Graston Technique in Physical Therapy: How Does It Work?


With over 32,000 certified providers throughout North America, the Graston Technique is rapidly becoming a household name in the therapy world. The Graston Technique was born in 1994 when an amateur athlete became frustrated with his lack of progress following a knee injury. The athlete used his background in machinery to create special tools to help with his soft tissue injury and then built the company from an outpatient clinic in Indianapolis.

Today, Graston physical therapy treatment is known for its unique instruments, astonishing results on acute and chronic injuries, and specialized training courses that are only offered to currently licensed therapists, medical doctors, chiropractors, and other members of the healthcare community. We’re going to explore the Graston Technique further and answer some of the most common questions around this course of treatment, like:

  • is the Graston Technique safe?
  • what is the Graston Technique used for?
  • does the Graston Technique work?

Let’s dive in and answer these important questions.

What is the Graston Technique and How is It Used?

The Graston Technique is a form of instrument-assisted soft tissue mobilization (IASTM). IASTM is defined as the use of instruments or tools to assist with the identification and/or treatment of movement dysfunction caused by pain or changes to the soft tissue structures (muscles, ligaments, tendons, fascia).

Graston Technique physical therapy differs from other forms of IASTM on the market because of its unique instruments and protocol that has been taught and researched for over 20 years. Unlike other tools made from wood, ceramics, or stone, Graston massage tools are created from stainless steel and designed with beveled edges and angles to detect myofascial restrictions.

There are six Graston physical therapy instruments of various sizes and shapes that work on all parts of the body, from the neck to the delicate parts of the foot and ankle. Instruments cannot be purchased from the Graston website or another vendor; they are only available to licensed practitioners who have completed the onsite or online Graston treatment training courses.

Does the Graston Technique Work and is It Safe?

The Graston Technique for pain is most effective when combined with rehabilitative exercises and modalities. The entire treatment is known as the Graston Protocol. Basic components of the Graston treatment protocol include cardiovascular warm up to the tissue/treatment area followed by the Graston massage technique, stretching, strengthening, and cold therapy.

Cardiovascular Warm-Up

The cardiovascular component is critical prior to initiating the Graston Technique for knee or other pain because it increases blood flow to the area which optimizes the environment for healing.

Graston Massage

The practitioner then applies the Graston therapy technique using specific strokes and pressure with the carefully selected treatment tool for a limited amount of time (usually eight minutes per body area).

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Post-Treatment Stretching and Cool-Down

Afterwards, the patient engages in light stretching to complement the movement impairment and strengthening exercises with light resistance, high repetitions. Afterwards, the practitioner applies cryotherapy, usually a cold pack, to decrease swelling or pain after the Graston Technique.

Does the Graston Technique Work?

Graston physical therapy is successful due to its ability to interrupt the pain cycle and scar tissue formation, which leads to changes in soft tissue flexibility and range of motion. The Graston massage instruments help to amplify soft tissue restrictions, like a stethoscope amplifies the sound of a heartbeat.

That tool also becomes the treatment tool in which the clinician twists, turns, and chisels away at the adhesion through the skin in order to induce controlled microtrauma to the area. By inducing microtrauma, an inflammatory process is triggered to promote healing and recovery to the area. Graston therapy also stimulates collagen regrowth and redistribution of collagen fibers in the correct pattern that optimizes range of motion, flexibility, and muscle recruitment.

What is the Graston Technique Used For?

During an acute injury, the main goals of treatment with the Graston Technique are to decrease edema, pain, and to increase range of motion. When a patient is treated for a chronic injury, the goals of Graston physical therapy treatment shift to disrupt fibrotic (scar) tissue in order to increase range of motion and to decrease pain.


A Graston Technique treatment for pain varies according to the body part, the patient’s current healing process, and instrument selection. If you’re wondering, “Is the Graston Technique painful?” the answer to that lies in the side effects some patients can experience during or after treatment. Potential reactions include discomfort or pain after the Graston Technique, bruising around the treatment area, or spontaneous connective tissue release which occurs when scar tissue releases from healthy tissue. Bruising may also occur due to the changes that are caused by the microtrauma inflicted by the instruments (necessary to re-stimulate the healing cycle).  

Most patients see results within 3-4 sessions. More information on what to expect during the first session can be read here.

Is Graston Therapy Right for You?

The Graston Technique for physical therapy is an evidence-based treatment that, when used in conjunction with rehabilitative exercise, can be effective at restoring movement caused by soft tissue dysfunction.

Although results can vary, patients can typically notice improvements in pain and/or range of motion by the end of the first or second week of treatment. If you think Graston therapy may be right for you, use the BetterPT website or mobile app to find licensed Graston Technique providers. The correct treatment and application of the Graston Technique can ease your discomfort so you can lead a pain-free life.

Dr. Marla Ranieri graduated from Stanford University with her bachelor's degree in Human Biology in 2005 and went on to receive her Doctorate in Physical Therapy from Columbia University College of Physicians and Surgeons in 2009. Marla has worked with all types of individuals, including professional athletes as part of the USA Gymnastics Medical Staff. Marla continues to treat patients with evidence-based medicine and the best quality of care.

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