Month: September 2015

  • Physical Therapy Going Graston

    September 29, 2015
    Written by: Victor Troha, SPT – Clinical Intern from Mount St Joseph University
    ​What is Graston Technique®?
    The Graston Technique® is the most popular form of instrument assisted soft tissue mobilization (IASTM) used today, and is now utilized by more than 22,650 clinicians worldwide.  It is an alternative approach from manual soft tissue mobilizations that allows physical therapists to induce microtrauma into specific areas with myofascial restrictions, soft tissue fibrosis and other abnormal tissue densities. This is done using specifically designed stainless steel instruments with the intention to create a natural inflammatory response to promote healing in a given area.
    Why use the Graston Technique®?
    As a solitary treatment, the Graston Technique® has proven to offer many benefits. It provides a more indicative way for the physical therapist to identify restrictions within the kinetic chain of connective tissue.  With this treatment accuracy, its been proven to have a therapeutic benefit for many different conditions.

    • Trigger Points

    One of the most common treatment options is for releasing myofascial trigger point tension. A trigger point is a hyperirritable bundle of muscle fibers that can cause pinpoint pain or refer pain to other areas of the body. Not only does the Graston Technique® decrease the amount of pain from a trigger point, but it also decreases the sensitivity for that trigger point to induce pain in the future.1

    • Achilles Tendinopathy

    Pain in the calf, specifically the mid portion of the achilles traveling down toward the calcaneus (heel) is a strong indicator of achilles tendinopathy. This is often described as a sharp pain that is debilitating to activities such as walking, running and recreational sports. Using the Graston Technique® on the achilles suggests that the controlled microtrauma stimulates healing via fibroblast proliferation.2 In other words, this utilizes the body’s natural healing process in order to decrease the pain and improve the movement range of the achilles tendon.

    • Limited Joint Range Of Motion

    It is often seen that joint movement is limited due to muscular restrictions. Tight muscles cannot only cause pain, but they can significantly inhibit movement into normal ranges of movement. The Graston Technique® has been shown as a beneficial tool to increase the muscle extensibility in a variety of populations, even if they are asymptomatic of pain. For example, a single application of the Graston Technique® to the posterior portion (shoulder blade region) of the shoulder can increase in both glenohumeral horizontal adduction (crossing arm in front of body) and internal rotation (rotating arm forward).3  This shows that even one application of the Graston Technique® can have benefits to improve the movement capabilities of a specific joint.

    ​​Along with the above circumstances, using the Graston Technique® can benefit patients with a multitude of other conditions, including:

    • plantar fibromatosis (fasciitis)
    • joint sprains
    • fibromyalgia
    • scar adhesions
    • tendinosis
    • back pain
    • carpal tunnel syndrome
    • epicondylosis
    • muscle strains
    • post fracture pain
    • IT band syndrome
    The pictures below show the process of a typical instrument assisted soft tissue mobilization.



    ​As this list of conditions benefiting from instrument assisted soft tissue mobilizations grow, some may wonder if there are any side effects to this treatment strategy. It has been found that some bruising and soreness can occur following using a Graston Technique®, but this isn’t out of the ordinary. As myofascial restrictions are released, redness develops indicating an increased flow of blood supply to the area. This has potential to cause bruising, but not to worry because this may be the body’s natural way of reacting to the treatment.4 Soreness typically lasts between 48 and 72 hours, but can be reduced with proper stretching, rest and ice.4 Each patient has different responses to the treatment, but the end results is almost always beneficial.

    If you find yourself with pain, discomfort or movement limitations, then the Graston Technique® may be for you.  Feel free to contact Premier Physical Therapy to learn more about this technique. Our skilled physical therapists can get you on a road to recovery!

    1.    Corum D, Kujawski J, Murphy T, Rice R. The Effect of Graston Trigger Points in the Upper Trapezius Muscle. Chesterfield, MO: Logan College of Chiropractic; 2009.
    2.    Papa J. Conservative management of Achilles Tendinopathy: a case report. J Can Chiropr Assoc. September 2012;56(3):216-224. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed September 11, 2015.
    3.    Laudner K, Compton B, McLoda T, Walters C. Acute effects of instrument assisted soft tissue mobilization for improving posterior shoulder range of motion in collegiate baseball players. Int J Sports Phys Ther. February 2014;9(1):1-7. Available from: MEDLINE with Full Text, Ipswich, MA. Accessed September 11, 2015.
    4.    Discover the Graston Technique. Advanced Orthopedics and Sports Medicine Institute Web site. Published 2015. Accessed September 11, 2015.