The Graston Technique | possible help for your intercostal muscle strain?

Last summer I strained my intercostal muscles. I wrote about the injury and was astounded by the number of people who responded, sharing their intercostal muscle strain stories and lamenting the long, slow road to recovery. (Click through the headline below to read their comments)

intercostal muscle strain

I’ve since updated this post, sharing the exercises that my chiropractor taught me to help re-strengthen my intercostal muscles and overall core strength (you can find a video demonstration of the exercises on my YouTube channel).

But a recent question from a reader (as well as an overzealous core workout that tweaked those muscles yet again…) made me realize that I’d never expanded on the details of the in-office treatment I received. Treatment that I believe helped speed up my recovery time.

The Graston Technique (GT) is a trademarked form of soft tissue manipulation that uses specifically designed stainless steel tools to break up scar tissue and adhesions.

It’s performed by rapidly running the instrument back and forth across the affected area, creating heat and friction and some moderate to severe discomfort. (My treatment left my skin bruised and a bit tender; nothing compared to the pain of the original injury, though).

intercostal muscle strain

How exactly does the Graston Technique work?

Patented stainless steel instruments are used to “comb over” and “catch” on adhesions and scar tissue. Once the area of restriction has been identified, the instruments are used to break up the scar tissue so it can be absorbed by the body.

According to the official website of the Graston Technique (, GT

  • separates and breaks down collagen cross-links
  • separates connective tissue and muscle fibres
  • increases skin temperate
  • facilitates reflex changes in the the chronic muscle holding pattern (i.e., helps release chronic muscle spasms)
  • increases blood flow to and from the affected area
  • increases cellular activity in the region (thereby improving cellular regeneration and healing)

Who can perform the Graston Technique?

GT can only be performed by trained and accredited therapists including (but not limited to), registered massage therapists, physiotherapists and chiropractors.

Any evidence that GT really works?

I could find no clinical trials comparing the efficacy of GT to standard, hands-on soft tissue manipulation. Only case studies of individuals or small groups reporting the beneficial effects of a variety of treatments, including GT, active release therapy (ART), ultrasound and electrical stimulation (sometimes all rolled into a single treatment).

Some critics of the technique cite the placebo effect as a likely explanation for the many anecdotal reports of GT’s success in treating everything from plantar fasciatis to carpal tunnel syndrome.

Bottom line?

For me, GT seems to have been the treatment that set me on the road to recovery. I didn’t start to notice any improvement in my range of mobility or any decrease in my ambient pain until my chiropractor started adding GT to my twice-weekly treatment sessions. One could argue that time was the true healer and that any benefit I attribute to GT was simply due to the placebo effect.

(In my opinion, the placebo effect doesn’t deserve the bad rap that it usually gets. If you had cancer and were assigned to a clinical trial  for a new treatment, would you care whether or not you’d received the ‘sugar pill’ or the real medicine as long as you were cured? The placebo effect is just further proof that we know very little about how the mind affects the health of the body…)

Regardless, if you’re suffering from an intercostal muscle strain and already receiving treatment from a GT certified practitioner, what’s the harm in asking them to include it in your therapy?

Placebo or not, if GT  leads to improved healing and pain reduction, what have you got to lose? (If you’re interested in reading a really interesting article on the evolution and maintenance of the placebo effect, click through to Nicholas Humphrey and John Skoyles’ recent editorial in Current Biology. Fascinating)

Has your health care practitioner ever performed the Graston Technique on you?

What was the outcome? Did it help or hinder the healing process?




  1. Really interesting Tamara! I have never had one of these strains BUT ya never know AND I have not heard of this technique. Very helpful post to many out there!!!
    Jody – Fit at 55 recently posted…Thinking Outside the Box – Exercise Fun! Legs, Arms, Shoulders, Back too!My Profile

    • Jody, I hope it helps somebody else. Almost daily I get people emailing me about intercostal muscle strain (apparently my original post has high Google page rank!) and I tell most of them about GT. About time that I wrote about it!

  2. I have had GT performed on my IT Band and tibialis anterior (lower leg), and had great success at speeding the recovery of those muscles (that were under constant contraction). Great post with lots of information about GT . . . a lot of people don’t know much about it. It’s weird at first–seeing someone come at you with a metal bar–but it definitely worked for me.
    Michelle @ Eat Move Balance recently posted…Sprouted vs. Whole Grain BreadMy Profile

    • Yes! That my exact response to. What the heck are those for? But in the end, the trauma was worth it!
      Hoping that this post introduces people to something new. Thanks for your comments.

  3. Okay, i’m officially a reader now. 🙂

    Graston is pretty much the greatest. I used it last fall when I fell and sprained my ankle. I have a NUCCA chiropractor that also does Graston and he has helped me since then with everything from plantar fasciitis to ITBS. LOVE. And glad you discovered it because it has been so amazing for me.

    I know it’s another anecdote, but I don’t think it’s placebo effect. My ankle lost mobility after my sprain, and I was able to regain more mobility after each session with graston. I’ve yet to see a bruise from the technique too, and trust me, there were times I felt like it would leave a bruise.

    Also, my thought on Graston — how is it any different than foam rolling to relieve IT band tightness? It’s more targeted. Foam rolling always worked well for me, but this kicks it up a notch!

    PS I was super skeptical at first too after reading up on it and not seeing much information about results. Good to see somebody else trying it out.
    Calee Himes recently posted…#WIAW: Dessert. Real dessert.My Profile

    • Excellent! Glad to have you Calee! I’m surprised that so few people know about GT. I had never heard about it before last summer. I agree, not much different than foam rolling or deep tissue massage. I’m hoping that they’ll be some good scientific research on it in the future!

  4. After my hip replacement, I complained regularly that there was pain in my adductor and that my one quad muscle seemed not to be working well. Last fall, someone suggested I find an ART and Graston practitioner.

    That first visit was more painful than anything I experienced after the THR. She worked on scar tissue near my knee and did Active Release along all the muscles of the adductor and quads. IT ALL HURT!

    The bruising ran from my knee to my thigh – and bruised again each time she worked the areas. But almost immediately I was moving more freely without the pain I’d been experiencing for 18 months.
    Deb recently posted…You Don’t Always Get What You Want…My Profile

  5. I had GT performed on my knee after my knee surgery last year to help break up some of the scar tissue. It made a HUGE difference and I think that it’s what helped set me on the road to recovery too. I was previously seeing another PT and wasn’t seeing a lot of improvement in my recovery. Then switched PTs and GT was one of the first things he did. I was sold immediately even though it hurt like crazy
    Christine @ Love, Life, Surf recently posted…I love skiingMy Profile

    • What did you think when you first saw the tools, Christine? Did they freak you out as they did me?

  6. sharing.
    SO well written.
    both posts.
    Miz recently posted…Sweet Relish 2 (AKA what Miz wants for Valentines Day).My Profile

  7. My husband got an intercostal strain– no fun!
    Blond duck recently posted…Love BitesMy Profile

  8. I have been certified in Graston for 6 years and I must tell you it does not need to hurt. My rule of thumb is that the patient may grimace but they should not need a piece of wood to bite down on during treatment. Since the tools magnify the doctor/therapist effort it is quite easy to “over-treat”. Glad you had a good experience and wanted to let others know that the treatment does not need to be excruciatingly painful to be effective.

    • Michael,

      Thanks so much for commenting and clarifying! I didn’t need to bite down on anything, but I did tense up and hold my breath a bit. I think it probably depends a bit on individual responses to pain or discomfort 🙂

  9. Oddly enough, I had never heard of Graston till reading your posts. The treatment sounds about as fun as Rolfing. But !!!! if it works, that’s what counts. A short treatment that hurts is better than a long, chronic amount of pain.
    AlexandraFunFit recently posted…Perky Pick Me Up SmoothieMy Profile

  10. Graston technique while it looks brutal and can hurt on really sensitive spots has done WONDERS for me. When I was in college I had it done on my shins, I currently have it done on my calf. My PT actually does not use the “patented silver instruments” She uses a hard plastic tool, I’ll take a video of it next time I’m in if she doesn’t mind.
    MegG recently posted…In My Twenties Tuesday: I got myself into debtMy Profile

  11. PS- I love your new header! I headed over here to check it out and I think it looks great!

  12. I swear I just strained this a few days ago and I wasn’t doing much more than walking and breathing! I’ve had Graston for various running injuries and it has worked miracles. Such a valuable tool!

    • Oh no Marcia! My strain was caused by a very careless backwards fall onto my bum. Nothing that should have caused the pain it did. What are you doing to heal it? Ice and ibuprofen are a great place to start!

  13. SOOOO painful! I understand the idea behind it, but a lot like deeeeep sports massage I decided it wasn’t the way for me to go 🙂
    Amanda @RunToTheFinish recently posted…1 mile at a timeMy Profile

  14. Interesting, I’ve had two skating friends recommend a sports medicine chiropractor in our area, and when I checked out his website I saw that he does Graston Technique. Now I encounter it here again. I’ve never had it done (or any chiropractic at all). I do have a very good massage therapist who does deep soft tissue work using St. John’s Method of Neuromuscular Release. It definitely hurts but is really effective.
    Mary @ Fit and Fed recently posted…Poppyseed Dressing (silken tofu-based)My Profile

    • Mary, you might give it a try next time you have an injury (although I’m hoping you don’t need to!).

  15. I am also a chiropractor who has been a GT provider for the past 2 years. I perform GT almost daily in my clinic and I see very good to excellent results on most patients I use GT on. It does not have to be painful to be effective and certainly bruising is not necessary to achieve good results. I honestly don’t believe the placebo effect is playing much of a role in the results. The treatment makes sense, using mechanical force to create tissue healing- there’s nothing new there, it’s been done for thousands of years. What makes GT unique is first of all the design of the stainless steel instruments and secondly the intensive training required to become a GT practitioner.

  16. I took a yoga class last Thursday which had a lot of core work out. I have been in pain since then.
    Sadly, I have all the things you mentioned my stomach is swollen as well. And I feel you I want to take my yoga class tomorrow night. Thank you again for share this with us. Hope you feel better.

    • Betty, I’m actually all better! It did take close to a year though and I still need to be cautious about overloading certain movements. As hard as it is to rest, you’ll be better off for it. Sorry that you’re going through this! Tamara


  1. […] He did some Active Release Therapy (ART; which hurts like the dickens), a couple of adjustments of my thoracic spine and then rubbed me (hard!) with a metal tool (which left a mark!). [Edited to add: I've since learned that this therapy is called the Graston Technique and spoiler, it has helped tremendously with the healing process. Check out the follow up post for details on the Graston Technique and it's use as a treatment for intercostal muscle strain] […]

  2. […] I no longer see my chiropractor regularly (a therapy called the Graston Technique seems to have helped), neither am I completely healed. I’m back to teaching and training, as before and am spending […]