Frequently Asked Questions

... by clinicians, patients and employers

Searching for answers regarding Graston Technique® treatment, scar tissue or patient outcomes?


What is Graston Technique®?

A. Graston Technique® (GT) is a unique, evidence-based form of instrument-assisted soft tissue mobilization that enables clinicians to effectively and efficiently address soft tissue lesions and fascial restrictions resulting in improved patient outcomes.

GT uses specially designed stainless steel instruments with unique treatment edges and angles to deliver an effective means of manual therapy. The use of GT instruments, when combined with appropriate therapeutic exercise, leads to the restoration of pain-free movement and function. The instruments also are used diagnostically to assess the kinetic chain, in an efficient manner using the principles of regional interdependence.


Is Graston Technique® an Evidenced-Based Form of Manual Therapy?

A. Empirical and anecdotal evidence exists for the following physiological effects of GT:

  • Separates and breaks down collagen cross-links, and splays and stretches connective tissue and muscle fibers
  • Facilitates reflex changes in the chronic muscle holding pattern (inhibition of abnormal tone/guarding leading to pain reduction via improved sensory input)
  • Alters/inhibits spinal reflex activity (facilitated segment)
  • Increases the rate and amount of blood flow to and from the area (angiogenesis vs. immediate local increases in blood flow)
  • Increases cellular activity in the region, including fibroblasts and mast cells
  • Increases histamine response secondary to mast cell activity
  • Visit GrastonTechique.com/research for a complete listing of empirical evidence of GT effectiveness.


    Why is scar tissue a problem?

    A. Scar tissue limits range of motion due its negative impact on sensory motor firing rates and frequencies. Abnormal sensory inputs perpetuate a dysfunctional cycle of nervous system sensitization, pain and dysfunctional movement/motor output. GT offers a positive method of manual therapy that interrupts and breaks this cycle of pain and dysfunctional movement.


    How is scar tissue different from other tissue?

    A. When viewed under a microscope, normal tissue can be organized in a couple of different fashions: dense, regular elongated fibers running in the same direction, such as tendons and ligaments; or dense and loose, irregular with fibers running in multiple directions. In either instance, when tissue is damaged, it will often heal in a fibrotic, haphazard manner and may appear radio-dense under diagnostic ultrasound. The tissue may show thickening, irregular organization or less precise margins as compared to non-injured tissues, which results in a restricted range of motion and, very often, pain and functional limitations.


    How are Graston Technique® instruments used?

    A. GT instruments are used first to enhance the clinician's ability to detect soft tissue lesions, scar tissue/fibrosis or restrictions in the affected areas as determined from a comprehensive examination of movement and function. Skilled clinicians use the stainless steel instruments to comb over and "catch" on fibrotic tissue, which immediately identifies the areas of restriction. Once the tissue has been identified, the instruments are then used to address and treat the abnormal tissue. When GT is combined with appropriate therapeutic exercises and activities, pain free function is often restored.


    Is Graston Technique® treatment painful?

    A. GT is not designed to be painful or cause excessive bruising. Occasionally, as with any form of manual therapy and depending on the patient's condition, minor discomfort during the procedure and some bruising afterward may be experienced. GT clinicians are trained to recognize these symptoms and adjust treatment intensity to minimize their occurrence, while realizing the benefits of the technique. GT does not need to be considered "painful" to be effective. Please inform your clinician if you are experiencing discomfort anytime during treatment.


    Is Graston Technique® used alone?

    A. No. Whether the treatment is injury specific or applied within a maintenance program, the Graston Technique® protocol is the same. It includes a brief warm-up exercise, Graston Technique® treatment, followed by stretching, strengthening and ice (only when subacute inflammation is of concern).

    Based on the patient's condition, as determined by the clinician, GT can be used in conjunction with other modalities including laser or electrical muscle stimulation.


    What is the frequency of GT treatment?

    A. Depending upon the nature of the injury or maintenance program, patients usually receive 1-2 treatments per week during the span of 4-5 weeks. Most patients have a positive response by the 3rd or 4th treatment. The average number of GT sessions per episode of care averages between 6-12 for more chronic conditions.


    Will GT treatments affect my everyday activities?

    A. Patients that have progressed beyond the acute stages of inflammation and repair are often encouraged to resume a pain-free level of activity and exercise with the modifications that are determined by their GT-trained health professional. GT is designed to be implemented with appropriate therapeutic exercises and activities to achieve an ideal outcome.


    Is Graston Technique® something new?

    A. The concept of cross fiber massage is not new. Graston Technique® is grounded in the works of Dr. James Cyriax, a British orthopedic surgeon. The use of our specially designed instruments and protocol has been a recognized part of the manual therapy industry for more than 20 years.

    Graston Technique® has become standard protocol in many universities and hospital-based outpatient facilities as well as industrial on-site treatment settings. The technique is also being used within the professional sports industry by the NBA, NHL, NFL, and Major League Baseball trainers. See our Who Uses GT? page for a complete list.


    What kind of results does Graston Technique® produce?

    A. Historically, the Graston Technique® has had positive outcomes in 75-90 percent of all conditions treated. It is equally effective in restoring function to acute and chronic injuries, pre- and post-surgical patients and maintaining optimal range of motion.


    Can anyone obtain the instruments?

    A. GT training is multi-disciplinary and is available to the following licensed professionals:

    • Physical Therapist/Physiotherapist/Physical Therapist Assistants who work under/with GT-trained Physical Therapists.
    • Occupational Therapist/Occupational Therapist Assistants who work under/with GT-trained Occupational Therapists
    • Chiropractor
    • Certified Athletic Trainer (Licensed Athletic Trainers in some states)
    • Medical Physician
    • Dentist
    • Osteopath
    • Podiatrist
    • Selected Canadian Registered Massage Therapists
    • Board Certified and Licensed Naturopaths
    • Board Certified and Licensed Acupuncturists

    Only clinicians who have been trained and accredited in the Graston Technique® Basic course are qualified to obtain the Graston Technique® instruments and apply the technique to treat patients. The course is offered either on-site or at trainings offered throughout the year at a variety of locations.


    How do I find a clinician in my area who can provide the Graston Technique®?

    A. Use the Locate a Provider section and search by clinic name, city, state or country.


    What conditions can be treated with the Graston Technique®?

    A. GT-trained clinicians use GT instruments to effectively and efficiently address soft tissue lesions and fascial restrictions while treating acute and chronic conditions, including:
    :

    • Achilles Tendinitis/osis (ankle pain)
    • Carpal Tunnel Syndrome (wrist pain)
    • Cervicothoracic Sprain/Strain (neck pain)
    • Fibromyalgia
    • Lateral Epicondylitis/osis (tennis elbow)
    • Lumbosacral Sprain/Strain (back pain)
    • Medial Epicondylitis/osis (golfer's elbow)
    • Myofascial Pain Syndromes
    • Patellofemoral Disorders (knee pain)
    • Plantar Fasciitis/osis (foot pain)
    • Post surgeries such as joint replacements, RTC repairs (once post-surgical protocol allows for soft tissue mobilization/manual therapy)
    • Rotator Cuff Tendinitis/osis (shoulder pain)
    • Scar Tissue/post-surgical scars (once completely closed)
    • Patients demonstrating central and/or peripheral sensitization (only used in light stroking/brushing mode to desensitize)
    • Shin Splints
    • Trigger Finger
    • Women's Health (post-mastectomy and Caesarean scarring)

    Graston Technique® can be used to treat any movement system dysfunction that has been determined to have a soft tissue component.