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The right tool for the job: ART v IASTM – By: Dr. Mark Kemenosh and Dr. Trisha Sileo

Although the chiropractic practice of Dr. Mark Kemenosh is focused on ART – Active Release Techniques – Dr. Mark and his associates are also certified in IASTM – instrument assisted soft tissue mobilization.

IASTM has similar therapeutic goals as ART – myofascial release to prevent the formation of scar tissue, break up existing scar tissue, loosen muscle fibers and prevent them from adhering together. What differs is the delivery and the theory behind it.

Tools of the trade

ART is delivered solely with the hands and reduces inflammation. With IASTM, the doctor uses specially designed stainless steel instruments that actually cause controlled inflammation. By applying pressure and friction with the tools, tissues are inflamed. That increases blood flow, which is believed to do the healing work.

Active Release Technique

IASTM is also known by the trade name Graston, named for machinist and athlete David Graston. He developed tools to help him perform soft tissue therapy on an injured knee. Other manufacturers include RockBlades and Ergo.


Graston trademarked his tools and his name became associated with the technique. But it goes back thousands of years, to the ancient Chinese – the reason IASTM is also called gua sha.

IASTM goes deeper

“We’re an active release practice and that’s always our first line of therapy,” Dr. Mark explains. “But there are occasions when the patient doesn’t respond as well or as quickly with ART and IASTM is sharper,” Dr. Mark says.

“Active release hurts good, especially when focused on an already inflamed area that needs attention. For scar tissue, IASTM is good in a different way, creating short-term discomfort for long-term relief and improved range of motion. It can be intense, which is why we use it sparingly,” he says.

A one-two punch of relief

Dr. Trisha Sileo agrees. “IASTM can be used just about anywhere a stubborn problem isn’t responding as well to ART. I like it for some areas. For example, the larger tendons of the leg are thick and can be more difficult to penetrate manually. The tools can help get deeper into the tissue and loosen things up – but you don’t get the immediate feedback you get with the hands and fingers, so it has to be done carefully,” she says.

She explains that IASTM is another tool, almost always used in concert with ART and range of motion. “It’s really all about progress. We use whatever combination of therapies the patient responds best to,” she says.

Graston, RockTool and Ergo are trademarks of their respective owners.