There's a common saying in the world of sports: the best ability is availability.
The quote is widely attributed to Bill Parcells, a legendary former football coach who's now a member of the Pro Football Hall of Fame. It means that a player's health and availability to play are always top priority. No matter how good a player is, he can't do much good when he's nursing an injury on the sideline.
When it comes to athlete-focused physical therapy, the goal is to keep players on the field and as close to 100 percent as possible.
Of course, there are many different opinions on the best ways to go about that. But many elite athletes are now turning to a intriguing method of soft-tissue manual therapy known as the "Graston Technique" in hopes that it can keep their bodies fresh. According to the Graston Technique's official website, the method is currently used by 18 NFL teams, 16 NBA teams and 16 MLB teams. If world champion teams like the New England Patriots and Cleveland Cavaliers use it, there's gotta be something to it, right? STACK investigates this burgeoning recovery method.
How Did The Graston Technique Come About?
The Graston Technique was originally conceived by David Graston, who had suffered a debilitating knee injury while he was water skiing and had found the progress achieved via conventional therapy techniques to be frustratingly slow. Graston decided to use his professional background in machining to create a set of stainless steel instruments that he believed could help him treat his soft tissue injury. He used the instruments with great success on his own knee, which inspired him to collaborate with medical and research personnel at Ball Memorial Hospital and Ball State University in Muncie, Indiana. This collaboration was how the official Graston Technique and standardized set of instruments were created.
In 1994, an outpatient clinic that focused on treatment centered around the Graston Technique was opened in Indianapolis. Shortly thereafter, the company that owned the Graston Technique started focusing on spreading the technique, training clinicians in the method at seminars around the United States. There are now more than 24,500 clinicians worldwide who are licensed in the Graston Technique.
What Makes The Graston Technique Different?
The key difference between the Graston Technique and other soft-tissue mobilization techniques is the standardized set of six stainless steel instruments used by clinicians. Each instrument is assigned a number— GT-1, GT-2, GT-3, GT-4, GT-5 and GT-6. These tools are specially designed to detect, address and treat abnormal soft tissue throughout the body.
This generally begins with a period of "scanning," in which a clinician uses a tool to scan the soft tissue in an area with moderate pressure. Chris Adams, a San Diego-based DC and licensed Graston Technique clinician, says he often uses the GT-4 for this process. The GT-4 tool looks like a butter knife with no handle. Adams says, "You want to go with the muscle fibers while you're scanning. I use the GT-4 most of the time for that. I'll go over a general area and if there's a spot with a muscle adhesion or muscle deficit, the tissue in that area is going to be super packed and tight. It's almost like you hit a blister, but it's inside the skin. Right away, you'll see kind of a sunburst of redness there. Let's say I was going on your hamstring—I'd scan in a general area, and right where it's tightest, it would break apart." That superficial redness can help clinicians identify exactly where a patient needs to be worked on.
Per the GT official website, soft tissue—also called fascia—is a white membrane located just under the skin which "wraps and connects the muscles, bones, nerves and blood vessels of the body." Ordinarily, joints and organs have slippery surfaces so they can move around each other smoothly. But sometimes, the muscles and fascia aren't stretched out enough and they become stuck together or torn. This results in soft tissue adhesions and injuries. Such issues cause "restricted muscle movement, pain, soreness and reduced flexibility." After the clinician has identified the restrictions in a patient's soft tissue, he or she can choose the right tool to dig deeper and break apart the soft tissue adhesions and scar tissue.
What Makes The Graston Technique Superior To Similar Methods?
Efficiency. Thanks to the six GT tools, which feature "unique treatment edges and angles," clinicians can diagnose and treat soft tissue restrictions much more effectively and efficiently than they would be able to purely by hand. "It's such a faster and more efficient way to do a tissue breakdown," Adams says. "Your hands aren't made to be stripping ligaments as hard as humanly possible. The tools allow you to get into places you normally can't with your hands. You can get into spots that weren't accessible, you can penetrate deeper into certain areas."
The Graston Technique is backed up by a fair amount of research. Studies have found that the controlled micro-trauma induced through the Graston Technique increased the amount of fibroblasts to the treated area. According to the Collins Dictionary of Medicine, a fibroblast is "a cell that generates the protein collagen, a major component of connective tissue and the main structural material of the body. Fibroblasts are important in wound healing." The Graston Technique also stimulates circulation, which helps get oxygenated, nutrient-rich blood into the affected area. According to their official website, the Graston Technique has historically achieved positive outcomes in 75 to 90 percent of all conditions treated and is "equally effective in restoring function to acute and chornic injuries, pre- and post-surgical patients and maintaing optimal range of motion." This infographic shows that GT has been especially successful when dealing with issues such as shoulder pain, tennis elbow, back pain, wrist pain and ankle pain.
"I've always gotten really good results with the Graston Technique. I feel it's the fastest way to get results. You can break up the soft tissue faster and quicker than other methods," Adams says. "People love it."
What Makes a Person a Candidate for The Graston Technique?
According to the company's website, the Graston Technique "can be used to treat any movement system dysfunction that has been determined to have a soft tissue component."
When soft tissue restrictions are causing limited mobility, pain, stiffness, etc., the Graston Technique can be employed. Even if you don't have an acute or chronic injury, the Graston Technique can be used as a maintenance measure. Regularly getting scanned and treated can be a smart way for athletes to stay in tune with their bodies and stay ahead of their recovery. "It definitely can be used for maintenance and preventative measures. If anything's feeling tight, anything like that. You're increasing blood flow to that area as well, which has healing properties all on its own," Adams says.
How Quickly Does The Graston Technique Produce Results?
Several variables can affect how long it will take before a patient sees results from the Graston Technique. Some experience noticeable relief and improved mobility after just one session. However, the company says most patients can expect to have a positive response by their third or fourth treatment. "It totally depends on the patient and their specific injury or condition. Sometimes it takes many sessions, especially for something like a severely pulled muscles or an injury where a lot of scar tissue has built up over time," Adams says. "Generally, the faster you get treatment after the injury, the less time it's going to take for you to see results. If you get someone who has a bunch of scar tissue that's built up over time, it's not going to be an overnight process."
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Is The Graston Technique Painful?
The Graston Technique can cause discomfort at times, but the company says it "does not need to be considered 'painful' to be effective." The amount of pressure applied by the clinician should be adjusted based on an individual's pain tolerance and threshold. As long as the patient is vocal about his or her comfort level, the technique can almost always be adjusted to a level where it's manageable for the patient."Some people take it better than others. I have one patient who I could do it as hard as I possibly could, and he likes it like that," Adams says. "I've had a very small percentage of people who just can't do it at all."
I'm Interested in Using The Graston Technique as a Treatment. How Should I Go About It?
The Graston Technique tools used to be under patent, meaning that only licensed clinicians could own them. However, that patent was lost several years ago. Nowadays, people with no formal training can own a set of tools very similar to those used with the Graston Technique. Adams urges people who are interested in the Graston Technique to seek out a licensed clinician, as they're guaranteed to have an extensive amount of training in the technique. "They have very good training, and you have to really know what you're doing on a physiological level to be effective," Adams says. There are more than 24,500 GT clinicians around the world. To find one in your area, use this locator tool.
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