Though doctors of chiropractic (DCs) have always used their hands to increase blood flow and break up restrictions in injured soft tissue, fingers alone can’t detect restrictions at deeper levels or treat the full range of restrictions. Because of this, several companies have now developed handheld tools to perform instrument-assisted soft-tissue mobilization.
Graston is the leading technique when it comes to IASTM, says Dr. Heller. It has developed a set of six stainless steel instruments of various shapes and sizes. “You would want an instrument with a beveled edge to go deeper into the tissue, and you would use an instrument with a flat edge if you were working more on the surface,” explains Dr. McCathie. Though many different materials have been used to make the instruments—wood, ceramics, plastics, stone— stainless steel appears to be the best, says soft-tissue expert Warren Hammer, DC, DABCO, who practices in Norwalk, Conn. “Stainless steel instruments have the highest resonation and make it easier to feel both local and broad areas of tissue restriction,” he continues. “Using the tools produces outcomes that are equal to, or better than, palpation by hands.”