What is the Graston Technique?

pt HealthModalities

Manual Therapy For Improved Mobility & Pain Relief

The Graston Technique is a patented form of manual therapy that uses stainless steel tools to perform muscle mobilizations.

It is a kind of soft tissue mobilization used mainly by chiropractors, osteopathic physicians, physical therapists/physiotherapists, occupational therapists, and some licensed Canadian massage therapists.

How Does it Work?

You can think of the Graston Technique as a deeper, more intense version of manual therapy.

Specially trained clinicians use specially designed Graston tools in two ways:

  • First, to locate muscle knots or restrictions. They do this by running the tools over your skin to feel for fibrous or scar tissue that may be causing you pain or restricting your movement.
  • Second, they use the tools to break up that tissue to restore mobility and function.

Graston Technique Q & A with Dr. Shawn Engell

We sat down with a fully certified Graston Technique Provider, Dr. Shawn Engell, to ask him a few questions about the Graston Technique.

Dr. Engell joined the pt Health team in 2011. He is a chiropractor at our Hagersville Physiotherapy and Rehabilitation – pt Health location.

In addition to his clinical work, Dr. Engell recently completed a Masters Degree in Rehabilitation Science at McMaster University. His research interests include the study of the biomechanics associated with spinal manipulation.

Q: What benefits do your patients see from using the Graston Technique?

A: In a clinical setting I find that mobility improvement and pain relief occur at about the same rate.

As for technique, I typically apply the test-treat-re-test approach. With this method, I find patients experience an immediate reduction in pain following treatment. This doesn’t mean that the reduction in pain will be sustained until the follow-up, but that is where active rehab comes in.

Overall, the pain reduction effects I see during treatment allow me to introduce a higher level of rehab exercises effectively.

Q: Why do you use the Graston Technique?

A: I look at research from others in my field and related fields, this is the evidence I use to support my choice to use Graston.

Terry Loghmani and others have done a fair amount of research exploring the mechanical effects of Graston while other sources provide information on fascial manipulation; both support my decision to use Graston.

As our understanding of the role fascia plays in musculoskeletal disorders increases, I think techniques like Graston will become more and more popular.

Q: Are patients familiar with Graston Technique? Do they request the therapy or do you have to recommend it to them?

A: Very few patients are aware of Graston technique.

It is something that I have to suggest to patients the majority of the time. In the past 10 years of using the technique, I have only had one patient ask for it directly.

This might be because my practice is predominately general population patients. I think that if I were treating thigh high-level athletes, I would receive more requests for the technique.

Q: Do you find that you get better outcomes for patients that have educated themselves more on the Graston Technique, or is this ironically a barrier to treatment?

A: Patient education is key to any good treatment.

I like my patients to be fully educated about the techniques. I do not find patient education a barrier. Any soft tissue treatment can be uncomfortable at times. I try not to dwell on this too much to avoid any negative effects.

Q: What if I’m hypersensitive, is the Graston Technique a good option for me? It can look pretty intense.

A: If you’ve seen videos of red and bruised patients on the internet, don’t worry. Graston is actually the perfect technique for patients who are hypersensitive.

In my own practice, I carefully modify the amount of pressure I apply so it’s within the patient’s tolerance. I have found that, with light pressure, you can easily desensitize the tissues, so you can apply more force.

Recently I have been playing around with using lighter and lighter force to see if I get the same outcomes. I have found that light pressure is as good as moderate to strong pressure. I think this speaks to the mechano-receptor stimulation (your body’s healing reaction to stimulation) you can achieve with the instruments.

My use of the Graston technique has evolved, my current approach uses a lighter pressure with movement.

Q: Is there anything else you’d like your potential future patients to know about the Graston technique?

A: I think the biggest thing patients should understand is that if Graston is going to work the results should occur quickly.

Regardless of whether the injury is chronic or acute, you really should see significant results within 6-12 treatments.

If you are not seeing results quickly, then it’s something that is not likely going to work for you and you need to re-evaluate.


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