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Basic STMfish® technique

Before using the instrument please read the cautions page.

Although the instrument can be used by applying the principles of manual soft tissue techniques as taught in professional manual therapy courses, training specific to the use of instrument assisted soft tissue mobilisation(IASTM) or Gua Sha is recommended. The video examples found on this site, provide a visual reference in the application of the instrument.

Before using the STMfish, the area may be treated with hot packs and the skin washed thoroughly. The skin should then be carefully examined for any evidence of lesions or conditions that may be contra-indicative of IASTM therapy (see Cautions page).

A wide variety of lubricating media, ranging from organically based sorbolene creams to proprietary massage oils or waxes can also be used. Generally low viscosity oils and creams provide low traction and thicker creams and waxes create higher tissue traction. In excessively hairy body areas, a disposable square of fine cotton or satin fabric may be used as the "lubricating" layer between instrument and skin.

The most common error is the use of excessive pressure which can lead to significant bruising or tissue trauma. Be patient: Do not try to reduce chronic adhesions in 1 go!

The basic technique of using the STMfish® involves 5 important steps:

  1. Scanning the injured area to identify the extent and degree of injury.
  2. Assessing areas associated by fascial trains both proximal and distal to the focal injury. If you are not familiar with this anatomy, Thomas Myers book "Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists" is an excellent resource.
  3. Determining the direction, depth and length of stroke required to release the affected tissues.
  4. Selecting the appropriate STMfish® profile to suit the area of treatment.
  5. Starting with the most superficial fascial layers slowly progress to deeper layers.

Scanning

Use the instrument to apply your selected lubricating medium to minimise contact trauma. Scanning is mostly performed with a broad non focal contact employing very light long strokes over the area of concern. The weight of the stainless steel instrument is almost enough pressure. Select the STMfish® profile that provides the largest contact area. Feel for "gritty" vibrations that can indicate adhesions and scar tissue in the area examined.

Treatment Strokes

Once scanning has identified areas requiring release. Start with light medium (5-10cm) strokes, feeling for loss of subcutaneous "glide". Repeat strokes in the direction where adhesions are most evident until maximal float of the superficial tissue is restored.

Where marked adhesions occur, change to shorter (1-2cm) strokes with a smaller edge profile, slowly changing direction until you have gone through 360 degrees. Spend more time in the restricted directions and gradually work down through the tissue layers.

Lymphatic Drainage

During and after focal treatment strokes, apply light long strokes in the direction of natural lymphatic drainage of the injured area. The wave edge can be used where there is interstitial oedema present. This creates areas of high and low pressure "corrugations" in the tissue to stimulate the lymph vessels.

To sum up, The objectives of treatment are

  1. to release adhesions between fascial layers,
  2. to break down poor quality scar tissue in the underlying structures,
  3. to stimulate the repair of damaged tissue,
  4. to promote blood flow to areas of injury ,
  5. to enhance lymphatic drainage from injured tissue.

Remember IASTM is only part of the overall process of healing. Practitioners still need to attend to their primary professional management and active rehabilitation advice for the best results.

Recommended Reading

  1. Thomas Myers; Anatomy Trains: Myofascial Meridians for Manual and Movement Therapists
  2. Craig Liebenson; Rehabilitation of the Spine - a Practitioners Manual
  3. Kendall et al; Muscles - Testing and Function with Posture and Pain (Contains a useful DVD that reviews tissue layers)
  4. Hoppenfeld; Physical Examination of the Spine and Extremities
  5. Michael Schuenke; General Anatomy and the Musculoskeletal System (THIEME Atlas of Anatomy)
  6. Philipp Richter & Eric Hebgen; Trigger Points and Muscle Chains in Osteopathy