IASTM: Fascia Lata

Thigh Fascia IASTM

This course describes instrument-assisted soft tissue mobilization (IASTM) of the fascia lata (thigh fascia), including the IASTM intended for the superficial fascial sheaths overlying the quadriceps (vastus lateralis, rectus femoris, and vastus medialis), the hamstrings (semitendinosus, semimembranosus, and biceps femoris), and the adductors (adductor longus, gracilis, and adductor Magnus). 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 below the knee, which are covered in a separate course (crural and plantar fascia ).

Different Names for IASTM

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.

Thigh Fascia IASTM Recommendations

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 hip or knee. Additionally, they may be included in a program designed to address low back pain, adductor strain, hamstring strain, or knee pain. Further, these techniques may be beneficial for those with assessed impairments, including hamstring flexibility issues (hamstring length test, straight leg raise test, or sit-and-reach test), or a loss of hip abduction, adduction, or extension ROM.

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.) who intend to develop an evidence-based , systematic, integrated , patient-centered, and outcome-driven approach.Pre-approved credits for:

• Integrated Manual Therapist (IMT) Certification

Pre-approved for Continuing Education Credits for:

• Athletic Trainers
• Chiropractors
• Massage Therapists
• Occupational Therapists
• Physical Therapists
• Physical Therapy Assistants

This Course Includes:

• AI Tutor
• Study Guide
• Text and Illustrations
• Audio Voice-over
• Research Review
• Technique Videos
• Case Study and Sample Routine

Topics Covered in this Course

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

Techniques Covered in this Course:

• Lateral Fascia Lata IASTM
• Anterior and Medial Fascia Lata IASTM

Additional IASTM Courses

• Cervical and Thoracic Spine Fascia IASTM
• Upper Extremity Fascia IASTM
• Thoracolumbar Fascia IASTM
• Plantar and Crural Fascia IASTM

For more on an integrated approach:

• Lumbo Pelvic Hip Complex Dysfunction (LPHCD)
• Lower Extremity Dysfunction (LED)

IASTM compared to Massage and Manual Release

1. Hampton, C. F., Demchak, T. J., Games, K. E., & Eberman, L. E. (2017). Massage and Instrument-assisted Soft Tissue Mobilization Acutely Increase Hamstring Flexibility. Journal of Athletic Training, 52(6), S96.
2. Spinoso, D. H., Goulart, M., Ferreira, A., & Navega, M. (2022). Analysis of the relationship between hamstring flexibility with muscular strength and its response to myofascial release. Manual Therapy, Posturology & Rehabilitation Journal, 20, 1-7. IASTM compared to Massage, Vibration, Ultrasound, and Exercise
3. Koumantakis, G. A., Roussou, E., Angoules, G. A., Angoules, N. A., Alexandropoulos, T., Mavrokosta, G., ... & Papadopoulou, M. (2020). what: A pilot study. Journal of Bodywork and Movement Therapies, 24(3), 96-104.
4. Zaghloul, H. M. S., Ali, H. A., Ghally, S. A. O., & Abdelsamee, M. Y. A. (2020). Comparison of The Effectiveness of Instrument-Assisted Soft Tissue Mobilization Technique, Ultrasound therapy, or Deep Friction Massage on Fast Recovery and Accelerating Tissue Healing in Groin Strain. Entomol Appl Sci Lett, 7(1), 54-60. IASTM Compared to Manual Stretching
5. Osailan, A., Jamaan, A., Talha, K., & Alhndi, M. (2021). Instrument assisted soft tissue mobilization (IASTM) versus stretching: A comparison in effectiveness on hip active range of motion, muscle torque and power in people with hamstring tightness. Journal of bodywork and movement therapies, 27, 200-206
6. Moon, J. H., Jung, J. H., Won, Y. S., & Cho, H. Y. (2017). Immediate effects of Graston Technique on hamstring muscle extensibility and pain intensity in patients with nonspecific low back pain. Journal of physical therapy science, 29(2), 224-227. IASTM compared to Active Stretching, Hold-Relax Stretching, and Strain-Counterstain
7. Lim, J. Y., Nam, S. H., & Kim, K. D. (2022). Effect of Active Stretching and Instrument-Assisted Soft Tissue Mobilization on the Hip Joint Range of Motion and Stiffness of the Tensor Fascia Lata in Subjects with Shortened Tensor Fascia Lata. Journal of Musculoskeletal Science and Technology, 6(2), 43-50.
8. Kim, D. H., & Lee, J. J. (2018). Effects of instrument-assisted soft tissue mobilization technique on strength, knee joint passive stiffness, and pain threshold in hamstring shortness. Journal of back and musculoskeletal rehabilitation, 31(6), 1169-1176. IASTM with Stretching or Exercise Compared to PNF Stretching, Stretching with TENS, and Mulligan's Bent Leg Raise
9. Chintamani R, Metgud S, Heggannavar A. short term effects of instrument assisted soft tissue mobilisation technique versus Mulligan’s bent leg raise technique in asymptomatic subjects with hamstring tightness- a randomised clinical trial. Int J Health Sci Res. 2019; 9(10):50-64.
10. Gunn, L. J., Stewart, J. C., Morgan, B., Metts, S. T., Magnuson, J. M., Iglowski, N. J., ... & Arnot, C. (2019). Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 27(1), 15-23.
11. Mubashar, H., Hassan, D., & Bushra, M. (2022). Effects of Instrumented Assisted Soft Tissue Mobilization (IASTM) Technique Versus Stretching on Ililotibal Band in Patients with Anterior Knee Pain. Pakistan Journal of Medical & Health Sciences, 16(11), 353-353. IASTM Compared to Foam Rolling
12. Noreen, A., Rashad, A., Iqbal, K., Younas, A., Hassan, M. F., Iqbal, U., & Baby, W. (2021). Comparative effects of graston technique and foam roller on the flexibility of hamstring muscle. Journal of Orthopaedics Trauma Surgery and Related Research, 16(8).
13. Sandrey, M. A., Lancellotti, C., & Hester, C. (2020). The effect of foam rolling versus IASTM on knee range of motion, fascial displacement, and patient satisfaction. Journal of Sport Rehabilitation, 30(3), 360-367.
14. Zutshi, K., SK, M. E., & Dhingra, M. (2022). Immediate and Acute Effect of Self Myofascial Release vs Instrument Assisted Soft Tissue Mobilization on Flexibility, Strength and Sport-Specific Performance in Young Male Soccer Players. Indian Journal of Youth and Adolescent Health (E-ISSN: 2349-2880), 9(2), 14-20. IASTM Compared to "The Stick"
15. Lee, J., Young, A., Erb, N. J., & Herzog, V. W. (2020). Acute and residual effects of IASTM and roller massage stick on hamstring range of motion. Journal of allied health, 49(1), 51E-55E.
16. Stroiney, D. A., Mokris, R. L., Hanna, G. R., & Ranney, J. D. (2020). Examination of self-myofascial release vs. instrument-assisted soft-tissue mobilization techniques on vertical and horizontal power in recreational athletes. The Journal of Strength & Conditioning Research, 34(1), 79-88. IASTM compared to Stretching, Foam Rolling, or Flossing
17. Simatou, M., Papandreou, M., Billis, E., Tsekoura, M., Mylonas, K., & Fousekis, K. (2020). Effects of the Ergon® instrument-assisted soft tissue mobilization technique (IASTM), foam rolling, and static stretching application to different parts of the myofascial lateral line on hip joint flexibility. Journal of physical therapy science, 32(4), 288-291.
18. Pathania, T., & Muragod, A. R. (2019). Comparative effect of foam roller and M2 T blade on hamstring flexibility in elderly population: A randomized control trial. Indian Journal of Health Sciences and Biomedical Research kleu, 12(2), 160-165.
19. Cheatham, S., Martinez, R., Montalvo, A., Odai, M., Echeverry, S., Robinson, B., ... & Viecco, K. (2020). Comparison of Roller Massage, Instrument Assisted Soft-Tissue Mobilization, and Floss Band on Passive Knee Motion Among Inexperienced Individuals. Clinical Practice in Athletic Training, 3(3), 24-36. IASTM and Exercise Compared to Exercise
20. Lee, J. H., Lee, D. K., & Oh, J. S. (2016). The effect of Graston technique on the pain and range of motion in patients with chronic low back pain. Journal of physical therapy science, 28(6), 1852-1855.
21. McCormack, J. R., Underwood, F. B., Slaven, E. J., & Cappaert, T. A. (2016). Eccentric exercise versus eccentric exercise and soft tissue treatment (Astym) in the management of insertional Achilles tendinopathy: a randomized controlled trial. Sports health, 8(3), 230-237. Additional Comparisons: Kinesiology Tape, Mobilizations, and Microcurrent
22. ÇAKMAK, Ö., ATICI, E., & GÜLŞEN, M. THE EFFECTS OF INSTRUMENT-ASSISTED SOFT TISSUE MOBILIZATION AND KINESIO TAPING ON PAIN, FUNCTIONAL DISABILITY AND DEPRESSION IN PATIENTS WITH CHRONIC LOW BACK PAIN: A RANDOMIZED TRIAL. Türk Fizyoterapi ve Rehabilitasyon Dergisi, 33(3), 179-186.
23. Qadree, M. S., Shakil-Ur-Rehman, S., Riaz, M. U., Anees, M., & Rajput, H. (2022). EFFECTS OF GRASTON INSTRUMENT SOFT TISSUE MOBILIZATION IN PATIENTS WITH SCIATIC NERVE ENTRAPMENT. Pakistan Journal of Rehabilitation, 11(2), 83-91.
24. Son, H. H. (2018). Effect of graston technique on fatigue recovery after High-Intensity exercise of the quadriceps femoris. Journal of the Korean Society of Physical Medicine, 13(4), 9-17. Comparing IASTM for Different Body Parts
25. Fousekis, K., Eid, K., Tafa, E., Gkrilias, P., Mylonas, K., Angelopoulos, P., ... & Tsepis, E. (2019). Can the application of the Ergon® IASTM treatment on remote parts of the superficial back myofascial line be equally effective with the local application for the improvement of the hamstrings’ flexibility? A randomized control study. Journal of physical therapy science, 31(7), 508-511.
26. Kazakos, D., Liapis, A., Mylonas, K., Angelopoulos, P., Koubetsos, A., Tsepis, E., & Fousekis, K. (2020). Treatment of scalene muscles with the Ergon technique can lead to greater improvement in hip abduction range of motion than local hip adductor treatment: a study on deep front line connectivity. Journal of Physical Therapy Science, 32(11), 706-709.
27. MacDonald, N., Baker, R., & Cheatham, S. W. (2016). The effects of instrument assisted soft tissue mobilization on lower extremity muscle performance: a randomized controlled trial. International journal of sports physical therapy, 11(7), 1040. IASTM for Hamstring Restriction
28. Boyer, S., Novack, J., Madsen, L. P., Kingma, J. J., Schrader, J. W., & Docherty, C. L. (2017). The immediate effects of graston technique© on hamstring flexibility compared to a control. Journal of Athletic Training, 52(6), S94.
29. Pathania, A. R. M. T. (2018). Immediate effects of M2T blade on hamstring flexibility in elderly population: A pilot study. IJAR, 4(1), 265-267.
30. Toscaro, C. G., Gonçalves, R., Quarto, B. F., Neto, L. F. M., Braz, I. A., & Jambassi Filho, J. C. (2022). Effects of Myofascial Mobilization on Flexibility in Young Men Adults. Journal of Health Sciences, 24(3), 206-210. The Effects of IASTM on Strength, Peak Force, and Power:
31. Pişirici, P., & Şakul, B. U. (2020). Investigation the effect of Graston Technique on strength and postural stabilization in individuals with asymptomatic dynamic knee valgus. Gait & Posture, 81, 279-280.
32. Kivlan, B. R., Carcia, C. R., Clemente, F. R., Phelps, A. L., & Martin, R. L. (2015). The effect of Astym® Therapy on muscle strength: a blinded, randomized, clinically controlled trial. BMC musculoskeletal disorders, 16, 1-10. IASTM with Active ROM and IASTM with Stim
33. Kim, J., & Yim, J. (2018). Instrument-assisted soft tissue mobilization improves physical performance of young male soccer players. International journal of sports medicine, 39(12), 936-943.
34. Kim, Y. K., Cho, S. Y., & Lee, K. H. (2021). Effects of transcutaneous electrical nerve stimulation and instrument-assisted soft tissue mobilization combined treatment on chronic low back pain: a randomized controlled trial. Journal of Back and Musculoskeletal Rehabilitation, 34(5), 895-902. Additional Findings: Skin Temperature, 2-point Discrimination, DOMS, and Swelling:
35. Fousekis, K., Varda, C., Mandalidis, D., Mylonas, K., Angelopoulos, P., Koumoundourou, D., & Tsepis, E. (2020). Effects of instrument-assisted soft-tissue mobilization at three different application angles on hamstring surface thermal responses. Journal of physical therapy science, 32(8), 506–509.
36. Ge, W., Roth, E., & Sansone, A. (2017). A quasi-experimental study on the effects of instrument assisted soft tissue mobilization on mechanosensitive neurons. Journal of physical therapy science, 29(4), 654-657.
37. Cheatham, S. W., Kreiswirth, E., & Baker, R. (2019). Does a light pressure instrument assisted soft tissue mobilization technique modulate tactile discrimination and perceived pain in healthy individuals with DOMS? The Journal of the Canadian Chiropractic Association, 63(1), 18.