The latest in treating running injuries with Graston Technique®.
Injuries can plague runners for a long time and may reoccur frequently once they do get back to running. In my practice, compromised soft tissue is one of the main causes of chronic injury. Accurately identifying the problem and regaining normal biomechanical function of these tissues is key to getting a runner back on the road. Graston Technique® is a tool that can help.
Most running injuries are slow to develop due to the high-volume repetitive nature of the activity. Problems may easily date back weeks or even months before the runner experiences any symptoms. Initial changes include low-grade inflammation, muscular tension or contracture, fascial adhesion and tissue hypoxia—a lack of proper oxygen delivery to the cells. With every run, these underlying issues can impact mobility, tissue strength/activation, endurance, post-run tissue recovery and ultimately lead to injury.
Getting to the root cause of the problem is always the main priority in my diagnostic process. It is important to go beyond identifying what the injury is. We need to understand why the injury is occurring to help completely address the problem and minimize the risk of injury reoccurrence.
Functional testing—palpating all the primary, secondary and associated muscular and fascial structures related to the diagnosis—is a tool I often use to understand an injury. How these tissues feel tells an experienced practitioner a tremendous amount about the current state of the tissue and the tissues’ ability to perform what is expected during running.
An invaluable treatment option I use in practice is a therapy called the Graston Technique® (GT), which not only addresses these types of tissue changes but also helps to identify the underlying problem. In GT the practitioner uses a flat stainless steel instrument on soft tissue to assess its health. These instruments are used not only to manipulate the problematic tissue but also to help identify problem areas.
The quality of how these tissues feel changes as a person develops a problem. Newer injuries, as long as inflammation isn’t too drastic, often feel bumpy and knotted. In longstanding chronic injuries, the tissues feels dense and ropey, sometimes even like thick leather.
Manual palpation is an excellent method of identifying tissues changes. However, the rigidity of the steel in GT instruments can provide insight beyond manual palpation.
Typically, between three and five treatments are necessary to release tissue tension. Patients work on mobility exercises between treatments to help prevent the tissues from reverting back to tight knots. After treatment, you can expect some mild redness and temporary swelling. Occasionally you might see petechia—small red dots where the blood vessels under the skin have been temporarily irritated, but they typically disappear within 24 to 48 hours.
Unfortunately, very deep structures cannot be effectively treated with this technique, as the practitioner would have to compress through too many layers of healthy tissue to reach the problem area. With deeper injuries, your practitioner will likely seek an alternative therapy, such as acupuncture or dry needling.
For any longstanding, chronic, re-occurring injury, consider seeing a certified GT provider for assessment and treatment. You’ll be back on the trail in no time!
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Author: Dr. Richard Thomson is practice lead at Active Approach in Halifax and is a contributor to Optimyz magazine. His doctorate is in chiropractic medicine and he has a degree in kinesiology from the University of Western Ontario.