Why Is My Therapist “Scraping” Me?
IASTM otherwise known as’ Instrument Assisted Soft Tissue Mobilization’ is often referred to by clinicians as “Graston” and clients as “scraping”. What is it? And more importantly why are we doing it?
IASTM is a skilled myofascial intervention used for soft tissue treatment. It is applied using an instrument usually made of stainless steel with beveled edges and contours that can conform to different body parts. Some renowned brands of IASTM tools include Graston and Hawk. There are also many “off” brands of these tools available at a more affordable price point. Cost can vary from $ to $$$’s. Keep in mind; the cost of the tool has less effect on treatment than the skill of the clinician providing it does. Clinicians utilizing this intervention are trained to do so and base their treatment on the patient’s individualized needs.
Myofascial tissue is a dense, tough tissue which surrounds and covers all your muscles. It is both strong and very flexible. In fact, it has a tensile strength of over 2000lbs. Fascia is an organized and pliable tissue in a healthy state that provides a framework and interconnectivity across multiple joints, muscles, and capsules. It covers our figure much like a body suit would, no beginning or end, a continuous weave of tissue. When a person experiences physical trauma, or inflammation, the pliability of fascia changes. Fascia can become tight and restricted, essentially it becomes anchored in place or limited in its function. These restrictions will influence posture, range of motion and flexibility. They will also have an effect on the tissues that lie deeper in the body including muscle. Restrictions left untreated can cause a wide variety of symptoms, including headaches, muscle pain, chronic joint pain, and recurrent injuries just to name a few.
So, we have established that healthy myofascia is an organized, strong and flexible tissue. Did you know that it is also a highly sensitive tissue? Fascial tissue possesses a network of sensory components that is 10 times greater than its muscular counterpart. This makes fascia a perceptual organ more than a mechanical one. When the fascia becomes unhealthy, not only do the pliability properties get altered, so do the sensory ones. It loses the signaling capacity. It is no longer capable of sending messages to the brain regarding movement. Essentially irritable, inflamed, or damaged fascia and the underlying variety of tissue that makes up our musculoskeletal system not only cause pain, but also a faulty motor control system by altering our brain’s body map. The brain doesn’t see our areas of pain, or at least not like it should.
This is where the “scraping” comes in to save the day. Pain is a request from your body for change. IASTM can provide the change. IASTM can help send signals back to the brain, making the invisible, visible again. It can help us to take generalized pain, and make it more localized and specific through improved body awareness, which in turn decreases pain and improves motor control. As we noted fascial tissue, muscle tissue, tendinous tissue, scar tissue, and other connective tissue structures are hardy, so most of the impact that IASTM has on the human body is through the neurological system. However, variables such as pressure, speed, accompanying joint/tendon stretch/load, vibration, or temperature can be utilized to change the neural stimulation based on the intent of the clinician. Therapists utilizing IASTM take the time to identify things like tone, hypersensitivity, underlying trigger points, mobility limitations, scar tissue development, and tissue quality to determine how/when to utilize IASTM to make the maximal impact on the patient’s dysfunction. IASTM is a great gateway back towards functional movement. It should be used with appropriate scaled physical activity to help a patient return to pain-free movement and freedom. IASTM is not just “scraping”…
Tara Esler PT, MSPT
