What is Graston/IASTM?
What is the Graston Tech/IASTM???
The Graston Technique is a form of manual therapy known as soft-tissue instrument-assisted mobilization. It is one of a number of manual therapy approaches that uses instruments with a specialized form of massage/scraping the skin gently.
The therapy is designed to help the practitioner identify areas of restriction and attempt to break up scar tissue.
The Graston Technique is often practiced by physical therapists, occupational therapists, chiropractors, osteopathic physicians, , and some licensed massage therapists and athletic trainers.
Graston Technique Goals
The general goals of the therapy are to reduce the patient's pain and increase function through a combination of:
Breaking down the scar tissue and fascia restrictions that are usually associated with some form of trauma to the soft tissue (e.g., a strained muscle or a pulled ligament, tendon, or fascia).
Reducing restrictions by stretching connective tissue in an attempt to rearrange the structure of the soft tissue being treated (e.g., muscle, fascia, tendons, ligaments).
See Myofascial Therapy for the Treatment of Acute and Chronic Pain
Promoting a better healing environment for the injured soft tissue.
There also appears to be a neurologic benefit to treating patients with the Graston Technique Instruments. This response is similar to that involved with other manual therapies. The literature suggests that when a patient is given manual or instrument assisted soft tissue mobilization (IASTM) therapy, certain nerve fibers are activated. Additionally, the body's position sense organs, such as mechanoreceptors and proprioceptors, seem to respond to these forms of treatment.
Potential Benefits of Graston Therapy
Most of the back is comprised of muscles, fascia, ligaments, and tendons. Injuries to these soft tissues play a significant role in the pain and dysfunction associated with back problems. While it may not sound like a serious injury, a simple back muscle strain or torn ligament in the back can cause excruciating pain and difficulty with movement.
The Graston Technique offers several potential advantages to the patient with such an injury:
Decreasing overall treatment time
Fostering faster rehabilitation/recovery
Reducing the need for anti-inflammatory medication
Resolving chronic conditions thought to be permanent
The treatment may be used alone or in conjunction with other treatments.
Graston Technique uses unique handheld instruments with a specialized form of massage that is designed to help the practitioner identify areas of restriction and break up the scar tissue.
The Graston Technique Tools
The Instruments are curved to contour around your body. These tools are made of stainless steel and are concave and convex-shaped. They have rounded edges and are not sharp. The instruments are used to scan over and detect areas of injured fibrotic tissue.
The process is designed to both identify the injured areas and provide needed treatment to them.
The Graston Technique Massage
Using a cross-friction massage, which involves brushing or rubbing against the grain of the scar tissue, the practitioner re-introduces small amounts of trauma to the affected area. In some cases, this process temporarily causes inflammation in the area, which in turn increases the rate and amount of blood flow in and around the area. The theory is that this process helps initiate and promote the healing process of the affected soft tissues.
Treatment is rendered along the kinetic chain and thus a patient presenting with back pain might also receive treatment to the hip flexors, abdomen, hamstrings, shoulders, and other regions of the body which often seem remote but are connected through the fascial network.
Clinical Data on the Graston Technique
At the time of this article, there are no peer-reviewed published clinical studies regarding the effectiveness of the Graston Technique in relieving lower back pain or neck pain. Research that has been conducted indicates a relatively high success rate for patients with chronic pain and acute pain from soft tissue injuries, both in terms of improving the patient's function and reducing pain.
While newer research is informative, there remain many aspects of this therapy for which we have no certain explanation and no clinical trials or other studies to verify the outcomes.
The typical course of treatment for lower back pain generally ranges from 1 to 10 visits over the course of several weeks. No medications are required in conjunction with this manual therapy.
Patients undergoing therapy with the Graston Technique can expect the following:
Prior to Treatment
Prior to an appointment with a chiropractor or another health practitioner, patients are advised to complete five minutes of cardiovascular activity, such as riding a stationary bike or walking on a treadmill.
At the clinician's office, ultrasound or heat treatment may first be applied to the injured area to warm up the soft tissue.
During Graston Treatment
The practitioner will utilize the appropriate Graston Technique instruments to scan, then treat, the affected area.
Treatment generally consists of the clinician rubbing the affected area(s) with the handheld stainless steel Graston Technique instruments, using very specific, calculated massage techniques.
Treatment time is usually 30 to 60 seconds per area treated.
It is common for patients to experience some discomfort during the procedure.
After Treatment
Patients are advised they may be sore, bruised or exhibit small red dots over the area treated, called petechiae.
If any soreness is felt after the procedure, ice application for 15 to 20 minutes following the treatment may ease the discomfort.
It is recommended that an exercise, stretching, and strengthening program be used in conjunction with the Graston Technique to rehabilitate the back and help the injured tissues heal.
Anecdotally, many patients have reported increased range of motion and reduced pain after the first treatment.
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