Physical Medicine and Rehabilitation
Matthew Natanson, Clare Safran-Norton
• Instrument-assisted soft tissue mobilization (IASTM) is a technique utilized in physical therapy to treat soft tissue restrictions in musculoskeletal injuries. Past research on this topic has investigated range of motion but has not considered the size of soft tissue restrictions. The purpose of this case report is to report changes in soft tissue restrictions from IASTM on a calf muscle strain.
A 63 year old male was referred to physical therapy (PT) with an acute gastrocnemius muscle strain due to ambulating on uneven terrain. Patient’s gait was antalgic and impaired. Treatment consisted of 11 weekly sessions which included IASTM and therapeutic exercise.
• Ultrasound imaging was performed before and after treatment, demonstrating a reduction in size of his calf tissue restriction: 5.7×4.1×1.2cm to 5.1×2.6×0.9cm. Gait was normalized. Ankle dorsiflexion ROM improved from 0 to 8 degrees. Patient was previously unable to perform single heel raises and was able to perform >10 without pain nor limitation.
• This case demonstrates a reduction in size of the individual’s soft tissue evaluated on ultrasound pre and post treatment with an IASTM tool. Further research with larger sample is needed to substantiate use of IASTM in patients with calf muscle strains.
This case report demonstrates the effect of a commonly used treatment in physical therapy and rehabilitation disciplines, referred to as instrument-assisted soft tissue mobilization (IASTM). This utilizes an instrument to perform a massage-type technique to restricted or impaired tissue. In this case report, IASTM was applied to an individual who sustained a strain in his lower leg. An Ultrasound imaging study was performed four days prior to a treatment visit and one day following. The size of his muscle restriction measured was notably smaller following his physical therapy treatment session utilizing this technique. Previously, evidence has measure range of motion changes to demonstrate effects of IASTM, however, to our knowledge, this is the first time this technique has been demonstrated to reduce tissue restriction size in a patient with a calf muscle strain between physical therapy sessions.