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IASTM (Muscle Scraping Therapy) in Scottsdale


IASTM or “muscle scraping therapy” is a technique that uses stainless steel instruments where the practitioner uses a scraping motion [1] to treat muscle injuries [2] , connective tissue injuries, loosen adhered scar tissue and promote healing.

Fascia is a type of connective tissue that surrounds different parts of our bodies including muscles, blood vessels, and nerves. In some instances, fascia binds things together, and in others, it allows for sliding movement.

Muscle scraping therapy has become popular in sports rehab and among athletes [3] due to its effectiveness in treating patients with limited or painful motion, patients with decreased muscle recruitment and patients suffering from excessive scar tissue. [4]

IASTM (Muscle scraping therapy) is thought to be an evolution of a Chinese medicine called “Gua sha”. [3]  The difference would be that Gua sha has a different goal: to make blood stagnation (a heart qi disruption) leave the body. [5]

A British orthopedic surgeon, Dr. James Cyriax, heavily influenced the development of IASTM or muscle scraping therapy. [6]

One of the first IASTM therapies, Graston Technique®, came from an amateur athlete, David Graston, that suffered a knee injury water skiing.    Graston used his machining background to make special muscle scraping tools that became “Graston Technique®.”

What is IASTM(Muscle Scraping Therapy)?
– Dr. Nikita Vizniak

Graston Technique®: How Does It Work

Why was muscle scraping therapy treatment done?

Fascial adhesions in the muscle and connective tissue can originate from surgery, immobilization, repeated strain. [7] [8] [9]

Muscle scraping tools, like ones used in Graston Technique®, are used to break down restrictions in the fascia and scar tissue. Muscle scraping therapy induces microtrauma which activates an inflammatory response [3] so that healing can start.

Common benefits of muscle scraping include: [4]

  • Faster recovery. Muscle scraping therapy like Graston Technique® accelerates rehabilitation [10]

  • Improved range of motion. Research shows improvements in range of motion and strength. [11]

  • Decreased pain. Muscle scraping therapy has research touting decreased pain perception. [11]

  • Decreased scar tissue formation. IASTM works great on scar tissue. Research shows it can be reduced and structural remodeling can occur after muscle scraping therapy. [8]

IASTM is great for:

  • Neck pain

  • Low back pain [12]

  • Myofascial Restrictions

  • Post-surgical or traumatic scaring

  • Medial Epicondylitis (golfer’s elbow)

  • Lateral Epicondylitis (tennis elbow) [9]

  • Carpal Tunnel Syndrome

  • Plantar Fascitis

  • Rotator Cuff Tendinitis

  • Patellar Tendinitis (jumper’s knee) [8]

  • Tibialis Posterior Tendinitis (shin splints)

  • Heel Pain /Achilles Tendinitis

  • DeQuervain’s Syndrome

  • Post-Surgical and Traumatic Scars

  • Ligament Sprains

  • Muscle Strains

  • Trigger Finger

  • Hip Pain after surgical replacement

  • IT Band Syndrome

Risks/Complications of treatment

IASTM (muscle scraping therapy) is generally safe. When side effects occur, they tend to be mild and are short lived. They may include:

  • Discomfort or pain. Muscle scraping therapy can be slightly uncomfortable depending on the body part being treated. Soreness after is normal.

  • Bruising. [4]

  • around the treatment area can occur due to microtrauma or the amount of adhered tissue in the area.

  • Spontaneous connective tissue release. occurs when scar tissue, especially from older trauma, releases. This can trigger on a physical, mental or emotional level.

  • Redness. That looks somewhat like a sunburn is normal after muscle scraping therapy.

Muscle scraping therapy like Graston Technique® isn’t for everyone. Your doctor might caution against IASTM if you have:

  • An Open wound
  • An Unhealed fracture
  • Thrombophlebitis
  • Uncontrolled hypertension
  • A hematoma
  • Osteomyelitis
  • Myositis ossificans
  • Hemophilia

How you prepare

Before IASTM (muscle scraping therapy), your practitioner will likely:

  • Review your medical history. Be prepared to answer questions in regards your condition, to prior treatment interventions, current medications, current or prior conditions, family history, etc.
  • Do a physical exam. an exam may include: vital signs, range of motion testing, or orthopedic testing.
  • Discuss your expectations. Talk about reasons for seeking treatment, risks, how many treatments you might need, and how long it will take for results.

Food and medications

  • There are no special precautions on diet or medications.

Clothing and personal items

  • Wear something so that the area of treatment is easily accessible.
  • Loose fitting clothing like stretchy fabric (leggings, yoga pants), sweatpants, gym shorts, shorts.
  • If possible, try to avoid wearing: tight clothing, dresses or skirts, pantyhose or shape-wear, jewelry, a suit jacket or tie, tight belts, layered, bulky or delicate clothing.

What to expect/How is the treatments administered?

The patient is either in a sitting position or lying down, depending on the area being treated.    The practitioner uses stainless steel muscle scraping tools to find areas of fibrotic tissue and restriction. Fibrotic and restricted areas typically feel like sand or gravel as the tool passes over them.

After an area has been located, the practitioner uses the IASTM tools to scrap or rub the area using a variety of strokes and directions.  The practitioner will usually spend 30 to 60 seconds on the area before moving on to another area.

While muscle scraping therapy like Graston Technique® is not intended to cause pain, there is some mild discomfort.  If the treatment is not tolerable or is too uncomfortable, make sure to let your practitioner know.

After a treatment

After Graston Technique® muscle scraping, the skin the treated area may be slightly red and there can be some minor bruising.

The day following IASTM, it is normal to experience soreness and mild discomfort. To ease pain and discomfort after muscle scraping, apply a cold pack as needed.

Patients are able to return to normal activities immediately after muscle scraping.

Typically, patients usually get muscle scraping therapy like Graston Technique® twice a week for 4 to 5 weeks; however, frequency can change and is dependent upon the individual’s tolerance and reaction to treatment.

Results/treatment success rates

Many patients start to see results after 3 or 4 sessions of muscle scraping therapy.

While IASTM (muscle scraping therapy) and its results are dependent upon the practitioner’s level of skill, research shows that it can improve soft tissue function and ROM in acute or chronic sports injuries. [3]

Studies suggest that muscle scraping, when used correctly, can significantly decrease pain.

Since the first controlled research study in 1997, [6] there has been much more research done to support using muscle scraping.

Research additionally shows benefits of muscle scraping like Graston Technique® improving range of motion in healthy individuals and decreased pain and improved function in healthy and injured patients. [6]


  1. Lewis, Z. T. P. D. (2012, October 22). Graston Technique gives muscles a sharp workout: Stretching Out. Cleveland.

  2. Lambert, M., Hitchcock, R., Lavallee, K., Hayford, E., Morazzini, R., Wallace, A., Conroy, D., & Cleland, J. (2017). The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review. Physical Therapy Reviews, 22(1–2), 76–85.

  3. Kim, J., Sung, D. J., & Lee, J. (2017). Therapeutic effectiveness of instrument-assisted soft tissue mobilization for soft tissue injury: mechanisms and practical application. Journal of Exercise Rehabilitation, 13(1), 12–22.

  4. Nazari, G., Bobos, P., MacDermid, J. C., & Birmingham, T. (2019). The Effectiveness of Instrument-Assisted Soft Tissue Mobilization in Athletes, Participants Without Extremity or Spinal Conditions, and Individuals with Upper Extremity, Lower Extremity, and Spinal Conditions: A Systematic Review. Archives of Physical Medicine and Rehabilitation, 100(9), 1726–1751.

  5. Cheatham, S. W., Baker, R., & Kreiswirth, E. (2019). INSTRUMENT ASSISTED SOFT-TISSUE MOBILIZATION: A COMMENTARY ON CLINICAL PRACTICE GUIDELINES FOR REHABILITATION PROFESSIONALS. International Journal of Sports Physical Therapy, 14(4), 670–682.

  6. Seffrin, C. B., Cattano, N. M., Reed, M. A., & Gardiner-Shires, A. M. (2019). Instrument-Assisted Soft Tissue Mobilization: A Systematic Review and Effect-Size Analysis. Journal of Athletic Training, 54(7), 808–821.

  7. Fowler, S., Wilson, J. K., & Sevier, T. L. (2000). Innovative approach for the treatment of cumulative trauma disorders. Work (Reading, Mass.), 15(1), 9–14.

  8. Wilson, J. K., Sevier, T. L., Helfst, R., Honing, E. W., & Thomann, A. (2000). Comparison of Rehabilitation Methods in the Treatment of Patellar Tendinitis. Journal of Sport Rehabilitation, 9(4), 304–314.

  9. Sevier, T. L., Gehlsen, G. M., Wilson, J. K., Stover, S. A., & Helfst, R. H. (1995). TRADITIONAL PHYSICAL THERAPY VS. GRASTON AUGMENTED SOFT TISSUE MOBILIZATION IN TREATMENT OF LATERAL EPICONDYLITIS. Medicine & Science in Sports & Exercise, 27(Supplement), S52.

  10. Papa J. A. (2012). Two cases of work-related lateral epicondylopathy treated with Graston Technique® and conservative rehabilitation. The Journal of the Canadian Chiropractic Association, 56(3), 192–200.

  11. MELHAM, T. J., SEVIER, T. L., MALNOFSKI, M. J., WILSON, J. K., & HELFST, R. H. (1998). Chronic ankle pain and fibrosis successfully treated with a new noninvasive augmented soft tissue mobilization technique (ASTM). Medicine & Science in Sports & Exercise, 30(6), 801–804.

  12. 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.

  13. Hussey, M. J., Boron-Magulick, A. E., Valovich McLeod, T. C., & Welch Bacon, C. E. (2018). The Comparison of Instrument-Assisted Soft Tissue Mobilization and Self-Stretch Measures to Increase Shoulder Range of Motion in Overhead Athletes: A Critically Appraised Topic. Journal of Sport Rehabilitation, 27(4), 385–389.

  14. Howitt, S., Jung, S., & Hammonds, N. (2009). Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report. The Journal of the Canadian Chiropractic Association, 53(1), 23–31.

  15. Orthopaedic Section Poster Presentations (Abstracts OPO1–OPO236). (2016). Journal of Orthopaedic & Sports Physical Therapy, 46(1), A58–A157.

  16. Papa J. A. (2012). Conservative management of De Quervain's stenosing tenosynovitis: a case report. The Journal of the Canadian Chiropractic Association, 56(2), 112–120.

  17. Howitt, S., Wong, J., & Zabukovec, S. (2006). The conservative treatment of Trigger thumb using Graston Techniques and Active Release Techniques. The Journal of the Canadian Chiropractic Association, 50(4), 249–254.

  18. Cheatham, S. W., Lee, M., Cain, M., & Baker, R. (2016). The efficacy of instrument assisted soft tissue mobilization: a systematic review. The Journal of the Canadian Chiropractic Association, 60(3), 200–211.

  19. 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.

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