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What are Graston and Astym? How are they different? How do they work?

Do you have a chronic injury that has never seems to fully heal or has not responded to standard treatment techniques? Do you have an acute injury that is preventing you from training for your sport or preventing you from completing your normal activities? Bridgetown Physical Therapy and Training Studio offers two forms of instrument assisted soft tissue mobilization called Graston Technique and Astym, performed by physical therapists Stephanie Schultz and Allison Theen, which can help bring you to the next step in your recovery. So what is the difference between these two techniques? Some practitioners from either camp would say "a lot", but when you get down to it there are lots of similarities.


 

Graston Technique consists of six different stainless steel instruments that help to diagnose and treat soft tissue fibrosis and chronic inflammation. The instruments consist of convex or concave curves that mold to the contours of the body and offer a gentler or more aggressive soft tissue release, depending on their shape. The shapes allow for the treatment of any region of the body, from the small contours of the hand to the larger muscle groups like the hamstring. The instruments magnify what the human hand can feel by resonating in the clinician's hands, which helps to detect adhesions and restrictions within the tissue. After detection of restricted tissue, the instruments are combed over the skin in multiple different directions to assist with the breakdown of fibrotic tissue, which then stimulates a process of regeneration and healing. Patients typically notice an immediate increase in range of motion and decreased pain.


 

Graston Technique has been clinically proven to treat both acute and chronic conditions, some of which include: Cervical sprain/strain (neck pain), Lumbar sprain/strain (back pain), Carpal Tunnel Syndrome (wrist pain), Plantar Fasciitis (foot pain), Lateral Epicondylitis (tennis elbow), Medial Epicondylitis (golfer's elbow), Rotator Cuff Tendinosis (shoulder pain), Patellofemoral Disorders (knee pain), Achilles Tendinosis (ankle pain), Fibromyalgia, Scar Tissue, Trigger Finger, and Shin Splints.


 

Astym (pronounced A-stym) is a similar treatment technique to Graston, though uses different tools and looks at the process through a slightly different approach. Astym uses three hard plastic tools that are moved along the tissue parallel to the tissues' alignment in order to stimulate healing; not to break down scar tissue as is sometimes assumed. By moving along the tissue in line with normal tissue alignment we can avoid injury to normal tissue. Astym is designed to promote the body's natural regenerative processes to resorb and remodel scar tissue. This occurs by cleaning out disorganized tissue, laying down new/high quality collagen and aligning the fibers for optimal function.  When the Astym instru­­­­ments contact abnormal tissue, appropriate forces lead to controlled capillary leakage and blood components (cells that build or resorb tissue) are released. Normal, healthy tissue is aligned in parallel whereas scar tissue is a disorganized matrix that does not allow the tissue to function normally. The goal of Astym is to realign this tissue back to normal so that it can function as it was meant to. Astym treatment calls for strokes parallel to muscle fibers to ensure that we are not damaging healthy tissue. 


 

Astym also addresses the entire kinetic chain, looking at the areas above and below the injury. For example with a knee injury, tissue from the foot to the hip can show compensatory tissue changes related to the injured area. Astym is used to treat a multitude of injuries: tendonitis (or tendonosis) such as rotator cuff, biceps, tennis elbow etc; scar management/ post surgical patients; muscle imbalances (postural dysfunctions, chronic ankle sprains, ITB syndrome, shin splints etc). 


 

With both of these treatments the treatment with tools is just a part of the rehab process: you will likely still receive other manual therapy (soft tissue or joint mobilizations) as well as an appropriate exercise regimen of stretching/ mobility and strengthening.  The goal is remodeling tissue for the activities that you want to perform- therefore during treatment you should be as active as possible with the goal is to discharge splints and braces when possible.  This is different from traditional therapy, which often requires a period of avoidance of certain activities while undergoing treatment. There may be some side effect following treatments, tenderness to the touch for 24-48 hours and possible bruising are side effects of the treatment that occur in some, but not all, patients who receive treatment.


 

If you have questions about Astym or Graston feel free to email Ali (atheen@bridgetownpt.com) or Stephanie (sschultz@bridgetownpt.com) or call the clinic at 503-222-1955 to schedule an appointment. We look forward to getting you back on your feet and back to your normal life!