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GRASTON TECHNIQUE. By Dymond Unutoa. Objectives. Know what Graston technique (GT) is Understand the history of Graston technique Be able to recognize Graston tools and understand the purpose behind each one’s design Understand the purpose of GT and its effects
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GRASTON TECHNIQUE By Dymond Unutoa
Objectives • Know what Graston technique (GT) is • Understand the history of Graston technique • Be able to recognize Graston tools and understand the purpose behind each one’s design • Understand the purpose of GT and its effects • Know contraindications associated with GT • Know other forms of Instrument assisted soft tissue mobilization and their basic premise • Understand how Graston differs from other IASTM
What is Graston technique? • Graston Technique is a form of instrument assisted soft tissue mobilization • Utilizes 6 different tools • Utilizes stainless steel tools to detect and treat tissue restrictions that affect normal function
History of Graston technique • Researched at Ball State University 1991-92 • Therapy Care Resources Inc. 1994 • 15,000+ Clinicians utilize GT • 1,400+ Out-Patient clinics • 200+ professional and amateur sports organizations • Currently part of curriculum at 50+ colleges and universities
The Technique Effects • Separates and breaks down collagen cross-links, and splays and stretches connective tissue and muscle fibers • Increases skin temperature • Facilitates reflex changes in the chronic muscle holding pattern • Alters spinal reflux activity (facilitated segment)
Technique Effects cont’d • Increases the rate and amount of blood flow to and from the area • Increases cellular activity in the region, including fibroblasts and mast cells • Increases histamine response secondary to mast cell activity
Some Conditions for GT Utilization • Sprains and Strains • Carpal Tunnel Syndrome • Medial/Lateral Epicondylitis • Scar Tissue Development • Shin Splints • Rotator Cuff Tendinosis • Plantar Fasciitis • Patellofemoral Disorders • Trigger Finger • Achilles Tendinosis
Contraindications Absolute Relative • Open wound • Unhealed fracture site • Thrombophlebitis • Uncontorolled Hypertension • Kidney Dysfunction • Hematoma • Osteomyelitis • Patient intolerance or Hypersensitive • Anti-coagulant Medications • Cancer • Varicose Veins • Burn Scars • Acute Inflammatory Conditions • Inflammation Secondary to Infection • RA • Pregnancy • Osteoporosis
Styles of Soft Tissue Mobilization • IASTM (Instrument Assisted Soft Tissue Mobilization) – Includes the following… • GRASTON • ASTM (Augmented Soft Tissue Mobilization) or ASTYM • ART (Active Release Technique) • SASTM (Sound Assisted Soft Tissue Mobilization) • Gua Sha Massage
Common Seen Effects • Petechiae • Bruising • Loss of Pain • Increased ROM • Restoration of function
Usage of Graston Tools • Enhance detection of adhesions, scar tissue or restrictions • Clinicians will use the tools to comb over and “catch” on fibrotic tissue to identify restricted area. • They will then use the tools to break up the scar tissue for reabsorption
Why Stainless Steel • The stainless steel of Graston tools act somewhat like a tuning fork when fibrotic tissue is contacted. • A resonance or reverberation within the instrument is created on contact and transmits through the instrument to the clinician’s hands
So Who Uses GT? • Available to the following licensed professionals:Physical Therapist/PhysiotherapistOccupational TherapistChiropractorCertified Athletic TrainerMedical PhysicianDentistOsteopathPodiatristSelected Canadian Registered Massage Therapists *PTA/OTAs are eligible for training when working under a GT-trained PT or OT.
Other Article Related Information • Sensitivity: GT was found not to be effective in pressure pain threshold • In Quadriceps testing, GT resulted in decreased muscle activation, yet increased force production
References • Hammer WI. The effect of mechanical load on degenerated soft tissue. J Bodyw Mov Ther. 2008 Jul; 12(3):246–56. • Hammer WI, Pfefer MT. Treatment of a case of subacute lumbar compartment syndrome using the Graston technique. J Manipulative Physiol Ther. 2005 Mar–Apr; 28(3):199–204. • Howitt S, Wong J, Zabukovec S. The conservative treatment of Trigger thumb using Graston Techniques and Active Release Techniques. J Can Chiropr Assoc. 2006 Dec; 50(4):249–54. • Howitt S, Jung S, Hammonds N. Conservative treatment of a tibialis posterior strain in a novice triathlete: a case report. J Can Chiropr Assoc. 2009 Mar; 53(1):23–31. • Black DW. Treatment of knee arthrofibrosis and quadriceps insufficiency after patellar tendon repair: a case report including use of the graston technique. Int J Ther Massage Bodywork. 2010 Jun 23; 3(2):14–21