Reviewed by Dr. Marshall Luck, DC | Last updated: September 28, 2026
Instrument-assisted soft tissue mobilization uses smooth handheld tools to apply controlled pressure to muscles, tendons, and other soft tissues. SASTM is a general description; Graston Technique is a branded training and instrument system.
What treatment may involve
A clinician first evaluates the painful area, movement, strength, recent activity, and relevant health history. When appropriate, an instrument is moved over the skin with pressure selected for the patient and the treatment goal. It may be combined with mobility work, progressive exercise, and activity guidance.
The technique is sometimes described as “breaking up scar tissue,” but that phrase overstates what can be concluded from current evidence. A more accurate goal is to use manual input as one part of a plan to improve comfort and function. Research is mixed and varies by condition, so benefits cannot be guaranteed.
Possible effects and safety
Temporary tenderness, redness, or mild bruising can occur. Treatment may need to be avoided or modified over open wounds, active infection, a recent fracture, significant skin disease, impaired sensation, bleeding disorders, or when a person uses anticoagulant medication. Tell the clinician about relevant medical conditions, recent surgery, pregnancy, and medications before treatment.
When another evaluation is needed
Sudden severe pain, a pop with loss of function, marked weakness, rapidly increasing swelling, fever, unexplained weight loss, or progressive numbness should be evaluated promptly. Imaging or referral may be appropriate depending on the findings.
Schedule in San Francisco
Learn more about chiropractic care in San Francisco, or view current chiropractic appointments in Jane. The clinician can determine whether instrument-assisted soft tissue work is appropriate and available for your needs.
What instrument-assisted soft tissue therapy feels like
During instrument-assisted soft tissue therapy, the practitioner applies a smooth handheld tool over selected muscles, tendons, or fascia. Pressure and duration can be adjusted to comfort and clinical goals. Some temporary tenderness or redness may occur, but treatment should not depend on causing heavy bruising or severe pain.
Who may need a modified approach
Tell the practitioner about blood-thinning medication, bleeding disorders, fragile skin, recent surgery, infection, fractures, reduced sensation, or other relevant conditions. The technique may be modified or avoided depending on the examination. It is generally used as one part of a broader plan that may include activity guidance, mobility, and strengthening.
Evidence and further reading
Instrument-assisted soft tissue techniques use a handheld tool as part of a broader examination and treatment plan. Research suggests possible benefits for pain and movement in some musculoskeletal conditions, but studies vary in quality and methods, and results cannot be guaranteed. The technique should be selected for the individual and combined with appropriate movement or rehabilitation when indicated. Review the evidence in this systematic review from NCBI/PMC: Instrument-Assisted Soft Tissue Mobilization Review.