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How Does Instrument-Assisted Therapy Work?

What It Is, What to Expect and Who It Suits

How instrument-assisted soft tissue mobilisation (IASTM) works, what a session involves, who it may suit, and when it is not appropriate.

Soft tissue mobilisation therapy benefits Graston therapy London

Instrument-Assisted Soft Tissue Mobilisation (IASTM) is a hands-on technique that osteopaths and other manual therapists use to work on tight or sore soft tissue with smooth-edged instruments. This article explains how instrument-assisted therapy works, what a session involves, what the research does and does not show, and when it is not suitable.

What Is IASTM?

IASTM uses specially shaped stainless-steel instruments that the practitioner glides over the skin, over muscle, tendon and the connective tissue around them. The instrument transmits pressure and can help the practitioner feel areas that seem tight, thickened or tender. The tools can also let the practitioner apply firm, focused pressure with less strain on their own hands than hands-only massage.

How Is It Thought to Work?

Several explanations are put forward, and the science behind them is still developing:

  1. Mechanical effects: The pressure and stroking may change how tight tissue feels and moves in the short term.
  2. Local response: The treated area often becomes warm and red, which suggests increased local blood flow. How much this matters for recovery is not settled.
  3. Nervous system effects: Pressure on the skin and muscle may change how pain is perceived and reduce muscle tension for a while.

These are possible mechanisms rather than proven ones, and individual responses differ.

What Does the Research Show?

Research into IASTM is still developing. Studies so far tend to be small, and reviews generally describe the evidence as limited, with some showing short-term gains in range of movement or pain in certain conditions and others showing no clear benefit over other approaches. For that reason we see IASTM as one option within a wider treatment plan, not a treatment that works on its own.

For low back pain, NICE guideline NG59 says manual therapy can be considered, but only as part of a package of care that includes exercise.

What a Session Can Involve

IASTM is usually used alongside other osteopathic techniques, so a session might include:

  1. Assessment: A case history and examination of how you move and where you are tender.
  2. Instrument work: Gentle to firm strokes over the affected area, adjusted to what you can tolerate.
  3. Other techniques: For example joint mobilisation or soft tissue work by hand.
  4. Advice: Stretches, exercises and changes to your routine to try at home.

Please tell the osteopath if you would like treatment to be lighter or stopped at any point.

Safety and When It Is Not Suitable

IASTM is generally well tolerated when it is used appropriately, but it is not suitable for everyone. Your osteopath will ask about your health first, and it is usually avoided or adapted if you have:

  1. Open wounds or skin problems in the area
  2. Active infection, or a suspected blood clot, which need medical assessment first
  3. Severe osteoporosis or fragile bones
  4. Bleeding or clotting disorders, or are taking blood thinners, or have poorly controlled diabetes

Redness and mild bruising can occur on the skin after treatment, and the area may feel sore for a day or two. Tell your osteopath if you bruise easily.

What You Might Notice

Some people feel the treated area is looser or less tense afterwards, while others notice little difference. Any benefit varies by person and condition, and we cannot promise a particular result or number of sessions.

Conclusion

IASTM is one of several hands-on techniques an osteopath may use to work on soft tissue. The research behind it is still developing, so it is best used as part of a wider plan that includes exercise and advice. If you would like to know whether it could suit you, you can book an appointment online or see our fees.

References:

  1. National Institute for Health and Care Excellence. NG59: Low back pain and sciatica in over 16s: assessment and management. https://www.nice.org.uk/guidance/ng59