1. GRASTON TECHNIQUE
By Dymond Unutoa

2. 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

3. 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

4. History of Graston technique
Researched at Ball State University
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

5. 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)

6. 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

7. 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

8. Contraindications Absolute 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

9. The GT Instruments

10. 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

11. Common Seen Effects Petechiae Bruising Loss of Pain Increased ROM
Restoration of function

12. 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

13. 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

14. So Who Uses GT?
Available to the following licensed professionals: Physical Therapist/Physiotherapist Occupational Therapist Chiropractor Certified Athletic Trainer Medical Physician Dentist Osteopath Podiatrist Selected Canadian Registered Massage Therapists
*PTA/OTAs are eligible for training when working under a GT-trained PT or OT.

15. ASTM or ASTYM

16. SASTM

17. Gua Sha

18. 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

19. Graston in Action

20. References Hammer WI. The effect of mechanical load on degenerated
soft tissue. J Bodyw Mov Ther Jul; 12(3):246–56.
Hammer WI, Pfefer MT. Treatment of a case of subacute
lumbar compartment syndrome using the Graston
technique. J Manipulative Physiol Ther Mar–Apr;
28(3):199–204.
Howitt S, Wong J, Zabukovec S. The conservative
treatment of Trigger thumb using Graston Techniques and
Active Release Techniques. J Can Chiropr Assoc. 2006
Dec; 50(4):249–54.
Howitt S, Jung S, Hammonds N. Conservative treatment
of a tibialis posterior strain in a novice triathlete: a case
report. J Can Chiropr Assoc Mar; 53(1):23–31.
Black DW. Treatment of knee arthrofibrosis and
quadriceps insufficiency after patellar tendon repair: a case
report including use of the graston technique. Int J Ther
Massage Bodywork Jun 23; 3(2):14–21