Dr. Lisa Goodman, DC, CCSP, CACCP
There is a reason we utilize the Graston Technique during nearly every treatment. Everyone from our maintenance care patients, performance-based treatments and acute injuries can benefit from it. For a number of reasons below, we'll go out on a limb and say yes, Graston does help heal everything.
The Graston Technique® has been around for nearly 30 years and was first used by David Graston to heal a waterskiing injury. David Graston was not a therapist, chiropractor or body worker, he was a machinist. The story goes, that David was struggling to recover full range of motion in his knee after surgery and his common sense approach was to try to mobilize the scar tissue in his knee using a blunt metal instrument. What do you know? It worked. Since then, the Graston Technique brand has become nearly generic for all types of Instrument Assisted Soft Tissue Mobilization (IASTM) or Scraping. Chiropractors rely on the Graston Technique to enhance adjustments and provide longer lasting and more effective overall treatments.
What to expect:
An IASTM treatment is typically quick ranging from 1-3 minutes per region and used to increase pain-free range of motion. There are several brands and types of instruments, some even available to the public! We generally advise against the type of self-IASTM gaining popularity among CrossFitters, etc. It is important to understand the anatomy and function of the areas being treated. Most chiropractors and body workers that use IASTM have extensive training. We understand that deep pressure is not necessary to create the desired response, however sometimes even with lighter pressure bruising can occur. An emollient or lotion is used to create less skin irritation. Typically, this therapy is used in combination with other manual therapy techniques, manipulation and movement training.
How it Works
There are many proposed thoughts and theories on the mechanism of how IASTM effects the body.
1. Breaking Down Scar Tissue - The original and most popular belief is that IASTM can help “break down adhesions or scar tissue”. Consider this, when you have an injury, your body starts to repair the area by laying down scar tissue. Early intervention with IASTM may improve the strength and directionality of the repaired tissue. Even intervening late in the game on a chronic scar will improve range of motion and it may be due to the breakdown of weak fibers in the area.
2. Improving Blood Flow - It seems reasonable that rubbing the skin with a stainless steel metal instrument would bring more blood flow to the area. This is actually because we are inflicting trauma (albeit controlled) to the area. The key here is how we proceed following the IASTM treatment. Improving blood flow to an injury will improve the healing process. Bruising is not necessary or expected following every treatment, however it can happen and is the most common side effect.
3. Stimulating Healing - This is as simple as reminding the immune system of the body to continue to pay attention to the healing process in the area of injury. Utilizing the instruments on a chronic injury or a slow-to-heal area may improve the healing process. There are several studies that support immediate increase in range of motion. The reason for this is likely neurologic due to the speed of the response. We have receptors in the skin and fascia that respond to pressure. When these receptors are stimulated, as in the pressure from IASTM, they send a signal to the brain which tells the muscles to relax, which translates to increased range of motion.
4. Pain Relief
Pain is a huge aspect of why treatment is warranted in the first place. Pain research is hard to conduct due to the complexity of pain, but the “pain gate theory” is helpful in understanding IASTM. For example, when stubbing your toe you may find yourself rubbing the area or slapping another body part to distract yourself from the pain. The idea is that we are stimulating other stronger sensations to override the painful stimulus from reaching our brain.
IASTM is theorized to break up scar tissue, re-align fascia and heal tissues faster. In addition, it definitely provides temporary pain relief and temporary increased range of motion, that when utilized in combination with other modalities and consistent movement therapy will ultimately result in significant change in movement and overall pain levels.
Lisa Goodman, DC, CCSP, CACCP founded Washington Park Chiropractic in 2006 in Denver, Colorado. Dr. Goodman is a Certified Chiropractic Sports Physician (CCSP) and Certified Prenatal and Pediatric Chiropractor (CACCP). She is a CrossFit L1 and CrossFit Kids Certified Trainer. Dr. Goodman incorporates sports chiropractic techniques with prenatal and pediatric patients, she teaches mobility and taping classes locally, and is a contributor to POPSUGAR, Urban Life Wash Park and DC Aligned. She is a committee member on the boards of the ACA Pediatrics Council and the ACA Sports Council. Areas of special interest include prenatal care, ankle and wrist injuries, instrument assisted soft tissue techniques, strength training, and pediatric fitness. Stay connected with Dr. Goodman on Instagram @washparkchiro or @lisakgoodman