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By Loren Hughes, Physical Therapist


When a physician wants to listen to your heart, they use a stethoscope. The metal amplifies the sound making something otherwise hidden come to life so they can analyze and treat and conditions.

It’s this same concept that is utilized by physical therapists through instrument soft tissue mobilization, sometimes called muscle scraping or the Graston technique. David Graston introduced the technique in the U.S. in the 1990s, which he created as a variation of gua sha, a Chinese medical technique that involved scraping the muscle.

“Metal allows me as a clinician to feel more of the fibrosis, or the connective tissues under the skin, than just my hands alone could pick up,” says physical therapist Loren Hughes.

The metal tool used also allows the patient to feel any restrictions in the fascia, like bumps in the roadway.

Instrument soft tissue mobilization can be very effective on repetition injuries. Hughes, who practices at OrthoCarolina Boone, often uses this technique with the college athletes she sees, like runners who are putting a lot of miles on their hamstrings and calves.

“Something like tennis elbow that has been going on for months can get stuck in one phase of healing,” Hughes said. “When you mobilize the fascia with that instrument it restarts the inflammatory process, which is actually a stage of healing.”

Physical therapists like Hughes use instrument soft tissue mobilization as part of an overall treatment plan for injury.

What’s Next?

Ready to address that nagging pain? Find an OrthoCarolina provider or location near you or call to make an appointment at 704.323.2778.

How does physical therapy work? Learn more about how these OrthoCarolina specialists can reduce pain and restore mobility.


February 28, 2019

Sounds good.
- M. McNinch, RN

February 26, 2019

Sounds interesting, I hope I will never need it .
- Barbara Robinson

February 26, 2019

Very educational thank you
- Mary Eudy