What is cupping, massage, and instrument-assisted soft tissue mobilization (IASTM)?

What do cupping, massage, and instrument-assisted soft tissue mobilization (IASTM) have in common?

They’re all things that we rarely do at MOTION RX. Some of you may have had some successful experiences with these modalities. I believe you! But my question is—how long did that “success” last? And was it successful without the use of properly dosed exercise as well?

Everyone wants their patients to be free from pain

But more importantly, we want our patients to have long lasting pain relief. Based on our experience working with hundreds of athletes and on what research tells us, temporarily changing the state of your tissues without addressing the mechanics and strength deficits that lead to the painful state in the first place isn’t going to get you out of pain permanently or prevent that pain from coming back.

Full disclosure, it would be easier for us to scrape you with a glorified butter knife for 15 minutes. It takes almost no mental, emotional, or physical effort. On the other hand, testing, modifying and properly dosing exercise takes effort and creativity. So we’re NOT taking the easy way out by focusing on exercise interventions.
A systematic review published late last year confirms this stance on IASTM mobilization. This review found no support for the efficacy of IASTM for a variety of body regions on function, pain, or range of motion. On the contrary, many of the published clinical practice guidelines (CPGs) support exercise interventions as the first line of treatment. CPGs are based on a large review of the literature on a particular topic, making them more reliable than a single study.
The grades of recommendation are as follows:

A summary of recommendations for exercise as the primary treatment of various orthopedic injuries and conditions are as follows:

Physical Therapy Diagnosis : Strength of Evidence for Exercise

Acute Low Back Pain with Leg Pain : Level II

Chronic Low Back Pain : Level I

Chronic Low Back Pain in Older Adults : Level I

Patellofemoral Pain (Anterior Knee Pain) : Level I

Hip Osteoarthritis : Level I

Meniscus and Articular Cartilage : Level II

Knee Ligament Sprain : Level I

Ankle Sprain : Level I

Achilles Tendinopathy : Level I

If you need more evidence, we are happy to provide it. You can’t go wrong with getting strong and we can certainly help you get stronger, pain free, and back to all the activities you love to do—without the help of a butter knife.


“Evidence of very low-quality certainty does not support the efficacy of IASTM in individuals with or without various pathologies on function, pain, and range of motion in the management of upper body, lower body, or spinal conditions.”

CPGs – clinical practice guidelines are based on a large review of all the literature on a particular topic. Here are links to the guidelines for some common injuries and conditions:

Low Back Pain

Patellar Femoral Pain

Hip Osteoarthritis

Meniscus/Articular Cartilage

Knee ligament sprain

Ankle Sprain

Achilles Tendinopathy

If you want to be pain free and stay that way—loading your tissues with properly dosed exercise and managing the volume and intensity of that loading is crucial. If you need help, reach out to us. We are the load experts!