Astym vs. IASTM (Graston®, Sastm, etc.): How They Are Different

There is a significant difference between Astym treatment and instrument assisted soft tissue mobilization (IASTM) techniques, such as Graston®, Sastm and other tooled friction massage.

Although Astym treatment evolved from research on manual therapies, including friction massage, it is very different than friction massage, and its variation, tooled friction massage. Tooled friction massage is often referred to as instrument assisted soft tissue mobilization or IASTM, and is also referred to by the brand of IASTM, such as Graston® Technique or Sastm.  IASTM works simply on a mechanical level, attempting to break down unhealthy tissue, and in the process, these approaches can adversely affect healthy tissue.

Rather than trying to mechanically break down tissue as IASTM does, Astym treatment focuses on activating an underlying physiological response leading to the regeneration of soft tissues.  Astym treatment was developed and refined over 15 years.  The research that lead to the development of Astym treatment began with the review of friction massage, and other manual therapies and how the addition of tools may assist in those approaches. After reviewing how tools could assist in friction massage, the Astym research team realized the limitations of IASTM/friction massage, and then they shifted their focus to concentrate on a more effective type of treatment approach.  The Astym research team was expanded, and they studied how certain physiological changes can be induced on a cellular level with the proper stimulation.  Inducing the desired underlying physiological responses which result in healing and regeneration became the fundamental factor that guided the development of protocols and application of the Astym process.  The goal of Astym treatment is to induce biological changes at a cellular level to promote the resorption of scar tissue, and to stimulate tissue turnover and regeneration of soft tissues.

After years of study, Astym treatment developed specific protocols and instrumentation that induce fibroblast activation, macrophage mediated phagocytosis (microdebridement) and local release of growth factors that result in additional fibroblast recruitment and activation.  This is how Astym treatment effectively and safely stimulates affected soft tissues to heal and regenerate at a cellular level. Astym treatment’s protocols and application ensure that only the unhealthy tissue receives the stimulation it needs to regenerate and heal, and that healthy tissues remain healthy, with no adverse effects from treatment.

There is evidence confirming Astym’s effectiveness in the medical literature. In addition, there is a large body of outcome evidence collected from independent clinicians across the country that also confirms the effectiveness of Astym treatment, and shows what results a patient can expect for each diagnosis in a real world setting.

In addition to treating the symptomatic area, Astym treatment also addresses other areas in the kinetic chain (chain of movement) that may be damaged by the condition (including compensatory areas, such as the tissue that may be overused by limping or other abnormal movement patterns due to pain or lack of function).

The application and results of IASTM/friction massage are quite variable, and treatment is usually limited to the point of pain only. There is little to no medical evidence showing that friction massage consistently works (perhaps due in part to the inconsistency of application), however, there have been some individual stories where there was positive benefit.  The literature is inconclusive, however, the Cochrane Review did note that deep transverse friction massage showed no consistent benefit for the control of pain, improvement of strength, or improvement of functional status in patients with tendinitis/tendinopathy.

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