Instrument assisted soft tissue mobilisation: The power of Graston technique!

What is Graston soft tissue technique?

Graston is a form of Instrument assisted soft tissue mobilisation (IASTM): a mobilization technique utilizing an instrument/tool to assist in releasing soft tissue adhesions or scar tissue. (1)“Soft Tissues” can refer to muscle, tendons, ligaments, myofascial, and scar tissue in this mode of mobilization. Graston stems from a form of myofascial release technique called “cross friction” in which deep friction is applied, but perpendicular to the tissue.

What does a Graston tool look like?

Graston tools or instruments can look a bit daunting.  They range in size and shape and are dependent on which area will be targeted or released.  Some resemble butter knives or steel boomerangs, while others have curved edges to fit into different contours of the body.

What does Graston technique do?

Graston is meant to help break down myofascial restrictions, fibrosis “knots” or scar tissue. When a practitioner presses into the tissue it elicits a controlled microtrauma to an area.  This stimulates blood flow to the affected area and aids in reabsorbing excessive scar tissue or fibrosis in myofascial tissue. 

This is important for promoting a healing response resulting in a remodelling phase. The microtrauma increases fibroblasts, which triggers a healing response to the area.  It also stimulates collagen, elastin, and proteoglycans.  These are essential for mobility and flexibility. (3) (4)

Adhesions within the soft tissue which may have developed because of surgery, immobilization, repeated strain or other mechanisms, are broken down allowing full functional restoration to occur. (1) (5) (6) (7). This allows for better tissue and overall joint mobility, along with strength and performance progressions.

What can it be used for?

Graston can be used for many different diagnoses including, but not limited to:

·       Lower back muscle strain or sprain

·       Rotator Cuff Tendinopathy

·       Achilles tendinosis

·       Carpal tunnel syndrome

·       Cervical sprain/strain

·       Plantar fasciitis

·       Shin splints

·       Tennis/golfer's elbow

·       General Muscular Strain

·       Myofascial release

What to expect Post-Graston Treatment?

Bruising and redness is common post treatment, but not essential for the remodelling phase. Muscle soreness and tenderness is also common, due to the pressure and impact to the associated soft tissue.  Factors to consider that will increase risk of bruising include: low iron or anaemia, high blood pressure, blood thinner medications.

Resources:

1.      Instrument Assisted Soft Tissue Mobilization - Physiopedia (physio-pedia.com)

2.      Deep Friction Massage - Physiopedia (physio-pedia.com)

3.      Cheatham SW, Baker R, Kreiswirth E. Instrument assisted soft-tissue mobilization: A commentary on clinical practice guidelines for rehabilitation professionals. International journal of sports physical therapy. 2019 Jul;14(4):670.

4.      Lambert M, Hitchcock R, Lavallee K, Hayford E, Morazzini R, Wallace A, Conroy D, Cleland J. The effects of instrument-assisted soft tissue mobilization compared to other interventions on pain and function: a systematic review. Physical Therapy Reviews. 2017 Mar 4;22(1-2):76-85.

5.       Fowler S, Wilson JK, Sevier TL. Innovative approach for the treatment of cumulative trauma disorders. Work. 2000 Jan 1;15(1):9-14.

6.      Wilson JK, Sevier TL, Helfst R, Honing EW, Thomann A. Comparison of rehabilitation methods in the treatment of patellar tendinitis. Journal of Sport Rehabilitation. 2000 Nov 1;9(4):304-14.