Efficacy of IASTM for the treatment of Musculotendinous Injuries

Graston Technique® therapy raises the bar again!

Graston Technique® therapy is an evidence-based method of instrument-assisted soft tissue mobilization (IASTM) combined with exercise to improve musculoskeletal function. There are various levels of evidence that support its efficacy for a wide variety of conditions.

In 2016, the first systematic review examining the efficacy of IASTM reported “some evidence supporting its ability to increase short term joint ROM.” (Cheatham et al)

In 2017, a second systematic review summarized that “IASTM is an effective treatment intervention for reducing pain and improving function in less than a three-month period.” (Lambert et al)

The abstract of a third systematic review was published in the January 2018 issue of the Journal of Orthopedic and Sports Physical Therapy. In it the authors draw an even stronger conclusion.

After reviewing the literature for randomized control trials, clinical control trials, and pilot studies evaluating the efficacy of IASTM, the authors concluded: Moderate evidence supports the use of IASTM combined with stretching and strengthening protocols when treating tendinopathies.” (Thompson et al)

This is Graston Technique® therapy!

We are very excited to see the research community come to this independent conclusion. Graston Technique® therapy is beyond IASTM. Our unique protocol of IASTM combined with exercise is an effective intervention for the treatment of soft tissue dysfunction, such as chronic tendinopathies.

The study just mentioned appears below.

Efficacy Of Instrument-Assisted Soft Tissue Mobilization For The Treatment Of Musculotendinous Injuries: A Systematic Review

Jeffrey A. Thompson, Landon Crowder, Daniel Le, Adam J. Roethele Physical Therapy, Louisiana State University Health Sciences Center-New Orleans, New Orleans, Louisiana

Journal of Orthopedic & Sports Physical Therapy 48(1), A187

PURPOSE/HYPOTHESIS: Instrument assisted soft tissue mobilization (IASTM) is a noninvasive method to mobilize soft tissue structures such as muscles, tendons, or ligaments. IASTM has been purported to positively impact speed of recovery, tissue regeneration, and range of motion. Previously published article included pathologies that were not musculotendinous and excluded a form of IASTM. The purpose of this study was to evaluate the clinical efficacy of using instrument assisted soft tissue mobilization for the treatment of musculotendinous injuries and the clinical outcomes that result from use.

NUMBER OF SUBJECTS: Twelve studies were reviewed totaling 452 subjects.

MATERIALS/METHODS: A literature search including PubMed, Cochrane, Ebsco, Index of Chiropractic Literature, ProQuest, PEDro, and Clinicaltrials.gov was completed in March 2016. Search terms included: “instrument assisted soft tissue mobilization,” “IASTM,” “augmented soft tissue mobilization,” “ASTYM,” “Graston,” and “GISTM.” Titles and abstracts were screened for relevance, inclusion, and exclusion criteria. Each article was critically appraised by the 3 independent reviewers using the PEDro scale and Levels of Evidence obtaining 100% agreement. Articles which graded 6/10 or greater on the Pedro scale were considered to be high quality and have a low risk of bias. The level of evidence present in each study was assessed using the Oxford Centre for Evidence-based Medicine Levels of Evidence. Only randomized control trials, clinical control trials, or pilot studies were included.

RESULTS: The average PEDro score of the 12 studies was found to be 5.4/10. Points were only awarded toward the PEDro score when the article being appraised explicitly stated each criteria being assessed. Six subgroups of interventions were found and analyzed: IASTM versus no treatment, IASTM versus self-stretch, IASTM versus a sham IASTM intervention, IASTM versus foam rolling, IASTM versus cross friction soft tissue mobilization, and IASTM versus a stretching and/or strengthening program. Moderate evidence supports the use of IASTM combined with stretching and strengthening protocols when treating tendinopathies such as lateral epicondylitis and insertional achilles tendinopathy, but this evidence arises from only 1 high-quality study supporting each pathology. There is weak evidence supporting the use of IASTM for increasing ROM, and only for an acute time period.

CONCLUSIONS: There is insufficient evidence supporting the use of IASTM as a stand-alone treatment for all musculotendinous pathologies. Moderate evidence does exist to support the use of IASTM in combination with stretching and strengthening programs.

CLINICAL RELEVANCE: The quality and quantity of current evidence is not sufficient to support the efficacy of IASTM as the sole treatment. Limited quantities of moderate evidence exists for improved outcomes using IASTM as a potential supplement to a stretching and strengthening protocol for musculotendinous injuries.

Peer-reviewed research on Graston Technique® therapy is performed independently by skilled clinicians from across the world. For access to this research, visit:



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