Instrument Assisted Soft Tissue Therapy In Chiropractic Practice

Spine Horizontal Clinic

Instrument Assisted Soft Tissue Therapy In Chiropractic Practice

Instrument Assisted Soft Tissue Therapy is a growing soft tissue technique used in practice. Here is a study looking at its effectiveness in the chiropractic setting.

Spinal manipulative therapy, Graston technique® and placebo for non-specific thoracic spine pain: a randomised controlled trial
Amy L. Crothers, Simon D. French, Jeff J. Hebert, Bruce F. Walker
Chiropractic & Manual Therapies201624:16
DOI: 10.1186/s12998-016-0096-9



It is accepted that in practice, multiple treatment options can be used to enhance outcomes. For example, combining manual therapy with instrument assisted soft tissue therapy with introduction of exercise.

We find in practice, choosing the correct treatments and in the correct order can enhance outcomes further. In this study we gain information on 2 treatment options we utilise in the clinic; Instrument Assisted Soft Tissue Therapy and Manual Therapy.

To understand the clinical decision making facing the chiropractor in any one specific case that enters the clinic, we need to make some judgement on the following questions (for example):

Q: When should we start specific exercise prescription ? (Either in conjunction with manual therapy or without ?)

Q: Do we progressively introduce stretching and other soft tissue therapies like instrument assisted soft tissue technique or not ?

Q: When should we progressively introduce foam rolling and other self care options ?

It all depends on the patient and their unique set of circumstances (pain is derived from what structure. length of injury, how many episodes has occurred in the past).

In chiropractic practice, we choose treatments that will affect the case. This is a multi-modal approach and can enhance outcomes. In this randomised controlled study, the participants did not get a multi modal approach, instead what was measured was the effectiveness of manual therapy and instrument assisted soft tissue technique in isolation. We learnt that both options improved outcomes for patient with time, however we weren’t able to see how combination of therapies can enhance healing.


“This study indicates that there is no difference in outcome at any time point for pain or disability when comparing SMT, Graston Technique® or sham therapy for thoracic spine pain, however all groups improved with time.” 



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