What is the Graston Technique?
The Graston Technique is a form of instrument-assisted soft-tissue mobilization, often shortened to IASTM. It uses smooth, handheld instruments to assess and treat muscles, tendons, ligaments, fascia, and scar-sensitive areas.
During treatment, a clinician moves the instrument across the skin with controlled pressure. The goal is not to “scrape out” tissue or forcefully break apart scar tissue. Instead, the technique is intended to identify areas of altered movement or sensitivity and provide a focused mechanical stimulus that may support mobility and rehabilitation.
The instruments may be made from stainless steel or another durable material. Their shape allows a clinician to feel changes in tissue texture that may be less noticeable with the hands alone.
How is it used in chiropractic care?
In a chiropractic setting, Graston-style treatment is generally used as one part of a broader plan. It may be combined with joint mobilization, stretching, strengthening exercises, posture education, movement retraining, or advice about modifying aggravating activities.
A typical session may include:
- A discussion of symptoms, activity levels, prior injuries, and health history
- Movement testing to identify painful or restricted motions
- A brief warm-up or active movement
- Application of a lubricant to reduce skin friction
- Gentle to moderate strokes over a selected area
- Reassessment of movement, tenderness, or function
- Exercises or home-care instructions
The treated area might include the neck, shoulder, forearm, back, hip, knee, calf, ankle, or foot. Treatment should be directed toward a specific clinical finding rather than applied automatically to every painful region.
For residents balancing commuting, desk work, home maintenance, recreational exercise, and seasonal outdoor activities, soft-tissue treatment may be considered when muscle or tendon discomfort affects ordinary movement. It should still be matched to the actual cause of symptoms.
What conditions may be considered?
Instrument-assisted soft-tissue mobilization has been studied for a range of musculoskeletal complaints. Examples include:
- Tendon-related pain, such as discomfort around the elbow, Achilles tendon, or shoulder
- Muscle strains and post-activity tightness
- Reduced range of motion
- Scar-sensitive or adhesive tissue after healing
- Certain forms of plantar heel pain
- Movement limitations associated with repetitive work or exercise
- Some neck, back, and limb complaints
The evidence is not equally strong for every condition. Research findings vary because studies use different instruments, treatment pressures, schedules, comparison treatments, and patient groups. Some studies report short-term improvements in pain, flexibility, or function, while broader reviews have found that the overall evidence remains mixed.
That means the technique should not be presented as a cure or as a replacement for diagnosis, exercise, or appropriate medical care.
Does it break up scar tissue?
This is one of the most common misunderstandings. The instrument does not mechanically “shatter” scar tissue in the simple way that a tool might break a hard object.
Scar tissue is living connective tissue that changes as the body heals. A clinician may use controlled loading, movement, and hands-on treatment to influence how a sensitive or restricted area feels and functions. Improvements may also result from changes in nervous-system sensitivity, circulation near the skin, joint movement, or a person’s confidence using the area.
For that reason, a reduction in pain after treatment does not prove that scar tissue has been physically removed. The practical goal is usually better movement and function, not the elimination of every difference in tissue texture.
What does treatment feel like?
Most people describe the sensation as firm rubbing, pressure, or a mild scraping feeling. It should not be sharply painful or feel like the skin is being injured.
Temporary effects can include:
- Mild tenderness
- Redness
- A warm sensation
- Small bruises or pinpoint discoloration
- Increased awareness of the treated area for a day or two
Bruising is not proof that treatment worked. More pressure is not necessarily more effective, and aggressive treatment may increase soreness without improving recovery. A person should be able to communicate during the session if the pressure feels excessive, painful, or unusual.
If swelling, severe pain, blistering, spreading redness, numbness, weakness, or other concerning symptoms develop, the area should be medically assessed.
Who should use caution?
A careful health history matters before any instrument-assisted treatment. Extra caution or avoidance may be appropriate for people with conditions such as:
- Blood-clotting disorders
- Use of blood-thinning medication
- Active skin infection, open wounds, or unexplained rash
- Recent fracture or surgery
- Significant swelling or acute inflammation
- Known or suspected blood clot
- Poorly controlled diabetes or reduced sensation
- Certain vascular or bleeding conditions
- Active cancer in the treatment area
- Severe osteoporosis or fragile skin
Pregnancy does not automatically rule out hands-on care, but treatment areas, pressure, positioning, and the underlying complaint may require modification. Anyone with a complex medical history should disclose it before treatment.
A painful area that has not been evaluated may represent something other than a muscle or tendon problem. Sudden weakness, loss of coordination, unexplained weight loss, fever, major trauma, bowel or bladder changes, chest pain, or new numbness affecting an entire limb require prompt medical attention rather than soft-tissue treatment alone.
Is Graston treatment appropriate for acute injuries?
Sometimes, but not automatically. A fresh injury with substantial swelling, bruising, instability, or loss of function may need protection and diagnostic evaluation before direct instrument work is considered.
During the early phase of an injury, the priority may be controlling symptoms and determining whether a fracture, significant tendon injury, ligament tear, or other problem is present. Direct pressure over damaged tissue can be inappropriate if the injury has not been assessed.
For a less serious strain, a clinician may later introduce gentle soft-tissue work as part of a gradual return to normal movement. Timing should depend on the injury, not on a fixed number of days.
What questions should residents ask before treatment?
Useful questions include:
- What specific finding is this treatment intended to address?
- How will improvement be measured?
- What other treatments or exercises should accompany it?
- What level of soreness is expected afterward?
- Are there medical conditions or medications that make it unsuitable?
- What should be avoided during recovery?
- What is the plan if symptoms do not improve?
These questions help distinguish a focused rehabilitation approach from treatment based only on a painful spot or a promise of “breaking up” adhesions.
How should someone prepare?
Wear clothing that allows access to the affected region and describe symptoms accurately, including when they began, what worsens them, and whether there is numbness, weakness, swelling, or night pain.
Avoid applying treatment over sunburned, irritated, infected, or broken skin. In a community where winter cold, summer humidity, household repairs, and regular walking can all influence muscle tension and activity levels, it is also useful to mention recent changes in exercise, work setup, footwear, lifting, or outdoor routines.
Graston-style care may be a reasonable supportive technique for selected soft-tissue problems, but its value depends on proper assessment, appropriate pressure, patient safety, and a rehabilitation plan that addresses strength and movement—not just temporary tenderness or tightness.
