Tissue scraping has long been utilized as a manual technique to help with soft tissue mobilization. This treatment can be identified by many other names including but not limited to “Graston”, “gua sha,” or “Instrument Assisted Soft Tissue Mobilization” (IASTM). This type of soft tissue mobilization involves the use of a scraping tool—most commonly made of metal, plastic, or wood—over a target area. Tissue scraping can help target tight, inflexible areas such as myofascial restrictions or scars.

During this treatment, a scraping or rubbing motion is performed over the target area to promote a change in the structure of the soft tissues; including the tendons, muscles, ligaments, nerves, and fascia. Tissue scraping is more specific than using just hands for soft tissue mobilization, as it allows for a directed force straight into the target tissues.

The goal of this treatment technique is to reinitiate the inflammatory response. While this may seem counterproductive, this response promotes an increase in blood flow which initiates a cascade of chemical mediators that help with inflammation reduction and healing.

Therefore, this technique can be especially beneficial for individuals dealing with chronic pain, because it essentially “resets the system” and allows the tissue to progress through the inflammation stage and into the remodeling phase, the final part of tissue healing.

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This treatment is a great option for those who are experiencing chronic conditions resulting in muscle or joint tightness, swelling, and pain.  It can also be beneficial for those who have movement restrictions or muscle imbalances due to previous surgeries or injuries. Individuals struggling with the following conditions may find relief from tissue scraping:

• Neck, shoulder, hip, knee, or ankle pain
• Carpal tunnel
• Plantar fasciitis
• Radiculopathy
• Long-term conditions, such as knee replacement or hip replacement
• Sprains or strains

Tissue scraping is a safe treatment that can help improve pain, swelling, range of motion, and muscle activation. As described earlier, it is a procedure that involves applying very specific and directed force to an area of the body to release restrictions and improve blood flow; this helps to facilitate the healing process. The direction and amount of pressure varies depending on the specific condition and patient tolerance.

It is important to note that tissue scraping may cause some discomfort, redness, or petechiae post-treatment, but rest assured the tool and pressure will be modulated accordingly for patient comfort. Be sure to always communicate with your therapist how things are feeling during the treatment so they can make the appropriate adjustments.

This is a specialized treatment that should only be performed by a professional. However, if deemed appropriate and necessary, your physical therapist may educate and instruct you on how to perform similar techniques at home. This can help extend the therapeutic benefit to your home program and expedite the recovery process.

Although the actual treatment may sound simple, the physical therapist is highly trained and modulates the intensity to specifically address each patient’s needs. Your physical therapist has a thorough understanding of the muscles, fascia, tendons, ligaments, and nerves in the area needing attention; and takes them all into account while performing this treatment!

This treatment is not performed on those who are in the initial phases of an acute injury, and it is not suitable for patients who are on blood thinners. Soreness after tissue scraping is normal, but shouldn’t last for more than 24 – 48 hours. Post-treatment, patients should be sure to hydrate, stay active, engage in their prescribed exercises, and modify any movements that have previously caused pain. Ice or heat therapy may be recommended to help manage any post-treatment soreness.