What is the Graston Technique?
The Graston Technique is a form of instrument-assisted soft-tissue mobilization, commonly abbreviated as IASTM. It uses smooth, shaped instruments to assess and treat muscles, tendons, ligaments, and other soft tissues. The technique is generally used as one part of a broader chiropractic or rehabilitation plan rather than as a stand-alone treatment.
During treatment, a clinician applies an instrument over the skin with controlled pressure and specific strokes. The goal may be to identify areas of altered tissue movement, reduce sensitivity, improve short-term mobility, or make movement exercises more comfortable.
The instruments do not “break up” scar tissue in a literal mechanical sense. That phrase is often used informally, but soft-tissue changes are more complex and may involve pain sensitivity, tissue loading, movement habits, and the healing process.
How does the treatment work?
A typical session begins with questions about symptoms, activity, prior injuries, medical conditions, and medications. The affected area may then be examined through movement, light pressure, and comparison with nearby tissues.
A small amount of lotion or another medium may be used so the instrument can glide across the skin. Treatment may produce a scraping, pressure, or pulling sensation, but it should not be treated as a test of endurance. Excessive pain is not required for the technique to be useful.
Temporary redness or mild tenderness can occur afterward. In some cases, small areas of bruising or pinpoint discoloration may appear, particularly when tissue is sensitive or pressure is too strong. A treatment plan should account for the person’s response during and after the session.
The technique is often followed by active movement, stretching, strengthening, or home exercises. This combination matters because improving movement during a session does not necessarily create lasting improvement without gradual, appropriate loading.
What conditions may be considered?
IASTM has been studied for several musculoskeletal complaints, including pain or restricted movement involving the shoulder, elbow, wrist, hip, knee, ankle, back, and neck. It may also be considered during recovery from certain overuse injuries, muscle strains, tendon problems, or activity-related stiffness.
Research findings are mixed. A systematic review found potential improvements in range of motion among people without significant injury and possible reductions in pain or improvements in self-reported function among some injured patients. However, studies used different instruments, treatment schedules, comparison groups, and exercise programs, making it difficult to determine exactly who benefits most. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/31322903/?utm_source=openai))
More recent research focused on low back and thoracic spinal pain found that the technique may reduce pain compared with a placebo treatment, but did not clearly outperform active treatments or consistently improve disability measures. The authors described the evidence as preliminary and called for stronger research. ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/40549553/?utm_source=openai))
For residents in Rome, the practical situations may be familiar: stiffness after extended time indoors during winter, soreness after shoveling, repetitive household tasks, physically demanding work, or returning to outdoor activities after a period of reduced activity. These examples do not automatically indicate that instrument-assisted treatment is appropriate. The cause of symptoms and the person’s overall health still need to be considered.
Is the technique painful?
It may feel intense, but it should not be needlessly painful. A tolerable pulling, pressure, or warming sensation is different from sharp pain, burning, numbness, or worsening symptoms.
The amount of pressure should be adjusted for:
- The location and suspected source of symptoms
- Skin sensitivity and sensation
- Whether the problem is recent or longstanding
- Current inflammation or swelling
- Medications that affect bleeding or sensation
- The person’s response during and after treatment
Pain during a session does not prove that treatment is working. Significant bruising is also not a required or desirable outcome. If symptoms become sharply worse, or if unusual swelling, numbness, weakness, or skin changes develop, treatment should stop and the symptoms should be reassessed.
Who should avoid it or use extra caution?
IASTM is not appropriate over open wounds, active skin infections, unexplained bites, blisters, significant rashes, or unhealed or unstable fractures. Recent surgery, fever, a contagious illness, a known bleeding disorder, or a history of blood-clot problems also requires careful medical consideration. A 2025 international expert-consensus study identified these issues among important precautions or contraindications, while also emphasizing that the list is a starting point rather than a complete safety standard. ([pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC11941819/?utm_source=openai))
Extra caution may be needed for people who:
- Take blood-thinning medication
- Have reduced sensation or numbness
- Have fragile or highly sensitive skin
- Have circulation problems or prominent varicose veins
- Have inflammatory or connective-tissue conditions
- Are pregnant, especially in a high-risk pregnancy
- Have recently undergone surgery
- Have difficulty communicating discomfort during treatment
The evidence for some precautions remains limited, and different conditions may require different decisions. This is why a careful health history is more useful than relying on a general online list. Older guidance has also varied substantially, reflecting the absence of universally accepted IASTM safety standards. ([pmc.ncbi.nlm.nih.gov](https://pmc.ncbi.nlm.nih.gov/articles/PMC6670063/?utm_source=openai))
How is it different from massage or chiropractic adjustment?
The Graston Technique focuses primarily on soft-tissue contact using an instrument. Massage usually relies on the hands and may involve broader pressure, kneading, or relaxation-based work. A chiropractic adjustment, by contrast, is a specific manual or instrument-assisted procedure directed at a joint or spinal segment.
These approaches can sometimes appear in the same care plan, but they are not interchangeable. Soft-tissue treatment does not realign bones, and a temporary increase in movement does not establish that a joint was “out of place.” Each technique should have a clear purpose related to the person’s symptoms, examination findings, and functional goals.
What should a person ask before treatment?
A useful discussion should cover:
- What problem is the technique intended to address?
- What other treatments could provide a similar benefit?
- What sensations and short-term effects are expected?
- How will progress be measured?
- What exercises or activity changes will support recovery?
- Are current medications or medical conditions relevant?
- What symptoms would mean the treatment should be stopped?
A person should also understand whether the technique is being used as an optional addition or as a central part of care. The available research does not support treating it as a universal solution for every muscle, tendon, or back complaint.
The practical takeaway
For local residents, instrument-assisted soft-tissue mobilization may be a reasonable option for selected musculoskeletal problems, particularly when it is paired with movement-based care and used after an appropriate examination. It should be viewed as a tool, not a diagnosis and not a guarantee of faster healing.
The most reliable approach is individualized: identify the likely source of symptoms, screen for safety concerns, use tolerable pressure, monitor the response, and connect any short-term mobility change to progressive activity. That framework helps keep the technique practical, measured, and consistent with evidence-based chiropractic care.
