Graston Technique

Chris Gabriel, PT, OCS, CSCS

Gua sha, a Chinese medicine technique that involves scraping muscle tissue to stimulate blood flow has been used for centuries to promote healing. A variation of this technique was introduced in the United States in the early ’90s by David Graston. Graston, an athlete with a knee injury, developed the tool and massage technique, now referred to as the “Graston technique” to treat himself.

This technique has since been used to help thousands of athletes and weekend warriors, suffering from strained and pulled muscles, ligaments, and tendons. Patients with chronic pain and inflammation have also benefited.


How does the Graston Technique work?

Muscles have different fibers and as fibers become tight they build up toxins. With the Graston technique, a stainless-steel instrument and special massage technique are used to identify areas of adhesion that can be improved. The instrument and massage are used in combination to stretch and relax the muscle tissues. This helps increase blood flow and restore movement patterns in injured tissues.

In the clinic, I begin treatment by having patients warm up their soft tissue by using a stationary bike, elliptical machine or other dynamic movements. Next, I’ll push the tool gently, using big, broad strokes across the injured area. The tool helps me sense muscle vibrations and identify specific areas to work.

I’ve seen patients who have benefited greatly from the technique but have also seen those who did not. 


Here are three reasons the treatment can fail:

  1. No pain, no gain - There will be some discomfort during treatment, but the instrument and massage should not cause intense pain. Some slight bruising may occur, however, if bruises appear often, the technique is being administered too intensely. The technique does not need to bruise or cause pain to be effective.
  2. Single treatment - While you will generally feel better after your first treatment, it typically takes three to four treatments before a patient will sense lasting relief. The technique should be used within the course of a full treatment plan – including active stretching, strengthening and dynamic exercise to maximize healing.
  3. A home fix - Self-treating with the wrong tools and without expert help, can cause more harm than good. I have seen patients try to perform a Graston like technique at home using butter knives or wrenches. Unfortunately, they often apply too much pressure or target the wrong areas, making the problem worse. To progress treatment at home, I may recommend additional exercises using safer tools such as a lacrosse ball or foam roller.

The Graston technique can be a useful muscle injury repair tool when incorporated into a full treatment plan.



Chris Gabriel, PT, OCS (Board Certified Orthopedic Specialist), CSCS (Certified Strength and Conditioning Specialist), practices with the OrthoCarolina Wellness Center. Chris and his team treat a range of patients for orthopedic and sports medicine needs. He enjoys working with various local high school, college, and professional sports teams.

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