Graston Technique is a soft tissue diagnostic and therapeutic method that has been used in outpatient clinics since 1993. A key protocol of the Graston Technique, Graston Instrument-assisted Soft Tissue Mobilization (GISTM) has only recently been introduced to the chiropractic profession. Graston instruments - made of stainless steel, specifically designed and developed as an alternative to transverse friction massage - are used as an aid in the diagnosis and treatment of soft tissue dysfunction or pathology. The instruments provide tactile diagnostic feedback to both the doctor and the patient, as the instruments act as a focused extension of the doctor's own hands while reducing wear and tear on the hands.

GISTM research, conducted at Ball Memorial Hospital and Ball State University, includes an in vitro rat tendon injury model showing that GISTM significantly activates fibroblasts to both replicate and synthesize.(1, 2) Thus, GISTM increases the amount of fibroblasts and the quantity of collagen deposited, which should speed healing of dense connective tissue like tendon and ligament. The rate of activation is proportional to the force applied to the tendon.(1)

Clinical experience has shown that Graston Technique is helpful in the management of a large variety of musculoskeletal disorders. These include: carpal tunnel syndrome, cervical pain, de Quervain's syndrome, epicondylitis, fibromyalgia, IT band syndrome, joint sprain, lower back pain, muscle strain, painful scar, plantar fasciitis, post fracture pain, and tendonitis.(3-6) A large case series found that Graston Technique reduces numbness, increases patient functional capabilities both in ADLs, and work related function.(7)

Clinical trials of the effectiveness of Graston Technique in the treatment of carpal tunnel syndrome, lateral epicondylitis and post-surgical low back pain are underway or have been funded.

Summary

• Graston Technique is both a diagnostic and therapeutic method

• Stainless steel instruments are used to focus treatment forces and improve diagnostic ability

• Graston Technique has been effective in the treatment of: carpal tunnel syndrome, cervical pain, de Quervain's syndrome, epicondylitis, fibromyalgia, IT band syndrome, joint sprain, lower back pain, muscle strain, painful scar, plantar fasciitis, post fracture pain, and tendonitis(7)
  

1. Gehlsen GM, Ganion LR, Helfst R. Fibroblast responses to variation in soft tissue mobilization pressure. Med Sci Sports Exerc 1999;31(4):531-5.

2. Davidson C, Ganion L, Gehlsen G, Verhoestra B, Roepke J, Sevier T. Rat tendon morphologic and functional changes resulting from soft tissue mobilization. Medicine and Science in Sports and Exercise 1997;29(3):313-9.

3. Earley BL, Carey MT, Hall A. The Graston Technique of Instrument-assisted Soft Tissue Mobilization. In: AOTA Annual Conference and Exposition; 2000 March 30 - April 2; Seattle, WA; 2000.

4. Sevier TL, Wilson JK. Treating lateral epicondylitis. Sports Med 1999;28(5):375-80.

5. Carey MT, Ploski M, Sweney L. The Graston Technique of Soft Tissue Mobilization. In: APTA Combined Sections Meeting; 1999 February 3-7; Seattle, WA; 1999.

6. Melham TJ, Sevier TL, Malnofski MJ, Wilson JK, Helfst RH, Jr. Chronic ankle pain and fibrosis successfully treated with a new noninvasive augmented soft tissue mobilization technique (ASTM): a case report. Med Sci Sports Exerc 1998;30(6):801-4.

7. Perle SM, Perry DG, Carey MT. Effects of Graston Technique on Soft Tissue Conditions: A Prospective Case Series. In: WFC's 7th Biennial Congress; 2003; Orlando, FL: World Federation of Chiropractic; 2003.