Has anyone had ASTYM. Can compare to Graston

I do ART and Graston. ASTYM uses the same concept as graston, and both are under the category of instrument assisted soft tissue mobilization. They just use different tools. ASTYM seminars won't allow chiropractors to take them, but Graston allows for both. Before I started doing Graston a few years ago, ASTYM was using plastic instruments while the Graston tools are stainless steel. I have used plastic instruments before Graston, though not the ASTYM tools, and the stainless is superior because of their weight and comfort to the patient. That said, most people still experience some discomfort during treatment, but it is more tolerable with the Graston compared to the plastic ones I have used. Graston recommends a treatment process...tissue warm-up, followed by treatment, then exercise or exercise during treatment, then ice. Because most of the research on both Graston and ASTYM has been done at Ball State Memorial Hospital, I am sure the process for them is the same. In short, the major differences to the patient are probably more comfort with Graston tools and for the provider, the weight of the Graston tools make them easier on the hands. Otherwise its probably identical and the results in the end will probably be the same.

If practitioner has talent; bare hands (no tools) are better. Remember this is scraping the skin with a weighted tool to effect the deep tissues. Don't be fooled; it's the magician not the wand.

I had fibrotic, scar tissue in the high hamstring area after recovering from a partial tear of the proximal hamstring tendon. I received 12 Graston sessions over a 9 week period to alleviate the pain that I felt was from trapped nerves. I experienced some discomfort during the sessions, but it was not too bad. The permanent improvement made the treatment sessions worthwhile in my opinion.

There is a fundamental difference between Astym treatment and tooled cross-friction massage (IASTM, Graston, etc.) The tooled cross-friction massages work to mechanically (physically) break down tissue. Astym treatment works on a cellular level to stimulate a regenerative response in soft tissues. If you would like to read more about these differences, here is a link:

http://blog.astym.com/blog/astym-3/0/0/astym-vs-iastm-graston-sastm-etc-how-they-are-different

It is important to note that Astym was scientifically developed by a research team from major universities(including IU Health Ball State, and Purdue) and hospitals. Astym is supported by peer-reviewed, clinical and scientific research, and has specific, consistent protocols for application.

There is very little research on Graston and other Instrument Assisted Soft Tissue Mobilization (IASTM) treatments. That doesn't mean they can't be helpful at times, however, the theory and application vary widely, so results can be unpredictable.

You are so very wrong. As far as physiological effects go, it doesn't matter what tool is used the outcome is the same. Go to Graston's website. There is plenty of research done at Ball State Memorial Hospital. Graston offers the same benefits of fibroblast proliferation and physically breaks down scar tissue. www.grastontechnique.com

see also:

Published Research

• Loghmani MT (PT, PhD, MTC); Warden SJ (PhD). Instrument-assisted cross fiber massage alters regional microvascular morphology in healing knee ligaments suggesting possible angiogenesis. APTA Combined Sections Meeting [platform presentation]. New Orleans (LA). 2011 Feb.

• Looney B, Srokose T, Fernández-de-las-Peñas, Cleland J. Graston instrument soft tissue mobilization and home stretching for the management of plantar heel pain: a case series. Journal of Manipulative and Physiological Therapeutics (JMPT). 2011 Feb; 138-142.

• Bayliss AJ, Klene FK, Gundeck EL, Loghmani MT. Treatment of a patient with post-natal chronic calf pain utilizing instrument-assisted soft tissue mobilization. APTA CSM [platform presentation]. 2010.

• Loghmani MT. Instrument-assisted cross-fiber massage improves blood flow in healing knee ligaments suggesting enhanced angiogenesis. APTA CSM [orthopedic section platform presentation]. 2010.

• Brantingham JW, Globe G, Jensen M, Cassa TK, Globe D, Price J, Mayer SN, Lee F. A feasibility study comparing two chiropractic protocols in the treatment of patellofemoral pain syndrome. JMPT. Sep 2009;32(7):536-548.

• Howitt S, Jung S, Hammonds N. Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report. J Can Chiropr Assoc. 2009; 53(1).

• Loghmani MT, Warden SJ. Instrument-assisted cross-fiber massage accelerates knee ligament healing. Journal of Orthopaedic & Sports Physical Therapy (JOSPT). 2009 Jul;39(7):506-514.

• Loghmani MT, Kiesel J, Lassiter J, Taylor L, Beaman M, Grogg J, Streeter H, Warden SJ. Long-term effects of instrument-assisted cross-fiber massage on healing medial collateral ligaments. JOSPT. 2007 Jan;37(1): A18.

• Hayes D, Loghmani MT, Lubitz R, Moore E. A comparison of two instrument-assisted soft tissue mobilization techniques: effects on therapist discomfort/fatigue and treatment time. JOSPT. 2007 Jan;37(1): A17.

• Burke J, Buchberger DJ, Carey-Loghmani MT, Dougherty PE, Greco DS, Dishman JD. A pilot study comparing two manual therapy interventions for carpal tunnel syndrome. Journal of Manipulative and Physiological Therapeutics (JMPT). 2007 Jan;30(1):50-61.

• Hammer WI, Pfefer, MT. Treatment of a case of subacute lumbar compartment syndrome using the Graston Technique. JMPT. 2005 Mar/Apr; 28(3):199-204.

• Gehlsen GM, Ganion LR, Helfst R. Fibroblast response to variation in soft tissue mobilization pressure. Medicine and Science in Sports and Exercise. 1999 Apr;31(4):531-535.1

• Davidson CJ, Ganion LR, Gehlsen GM, Verhoestra B, Roepke JE, Sevier TL. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Medicine and Science in Sports and Exercise. 1997 Mar;29(3):313-319.1

• Hammer W. The use of transverse friction massage in the management of chronic bursitis of the hip and shoulder. JMPT. 1993 Feb;16(2):107-111.

Your statements are not accurate. This process does not simply scrape the skin. This is not Gua Sha. Bare hands can't come close to the treatment outcomes, especially compared to the same number of treatments, as Graston or ASTYM.

David Vs Goliath wrote:

If practitioner has talent; bare hands (no tools) are better. Remember this is scraping the skin with a weighted tool to effect the deep tissues. Don't be fooled; it's the magician not the wand.

I had 4 sessions of ASTYM for high hamstring issues and got no relief at all.

Finally figured out that strengthening and montly deep tissue work keeps it under control.

Undoubtedly high hamstring issues are harder to treat but should still get better and you should have noticed a difference in 4 treatments. Outcomes are determined by the accuracy and application of treatment, just like any treatment.

For any or all soft tissue manipulation, what would the focus be? e.g What is the pressure required, duration frequency? What actually happens to fibrosis and adhesion during therapy( short and long term)? I am still unclear what the goal is. E.g. stretching or breaking up fascial tissue? It seems I haven't found conclusive evidence or detailed methodologies in the studies and at best the anecdotal evidence is mixed from my findings. Anything someone can point out is greatly appreciated.

voiceofreason wrote:

Undoubtedly high hamstring issues are harder to treat but should still get better and you should have noticed a difference in 4 treatments. Outcomes are determined by the accuracy and application of treatment, just like any treatment.

[quote]good art wrote:

For any or all soft tissue manipulation, what would the focus be? e.g What is the pressure required, duration frequency? What actually happens to fibrosis and adhesion during therapy( short and long term)? I am still unclear what the goal is. E.g. stretching or breaking up fascial tissue? It seems I haven't found conclusive evidence or detailed methodologies in the studies and at best the anecdotal evidence is mixed from my findings. Anything someone can point out is greatly appreciated.

[quote]voiceofreason wrote:

So what are your "findings" of ancedotal evidence? The goal for soft tissue manipulation depends on the method used. If you are specifically speaking of Graston, the goal is to break down fibrous cross linkages within fascia and between fascia and other connective tissue and/or nerves. This is done by using mechanical pressure, which through the thixotropic effect on scar tissue, causes it to become malleable. We can thus allow for enhanced fascial and connective tissue gliding, as well as remodeling dysfunctional restrictive fibrous tissue into functional scars. In addition, soft tissue therapies, particulary those using instruments, cross friction work on tendinopathies causes reproduction of the primary inflammatory response causing fibroblastic proliferation which allow for synthesis of collagen, fibronectin and proteoglycans, as well as the synthesis of enzymes (collagenases, proteogylcanases, glycosaminodases and other proteolytic enzymes) which remodel the matrix. With this recreation of the primary inflammatory response, we also get seperation of the collagen cross linkages (breaking down of scar tissue), splaying and stretching of connective tissue fibers, increased skin temperature and oxygenation of muscle tissue, facilitation of chronic holding patterns in muscle reflex patterns, alteration of spinal neuroreflex activity, and increased histamine response.

Treatment with Graston is typically done 2x per week for 4-6 weeks, sometimes less, sometimes more depending on the chronicity or acuity, as well as the severity and area of complaint. The pressure required is the pressure needed to feel the restrictions with the tools, considering the tolerance of the patient. In using only the tools, treatment takes 30 seconds to 2 minutes per area, and needs to be followed by stretching to help in reestablishing the orientation of the adhesions along the direction of the muscle fibers.

If you click on the post I did above, there is a page on their website with treatment outcomes for different conditions. It is not just "antecdotal".

Other soft tissue techniques may have different goals. The above applies to Graston, ASTYM, or any other form of instrument assisted soft tissue mobilization.

Before you thrown down the money for these treatments, it'd be worth checking these out:

http://www.sciencebasedmedicine.org/index.php/the-graston-technique-inducing-microtrauma-with-instruments/

http://saveyourself.ca/articles/shorts/2009-08-17-modality-empires.php

The second website is nothing but a jealous rant and really contains no information. The first one makes its living and basis on attempting to find fault with everything under the sun, and is sketchy and incomplete. The Outcome Research link I posted above was Ball State Memorial Hospital.

The research I listed above is valid, and these treatments are not expensive. Graston is done in conjunction with other treatments and is covered by insurance as myofascial release. In my office a 25-30 minute session of Graston/ART/rehab is 40. My prices are problably average of what practitioners are charging. If you read runners world forums and posts on here, you will find that many people have gotten great benefit from it. That said, it only does what it is designed to do. If you have scar tissue restrictions and muscle imbalance, all your problem may not go away with a few treatments are there are other variables to consider.

Consider that 15 NBA teams, 12 NFL teams, 14 MLB teams, the PGA tour, the Champions tour, 4 US olympic training centers and over 125 college teams use Graston to treat their athletes.

thanks

You sir are a troll selling a name brand nothing more. If I use chop sticks, fork or my fingers the food still arrives to my mouth.

Are you a massage therapist? Have you ever had graston done? Did you read any of the research and have an understanding how it works? I am absolutely not selling the brand. I said astym will most likely have the same outcome but if you think massage deep tissue or otherwise does the same thing you are sorely mistaken. And by the way, i was not the op for this post. They specifically asked about graston so how is this trolling?

I've been struggling with a severe case of plantar fascitis for a bit over 18 months. Attempted about every modality I could afford and/or recommended. Finally had someone mention Graston and was the one thing that got me back on the road to some jogging. Moved out of state and couldn't fine a local Graston practicioner so I'm trying ASTYM. It is different (yes the tools are different as well) in how it's done and the result I'm feeling. As someone mentioned above, could be just that the provider was better, but it also feels differently in it's application which I relate to the tool/instrument. Just my two cents.

I appreciate your response and am glad its working for you. There are people who have just learned the techniques and people who have been practicing them for years. There are also other variables such as static treatment, dynamic treatment, treatment under provocative motion and treatment while performing rehab. Pressures can also vary, and the phase of your injury and recovery can also affect how things feel and progress. The most important thing is the outcome. Thanks.

Graston is used by higher end athletes & weekend warriors alike. It seems to me to get more results than deep tissue massage & at a better value. Just because Graston has a brand name/ technique doesn't necessarily make it a better selling point. It's more uncomfortable than massage, but the results get a runner back to running.