The Effect of Single Instrument-Assisted Manual Therapy of Lower Back in Female Soccer Players

Instrument-assisted manual therapy (IAMT) is a technique used to rehabilitate soft tissues and enhance movement dynamics. It involves applying pressure, tensile, and shear forces to specific fibrous tissues to achieve targeted therapeutic deformation. IAMT is reported to provide pain relief, increase blood flow, and improve functionality and range of motion. The mechanisms behind these effects are not fully understood, but are believed to involve physiological adaptive reactions such as increased microcirculation, activation of fibroblasts, and enrichment of cytokines in the ground substance. In athletes, IAMT is used to aid in the recovery of acute and chronic soft tissue injuries and improve hamstring flexibility.

A study from Germany involving Dr Robert Schleip aimed to gain insights into the effects of instrument-assisted manual therapy (IAMT) on the structural and functional properties of the myofascial tissues of the lower back and adjacent movement segments.

67 healthy female soccer players were randomly assigned to receive IAMT (intervention group), heat application (comparison group), or a pressure-less placebo (placebo group). Ultrasonography, flexibility tests, and superficial skin temperature were measured before, immediately after, and 45 minutes after the intervention.

This study found that instrument-assisted manual therapy (IAMT) of the lower back had a short-term reduction in the absolute movement of the thoracolumbar fascia-superficial lamina (TLF-SL) immediately followed by an improvement. It also led to a decrease in the shear motion to the superficial fascia (SF) immediately after the intervention. IAMT also positively influenced hamstring flexibility, likely through the myofascial chains through the TLF as a mechanical pivot and anchor point of the back side of the body.

The short-term effects within the intervention group and placebo group were inconsistent. The exact mechanisms behind these findings are not clear, and further research is needed to investigate the mechanical and sensory impacts in larger populations and additional target groups.

The study concludes that IAMT of the lumbar back briefly reduces absolute mobility of the superficial lamina and its shear motion to the superficial fascia, improves flexibility, and increases the skin temperature.