Instrument Assisted Soft Tissue Manipulation or IASTM is when the Therapist uses metal tools to massage the muscles, tendons and fascia. They are indicated for fascial restrictions or trigger points and can be used with a gentle or firm pressure depending on the indication and patient preference. Some conditions that are effective with IASTM treatment are plantar fasciitis, repetitive strain, Dupuytren's contracture, ITB syndrome, Achilles tendon, trigger points and muscle tension.