Soft Tissue Mobilization Techniques to Improve Range of Motion Deficits: A Critically Appraised Topic

Clinical Scenario - Soft tissue injuries can range in severity and can occur throughout the body. One of the most common physiological deficits that is observed after sustaining a soft tissue injury, or undergoing a surgical reconstruction or repair, is a lack of pain-free range of motion (ROM). To improve ROM deficits, clinicians use various techniques including Instrument Assisted Soft Tissue Mobilization (IASTM). IASTM has been a popular therapeutic modality in recent years. IASTM utilizes specially designed tools that contour to the body allowing the clinician to gain a mechanical advantage in mobilizing the tissue. The mechanical advantage gained through IASTM treatments gives the clinician access to a broader scale of surface area and pressure that can be applied during the treatment. Subsequently, limiting strain is placed on the hands of clinicians who provide soft tissue mobilization manually. Clinical Question- How does IASTM compare to other soft tissue mobilization techniques in restoring pain-free ROM? Summary of Key Finding(s) - All three studies found acute increases in ROM with IASTM after a single treatment. However, one study found more favorable greater ROM improvements with Compressive Myofascial release techniques, while the other two studies found comparable results between IASTM and the other chosen soft tissue mobilization techniques (Compressive Myofascial Release, Roller Stick Massage, Tissue Flossing, Kinesiology Taping). Both of these studies reported comparable results and recommended combining techniques to elicit greater improvements in ROM. Clinical Bottom Line - IASTM is an effective technique for restoring pain-free range of motion in the immediate term (under 48 hours); however, it is recommended to use a combination approach of IASTM with CMR or Tissue Flossing. This may lead to sustainable physiological effects. Strength of Recommendation - B Keywords - IASTM, Instrument-Assisted Soft Tissue Mobilization, roller stick massage, tissue flossing, Myofascial