The Graston Technique uses stainless steel instruments, contoured to fit different parts of the body, to work over soft tissue. It belongs to a category called instrument assisted soft tissue mobilization, or IASTM, and it is used by chiropractors, physical therapists and athletic trainers.

People usually want to know two things: whether the marks it leaves are a problem, and whether it does anything the hands cannot.

What the Treatment Involves

The practitioner applies an emollient, then uses an instrument to stroke over the target area at various angles and pressures. The edge and curve of each tool suit different regions, and treatment usually lasts a few minutes per area.

Sessions are typically brief, and the technique is nearly always combined with stretching and strengthening rather than delivered on its own. Most protocols involve twice-weekly treatment over several weeks.

The Traditional Explanation, and Where It Stands

The original rationale was mechanical: the instrument breaks down scar tissue and soft tissue fibrosis, allowing disorganised connective tissue to remodel along normal lines and restoring movement.

That explanation is now considered incomplete. The forces involved appear unlikely to physically break down mature scar tissue, and it does not account for why relief is often reported within a single session.

Current thinking leans toward a combination of effects: stimulation of mechanoreceptors in the tissue altering how the nervous system perceives the area, a temporary local increase in blood flow, a controlled inflammatory response that may support tissue remodelling, and short-term changes in pain sensitivity. Stretching connective tissue in a controlled way likely contributes as well.

Practically, this distinction matters less to a patient than it might seem. What matters is whether it helps, and what it should be combined with.

What the Evidence Shows

The research base is modest and mixed. Systematic reviews have generally found IASTM can improve range of motion in the short term, with effects on pain that are less consistent across studies. Many trials are small, and comparisons against hands-on manual therapy often show similar results rather than superiority.

The reasonable summary: it appears to be a useful tool among several, works comparably to other manual therapy approaches, and its benefits are strongest when paired with exercise. Claims that it dissolves scar tissue or produces lasting structural change go beyond what the evidence supports.

Conditions It Is Commonly Used For

• Plantar fasciitis

• Achilles and patellar tendinopathy

• Lateral and medial elbow tendinopathy

• Rotator cuff-related shoulder pain

• IT band–related knee pain

• Chronic soft tissue pain and post-surgical scar restriction

• Neck and back soft tissue restrictions

It is used across acute and chronic presentations, though chronic conditions with longstanding tissue changes are the more typical application.

Does It Hurt, and What About the Bruising?

Treatment is often described as uncomfortable rather than painful, with a scraping or gritty sensation over restricted areas. Petechiae, small red pinpoint marks, are common and are the effect people ask about most.

These marks reflect small capillary disruption. They typically fade within a few days. Some soreness for a day or two afterward is normal, similar to post-exercise ache.

Worth being clear about: more bruising does not mean better treatment. Aggressive application producing significant bruising is not supported as a goal, and treatment should not leave you unable to use the area.

Who Should Avoid It

Tell your practitioner if you have a bleeding disorder or take anticoagulants, active infection or open wounds in the area, uncontrolled hypertension, an unhealed fracture, a history of blood clots, cancer with local involvement, or severely compromised skin integrity. Some of these rule it out; others simply mean lighter application.

How It Fits into Treatment

The most consistent finding across the literature is that instrument work alone does less than instrument work plus loading exercise.

The reasonable model: the technique creates a window in which the tissue tolerates more movement with less pain, and exercise during that window is what produces durable change. Treatment consisting only of repeated scraping tends to produce a cycle rather than a resolution.

Frequently Asked Questions

How Many Sessions Will I Need?

Protocols commonly run six to twelve sessions over several weeks, though this depends on the condition and your response. A practitioner should set a reassessment point rather than an open-ended plan.

Is It the Same as Gua Sha?

The mechanics are similar, but the clinical application and reasoning differ. Graston is a trademarked protocol with specific instruments and practitioner training.

Can I Do It Myself with a Tool from Online?

Self-application without training risks excessive pressure and treating the wrong area. If you use a tool at home, get guidance on where and how much first.

Will the Marks Affect My Training?

Usually not, though mild soreness may warrant reducing intensity for a day. Tell your practitioner what you are training for.

Where It Fits at Our Clinic

At Heem Health in Tustin, instrument-assisted work is one of several soft tissue approaches, chosen based on what the assessment finds rather than applied by default, and always alongside rehabilitation exercise.

Read about our supportive therapies, our chiropractic care, or the full range of services we offer. To discuss whether it suits your situation, contact the clinic.

This article is provided for general educational purposes and is not medical advice. It does not replace assessment by a qualified healthcare provider, and individual results vary. Discuss your health history and any medications with your practitioner before treatment.