Graston Technique® is a nearly ubiquitous reference to instrument-assisted soft tissue mobilization, where a provider will use a instrument to treat certain soft tissue disorders. Dr. Melander has been a Graston® provider for 10 years and uses that system periodically for certain conditions.
The Graston Technique is an instrument-assisted soft tissue mobilization. These days there are innumerable treatment instruments but because of its early success and patent, “Graston” is largely synonymous with all instrument mobilization techniques.
During an instrument-assisted soft tissue mobilization (IASTM for short), the treating provider will massage a tissue or tissues with an instrument.
The provider, and the patient, are able to feel textural differences in areas assessed with the instrument that may indicate where a treatment should occur. The textural differences are often described as though normal tissue “feels” smooth under the instrument whereas abnormal tissue “feels” rough, gravelly, bumpy.
At North Shore Spine and Sport, Dr. Melander will use IASTM on a few particular body regions or conditions for which he finds an instrument to be an efficient means of accessing and affecting tissue.
To be fair, it is unclear exactly what physiologic processes are influenced by IASTM and thereby difficult to say how it works with absolute confidence.
The positive therapeutic effect is most likely due to a combination of increased blood flow (perfusion) to the treated area as well as neuromodulation (fancy way of saying that the information received by the brain from the treated area is different).
Some providers argue that by increasing blood flow to tissue there is an inherent increase in stem cell delivery to the tissue. The stem cells that arrive in the tissue are “pluripotent” which means they can become multiple kinds of tissue cells and cause an eventual favorable adaptation to more healthy tissue in the treated area.
There is a common misconception that Graston “scrapes” or “breaks down” scar tissue, unfortunately there is no science or research supporting this idea. Interestingly, instruments have been used for millennia in the manual treatment of pain and injury as Eastern Medicine practitioners utilized “Gua Sha” tools and there is some speculation that early Greek Olympians were treated with “tools” prior to their competition.
Particularly in early Gua Sha applications that intention of treatment was to create actual bleeding in the targeted area…fear not, none of the instrument-assisted soft tissue mobilization protocols call for any bleeding these days!
Over the years Dr. Melander has narrowed the list of areas or conditions for which he believes Graston may be beneficial, but as with any kind of hands-on therapy the benefit and intention is to:
Dr. Melander uses Graston as an adjunct therapy for:
The common theme amongst these body regions is that the muscle tissue in these areas is not terribly thick which permits a sufficient depth of contact with the instrument to efficiently influence the tissue.
No. No matter what tons of healthcare providers claim, Graston does not break up scar tissue because the forces required to break scar tissue are far greater than Graston can match.
Not to mention that the depth of tissue accessed sufficiently with a Graston instrument is not much deeper than skin, or more specifically, the superficial fascia that resides immediately deep to the skin.
That being said, many patients experiencing stubborn areas of tension that they may identify as scar often feel relief after a Graston treatment (this is due to neuromodulation, not breaking down scar tissue).
No, icing may in fact hinder the healing affects driven by the localized inflammation created during an instrument-assisted soft tissue mobilization because ice reduces blood flow to tissue. Dr. Melander does not use or recommend ice or heat very often, but if any “temperature modality” helps Graston it would be heat due to the positive impact heat can have on blood flow.
Tough to say, this completely depends on the patient and the condition being treated. Factors that influence how often any treatment should occur include age, general health, physical fitness, diet, sleep, stress, how long has the condition been present, etc.
In situations of bruising or post-treatment soreness it is advisable to refrain from additional Graston treatment until the treated area is sufficiently recovered. No matter the patient, injury, or condition Dr. Melander has the goal to help people as quickly as possible.
In that vein he might only use Graston once provided that his patient improves as expected and learns the self-care strategies needed to help themselves.
It is common to see a red or pink and almost rash-like appearance to skin after instrument-assisted soft tissue mobilization. This is due to the blood flow facilitated by the technique and is not something to be concerned about.
Occasionally some individuals develop mild bruising in treated areas that goes away within a few days. Certainly, a patient prone to easy bruising or using blood thinners should proactively discuss the potential bruising effect of instrument work with Dr. Melander. It is very rare that Graston Technique will aggravate a condition being treated.
Yes, no, sometimes, it depends! Any instrument-assisted soft tissue mobilization can be uncomfortable, particularly if a treated area is inflamed or tender. Dr. Melander uses Graston on only a few body regions as he has learned over the years which body regions tend to be most pain sensitive to instrument mobilization.
In Dr. Melander’s experience, the neck, shoulder, elbow, and knee are not overly sensitive regions (most of the time), and with his practiced hand he can find a tolerable depth and pressure for his patient.
All that being said, some people LOVE the way instrument mobilization feels and will request it be used in multiple body areas. Dr. Melander does not prefer Graston in the treatment of hip, thigh, calf, or foot conditions due to the tissue breadth and depth and the usual discomfort inherent to treating those areas with an instrument.
Curious about Graston or other instrument-assisted soft tissue mobilization? At North Shore Spine and Sport Dr. Melander utilizes these techniques frequently and is happy to answer any questions. Call, text, or email to learn more.
Dr. Melander has often described his work as new-school rehab, which is to say, an amalgamation of current best practices regarding pain or injury management, hands-on manual therapy or strength/mobility training, and endless advocacy and support for his patients.
In Dr. Melander’s opinion, the best providers in the field of musculoskeletal injury are able to draw from multiple disciplines to create the most efficient and impactful care strategy for their patients. If you are injured or hurting and not sure what to do, please reach out, it will be our greatest pleasure to help you.
We serve Newburyport and surrounding North Shore communities, including: Newbury, West Newbury, Rowley, Byfield, Georgetown, Amesbury, Salisbury, Ipswich, Seabrook NH, Hampton NH, Rye NH.
Graston can be effective in treating certain painful conditions
Graston can help loosen up areas of muscle tightness
Graston can help reduce visible scarring from prior injury
We've compiled a list of common chiropractic questions to help you get all the answers you are looking for. If you have additional questions if our chiropractic and treatment services in North Shore would be a good fit for you, please contact our team.
Chiropractors are trained in the evaluation and management (IE: treatment) of issues affecting the neuromusculoskeletal system (muscles, joints, connective tissue, nerves). Many people associate chiropractic care with the spine only, but this is an inaccurate reflection of many chiropractors in the 21st century who are experts in treating spinal issues AND extremity issues (arms and legs). As a general rule of thumb, if you have a painful condition that does not get better given a few days of activity modification you may want to consult a professional like a chiropractor. Your chiropractor should be able to evaluate your painful condition, offer you some perspective and guidance relative to the painful condition, and help you care for the painful condition if treatment is warranted. Like any profession though, each chiropractor has different clinical experience and different post-graduate education that may lend their practice toward a focus on sports injuries or pregnancy/neonatal care or neurologic issues or nutritional issues to name just a few. If you are considering seeing a chiropractor, make sure that their experience and skill set seems like a proper match for your complaint and your ultimate goals.
Choosing a good chiropractor does not have to be a complicated process. To begin with, ask your friends or family if they know someone they trust and can vet for you. Next, check online as most chiropractors should have fairly informative websites relative to their clinical interests and experience that may help indicate whether they are a good fit for your issue. If you are still not sure who to see after taking those steps, call your prospective chiropractor’s office as either the staff or the chiropractor will be more than happy to answer any questions and tell you if your issue is something commonly treated in that office. Many people also like to read online reviews and while some online reviews can be misleading, if the significant majority of a chiropractor’s reviews are super positive then chances are you can trust the expertise of that provider. Lastly, and arguably the most important step in choosing a good chiropractor, remember that you are in total control of your healthcare decision making. If you go to an initial or follow-up appointment and you are not absolutely confident in the assessment and plan your chiropractor has rendered, then seek a second opinion.
A chiropractor can help you fix a wide variety of painful conditions related to the neuromusculoskeletal system such as headaches, back/neck pain, shoulder/elbow/wrist/hand pains, hip/knee/ankle/foot pains to name just a few. Injuries of actual orthopedic compromise like fractures are best handled by orthopedists, but chances are if your pain/injury is non-surgical in nature then a chiropractor may be a great option to help you. The best chiropractors will explain what they can about your pain/injury, offer guidance and likely treatment as efficiently as possible (days to weeks, maybe months in extreme situations), and then remove themselves and let your brain/body do the rest. A great deal of research these days indicates that in many healthcare interactions providers should try and limit their patient’s dependency on them, opting instead for interventions and language that fosters resiliency and self-efficacy (independence).
Your first chiropractic appointment should include a detailed discussion of your health history and presenting complaint(s), an examination of your complaint(s), a discussion regarding what is indicated by the examination relative to prognosis and treatment plan, and finally some form of treatment/intervention assuming time permits. Many painful conditions can be evaluated thoroughly and completely in a matter of minutes and certain treatment interventions could yield immediate relief, while other conditions may require more complex evaluations and more lengthy treatment plans. Above all, you should leave your first chiropractic appointment feeling confident that your chiropractor is the best option to help you with your problem and you should leave feeling confident that you are on the road to recovery.
You should see a chiropractor as often as you want or need. Perhaps the most common criticism of chiropractors is that chiropractors “need to see you for the rest of your life”, and while there are unfortunately examples of chiropractors who advocate for this kind of dependency, the significant majority of chiropractors today want to help you as quickly as possible with no long-term commitments of any kind. The best chiropractor will see you the minimally necessary number of times to help you overcome your issue and suggest you follow-up if there are any residual issues or new complaints sometime in the future. Many patients however recognize how good they feel after chiropractic care and therefore wish to see their chiropractor with some kind of recurring frequency (IE: once/month, twice/year, or more). These examples though should be dictated by the patient based on their assessment of their body’s needs and absolutely not dictated by the chiropractor based on some kind of pseudoscientific reasoning.
In many cases, yes, insurance will help pay for chiropractic care assuming the chiropractor is participating with your health insurer. If your chiropractor is not participating with health insurance, then it is still possible you have an out-of-network benefit with your insurer and can seek reimbursement that way.
At NSSS our approach to health, fitness, movement, and pain is unique. We can’t wait to show you how much better you can feel. Call, email, or stop by today!
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