Laurie's Blogs.

A recent randomized controlled trial (Karimi Soloklo et al., J Man Manip Ther, 2026) investigated the adjunctive effects of instrument-assisted soft tissue mobilization (IASTM) combined with exercise versus sham IASTM plus exercise in 30 adults with unilateral moderate knee osteoarthritis (KOA). Over four sessions in two weeks, outcomes included pain, range of motion (ROM), WOMAC scores, and gait kinetics (vertical ground reaction force, knee adduction moment) at preferred, fixed, and fast walking speeds.

Both groups demonstrated significant improvements in pain, ROM, and WOMAC scores post-intervention. However, the IASTM group exhibited superior gains in pain reduction, knee flexion, ankle plantarflexion, and a pain scale score. Kinetically, IASTM uniquely prolonged time to heel strike transient, indicating enhanced shock absorption. At fast speeds, kinetic variables increased across both groups.

These findings support IASTM as an effective adjunct to exercise for symptom relief and functional gait optimization in moderate KOA.

Relevance to Canine Stifle Osteoarthritis

Canine stifle osteoarthritis shares pathophysiological and biomechanical parallels with human KOA, including cartilage degradation, synovial inflammation, periarticular soft tissue restrictions, pain, reduced ROM, quadriceps atrophy, and altered gait (e.g., shortened stride, increased loading asymmetry, compensatory patterns).

IASTM—adapted from human techniques such as Graston, GuaSha or similar tool-based myofascial release—is increasingly incorporated in veterinary rehabilitation. Specialized stainless-steel instruments (or Chinese soup spoons) target fascial adhesions, muscle restrictions, and scar tissue around the stifle, quadriceps, hamstrings, and crus, aiming to improve tissue compliance, circulation, and neuromuscular function.

IASTM principles align with veterinary applications for myofascial restrictions, post-surgical scar management, and chronic musculoskeletal conditions, despite a general lack of RCT’s on the subject.

Clinical Application in Veterinary Practice

In dogs with moderate stifle OA, qualified veterinary rehabilitation professionals may integrate adapted IASTM as follows:

•  Gait assessment and palpatory assessment to identify restricted soft tissues. 

•  Targeted tool-assisted strokes to address adhesions or simply increase blood flow in quadriceps, hamstrings, gastrocnemius, cranial tibial muscle, and periarticular fascia.

•  Integration with therapeutic exercises: active weight-shifting, sit-to-stand, cavaletti, hill walking, and/or underwater treadmill work.

•  Initial protocol: 3–4 sessions over 1–2 weeks, followed by maintenance and owner home exercises.  (As per the human protocol used in the research paper.)

IASTM should complement multimodal management (weight control, pharmacotherapy, joint nutraceuticals, other physical modalities) and requires training to safeguard neurovascular structures. 

This study reinforces exercise as foundational while highlighting targeted soft tissue interventions like IASTM for additive benefits in pain modulation and biomechanical optimization—principles readily translatable to canine stifle OA rehabilitation. Further veterinary-specific research would be most welcome!

I for one, would like to give this a try!!

Until next time,

Cheers!  Laurie

Reference:

Karimi Soloklo, Z., Boozari, S., & Kahrizi, S. (2026). Effects of a two-week instrument-assisted soft tissue mobilization and exercise therapy versus sham and exercise on gait kinetics in moderate knee osteoarthritis: a randomized controlled trial. Journal of Manual & Manipulative Therapy, 34(1), 16–27.