GRASTON TECHNIQUE

By Dymond Unutoa

Objectives Know what Graston technique (GT) is Understand the history of Graston technique Be able to recognize Graston tools and

understand the purpose behind each one’s design

Understand the purpose of GT and its effects Know contraindications associated with GT Know other forms of Instrument assisted soft

tissue mobilization and their basic premise Understand how Graston differs from other

IASTM

What is Graston technique?

Graston Technique is a form of instrument assisted soft tissue mobilization

Utilizes 6 different tools Utilizes stainless steel tools to detect and

treat tissue restrictions that affect normal function

History of Graston technique

Researched at Ball State University 1991-92

Therapy Care Resources Inc. 1994 15,000+ Clinicians utilize GT 1,400+ Out-Patient clinics 200+ professional and amateur sports

organizations Currently part of curriculum at 50+

colleges and universities

The Technique Effects Separates and breaks

down collagen cross-links, and splays and stretches connective tissue and muscle fibers

Increases skin temperature

Facilitates reflex changes in the chronic muscle holding pattern

Alters spinal reflux activity (facilitated segment)

Technique Effects cont’d Increases the rate and amount of blood

flow to and from the area Increases cellular activity in the region,

including fibroblasts and mast cells Increases histamine response secondary

to mast cell activity

Some Conditions for GT Utilization

Sprains and Strains Carpal Tunnel

Syndrome Medial/Lateral

Epicondylitis Scar Tissue

Development Shin Splints Rotator Cuff

Tendinosis

Plantar Fasciitis Patellofemoral

Disorders Trigger Finger Achilles Tendinosis

ContraindicationsABSOLUTE RELATIVE

Open wound Unhealed fracture site Thrombophlebitis Uncontorolled

Hypertension Kidney Dysfunction Hematoma Osteomyelitis Patient intolerance or

Hypersensitive

Anti-coagulant Medications Cancer Varicose Veins Burn Scars Acute Inflammatory

Conditions Inflammation Secondary to

Infection RA Pregnancy Osteoporosis

The GT Instruments

Styles of Soft Tissue Mobilization

IASTM (Instrument Assisted Soft Tissue Mobilization) – Includes the following…

GRASTON ASTM (Augmented Soft Tissue

Mobilization) or ASTYM ART (Active Release Technique) SASTM (Sound Assisted Soft Tissue

Mobilization) Gua Sha Massage

Common Seen Effects Petechiae Bruising Loss of Pain Increased ROM Restoration of

function

Usage of Graston Tools Enhance detection of

adhesions, scar tissue or restrictions

Clinicians will use the tools to comb over and “catch” on fibrotic tissue to identify restricted area.

They will then use the tools to break up the scar tissue for reabsorption

Why Stainless Steel The stainless steel of Graston tools act

somewhat like a tuning fork when fibrotic tissue is contacted.

A resonance or reverberation within the instrument is created on contact and transmits through the instrument to the clinician’s hands

So Who Uses GT? Available to the following licensed professionals:

Physical Therapist/PhysiotherapistOccupational TherapistChiropractorCertified Athletic TrainerMedical PhysicianDentistOsteopathPodiatristSelected Canadian Registered Massage Therapists

*PTA/OTAs are eligible for training when working under a GT-trained PT or OT.

ASTM or ASTYM

SASTM

Gua Sha

Other Article Related Information

Sensitivity: GT was found not to be effective in pressure pain threshold

In Quadriceps testing, GT resulted in decreased muscle activation, yet increased force production

Graston in Action

References Hammer WI. The effect of mechanical load on degenerated

soft tissue. J Bodyw Mov Ther. 2008 Jul; 12(3):246–56. Hammer WI, Pfefer MT. Treatment of a case of subacute

lumbar compartment syndrome using the Grastontechnique. J Manipulative Physiol Ther. 2005 Mar–Apr;28(3):199–204.

Howitt S, Wong J, Zabukovec S. The conservativetreatment of Trigger thumb using Graston Techniques andActive Release Techniques. J Can Chiropr Assoc. 2006Dec; 50(4):249–54.

Howitt S, Jung S, Hammonds N. Conservative treatmentof a tibialis posterior strain in a novice triathlete: a casereport. J Can Chiropr Assoc. 2009 Mar; 53(1):23–31.

Black DW. Treatment of knee arthrofibrosis andquadriceps insufficiency after patellar tendon repair: a casereport including use of the graston technique. Int J TherMassage Bodywork. 2010 Jun 23; 3(2):14–21