The question of whether “scraping” can help with foot pain is gaining attention from people seeking relief from chronic heel discomfort. This form of therapy, known formally as Instrument-Assisted Soft Tissue Mobilization (IASTM), is a non-invasive physical treatment approach. Plantar fasciitis is a common source of intense heel pain that can severely limit daily activities. IASTM is one specific technique that targets the affected tissues to restore mobility and reduce persistent symptoms.
Understanding Plantar Fasciitis
Plantar fasciitis is a disorder of the plantar fascia, the thick band of connective tissue running along the bottom of the foot, connecting the heel bone to the toes. This tissue is designed to support the arch of the foot and absorb shock during movement.
The condition commonly causes a stabbing pain near the heel, which is typically most severe with the first few steps after waking up or following long periods of rest. The pain often lessens as the foot warms up with activity but may return after extended standing or vigorous exercise.
While the name suggests inflammation (fasciitis), the condition often involves non-inflammatory degenerative changes, sometimes referred to as plantar fasciosis. This degeneration involves the breakdown of collagen and the formation of micro-tears and scar tissue at the fascia’s insertion point on the heel bone.
The Scraping Technique Known as IASTM
The technique often described as “scraping” is formally known as Instrument-Assisted Soft Tissue Mobilization (IASTM). This method is a modern adaptation of traditional therapies, such as the Chinese practice of Gua Sha.
IASTM involves the use of specialized, ergonomically shaped instruments, most often made from stainless steel. A certified practitioner uses the rounded edges of these tools to apply targeted pressure and a shearing force across the skin and underlying soft tissues.
This application is highly specific, allowing the clinician to detect and treat areas of fascial restriction, scar tissue, or adhesions that may be contributing to chronic pain. When treating plantar fasciitis, the instrument is applied to the sole of the foot and often to related structures like the calf muscles and Achilles tendon.
Clinical Evidence for IASTM in Plantar Fasciitis
Research suggests that IASTM can be a beneficial component of a comprehensive treatment plan for people with plantar fasciitis. Studies show that including IASTM with traditional care, such as stretching and exercise, leads to better outcomes than conservative care alone.
The therapy has been linked to clinically important reductions in pain intensity and significant improvements in overall foot and ankle function. IASTM also appears effective at increasing ankle range of motion, particularly in plantarflexion (the motion of pointing the toes downward).
IASTM is generally considered an adjunct therapy, meaning it works best when combined with other methods, including stretching and strengthening exercises. Patients receiving IASTM can experience a faster return to normal activities and a substantial decrease in pain scores over several weeks of treatment.
How IASTM Works and Safety Precautions
The effectiveness of IASTM is attributed to a combination of mechanical, biological, and neurological effects on the injured tissue.
Mechanical Effects
The tools disrupt and release cross-links in the collagen fibers and adhesions within the plantar fascia that limit movement. This process helps break down scar tissue and restore the tissue’s normal gliding capacity.
Biological Effects
The controlled, focused force of the instrument causes localized microtrauma, which initiates a renewed inflammatory cascade. This micro-injury promotes increased blood flow and stimulates fibroblasts, the cells responsible for synthesizing new, organized collagen, thereby restarting the healing process.
Neurological Effects
IASTM may help reduce pain by stimulating local mechanoreceptors, which inhibit the transmission of pain signals to the brain.
Safety Precautions
IASTM is not appropriate for everyone, and several safety precautions must be followed. Contraindications include using the technique over open wounds, active infections, or areas of unmanaged inflammation.
Individuals taking anticoagulant medications or those with conditions like thrombophlebitis or unhealed fractures should avoid IASTM, as it can increase the risk of bruising or other complications. IASTM should be performed only by a licensed health professional, such as a physical therapist or chiropractor, who has been certified in the specific technique.