History of Graston Technique… David Graston was competitive water skier; sustained injury but frustrated with poor results from other treatments; went and used jar top as a self massage tool and improved; used his engineering knowledge to create specialized instruments, hence the birth of Graston Technique
More than just scraping and making the skin red (people often associate Graston with these giant bruises, but contemporary thinking has evolved quite significantly)..
Many variables to consider for best possible treatment…size of instrument, which treatment edge, shape of body part being treated, speed of stroke, length of stroke, type of stroke, target tissue length, angle of instrument edge, treatment duration…
I did go in without an intention of purchasing the instruments….but I ended up getting them anyway (in full disclosure, the military and student discounts did play a role in my decision to ultimately purchase)
Moved beyond the idea of just creating an inflammatory response (the original theory upon which the technique was based)
Other proposed mechanisms – biofeedback, edema reduction, pain reduction, scar mobilization, pressure (but not so much to create inflammation) and fascial mobilization
Good review of connective tissue, muscle physiology, tissue healing…
Davis’ Law (the soft tissue analog of Wolff’s Law…) – “Ligaments, or any soft tissue, when put under even a moderate degree of tension, if that tension is unremitting, will elongate by the addition of new material”
Only thing that didn’t sit well was all the talk about “breaking up adhesions” although they did present some ultrasound imagery to show changes in tissue (albeit temporary) after treatment. So maybe there is something to that logic…
Its good that they presented the idea of incorporating exercise to pair with treatment – we know that a treatment can only have so much effect if its just done and you move on (patient gets in the car and leaves) better chance for more lasting change. Each region covered in the curriculum also included a review of exercise options
Effective to have multidisciplinary group in the room (PT, OT, LMT, chiro, AT…)
Graston as assessment…in some cases, the instruments can be more effective for assessment than hands, as they an amplify tissue irregularities
11/30/2020 11:06:40 pm
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Allan Phillips, PT, DPT is owner of Ventana Physiotherapy