What Is the Graston Technique?
The Graston Technique is an evidence-based, clinician-applied form of instrument-assisted soft tissue mobilization (IASTM). It uses a set of six stainless steel tools of varying shapes and sizes to systematically scan, detect, and treat areas of soft tissue fibrosis, chronic inflammation, and myofascial restriction throughout the body.
The tools allow the clinician to feel subtle textural changes in soft tissue — areas of scar tissue, adhesions, and fascial restrictions — that are difficult or impossible to detect with hands alone. Once identified, the instruments are used to apply controlled, targeted force to break down these restrictions and stimulate a localized healing response.
The mechanism: Graston works by introducing controlled microtrauma to dysfunctional tissue, which triggers the body's healing cascade — increasing blood flow, stimulating fibroblast activity, and remodeling collagen to restore proper tissue architecture. This is why conditions that have been present for years can respond rapidly to Graston treatment.
Conditions Treated with Graston Technique
- Tendinopathy — Achilles tendinopathy, patellar tendinopathy, rotator cuff tendinopathy, tennis elbow (lateral epicondylosis), golfer's elbow
- IT band syndrome — lateral knee pain from iliotibial band friction, common in runners and cyclists
- Plantar fasciitis — chronic heel and arch pain from fascial fibrosis
- Post-surgical scar tissue — breaking down adhesions following knee, shoulder, hip, or spine surgery
- Carpal tunnel syndrome — fascial restrictions in the wrist and forearm
- Cervical and thoracic soft tissue restrictions — chronic neck tension and upper back tightness
- Shin splints (medial tibial stress syndrome)
- Lumbar fascia restrictions — contributing to chronic low back pain
- Muscle strains with residual adhesions — hamstring, quadriceps, calf
What to Expect During Graston Treatment
A Graston session at Pittsburgh Physical Medicine typically begins with a brief warm-up to increase tissue pliability, followed by systematic scanning of the affected area with the instruments. When a restriction is identified, the clinician uses specific strokes to mobilize the tissue.
Some patients experience mild discomfort during treatment, and temporary bruising or redness (petechiae) is common and expected — it indicates the therapeutic microtrauma response is occurring. Most patients notice significant improvement in pain and mobility within 4–6 sessions. Graston is typically combined with stretching, strengthening exercises, and chiropractic adjustment for comprehensive treatment.
