some sort of rehab or activity to help your body realign the fibers in your body that you have just been working on.  This
could include biking for lower body work, going out for a quick run or utilizing a couple simple and easy rehab exercises utilizing the muscles you just worked.  This will help you get everything moving correctly and set up for healing.

You can fix a lot of stuff on your own if you take the time and really work at the tissues.  As always check with someone before you get to far into self-treatment and double check with professionals if questions or concerns come up.  If things are getting better on your own, find a soft tissue specialist, set an appointment, learn a few things and the maybe give it a try again.

There are many things you can use for IASTM.  I've used different edges of a pair of medical shears, a spoon and also a butter knife.  Here are some more professional options:
-Gua Sha Set (Jade)
-Gua Sha Set (Titanium)
-The Edge

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