IASTM: Comprehensive Systematic Research Review

Common Questions:

• What is Instrument Assisted Soft Tissue Mobilization (IASTM)? 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.
• What is IASTM used for? Research suggests that IASTM is best used for improving range of motion (ROM) when a loss of mobility has been assessed. However, research also suggests that IASTM is effective for improving pain, pain pressure threshold, disability, function, balance, exercise recovery, and altering fascial mobility.
  
• Is Graston and IASTM the same thing? Graston is the most well-known brand of IASTM stainless steel tools. Historically the origin of IASTM is undoubtedly Gua Sha, which is perhaps 1000s of years old, Graston popularized IASTM in the Western world with a western orthopedic medicine approach, and this course, and related courses (listed below), have refined this approach with the most comprehensive research reviews to date.
• Does IASTM actually break up scar tissue? "Break up" is likely too simple of a term to describe the effect that IASTM has on scar tissue, fascial tissue, and the neuromuscular system. Research has demonstrated that IASTM affects fascial mobility, as well as resulting in changes in neuromuscular reflex, serum concentrations of inflammatory markers, and tissue remodeling.
• Is IASTM better than massage? Studies suggest that IASTM will result in less improvement in range of motion (ROM) than specific manual techniques (e.g. static manual release techniques, dry needling, and joint mobilizations/manipulations), similar improvements as massage and tissue flossing, and larger improvements than self-administered mobility techniques and most modalities (self-myofascial release, stretching, kinesiology tape, vibration, TENS, shockwave, and heat). Most studies also demonstrate that IASTM is as effective or more effective than other techniques for improving pain, pain pressure threshold, disability, and function.

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
• Practice Exam
• Pre-approved Final Exam

Brookbush Institute Research-based Summary Statement:

Studies suggest that IASTM will result in less improvement in range of motion (ROM) than specific manual techniques (e.g. static manual release techniques, dry needling, and joint mobilizations/manipulations), similar improvements as massage and tissue flossing, and larger improvements than self-administered mobility techniques and most modalities (self-myofascial release, stretching, kinesiology tape, vibration, TENS, shockwave, and heat). Most studies also demonstrate that IASTM is as effective or more effective than other techniques for improving pain, pain pressure threshold, disability, and function. The addition of IASTM to exercise, stretching, manual soft tissue techniques, joint mobilizations, and/or conventional therapy results in significant improvements in ROM, pain, and function. IASTM may also significantly improve strength and performance when used to address an assessed mobility restriction, and may significantly improve recovery from exercise, mitigate performance declines during a sporting season, and contribute to larger strength gains from a weight training program. The Brookbush Institute recommends that IASTM be used as an additional manual mobility technique following release techniques and joint mobilizations to address assessed ROM restrictions.

• Primary Benefit: Increase Range of Motion (ROM)
  • Less effective than manual release techniques, dry needling, and joint mobilizations/manipulations.
  • Similarly effective as massage and tissue flossing.
  • More effective than self-myofascial release, stretching, kinesiology tape, vibration, TENS, shockwave, and heat
• Additional Benefits: Improvements in pain, pain pressure threshold, disability, function, balance, exercise recovery, and changes in fascial mobility.
• Recommended Use: The Brookbush Institute recommends that IASTM be used as an additional manual mobility technique following release techniques and joint mobilizations to address assessed ROM restrictions.

What to expect from this course:

• This course is a comprehensive systematic review of all peer-reviewed and published original research investigating IASTM.

Topics Covered in this Course

• Comparisons when performed independently
• Comparisons when performed in combination
• Comparisons with and without IASTM
• IASTM and Fascial mobility
• Effect of IASTM on exercise performance and recovery

Additional IASTM Courses

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

Static Release (Ischemic Compression) Techniques Compared to IASTM:

1. Fousekis, K., Kounavi, E., Doriadis, S., Mylonas, K., & Kallistratos, E. (2016). The effectiveness of instrument-assisted soft tissue mobilization technique (ergonš technique), cupping and ischaemic pressure techniques in the treatment of amateur athletes΄ myofascial trigger points. J Nov Physiother S, 3(2), 1-7.
2. Stanek, J., Sullivan, T., & Davis, S. (2018). Comparison of compressive myofascial release and the Graston technique for improving ankle-dorsiflexion range of motion. Journal of athletic training, 53(2), 160-167.
3. Vijayakumar, M., Jaideep, A., Khankal, R., Gazbare, P., & Abraham, B. (2019). Effectiveness of compressive myofascial release vs instrument-assisted soft tissue mobilization in subjects with active trigger points of the calf muscle limiting ankle dorsiflexion. Int J Health Sci Res, 9(4), 98-106.
4. Arshad, M. U., Bashir, M. S., Zia, W., & Ahmad, S. Effects of Instrument Assisted Soft Tissue Mobilization and Myofascial Release Technique among patients with Chronic Heel Pain.
5. Shah, J. T., Ghumatkar, M., & Kumar, A. Comparison between the Immediate Effects of Instrument Assisted Soft Tissue Mobilization and Active Release Technique in Individuals Wearing High Heels.

Dry Needling Compared to IASTM

1. Haq, K., & Riaz, H. (2022). Comparison of dry needling and Graston technique on Active Myofascial trigger points in the upper trapezius. Rawal Medical Journal, 47(1), 129-129.

Joint Mobilizations and Manipulations Compared to IASTM

1. Zaghloul, H. M. S., Ghally, S. A. O., Abdelkhalek, M. M. T., Mohamed, M. T., Mahmoud, L. S. E. D., & Ghaly, L. A. O. (2022). Comparison between upper thoracic spine mobilization and the Ergon technique in the treatment of mechanical neck pain. SPORT TK-Revista EuroAmericana de Ciencias del Deporte, 3-3.
2. Crothers, A. L., French, S. D., Hebert, J. J., & Walker, B. F. (2016). Spinal manipulative therapy, Graston technique and placebo for non-specific thoracic spine pain: a randomized controlled trial. Chiropractic & manual therapies, 24, 1-9.

Massage Compared to IASTM

1. Paranjape, S., & Lad, R. (2020). Comparison of manual versus instrument assisted soft tissue mobilization of levator scapulae in chronic neck pain. International Journal of research and Review, 7(3), 364-369.
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.

Manual Stretching Compared to IASTM

1. 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.
2. 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.
3. 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.
4. 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.

Self-administered Stretching Compared to IASTM

1. 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.
2. Myburgh, C., Hammern, A., Mannfjord, P., & Boyle, E. (2018). Effects of instrument-assisted soft-tissue mobilization on ankle range of motion and triceps surae pressure pain sensitivity. Journal of Rehabilitation Medicine-Clinical Communications, 1.
3. Kang, H. S., & Lee, J. H. (2020). The immediate effects of Graston instrument-assisted soft-tissue mobilization and self-stretching on the muscular properties of the gastrocnemius in athletes. Journal of the Korean Society of Physical Medicine, 15(4), 29-35.
4. Shinde, S., Jethwa, K., & Pawar, D. (2022). Comparative study between instrumental assisted soft tissue mobilization and static stretching on delayed onset of muscle soreness in young adult female. International Journal of Health Sciences and Research, 2(6), 186-196.

Self-myofascial Release Compared to IASTM

1. Maniatakis, A., Mavraganis, N., Kallistratos, E., Mandalidis, D., Mylonas, K., Angelopoulos, P., ... & Fousekis, K. (2020). The effectiveness of Ergon Instrument-Assisted Soft Tissue Mobilization, foam rolling, and athletic elastic taping in improving volleyball players’ shoulder range of motion and throwing performance: a pilot study on elite athletes. Journal of Physical Therapy Science, 32(10), 611-614.
2. SK, M. E., Zutshi, K., & 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.
3. 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.
4. 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.
5. Rivera, M., Eberman, L., Games, K., & Powden, C. J. (2020). Comparison of myofascial release techniques on pectoralis minor length, glenohumeral total arc of motion, and skin temperature: a pilot study. Journal of sport rehabilitation, 29(2), 137-141.
6. 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).
7. 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.
8. 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.
9. 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.

Tissue Flossing compared to IASTM

1. Angelopoulos, P., Mylonas, K., Tsepis, E., Billis, E., Vaitsis, N., & Fousekis, K. (2021). The effects of instrument-assisted soft tissue mobilization, tissue flossing, and kinesiology taping on shoulder functional capacities in amateur athletes. Journal of Sport Rehabilitation, 30(7), 1028-1037.

Heat Compared to IASTM

1. Braun, M., Schwickert, M., Nielsen, A., Brunnhuber, S., Dobos, G., Musial, F., ... & Michalsen, A. (2011). Effectiveness of traditional Chinese “gua sha” therapy in patients with chronic neck pain: a randomized controlled trial. Pain Medicine, 12(3), 362-369.
2. Weber, P., Klingler, W., Schleip, R., Weber, N., & Joisten, C. (2022). The Influence of a Single Instrument-Assisted Manual Therapy (IAMT) for the Lower Back on the Structural and Functional Properties of the Dorsal Myofascial Chain in Female Soccer Players: A Randomised, Placebo-Controlled Trial. Journal of Clinical Medicine, 11(23), 7110.

Vibration and Microcurrent Compared to IASTM

1. Tyagi, A., & Bhardwaj, A. (2022). Effect of IASTM vs. THERAGUN on Triceps Surae Active Range of Motion and Functional Movements in University Level Sprinters. Indian Journal of Physiotherapy & Occupational Therapy Print-(ISSN 0973-5666) and Electronic–(ISSN 0973-5674), 16(4), 1-6.
2. 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.

Massage and Stretching versus IASTM and Stretching

1. El-Hafez, H. M., Hamdy, H. A., Takla, M. K., Ahmed, S. E. B., Genedy, A. F., & Al Shaymaa, S. (2020). Instrument-assisted soft tissue mobilization versus stripping massage for upper trapezius myofascial trigger points. Journal of Taibah University Medical Sciences, 15(2), 87-93.
2. 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.
3. Garrett, T. R., & Neibert, P. J. (2019). Graston Technique® as a treatment for patients with chronic plantar heel pain. Clinical Practice in Athletic Training, 2(3), 35-47.

Static Manual Release and Stretching versus IASTM and Stretching

1. YOUSSEF, E. F., MOHAMED, N. A., MOHAMMED, M. M., & AHMAD, H. A. (2020). Trigger Point Release versus Instrument Assisted Soft Tissue Mobilization on Upper Trapezius Trigger Points in Mechanical Neck Pain: A Randomized Clinical Trial. The Medical Journal of Cairo University, 88(December), 2073-2079.
2. Jadhav, A., & Gurudut, P. (2023). Comparative Effectiveness of Gua Sha, Cryostretch, and Positional Release Technique on Tenderness and Function in Subjects with Plantar Fasciitis: a Randomized Clinical Trial. International Journal of Therapeutic Massage & Bodywork, 16(1), 13.

Shockwave and Stretching versus IASTM and Stretching:

1. Pisirici, P., Cil, E. T., Coskunsu, D. K., Saylı, U., & Subasi, F. (2022). Extracorporeal Shockwave Therapy Versus Graston Instrument-Assisted Soft-Tissue Mobilization in Chronic Plantar Heel Pain: A Randomized Controlled Trial. Journal of the American Podiatric Medical Association, 112(6).

Exercise and Stretching versus IASTM and Stretching (versus Exercise Only)

1. Gupta, U., Sharma, A., Rizvi, M. R., Alqahtani, M. M., Ahmad, F., Kashoo, F. Z., ... & Ahmad, I. (2023, March). Instrument-Assisted Soft Tissue Mobilization Technique versus Static Stretching in Patients with Pronated Dominant Foot: A Comparison in Effectiveness on Flexibility, Foot Posture, Foot Function Index, and Dynamic Balance. In Healthcare (Vol. 11, No. 6, p. 785). MDPI.

Tissue Flossing, Stretching, and Exercise versus IASTM, Stretching, and Exercise:

1. Williams, Z., Carlson, S., & Rife, G. (2019, April). Comparing the Effects of Tissue Flossing and Instrument Assisted Soft Tissue Mobilization on Ankle Dorsiflexion. In Proceedings of The Research and Scholarship Symposium, Cedarville, OH, USA (Vol. 3).

Static Manual Release/Massage and Exercise versus IASTM and Exercise

1. Thakur, R., Mande, P., & Lokwani, M. (2022). Effectiveness of Integrated Neuromuscular Inhibition Technique and Instrument Assisted Soft Tissue Mobilisation in the Management of Upper Trapezius Myofascial Trigger Points. Indian Journal of Physiotherapy & Occupational Therapy Print-(ISSN 0973-5666) and Electronic–(ISSN 0973-5674), 16(4), 94-100.
2. 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.
3. Aksan Sadikoglu, B., Analay Akbaba, Y., & Taskiran, H. (2022). Effects of ischemic compression and instrument-assisted soft tissue mobilization techniques in trigger point therapy in patients with rotator cuff pathology: randomized controlled study. Somatosensory & Motor Research, 39(1), 70-80.
4. Burke, J., Buchberger, D. J., Carey-Loghmani, M. T., Dougherty, P. E., Greco, D. S., & Dishman, J. D. (2007). A pilot study comparing two manual therapy interventions for carpal tunnel syndrome. Journal of manipulative and physiological therapeutics, 30(1), 50-61.

IASTM and Exercise versus Ultrasound and Exercise

1. Bhurchandi, S., & Phansopkar, P. (2021). Efficacy of Instrument Assisted Soft-Tissue Mobilization in Patients with Heel Pain: An Experimental Study.

Combined with "Conventional Therapy"

1. Mostafa, M. S. E. M., Abdelraouf, N. A., Eldein, Z. S., Mohamed, M. I. A. E., & Abdalla, M. R. EFFECT OF INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION ON MECHANICAL NECK PAIN: A RANDOMIZED CONTROLLED TRIAL. Turkish Journal of Physiotherapy and Rehabilitation, 32, 3.
2. Mahgoub, M. S. E., Abdelraouf, N. A., Elshafey, M. A., Eldesoky, M. T., Aly, S. M., Zahran, S. S., & Abutaleb, E. E. (2022). Graston Technique Versus Soft Tissue Release on Myofascial Neck Pain Syndrome: A Randomized Controlled Trial. Revista iberoamericana de psicología del ejercicio y el deporte, 17(6), 441-444.
3. 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.

Static Manual Release/Massage and Exercise with and without IASTM

1. Kumar, V. N. (2020). Effect of Sub Occipital Release, Myofascial Release with Iastm Tool on Cervicogenic Headache. Indian Journal of Physiotherapy & Occupational Therapy Print-(ISSN 0973-5666) and Electronic–(ISSN 0973-5674), 14(4), 204-210.
2. Mylonas, K., Angelopoulos, P., Billis, E., Tsepis, E., & Fousekis, K. (2021). Combining targeted instrument-assisted soft tissue mobilization applications and neuromuscular exercises can correct forward head posture and improve the functionality of patients with mechanical neck pain: a randomized control study. BMC musculoskeletal disorders, 22(1), 1-9.
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.

Traction and Nerve Mobilization With and Without IASTM

1. 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.

Exercise With and Without IASTM

1. 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.
2. 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.

Stretching With and Without IASTM

1. 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.
2. Nasir, M., Khan, L. G., Haq, K., Khan, U. A., Batool, M., & Ali, S. (2022). Effects of Graston assisted soft tissue mobilization in patients with chronic plantar fasciitis. Rawal Medical Journal, 47(4), 978-978.

Exercise and Stretching With and Without IASTM

1. Saad, N. G., Yamany, A. A., Azzam, A. A., & Grase, M. O. (2021). Effect of instrument-assisted soft tissue mobilization on trigger points of tension headache. Turkish Journal of Physiotherapy and Rehabilitation, 32, 3.
2. Mahmood, T., Afzal, M. W., Waseem, I., Arif, M. A., & Mahmood, W. (2022). Comparative Effectiveness of Routine Physical Therapy with and without Instrument Assisted Soft Tissue Mobilization for Improving Pain and Disability in Patients with Neck Pain Due to Upper Crossed Syndrome. Annals of Punjab Medical College (APMC), 16(1), 45-50.
3. Sevier, T. L., & Stegink-Jansen, C. W. (2015). Astym treatment vs. eccentric exercise for lateral elbow tendinopathy: a randomized controlled clinical trial. PeerJ, 3, e967.
4. Nadeem, K., Arif, M. A., Akram, S., Arslan, S., Ahmad, A., & Gilani, S. Effect of IASTM ergon technique on pain, strength and range of motion in plantar fasciitis patients. RCT. Physiotherapy Quarterly, 31(4).
5. Jones, E. R., Finley, M. A., Fruth, S. J., & McPoil, T. G. (2019). Instrument-assisted soft-tissue mobilization for the management of chronic plantar heel pain: a pilot study. Journal of the American Podiatric Medical Association, 109(3), 193-200.
6. Bush, H. M., Stanek, J. M., Wooldridge, J. D., Stephens, S. L., & Barrack, J. S. (2020). Comparison of the Graston technique with instrument-assisted soft tissue mobilization for increasing dorsiflexion range of motion. Journal of Sport Rehabilitation, 30(4), 587-594.
7. Schaefer, J. L., & Sandrey, M. A. (2012). Effects of a 4-week dynamic-balance-training program supplemented with Graston instrument-assisted soft-tissue mobilization for chronic ankle instability. Journal of sport rehabilitation, 21(4), 313-326.
8. Ahmed, M.M., Amin, F., & Sedhom, M.G. (2022). Efficacy of instrument-assisted soft tissue mobilization on chronic ankle instability. Fizjoterapia Polska.

Conventional Therapy With and Without IASTM

1. Amin, F., Abdel-Aal, N. M., Ali, N. S., & Moharram, A. EFFECT OF INSTRUMENT ASSISTED SOFT TISSUE MOBILIZATION ONHAND GRIP STRENGTH IN PATIENTS WITH SUBACROMIAL IMPINGfEMENT SYNDROME: A RANDOMIZED CONTROLLED STUDY. Turkish Journal of Physiotherapy and Rehabilitation, 32, 3.
2. Erden, A., Şenocak, E., Kalaycıoğlu, A., & Aktürk, A. (2020). Effectiveness of instrument assisted soft tissue mobilization in myofascial pain syndrome: preliminary results of a randomized controlled trial. Sports Medicine Journal/Medicina Sportivâ, 16(1).
3. Kiran, N., Sahar, W., Hameed, N., Sarfraz, N., & Niaz, A. (2022). Effectiveness of the Graston Technique on Pain and General Foot Health in Patients with Chronic Plantar Fasciitis: A Randomized Clinical Trial. Alternative Therapies in Health and Medicine.

Unmatched Combinations

1. Chintamani R, Metgud S, Heggannavar AShortrt term effects instrument-assisted soft tissue mobilization technique versus Mulligan’s bent leg raise technique in asymptomatic subjects with hamstring tightness- randomized clinical trial. Int J Health Sci Res. 2019; 9(10):50-64.
2. 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.
3. Bhosale, P., & Kolke, S. (2022). Effectiveness of instrument assisted soft tissue mobilization (IASTM) and muscle energy technique (MET) on post-operative elbow stiffness: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 1-9.

Comparing IASTM for Different Body Parts

1. 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.
2. Lauche, R., Wübbeling, K., Lüdtke, R., Cramer, H., Choi, K. E., Rampp, T., ... & Dobos, G. J. (2012). Randomized controlled pilot study: pain intensity and pressure pain thresholds in patients with neck and low back pain before and after traditional East Asian" gua sha" therapy. The American Journal of Chinese Medicine, 40(05), 905-917.
3. 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.
4. 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.

Fascial Mobility and Stiffness

1. Brandl, A., Egner, C., Schwarze, M., Reer, R., Schmidt, T., & Schleip, R. (2023). Immediate Effects of Instrument-Assisted Soft Tissue Mobilization on Hydration Content in Lumbar Myofascial Tissues: A Quasi-Experiment. Journal of Clinical Medicine, 12(3), 1009.
2. Vardiman, J. P., Siedlik, J., Herda, T., Hawkins, W., Cooper, M., Graham, Z. A., ... & Gallagher, P. (2014). Instrument-assisted soft tissue mobilization: effects on the properties of human plantar flexors. International journal of sports medicine, 197-203.
3. Ikeda, N., Otsuka, S., Kawanishi, Y., & Kawakami, Y. (2019). Effects of instrument-assisted soft tissue mobilization on musculoskeletal properties. Medicine and science in sports and exercise, 51(10), 2166.

Strength and Performance

1. 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.
2. Park, J. H., Rhyu, H. S., & Rhi, S. Y. (2020). The effects of instrument-assisted soft tissue mobilization rehabilitation exercise on range of motion, isokinetic strength, and balance in chronic ankle instability taekwondo players. Journal of exercise rehabilitation, 16(6), 516.
3. 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.
4. ÇAKIR, E., & KARADENİZLİ, Z. İ. Effect of Graston Soft Tissue Mobilization Technique on Muscular Force. International Journal of Sport Culture and Science, 9(2), 185-191.
5. 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.

IASTM as a Post-exercise Recovery Aid

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2. Beaupre, M., Tassoul, T., LeMire, P., Elsing, M., Braun, S. I., & Stow, R. C. Effects of the Graston Technique on Overhead Throwing Velocity in Collegiate Baseball Players.
3. Xingze, W., Baohui, J., Houyong, Z., Xingyu, H., Rong, C., & Jinsheng, Y. (2019). Effects of Gua Sha therapy on weightlifting training: a randomized trial. Journal of Traditional Chinese Medicine, 39(04), 575.