Muscle pain can make everyday movement, exercise, and physical activity more difficult. When pain is related to an injury, overuse, or musculoskeletal condition, physical therapy may use several different techniques to help improve how a patient moves and feels.
One treatment you may encounter during physical therapy is instrument-assisted soft tissue mobilization, commonly called IASTM.
IASTM uses specialized tools to apply pressure and movement to the body's soft tissues. It is often incorporated into a larger physical therapy program that may also include therapeutic exercise, mobility work, manual therapy, and neuromuscular training.
So, can IASTM help reduce muscle pain?
Research suggests that IASTM may help reduce pain in some people with musculoskeletal conditions, particularly when it is combined with other rehabilitation strategies. However, it should not be considered a stand-alone solution for muscle pain.
What Is IASTM?
Instrument-assisted soft tissue mobilization is a hands-on physical therapy technique that uses specially designed instruments to apply pressure to muscles and other soft tissues.
The instruments are moved across the skin over a targeted area while the physical therapist adjusts the pressure, direction, and technique based on the patient's condition.
IASTM is sometimes used for areas that feel tight, restricted, or painful.
It may be incorporated into treatment for conditions involving:
- Muscle pain
- Tendon pain
- Sports injuries
- Overuse injuries
- Limited range of motion
- Soft tissue restrictions
- Some chronic musculoskeletal conditions
- Areas affected by scar tissue
IASTM is not a diagnosis or treatment for one specific condition. Instead, it is a technique that may be used as part of an individualized rehabilitation program.
How Does IASTM Work?
The exact mechanisms behind IASTM are still being studied.
Historically, IASTM has often been described as a technique that mechanically breaks up scar tissue, adhesions, or restrictions within the fascia.
However, the scientific evidence does not clearly establish that this is exactly what happens to the tissue during a typical IASTM session.
Current research suggests that the effects of IASTM may involve a combination of mechanical and neurological responses, including changes in pain sensitivity, muscle tone, and movement.
This is an important distinction because patients do not necessarily need to think of IASTM as physically "breaking apart" damaged tissue.
Instead, the goal is to use the technique to help improve symptoms and movement so the patient can participate more effectively in active rehabilitation.
Can IASTM Reduce Muscle Pain?
Research suggests that it can.
A 2025 systematic review and meta-analysis examined 11 randomized controlled trials involving 427 people with musculoskeletal disorders. The researchers found moderate-certainty evidence that IASTM reduced patient-reported pain compared with control treatments. They also found low-certainty evidence for improvements in patient-reported function.
Another newer meta-analysis included 20 randomized controlled trials involving 1,420 adults with musculoskeletal disorders. IASTM was associated with significant reductions in pain and improvements in range of motion. The researchers also found that IASTM combined with conventional rehabilitation produced more consistent pain relief than IASTM used by itself.
These findings are encouraging, but they do not mean IASTM will eliminate pain for every patient.
Pain is influenced by many factors, and the effectiveness of any treatment depends on the underlying condition and the individual's response.
What Does IASTM Feel Like?
During treatment, you may feel pressure, pulling, or a scraping sensation as the instrument moves across the skin.
IASTM should not be performed with the goal of causing significant pain.
Some patients may experience mild temporary redness in the treated area. This can occur because of increased local blood flow and pressure from the treatment.
Your physical therapist should adjust the technique based on your symptoms and tolerance.
Does IASTM Improve Range of Motion?
IASTM may also help improve mobility.
A 2024 meta-analysis examining nine randomized controlled trials found that IASTM improved range of motion in several groups, although the certainty of the evidence ranged from very low to low.
Another meta-analysis of 20 randomized controlled trials found significant improvements in range of motion following IASTM, with particularly consistent improvements reported for spinal conditions.
Improving mobility can be especially useful when pain or restricted movement is limiting a patient's ability to exercise.
For example, if a patient has painful or restricted movement that makes strengthening difficult, a physical therapist may use IASTM as one part of treatment and then follow it with active mobility or strengthening exercises.
Does IASTM Treat the Cause of Muscle Pain?
Not necessarily.
This is one of the most important things to understand about IASTM.
Reducing pain during a treatment session does not automatically mean the underlying cause of the pain has been corrected.
For example, muscle pain could be associated with:
- Training errors
- Muscle weakness
- Poor movement mechanics
- Joint mobility limitations
- Repetitive loading
- Previous injury
- Sudden increases in activity
- Poor recovery
- A broader musculoskeletal condition
IASTM may help address symptoms or improve movement, but your physical therapist should also identify factors contributing to the problem.
This is why IASTM is generally most useful when combined with active rehabilitation.
IASTM and Exercise
One of the most important ways IASTM can fit into physical therapy is as a complement to exercise.
For example, a physical therapist may use IASTM to address an area of discomfort or mobility restriction and then have the patient perform:
- Stretching
- Mobility exercises
- Strengthening
- Neuromuscular re-education
- Balance exercises
- Functional movement
- Sport-specific exercises
The goal is to take advantage of any short-term changes in pain or movement and then use active exercise to build longer-term improvements.
This approach is consistent with current evidence suggesting that IASTM combined with conventional rehabilitation may provide more consistent pain relief than IASTM alone.
Is IASTM Better Than Other Physical Therapy Treatments?
There is not enough evidence to say that IASTM is universally better than other physical therapy treatments.
This is where the research becomes more complicated.
An updated systematic review published in 2022 analyzed 46 randomized controlled trials and found very-low-certainty evidence that IASTM provided clinically meaningful improvements in pain, function, or range of motion compared with other active treatments.
More recent reviews have reported more favorable results.
For example, the 2025 meta-analysis found moderate-certainty evidence for reduced patient-reported pain, while the newer 20-study meta-analysis found significant improvements in pain and range of motion.
These differences highlight an important point:
The evidence surrounding IASTM is evolving, and results depend on the condition, comparison treatment, treatment protocol, and outcome being measured.
Can IASTM Help With Sports-Related Muscle Pain?
IASTM may be useful for athletes experiencing certain musculoskeletal conditions.
Athletes frequently deal with muscle soreness, overuse injuries, restricted mobility, and other soft tissue complaints.
IASTM may help temporarily reduce pain or improve mobility, which can make it easier to participate in an active rehabilitation program.
However, athletes should not use IASTM simply to push through an injury.
If pain is persistent or worsening, the underlying problem should be evaluated.
A complete sports rehabilitation program may include IASTM when appropriate, but it should also address strength, mobility, movement mechanics, workload, and sport-specific demands.
Can IASTM Help With Tight Muscles?
It may help some patients feel less restricted or improve their range of motion.
However, the sensation of a "tight" muscle does not always mean the muscle or fascia is physically shortened.
Muscle tightness can be influenced by pain, nervous system sensitivity, weakness, fatigue, training load, and other factors.
This is why a physical therapist should evaluate the reason behind the restriction rather than assuming that tissue needs to be "broken up."
IASTM can be one tool used to address the patient's symptoms, but it should be selected based on the individual's assessment.
Is IASTM Safe?
IASTM is generally considered a low-risk treatment when appropriately applied, but it is not appropriate for every patient or every body region.
A physical therapist should consider factors such as:
- Skin condition
- Recent surgery
- Acute injury
- Medication use
- Bleeding or clotting concerns
- Sensory changes
- Inflammation
- The location and severity of the injury
Patients should tell their physical therapist about relevant medical conditions, medications, recent procedures, and changes in symptoms before treatment.
Does IASTM Cause Bruising?
It can.
Some patients may develop temporary redness or bruising after IASTM, particularly when more pressure is applied.
However, bruising should not be viewed as proof that the treatment was effective.
The goal of IASTM is not to create bruising. The goal is to help the patient manage symptoms and improve movement when the technique is clinically appropriate.
How Long Do the Effects of IASTM Last?
The duration of benefit can vary.
Some studies have demonstrated short-term improvements in pain or range of motion, while evidence for longer-term improvements is less consistent.
This is another reason why IASTM should be combined with active rehabilitation.
A temporary improvement in pain or mobility can create an opportunity for the patient to perform exercises that address strength, movement, and function.
The long-term goal is not to repeatedly treat the same painful area without addressing contributing factors.
What Does the Research Say Overall?
The current evidence suggests that IASTM may reduce pain and improve range of motion in people with certain musculoskeletal conditions, but the evidence is not completely consistent.
A 2025 systematic review and meta-analysis found moderate-certainty evidence supporting reductions in patient-reported pain and low-certainty evidence for improvements in function.
A newer 2026 meta-analysis of 20 randomized controlled trials also found significant improvements in pain and range of motion, with more consistent pain relief when IASTM was combined with conventional rehabilitation.
At the same time, earlier systematic reviews have found limited or very-low-certainty evidence and questioned whether IASTM provides clinically meaningful benefits beyond other active treatments.
The best takeaway is therefore not that IASTM is a miracle treatment or that it does not work.
IASTM may be a useful adjunct for managing pain and improving mobility in selected patients, particularly when it is combined with active physical therapy.
The Bottom Line
Can IASTM help reduce muscle pain?
It can help some patients.
Current research suggests IASTM may reduce pain and improve range of motion in people with certain musculoskeletal conditions. However, the quality of evidence varies, and IASTM does not appear to be universally superior to other forms of physical therapy.
The most appropriate role for IASTM is as one component of a comprehensive rehabilitation program.
At Core Performance Physical Therapy, soft tissue techniques can be paired with therapeutic exercise, strengthening, mobility work, neuromuscular re-education, and functional training based on each patient's needs.
The goal is not simply to make a painful area feel better temporarily. The goal is to help patients move better, build capacity, and return to the activities they enjoy.
Frequently Asked Questions
Does IASTM help with muscle pain?
Research suggests that IASTM can reduce patient-reported pain in some people with musculoskeletal disorders. A 2025 meta-analysis found moderate-certainty evidence supporting this effect.
Does IASTM break up scar tissue?
IASTM is often described this way, but the evidence does not clearly establish that the instruments physically break up scar tissue or adhesions. The effects may involve multiple mechanical and neurological mechanisms.
How often should IASTM be used?
There is no universal treatment schedule. Frequency depends on the patient's condition, symptoms, treatment goals, and overall rehabilitation plan.
Does IASTM hurt?
IASTM can create pressure or an intense sensation, but treatment should be adjusted to the patient's tolerance. Significant pain is not required for IASTM to be effective.
Does IASTM cause bruising?
It can sometimes cause temporary redness or bruising. However, bruising is not an indication that treatment was more effective.
Is IASTM better than massage?
Not necessarily. IASTM and massage use different techniques, and research does not establish one as universally superior. The most appropriate treatment depends on the patient's condition and goals.
Can IASTM replace exercise?
No. IASTM is best viewed as an adjunct to rehabilitation. Exercise and progressive loading are important for developing long-term strength, mobility, and physical capacity.
Can IASTM help athletes?
IASTM may help athletes manage certain musculoskeletal symptoms and mobility restrictions. It should be incorporated into a broader rehabilitation or performance program rather than used to mask pain and continue training through an injury.
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