Could shiny steel instruments properly manipulated be the answer to your chronic pain and inflammation? Quite possibly, yes! The Graston Technique® (GT) is a unique and outcome-proven form of soft tissue mobilization using specially designed stainless steel instruments alongside appropriate therapeutic exercise. Graston technique is considered an instrument-assisted manual therapy technique just like dry needling and acupuncture, all of which are really gaining popularity these days.
This noninvasive method of healing known as Graston technique or instrument-assisted soft tissue mobilization (IASTM) is used to treat all kinds soft tissue conditions, whether they are chronic, acute or post-surgical. You may have never heard of Graston technique before, but other people have, like the 431 professional and amateur sports organizations currently utilizing Graston technique on a regular basis. (1a) Clearly, some of the most physically active and frequently injured people on the planet must be feeling the relief of this healing technique!
Graston technique is used to help treat all kinds of bodily issues from annoying neck pain to the widespread muscle pain of fibromyalgia. So how does this technique help patients to become free of torturous pain and injury? Read on to find out.
What Is the Graston Technique?
Graston technique is a form of instrument-assisted or augmented soft tissue mobilization (ASTM) that enables practitioners to improve scar tissue, fascial restrictions and range of motion. The theory behind this IASTM technique is that by using a tool to introduce microtrauma into an area of excessive scarring and/or soft tissue fibrosis, an inflammatory response will occur. In a 2017 Journal of Exercise Rehabilitation study, the authors describe that “Such inflammation restarts the healing process by removing the scar tissue and releasing adhesions, while also increasing blood and nutrient supply to the injured area and migration of fibroblasts.” (1b)
The use of tools helps to get to the root of the problem, but it’s also intended to reduce stress on the therapist’s hands. Graston technique allows a practitioner to get deep into the problematic tissue yet be sensitive to a patient’s level of pain tolerance. As the instruments are moved over the affected area and come in contact with adhesions, they help to break up scar tissue dysfunction and restrictions of the fascia.
In time, this process can reduce or eliminate the adhered fibers, restoring range of motion and eliminating the associated pain. The aim and ideal outcome of Graston technique is to help transform your soft tissue injury into healthy functioning tissue once again.
Why does Graston technique aim to reduce scar tissue? Scar tissue is thick, dense tissue that appears after injury or trauma. It can limit your range of motion, cause pain and lead to dysfunctional movement. Graston technique aims to break up this scar tissue to interrupt and break the cycle of pain and dysfunction.
Graston technique is never used completely on its own. The full treatment includes brief warm-up exercises, Graston technique treatment, followed by stretching and strengthening activities. Ice can also be a part of the follow-up portion of treatment if subacute inflammation (inflammation that lasts longer than acute inflammation but is not chronic) is present.
Who is using this healing physical therapy? Graston technique is used by more than 24,500 clinicians worldwide in 3,042 outpatient facilities and is included in the curriculum at more than 45 respected universities and colleges. Graston technique is also utilized by over 431 professional and amateur sports organizations and on-site at 86 major corporations. (3)
It depends upon the specific patient, but Graston technique typically involves one to two treatments per week during the span of four to five weeks. Most patients have a positive response by the third or fourth treatment session. For more chronic conditions, the average number of Graston technique sessions per episode of care averages between six to 12 treatments. (4) You can locate your nearest Graston technique provider on the official Graston technique website.
What Is the Graston Technique Able to Treat?
According to the Graston technique official website, the technique is clinically proven to achieve faster and better patient outcomes in treating the following (4):
- Achilles tendinosis/tendonitis
- Carpal tunnel syndrome
- Cervical sprain/strain (neck pain, stiff neck)
- Hip flexor strain
- Lateral epicondylosis/tendonitis (tennis elbow)
- Lumbar sprain/strain (back pain in the lumbar spine region)
- Medial epicondylosis/tendonitis (golfer’s elbow)
- Patellofemoral disorders (knee pain)
- Plantar fasciitis (foot pain)
- Posterior tibialis tendonitis (medial tibial stress syndrome)
- Rotator cuff tendinosis/tendonitis (shoulder pain)
- Scar tissue
- Shin splints
- Trigger finger
- Women’s health (post-mastectomy and Caesarean scarring)
1. Decreases Treatment & Recovery Time
When a patient opts to use the Graston technique as part of a treatment plan and sticks with the technique until relief is found then treatment and recovery time can certainly be reduced. Unlike ignoring or attempting to numb your acute or chronic pain, the Graston technique actually focuses on the root of the problem so it’s a no-brainer that you can reduce your recovery time by actually doing something to help your pain rather than waiting for it to hopefully go away on its own at some point.
One Graston technique study looked at two cases of work-related elbow pain. Both patients underwent a conservative treatment approach including activity modification, Graston technique, medical acupuncture with electrical stimulation and rehabilitative exercise prescription. This treatment was very successful and both patients had a complete resolution of their complaints. Additionally, neither individual reported any reoccurring symptoms eight months later. This study concluded that a treatment approach including Graston technique allows for patients to minimize recovery time. (5)
Another study looked at Achilles tendon problems in rats and found that IASTM or Graston helped increase fibroblasts, which are associated with collagen synthesis. (1b)
2. Reduces OTC Painkiller Usage
Since Graston technique aims to get at the root of your pain, it can reduce or ideally eliminate your need for over-the-counter painkillers. Chronic pain can be really unbearable, but OTC painkillers come with all kinds of questionable side effects ranging from liver damage to gastrointestinal issues. I’ve previously talked about how aspirin can even cause stomach ulcers and kidney failure for some users. There are also serious health consequences for ibuprofen overdosing.
If a non-invasive technique can help you to reduce pain naturally, wouldn’t that be ideal? Graston technique has been shown in studies to increase skin temperature and blood flow to manipulated areas. (6) Greater blood flow to the injury site helps the body to remove toxins and dead cells and promotes healing. Just like exercise increases overall blood flow and oxygen levels, Graston technique can do this to specific areas of your body and promote healing in the process. Cupping therapy works in a similar way.
3. Improve Chronic Conditions
Chronic conditions are truly amongst the most frustrating of issues, especially when the chronic condition involves daily or even hourly pain. Many people turn to Graston technique for chronic pains plaguing their bodies from neck pain to ankle pain to pain literally all over, like in the case of fibromyalgia. Graston technique can break up the debilitating soft tissue injuries that are causing your chronic movement issues and pain.
A 2012 study published in the Journal of Sport Rehabilitation looked at the effects of a four week dynamic-balance-training (DBT) program supplemented with Graston technique (GT) on chronic ankle instability. Thirty-six healthy, physically active individuals with a history of chronic ankle instability were divided into three groups: both DBT and GT treatment, DBT with bogus GT treatment or and just DBT treatment. After treatment, pain, disability, range of motion and dynamic postural control were evaluated with the greatest improvements being seen in the group that received both dynamic-balance-training (DBT) along with the Graston technique. (7)
4. Proven Trigger Finger Relief
Trigger finger is a condition that causes the fingers or thumb to catch or lock when bent. When trigger finger occurs in the thumb then it is called trigger thumb. Regardless of what finger it occurs in, trigger finger is a painful problem that can be caused by repeated/forceful use of a finger, rheumatoid arthritis, gout or diabetes. (8)
A 2006 study published in The Journal of the Canadian Chiropractic Association examined the progress of a patient with unresolved symptoms of trigger thumb who underwent a treatment plan featuring Graston technique and active release technique (ART). Conventional treatment of persistent trigger finger typically involves corticosteroid injection or surgically removing imposing tissue. This study showed that with the use of Graston technique and ART, rather than questionable steroid injections and surgery, the patient was totally relieved of his persistent disability and pain. (9)
5. Hamstring and Low Back Pain Relief
In a 2017 Journal of Physical Therapy Science study entitled “Immediate effects of Graston technique on hamstring muscle extensibility and pain intensity in patients with nonspecific low back pain,” 24 patients with nonspecific low back pain were randomly assigned to one of two groups: 12 in a Graston technique group and 12 in a static stretching group.
The purpose of this study was to analyze the effect of Graston Technique on hamstring extensibility and pain intensity in patients with nonspecific low back pain. [Subjects and Methods] Twenty-four patients with nonspecific low back pain (27–46 years of age) enrolled in the study. All participants were randomly assigned to one of two groups: Graston technique group (n=12) and a static stretching group (n=12).
The Graston Technique was used on the hamstring muscles of the experimental group, while the static stretching group performed static stretching. Hamstring extensibility was recorded using the sit and reach test, and a visual analog scale was used to measure pain intensity. [Results] Both groups showed a significant improvement after intervention.
In comparison to the static stretching group, the Graston technique group had significantly more improvement in hamstring extensibility. [Conclusion] The Graston Technique is a simple and effective intervention in nonspecific low back pain patients to improve hamstring extensibility and lower pain intensity, and it would be beneficial in clinical practice.
How to Use
When practitioners of Graston technique comb their stainless steel instruments over your body they are able to “catch” on fibrotic tissue, which immediately identifies the areas where there is restriction. After the tissue dysfunction has been identified, the instruments are used to break up the scar tissue so it can be absorbed by the body.
The process of the Graston technique is to first break up problematic adhesions by breaking down the collagen cross-links that have been formed and then to realign them with proper stretching and strengthening. The Graston technique can be used through muscles, tendons and ligaments, and on a wide variety of acute and chronic conditions.
The Graston technique is often combined with other forms of alternative and complimentary healing techniques like active release technique, dry needling and acupuncture. Active release techniques, which Graston technique is most common combined with, also focuses on soft tissue system problems. It is a non-invasive process that locates and breaks down the scar tissue and adhesions that accompany soft-tissue injuries. Instead of using tools, ART practitioners us their hands to evaluate the texture, tightness and movement of muscles, fascia, tendons, ligaments and nerves. Abnormal tissues are treated by combining precisely directed tension with very specific patient movements.
Dry needling is a treatment that involves a very thin needle being pushed through the skin in order to stimulate a trigger point. Dry needling is usually combined with other manual therapies and is considered an instrument-assisted manual therapy technique like Graston technique. Dry needling is used to release tight muscle bands that are associated with a trigger point or hard “knots” within a muscle that can cause pain over a large area.
Acupuncture involves needles and is also an instrument-assisted manual therapy. It is a holistic health technique that stems from Traditional Chinese Medicine practices in which trained practitioners stimulate specific points on the body by inserting thin needles into the skin.
The Graston technique is typically combined with appropriate therapeutic exercises and activities to restore pain free physical function. Active release technique, dry needling and acupuncture can also add complimentary layers to your treatment plan. Depending on your issue(s) and your GT practitioner’s evaluation, you can make a holistic treatment plan that specifically fits your health concerns and your budget.
Graston technique is grounded in the work and discoveries of a British orthopedic surgeon, Dr. James Cyriax. Graston technique’s cross fiber massage is not a brand new concept. Graston technique’s use of specially designed tools and protocol has been a recognized part of the manual therapy industry for over 20 years.
Indiana University became the first college to include Graston technique in its teaching curriculum. As of 2000, Graston technique was included in the university’s graduate kinesiology course for athletic trainers, and it also became an elective in their doctoral physical therapy program. Since Indiana University broke the ice, Graston technique has become part of the curriculum in 45 advanced degree programs for physical therapy, chiropractic and athletic training.
Over the past two decades, Graston technique has become standard protocol in many hospital-based outpatient facilities as well as industrial on-site treatment settings. Graston technique is also being used by the professional sports industry including MLB, NBA, NFL and NHL trainers.
Without a doubt, you should only have the Graston technique performed on you by a certified professional. Only clinicians who have been trained and accredited in the GT Basic course are qualified to obtain the Graston technique instruments and apply the technique to treat patients. When you’re seeing an expert, the technique is considered to be very safe.
The most common side effects of a Graston technique is minor discomfort during the session and bruising afterwards. You also might be mildly sore afterwards. Graston technique is not meant to be especially painful or cause excessive bruising. GT does not need to be considered painful in order for it to be effective so definitely speak up if you are experiencing discomfort anytime during treatment. Like a good massage therapist, a good Graston technique practitioner will adjust your treatment intensity when needed to minimize discomfort.
- Whether you’re a professional athlete or on the less active side of the spectrum, Graston technique can be helpful for pretty much anyone suffering from soft tissue issues.
- Graston technique can be used for both acute and chronic problems.
- Consider combining Graston technique with Active Release Technique, dry needling and/or acupuncture for a multi-layered approach to your issues.
- Always receive treatment from a licensed Graston technique provider.