What is the Graston Technique® and how can it help with Spine Rehab/Back Pain?

In our last blog we discussed our specialty in Spine Rehabilitation and mentioned we would further explore some of the modalities we use to treat Back Pain.  In this issue we discuss the use of the Graston Technique® as one option in treating Back Pain.  Read more to learn what the Graston Technique® is, how it works, what a patient can expect prior to, during and after treatment.

Graston Technique®

There are many treatment options available for back pain caused by soft tissue problems, such as a back muscle strain. One method of treatment is soft tissue instrument assisted mobilization, also known as the  Graston Technique®. 

Graston Technique® is an innovative, patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break down scar tissue and fascial restrictions. The Technique utilizes specially designed stainless steel instruments to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation.

The Graston Technique®, originally developed by athletes, is changing the way clinicians — including athletic trainers, chiropractors, physical therapists, occupational therapists — and patients view treatment of acute and chronic soft tissue injuries.

The majority of practitioners specializing in this technique are osteopathic physicians, athletic trainers, physical therapists and occupational therapists, and it is also available to medical doctors and registered nurses.

Fairly extensive training is required in order to use the technique and we are trained and experienced in using the Graston Technique® for many conditions including back pain.

Soft Tissue Injuries and Back Pain

Most of the back is comprised of muscles, ligaments and tendons, and injuries to these soft tissues play a significant role in the pain and dysfunction associated with back problems. While it may not sound like a serious injury, a simple muscle strain or torn ligament in the back can cause excruciating pain and difficulty with movement.

When an injury within the soft tissue occurs, the tissue repairs itself in a haphazard pattern, forming scar tissue. While the scar tissue itself is not painful, it does tend to limit range of motion, and the ongoing stiffness may contribute to back pain or neck pain on an ongoing basis.

How the Graston Technique® Works

This form of manual therapy comprises soft tissue mobilization and incorporates the use of stainless-steel instruments. The goal of the therapy is to separate and break down the scar tissue, as well as stretch connective tissue and muscle fibers. There also appears to be a neurologic component to treating patients with the Graston Technique Instruments.

The Graston Technique® uses the instruments with a specialized form of massage that is designed to help the practitioner identify areas of restriction and break up the scar tissue. The concave and convex stainless steel instruments are used to comb over and catch on injured fibrotic tissue.

Using a cross-friction massage, which involves brushing or rubbing against the grain of the scar tissue, the practitioner re-introduces small amounts of trauma to the affected area. This temporarily causes inflammation in the area, which in turn increases the rate and amount of blood flow in and around the area. The theory is that this process helps initiate and promote the healing process of the affected soft tissues.

Treatment is rendered along the kinetic chain and thus a patient presenting with back pain might also receive treatment to the hip flexors, abdomen, hamstrings and other regions of the body.

Patients undergoing therapy with the Graston Technique can expect the following:

Prior to Treatment

• Prior to an appointment with your physical therapist, patients are advised to complete five minutes of cardiovascular activity, such as riding a stationary bike or walking on a treadmill
• At the office of the physical therapy clinic, ultrasound or heat treatment may first be applied to the injured area to warm up the soft tissue

During Treatment

• The practitioner will utilize the appropriate Graston Technique® instruments to scan, then treat, the affected area of the back
• Treatment generally consists of the clinician rubbing the affected area(s) with the handheld stainless steel Graston Technique® instruments, using very specific, calculated massage techniques
• Treatment time is usually 30 to 60 seconds per area treated

After Treatment

• The patient is advised to stretch the areas treated
• Following stretching, the patient may begin low load, high repetitions of exercises using an elastic band.
• It is common for patients to experience some discomfort during the procedure and possibly some bruising. Ice application for 15 to 20 minutes following the treatment may ease the discomfort.
• Patients are advised they may be sore, bruise or exhibit small red dots over the area treated called petechiae.

It is recommended that an exercise, stretching and strengthening program be used in conjunction with this technique to rehabilitate the back and help the injured tissues heal.

The typical course of treatment generally range from 6 to 10 visits. No medications are required in conjunction with this specific treatment.

Contraindications

Not all candidates with pain related to soft tissue injury are candidates for Graston Technique® therapy. Patients any with the following are not good candidates for the treatment:

• Open wounds
• High blood pressure
• Cancer (depending on the type and location)
• Pregnancy (pregnant women should avoid having the therapy done over the spine, pelvis, abdomen or along certain acupuncture points)
• Unhealed, complicated fractures

For a full list of both absolute and relative contraindications to the use of this therapy, please consult a trained Graston Technique® clinician by calling us today!

(web sources for this article include: http://www.spine-health.com and http://www.ssprehab.com/services/graston-technique)

Spine Rehabilitation

Did you know that Progressive Physical Therapy specializes in Spine Rehabilitation?

Your recovery from spine pain or injury can be improved by learning new ways to strengthen your spine and prevent future problems. Our physical therapists can teach you ways to help reduce your pain now and form new habits to keep your spine healthy in the future without becoming dependent upon weekly or monthly interventions for years.

At your first physical therapy visit, our physical therapist (PT) will gather information about your spine condition. You may be asked questions about when it started, where you hurt, and how your symptoms affect your day-to-day activities. This helps your PT to begin zeroing in on the source of your problem and to know what will be needed to help relieve it.

Your therapist will evaluate your answers and your exam results to determine the best way to help you. He/she will then write a plan of care, which lists the treatments to be used and the goals that you and your therapist decide on to do your daily activities safely and with the least amount of discomfort. The plan also includes a prognosis, which is your therapist's idea of how well the treatments will work and how long you'll need therapy in order to get the most benefit.

The main goal of therapy is to make sure you have ways to take care of future spine pain or problems. You'll be shown ways to help control pain or symptoms if they don't go completely away and if they return in the future. Because you've experienced spine pain, there is a possibility you may have soreness in the future. You may be encouraged to continue with some of the exercises to help keep your spine healthy over time.

Treatment to control pain and symptoms includes a variety of options that your physical therapist will choose based upon your individualized care plan that he/she developed based upon his/her exam of your spine.  They may include rest, positioning, ice, heat, ultrasound, electrical stimulation, soft tissue mobilization/massage, manual therapy, joint mobilization, traction and the Graston technique.

The next step in your therapy course would be the introduction of therapeutic exercise which is individually designed to help you to work on flexibility, stabilization, coordination and fitness conditioning.

This step is then followed by functional training which helps you with doing specific activities with greater ease and safety. Examples include posture, body mechanics, and ergonomics.

Once your pain is controlled, your range of motion has improved, and your strength is returning, you will be progressed to a final home program. Your therapist will review some of the ideas listed above to help take care of any soreness at home. You'll be given some ways to keep working on your range of motion and strength. Before you are done with therapy, more measurements may be taken to see how well you're doing now compared to when you first started in therapy.
We will be exploring some of the treatments and modalities discussed above in more detail with future blogs. 

We hope you found this overview of Spine Rehabilitation helpful and will keep Progressive Physical Therapy, Inc. in mind for all of your or your family and friends' Rehabilitation needs!

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(source referenced for this blog: allaboutbackpain.com)