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The Graston Technique: An Instrument Assisted Soft Tissue Manual Therapy for Back Pain-Back pain treatment NYC

Back pain treatment using the Graston technique in NYC.

There are many treatment options available for back pain caused by soft tissue problems, such as a back muscle strain. One method of treatment is soft tissue instrument assisted mobilization, which is a form of manual therapy designed to break down scar tissue and restrictions that are usually associated with some form of trauma to the soft tissue (such as a strained muscle, pulled ligament, tendon and fascia).

The instruments used in the Graston Technique are concave and convex-shaped handheld stainless steel instruments, which the practitioner rubs against the patient, using very specific methods, to help break down the scar tissue and promote a healing environment.

In This Article:

The Graston Technique is a relatively new form of soft tissue mobilization that uses specifically designed stainless steel instruments to help the practitioner identify and break down the scar tissue.

Soft Tissue Injuries and Back Pain

Most of the back is comprised of muscles, ligaments and tendons, and injuries to these soft tissues play a significant role in the pain and dysfunction associated with back problems. While it may not sound like a serious injury, a simple muscle strain or torn ligament in the back can cause excruciating pain and difficulty with movement.

When an injury within the soft tissue occurs, the tissue repairs itself in a haphazard pattern, forming scar tissue. While the scar tissue itself is not painful, it does tend to limit range of motion, and the ongoing stiffness may contribute to back pain or neck pain on an ongoing basis.

How the Graston Technique Works

This form of manual therapy comprises soft tissue mobilization and incorporates the use of stainless-steel instruments. The goal of the therapy is to separate and break down the scar tissue, as well as stretch connective tissue and muscle fibers. There also appears to be a neurologic component to treating patients with the Graston Technique Instruments. There remain many aspects of this therapy for which we have no explanation and no clinical trials or other studies to verify the outcomes.

The Graston Technique uses the instruments with a specialized form of massage that is designed to help the practitioner identify areas of restriction and break up the scar tissue. The concave and convex stainless steel instruments are used to comb over and catch on injured fibrotic tissue.

Using a cross-friction massage, which involves brushing or rubbing against the grain of the scar tissue, the practitioner re-introduces small amounts of trauma to the affected area. This temporarily causes inflammation in the area, which in turn increases the rate and amount of blood flow in and around the area. The theory is that this process helps initiate and promote the healing process of the affected soft tissues.

Treatment is rendered along the kinetic chain and thus a patient presenting with back pain might also receive treatment to the hip flexors, abdomen, hamstrings and other regions of the body.

Graston Technique Practitioners

The majority of practitioners specializing in this technique are chiropractor, osteopathic physicians, athletic trainers, physical therapists and occupational therapists, and it is also available to medical doctors and registered nurses.

Fairly extensive training is required in order to use the technique. Graston Technique training consists of 2 modules:

  • Module 1 is a 12-hour course that teaches a global approach to the use of the instruments. It also covers research articles, indications, contraindications, the 7 strokes used with the instruments and several hours of hands-on utilization of the instruments.

  • Module 2 is a 14 hour course and is more condition specific. The clinician is introduced to adding motion during treatment and how to utilize the instruments for nerve flossing as described by Shacklock and Butler.

At the time of this article, there are no peer-reviewed published clinical studies regarding the effectiveness of the Graston Technique in relieving lower back pain or neck pain. The research that has been conducted indicates a relatively high success rate for patients with chronic back pain and neck pain from soft tissue injuries, both in terms of improving the patient's function and reducing pain.

We utulize the Graston technique in our NYC office along with ART, Kinesio taping and Cox technique.

If you are suffering with back or neck pain give us a call at

(212) 645-1495 for an immediate appointment.


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