If you’ve ever seen the set of stainless steel Graston tools in our office, you may have wondered what those scary-looking devices are good for! You may have even experienced a Graston treatment on your knee or shoulder, but not really understood what the tools do. Today’s article will explain the theory behind Graston, aka “Why This Torture is Really Effective”
*Since this is the internet, it should be noted that we use the word “torture” in a tongue and cheek way. Of course we’re always working within patient tolerance and encouraging our patients to use breathing techniques to keep the muscles relaxed and their mind distracted from the pain. And some people report that it doesn’t feel like torture at all, and that they even prefer the Graston technique to manual therapy. But for most people, it’s worth the temporary discomfort during treatment to arrive at a pain-free place after treatment.
Graston falls under the umbrella of Instrument Assisted Soft Tissue Mobilization (IASTM). This is a form of therapy that uses specialized stainless steel instruments to assist the clinician in the mobilization or poorly organized scar tissue in and around muscles, tendons, and fascia. The instruments are solid and have angled edges, and are guided with the help of a lubricant such as coconut oil. Longitudinal strokes are applied parallel to the fiber alignment in a stroking motion along the skin to mobilize the underlying soft tissues.
As the instruments move over an area with underlying fibrotic adhesion, a change in texture is palpable. The initial strokes, which are used for screening purposes, are smooth and flowing, but become shorter and more concentrated to increase the pressure per unit area once the fibrosis is located. The pressure needs to be firm enough to locate the fibrosis and cause microtrauma, but not so hard that macrotrauma occurs. The microvascular trauma and capillary hemorrhage induces a localized inflammatory response and stimulates the body’s healing cascade and immune-reparative system. (We need to stir up a little bit of inflammation to get rid of a larger inflammatory problem).
Usually upon completion of treatment, there is immediate erythema and the potential for some transient ecchymosis. (This means there are some tiny red dots that show up as the tiny microcapillaries burst open, and there can be some possible short-term bruising.)
Treatments can be one-time only, or performed over a course of 6-8 sessions, depending on the severity and duration of the injury.
Have you experienced Graston treatments? What do you like or dislike about it? Let us know in the comments below.
Source: Orthopaedic Examination, Evaluation, and Intervention. Dutton, Mark.
Photos: Wiki commons