Graston Technique

Chris Gabriel, PT, OCS, CSCS

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

For centuries, the Chinese Gua sha technique has been used to promote healing by scraping muscle tissue to stimulate blood flow. In the early '90s, amateur athlete David Graston introduced a variation of this technique in the United States. Graston, who had a knee injury at the time, developed the unique 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 recover from strained and pulled muscles, ligaments and tendons. Patients with chronic pain and inflammation have also benefited.

How does the Graston Technique work?

Muscles are comprised of different fibers, and as fibers become tight, they build up toxins. The Graston technique uses a stainless-steel instrument and special massage method to identify areas of muscle adhesion, or scar-like tissue, that can be improved. 

A healthcare provider uses the instrument and massage 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 tissues. They can perform this warm-up with a stationary bike, elliptical machine or simple dynamic movements. Next, I’ll push the tool gently across the injured area using big, broad strokes. The tool helps me sense muscle vibrations and identify specific areas to work.

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

Here are three reasons the treatment can fall short:

  • 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.
  • Single treatment 
    • While patients will generally feel better after the first treatment, it typically takes three to four treatments before patients 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.
  • At-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.

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.


February 21, 2022

My therapist did this technique to my lower spine because of angry nerves running down my legs. It's working! The pain in my legs and knee are me it's a miracle.
Reply From: OrthoCarolina

February 25, 2022

We are so glad this technique allowed you relief from pain!

September 05, 2020

Technique is amazing. After a rough knee replacement, severe swelling, pain, and lost hope this treatment has changed my life. It was a last resort but so worth it. Most Insurance’s don’t cover this but an investment in oneself is freeing
- Michelle

August 12, 2020

Spot on with this write-up, I truly think this website needs much more consideration. I’ll probably be again to read much more, thanks for that info.
- jennifer
Reply From: OrthoCarolina

August 12, 2020

Thanks Jennifer, we welcome you back anytime.