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What is the Graston Technique?

What is the Graston Technique?

Written by:  Paul Kochoa, PT, DPT, OCS, CKTP, CGFI

I’ve heard it called many things: the knife, the scraper, “the really painful thing that I don’t enjoy”…  Usually it’s goes like, “Hey, what’s that metal thingy that you scrape on my leg?”  It’s been called many things and cursed by most patients, but I find that the results are always very good.

The Graston Technique is a type of instrument-assisted soft tissue mobilization. It originates from a traditional Chinese medical treatment called Gua Sha which used bone or jade tools.   The Graston instruments are 6 stainless steel instruments that are different sizes and shapes to fit different parts of the body.  Physiotherapists and other medical professionals use the instruments to scan parts of the body and treat the soft tissue for limits in mobility or scar tissue or edema.

The soft tissue of the body: skin, fascia, muscles, tendons, and ligaments;  are basically made up of fibers.  These fibers, when aligned in a parallel, organized fashion, can slide back and forth and over each other and against each other when we move or stretch.  When these fibers are unorganized, twisted, tangled, or adhered to each other, they can lose their mobility and flexibility.  The fibers can then become stiff and create movement dysfunctions or pain.

The Graston instruments help us break up these adhesions and restore normal tissue mobility, just like any other form of soft tissue mobilization or deep tissue massage.  We follow the Graston treatment with further soft tissue work, joint mobilization, or therapeutic exercise, thus correcting many musculoskeletal issues that cause pain.  We usually start with a larger Graston instrument, scan an area of the body and determine the quality of the tissue there.  Then we move on to smaller and smaller, more specific instruments to break up adhesions and get rid of any scar tissue.  Basically, we get into the nooks and crannies of the body.

The treatment itself can be uncomfortable, it is pretty common to experience some discomfort, petechiae, or redness during the treatment and some soreness the day after treatment. In rare cases, some bruising may occur which may last for 24-48 hours.  I always start really easy with the treatment to determine the patient’s tolerance and then gradually move on and progress from there, and use ice to address any acute areas.  If you do a Google search for the Graston Technique, you may run into horror stories or graphic pictures of extreme black, blue, or purple bruising.  These results are not common, and if they are, there may be an issue with the practitioner applying too much pressure with the instruments, being too inexperienced, or lacking the specific training to perform the Graston technique properly.

My advice is that the Graston treatment only hurts for the 20-30 seconds that we apply the instruments to the body, but decrease and go away when we stop and remove the instrument. Total treatment time can be anywhere from 10-30 minutes depending on the size of the body part.

Patients usually receive 1-2 treatment sessions per week for 4-6 weeks.  Sometimes, we see dramatic results with decreased pain and increased range of motion after the first session.  We specialize in the Graston Technique as well as other manual physiotherapy techniques and each physical therapy session is an hour long.

If you would like more information, please call Professional Physical Therapy and Training at 973-270-7417.  Our offices are located within the YMCA locations in Madison and Summit, NJ.  You do not need to be a member of the YMCA to visit with us.

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