Graston Technique

About Graston Technique^®

Changing the way soft tissue injuries are treated

Graston Technique® is an evidence-based form of instrument that helps in assisting soft tissue mobilization enabling clinicians to effectively address scar tissue and fascial restrictions through comprehensive training to improve patient outcomes.

The technique uses specially-designed surgical steel instruments, along with appropriate therapeutic exercise, to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation. The instruments are also used to diagnostically follow the kinetic chain, to locate and treat the cause of the symptom as well as the specific area of pain.

Originally developed by athletes, Graston Technique® is an interdisciplinary treatment used by more than 20,000 clinicians worldwide — including physical and occupational therapists, hand therapists, chiropractors, and athletic trainers.

GT is utilized at some 2,300 outpatient facilities and 66 industrial sites, by more than 350 professional and amateur sports organizations, and is part of the curriculum at more than 50 respected colleges and universities.

Advantages of GT:

Decreases overall time of treatment
Fosters faster rehabilitation/recovery
Reduces need for anti-inflammatory medication
Resolves chronic conditions thought to be permanent

See what experts and researchers have to say about the Graston Technique®

“The Graston Technique® Instruments allow a deeper, more sensitive palpation and treatment of densified tissue.”

—Warren I. Hammer, MS, DC, DABCO

The curvilinear edge of the patented Graston Technique® Instruments combines with their concave/convex shapes to mold the instruments to various contours of the body. This design allows ease of treatment, minimal stress to the clinician’s hands and maximum tissue penetration.

The Graston Technique® Instruments, much like a tuning fork, resonate in the clinician’s hands allowing the clinician to isolate adhesions and restrictions, and treat them very precisely. Since the metal surface of the instruments does not compress as do the fat pads of the finger, deeper restrictions can be accessed and treated. When explaining the properties of the instruments, we often use the analogy of a stethoscope. Just as a stethoscope amplifies what the human ear can hear, so do the instruments increase significantly what the human hands can feel.

What is Graston Technique?

The Graston Instrument assisted soft tissue mobilization technique is a soft tissue technique designed to mobilize, reduce and reorganize fibrotic restrictions in the neuromusculoskeletal system. The technique is delivered through the use of six (6) handheld stainless steel instruments. A specially designed lubricant must be applied to the skin prior to utilizing the instrument. The lubricant allows the instrument to glide over the skin without causing irritation.

The treatment is applied in multiple directions: with venous drainage, against venous drainage and cross fiber in multiple directions to the lesion. As with other soft tissue techniques, the treatment application is also part of the diagnostic process. As the Graston tools are applied a “vibratory” sensation is felt through the tool to the examiner’s fingertips. The patient simultaneously experiences a similar sensation while the tool traverses the area being treated.

Frequently Ask Questions? (Graston Technique www.grastontechnique.com)

Q: What is the Graston Technique?
A: The Graston Technique incorporates a patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively detect and treat scar tissue and restrictions that affect normal function.

The Technique:

Separates and breaks down collagen cross-links, and splays and stretches connective tissue and muscle fibers
Increases skin temperature
Facilitates reflex changes in the chronic muscle holding pattern
Alters spinal reflux activity (facilitated segment)
Increases the rate and amount of blood flow to and from the area
Increases cellular activity in the region, including fibroblasts and mast cells
Increases histamine response secondary to mast cell activity

Q : How is scar tissue different from other tissue? Q : Why is scar tissue a problem?
A: Scar tissue limits range of motion, and in many instances causes pain, which prevents the patient from functioning as he or she did before the injury.

A: When viewed under a microscope, normal tissue can take a couple of different fashions: dense, regular elongated fibers running in the same direction, such as tendons and ligaments; or dense, irregular and loose with fibers running in multiple directions. In either instance, when tissue is damaged it will heal in a haphazard pattern–or scarring–that results in a restricted range of motion and, very often, pain.

Q : How are the instruments used?
A: The Graston Technique Instruments are used to enhance the clinician’s ability to detect adhesions, scar tissue or restrictions in the affected areas. 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 used to break up the scar tissue so it can be absorbed by the body.

Q : Is the treatment painful?
A: It is common to experience minor discomfort during the procedure and some bruising afterwards. This is a normal response and part of the healing process.

Q : Are other procedures involved in using Graston Technique?
A: Our protocol includes a brief warm-up exercise, Graston Technique treatment, followed by stretching, strengthening and ice. We will often combine Graston Technique with Active Release Technique and Chiropractic Adjustments.

Q : What is the frequency of treatment?
A: Patients usually receive two to three treatments per week over 2-3 weeks.

Q : What kind of results does Graston Technique produce?
A: Historically, the Graston Technique has resolved 87% or more of all conditions treated. It is equally effective on restoring function to acute and chronic injuries, and pre and post surgical patients.

Research Findings

Research conducted by Graston Technique trained clinicians at Ball Memorial Hospital and Ball State University, Muncie, Indiana, found that the controlled micro trauma induced through the Graston Technique protocol, increased the amount of fibroblasts to the treated area. That amount of inflammation to the scar tissue helps initiate the healing cascade.

The structure of the tissue is rearranged, and damaged tissue is replaced by new tissue. Ice is then applied to reduce the pain and exercise is implemented to increase function and range of motion.

Other clinical studies continue to document the success of the Graston Technique, generally achieving better outcomes when compared to traditional therapies, and resolving injuries that have failed to respond to other therapies.

Research on the Graston Technique is ongoing. The following studies were conducted using the GASTM* Protocol by Graston Technique trained clinicians:

Davidson CJ, Ganion L, Gehlsen G, Roepke J, Verhoestra B, Sevier TL: Morphologic and functional changes in rat achilles tendon following collagenase injury and GASTM . Journal of the American College of Sports Medicine 27(5) 1995.

This study examined morphologic changes and functional changes in the Achilles tendon of rats following collagenase injury and subsequent intervention with the Graston Technique (GASTM). Animals were randomly assigned to one of four groups (five rats per group): (1.) control; (2.) tendinitis; (3.) tendinitis plus GASTM; and (4.) GASTM alone.

The Achilles tendons were harvested six weeks after injury. Gait analysis was performed using a rat treadmill, high-speed film and computer digitalization. Results indicated a significant therapeutic effect of the GASTM for stride length, stride frequency and knee range of motion (ROM). Electron microscopy found an increased number of fibroblasts in both groups treated with the Graston Technique (GASTM) (groups 3 & 4).

Sevier TL, Gehlsen GM, Wilson JK, Stover SA, and Helfst RH: Traditional physical therapy vs. Graston Technique Augmented Soft Tissue Mobilization in treatment of lateral epicondylitis . Journal of the American College of Sports Medicine 27 (5), 1995.

Forty patients diagnosed with lateral epicondylitis were randomly assigned to one of two groups; traditional PT protocol; phonophoresis and manual cross-friction; the Graston Technique protocol. Both groups received identical cryotherapy, exercise and stretching programs. Pain level, mechanical finger power and grip strength were measured. There was a statistical difference between groups, in favour of the Graston Technique protocol for the above measures.

Clinical Applications of the GT Instruments

The Graston Technique® (GT) Instruments, while enhancing the clinician’s ability to detect fascial adhesions and restrictions, have been clinically proven to achieve quicker and better outcomes in treating both acute and chronic conditions, including: