Graston is a form of instrument assisted soft tissue mobilization (IASTM). It is a steel instrument frequently used by clinicians to address the pain and dysfunction cycle associated with a multitude of neuromusculoskeletal conditions. These conditions are usually in association with myofascial trigger points that are either actively causing pain or not. A myofascial trigger point is a hyperirritable spot, usually within a taut band of skeletal muscle, which is painful on compression and can give rise to referred pain, motor dysfunction, and autonomic phenomena.
The myofascial trigger point is usually associated with mechanical trauma in the form of muscle overload and fatigue, which may be acute, sustained, or repetitive. It can also arise due vitamin deficiency, gait and or postural syndromes, lack of exercise, aging, and mobility. The trigger point can shorten muscle, increase tension of the muscle and its bony attachments, and can compress surrounding soft tissue resulting in decreased range of motion, increased susceptibility to injury, pain at the site or further from the actual lesion, decreased strength and endurance, or cause numbness and tingling. Trigger points are also found in fascia (the envelope that surrounds muscle allowing it to glide without friction or restriction), ligaments (bone to bone attachment), and joint capsules (fluid filled envelope that encapsulates ligaments and tendons).
All bone is covered in a thin layer that contains a dense amount of sensory nerve endings for pain. All joint capsules are covered in a membrane with a dense amount of the same sensory nerve endings for pain, and also for joint position sense. Graston is an attempt to induce mechanical and chemical changes by disrupting the dysfunctional neurological circuitry within the motor end plate of a muscle fiber to decrease pain and increase function of that muscle, and its surrounding joints and soft tissue. This process allows for the soft tissue to heal, but it is important to follow Graston with functional training to target the muscle’s impaired motor pattern circuitry.
Benefits of Graston
- increased global range of motion
- increased perception of joint position sense
- increased motor output of the defunct muscle endurance, stamina, and strength
- increased stimulation of connective tissue
- increased regeneration of collagen production
- increased regeneration and repair
- increased fibroblast proliferation in cases of tendinopathy
- decreased injury susceptibility
- decreased pain perception
