Tuesday, November 10, 2009


Acronym for Instrument Assisted Soft Tissue Mobilization. Here I am doing Graston Technique (only one type of IASTM) with the #3 tool ("tongue depressor") on this athlete's patellar tendon. Sort of like an instrument assisted deep transverse friction massage. Only it's a lot easier on the hands & treatment times are a lot shorter; about 2 minutes max. It is immediately followed by active ROM, then functional exercise. Dr. Warren Hammer introduced Graston at this year's Fascial Congress last month in Belgium. There are several types, including SASTM & ASTYM. They definitely have a place in the A.T.'s toolbox.

Graston is an NATA sponsor. However, we don't get a price break on learning the technique or purchasing the tools. Again, this keeps a valuable modality out of the hands of a typical high school ATC. I have seen collegiate programs send out entire A.T. staffs to be certified in Graston or ART at premium $$$. ALL of my continuing ed (almost 30 years worth now) has come out of my own pocket. Not fair NATA- help us.


Kev said...

I think the NATA has helped a little by making 10 CEU's free to us each year. Even after several years I am still a little miffed that while ECCC is a requirement it isn't apparently deemed important enough to give CEU's for.

Like Joe virtually all my CEU's bills are footed by me. This makes the Graston and ASTYM stuff totally out of reach for me. Would love to learn it but my checkbook says fa getta 'bout it!

W. Harris said...

Let me affirm that Graston/ASTYM are great techniques. I have seen several athletes benefit greatly.

I use the poor man's version with scissors, shark tape cutters, etc.

We are all pretty bright folks, there is plenty out on the WWW that could help us use the techniques without the 'official' training and/or tools.

Joe Przytula said...

Good point W.H.; has anyone had any experience with Gua Sha instruments? They are a lot cheaper.

Pat said...

Hey Joe and everyone...

Loving the discussion IASTM has been something that has always interested me, but currently is out of my budget. Being at a mid major D1 state university we struggle just to make sure we have enough money to buy our general supplies for the year. So I had searched out cheaper alternatives. I tried ebay which had some of the original gua sha instruments which worked well but they become brittle and break over time. Over the summer while walking through a kitchen store I started looking at different kitchen utensils and found some that were pretty similar to the original graston tools. I've played a little with using them and get a lot of weird looks from the kids when I start working their soft tissue with different spoons and what not. More recently I purchased an updated version of the gua sha tools from guashaorthopedic.com These are plastic tools there are three different tools and they seem to work pretty well. You get a good "feel" for the density and quality of teh soft tissue. And the price is pretty resonable. I believe for the three tools and a users manual and universal handle it was right around 100 bucks. No bad when your footing the bill for this stuff on your own. I would still like to take the Graston courses just to get an idea on how they make use of the tools and maybe someday purchase the actual tools but currently not an option for us.

Joe thanks for keeping us thinking, we need to talk sometime soon, things are finally slowing down here as fall sports come to an end...Hope all is well...


drcieslak said...

Hi Joe;
I have not visited lately, but I came across this thread and I thought I would comment. I have researched this topic quite a bit, as I presented on this very area at EATA and NATA last year. In short, all the IASTM techniques work. I have taken Graston, and I do like their tools, but I can say that Gua Sha tools work almost as well, and are thousands of dollars cheaper. I have even used an aluminum SHRIMP DEVEINER (ebay $2.99) with decent success. They key is learning the techniques, and getting a feel for the pressure and strokes needed for each tissue area/type. As with most things, practice makes perfect.


Buddy Touchinsky, D.C. said...

Hi all,

I was writing a blog post on this subject and came across this blog entry. I just wanted to mention that I have had very good success with the technique as well, especially for chronic and recurring issues. It's definitely worth a 4-6 visit trial. Within that time, you can usually tell if it's helping or not.

Here's the link to my blog entry on the topic.


Buddy Touchinsky, D.C. said...

Oh, and I think you can pretty much use any type of instruments and get the same response. I like the SASTM tools because they are ergonomically friendly. They seem a bit pricey but considering I use them daily with patients and they'll last my entire career, the cost is worth it to me.