IASTM: Crural and Plantar Fascia

This course describes instrument assisted soft tissue mobilization (IASTM) of the crural fascia (lower leg) and plantar fascia (bottom of the foot), including the superficial fascial sheaths overlying the gastrocnemius, soleus, peroneal muscles (fibularis muscles), tibialis anterior, Achilles tendon, calcaneus, interossei, and toe flexors. Additionally, modifications of these techniques are discussed, including specific techniques for addressing trigger points, and pin and stretch (a.k.a. active or dynamic release) techniques with IASTM tools.

This course does not cover the fascial sheaths above the knee (fascia latae), and does not cover the superficial fascia over the dorsal aspect of the foot (top of the foot). Although the fascia lata will be covered in a separate course, the dorsal fascia of the foot is not covered due to excessive discomfort for the patient and inconsistent outcomes.

Unfortunately, it is easy to be confused by a large number of synonyms for the techniques in this course. Instrument-assisted soft tissue mobilization (IASTM) is a technique that generally includes the application of shear force (scraping) to skin and superficial fascia using a tool with a rounded, but relatively acute edge. IASTM could be viewed as a Western approach to a Traditional Chinese Medicine (TCM) technique called Gua Sha. While the application of IASTM is most commonly based on orthopedic assessment with stainless steel tools, the application of Gua Sha is based on TCM-specific assessments with jade or stone tools. Graston is the most well-known brand of IASTM stainless steel tools; however, we do prefer Smart Tools based on their quality, edge, and price. Note, historically the origin of these techniques is undoubtedly Gua Sha, which is perhaps 1000s of years old, Graston popularized IASTM in the Western world, and now there are many brands and tools to choose from.

The IASTM techniques in this course are recommended as an adjunct mobility technique, included in an integrated program that already includes, or has considered soft-tissue release techniques, joint mobilization and manipulation techniques, and/or stretching techniques. The addition of the techniques described in this course may be especially beneficial for individuals assessed with range of motion (ROM) restriction of the foot, ankle, or knee. Further, they may be included in a program designed to address plantar fasciitis, Achilles tendonitis (tendinopathy), chronic ankle instability (CAI), chronic ankle pain, or balance issues. Further, these techniques may be beneficial for those with assessed impairments including dorsiflexion restriction, pes planus, hyper-pronation, a positive Feiss line test, a positive Jack's test, pronation distortion, or lower extremity dysfunction (LED) .

The techniques in this course are recommended for all clinical human movement professionals (physical therapists, physical therapy assistants, athletic trainers, massage therapists, chiropractors, occupational therapists, etc.) with the intent of developing an evidence-based , systematic, integrated , patient-centered, and outcome-driven approach.

Topics Covered in this Course

• Signs of Altered Extensibility
• Sample Program
• Research Corner
• IASTM Protocols
• Techniques (with Video)

Techniques Covered in this Course:

• Plantar Fascia IASTM
• Crural Fascia IASTM

Additional IASTM Courses

• Upper Extremity Fascia IASTM
• Cervical and Thoracic Spine Fascia IASTM

For more on an integrated approach:

• Lower Extremity Dysfunction (LED)