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Graston technique is a  form of therapy known as instrument-assisted soft tissue mobilization or IASTM. Instrument assisted soft tissue mobilization (IASTM) is a skilled myofascial intervention used for soft-tissue treatment. It is based on the principles of James Cyriax cross-friction massage. 

It is applied using instruments that are usually made of stainless steel with beveled edges and contours that can conform to different body anatomical locations and allows for deeper penetration. It is used for the detection and treatment of soft tissue disorders.

A proposed description for IASTM is  “a skilled intervention that includes the use of specialized tools to manipulate the skin, myofascia, muscles, and tendons by various direct compressive stroke techniques”.

The technique itself is said to have evolved from Gua sha which is a method used in Chinese medicine. Gua sha uses instruments with smoothed edges to scrape the skin till red blemishes occur. However, Gua sha has different rationale, goals and application method from IASTM.

Graston technique is an evidence based method of IASTM that uses six specifically designed stainless steel instruments to aid in the detection and treatment of soft tissue dysfunction. Graston Technique is combined with rehabilitative exercises to improve musculoskeletal function. It is an adjunct therapy and NOT a replacement for veterinary care. 

There are many indications for IASTM but the most common are: 

• Tendinopathies
• Muscular strains
• Edema
• Pain/body soreness
• Scar tissue/adhesions (post-surgical or traumatic)
• Secondary soft tissue lesions associated with other diagnoses
• Prehab

Graston Technique uses metal instruments of very precise composition to detect and amplify the tactile feel of soft tissue restrictions to the hands, similar to how a stethoscope amplifies the sound of a heartbeat. 

Instruments effectively break down fascial restrictions and scar tissue. The ergonomic design of these instruments provides the clinician with the ability to locate restrictions and allows the clinician to treat the affected area with the appropriate amount of pressure.

The introduction of controlled microtrauma to affected soft tissue structure causes the stimulation of local inflammatory response. Microtrauma initiates reabsorption of inappropriate fibrosis or excessive scar tissue and facilitates a cascade of healing activities resulting in remodeling of affected soft tissue structures. Adhesions within the soft tissue which may have developed as a result of surgery, immobilization, repeated strain or other mechanisms, are broken down allowing full functional restoration to occur.

Your horse can be ridden prior to the treatment but it is best they not be worked hard.  As with many soft tissue therapies it is best the horse be lightly warmed prior to treatment so that there is increased blood flow and pliability of the soft tissues. A 10-20 minute walk or 10 minute light lunge session will be adequate to warm the muscles and tissues for treatment. 

As with every good medical exam we will start with a discussion of the horses history and any problems/concerns you may have as well as what you may be feeling under tack. 

After that we will perform a baseline exam which involves watching the horse walk, palpation of the spine for pain or heat as well as scanning the horse for areas of sensitivity.  Once the patient has been assessed and a plan formulated treatment is started and usually lasts 45-50 minutes for a typical horse. 

There is some potential for soreness to occur for 24-48 hours after treatment (remember IASTM works in part by creating microtrauma).  This is a normal side effect and will ultimately result in functional improvement  Therefore icing the treated areas and gentle stretching the area will be beneficial to remodel and soften the tissue.  Additionally walking the horse in figure 8‘s will encourage the horse to stretch both sides of the body and further facilitate tissue remodeling. 

*Bruising and pain is NOT necessary or expected for IASTM to be beneficial. 

This question must be answered on an individual basis for each patient. In most cases, a single treatment is not enough to eliminate the problem. Most treatment protocols are 1-3 times per week on non-consecutive days. As with other therapies acute conditions usually respond quicker than those with more chronic conditions. 

Frequency of preventative or “maintenance” treatments depend on the horses problems, work load and performance level but are typically once every 4 to 6 weeks.