What is IASTM in Physical Therapy?

Instrument-Assisted Soft Tissue Mobilization (IASTM) is a type of manual massage therapy used by physical therapists. Commonly known as the Graston Technique, this type of treatment can be beneficial for many people with movement restrictions, tension, and pain.

The Taylor and Francis journal defines IASTM as “a skilled intervention that includes using specialized tools to manipulate the skin, myofascia, muscles, and tendons by using various direct compressive stroke techniques.”

What does IASTM Do?

Instrument-Assisted Soft Tissue Mobilization helps break down restrictions, reduce pain, and facilitate healing by addressing musculoskeletal problems at the cellular level.

At the musculoskeletal level, a facial restriction is often a combination of scar tissue and adhesions built up over time. Ortho Bethesda does a great job explaining that “Scar tissue and adhesions essentially act like superglue in your body. When scar tissue is created after injury, new cells are laid down excessively and in a disorganized manner. Scar tissue/ adhesions prevent the muscle or other tissues from lengthening appropriately.” 

IASTM is a way for physical therapists to use controlled microtrauma to stimulate a natural inflammatory response. When your body produces an inflammatory response, it triggers a series of events that include reabsorption of excess scar tissue and fibrosis that is causing restriction.

Additionally, IASTM also triggers a vascular response resulting in increased blood flow and improved healing. There is even a neural effect throughout pain receptors along the skin responsible for managing pain.

Who can benefit from IASTM?

IASTM treatment can be beneficial for a variety of impairments and conditions. It can be beneficial for many people undergoing orthopedic surgery, people that sit for long hours in an office, and athletes after intense training or injuries. Your physical therapist may provide you this manual therapy for impairments such as:

• Limited mobility
• Pain with motion
• Loss of range of motion
• Decreased muscle recruitments
• Excessive scar tissue formation 

More specific conditions that benefit from the application of IASTM include:

• Plantar Fasciitis
• Carpal Tunnel Syndrome
• Neck Pain
• IT Band Syndrome
• Heel Pain/ Achilles Tendinitis
• Ankle Sprains and Strains
• Back Pain
• Shin Splints
• Post Surgical Hip and Knee Replacements
• Musculoskeletal Imbalances
• Rotator Cuff Tendinitis
• Myofascial Pain and Restrictions

For certain conditions, instrument-assisted soft tissue mobilization may not be recommended. These can include having:

• Unhealed Fracture
• Hematoma
• Hemophilia
• Uncontrolled Hypertension
• Open Wound
• Patient Hypersensitivity 

What to expect during and after an IASTM Treatment

IASTM treatments during physical therapy sessions are often paired with a warm-up such as heat, stationary bike, elliptical machine, or light jogging to make the tissue more pliable. After a warm-up, your therapist can begin working with stainless steel, plastic, or titanium instruments that contour to your body in order to find the specific tissue and muscles that are restricted.

Instrument-Assisted Soft Tissue Mobilization starts with gentle pressure and steadily increases in order to effectively treat the areas causing pain and movement restrictions. At Balanced Physical Therapy, we encourage open communication and let our therapists know when the pressure becomes too uncomfortable to tolerate.

After the IASTM treatment, most patients follow up with more exercise to help restore better movement patterns. Some soreness after treatments is considered normal; patients should not panic because it does go away and gets less severe with multiple treatments. If you are attending physical therapy anywhere from 2-3 times per week, a noticeable result can be felt by the 3rd or 4th appointment (sometimes even on the first treatment). When IASTM is combined with exercise, stretching, and a focused effort on home exercises, patients can progress reasonably quickly through their recovery.

If you would like to learn more about IASTM or are experiencing pain, tension and movement restrictions give us a call to speak with a therapist. Our team is always ready to help you make the best decision with regard to your overall health and wellness.

Balanced PT offers dry needling treatment to help with neuromusculoskeletal pain and movement impairment. Learn more about the dry needling process and some specific conditions that benefit from this treatment.

What is Dry Needling?

Dry needling is a safe and minimally invasive treatment used to help patients with neuromusculoskeletal pain and movement impairments(Mayo Clinic). Some benefits include decreased muscular pain, easing trigger points, and improved range of motion.

It is administered by certified and trained healthcare professionals such as physical therapists, medical doctors, and some chiropractors. Some other common names for dry needling therapy include trigger point dry needling (TDN) and Functional Dry Needling (FDN).

Difference Between Dry Needling and Acupuncture?

While dry needling stems from traditional Chinese medicine like acupuncture, dry needling is a treatment that has evolved into a modern western medicine treatment. Inserting needles into the skin is something both dry needling therapy and acupuncture share, but after that, the treatments are undoubtedly different (Denver Physical Medicine and Rehab).

Acupuncture treatments are more of traditional eastern medicine based on restoring the proper energy flow throughout the body by inserting needles along meridian lines. 

Dry needling therapy has been developing since the 1980s and focuses on relieving chronic and acute pain by inserting needles into trigger points to restore normal function.

Will Dry Needling Therapy Work For Me?

Patients that are experiencing chronic pain are typically great candidates to receive dry needling therapy. Patients can expect to see the most significant benefits when this dry needling is incorporated with exercise, manual therapy, stretching, and education. It is a low cost, low-risk treatment that can help with conditions such as (Virginia Sports Medicine Institute):

• Acute and Chronic Tendonitis/ Tendinosis
• Athletic Overuse Injuries
• Carpal Tunnel Syndrome
• Frozen Shoulder
• Muscle Spasms
• Whiplash from auto accidents
• Ehlers Danlos Syndrome
• Fibromyalgia
• IT Band Syndrome
• Sciatic pain
• Tennis and Golfer’s Elbow
• Neck and lower back pain

While dry needling can be beneficial to various conditions, it is also essential to know when dry needling is not appropriate. Dry needling is not suitable and potentially harmful (Cleveland Clinic) for the following reasons:

• A patient with a needle phobia
• Pregnancy (first trimester)
• Patient with an allergy to metals
• Patients that have an infection present
• Needling over cosmetic implants
• Patients with a heart valve replacement (endocarditis)
• Patients with epilepsy (or other seizure disorders)

Suppose you are looking for natural pain management treatment options, and dry needling is not an option. In that case, we always recommend scheduling an appointment with your primary care physician, orthopedic surgeon, or physical therapist. They will be able to diagnose your pain and provide you with a list of safe treatments available near you.

How Does Dry Needling Work?

Multiple clinical studies show that dry needling works by restoring muscles to a normal resting state. We know that patients suffering from chronic pain, a traumatic injury, or overused muscles often develop trigger points (also known as knots) that cause pain and discomfort. 

Looking further into why this causes you pain, research shows that the trigger points form due to prolonged or abnormal muscle contraction where your muscle is not receiving enough blood supply. The lack of blood supply (filled with oxygen and nutrients required for healing) to an injured area will cause the surrounding tissue and nerves to become more sensitive.

By stimulating the trigger point with a sterile needle, dry needling therapy can help drive more blood to an injured area, release muscular tension, and help the brain release endorphins that promote healing.

Step By Step Dry Needling Procedure

Before administering dry needling therapy to any patient, your physical therapist will perform an examination that includes your past medical history to ensure the treatment is appropriate and safe. Part of the evaluation will also consist of your therapist using palpation skills to identify trigger points causing pain and limited motion.

Once you and your therapist agree that dry needling will benefit your recovery, the therapist will go over each part of the treatment in more detail (Verywell Health). Specific details that help patients understand dry needling can include:

• How long does dry needling take? Typically a single treatment can take anywhere from 15-30 minutes, which is most commonly a part of a total of 30-60 physical therapy sessions.
• What to wear for a dry needling appointment: We recommend our patients wear the usual, comfortable physical therapy attire. Clothing that allows easy access for your therapist to administer the treatment is always a good idea. 
• Insurance information and expected costs: Some insurances do cover dry needling, while others do not. It helps to know upfront what co-pay and out-of-pocket costs to expect.

Once an evaluation is complete, some patients can start dry needling therapy that same day( others may need to wait until the second appointment, this varies from clinician to clinician.)

Your physical therapist will always begin the dry needling procedure by sterilizing the treatment area and preparing the needles in a private setting. After preparing the treatment area, the therapist will start inserting thin, dry needles (needles that do not contain medications or fluids ) into problem-causing trigger points. 

The dry needles are inserted directly into the skin at varying depths (depending on the dry needling technique). Oftentimes, patients will feel the physical therapist gently move the needle around to stimulate a local twitch response. A local twitch is a good thing, as it signifies that a muscle is reacting to the treatment.

After 15-30 minutes, your therapist will carefully remove the dry needles. They will inspect the treatment area for bleeding and skin reactions before leaving for home.

What To Expect After a Dry Needling Treatment

After a dry needling treatment session, patients often report a decrease in pain and an increase in range of motion. In more severe cases, a patient will require more than one treatment to reach the desired results.

Muscle soreness and light bruising is a common side effect of dry needling, for which your therapist may recommend rest, heat, or ice. These symptoms typically resolve themselves over a couple of days to a week.

If you are experiencing more severe side effects (these are considered rare), such as difficulty breathing or significant bleeding, we recommend contacting emergency medical services immediately.

Schedule Dry Needling Treatment Today

Balanced Physical Therapy offers safe, effective, and certified dry needling treatments. Our patients enjoy working in one-on-one therapy settings with board-certified physical therapists. To schedule an appointment, call us at (586) 741-5806 or visit our Appointments page to schedule an evaluation.