IASTM vs. Astym vs. Graston Technique vs. Gua Sha

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With muscle scraping becoming an increasingly popular recovery method, it can often get confusing as to which techniques are which, and when or why we would use them…


The differences between Astym, IASTM, Gua Sha, and Graston Technique lie mainly in the tools they use, with Astym using a small variety of plastic tools and IASTM/Graston/Gua Sha using a wider variety of tools usually made from stainless steel, plastic, or stone.

In this article, we’ll explain what each of these muscle scraping techniques are and how they differ, and explore when you would choose one over the other.

Let’s begin!

What Is Astym?

Astym (pronounced “A-stim”) is a type of muscle scraping that uses plastic tools.

This is marketed as the least painful of the muscle scraping techniques, and focuses on just the dysfunctional tissues.

The idea behind Astym is that scraping over these tissues creates inflammation and restarts the body’s healing process, allowing those tissues to finally recover. 

Like IASTM, it provides a lot of benefits that we can take advantage of.

For example, it increases blood flow to the target area, which helps decrease any swelling and pain you may be having. 

“Increased blood flow can quickly remove pain substrates or reduce swelling that develops around the injured tissue”1https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5331993/

When our muscles become damaged or dysfunctional, their fibres can become mixed up when they usually should be running parallel to each other.

Astym tries to correct that through scraping over top of those muscles, helping restore normal range of motion and muscle function.

Because Astym stimulates the body to begin healing from a cellular level, it tends to feel more comfortable than IASTM and Graston, which focus more on breaking down dysfunctional tissue and trying to get a “deep massage” effect.

What Is IASTM?

IASTM (Instrument Assisted Soft Tissue Mobilization) is very similar to Astym, but can be considered as more of an umbrella term for Astym, Gua Sha, and Graston Technique…although some people claim it’s its own thing.

Just like Astym, this is a safe muscle scraping option, and doesn’t have any extra risks.  

IASTM usually uses tools made from stainless steel, hard plastic, or stone.

It aims to break down scar tissue and dysfunctional muscles through a more intense approach, where it works a painful or dysfunctional area of the body.

IASTM is based off of deep muscle massage and transverse massage — a “mechanical” approach — which is a bit different from the physiological approach of Astym. 

The main criticism that IASTM faces versus Astym is that it can inflame healthy tissues as well, leading to inconsistent results and higher pain levels during and after treatment. 

This isn’t perfectly accurate, as IASTM techniques also provide a physiological response in the body, creating inflammation and restarting the body’s recovery process.

It also improves blood flow and relaxes muscles, meaning that it’s a worthwhile option to look into.

What Is The Graston Technique?

The Graston Technique is the most popular form of IASTM.

It was created by an amateur athlete who injured his knee while water skiing, and decided to try making tools that “scrape” his muscles.

He found that this actually worked really well, and decided to continue developing this technique into the beast that it is today. 

The Graston Technique uses a set of stainless steel tools to perform the treatment, and has been shown to improve pain levels and range of motion for people with injuries like low back pain or plantar fasciitis.

Our results show that the Graston technique decreased pain and increased ROM…these findings indicate that the Graston technique could be recommended in the rehabilitation of patients2https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4932073/

When athletes and bodybuilders muscle scrape, they often use this technique because the intensity of it gives a perception of added benefit (which isn’t necessarily accurate).

That being said, anyone can take advantage of this therapy by learning how to do Graston Technique on yourself!

What Is Gua Sha?

Gua Sha is the original version of muscle scraping stemming out of ancient China some 2000 years ago.

The modern versions of muscle scraping are based off of Gua Sha, which translates to “scrape” and “sand” — this refers to the scraping of skin and the red dots (AKA blood) that rush to the surface of our skin, which resembles sand.

The goal of Gua Sha is to stimulate a specific part of the body and improve blood flow — much like all forms of muscle scraping. 

However, the belief behind Gua Sha is that it will bring the problems of the body out to the surface of the skin, allowing them to evaporate and heal — kind of like using a broom to sweep out dust under couches, corners, and other hard-to-reach places.

In more scientific terms, it provides pretty much the same benefits as all the other muscle scraping techniques we talked about, although it tends to be a bit more gentle similar to Astym.3https://pubmed.ncbi.nlm.nih.gov/17905355/

How Do You Choose Between Astym vs. IASTM vs. Graston vs. Gua Sha?

As you can see, all four of these are very similar to one another, and mainly differ by:

  • Tools — Astym uses plastic tools whereas IASTM often uses a wider variety of harder tools made from things like stone and stainless steel. Check out my article comparing the best muscle scraping tools!
  • Approach — Astym therapists claim to create a physiological change, rather than trying to mechanically “break down” dysfunctional tissue like IASTM does (although they both do the same thing to an extent)

The biggest difference you’ll find, however, is the experience you’ll get from therapist to therapist. 

One therapist who is really good at IASTM may give you a more comfortable and tolerable treatment than a therapist who isn’t as experienced in Astym, even though Astym practitioners claim their method is the gentler one.

The best way to choose a technique is by exploring the options you have around you and try them out, since the outcome and application of Astym and IASTM are largely the same. 

Marketing on both the Astym and IASTM sides will try to convince you that one is better than the other — but both are supported by evidence and are essentially the same thing with very minor differences. 


Looking at each of the four muscle scraping techniques side by side reveals that there really aren’t many differences besides what marketers of each will tell you…

They provide similar benefits of improving blood flow, relaxing muscles, decreasing swelling, and helping with pain. 

An Astym provider will use plastic tools, whereas an IASTM, Gua Sha, or Graston Technique provider will often use a wider array of stone, stainless steel, or also plastic tools to give treatment. 

Regardless, they all sit very closely on the muscle scraping spectrum, and all can help you in your recovery!

Eric Richter, MSPT

Eric Richter, MSPT

I'm Eric, a physiotherapist with a Bachelor’s degree in Kinesiology and a Master’s degree in Physiotherapy from the University Of Manitoba. I have enjoyed the better part of a decade working with both amateur and professional athletes as a physical therapist.I've also worked as a strength and conditioning coach at an MMA gym!

Learn more about me...

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