Graston Technique® as a Treatment for Patients with Chronic Plantar Heel Pain

Abstract

Use of Instrument-Assisted Soft Tissue Massage has increased in popularity, and the plantar fascia is a superficial tissue that may benefit from this treatment. The objective of this study was to determine the effectiveness of Graston Technique® (GT) for decreasing pain and increasing function in participants with chronic plantar heel pain over a six-week period. A single blind, pretest-posttest control/comparison group design, with a sample of 22 adults (5 males, 17 females) was utilized. Participants were assigned to three groups: GT/stretching, effleurage/stretching, and stretching only. After completion, effleurage/stretching and stretching only groups were later offered GT with posttest scores recorded. Participants were pretested/posttested using the Foot Health Status Questionnaire (Foot Pain, Foot Function, and General Foot Health), McGill Pain Questionnaire, and Visual Analog Scale. A posttest Kruskal-Wallis analysis between the three groups demonstrated a significant difference of the Visual Analog Scale between the GT/stretching and effleurage/stretching groups. From pre to posttest, Wilcoxon Test resulted in GT/stretching group significantly improving in 4 out of 5 variables, with effleurage/stretching significant in 1 out of 5, and stretching only demonstrating  significance in 3 out of 5. Friedman’s Test for effleurage and stretching only groups resulted in significant differences in all the variables when GT was later administered. The mean differences between pre and posttest for the groups demonstrated a minimal important difference of 4 out of 4 variables for GT/stretching, 2 out of 4 variables for effleurage/stretch, 2 out of 4 variables for the stretching only group. Participants improved in variables measured over a six week treatment of GT. This was both shown to be not only statistically significant, but clinically significant utilizing minimal important difference.