Graston Technique (Soft Tissue Mobilization)
Changing the way soft tissue injuries are treated
Graston Technique® is a unique, evidence-based form of instrument-assisted soft tissue mobilization (IASTM) that enables clinicians to effectively address scar tissue, fascial restrictions and range of motion through comprehensive training, resulting in improved patient outcomes.
Why Use Graston Technique?
The unique protocol uses specially designed stainless steel instruments, along with appropriate therapeutic exercise, to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation. The instruments also are used diagnostically to follow the kinetic chain, to locate and treat the cause of the symptom as well as the specific area of pain. GT is also frequently used as an effective protocol to maintain range of motion.
We recognize there are options in the marketplace. However, GT is the originator of IASTM in the manual therapy industry and has perfected the technique during the past 20+ years. With a commitment to very high standards, GT is a strong advocate for proper education. Course materials are constantly being revised to reflect the latest research and industry best practices.
Originally developed by athletes, Graston Technique® is an interdisciplinary treatment used by more than 24,500 clinicians worldwide – including physical and occupational therapists, hand therapists, chiropractors, and athletic trainers. GT is utilized at some 3,042 outpatient facilities and 86 industrial sites, by more than 431 professional and amateur sports organizations, and is part of the curriculum at more than 45 respected colleges and universities.
For the Clinician:
- Provides improved diagnostic treatment
- Detects major and minor fibrotic changes
- Reduces manual stress; provides significant hand and joint conservation
- Increases patient satisfaction by achieving notably better outcomes
- Expands business opportunities through positive referrals
For the Patient:
- Decreases overall time of treatment
- Fosters faster rehabilitation/recovery
- Reduces need for anti-inflammatory medication
- Resolves chronic conditions thought to be permanent
- Provides an efficient way to maintain optimal range of motion
Graston Technique® (GT) is accepted worldwide by clinicians, elite athletes and everyday patients as a trusted and effective treatment for rehabilitation.
What is Graston Technique®?
Graston Technique® (GT) is a unique, evidence-based form of instrument-assisted soft tissue mobilization that enables clinicians to effectively and efficiently address soft tissue lesions and fascial restrictions resulting in improved patient outcomes.
GT uses specially designed stainless steel instruments with unique treatment edges and angles to deliver an effective means of manual therapy. The use of GT instruments, when combined with appropriate therapeutic exercise, leads to the restoration of pain-free movement and function. The instruments also are used diagnostically to assess the kinetic chain, in an efficient manner using the principles of regional interdependence.
Is Graston Technique® an Evidenced-Based Form of Manual Therapy?
Empirical and anecdotal evidence exists for the following physiological effects of GT:
- Separates and breaks down collagen cross-links, and splays and stretches connective tissue and muscle fibers
- Facilitates reflex changes in the chronic muscle holding pattern (inhibition of abnormal tone/guarding leading to pain reduction via improved sensory input)
- Alters/inhibits spinal reflex activity (facilitated segment)
- Increases the rate and amount of blood flow to and from the area (angiogenesis vs. immediate local increases in blood flow)
- Increases cellular activity in the region, including fibroblasts and mast cells
- Increases histamine response secondary to mast cell activity
Visit GrastonTechique.com/research for a complete listing of empirical evidence of GT effectiveness.
Why is scar tissue a problem?
Scar tissue limits range of motion due its negative impact on sensory motor firing rates and frequencies. Abnormal sensory inputs perpetuate a dysfunctional cycle of nervous system sensitization, pain and dysfunctional movement/motor output. GT offers a positive method of manual therapy that interrupts and breaks this cycle of pain and dysfunctional movement
How is scar tissue different from other tissue?
When viewed under a microscope, normal tissue can be organized in a couple of different fashions: dense, regular elongated fibers running in the same direction, such as tendons and ligaments; or dense and loose, irregular with fibers running in multiple directions. In either instance, when tissue is damaged, it will often heal in a fibrotic, haphazard manner and may appear radio-dense under diagnostic ultrasound. The tissue may show thickening, irregular organization or less precise margins as compared to non-injured tissues, which results in a restricted range of motion and, very often, pain and functional limitations.
How are Graston Technique® instruments used?
GT instruments are used first to enhance the clinician’s ability to detect soft tissue lesions, scar tissue/fibrosis or restrictions in the affected areas as determined from a comprehensive examination of movement and function. Skilled clinicians use the stainless steel instruments to comb over and “catch” on fibrotic tissue, which immediately identifies the areas of restriction. Once the tissue has been identified, the instruments are then used to address and treat the abnormal tissue. When GT is combined with appropriate therapeutic exercises and activities, pain free function is often restored.
Is Graston Technique® treatment painful?
GT is not designed to be painful or cause excessive bruising. Occasionally, as with any form of manual therapy and depending on the patient’s condition, minor discomfort during the procedure and some bruising afterward may be experienced. GT clinicians are trained to recognize these symptoms and adjust treatment intensity to minimize their occurrence, while realizing the benefits of the technique. GT does not need to be considered “painful” to be effective. Please inform your clinician if you are experiencing discomfort anytime during treatment.
Is Graston Technique® used alone?
No. Whether the treatment is injury specific or applied within a maintenance program, the Graston Technique® protocol is the same. It includes a brief warm-up exercise, Graston Technique® treatment, followed by stretching, strengthening and ice (only when subacute inflammation is of concern).
Based on the patient’s condition, as determined by the clinician, GT can be used in conjunction with other modalities including laser or electrical muscle stimulation
What is the frequency of GT treatment?
Depending upon the nature of the injury or maintenance program, patients usually receive 1-2 treatments per week during the span of 4-5 weeks. Most patients have a positive response by the 3rd or 4th treatment. The average number of GT sessions per episode of care averages between 6-12 for more chronic conditions.
Will GT treatments affect my everyday activities?
Patients that have progressed beyond the acute stages of inflammation and repair are often encouraged to resume a pain-free level of activity and exercise with the modifications that are determined by their GT-trained health professional. GT is designed to be implemented with appropriate therapeutic exercises and activities to achieve an ideal outcome.
Is Graston Technique® something new?
The concept of cross fiber massage is not new. Graston Technique® is grounded in the works of Dr. James Cyriax, a British orthopedic surgeon. The use of our specially designed instruments and protocol has been a recognized part of the manual therapy industry for more than 20 years.
Graston Technique® has become standard protocol in many universities and hospital-based outpatient facilities as well as industrial on-site treatment settings. The technique is also being used within the professional sports industry by the NBA, NHL, NFL, and Major League Baseball trainers.
What kind of results does Graston Technique® produce?
Historically, the Graston Technique® has had positive outcomes in 75-90 percent of all conditions treated. It is equally effective in restoring function to acute and chronic injuries, pre- and post-surgical patients and maintaining optimal range of motion.
What conditions can be treated with the Graston Technique®?
GT-trained clinicians use GT instruments to effectively and efficiently address soft tissue lesions and fascial restrictions while treating acute and chronic conditions, including:
- Achilles Tendinitis/osis (ankle pain)
- Carpal Tunnel Syndrome (wrist pain)
- Cervicothoracic Sprain/Strain (neck pain)
- Lateral Epicondylitis/osis (tennis elbow)
- Lumbosacral Sprain/Strain (back pain)
- Medial Epicondylitis/osis (golfer’s elbow)
- Myofascial Pain Syndromes
- Patellofemoral Disorders (knee pain)
- Plantar Fasciitis/osis (foot pain)
- Post surgeries such as joint replacements, RTC repairs (once post-surgical protocol allows for soft tissue mobilization/manual therapy)
- Rotator Cuff Tendinitis/osis (shoulder pain)
- Scar Tissue/post-surgical scars (once completely closed)
- Patients demonstrating central and/or peripheral sensitization (only used in light stroking/brushing mode to desensitize)
- Shin Splints
- Trigger Finger
- Women’s Health (post-mastectomy and Caesarean scarring)
Graston Technique® can be used to treat any movement system dysfunction that has been determined to have a soft tissue component.
WJXT-TV4 Sam Kouvaris interview:
Graston Technique used by Michael Phelps available at JOI Rehab