An Advanced Method to Decrease Pain and Improve Function

We’ve recently added a new treatment called Graston Technique* to the health care services we provide.

This remarkable procedure allows us to detect and treat areas of “scar tissue” or adhesion in muscles, tendons and ligaments that can reduce our range of motion and cause pain.
In the healing process, our body attempts to repair those areas by creating “scar tissue,” much like the scar that forms on the skin when you have scraped or banged your knee.

Soft Tissue Dysfunction

Graston Technique © has been effective in the treatment of:

  • Carpal tunnel syndrome
  • Cervical pain
  • De Quervain’s syndrome
  • Epicondylosis
  • Fibromayalgia
  • IT band syndrome
  • Joint sprain
  • Lower back pain
  • Muscle strain
  • Painful scars
  • Plantar fasciitis
  • Tendinosis
  • Post-fracture pain
  • Women’s health (post-mastectomy and Caesarean scarring)



In time, we can have build up of this fibrous scar tissue, particularly in the muscles, tendons and ligaments that get a lot of use. This can lead to pain and dysfunction because this replacement tissue lacks the strength and flexibility of healthy tissue (in some areas it may even mat down and entrap a nerve).

GT Instruments

The Graston Technique © allows us to better detect and treat these areas because it uses a stainless steel instrument that glides along a patient’s muscle, tendons or ligaments, with the right amount of pressure to detect just where the scr tissue or restrictions are located.  When these knots or bands of scar tissue are encountered, both the clinician and the patient sense a restriction, almost like a speed bump or a granular feeling. The instrument can then be used to “break up” this restriction or adhesions. Stretching exercises are used to promote re-alignment of the fibers into the normal pattern or healthy tissue.



The benefit of the Graston Technique © is not only in detection of restrictions or adhesions, but also in the amount of improvement that takes place in a short amount of time.  Remember the song and words “…the knee bone is connected to the thigh bone…”? Well, so they area and so are all of the body parts connected in what is referred to as the kinetic chain. The instruments allow the clinician to follow that kinetic chain, effectively uncovering the cause of the problem, then treating the cause and the area of the pain or restriction.  The unaided hand is hard pressed to detect and break up as much scar tissue, or follow the kinetic chain, as effectively or efficiently as stainless steel instruments can.  Patients usually receive two treatments per week for four to five weeks. Most patients have a positive response within two to three treatments. Most patients are not disabled and continue to perform their regular functions at home or work.  GT decreases overall time of treatment, fosters faster rehabilitation/recovery, reduces need for anti-inflammatory medication and resolves chronic co nditions thought to be permanent.  If you have not experienced the Graston Technique©, yet you have lingering discomfort or stiffness, please ask us whether you may be helped by this effective treatment.

Care Instructions and Possible Side Effects  Dedication to a prescribed home exercise program is essential to the success of your treatment. Stretching and strengthening exercises are given to you in order to maintain the release of scar tissue, restrictions and adhesion.



Since the involved tissue binds with normal tissue, It develops a bloody supply. As restrictions are released from healthy tissue, bruising may occur, especially in treating chronic conditions. Some areas of the body that have a very rich blood supply may produce more bruising. Bruising can be controlled with ice.


An increase in soreness and discomfort is not uncommon after the first treatment session and is most often a positive sign that restrictions have been released. Soreness is usually minimized after 48 to 72 hours and can be controlled with ice and stretching.

Water Intake

It is recommended that you drink six to eight 8-oz glasses of water per day. Adequate hydration is important to promote proper healing.  Should you have any questions regarding you instructions, please contact you clinician.

For more information, go to Graston

Frozen shoulder syndrome, clinically known as adhesive capsulitis, is a painful and debilitating condition affecting up to 5% of the population Soft tissue mobilization and deep friction massage may benefit adhesive capsulitis patients. Deep friction massage using Graston Technique®  has become increasingly popular in physical therapy practice. IASTM reportedly provides strong afferent stimulation and reorganization of collagen, as well as in increase in microcirculation.

Figure 2:

Instrument-assisted Graston Technique® for treatment of the pectoral fascia.

The Graston Technique is a form of rehab therapy that’s already been embraced by more than 12,000 clinics and private practitioners worldwide.  By making use of a set of precisely-fashioned stainless steel tools, a trained Graston practitioner can pinpoint and target problems in a patient’s tendons and musculature.  This allows them to help with work and sports-related injuries that other, more traditional massage therapies cannot effectively treat.

Because of this, the Graston technique is one of the fastest-growing newer therapies.  It’s uniquely suited to treat a wide variety of common muscle-related problems, including carpal tunnel syndrome.

  • Graston and Scar Tissue

    The Graston Technique®

    originally developed by athletes, is changing the way clinicians — including physical and occupational therapists, hand therapists, chiropractors and athletic trainers — and patients view treatment of acute and chronic soft tissue injuries.

    How is scar tissue different from other tissue?

    When viewed under a microscope, normal tissue can take a couple of different fashions: dense, regular elongated fibers running in the same direction, such as tendons and ligaments; or dense, irregular and loose with fibers running in multiple directions. In either instance, when tissue is damaged it will heal in a haphazard pattern–or scarring–that results in a restricted range of motion and, very often, pain

  • East Bay Chiropractic and Wellness

    Dr. Martin Marmorale

    We care  for patients of all ages, with a variety of health conditions. Dr. Martin Marmorale is especially well known for his expertise in caring for patients with back pain, neck pain and headaches…particularly with his highly skilled  manipulations or chiropractic adjustments. He also care for patients with a wide range of injuries and disorders of the musculoskeletal system, involving the muscles, ligaments and joints.  These painful conditions often involve or impact the nervous system, which can cause referred pain and dysfunction distant to the region of injury.  The benefits of chiropractic care extend to general health issues, as well, since our body structure affects our overall function. We also counsel patients on diet, nutrition, exercise, healthy habits, and occupational and lifestyle modification.

    "Graston Technique® is an innovative, patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break down scar tissue and fascial restrictions The technique utilizes specially designed stainless steel instruments to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation."
    Moses Rivera
  • "Dr. Marmorale is an extraordinary practitioner. He is gifted and does not use a one size fits all approach with his patients. Dr. Marmorale is a good listener and is very patient and I found him to really hear my needs. He is very generous with his time. I have received much relief from both the Graston Technique and the other therapeutic techniques that he utilizes. If you are looking for a kind, skilled chiropractor, Dr. Marmorale is an excellent choice."
    Kathleen Dwyer-Blair