Definition & Overview

Graston technique is a method developed for diagnosing and treating disorders of the connective tissue and skeletal muscles. It is a type of chiropractic treatment that uses specialised instruments to mobilise soft tissue through manual therapy. It is typically used for the treatment of sports injuries, where scar tissues develop. The formation of scar tissues often leads to stiffness that limits movements and causes chronic pain.

Manual therapy involves the use of the practitioner’s hands to apply pressure and massage injured tissues to relieve tension and pain. The joints are also manipulated to improve mobility and encourage flexibility. Other techniques of manual therapy include the diversified technique, Atlas Orthogonal technique, and Koren specific technique, among others.

The Graston technique is a modified manual therapy developed and trademarked by David Graston, an athlete who sustained a knee injury and sought to find ways of enhancing his physical therapy. He applied the concept of cross-fiction massage using stainless steel tools with the ultimate goal to restore movement and function to the injured muscles.

Practitioners must be licensed and accredited by Graston Technique LLC before they can offer this kind of physical therapy to patients.

Who Should Undergo and Expected Results

Graston technique is offered for those who suffer from:

  • Muscle strain in the lower back muscles, a painful condition resulting from over-stretching the muscle fibres
  • Damaged muscle or tendons in the neck
  • Neck sprains caused by the tearing of ligaments that connect the neck and cervical bones
  • Conditions in the limbs like plantar fasciitis and carpal tunnel syndrome
  • Achilles tendinitis
  • Rotator cuff tendinitis
  • Shin splints, tennis or golfer’s elbow, and other sports-related injuries


Patients who underwent surgical procedures involving the skeletal muscles and related structures can also undergo this therapy.

This technique has a high success rate in restoring mobility and function to affected muscles and connective tissues. Significant pain relief has also been reported, with many patients achieving reduced dependency on pain and anti-inflammatory medications. Most patients are advised to follow a dedicated exercise and physical therapy programme in conjunction with the Graston technique to help in tissue rehabilitation and strengthening.

How is the Procedure Performed?

The goal of the Graston technique is to locate and break up scar tissue. The treatment session starts with a series of warm up exercises, with some practitioners advising patients to perform cardiovascular activities prior to their appointments. The practitioner then guides the patient in moving and flexing the affected part to make them more receptive to treatment.

The instruments, with their curved edges, are used to slide and combed over the affected parts. They are designed to detect underlying fibrotic tissues, which are typically not visible on the skin surface. The located scar tissues are then rubbed against the grain to break up adhesions. Depending on the need, the practitioner applies increasing pressure to encourage mobility with each area getting treated for about a minute. The sliding and rubbing movements are designed to break down collagen cross-links in injured muscles. Patients are encouraged to provide feedback if the treatment becomes too painful so the practitioner can adjust the rubbing and scraping movements. The process also involves causing intentional inflammation in some areas to increase circulation and initiate the healing process by creating new cellular matrix.

After treatment, the affected area are stretched before the session ends and ice packs may be applied to reduce soreness. Patients have to undergo several weekly sessions for a month or so to achieve maximum benefits.

Possible Risks and Complications

Patients usually experience bruising, soreness, and redness in treated areas, which can last for a day or two.

References:

  • Ernst E, Posadzki P (2012). "Reporting of adverse effects in randomised clinical trials of chiropractic manipulations: a systematic review". N Z Med J 125 (1353): 87–140.

  • Gouveia LO, Castanho P, Ferreira JJ (2009). "Safety of chiropractic interventions: a systematic review". Spine 34(11): E405–13.

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