~ by Dr. Robert Cumming
Good morning, everyone!
In my practice I evaluate, diagnose and treat a diverse number of sports injuries that typically involve soft tissue. Soft tissue injuries, like most other injuries, are as numerous and unique as the people that suffer them. Today I would like to talk about Graston technique which is a therapy that combines well with chiropractic care and other rehabilitative protocols. Soft tissue is a catch-all term that basically encompasses all tissues other than bone. The tissues we will predominantly cover today are: tendons, fascia, muscle and the various layers of skin. All of these tissues can become damaged in an injury scenario. Achilles tendinitis/tendinosis is a condition I frequently see in the clinic often in runners and triathletes. As the calf muscles become tight the extra tension placed on the tendon and surrounding structures cause it to swell and become inflamed. As the inflammatory process progresses adhesions develop which causes theses structures to stick to one another which, if left untreated, can eventually develop into scar tissue. Graston is an instrument assisted soft tissue technique that mobilizes these soft tissue lesions and fascial restrictions. It utilizes specially designed stainless steel instruments in various shapes to conform to every region of the human body. A wax based emollient is placed on the skin in the area in question and these instruments are stroked or dragged across the skin similar to the action of combing hair. The effect of these treatments is to break up any adhesions and stimulate the production of new, appropriate tissue in and around the area of injury. In the Achilles case, that means treatment to decrease the muscular tightness, decrease the stickiness of the tissues around the tendon, decrease the adhesions between the fascia and the muscle and trigger the development of parallel fibres in the healing tissues. Scar tissue tends to be sticky, disorganised tissue without parallel fibres which make it weak and susceptible to re-injury. Normal tissue has fibres organized in parallel to make it stronger, able to glide past or over other structures and more resistant to tearing or other injury. Treatments are generally non-painful, last 5-15 minutes and are usually repeated 1-2 times/week for 4-5 weeks often as few as 6-12 treatments are required for more chronic conditions. Acute injuries generally respond faster and both the health status and maturity (age) of the patient play a significant role in the rate of healing. I have found Graston technique to be a very useful tool in my arsenal of soft tissue interventions.