Getting Rid of Inflammation By Creating More?

Instrument Assisted Soft Tissue Mobilization: Getting Rid of Inflammation By Creating More?
Posted on 12/07/2018
Article by: Tyler Ubben, ATC

Tendinitis, the gradual and chronic inflammation of a tendon anywhere in the body, is characterized by redness, swelling, loss of function, and of course, pain, over what is usually a very long period of time. The pain is often tenacious, outlasting many different types of treatment, causing serious frustration. At this point in the treatment plan, introduction to a new treatment may be necessary. Instrument Assisted Soft Tissue Mobilization (IASTM) has been shown in research to aid in the healing of chronic inflammatory athletic injuries.

IASTM is the mobilization of soft tissue with the use of special hand tools by a healthcare professional. This mobilization of the soft tissue has many benefits, resulting in increases in range of motion, increased blood flow to the affected area, and even allowing for better alignment of collagen fibers within the tissue. Collagen fibers help to maintain the shape of the matrix within which each cell sits. Better alignment of these collagen fibers allows for better function of the area and better interaction.

When an injury occurs, chronic or not, the body begins trying to repair the area immediately. Without proper rehabilitation, wound treatment, and timing, the body can lay down these collagen fibers in unusual patterns. These unusual patterns are a major cause of loss of motion in many chronic injuries. Rehabilitation and timing are key in collagen direction laying, as the small tensions felt throughout rehab will allow the body to know which directions will experience more tension. Without this stimulation, the collagen may be laid incorrectly, causing a loss of motion in the affected area, unusual inflammatory responses, and ultimately scarring that may last longer than expected. IASTM has been found to combat this and has even been shown to reverse these effects. The increase in blood flow to the area where the treatment was applied will allow for more healing to occur in that area. Higher blood flow will bring about higher amounts of regenerative cells, called fibroblasts, and can even cause these cells to regenerate tissue at a higher rate. This regeneration of tissue, and correct laying of collagen fibers can ultimately result in a regaining of a painless range of motion at the site of injury.

When paired with consistent rehabilitative exercise, tissue heating, eccentric exercise, stretching, and cryotherapy treatments, research has found IASTM treatment has improved patient pain and mobility over the earlier listed treatments, which could not provide any improvement on their own. While the IASTM treatment has been explained as uncomfortable, this discomfort is thought to be the breaking up of large masses of collagen fibers laid incorrectly due to a chronic injury such as tendinitis. This elicits a new inflammatory response, allowing for the laying of new collagen fibers, which will most likely be laid correctly due to the other treatments mentioned allowing small tensions to dictate where the directions of this collagen will be laid for optimal motion between cellular surfaces.

IASTM can be thought of as a reset, of sorts. By introducing even more inflammation where chronic inflammation already is and clearing a possible mass of collagen fibers that could be restricting the range of motion, this allows the body to begin from scratch. When paired with rehabilitative exercises and modalities, this reset can ultimately result in complete resolution of the chronic injury that has been plaguing a tendon for what seems like an eternity.

References:
A Case Report on a Patient of Achilles Tendinitis Treated with Gyeon-mak Chuna, Korean Medicine and Graston Technique. Park et al. - Journal of Korean Medicine Rehabilitation - 2015

Miners, Andrew L. “Chronic Achilles Tendinopathy: a Case Study of Treatment Incorporating Active and Passive Tissue Warm-up, Graston Technique®, ART®, Eccentric Exercise, and Cryotherapy.” 2011.

Epidemiology of Shoulder Injuries in Overhead Athletes. Noreski & Cohen - Sports Injuries to the Shoulder and Elbow - 2015
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